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15050120CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:i 15050120 1065 COLONY HILLS IN CUPERTINO CA 95014 (359 30 008) ALPS CONSTRUCTION 1011 DE ANZA BLVD SAN JOSE, CA 95129 ` OWNER'S NAME: GUPTA VINAYAK AND MONIKA DTE ISSUED: 08/25/2015 OWNER'S PHONE: (408) 828-8278 PHONE NO: None LICENSED CONTRACTOR'S DECLARATION N BUILDING PERMIT IN FO: License Class B Lic. #909433 Contractor ALI'S CONSTRUCTION 'Date 07/31/2016 —BLDG _ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing. _ IVIECH _ RESIDENT — COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: ADD 1,277 S.F. TO CRE TE (N) BEDS/BATHS. REMODEL & I hereby affirm under penalty of perjury one of the following two declarations: RECONFIGURE ENT (E) SFD (1,760 S.F), RELOCATE & 1. i haveand will maintain a certificate of consent to self-insure for Worker's UPGRADE PANEL (200 S), REPLACE. (E) WINDOWS/DOORS (10) Compensation, as provided for by Section 3700 of the Labor Code, for the & RAISE (E) CEILING RE-ROOF (E) 20 SQ'S). erformance of the work for which this permit is issued. z: I have and will maintain Worker's Compensation Insurance, as provided for by DEFERRED #1 - TRUSS CALC'S - ISSUED 4/1/2016 Section 3700 of the Labor Code, for the performance of the work for which this REV #1 -REMOVE STONE VENEER -ISSUED 1/12/2017 permit is issued. APPLICANT CERTIFICATION certify that I have read this application and state that the above Sq. Ft Floor Area: Valuation: $230000.00 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for APN Number: O cupancy Type: inspection purposes. (We) agree to save indemnify and keep Harmless the City of Cupertino against liabilities, judgments, costs, and expenses which 359 30 008 may accrue against said City in consequence of the grant' of this permit. Additionally, the applicant understands and will com ith all non-point source regulations per the Cupertino Munici al e, Se 'on 9;18. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 D YS OF PERMIT ISSUANCE OR ,Signature Date 1/1212017 180 DAYS FRONI LAST CALLED INSPECTION. OWNER-BUILDER DECLARATION Issued by: ABBY AYE E I hereby affirm that I am exempt from the Contractor's License Law for one of the Date: 08/25/2015 following two reasons: 1. 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for RE-ROOFS: sale (Sec.7044, Business & Professions Code) All roofs shall be inspected prior to any roofing material being installed. If a roof is 2. I, as owner of the property, am exclusively contracting with licensed installed without first obtaiiiii ig an inspection, I agree to remove all new materials for contractors to construct the project (Sec.7044, Business &Professions Code). inspection. I hereby affirm under penalty At perjury one of the following three declarations: Signature of Applicant: 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Date: 1/12/2017 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF CO RINGS TO, BE CLASS "A" OR BETTER 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 3. I certify that in the performance of the work for which this permit is issued, I I have read the hazardous materials requirements under Chapter 6.95 of the shall not employ any person in any manner so as to become subject to the California Health & Safety Code, Sections 25505, 25533, and 25534. I will Worker's Compensation laws of California. If, after making this certificate of maintain compliance with Health & Safety Code, the Cupertino Municipal Code, Chapter 9.12 and the Section 25532(x) should I store or handle hazardous exemption, I become subject to the Worker's Compensation provisions of the material. Additionally, sho Id I use equipment or devices which emit hazardous Labor Code, I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I be deemed revoked. will maintain compliance with the Cupertino Municipal Code, Chapter 9 nd the Health & Safe Code, Sections 25505, 25533, and 25 APPLICANT CERTIFICATION certify that I have read this application and state that the above information is Owner or authorized agent: . correct. I agree to comply With all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city Date: 1/12/2017 to enter upon the above mentioned property for inspection purposes. (We) agree CONST IIUCTION LENDING AGENCY to save indemnify and keep harmless the City of Cupertino against liabilities, I hereby affirm that there is a construction lending agency for the performance judgments, costs, and expenses which may accrue against said City in of work's for which this pen nit is issued (Sec. 3097, Civ C.) consequence of the granting of this permit. Additionally, the applicant understands Lender's Name and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. Lender's Address ARCHITE TISDECLARATION Signature Date 1/12/2017 1 understand my plans shal be used as public records. 