Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
15090154
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10336 E ESTATES DR CONTRACTOR: GROH JUNE B TRUSTEE PERMIT NO: 15090154 &ET AL OWNER'S NAME: GROH JUNE B TRUSTEE & ET AL 10336 E ESTATES DR DATE ISSUED: 11/16/2015 OWNER'S PHONE: 4082522939 CUPERTINO, CA 95014-3305 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class Lic. # .REVISION #1: ADD 1/2 BATHROOM AND REVISE SIZE OF Contractor(2) Date WINDOWS TO AVOID INSTALLATION OF HARDY PANELS. 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 . performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $216500 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. APN Number: 36907019.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK 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 WITHIN 180 DAB'S OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST 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 comply Issued by: ��%� y ���� Date: %/2 '/22 `!j 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 F1OWNER-BUILDERDECLARATION inspection. I h reby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: following two reasons: owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER wi 1 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: I have and will maintain a Certificate of Consent to self-insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous 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 Air uality Management District I performance of the work for which this permit is issued. will maintain compliance wino u icip I Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by AhBea the Health & Safety Code, S2 , and 5534. S tion 3700 of the Labor Code, for the performance of the work for which this i 2 ^ � �I is issued. Owner or authorized agent: ate: Rnit ertify that in the performance of the work for which this permit is issued, I shall t 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 CO STRUCTION LENDING 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 l Code, Section with all non-point sours lations per the C=ate Licensed Professional 9.18. Signature ,�---3 -d5 CITY OF CUPERTINO FEE ESTIMATOR — BUI]LDING DIVISION ADDRESS: 10336 E Estates Dr. DATE: 12/03/2015 REVIEWED BY: Sean APN: BP#: - "VALUATION: $0 A 0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION USE: p PERMIT TYPE: 1 GENRES WORK REVISION #1: ADD 1/2 BATHROOM AND REVISE SIZE OF 2 WINDOWS TO AVOID SCOPE INSTALLATION OF HARDY PANELS. of 11i. 1 ma uxumutu uues noa encivae fees aue to outer uepartments (i.e. Planning, 'Public Works, Fire, Sanitary Sewer District, School District. eta). These fein arp h/I.vo mi tho FEE ITEMS (Fee Resolution .1.1-053 F_ff 7,-1/13) FEE QTY/FEE :'Iuc, ). 6 $0.00 = hours Plan Check, Hourly $286.00 /STPLNCK Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Pri:%?i%. $0.00 of 11i. 1 ma uxumutu uues noa encivae fees aue to outer uepartments (i.e. Planning, 'Public Works, Fire, Sanitary Sewer District, School District. eta). These fein arp h/I.vo mi tho FEE ITEMS (Fee Resolution .1.1-053 F_ff 7,-1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? (0 Yes (D No $0.00 = hours Plan Check, Hourly $286.00 /STPLNCK Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 Permit Fee: $0.00 //PME pp t x: 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced. PlannjDg Fee: $0.00 Select a Non -Residential Building or Structure 0 Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00TOTAL FEE. $286.00 Revised: 10/01/2015 mv, -- CONSTRUCTION PERMIT APPLICATION - � CONiIdiUNIlY DEVELOPMENT DEPAR i MENT • BUhDl ! - D- .. � ON _ f 0300 TO RR= AVENUE • CUPER i INO, CA 95014- 25 81 r Li CUPERT[0, (408) 777-3228 • FAX (408) 777-3333 • buildino�cuino aFe i� ❑ NEW CONSTRUCTION ❑ ADDITION ❑ A RATION / 1i tK REVISION / DEFER ED O1RIGII\ Q T PER21YET � PROjECf ADDRESS A1,N R 7 / . F� -� U c✓ s OWNER NAIYM I PHON IJ�a II :�_� e-- C r 9w" ; 5l?l5 9 'IYJ, dCu�A 13*1ice^�, l cam:z� S TR EF A.DDRSS y C: i Y, STATE Zu FAX l c� 33 c� -� 5 ' la�_� ,nom CU �i"N Gl 4 COIviACT h:<Vz` I PHOWE I E p,tT t... S T REF ADDRESS 1 / j C-1 Y, STA : t, Z3 I pp ❑ OV kcR %0vW--_R-BUaZE-R ❑ COI.TFR0.CTOR ❑ CO1,7r?.1LCTOR.e.GTT ❑ ARm'=CT ❑ T'G2rawR ❑ DE1 LOPS ❑ Tat:fh-r CONTRACTORNA3✓B I LIC_ENSBXMIMER - - I LICENSE TYPE ( BLAS. UC CO1J3AhY NAh�'--. I E -K- Am STREET ADDRESS � CITY, STATE, t, ZIP � P HONE, ARCHTCTrIvGLNEER NA�fB I LICENSE NLkSaR BUS.R LIC COl✓3AI Y NAh _ 5��.n�Albt» )n F_M LAIL r A : 4 091 y� , 1016 STRIET,AMMESS I CA- CITY, STATE: ZIP I P 301 ? JJtS(=K:i'ilU?� Ur WOP.iC jam'_ 9� _® MOSTDvG USE PROPOSED USEI coil's -,?-TYPE r' STOP ! I USE I TYPE I OCC, I SQ -FT. V,-.LUATION (E) E7Dr4zTG ALJ!FLOOR DEMO TOTA11 AREA AP.=A A R 7A NET AREA OM IliC: I- 07HER REMOD REl 40D=L ARtE.4 P.E1.40DEL A3_rA R MMDEL AKEA OR CH ARA _ DaCK .ARRA ,_ TO i:1 DECSUP ORCH ARRA G -4 -RAGE A1Z'-A: DZ'AC3 I ATTACK I �DtiELLD.CU,,'ir5: IS A SECOND UNrr ❑YEs SECOND STORY ❑YES BEING ADDED? ❑1:0 I I ADDMON? ONO PRE-lc9LiCATION ❑ :'as 1 Yzs, PRO Nm-- COPY OF IS THE BLDG AM ❑ r� =_ C I\ F� 3�'•'` " -^ '. =-?`- -, .r= '% � p TOT. L L A..ON: PLANI.TIQG ADPL R ❑ NO PLAR.'I,Z>\G ASPROVAT_ Lt! TE I EI PLER HOME? ❑ NO y :::r ::j_ u: 1 Ic1111-y LU ee.U11 U1 �u� 1L'l! O�i'171�; ' I am p p ery o\; eror a:lthorl-ed eaent to act on the prope, ow lei's behalf. I have reed this - application end the information I have pro Ide corect: I a e rea Merl), iptio of ��%ark and verify it is 2ecuate: I ag ee to comply \;'ith'all applicable ] //}} // Deal OrdlnaACBS and State lc\i'S ie�cti'g t0 bL1' ,Qyt 0+151 'Ct10n, c�tc13Di;Ze represen tlFe '0 is CUD"J11no to enter the above -identified prop- IOi IrlspeCtlOR pLrposes, 4��k 1 51�']aiLre DI Applicant/Agent: - - Date:- SUTPPLEl`,f_1ENT2 �' T > - - Il�rOR �11_ONR� U1RED — - - —a _ A - -- - •y =D r 11.O.ltion pei-�I_t :or - - - - - - - - --- -- -- - p yO�tr2 TEICOLI�R �BLT?SD�GPL3�Xt�' Fi' y existing building(s). DerII011a1 ri permit is .eou' ed i55 P f s prior to u=-Ic., o bLild�-lg pelrmmit fornew building, E� SS PL 4�T��hGPLeir,P�hZE; COinmercial Bldgs: Provide 3 completed HaZ2rdoius _S3'erlalJDIScIosL{ Y . om, if any Hazardous A4aterizl_s are being used as part es« r ., is project. c ]� I ZRG �z r su.ESJr�� t Copy of Plan, ing Approval Lefler or I\/eeting with PlanaL g arior to -- NLE SORA- Sd� 4TLaYSE�i nFDI�? 12ICTE submittal of Building Pe_t it application. _� - B1d9:�a.P_2011. aoc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10336 E ESTATES DR CONTRACTOR: GROH JUNE B TRUSTEE PERMIT NO: 15090154 & ET AL OWNER'S NAME``: GROH JUNE B TRUSTEE & ET AL 10336 E ESTATES DR DATE ISSUED: 11/16/2015 OWNER'S PHOn: .4082522939 CUPERTINO, CA 95014-3305 FHONE NO: ❑ :•EN "•LICSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ADD 220 S.F. TO CREATE (N) BEDROOM & BATH. License Class Lic. # REMODEL (E) 1404 S.F. SFD. UPGRADE FROM 100 TO 200 AMP Contractor,: ;'' Date • ,:.; .. PANEL & ADD (1) A/C, REPLACE (E) FURNACE & WATER I herebyyaffirm`thaf ]l im licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my..l cense i$ in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and;will:mpih* it'ceitif cat, of consent to self-insure for Worker's Compensation; as provided f6r6y Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $216500 performance of the:W6rk for'which this permit is issued. I have and will'maintain Worker's Compensation Insurance, as provided for by Section 3700 of tlie,JJabor Code, for the performance of the work for which this APN Number: 36907019.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this; application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon; the above-.mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST 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 Issued by: � �ZA�W Date: granting of this permit.' Additionally; the applicant understands and will comply with all non-point source'regi lations per the Cupertino Municipal Code, Section 9.18. RE-ROOFS: Signature ` ' , ! Date 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I here6y.affirin.thaf I am exempt from the Contractor's License Law for one of she following two.reasons:.,1? ,: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER as owner of the property, �or'iny employees with wages as their sole compensation, will do the work;'and the structure is not intended or offered for sale (Sec.7044, & Business Professions Code) I :.. I, as owner'• ofthe. 