08070063 CITY OF CUPERTINO ,-*�*v
BUILD
UIL DING DIVISION PERMIT �RONTRACTOR INk',ORMA.TIO
BUI ING ADDRESS: PERMTT NU.
.1032.6 VIRGINIA SWAN PL TBD - TO BE DETERMINED 08070063
OWNER'S NAME: PERMIT LEVE DATE
WOLF ERIKA AND ERWIN 07/10/2008
NE: SANITARY NO. CONTROL NO.
ARCHTTEC(ENGINEER: BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
0 0 0 0
o o LICENSED CONTRACTOR'S DECLARATION
in� 1 hereby.M.that 1 am lusnmd under pmvisiou of Chap¢r 9(commencing Job Description
ii w)thSection7000)ofDivman3ofNCBusinessandpmrossionscode.ammylkenseis RPLC HTR UNIT be ADD A/C
^=m in full fora and erten.
jnz License Class Lie.is
Ect Dam.Contractor
pp ARCHITECT-S DECLARATION
W 1 uMeratand my plans shall he used as public records
gQln Licensed Professional
3 OWNER-BUILDER DECLARATION
I hereby all,.Net I am exempt from the Comrmmrs License Law far Ne
p o following reason.(Section 7173 1.5,Business and Proessiom Code:Any city Of county
which scquirex a permit to construct,abort improve,demoted,or repair any stuctusc
-z prior m issceinquires its issuance.also the applicant for men permit to file a signed statement
< that bculicensed purmanttoLim provisions ofthe,ComrxmriluemeLaw chop=9 Sq.Ft. Floor Area Valuation
xis (commencing wish Section700f1)ofDivision 3of the,Business and professor.Code)or $9500
_ Nat MIs exempt therefrom and Ne basis for the alleged moreption.Any violadon of
Session 7031.5 by any applicant for a permit subjects de applicant to a civil penalty of �,p�t Number Occas
mtowrechaofvabmtducddellme(s500). 31646008 .'CfV' Occupancy Type
❑I.as owner of Ne property,or my employees wish wegaudein ink campenation,
will do lewmk,and the swnme u stades LMed Law do
farakpply to an wrier of
w property
wh bas code:The Comraee t, rid who law ach Out apply lf rt owner car Required Inspections
Own emy who buildsorimphastasheraaarW whodoes smhwmk Mmalfos through his
awnemployu Wilding
thatfuch improvematsarenot imeMedaraRu .for ale If.
hawser,Ne an the u den ovwrm 4 hath within ane yens of i mnpktim,the owma-
builar will ban she Burda of proving Nu k did not Wild m improve for purpose of
s
as1Lk.L
t_41.as.of the property am exclusively cenuscting with Reused amrams;W
construct the pmjea(Sec.7014.Business and Profmaions Code:)The Comsmmra U. _
cease law dms not apply to an owner of property,who milds or improves chances,and
who con.for such projects with a conusmrts)licensed pocomm us does Conuuto's -
Lacs.Law.
❑lamexe pt�li car See Bk P C for Ws moan
ow vr, 1LC1L�— I� Dam T O
WORKERS COMPENS,010N DECLARATION
I hereby affirm under penally of pe eery me of the 1.1mm.g declaalkN:
Inas mWwBl forbyns CutiRae of Com abourC Code.
d Wooers Camp the
ton,r provided for by section nn 3700 of Ne labor Code.for she perfarma a o!the
wink for which this permit u issued.
❑I basic and will maintain workers Compensation Insurance,as scattered by Section
3M of NC Labor Coke.for Ne performance ofthe wink for which this permit is tamed.
My Workers Compensation Insurance carrier and Policy number are:
timer: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
- COMPENSATION INSURANCE
rfhlsseelm heed mthecmnplced tribe permute fm am hundred doBua($100)
Or Less)
I cenify that in Ne perform.a she wars for which this Permit u issued,l Nall ria
employ any person in any summer an y as be rob" Wartxm'Compensation
Laws of California.Date T`
Applicant >i�_ or`ja� �\
NOTICE TO APPLICANT:IL after making this Cenificatelf Exemption,you Houk
become subject m the Workers Compensation provisions of the Labor Coda you most
O forthwith amply with such p.We.m Nu Permit Nro
all be dmnaNi oked.
Z'`-' CONSTRUCTION LENDING AGENCY
[-,��+ I hereby affirm dta chert sea comvuctinn kndingagency far the performance or
lY, the were for which dtis permit Is issued(Sec.3091,Civ.C)
Le does Nater,
rs -
.7 Z LoMel Addm,.
U O 1 certify that t have tad this application and some Nat use soon information Ice .
IP.F cortect-T agme to comply with all city and county ordinama and state Taws relating m
0 Wilding consomtimn,and hereby autherine reprtsentstiva of Nu city in crow upon the
Wabove-mentiohed property for iupectios purposes.
G (We)agree to ave,indemnify and kap harmless tbo City of Cupertino against
to Ilabilitiex,judgments.costsudexpemm which mayinanyway accrue agaimtsaid City
U Z in caruequcrce of she granting of this permit.