1 CONSTRUCTION PERMIT APPLICATION a COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUlPER 4 N4 (408) 777-3228 FAX (408) 777-3333 building(a)-cupertino.org J j ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Ti F&REvisioN / DEFERREE ORIGINAL PERMIT # PROJECT ADDRESS /J1 APN # (/d1La• OWNER NAME �, /,a g9 f/yi��/j j %%y (, PHONE MAIL STREET ADDRESS �! - - CITY, STATE, ZIP FFAX CONTACT NAME PHONEy 3 2� -MAIL STREET ADDRESS/ 7//�®/J"A � V // 70 CITY, STATE, ZIP P Qi � FAX ❑ OWNER ❑ OWNER-B`UHCDFR,,`❑ OWNER AGENT ❑ CONTRACTOR #94QNTRACTORAAGEENTT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME,6 ! LICENSENUMBER LICENSE T E BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESSCITY, STATE, ZIP �, / it PHONE ARCHITECT/EN GINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Ad" EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM - KITCHEN OTHER_ REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: IS.A SECOND UNIT El YES SECOND STORY ❑YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIV D BY: TOTAL VALUATION: PLANNING ADPL # M NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act Im the p perty owner's behalf. I have read this application and the information I have provided is correct. I have read the Desgpp ' of Work and verify it is accurate I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize re atives of Cupertino to enter the above- entified property for inspection purposes. Signature of Applicant/Agent: Date:11 _— SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYP ROUTING SLIP ❑ OVER-THE-COUNTEB ❑ BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. -❑ EXPRESS PLANNING PLAN REVIEW CA4,t--c1,7 - U _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD [IPUBLIC WZ)RKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 I! TY OF CUPERTINO BUILDINGPERMIT IIL iT i?It�l iii8 5, t C z TTIIiA t l�: I'T Mtil ' X0. 15t 50120 1065 COLONY IIIX I S LN CIJPFR.i` N0 CA 95014 (359 30 008), 1 ALI'S C ONSTRUC;T 10- 1011I3rANA%N SAXI IC1SL, CA 95129 OWlaRIS NAME: Cit,TP'SSS.WNTA'i'IISC:AidD11ONIKA DATE ISSUED:OV2512015 R8WNIfR'S 1`ki€tI"NIM 408-857"6968 Is%Irl > is#Oi40-89U,477 T 4 1 iI c T x 7 r z L €L BUILD)ING PFRMT INFO. License Class LONTRAC TOR -,GENES& ulo. #tel Contractor ANSTR ,1C "ION Gate 4� 1-t Oi AM (��t°? _ �,i� _ LLEC-r — PLUMB herreby affirm that I ain licensed under the provisions orf Chapter 9 (commencing MW -1 — CJIti. _ It�Sii3 i� I IA% , +C tib � Eit T i s with Section 7040) of Division 3 nd the Business 8& Ilrofrsslitns Code and that Azov Recast Is In Roll force and effects JOB ,DESCRII.'`TI(I'' ADD 1,277 &E TO CREATE (N) BEDS/D; TIRKRMIODEt, I It"oby zaftig& under penalty of perjury one of the following two declarations. : FCONFIGiIRE 17NTIRE (F) SFD (1,760 s.1t), RELOCATE i. I have and will maintain a certiffratt of aitiicnt to soli insure £lir Al rkcr's UPGRADE PANEL (20tiANIPS), REPLAC P (F) NMIDCIWS,t'i300RS (I Q) Componsation, tas provided for by Sootion 3700 of the Labor Code, for the & RAISE: (i) C LILMIG & M-RC3-CF (E) 20 SQA S), perfortnnna oftlte wort; for whiyah this permit is €sstied. I €save anti will FnaintainWtrrker's Compewation Tmoranee, as provided for by I3ygt ptit l" i -T Section 3700 of the Labor Cade, for €lin performan of Che work for which €it is I a {tenni€ is issued, I mortify that I have read this appl°cation and state that the above Sq. Ft pinatr e�reaz Vaisaat%rti �23t1�9'�.t�� Information is =rest, l agree to comply %.4th all city and county ordinances and state locus rotating to building construction, and hereby authorize representdiives of'this rite to enter upon ilia: above mentioned for � a _ - � AIIN Number— 0ccuprancy ljlae: property inqpection purposes. rt a rear to save indemnify and keep harmless the 359 3fl Qtl3 City of Cupertino against liabilities, judgments, posts, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally the applicant understands and will comply with all non -point PE RMIT EXPIRES fits WORK ISNOT STARTED sautra regulations r e Cupertino Municipal Ctar€a: Section 9.98. WITHIN 1.80DAY'S OF YFR* 'tlT ISSUANCE OJT: _ 180 DAYS ' FROM LAST CALLED INSPECTI . ' Signature fir, _ oto 481 0 73 T tI I iI Issueif 1ty: Ari ) a Date< 411 J hereby Affirm that I aro a mot bout the Contractcar's Licein& Law for one of the following fto reasons: Y. 1, as owner lbs properly, or tray employees with wages as, tlicir sole contperaaaziaat, will do lite work, and the strn£tate is not intcridud or oir'aicd for All Mea sllall be.inspeeted prior to any rooting material being installed. If a roof is solo ( eC.?iId 1, Jiro&M ess & Prof 47oT E Code) instilled wi6out first obtaitnng all inspection, I agree to Y'{3i eve till new rdaterials fix, a. 1, as wwrier of the property; arca exclusively contracting with fieettse.d itaspeetian conerictoa: toeansta oat rile project (Sec -704-4, Business elk i roicssltnts Codc), Sigpatum rafApplicautt I ka£rel5y atiirrtr neFtier penalty of perjury ease of the following three declarations; Date -4 !NaM 1. J havo and will #t ahit tln'a Cortificale-or Consent to see Nest i'r for' orker's Compensation, as providod forby Secticiat :37(l() of 0 i Labor mole, for the Al, .f ;t0OF C'0V ,l INGs Tia BE S9 .aA„ CiR '811 l` 1711 -perfbipinme of lite work, for wbioh tufa pertnitis Issued, 21 1 haws and will waintain Woxiter n Compeveation Insmanco, as prodded. for by Section 3700 of tbo Tabor Code for the pei forroanao tri iltc work for whiell this MZA-,.RDOli t'a ATERfA) aP1SDC Sti6Z�" permit is. iarkied. S. bav read -tete hazardinis niaterlaf8 requirements under C haptti- 67 95 of the s= 1 ctifify that in the performance of lite ia oro for which Oda peraiit is issued, I California Health rS Safety Calle, Rections 2559S, 2553:1, and 25534. 