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 California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three 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 andwill maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation,ias provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Area Air Quali - anagement District I Area performance of the' for. which this permit is issued. will maintain compliance with the u Munici 1 de, Chapter 9.12 and I have and will main tain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sectio s , 25533, a 255 4. Section 3700 of the Labor Code, for the performance of the work for which this I,. • ' Owner or authorized agent. Date: ermit, is issued. ;; 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 CO STRUCTION LENDING 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.) i Lender's Name i .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 w4: ep'hatmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and 'expenses whichmay, ac zue against said City in consequence of the I understand my plans shall be used as public records. granting of this pe ii A ition ly, he applicant understands and will comply with all non-po; sou r gula Ions r the rtino Municipal Code, Section Licensed Professional 9.18. ; Signator I �' : Date CUPERTINO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 e FAX (408) 777-3333 a building(cr�.cupertino.org � �} 0 -NEW CONSTRUCTION ® ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10336 E. Estates ®rive TAPN # OWNER NAME. 0 „ R PHONE (408) 252-293 E-MAIL mp,michelle.pearl@gmail.com STREET ADDRESS 10336 E. Estates Drive CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAMES e n s e r V i e i ra PHON E-MAIL p 408)432-1402 ext 20 spenser@feranandez-designs.com STREET ADDRESS 2188 Ringwood Ave, CITY, STATE, zlPSan Jose, CA 95131 FAX (408)432-1410 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT X ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME a e m LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/UGINE to nandez LICENSE NUMBERB4$2�03 BUS. LIC# COMPANY NAME Fernandez Designs & Builder's Inc. E-MAIL spenser@feranandez-designs.com FAX(408)432-1410 STREET ADDRESS 2188 Ringwood Ave. CITY, STATE, zIPSan Jose, CA 95131 PHONE(408)432-1402 DESCRIPTION OF WORK 5 A °',v i Ct, k; P 0 P Remodel/addition to a 1,403.13 S.F. 3 bedroom, 2 bath home with at 440.70 garage. a %V .- a An addition of 219.45 to be added to the living area of the home creating a 1,622.58 S.F 4 bedroom, 3 bath home The existing livable area of 1,403.13 S.F. will be remodeled as part of this project EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES Residential Residential V -B 1 USE TYPE OCC. SQ.FT. VALUATION (S) TOTAL AREAEXIST1403 AR A 20 AREA NEW FLOOI� DEMO 0 NETAREA 1623 Addition 220 33,000 L BATHROOM KITCHEN p OTHER REMODELAREA 38 REMODEL AREA 100 REMODELAREA 1135 Remodel 1135 113,500 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH 0 p 0 441 ;Q ATTACH Kitchen 180 50,000 # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES 1 BEING ADDED? ONO ADDITION? IONO B � $$ 20,000 PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLD ---®Y1 SC TOTAL VALUATION: PLANNING APDL # NO PLANNING APPROVAL LETTER EICHLE OME? ? a 216,500 By my signature below, I certify to each of the following: I am a roperty er or authorized age �n the property owner's behalf. I have read this application and the information I have provide ,: s c�orrect. I ve re d the escr tion of Work an erify itis accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ing•co�,sf`v tion. aut ize rep esell tives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: ' �% Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN �xEc�c TxrE ROUTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for [] OYER THE COUNTER BUILDING`1,LX9RE 'tN existing building(s). Demolition permit is required prior to issuance of building permit for new building. © EXPRESS PLANNNGPLAN RFViF1y Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTANDAItn D: PUBLICwoRxs t form if any Hazardous Materials are being used as part of this project. '- l� LARGE � 'FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to - CI 1VIAJOR sANIARY SEWER DISTRICT submittal of Building Permit application. I�::,,,ENYIRgNMENTAL AEALTH, BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO IM -7 FEE ESTIMATOR -BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10336 E ESTATES DR DATE: 09/23/2015 REVIEWED BY: MELISSA PC FEE ID APN: 369 07 019 BP#: `VALUATION: 1$216,500 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? - Yes �; No OTC? Yes •. No PENTAMATION PERMIT TYPE: 1 R3SFDADD WORK ADD 220 S.F. TO CREATE N BEDROOM & BATH. REMODEL E 1404 S.F. SFD. UPGRADE SCOPE FROM 100 TO 200 AMP PANEL & ADD (N) A/C, REPLACE (E) FURNACE & WATERHEATER OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA 01). PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 220 $1,091.00 IADDPLCK $1,057.00 IADDINSP Other Elec. Insp. 0.0 hrs $48.00 kl ech. hap- Fee: Phuub. Insp. Fc e: llec. Insp. Fee: hrs $0.00 0 # Mechanical $72.00 IBREAMIR . A/C Units (<=10K cfm) PME Unit Fee: $0.00 PME Permit Fee: $144.00 = # )Plumbing $29.00 IPRWHEATR Water Heater Construction Tax: F ,4(17ninistrative Fee: 200 amps Electrical 0 $48.00 1 IBELEC200 Services G Work Without Permit? 0 Yes (j) No $0.00 TOTALS: 220 $1,091.00 - $1,057.00 Strong Motion Fee: IBSEISMICR MECIi, HOURLY _ : Yes f • No PLITMB`HOURLY, `. O ' Yes HOURLY . Plan Check Fee: -ELEC, Mech. Plan Check 1-0-01hrs $0.00 Plumb. Plan Check 0.0 1 hrs $0.00 Elec. Plan Check 0.0 1 hrs $0.00 Mech. Permit Fee: 1MPERMIT Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Other Mech. Insp. 0.0 hrs $48.00 Other Plumb Insp. 0.0 hrs $48.00 Other Elec. Insp. 0.0 hrs $48.00 kl ech. hap- Fee: Phuub. Insp. Fc e: llec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Preliminary information available and are only an estimate Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13,1 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,091.00 IDEs.f. Remodel, Other $4,888.00 1REMRES2 Suppl. PC Fee: 6) Reg. (:) OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 =# Mechanical $143.00 1 IMFR=<100 Furnace, Forced -Air Permit Fee: $1,057.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 0 # Mechanical $72.00 IBREAMIR . A/C Units (<=10K cfm) PME Unit Fee: $0.00 PME Permit Fee: $144.00 = # )Plumbing $29.00 IPRWHEATR Water Heater Construction Tax: F ,4(17ninistrative Fee: 200 amps Electrical 0 $48.00 1 IBELEC200 Services G Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: IPLLONGR $30.80 Select a Non -Residential E) _T Building or Structure Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICR $28.15 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $9.00 - SUBTOTALS: , $2,407.95 $5,180.00 .. TOTAL FEE '.' $7,587.95 Revised: 07/02/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15090154 10336 E ESTATES DR CUPERTINO CA 95014 (369 07 019) OWNER/BLDR OWNER'S NAME: GROH JUNE B TRUSTEE & ET AL DATE ISSUED: 11/16/2015 OWNER'S PHONE: 408-707-0977 PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. # Contractor OWNER/BLDR Date _BLDG _ELECT _PLUMB MECH RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: ADD 220 S.F. TO CREATE (I) BEDROOM & BATH. REMODEL I hereby affirm under penalty of perjury one of the following two declarations: (E) 1404 S.F. SFD. UPGRADE 100 AMP PANEL & ADD (N) i. I have and will maintain a certificate of consent to self -insure for Worker's A/C, REPLACE (E) FURNACE & WATER HEATER. Compensation, as provided for by Section 3700 of the Labor Code, for the REV # 2 - ADD (I) SUB PANEL IN HALLWAY - ISSUED 9/8/16 performance of the work for which this permit is issued. REVISION #1: ADD 1/2 BATHROOM AND REVISE SIZE OF 2. I have and will maintain Worker's Compensation Insurance, as provided for by (2) WINDOWS TO AVOID INSTALLATION OF HARDY Section 3700 of the Labor Code, for the performance of the work for which this PANELS. ISSUED 12-3-015 permit is issued. APPLICANT CERTIFICATION Sq. Ft Floor Area: Valuation: $216500.00 I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 369 07 019 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, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 09/08/2016 Issued b • N Date: 11/16/2015 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is i. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for c pensation, will do the work, and the structure is not intended or offered for inspection. le (Sec.7044, Business &Professions Code) I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 09/08/2016 I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, 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 2. &ve and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the ction 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupe unic Co , Chapt . 2 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health & Safety Code, Se ions 0 533, nd 25 4. be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 09/08/2016 I certify that I have read this application and state that the above information is CO STRUAON LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a lonstruction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the gr ting of this it. Addit' the applicant understands and will comply wit all on-po; s urce egul ons pe the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9. 1 understand my plans shall be used as public records. Signature Date 09/08/2016 Licensed Professional 51 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10336 E ESTATES DR CONTRACTOR: GROH JUNE B TRUSTEE PERMIT NO: 15090154 & ET AL OWNER'S NAME: GROH JUNE B TRUSTEE & ET AL 10336 E ESTATES DR DATE ISSUED: 11/16/2015 OWNER'S PHONE: 4082522939 CUPERTINO, CA 95014-3305 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ADD 220 S.F. TO CREATE (1) BEDROOM & BATH. License Class Lic. # REMODEL (E) 1404 S.F. SFD. UPGRADE FROM 100 TO 200 AMP Contractor Date PANEL & ADD (N) A/C, REPLACE (E) FURNACE & WATER 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: $216500 performance of the work for which this permit is issued. I have andwill maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36907019.00 Occupancy Type: permit is issued APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon; the above' mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST 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 comply Issued bye Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of he following two reasons: ' ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER as owner of the property, or my employees with wages as their sole compensation, ill do the work; and the structure isnot 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 constructthe project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three 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 Area Air Quali anagement District 1 performance of the work for which this permit is issued. will maintain compliance with the cr mo Munici I de, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sectio , 25533, a 255 4. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent. Date: ermit is issued: 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 CO STRUCTION LENDING 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 keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which in, ac rue against said City in consequence of the I understand my plans shall be used as public records. granting of this pe tt A itioh ly, a applicant understands and will comply with all non-po' so r gula ons r the rtmo Municipal Code, Section Licensed Professional 9.18. Signat R.." Date CCUPERTINO F-1 MFW CnNISTRI 1r'TTr1M CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building (@cupertino.org 1511 AnnITTnN I—I AT.TF.RATTON / TI n REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10336 E. Estates Drive 7PN # b vl OWNER NAME'(�� D6�1 , J PHONE (408) 252-2939 (/ E-M"ILmp.miChelle.pearl@gmail.com STREET ADDRESS!/ 10336 E. Estates Drive CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAME Spenser Vieira PHONt408)432-1402 ext 20 L spenser@feranandez-designs.com STREET ADDRESS 2188 Ringwood Ave. CITY, STATE, ZIPSan Jose, CA 95131 FAX (408)432-1410 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT X ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ 'rFNANT CONTRACTOR NAME ^ , LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTUOUg fe nandez LICENSE NUMBERg4E27O3 BUS. LIC# COMPANY NAME Fernandez Designs & Builder's Inc. E-MAIL Spenser@feranandez-designs.com FAX(408)432-1410 STREET ADDRESS 2188 Ringwood Ave. CITY, STATE, zIPSan Jose, CA 95131 PHONE(408)432-1402 & m V I Cl_ V e b�D Dg DESCRIPTION OF WORKS Remodel/addition to a 1,403.13 S.F. 3 bedroom, 2 bath home with at 440.70 garage. c� v An addition of 219.45 to be added to the living area of the home creating a 1,622.58 S.F 4 bedroom, 3 bath home with a 440-7n S E_ garagp- The existing livable area of 1,403.13 S.F. will be remodeled as part of this project EXISTING USE Residential PROPOSED USE CONSTR. Residential V TYPE -B I # STORIES ] USE TYPE OCC SQ.FT VALUATION (5) AREAEXIST AREA 1403 AREA L AREANEW OI 20 AREA 0 TOTAL 1623 Addition 220 33,000 BATHROOM REMODELAREA 88 KITCHEN REMODEL AREA 180 OTHER REMODELAREA 1135 Remodel 1135 113,500 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA 0 GARAGE AREA: E DETACH 441 ATTACH Kitchen 180 50,000 0 0 # DWELLING UNITS: 1 IS A SECOND UNIT YES BEING ADDED? WNO SECOND STORY ❑YES ADDITION? 50NO Bat 88 20,000 IS THE BLD C TOTAL VALUATION: PRE -APPLICATION []YES IF YES, PROVIDE COPY OF PLANNINGAPPL# JANO PLANNING APPROVAL LETTER EICHLE GME?;��- 216,500 e following: I a e roperty er or authorized age on the property owner's behalf. I have read this By my signature below, I certify to each�ing,-do application and the information I have ped,t rrect. ve re d the escr tion of Work a erify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bution. for inspection purposes. au ze rep esen Lives of Cupertino to enter the above -identified jproperty r! /? TJ f Signature of App]icanUAgent; Date: `-7 SUPPLEMENT L INFORMATION REQUIRED PLAN CHECK Tyre ROUTING sLlr _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER )(BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ F.XPRFSS PLANNING PIAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD /❑ PUBLIC WORKS _ 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 B1dgApp_2011.doc revised 06121111 J� CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingCftupertino.org n NEW CONSTRUCTION I—I ADDITION n ALTERATION / TI Q1;1 REVISION /DEFERRED ORIGINAL PERMIT # L 6c;,qO GS1f PROJECT ADDRESS APN # ONE OWtNERN E .� �. H-7 --7 E- AIL STREET ADDRESS CITY, STATE, ZIP ` FAX CONTACT N E E-MAIL/ STREET ADDRESS _ /l(e-�. i CITY, STATE P ljD� FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME O CS /�/ j�� 'l CENSE. NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX PHONE STREET ADDRESS CITY, STATE, ZIP T DESCRIPTIONOF\PORK --------- EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALU.AT!uN (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA i BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKPORCH AREA GARAGE AREA: DETACH ❑ ATTACH I # DwELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES L VALUATION: PLAN'NIING APPL # []NO PLANNING APPROVAL LETTER EICHLER Ho O By my signature below, I certify to each of the following: 1 am tVe:Dty er or a orized agent to act on the property owner's behalf. I have read this application and the information I have pr i d i ect. aveescriptio f ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b d' c ction. upresentativ of pertino to enter the above -identified property for inspection purposes. 