^ APP UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO EGULVION3
Re-roofs �✓
Ignmure of AppliaDO Oato
HAZARDOUS MATERIALSDISCLOSURE Type of Roof
Will the a C.pert m future building oceupat M.mluddle Health
anmotorial
u defined by de Cupertino Municipal Code.Chapter 9.13,and the Healsh and Safety
Code,Suction 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Ya tfko
If a roof is installed without first obtainingan inspection,I agree to remove
.7 Ne applicant or ents a building by the Bt use e.Ail Qu or devices;which P g
t harardnus sur eonumiants as armed by the Bay Arta Air Quality Mamgemat all new materials for inspection.
40 0 Yes 11�11"
w rt7
1 hers read Na harudous materials requfrcm out umer Chaper6.95 oflc Califor.
maHalut At Safety Codc,sections 15505.25533 am25534.1unaetsnd illustrate building
does not cu Y IuvC crone chat It u sur mgemihiliry to mtifY Ne omvpant or de
require n� hrrsulb,:t 'rm mertaeafOatpame Signature of Applicant Date
Owner or amhadsd agent Dam All roof coverings to be Class'%¢"or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31646008 . 00
DATE ISSUED. . . . . . . : 07/10/2008
RECEIPT # . . . . . . . . . : BS000005391
REFERENCE ID # . . . : 08070063
SITE ADDRESS . . . . . : 10326 VIRGINIA SWAN PL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WOLF ERIKA AND ERWIN
ADDRESS . . . . . . . . . . : 10326 WOLFE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2025
RECEIVED FROM . . . . : ERIKA M WOLF
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . : .
CITY/STATE/ZIP . . . .
TELEPHONE . . . . . . . . :
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- ------ ---------- ---------- ---- ---- ----------
1BSEISMICR VALUATION 9, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
ITRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 54 0 . 00 286 . 54 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 286 . 54 #3377
---------------
TOTAL RECEIPT 286 . 54
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FURNACE/AC
•CUPERTINO PERMIT APPLICATION FORM
APN # / Ll / _ 0(Djy � Date: `iO _ 0
Building Address:
v l2l�Z� P. �G `
Owner's Name: a&IIA-, loot Phope 0 0s7
Contractor: Phone#7TNCV 6,yO
Fax #:
Contractor License#: C—ZQ Cupertino Business License#:
Contact: (!'J U CF Phone #:
Fax #:
Building Permit Info:
Elect Plumb Mech
Residential 2R Commercial
' Job Description: !- L/ICt
For Residential Installations:
Attic ❑ I" floor�m 2nd floor ❑
Adhere to minimum setback re uirement
For Commercial Installations:
Replacement same weight ❑ Additional weight(structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
es 00l -
3
Strapped ❑ On Platform [t] Bonded New Location Replacement
Project Size: Express Standard ❑ Large ❑ Major❑
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Revised 6/16/08
CITY OF CUPERTINO
« ' FURNACE/AC
CUPEI,TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
IMCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code. • ,
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
IMRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install & not incl in an nnni nprmit.
CITY OF•CUPERTINO
baa' FURNACE/AC
RT`
•CUPEINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst <=100k BTU install or M
relocate ea forced-air/gravity type
fumace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
I EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
1BUSLIC Business License B
N
CITY OF CUPERTINO
FURNACE/AC
CUPEkTiNO FEE SCHEDULE •
1
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= l Ok CFM B
IMCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5' or P
more per outlet. Comm/Resid
1BRENLkHMAN Residential A/C units <= l0k CFM B
f 1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B • ,
p IEPERMITFEE Electric Permit E
1 1MPERMITFEE Mechanical Permit M
IPPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
1BUSLIC Business License B
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below,
B. Site 9. Install H.E. Irrigation, (details/spec)` L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal.Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 6L 40 points
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is •
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
A.Site INPUT Resources Energy A011-lealth
1.Recycle Job Site Construction 8 Demolition Waste'
65%=1 point;75%= 2 points;80%=4 points -up to 4 Resource pts 0
2.Salvage Reusable Building Materials 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts Y--yes 0
4.Protect Native Soil 2 Resource pts y--yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y--yes 0
B.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1
OW
B.Foundation
1.Incorporate Recycled Ryash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10% •
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y--yes 0
4.Use Web Floor Trusses 2 Resource pts y--yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y--yes 0
1 1
INPUT Resources Energy IAQ[Health
I.Windows
1.Install Energy-Efficient Windows
• a.Double Paned 1 Energy pt y=yes D
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames 2 Energy pts y=yes D
2,Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints . 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts Y--yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pis y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stovesfinserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes D
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 31AQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating :Resource
pts y=yes 0
2.Install Solar Water Heating System pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=16 points) o 16 Energy pts 0
6.Select Safe and Durable Roofing Materials pt y=yes 07.Install Radiant Barrier pts y=
yes 0
I 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1
Community Development
10300 Torre Avenue
l Cupertino CA 95014
" * ' Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building De artment
JOB ADDRESS:/Q 3z--PG Y/ II °W� -14 S(v/ / ?L PERMIT # D7(>� ��
OWNER'S NAME: 40/-V PHONE #Z s 7-744 5!-
GENERAL CONTRACTOR: qK� ,f{�-ev C-P FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the followinginformation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contract r Signature Date