1 will sisal€tut eanlrloy say person in anytnrxtaiar sa as arc 1 ct a tFtC site just to iEze = w alntaain canipliance with the Coperttrao itfunlelpatl Code, Chapter 912 and fire Health & Safety Code, vection 25532(a) should i store or handle hazardous 'otic i s C'arnpensatialax laws a# t"alifa €iota, it; ata r zzta kisay Its ccrii eFt of waterltcl. Additionally, should ties equipment or toeless whichemft laax' n tions exemption, I become subject to the Worker's Comprinatioat previsions of lite air tont4ininants as defined by the Buy Area Air Quality fliaata etnent District i Labor C ode, I must forthwith comply with succi provWons or tats peraaut shall s still. maintain eornpiiance with-,tht» Cupertino Munielpid Cade, Chapter 9,12 and be dcetued revoked. the Health &Safety Cube, Seett _ 55s5� 25533, and. 25534, LIVANT N I certify that I have read this application and states that the above' Information s Owner or authorized agent: {correct, I agree to comply with all city and county ordinances and state laws elate: 4J L2 j0_1_5 relating to building construction, and hereby authorize representatives of this city j to anter upon the above mentioned property for Inspection purposes. Nile) Ogre l hereby affirm that alert Is a t=structlor0end',ig agency for the pofformance ! to save indemnity math keep harmless the City of Cupertino against tl�biflfes' i of volare€ a for which this permit is issued (Sec: CISi, Clu G.) Judgments, casts, and experissawhich may aecnje against said City in I Lender's Raine consequence of the granting of this permit AdditionmNy, the applicant understands I � and will comply with all nen-point source regulations per the Cupertino Municipal Londer'a, Adeirps; Cde, Section 9.18.sRC %Il :y i A TM i I understand myplans shall be used as public records. 5lna.urs W _ _. Mateo` -121 L -.__..-..,N.._,..... - - -w..,- i CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255. (408) 777-3228 FAX (408) 777-3333 • buildinaBcuperdno.or LION ❑ ADDITION ❑ ALTERATION / TI REVISI N / DEFERRE ORIGINAL PERMIT # PROJECT ADDRESS �0 00e)) / P �� APN# OWNER NAME � PHONE �i� � f) A � EMAIL E/� STREET ADDRESS /�g� y )I gr}C CITY, STATE, ZIP,m l .� „ FAX CONTACT NAME /� {I .' 01 PHONE L10 it<0 ,9 9 g7 -L E-MAIL STREET ADDRESS 10/ �)k)q-n 2 R 6 , v CITY, STATE, ZIP � 3(�1 FAX ❑ OWNER ❑ OR'NER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 13 TENANT CONTRACTOR NAME �] /J _' LICENSE NUMBER qo q q 3 3 LICENSE TYPE l �/ 1 ! BUS. LIC # COMPANYNAME f� l%�, J %7 dA5:1�r ® �n ELJ Is 5 �C ➢ 5tia (r I' a'iC `G .r�r 6 c}I FAX STREET ADDRESS 0 j UV CITY, STATE, ZIP C q r5 i �g !f -F `1 f 'i PHONEy � C� `�, n ® q O 1` j (! ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE y a DESCRIPTION OF WORK UVA 711C EXISTING USE PROPOSED USE CONSTR TYPE - STORIES - - -- USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL - AREA AREA AREA. NET AREA BATHROOM - KITCHEN - OTHER - - REMODELAREA REMODELAREA REMODELAREA - PORCH AREA DECK AREA TOT AL DECK/P.ORCH AREA GARAGE AREA: DETACH- ❑ ATTACH # DWELLINGUNITS IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? ❑NO - - PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING ADPL # ❑ NO PLANNING APPROVAL LETTER IS THEBLDG AN ❑ YES' EICHLER HOME? NO C TOTAL DATION; - -" - By my signature below, I certify to each of the following: I am the property owner or authori ed agent to act on the property owner's behalf. I ave read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating tob ' g nstruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Y Signature of Applicant/Agent: Date: U° 3 a d 1b SUPPLEMENTAL. INFORMATION REQUIRED{ PL. cliECK i rE r r„� ovTi +c sLlr _ New SFD or Multifamily dwellings: Apply for demolition permit for z s Oti ER TILE COU\TER A� BUILDI\G PLA RE] iER' f existing building(s). Demolition permit is required prior to issuance of building � � permit for new building. E\TuESs .