4z> `��i� Signature of Applicant/Agent: D -2:!!_ SUPPLE.'QEN L INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER -THE -COL -ITER ❑ BUILDING PLAN REVIEW New SFD or Multifam' 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 REVIENV Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El SrASDARD ❑ PUBLIC «oRla _ 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 ❑ s-a:ITaRr sENVER DlsrRlcr submittal of Building Permit application. ❑ ENVIRON -MENTAL HEALTH BldgApp_2011.doc revised 06121/11 CITY OF CUPERTINO RRWA FEE ESTIMATOR - BUILDING DIVISION im,ADDRESS: 10336 E ESTATES DR DATE: 09/23/2015 REVIEWED BY: MELISSA PC FEE ID APN: 369 07 019 BP#: `VALUATION: 1$216,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: P 2nd Unit? • Yes No OTC? 0 Yes (F) No PENTAMATION 1 R3SFDADD PERMIT TYPE: WORK ADD 220 S.F. TO CREATE N BEDROOM & BATH. REMODEL E 1404 S.F. SFD. UPGRADE SCOPE FROM 100 TO 200 AMP PANEL & ADD (N) A/C, REPLACE (E) FURNACE & WATERHEATER OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 220 $1,091.00 IADDPLCK $1,057.00 IADDINSP PME Plan Check: $0.00 1 # $143.00 Mechanical IMFR=<loo Furnace, Forced -Air Permit Fee: $1,057.00 Suppl. Insp. Fee0 Reg. Q OT 0,0 hrs $0.00 0 # Mechanical $72.00 1BREMAIR A/C Units (<=10K cfm) PME Unit Fee: $0.00 PME Permit Fee: $144.00 # $29.00 Plumbing IPRWHEATR Water Heater t: on%wt ction 74t:r: TOTALS: 220 $1,091.00 1 $1,057.00 200 amps $48.00 MECH, HOURLY 0 Yes (2) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No Mech. Plan Check 0.0 hrs $0.00 Plumb. Plan Check 0.0 hrs $0.00 Elec. Plan Check 0.0 1 hrs $0.00 Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Other Mech. Insp. 0.0 hrs $48.00 Other Plumb Insp. 0.0 hrs $48.00 Other Elec. Insp. 0.0 hrs $48.00- I I I � NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer Distract, School District etc) These ees are based on the nrelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,091.00 E4Es.f. $4,888.00 Remodel, Other IREMRES2 Suppl. PC Fee: (D Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 1 # $143.00 Mechanical IMFR=<loo Furnace, Forced -Air Permit Fee: $1,057.00 Suppl. Insp. Fee0 Reg. Q OT 0,0 hrs $0.00 0 # Mechanical $72.00 1BREMAIR A/C Units (<=10K cfm) PME Unit Fee: $0.00 PME Permit Fee: $144.00 # $29.00 Plumbing IPRWHEATR Water Heater t: on%wt ction 74t:r: 200 amps $48.00 Electrical IBELEC200 Services Q Work Without Permit? 0 Yes (j)No $0.00 Advanced Planning Fee: IPLLONGR $30.80 Select a Non -Residential Building or Structure 0 i Travel Documentation Fee: ITIN VDOC $48.00 Strong Motion Fee: 1BSEISMICR $28.15 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $9.00 SUBTOTALS: 1 $2,407.951$5,180.001 TOTAL FEE: $7,587.95 Revised: 07/02/2015 CUPERTINO 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: PERMIT # / S 1 `t OWNER'S NAME: �;.' �:= .�,^c i,,'T^,� PHONE # 'r 5 - 6� -'� GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) 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 Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical '( << �; ,� _ (. C `�, , y 3 a I 7 Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating,f��} ,�; i' 7 q<3-7 psi Insulation Landscaping Lathing % R Pam Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 11 '?-&-/�L-- Owner / eontractor Signature Date i/ '� « '► Q Archive © Move U3 Delete 10 Sp* .i► New Business License A pli ation (#6264) Re ei... People p � � bf@cupertino.org Today at 12:31 PM To r!amantia@sbclobal.net A -I cz) Thank you! The information you provided has been forwarded to the Finance Department. Your Business License payment to City of Cupertino was successful. If your business is located outside City of Cupertino, your Business License will be mailed to you within 3-5 business days. If your business is located within City of Cupertino, your Business License will be mailed to you within 5-10 business days. For further information please call (408) 777-3221. e ,lir CReply to All a* Forward 9*11 More Print Subject: FW: New Business License Application (#6261) Received From: Treasa Hovorka (TreasaH@BlackDiamondLandscape.com) To: Iwpearl@yahoo.com; Cc: David E@blackdiamondlandscape. com-, Date: Wednesday, September 7, 2016 10:46 AM Hello Mr. Pearl, Page 1 of 2 Our application for the City of Cupertino been paid for and approved. I was told all you need to do is submit this email with then er #6261 and ' will suffice for your purposes. Best regards, and enjoy your new outdoor living space! Treasa Hovorka, CDT Human Resources I Executive Assistant Liamond Paver Stones &landscape, Inc. 1975 Hamilton Ave, uite 5 San Jose, CA 95125 Cell: (408) 647-5386 TreasaH@BlackDiamondLandscape.com Ph: (800) 942-1955 Fx: (888) 845-2443 www.BlackDiamondLandscane.com License # 841042 https://us-mg4.maii.yahoo.com/neo/launch?.rand=5683764583nlp 9/8/2016 P tint From: bl@cupertino.org [mailto:bl@cupertino.org] Sent: Wednesday, September 07, 2016 10:18 AM To: treasah@blackdiamondlandscape.com Subject: New Business License Application (#6261) Received Thank you! The information you provided has been forwarded to the Finance Department. Your Business License payment to City of Cupertino was successful. Page 2 of 2 If your business is located outside City of Cupertino, your Business License will be mailed to you within 3-5 business days. If your business is located within City of Cupertino, your Business License will be mailed to you within 5-10 business days. For further information please call (408) 777-3221. https://us-mg4.mail.yahoo.com/neo/launch?.rand=5683764583nlp 9/8/2016 ,&d ess LL SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENTDEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255; (408) 777-3228 FAX (408) 777-3333 building(ftupertino.org PERFECT CAMNOT BE FINALED A_ND CO .IPLLETED UNTIL TRIS CERTIFICATE HAS DEEM, C -h , AND NTED TO TILE RUILI)PiG DD ISIOIti xn^' .i.nr....n.+.fF'*`x.. xcx`ttaT--a-'-... .u�-x...aT•rz=:�'..`T�- .x-+nz��.av- - ._.... -r. - PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing sitngle-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00; CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarms) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comp wi e terms 63Vonditions of this statement ,-Owner or Owner.Agent'sf -Nam -1 i% - r �' —^e� E «Si a i G� na�trl e ...... ............... ... ........... ... ... ... Qa#et Cont� ° otr ........ .. L_ .��r��.:.......... Q2Ye.'{.....�.:ti. Smoke and W forrrz.doe, revised 03118114 'WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building Cupertino org Owner Name 4, *. �.„ Q �. �. _ f's� � ➢ �,��r � � �-a Permit No. r� l� � 1 ID lv Address % r-7' 1. Is your real property a registered historical site? ❑. Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? 11 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. LO )k No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built -and available for use or occupancy after January 1; 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. PIease check ONE of the following: X 1vlyproperty is a single-family residential realroPerty. See Civil Code Section 1101.4. P On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be. replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017', all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). El My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or nprovements), _ ❑ My property is a commercial real properly. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant, plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water- se pl in tures comply with the requirements as indicated in the table on the followin age q `�, , Owner or Owner Agent's Signatuira` . �_A - Date` _ ( . Upon completing and signing this C tificate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 0 CALOREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT+ BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, GA.95014-3255 (408) 777-3228 FAX (408) 777-3333 buildingO_cupertino.org PURPOSE: The 2013 CalGreen Code applies to additions or alterations of existing residential buildings where the addition or alteration increases the building's conditioned area, Volume, or size and also applies to all new low-rise residential buildings, high-rise residential buildings, or both. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: Peary Residence Project Address:. 10336 E. Estates Drive Project Description: 220 S.F. room addition and interior remodel of home. Instructions; 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Page 1 of 5 Ca[Green 2014.doc revised 11104114 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following; 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be ©' designed to allow only one shower outlet to be in operation at a time. 2V 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. IE 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate; but not to exceed 2.2 gallons per minute at 60 psi, and must default to -a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, Lai and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 GalGreen 2014. doe revised 11104114 Page 3 of 5 CalGreen 2014.doc revised 11104114 kr�tr, y � f-:^ t,i"sJ�: �7'- n �^. % � -i i s W -. s$ K Fl�� � a � ✓;rt�' �' �il, � i9 � t .- � �° �t'�`� n Y i 'S�-` 4.304.1 :Irrigation controllers. Automatic :irrigation systems installed at the time of final inspection shall be weather -based:. 4.304.1.1 Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants` needs as weather conditions change. ❑ 0 4.304.1.2 Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. A4.4 MATERIAL ?w'�" ; F., f ' � i-�,�4 ;� .. i?+{ 1% � � r# S 1 1 { }' 1 ,�}2 -_ 'nti f 4 }.�nr V` ,�' •.i ,. \ S N `h.: 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables.,. conduits,. or other openings in plates at exterior walls shall be protected against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. { � `y �uN ...'Y' � ,7: 2 } ' ' �' �' �^ r�`.G`s f`{ c{ 4" '�' `'x 43' "Y''"r ,.•..i'""iv5"`5� �- k kNd '.XiS ✓.' '�' 'K fi- � f �` 3J 4.s�+' 'g +3 4.408.2 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a UM ❑ construction waste management plan shall be submitted for approval to the enforcing agency. �( ■ 4'i -. i`#.,{ {`Si y •�r4.'�S F� �r `� .$r m,�-.!✓Tx 1 � # $"" ^t' }'1 �? .� f,. � �,� Ss? �� ��n�e�� `� �4l tt, � ,1 .✓.. � v ��k .. >a;�F'Y'�'., sy..,N ,xc `.�,, ..'"r+. �..:.+ ���7 n X 3. ...+?�... .;.�hx .tb*_-k� §.,.�ss..Y✓ �.} '�.;hL.'1in..i�v S�ka";S�S,-.'�..,.�-.✓S%3, .�. x. '.3Y".�,.d.'SG .._Mw,•�,. 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance'manual shall be provided to the building occupant or owner. A4.5 ENVIRONMENTAL '#TMd�.,��' � ', � d` «` "� 4 F r.., {R �i�'.e"i�{M,V���' �,nF�£ 4 yf` � G ''�t�'�,isp'�'s`�t�' � ,� � � G & } 'ns- k .�',•� � f 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed ❑ wood -burning fireplace, or a sealed woodstove. � �'4e � y � y; $ Fk;1 .; �'��:... ��� Ys �� sY,,,�'y���..,,�✓,,,, ,L�..� xi .,: ;!', �. „x�£.�y�m Sb�F.. .-.. _�� f�+. �m,.`�v ._�:Ymv �� J � �. -:3 � �� 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic ❑ ❑ compounds. Page 3 of 5 CalGreen 2014.doc revised 11104114 1�I 4.504.2.4 Verification. Documentation shall be provided to verify that compliant VOC limit finish materials have been used. 0 0 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with VOC limits. ® ❑ 4.504.4Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low-emitting 0 Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF); and hardwood plywood used in interior finish systems shall' comply with low formaldehyde emission standards. }■ "�4.5�y{ i�. ^k* �- W 4 ;�':yN"'r's',�y, A y"�. N/� Y�, ,� ,F'� 9f'*c � S"i €� icy # � ���i9 4"3 � a`f* $:6�.k��5 Y �r�. ief. '."3 y3:^edT�'�.' .r" i' P.:,.�a ^T'C`e � � 2 � r� .i`_ •lti,. :��h3'a � ��s�i.����i.,l��.,�.f�� �•J& S i"..."� 5 ./ �,� "„ .�: �`3 ��a�� •�T�/��ol .�x'�'".3 � ty � ar' :h''%�` �� � � -s .�'�%.g ,�A"� ��� ��f'"''� G 14 �'� �.i'°'ei' -r "`''i' '€ #' �" "p ,+cNFx+eC:•' � ��r �k.'�'"a f ��"... � .s'�'Ri � `i`'? ff � i�yy� t�5 x{ Y "= ,y3'� ., x' �{ .,,^.,4 ,�� ,F, ,}�di, r• Ny.,y F ��'� .+.,>. ar i..+,�-�5 r, A...f. s ,.. c.� ,.... r+` r,..e.ru�, k .,, .�.." .sL ?:. .9i r/.��r"k� '��n�z.:. ��a '". 1. x*e .. ✓, ^'y� �..�w+s.2r+..K :��R�.'�.�, Y,^"�����+�.uf�u.'�'„y � �. `.�;� 4.505.2 Concrete slab foundation. Required vapor retarders and capillary ' breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building materials used in wall and floor framing is checked before enclosure. � f-� �2� ({4 Sys 't',�v?-1r'�-ri;. l #z � �6:^z.� Y h ✓ fy' ia'S`?a, g ,� � 15ffFr'Po� �$��. x5. [.-rv�h, F9n 31'''"L'�` t t.3�r �?'�F. �i �r,*�� "�� 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building in bathroom. are provided every 4.507.2. Duct systems are sized and designed and equipment is selected: using the following methods: 1. Establish heat loss and heat gain values. according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-0 (Manual D) or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSTALLER AND SPECIALINSPECTOR ni' '3M3. y }" 4 3 3H "p �„Y.e*. 2,� � ; :. €. K3Fa=Y'. �Y� � +2F' 2C 5`l "�£ �}� SL"A'5 �„y. € 3 ,e�P''•�F :§ -� ? �£U'zFav�'S ^F $m -i, ya'siY v ,,..i+Y.`..y .X'. 'L., .,.'':.v � •s''F'r �.z b, _��rif,. fir' - .+6. G.! 702.1 Installer training. HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 Special inspection, The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the 0 Q discipline they inspect and verify. ✓.r ' "Y�!�.,�1 �^ c. ti d- - `u t R 1 l :AFF tl` t k,�. T= � �s ^t` r �^ '^.xr' , �ii"�x� �,�,:�� �33 yTl. �-,,u �/,�� 4i��'T+a�nsa`�,'��?dhf Y'�:q��3 :� T�..��f §�,,��c"{�� .�5'A �W...'���*y� '!.s� '✓'S">��` �'r``i'yi`�„#v% �""{%4��+'1����;�3- 'ter 4"�'#r C �C ✓'i 4? �'S'u.., kl LY � : ,,u '. S'' n.' 3 r✓ � ��. �l '�, � c`x 2 4;! J ,'� �'T h f. `� Y" t N� C i� £' f � 703.1 Documentation. Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing ❑. agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 q CaiGreen 2014.doc revised 11/04114 CALGREEN SIGNATURE DECLARATIONS Project Name: Pearl Residence Project Address: 10336 E. Estates Drive Project Description: 220 S.F. room addition and interior remodel of home. SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 —"Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building .permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards haverevised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. 10-22-15 Owner's Signature Date Michelle Pearl Owner's Name (Please Print) r ' 9-10-15 Design Professional's: Signature Date Doug Fernandez Design Professional's Name (Please Print) i 9-12-16 Signature of License Professional responsible for CalGreen compliance Date Doug Fernandez 408-432-1402 Name of License Professional responsible for CalGreen compliance (Please Print) Phone Doug@fernandez-designs.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. 9-12-16 Signature of License Professional responsible for CalGreen compliance Date Doug Fernandez 408-432-1402 Name of License Professional responsible for CalGreen compliance (Please Print) Phone Doug@fernandez-designs.com Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen 2014.doc revised 11104114 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - build ina(a cupertino.orq — Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS - - - BP# 012 OIR NAME �. _ ..: , OWNER ADDRESS. DESCRIPTION OF WORK: IZOo., We are providing you with an Ownet-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this infonnationJ ]Z.r _1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. j, .e, 1 understand. building permits are not required to be signed by property owners unless they are responsible for the construction and are not hieing a licensed Contractor to assume this responsibility. 