- `I—',,`T kN-NN l AIa IZEVIE]V _' ❑ pvsiic�©RILS �l Commercial Bldgs: Provide a completed Hazardous Materials DisclDsurepp sTA ARD form if any Hazardous Materials are being used as part of this project. A I ” Co of Planning Approval Letter or Meetin6 with Planning prior to 1'y LARGE r FIRE DEPTH e �z I] _ submittal of Building Permit application. Ma190R SA \ITAA] SERER DISTRICT M ,u fl E �� IRO\i�4ENTAl HEALTH BldgApp_2011.doe revised 06/21/11 Y; CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1065 COLONY HILLS LN CONTRACTOR: ALI'S CONSTRUCTION & PERMIT NO: 15050120 REMODELING OWNER'S NAME: VINAYAK GUPTA 1011 S DE ANZA BLVD DATE ISSUED: 08/25/2015 OWNER'S PHONE: 4088576828 SAN JOSE, CA 95129 PHONE NO: (408) 898-6474 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL ADD 1,277 S.F. TO CREATE (N) BEDS/BATHS. REMODEL & License Class_ Lic. # 3 3 RECONFIGURE ENTIRE (E) SFD (1,760 S.F), RELOCATE & Contractor �r Date UPGRADE PANEL (200AMPS), REPLACE (E) a� t�4� �_ WINDOWS/DOORS I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $230000 performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as provided for by -Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 35930008.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES 3 IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter IT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to say 180 D A� CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the �— granting of this permit. Additionally, the applicant understands and will co ssued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWN6-B41,DEM DECLARATION I hereby affirm th 't exempt from the Contractor's License Law for one of Signature of Applicant; Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 5 , 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this p (J Z permit is issued. Owner or authorized agent: Date: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTI ENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date V CONSTRUCTION PERMIT APPLICATION d COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION x0 B - 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERT[NO (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org / ❑ NEW CONSTRUCTION F� ADDMON F� ALTFRATTOW /TT F1 RPVTST(-)M /T)PFPRRPTI C)PT(3TTTAT PPPTvTTT+-I PROJECT ADDRESS Q Co / a1� l 5. > APN 93 5 —3(o 3d ^QO2 OWNER NAME ' A ^ (C� n 614PHO V Jv1 W V o, �y -6 vJ E-MAIL STREET ADDRESS Ao CITY, STATE, ZIP FAX CONTACT NAME G! 70`x,' Alt PHONE G C(W! 6 �-/ . { E-MAIL / STREET ADDRESS �` t � � CITY, STATE, ZIP �! �� I F D 7 �U ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME:AL, `� , ,n 1� �� LICENSE NUMBER ®�' ` LICENSE TYPE BUS. LIC # COMPANY NAME )� ri c J ! 1 / L:kl� � E MAIL f s coyi: WZIP T ® v\c iotiQ STREET ADDRBS /p . �Y p CITY, STATE, P .� ( I�9 e 1 �� JJ f PHO ne 6 f� � (C ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC,' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE Vial Ir-/6l)j DESCRIPTION OF WOi — / A)�rf'V 11ny � (�l J jG7GJ�?1d�' / jY�g31 ��s��✓� P!�/Y . EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA ` DEMO AREA TOTAL NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA CKfy, TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH t7" []ATTACH I # D WELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? []NO PRE -APPLICATION ❑ TBS IF YES, PROVIDE COPY OF PLANNING APPL # [:]NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO C � �t�,F�. ;� "' 'r; TOTAL VALU TION: �l co 3 i By my signature below, I certify to each of the following: I am the property owner or authorized agent to e property owner's behalf. I have read this application and the information I have proyde is correct. I have read the Description of Work and ve-ri-ly it is accurate. I agree to comply with all applicable local ordinances and state laws relating tn onstruction. I authorize representatives of Cupertino to enter the above-identifie property f f inspection purposes. Signature of Applicant/Agent: Date: ON RE UIR FD Q SUPPLEMENTAL INrlseq NA. _ SPAN CTiECK T1�E �: , : A 7 3iOT3T�NG.SLIP-r b f.. Vin;. New SFD or Multifamily d��Pellinfor demolition permit for []az OVER �i�TIII�DINGPIAN4REVIEW existing building(s)..Demolition pe ed rior to issuance of buildin P P g THF�COUhTER� r g permit for new building. DExPxEss „rn� �{]inuVc��Axizvw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 'A`7 ; CIX�A1vnaRD r gj'&gg,M ErII=PFSIYcwox�cs�� _ form if any Hazardous Materials are being used as part of this project. #z as,❑.���' Copy of Planning Approval Letter or Meeting with Planning to ���LeLRC,E`�� ��f� �t�h`��-s� � REPT � a �3,t���� a� �• t `n _ prior submittal of Building Permit application. 1]�IVIfiSOR ry^STPARYSEVYERISTRIC� E Ova �Y1 4 �� ��� '�..•'i;�'� w�;��3'.,r., �� � re. �.�Ny.IR��iNi2;NTt1Z.HE.�7�THr� _ s..�: BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 1065 COLONY HILLS DATE: 05/1912015 REVIEWED BY: MELISSA 21 APN: 359 30 008 BP#: Zd *VALUATION: $230,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition 2nd Unit? Yes ' No PENTAMATION 1 R3SFDADD PRIMARY SFD or Duplex OTC? 0 Yes ' USE: PRIMARY PERMIT TYPE: E ENTIRE (E) SFD WORK ADD 1 277 S.F. RE &TUPGRADE PANEL (200AMPS)E (N) EDS/BATHS. REMOELREPLACE (E) WIRNDOWS/DOORS (10) &1 SCOPE (1,760 S.F), RELOCATES), OCCUPANCY TYPE: R-3 (Custom) TYPE OF Co 11 -B,111 -B, IV,V-B FLR AREA I PC FEES I PC FEE ID I BP FEES I BP FEE ID 1,277 1 $2,715.891 IR3PLNCK TOTALS: 1 1,277 IVIEGH; HOURLY Yes 0 No;; PLUMB; HOURLY :llech. Plart ("heck ptuwb. Plan ("heck ;11ecPz. Permit Fel: Plumb. Pe+mitT'ea: $2,715.89 $1,887.73 IR3INSP $1,887.73 Elec. Plan Check0.0 hrs $0.00 Elec. Permit Fee: ]EPERMIT Other Elec. Insp. 0.0 hrs $48.00 Orher• Hech. Insp. Other Plunib IrNP. u lrzsp. 1 • Ee: Pb, lusp. lee: bh'ri. lnl. lie: l (Le. Planning, Public Works, Fire, Sanitary Sewer District, School 'l NOTE: This estimate does not include fees due to other Departments in inform available and are onl an estimate. Contact the Dent or addno. District, etc.). These fees are based on the preliminary QTY/FEE MISC ITEMS FEE ITEMS (Tee Resolution 11-053 Eff. 711/13) FEE $2,715.89 1,760 s.£ Remodel, Other Plan Check Fee: Supp1.PCFee: Q Reg. 0 OT 0.0 hrs $0.00 $5,172.00 IREMRES2 $0.00 10 # Window / Sliding Glass Door PME Plan Check: $1,887.73 $574.00 IWINREP Replacement Permit Fee: Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 200 amps Electrical $0.00 $48.00 1BELECzoo Services PME Unit Fee: $48.00 2,000 s.f. Re -roof PME Permit Fee: $340.00 1 REROOFRES (..'0113t1`Ltction Tax: Administrative 1,-ee: Work Without Permit? 0 Yes (j) No. $0.00 Select allon-Residential Advanced Planning Fee: IPLLONGR $178.78 Building or Structure Travel Documentation Fee: 1 TR,4VDOC $48.00 $29.90 Select an Administrative Item Strom Motion Fee: 1BSEISMICR Fee IBCBSC $10.00 X Bld Stds Commission SUBTOTALS $4,918.30 $6,134.00 TOTALFEE ;, $11,052.30 Revised: 05/07/2015 [ S - K-2 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a.cupertino.org B ISOSDI 2ej n w nnl:cTRTi(-TTnN ❑ ADDTTTON ❑ ALTERATION/T1 ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECTADDRESS y q I I1`�/ p, APN n .7 �7 colot\ OWNER NAME `l ` -A at I PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP /' A I FAX CONTACT NAME Pw E-MAIL STREET ADDRES 0 L, 6 lC IAZA❑ CITY, STATE, ZIP ��' FAX O',NER ❑ OWNER -BUILDER ❑ OWNER AGENT PICONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGLNEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NL LICENSE TYPE.B BUS. LIC COMPANY NAME \ / ^ (�J E V C f� ,l W n 5 LT '1 n vl FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTlENGLNEER NAME LICENSE NUMBER BUS. LIC n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ^ DESCRIPTION OF WORT ✓( � �- �/ Y o � s EXISTING USE PRO SED USE CONSTR. TYPE = STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK?ORCH AREA GARAGE AREA: LIDETACH ❑ ATTACH 4 DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑ 1'Es BEING ADDED? ❑NO ADDITION? NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF 1S THE BLDG AN ❑ YES RECEIVED BY: -.. OT.AL VALUATION: PLANNING APPL m ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO�)j By my signature below, I certify to each of the following: I am the property owner or authorized agent It act o the property owner's behalf. I have read this application and the information I have provide is rrect. I have read the Description ofWork and verify itis accurate. I zgree to comply with all applicable local ordinances and state laws relating to bu n- c Ivctioa. I authorize representati -es of Cupertino to enter the above-identi ed prop for inspection purposes. 4. SignatureofApplicant/Agent: Date: I UIRED SUPPLEMENIIT L ENF 4rdprior PLAN CHECKT1-PE ROUTING SLIP ❑ ER-TxE-coLNTEu ❑ New SFD or Multifamily dwellings: Aplition permit for existing buildine(s). Demolition permit is reo issuance of building o\ sL'ILDINc PL AN REVIEW permit for new building. ❑ EXTRESS ❑ PL�NNLNc PLAN RE�I> Tv� Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ ST.ANDkRD ❑ PUBLIC« ORKS _ form if any Hazardous Materials are being used as part of this project. ❑ ❑ L.ARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ ',LAJOR ❑ submittal of Building Permit application. 5.A-\ITARY SEti'ER DISTRICT ❑ ENVIR0\.MMNTAL HEALTH Bldo 4pp_?01 Ldoc revised 06121111 CITY OF CUPERTINO 00MRRED # W -W FEE ESTIMATOR - BUILDING DIVajQ 0% 1, r ADDRESS: 1065 COLONY HILLS DATE: 03/04/2016 MISC ITEMS APN: 359 30 008 BP#: "VALUATION: Tsit 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: $0.00 PENTAMATION 1GENRES PERMIT TYPE: WORK DEFERRED#1 - TRUSS CALCS SCOPE Suppl. Insp. Fee.e Reg. Q OT O � r NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the prelimina information available and are only an estimates Contact the De t or addn'/ in o. FEE ITEMS (Fee Resolution 11-053 Iff. 7'1,%73) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # Deferred Submittal $286.00 IDEFSUBM Suppl. PC Fee: Q Reg. OT 0.0 1 hrs $0.00 PME Plan Check: Permit Fee: $0.00 $0.00 Suppl. Insp. Fee.e Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced PlanninL, Fee: $0.00 Select allon-Residential E) Building or Structure Strona Motion Fee: $0.00 Select an Administrativ 1 Bldg Stds Commission Fee: $0.001 SUBTOTALS: $0.00 $286.00 TOTAL FE(. $286.00 Revi� 01 /01/2016 CUPERTINO 0ff'c2 : yDk #zj( o %7- , 4gll'✓ , L/D �/ e09 6 SSo (141 f5* / > ,/lain l� & : -qo V 6 9� CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 65 fo 0 tj11,5 t4 PERMIT # %5050 O OWNER'S NAME: '2AQ . /A9,74a PHONE # GENERAL CONTRACTOR: Af/s BUSINESS LICENSE # �6 ADDRESS:/O�j S DeagZ&- BlVd _',t* SSC- CITY/ZIPCODE: s/,?