0G— 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the -permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. _14a-4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. u*& 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. fQ:::G. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. X�. 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. I'Z� 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 S°. &G- 9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. CL— 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. MG- 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. X12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information l have -provided on this form. Licensed contractors are regulated bylaws designed to protect.the.public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a. result of a complaint,..Your only remedy against unlicensed Contractors maybe in civil court. Itis also important for you -to understand that if an unlicensed Contractor or employee of that individual or firm is injured .while working on your property, you may held liable for damages. If you obtairi a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's drivers license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued I o veru the property owners sl nature. Property Owner's Signature: Date: =-.7-3 /s --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. I Scope of Construction Project (or Description of Work): Project Location or Address: 1033(, r EAe-j Isr-. � ��-T �o q5-0 / Name of Authorized Agent: L -,o (.0 . Ne,— ,^ I Tel No 'tolb -1w7 -n9� Address of Authorized Agent: 1 03 3 , �s-`-yes �. C�Ae�'t:.w �i So ✓Y I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: !i l 5 OwnerBuilderForm 2010.doc revised 04/14/10 BUILDING ENERGY ANALYSIS REPORT PROJECT: Pearl Residence 10336 E. Estates Drive Cupertino, CA 95014 Project Designer: Fernandez Designs & Builders Inc. 2188 Ringwood Ave. San Jose, CA 95131 (408) 432-1402 0 0 T Report Prepared by: �(�\Jl A - Michael Kunz, CEPE 4Z Energy Performance Services P.O. Box 7483 South Lake Tahoe, CA 96158 888-828-9488 Job Number: 23803 1[,& Date: e 9/15/2015; The EnergyPro computer program has been used to perform the calculations summarized in this compliance report, This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2013 Building Energy Efficiency Standards. This program developed by EnergySoft, LLC — www.energysoft.com. I Energ Pro 6.7 by Energ Soft User Number: 5748 ID: 23803 CERTIFICATE OF COMPLIANCE • RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01 Project Nanw Peart Residence Calculation Date(TAne: 15:16, Tue. Sep 15, 2015 Pays 1 of 8 Calculation Description: Title 24 Analysis Input File Name: 23803-vieira•10336 E. Estates DriveAml GENERAL INFORMATION ENERGY USE SUMMARY 01 Project Name Pearl Residence 04 05 02 Caleulallon Description Tills 24 Analysis 08 Energy Use ikTDVAt?-yr) 03 Project Location 10336 E. Estates Drive Compliance Margin Percanl Improvement 04 City Cuperono 05 Slanderds version Conpiiancr 2015 06 Zip Code 95014 07 Compliance Manager Version BEMCmpMg(20134 1744), 00 C1Altsle Zone GZ4 00 Software Version EnergyPra 5 5 10 Bulking Type Single Farrvly 11 Front Orientation ideg.1CsrdnW) 290 12 Project Scope Awitlon and,Or AJteraoon 13 Number of Dwelling Unite 1 14 Total Cond. Floor Ares (12) 1622 15 Number o1 Zones 12 15 Slab Arae (n2) 0 17 Number of St«lea 1 10 1 Addition Cond, Floor Area 219 19 Natlrral Gas Avaaabfe Yes 20 1 Addition Stab Ares (112) 0 21 Glazing Percentage 4%) 15.6` COMPLIANCE RESULTS 01 Budding Compiles with Campulx NOMMance' 02 This building incarporales lectures that require!fold testing and,or verilication by a certified HERS rsfer under the supervision of a CEC-approved HERS provlder. 03 This budding uuorporalas one or more Speeral Features sbown below Registration hurnbec 215-A6326861A-000000000-0000 Regislration Date/time, 2015-09-1516:33:47 HERS Provider CaiCERTS mc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Vera - CL1R-4825.2015-744 Report Generated at: 2015-09-15 15:1640 ENERGY USE SUMMARY 04 05 06 07 08 Energy Use ikTDVAt?-yr) Standard Design Proposed Design Compliance Margin Percanl Improvement Space Heating 44-17 37.40 5.77 15.3% Space Coolltg 22-67 2(1.27 -3.60 15.9`16 IA0 Ventilation 000 0, DO 000 0.01% Water Heating 1599 10.68 5.31 33.2% Photovoltaic OBeet ---- 0,00 0.00-- Compllanee Energy Tataf 52-0 74.35 0.46 10.2% Registration hurnbec 215-A6326861A-000000000-0000 Regislration Date/time, 2015-09-1516:33:47 HERS Provider CaiCERTS mc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Vera - CL1R-4825.2015-744 Report Generated at: 2015-09-15 15:1640 CERTIFICATE OF COMPLIANCE - RESIDE"AL PERFORMANCE COMPLIANCE METHOD CFl R -PRF -01 Project Name: Pearl Residence Calculation DateiTilm. 15:16, Tue. Sep 15, 2015 Page 2 of 6 Calculation Description: Title 24 Anatysis input File Name: 23803-vieira-10336 E. Esiates Drive.zml REQUIRED SPECIAL FEATURES The following am features that crust be installed as condition for maeling the modeled energy pariormance for ibis computer analysis. • New ductmrk added is less than 40 fl. In length HERS FEATURE SUMMARY IN- following Is a summary 01 the features that mull be lleid-ye(dbed by a cer9liad HERS Rater as a condition for meetng tete modeled energy performance far this aorrWer analysis Addtiopal detail 6 '. pravloed in the budding components tablas below Sultdmg-41sve1 Yertficadons, • —None -- coaling Syslem Verlfloadions. • 6inimum Airflow • Fan ENlcacy WattsCFM HYAC Ddatribullon Solam Verifications: • — None -- Domamie Hat Water Syslarn Vorlllcallons: • — Nana -- ENERGY DESIGN RATING 01 42 03 D4 06 06 Tara at Ilse sum of Me annual TDV energy consumption V energy use carnpu,!erts ❑u ver d in Lne Pertcrmance corlvilanc& approar.-1i for the Standard Design Building (Energy Budae4) and INe annuli TDV energy consumption to lighting and components nal regulated try Tlt!e 1`4, Par-. 6 ijch as dcjmesir:: avplaras airi consumer alearancsJ and accounting for tete annual TOY energy onset by an on -sae rertawable energy system. Number of Dwelling Number of Ventilation Prolecl Name Conditioned Floor Area ((12) Units Number of Bedrooms Number of Zones CoaNing Syaterns Number of Water Hearing Syalerna Relsr" we Energy Usv Energy Design Rating Margin Percenl Fmprovem" A Told &+"rgy lkTOV,12•yn' 03 636.73 1 Nl,2yd B.JB 6.21 includes calculated Appliances and Miscellaneous Energy Use (AME: U) BUILDING - FEATURES INFORMATION 01 42 03 D4 06 06 07 Number of Dwelling Number of Ventilation Prolecl Name Conditioned Floor Area ((12) Units Number of Bedrooms Number of Zones CoaNing Syaterns Number of Water Hearing Syalerna Pearl Residence 1622 1 4 2 0 a+ ZONE INFU MATION a+ as 03 04 es 06 07 - Zone Nome Zona Typo HVAC System Nun" Zeno Floor Area If? Avg. Calling Now" Water Hash" Sys4sen 1 Vater Nesting System 2 Emssng Arm condibonod Res HVACI 14413 6 DHW Sys t Addition Area Conditionod Res HVACI 219 a DHW Sys t Registration Number 215-A6326861A-000000000-0000 RMistration Dalefrwne: 2015-09-1516:33:47 HERS Provides CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Vemim , CFIR-MS2015-744 Report Generated at: ZOIS-09.15 15:16-40 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01 Project Name: Pearl Residence Calculation DatnTAne: 1516. Tue. Sup 15, 2015 Page 3 of 8 Calculation Description: Title 24 Anit"is Input File Name: 23803-vieira-10336 E. Estates Drive.xml OPAQUE SURFACES 01 02 M 04 05 06 07 OB 09 01 02 03 04 05 06 97 08 01 10 Name zone Construction A:inWn Orientation cross Area (n3) Wlndow & Door Ana (11� Till long) Status Verttled Existing Co"tion Front Walls Existing Area 8-0 Wail 290 Fran 285 73 90 Existing No Lett Wales Existing Area R-0 Wall 20 Lett 134 24 90 Existing Na Rear Walls Existing Area 8-0 