— *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Demo „sem '-(0 7[ Fencing Flooring / Carpeting 6d m V,6 rJ0 Linoleum / Wood Glass / Glazing Heating Insulation - Landscaping 1/S �/JflSfr�l�n L O �i� Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile / Contractor Signature Date CUPERTINO CONT Building Department _ L/ 3 Q q - /Alla/-v (A' l S (t) OS �n c c 1_'061y Of Cupertino �� _ 10300 Torre Avenue _ 0'7 % - d CQ Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 RACTOR / SUBCONTRACTOR LIST JOB ADDRESS: SUBCONTRACTOR I i I PERMIT # OWNER'S NAMk: hj VA C-tu - PHONE # GENERAL CONTRACTO : 4 S con IA- ch o Vl BUSINESS LICENSE # ADDRESS: ( j DC AI y CITY/ZIPCODE: *Our municipal code requi1 businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontrs: Signature Date Please check applicable sl ntractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwor Cement Finishing Electrical Exrauation Fencing Flooring / Carpetind 04 o -f 10 CC , CO r_ Linoleum / Wood Glass / Glazing Heating Insulation Landscaping vjqjcr)7✓ ��� SCap, a •ng�`� Masonry Painting / *allpaper Paving Plastering Plumbing ' Roofing Septic Tank Sheet Metal ' , Sheet Rock 1 v1 rn cj t, ^'I1 / Conteactor Signature Date CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysij j R n n IT ? '' Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CF1 R -PRF -01 Page 1 of 9 GENERAL INFORMATION -} W i 01 01 Project Name Gupta Residence 02 This building incorporates features that require field testing and/or verifi4ti by a certified HERS rater under the supervision of a CEC-approved HERS provider. - N 02 Calculation Description Title 24 Analysis 03 Project Location 1065 Colony Hills Ln. 04 05 04✓ City Cupertino 05 Standards Version Compliance 2015 06 71 Zip Code 94087 7 W ;J Compliance Manager Version BEMCmpMgr 2013-3bl (694) 08 Climate Zone CZ4 9 Q Software Version EnergyPro 6.4 10 Building Type Single Family X11 a ront Orientation (deg/Cardinal) 45 12 Project .90e Addition and/or Alteration G 3 ---- Number of Dwelling Units 1 14 Total Cond. Floor ea (FT2) 3037 �5 U Number of Zones 2 16 lab Area (FT2) 0 7 Number of Stories 1 18 Addition Cond. Floor Area 1273 19 J �, Natural Gas Available Yes 20 Addition Slab Area (FT2) 0 21 Q p Glazing Percentage (°/) 15.9% COMPLIANCE RESULTS -} W i 01 Building Complies with Computer Performance tll 02 This building incorporates features that require field testing and/or verifi4ti by a certified HERS rater under the supervision of a CEC-approved HERS provider. - N 03 This building incorporates one or more Special Features shown below ENERGY USE SUMMARY 04 05 06 07 08 Energy Use Standard (kTDV/ft2-yr) Design Proposed Design Compliance Margin Percent Improvement Space Heating 16.93 15.68 1.25 7.4% Space Cooling 10.15 12.10 -1.95 -19.2% IAQ Ventilation 0.88 0.88 0.00 0.0% Water Heating 9.99 9.14 0.85 8.5% Photovoltaic Offset ---- 0.00 0.00 ---- Compliance Energy Total .9 37.80 0.15 0.4% %i r r v l. Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Proj6ct Name: Gupta Residence Calculation Description: Title 24 Analysis REQUIRED SPECIAL FEATURES CF1 R -PRF -01 Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Page 2 of 9 Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml The following are features that must be installed as condition for meeting the modeled energy performance for this computer analysis. • Ducts with high level of insulation • Cathedral Ceiling • Ceiling has high level of insulation • Window overhangs and/or fins HERS FEATURE SUMMARY The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting the modeled energy performance for this computer analysis. Additional detail is provided in the building components tables below. Building -level Verifications: • IAQ mechanical ventilation Cooling System Verifications: • Minimum Airflow • Verified EER • Verified SEER • Refrigerant Charge • Fan Efficacy Watts/CFM HVAC Distribution System Verifications: • Duct Sealing Domestic Hot Water System Verifications: • -- None -- ENERGY DESIGN RATING This is the sum of the annual TDV energy consumption for energy use components included in the performance compliance approach for the Standard Design Building (Energy Budget) and the annual TDV energy consumption for lighting and components not regulated by Title 24, Part 6 (such as domestic appliances and consumer electronics) and accounting for the annual TDV energy offset by an on-site renewable energy system. Reference Energy Use Energy Design Rating Margin Percent Improvement Total Energy (kTDV/f2-yr)* 81.13 80.98 0.15 0.2% * includes calculated Appliances and Miscellaneous Energy Use (AMEU) BUILDING - FEATURES INFORMATION 01 02 03 04 05 06 07 Project Name Conditioned Floor Area (ft2) Number of Dwelling Units Number of Bedrooms Number of Zones Number of Ventilation Cooling Systems Number of Water Heating Systems Gupta Residence 3037 1 5 2 0 1 Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CFI R -PRF -01 Page 3 of 9 ZONE INFORMATION 01 02 03 04 05 06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ft2) Avg. Ceiling Height Water Heating System 1 Water Heating System 2 Existing Area Conditioned Res HVAC1 1764 9 DHW Sys 1 Addition Area Conditioned Res HVAC1 1273 9 DHW Sys 1 Verified OPAQUE SURFACES 01 02 03 04 05 06 07 08 09 10 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window and Door Area (ft2) Tilt (deg) Status Verified Existing Condition Left Walls Existing Area R-13 Wall 135 Left 269 52.9925 90 Altered N/A Rear Walls Existing Area R-13 Wall 225 Back 341 92.9934 90 Altered N/A Right Walls Existing Area R-13 Wall 315 Right 225 20 90 Altered N/A Roof 3 Existing Area R-38 Roof Exiigstin No 1764 Cathedral Altered N/A Interior Surface Existing Area—Garage R-13 Wall1 236 New N/A Raised Floor Existing Area R-19 Floor Crawlspace 1764 Altered N/A Front Walls Addition Area R-13 Wall 45 Front 441 138 90 New N/A Left Walls 2 Addition Area R-13 Wall 135 Left 351 28.9992 90 New N/A Rear Walls 2 Addition Area R-13 Wall 225 Back 300 52 90 New N/A Right Walls 2 Addition Area R-13 Wall 315 Right 359 8 90 New N/A Roof 4 Addition Area R-38 Roof 1183 New N/A Raised Floor 2 Addition Area R-19 Floor Crawlspace 1273 New N/A Front Walls 2 Garage R-0 Wall 45 Front 198 90 Existing No Left Walls 3 Garage R-0 Wall 135 Left 144 90 Existing No Right Walls 3 Garage R-0 Wall 315 Right 180 90 Existing No OPAQUE SURFACES – Cathedral Ceilings 01 02 03 04 05 06 07 08 09 10 11 12 13 Roof Roof Framin Verified Orientatio Area Skylight Roof Rise Roof Roof Reflectan Emmittan g Statu Existing Name Zone Type n (ft2) Area (ft2) (x in 12) Pitch Tilt(deg) ce ce Factor s Condifion Roof Addition Area R-38 Roof1 Front 90.1 30 4 0.33 18.43 0.1 0.85 0.07 New N/A Roof 2 Garage R-0 Roof Front 456 0 4 0.33 18.43 0.1 0.85 0.1 Exiigstin No Cathedral Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16.54.30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Projdct Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CFI R -PRF -01 Page 4 of 9 ATTIC 01 02 03 04 05 06 07 08 09 Name Construction Roof Rise Roof Reflectance Roof Emittance Radiant Barrier Cool Roof Status Verified Existing Condition Attic Existing Area Attic Roof Cons Existing 4 0.1 0.85 Yes No Existing No Attic Addition Area Attic Roof Cons Addition 1 4 0.1 0.85 Yes No New No WINDOWS 01 02 03 04 05 06 07 08 09 10 11 Name Surface (Orientation -Azimuth) Width(ft) Height (ft) Multiplie r Area (ft2) U -factor SHGC Exterior Shading Status Verified Existing Condition Left Windows Left Walls (Left -135) 11.0 4.7 1.025 53.0 0.32 0.25 Insect Screen (default) New N/A Rear Windows Rear Walls (Back -225) 17.0 5.4 1.013 93.0 0.32 0.25 Insect Screen (default) New N/A Right Windows Right Walls (Right -315) ---- ---- 1 20.0 0.32 0.25 Insect Screen (default) New N/A Front Windows Front Walls (Front -45) ---- ---- 1 138.0 0.32 0.25 Insect Screen (default) New N/A Left Windows 2 Left Walls 2 (Left -135) 8.0 4.3 0.843 29.0 0.32 0.25 Insect Screen (default) New N/A Rear Windows 2 Rear Walls 2 (Back -225) 13.0 4.0 1 52.0 0.32 0.25 Insect Screen (default) New N/A Right Windows 2 Right Walls 2 (Right -315) ---- 1 8.0 0.32 0.25 Insect Screen (default) New N/A Skylight Roof (Front -45) 1 30.0 0.44 0.25 New N/A Sun Tunnel Roof (Front -45) 1 60.0 0.44 0.25 New N/A DOORS 01 02 03 04 05 06 Name Side of Building Area (ft2) U -factor Status Verified Existing Condition Door Interior Surface 38.0 0.50 New No Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at- 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Projdct Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CF1 R -PRF -01 Page 5 of 9 OVERHANGS AND FINS 01 02 03 04 05 06 07 08 09 10 11 12 13 14 05 Overhang Left Fin Right Fin Window Depth Dist Up Left Extent Right Extent Flap Ht. Depth Top Up DistL Bot Up Depth Top Up Dist R Bot Up Left Windows 1 0.5 3 3 0 0 0 0 0 0 0 0 0 Rear Windows 1 0.5 3 3 0 0 0 0 0 0 0 0 0 Left Windows 2 1 0.5 3 3 0 0 0 0 0 0 0 0 0 Rear Windows 2 1 0.5 3 3 0 0 0 0 0 0 0 0 0 OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 Total Cavity Winter Design Construction Name Surface Type Construction Type Framing R -value U -value Assembly Layers • Cavity / Frame: no insul. 