Wall 110 Bach 34.0 120 90 Exisling No Right \Valls Existing Area 8-0 Wail 200 Right 255 19 90 Exisling No Interior Surface Exrstn0 Areas, Garage R Q W610 200 18 Existing w Hoot 2 Exlsltnq Area H -I l Root 1403 Exlilfnq I No Ralaed Floor Existing Arca R-0 Floor Cr"Iwac* 1403 ExKlinq No Lail Walls 2 Addriwn Area R 13 Will 20 Lett 154 8 9P New NSA Rear Walla 2 Add+lwn Area R• 13 W RII 110 Bade 105 33 90 NeW N,A Flight Walls 7 Adailwn Aran R•13 will ?00 Right 65 90 NeW 14- A Real Add4ian Area R 30 Root 219 New N,A Rarsod Floor 2 Adcliflon Arra R 14 Floor C{rawhpxc 219 NeW NSA Front Walk 2 Garaga R••-0 4Jail 290 Front 196 90 Exeslirg No Lett Walls 3 _Garaga_ R--0 Wail 20 Lett 168 90 Exerting No Rphl Walls 3 Garage A-0 \Vali 20C Riehl 136 90 Exisling No ATTIC 01 02 M 04 05 06 07 OB 09 10 Nana Construcilon T"M Roof Rlw Root RwftcfAncc Roof Emlttance Radlant Barrer Cool Roof Statu s VeriNed Exist" Corxdltion Anne Exrsing Ar w Allw RwotExiiiiiN Area Varrllwtwd 4 0.1 0.85 No NQ Eng II No Alhc. Addiliorn Area Alii. Raol Atldbon Area VenliLtlod 4 0.1 0.85 No No Naw No Regislrelion Nurnbrr- 215-A6326861A-000000000-0000 Registration Pale/Tane: 2015-09-1516:33:47 HLRS Provider CaICERTS inc. CA Building Energy Elficiency Standards , 2013 Residential Compliance Report Version - CF 1R-0825.201.5-714 Report Generated at: 2015.09.15 15:16 40 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01 Project Nems: Pearl Residence Calculation DsteirHmly 1516, Tue. Sep 15, 2015 Page 4 of 6 Calculation Description: Title 24 Aratysis Input File Name: 238173-vieira-10336 E. Estates Drive.xml WINDOWS 01 02 03 01 02 03 04 05 06 07 08 09 10 11 Name 9urlace (Orientellan-Azirnulh) Nultipl(e Wldlh(tl.) Helghl (ft) r Area (112) 0 -factor 9HGC Exterior sihading statue Verified Exieling Canddion Front Glazing Front Walls (Front -2901 ---- --- 1 59,0 040 0 34 Ins.-+ct Screen (dela^ New KA Left Glazing Ler1 Walls (1-e1t20) - - 1 240 040 0.34 Insect Screen Idatauhl New NIA Rear Glazing Rear Wats l8ad,I I01 ---- --- 1 34,0 0 tib 0.65 Insacl Screen (detautll New NIA Rgar Gazing 2 Rear Wats (back -1101 ---- •- 1 66.0 040 0,34 Insect Screen (del ^ Naw NIA Righ Glazing Right Waits IiR ght 200) 1 19.0 040 0.34 Insect Screen (detauNt New NIA Lail Gazing 2 LAit Wails 2 IL*M 201 1 8.0 040 0-34 Ins4cl Screen (dalaull) Naw N;A Rear Glazing 3 Roar Walls 2 (Back 110) 1 33.0 0..40 0.34 Iniad Screen (deiauhl New NrA DOORS 01 02 03 04 06 06 Noma Side of Budding Area (ill) tNactor Slstus VWNetl Existing Condition Door Runt Wails 20.0 0,50 New No Door 2 IrrSrlrot Surtilee 180 050 Never No Resistration Number: 215-A6326e61A-000000000-0000 Rrgistre0on Mite/T1me: 2015-09-15 16:33:47 HLRS Provides CaICERTS iris. CA Building Energy Efficiency Standards • 1013 Residential Compliance Repart Version - Cf IR -08252015-744 Report Generated at 2015.09-15 15:16.-40 CERTIFICATE OF COMPLIANCE • RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PAF -01 Project Name: Peari Residence Calculation Date,Tin o: 15:16, Tue. Sep 15, 2015 Pago 5 of 8 Calculation Description: Title 24 A1latysis Input File Name: 23803-vieira-10336 E. Eslales Drive.xml OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 TOM Cavity Winter Deslgn ConstrudicioName Swisce Type Construc*MType Framing FI -Value U -valor Assembly Layer klside Frhah: Gypsum Board • CavRy? Frww: no MSW. r2x4 • Rcwf Pec*: Hbor1 S¢An4';chearfwlD'tlechm7 R 0 Rod Cathedral Cc.ingn Waco Frvnad Caiing 2x4 V 16 in O.C. none 0 4S4 RoPOV 09N Roof fAl' &hY Sfunglal • inside Finish: Gypsr m Board • Cavky/FY&m . no.wsui 12x4 • E-xrerbr 17W'sk Wood 1:-0 Wail Exlertov Walls Wood Framed Wall 2x4 L& 16 In. O.C. rune 0.302 SkAtrq•ShearhlntYYiat-rmp • Cavity! Frame: no Xrsul. !2x4 Top CArd :x4 Top Chord of RootTfuss:4 RoolDecEr Y160t1Shcry,aAaaNun4gecroTg Atac R+oolExisang Arra Attic Roots Wcod Framed Cailing in. QC. none 0.644 Roolk%ig t1fY Roof fAspha'I Shvxpe.J M%rda Frush: Gypsum Board Ceiings (below CavJly, i Franca. R -9J . 2x4 R 11 Rvol attic) Wood Framed Ceiling 2x4 241n.. O.C. S11 0-081 Over FAwr Jursis: R-i.g MstA FkwSudace. Carpefed Floors Over Ffoor 09sic: It cid S dhg•At a edlnng l7taa Mp R 0 Flour Crawispacri Cra.vttpdce Wood F.arrwd Fbvr {L 1 ti in O C nuns 0216 C4v4y r Frww 7 no vraW ?x 12 Msrue Felu Ot Gypsum Board • Cavrl y Frame: no o%W 2x4 R-0 Wain vit«,rbc Wallis Mod Framed W.111 2%4 t:,4 16 Ir.. O.C.. Vann 0.277 C11rx+r Shfe Fkliah: Gypsum Board • CavRy! Ffsriv no MsW i 2x4 Tqn Chrd 2x4 Top Chord of Root Ttus* 24 Roof Deck ilbod SWnp,sheattwltyi7eclnrg Alm RootAddnlon Area AtHe R4ols Wood Framed C40eng in. O.C. nuns 0.644 Roolag: L,gfrl Raxrf jAsphO ShurgleJ Msrde FmW1: Gypsum Board Ceilings(Cabw Cavdy;'Frame :R -91:'2x4 R-30 Roos attic) Wood Framed Catling 2x4 24 in O.C. R 30 0.032 Owr Franc Joists: 8-20.9 rrrsuf. • Msta- Ferksh: Gypsuryt Board • CavAy i F7anrc . R-13 %2x4 ExTerfor FMiah: tt4actd R-13 Wall Exterior Walls Woad Framed Wall 2,14 1 16 in DQ R 13 0,095 S+olnryKhsaMutg+t4ecArrq Ffaor S4lrtace: Carpereo Fklors Over Fkw Oeck. Wood S",Vi VvaNenj�'dm*tr J R-19 Flag Cr&Mspace Crawlii Wood Framed Floor 2x8 0 16 in. O.C. R 19 0.049 Cavity ; Frm rte: R• 19, 2x6 RegiIi.Iraliun Number- 215-A6326861A-000000000-0000 Registration Date/Time: 2015-09-1516:33:47 HERS Provider CaICERTS Inc. CA 8uildin8 Energy Efficiency Standards - 2013 Residential Compliance Report Version • CF1R-0&25.2015-744 Report Generated at: 2015-09-1S 15:16-40 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-,PRF-07 Project Namr: Pearl Residence Calculation DateTilne: 15 16, Tue. Sep 15, 2015 Paye 0 of 8 Calculation Deecrlptbn: Title 24 Analysis Input File Name: 23803-vieira-10336 E. Estates Drive.xml WATER HEATING SYSTEMS 01 02 03 04 06 06 07 018 Name Sysfam Type Dletributlon Type Water Heater Number of Heaters Solar Fraction N Status Verified Exisling Condition DHW Sys 1 DMV Starclard DHW Heater t 1 Aruxtsf New No WATER HEATERS 01 02 03 04 06 06 07 00 Nems Hasler £lamanl Type Tank Type Tank Volume (gal) Energy Faclar or EHlaancy Input Rating Tank Exterior Insulation R -value Standby Loss IFraciion) DI4W 14ealar, 1 Naeurai Gan Small Instanlaiwous 0 0.82 Cf 190000-B&.t1r 0 0 WATER HEATING • HERS VERIFICATION 01 02 01 02 D3 04 05 06 07 Name Pipe Insulation Parallel Piping Compact Dlalrlbullon Recirculation wllh Point -oil Use Manual Conlrol Recirctriatlon wllh Sensor ConUol DHW Sys 1 n�a ma NEI Na Na nla SPACE CONDITIONING SYSTEMS 01 02 ': 03 04F-- 05 06 07 08 05 CnMFurnace F,.l teed cenlral tu—n 80 AFUE Heating System Coolling System Distribution Fen Floor Area Venfted Existing Name Syslem Type Name Dwkd Name Ducted System System Served Statua Conditlat flea HVAC-1 011ier Heatnl8 and Omer Healing Yes Calving ms's Alr Dr5lr Drakln HVACFan �� 16.. N_m No Syslern Component 1 Connonenl t Syst6m 1 1 HVAC - HEATING SYSTEM 01 02 03 Nang Type ENlplency Heabng Camponern t CnMFurnace F,.l teed cenlral tu—n 80 AFUE Registration Number: 215-A6326861A-000000000-0000 Registration ElaLe%Time: 2015-09-1516:33:47 HERS Provider CaICERTS Inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report. Version - CF 19-09252015-744 Report Generated at: Z015-09,15 15:16 40 CERTIFICATE OF COMPLIANCE • RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1R-PRF-01 Project Namse: Pearl Residence Calculation Data.?in»: 15:16, Tue. Sep 15, 2015 Paye 7 of 8 Calculation Description: Title 24 Analysis Input File Name: 23803-vieira-10336 E. Esiates Drive.zml HVAC - COOLING SYSTEMS 01 02 03 04 06 08 07 Coaling Componont 1 •hars,cool Roquirud 350 Effickncy Multi -speed Name System Type EER SEER Zonally Controlled Conipreasor HERS Veriliwllon Cooling component 1 SpkmrCond - spilt air condaianing 11 7 14 No No Cooiing Compolwnl Corldtion system Air 0latrtx4lon Duca bcatad m OTC Exledn0 inot 6.0 1 -tiers -cool HVAC COOLING • HERS VERIFICATION o1 02 03 04 05 06 Name Verified Aidlow Airflow Target Verified RSMlgere" Verified EER VerHkd SEER Charge Coaling Componont 1 •hars,cool Roquirud 350 Not Roquirud Not Roq.tirod