12x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic Roof Cons Existing Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Inside Finish: Gypsum Board Ceilings (below Cavity/Frame: R-9.1 /2x4 R-38 Roof attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. R 38 0.025 Over Floor Joists: R-28.9 insul. • Inside Finish: Gypsum Board • Cavity/Frame: R -13/2x4 • Exterior Finish: Wood R-13 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.095 Siding/sheathing/decking • Floor Surface: Carpeted Floors Over Floor Deck: Wood Siding/sheathing/decking R-19 Floor Crawlspace Crawlspace Wood Framed Floor 2x6 @ 16 in. O.C. R 19 0.049 Cavity/Frame: R -19/2x6 • Inside Finish: Gypsum Board • Cavity / Frame: R-13 / 2x4 R-13 Wall1 Interior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.092 Other Side Finish: Gypsum Board • Cavity/ Frame: no insul. /2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic Roof Cons Addition Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Rooting: Light Roof (Asphalt Shingle) • Inside Finish: Gypsum Board • Cavity / Frame: R-38 / 2x4 • Roof Deck: Wood Siding/sheathing/decking R-38 Roofl Cathedral Ceilings Wood Framed Ceiling 2x4 @ 24 in. O.C. R 38 0.036 Roofing: Light Roof (Asphalt Shingle) Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:3u CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CF1 R -PRF -01 Page 6 of 9 WATER HEATING SYSTEMS 01 02 03 04 05 06 07 08 Name System Type Distribution Type Water Heater Number of Heaters Solar Fraction N Status Verified Existing Condition DHW Sys 1 DHW Standard DHW Heater 1 1 Annual New No WATER HEATERS 01 02 03 04 05 06 07 08 Name Heater Element Type Tank Type Tank Volume (gal) Energy Factor or Efficiency Input Rating Tank Exterior Insulation R -value Standby Loss (Fraction) DHW Heater 1 Natural Gas Small Storage 50 0.65 EF 40000-Btu/hr 0 0 WATER HEATING - HERS VERIFICATION 01 02 03 04 05 06 07 Name Pipe Insulation Parallel Piping Compact Distribution Point -of Use Recirculation with Manual Control Recirculation with Sensor Control DHW Sys 1 n/a n/a n/a n/a n/a n/a SPACE CONDITIONING SYSTEMS 01 02 03 04 05 06 07 08 09 Heating System Cooling System Distribution Fan Floor Area Verified Existing Name System Type Name Ducted Name Ducted System System Served Status Condition Res HVAC1 Other Heating and Heating Yes Cooling Yes Air Distribution HVAC Fan 3037 New No Cooling System Component 1 Component 1 System 1 1 HVAC - HEATING SYSTEMS 01 02 03 Name Type Efficiency Heating Component 1 CntrlFurnace - Fuel -fired central furnace 95 AFUE Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Projdct Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CF1 R -PRF -01 Page 7 of 9 HVAC - COOLING SYSTEMS 01 02 03 04 05 06 07 Name Verified Airflow Efficiency Verified EER Multi -speed Verified Refrigerant Charge Name System Type EER SEER Zonally Controlled Compressor HERS Verification Cooling Component 1 SplitAirCond - Split air conditioning 13 16 No No Cooling Component Duct Leakage system Location Location Bypass Duct Status 1 -hers -cool HVAC COOLING - HERS VERIFICATION 01 02 03 04 05 06 Name Verified Airflow Airflow Target Verified EER Verified SEER Verified Refrigerant Charge Cooling Component 1 -hers -cool Required 350 Required Required Required HVAC - DISTRIBUTION SYSTEMS 01 02 03 01 02 03 04 05 06 07 08 09 10 --- --- I --- Insulation Supply Duct Return Duct Verified Existing HERS Name Type Duct Leakage R -value Location Location Bypass Duct Status Condition Verification Air Distribution Air Distribution Ducts located in attic Sealed and tested 8.0 Attic Attic None New No System System 1 1 -hers -dist HVAC DISTRIBUTION - HERS VERIFICATION 01 02 03 04 05 06 Name Duct Leakage Verification Duct Leakage Target (%) Verified Duct Location Verified Duct Design Return Supply Air Distribution System 1 -hers -dist Required 6.0 --- --- I --- HVAC - FAN SYSTEMS & HERS VERIFICATION 01 02 03 04 Name Type Fan Power (Watts/CFM) HERS Verification HVAC Fan 1 Single Speed PSC Furnace Fan 0.58 Required IAQ (Indoor Air Quality) FANS 01 02 03 04 05 Name IAQ CFM IAQ Fan Type IAQ Recovery Effectiveness(%) HERS Verification SFam IAQVentRpt 58 Default 0 Required Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Projdct Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml .,� t..aICERTS, Inc. HERS PROVIDE R CF1R-PRF-01 Page 8 of 9 Registration Number: 215-A0077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-01152015-694 Report Generated at: 2015-03-23 16:54:30 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Projdct Name: Gupta Residence Calculation Date/Time: 16:53, Mon, Mar 23, 2015 . Calculation Description: Title 24 Analysis Input File Name: 23514 -alis -construction -1065 Colony Hills Ln..xml CF1 R -PRF -01 Page 9 of 9 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: le"Wee' Michael Kunz Company: Signature Date: Energy Performance Services 2015-03-24 16:22:00 Address: CEA/HERS Certification Identification (If applicable): P.O. Box 7483 n/a City/State/Zip: Phone: South Lake Tahoe, CA 96158 (888)828-9488 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. 2. 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 3. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Responsible Designer Name: Responsible Designer Signature: clkA&zd y6auz� Mehrdad Zamani Company: Date Signed: ALI'S CONSTRUCTION & REMODELING INC 2015-05-11 10:32:58 Address: License: 681 EAST BROKAW ROAD n/a City/State/Zip: Phone: SAN JOSE, CA 95112 (408) 898-6474 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-AO077601A-000000000-0000 Registration Date/Time: 2015-05-11 10:32:58 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF113-01152015-694 Report Generated at: 2015-03-23 16:54:30