Not Roq.iimd MVAC - DISTRIBUTION SYSTEMS 01 02 03 04 05 00 07 00 09 10 Insulation Supply Dud Return Duct Verified Es M" HERS Name Type Duct Leakage R -value LOC84*0 Location Bypass Duct Status Corldtion Yerincation Air 0latrtx4lon Duca bcatad m OTC Exledn0 inot 6.0 A1Uc A21+:. Non<d ' Exrsltng .Naw No WA SYstam t spscitiad) HVAC - FAN SYSTEMS b HERS VERIFICATION 01 02 03 D4 Name Type Fan Power iWallavICF101) HERS Verification HVAC Fan 1 Singie Speed PSC Furnace Fan (1.56 Raqured IAQ tMt ow Air Quality) FANS 01 02 03 a os Name IAQ CFM IAQ Fen Type IAQ Recovery ElfeclNemes(%) HERS VeriNcation SI -am IA0Yei1>Hpc 0 6ata ill 0 Not Repulred Registration Number' 215-A6326861A-000000000-0000 Regintralion Pate/lwnc 2015-09-1516:33:47 HORS Provider CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Repan Version - CF IR -08252015-744 Report Generated at: 201S.09- 15 15:16-40 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Nam♦: Pearl Residence Calculation Description; Title 24 Anatysis Calculation DatarTifne: 15:16, Tue, Sep 15, 2015 Input File Name: 23803-visira-10336 E. Esiates Drive. ml CF1 R -PRF -01 Page 5 of 6 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT I. I cw* that this Cwlilicada of Catrpflance documentation is accurate and complete. Documentation Author Name- Dacumenlaiicn Author Signature. Michael Kunz Co npany: Signature Daze. Energy Performance Services 2015-09-15 15:35:40 Address' CEA/HEHS Certification kWilldwaoon th appl"bla), P.O. Box 7483 n/a Cily,Stalwzp: Phone - South Lake Tahoe, CA 96158 (888)828-9488 RESPONSIBLE PERSOWS DECLARATION STATEMENT I carlify the lcllowing under penalty of purlwy, under the Iah s of the State of Cafifornia- 1 _ I am eligiWu urder OiMsion 3 of the Guslness and Professions Cote to an cepf responsibility for the huil3ng design idenllilied on this Cartificole of Complanoe. 2, 1 Lerilly that the energy lealures end performance spetilleallons idenllned oil this Cerldicate of Compliance conform to the rN uiremenls of Title 24. Pail 1 and r'afl 6 of the California Code of tietyulafions. 3. The building design features or system design fealurees idendilled on Wig Ceniticele of Compliance are cvrnirstent Wart the filiormal on prvnded on Omer apO tcable oompitancs documents. rorxsteals. calculations, pians and specArasons suor mtad 1o,1lw andoreement agency dor approvai will ljiis Wilding pwma appticalwn Responsible Designer Name Pil*Ws"t Designer Slgnahsvw Spenser Vieira Company: Dutra, Signed Fernandez Designs & Builders Inc. 2015-09-15 16:33:47 Adttess. License: 2188 Ringwood Avenue n/a Cly-'Slalwlz0v Phone. San Jose, CA 95131 408-432-1402 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. ReSistratian Number. 215-A6326861A-000000000-0000 RL Sistration NLe/Tone: 2015-09-1516:33:47 HERS Provides CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Veniwn • CFIR-MS.2015.744 Report Generated at: NIS -09.15 15:16.40 2013 Low -Rise Residential Mandatory Measures Summary NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the In finnre nnnrnarh u.ced Frrentinnc may annly. Review the resnective code section for more information. Building Envelope Measures: § 110.6(a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain § 110.6(a)5: Coefficient SHGC , and infiltration that meets the requirements of § 10-111 (a). § 110.7: Exterior doors and windows are weatherstripped; all joints and penetrations are caulked and sealed. § 110.8(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on the CF2R. The thermal emittance and aged solar reflectance values of the cool roofing material meets the requirements of § 110.8(i) when the § 110.8(i): installation of a cool roof is specified on the CF 1 R. § 110.80): A radiant barrier shall have an emittance of 0.05 or less when the installation of a radiant barrier is specified on the CFI R. Minimum R-30 insulation in wood -frame ceiling; or the weighted average U -factor shall not exceed 0.031. Minimum R-19 in a § 150.0(a): rafter roof alteration. Attic access doors shall have permanently attached insulation using adhesive or mechanical fasteners. The attic access shall be gasketed to prevent air leakage. § 150.0(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -value. Minimum R-13 insulation in 2x4 inch wood framing wall or have a U -factor of 0.102 or less (R-19 in 2x6 or 0.074 maximum U - §150.0(c): factor). §150.0(d): Minimum R-19 insulation in raised wood -frame floor or 0.037 maximum U -factor. In Climate Zones 14 and 16 a Class II vapor retarder shall be installed on the conditioned space side of all insulation in all exterior §150.0(g)l: walls, vented attics and unvented attics with air -permeable insulation. In Climate Zones 1-16 with unvented crawl spaces the earth floor of the crawl space shall be covered with a Class I or Class II § 150.0(g)2: vapor retarder. In a building having a controlled ventilation crawl space, a Class I or Class II vapor retarder shall be placed over the earth floor of §150.0(g)3: the crawl space to reduce moisture entry and protect insulation from condensation, as specified in the exception to Section 150.0(d). §150.0(1): Slab edge insulation shall: have a water absorption rate, for the insulation material alone without facings, no greater than 0.3%; have water vapor permeance rate is no greater than 2.0 perm/inch, be protected from physical damage and UV light deterioration; and when installed as part of a heated slab floor meets the requirements of § 110.8 150.0 (q)' Fenestration, including skylights, separating conditioned space from unconditioned space or outdoors shall have a maximum U - factor of 0.58; or the weighted average U -factor of all fenestration shall not exceed 0.58. Fireplaces, Decorative Gas Appliances and Gas Log Measures: § 150.0(e)IA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150.0(e)1B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a readily accessible, operable, and tight -fitting damper or a combustion -air control device. §150.0(e)1C: Masonry or factory -built fireplaces have a flue damper with a readily accessible control. § 150.0(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: § 110.0-§ 110.3: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified to the Energy Commission. § 110.3(c)5: Water heating recirculation loops serving multiple dwelling units meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of §I 10.3(c)5. Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appli- § 110.5: ances without an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a heaters. §150.0(h)1: Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA using design conditions specified in § 150.0(h)2. § 150.0(h)3A: Installed air conditioner and heat pump outdoor condensing units shall have a clearance of at least five feet from the outlet of any dryer vent. § 150.0(i): Heating systems are equipped with thermostats that meet the setback requirements of § 110.2(c). §150.00)IA: Storage gas water heaters with an energy factor equal to or less than the federal minimum standards shall be externally wrapped with insulation having an installed thermal resistance of R-12 or greatE. §150.0(j)1B: Unfired hot water tanks, such as storage tanks and backup storage tanks for solar water -heating systems, have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. For domestic hot water system piping, whether buried or unburied: the first 5 feet of hot and cold water pipes from the storage tank, all piping with a nominal diameter of 3/4 inch or larger, all piping associated with a domestic hot water recirculation system §150.00)2A: regardless of the pipe diameter, piping from the heating source to storage tank or between tanks, piping buried below grade, and all hot water pipes from the heating source to kitchen fixtures must be insulated according to the requirements of TABLE 120.3- A. §150.00)2B: All domestic hot water pipes that are buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. 2013 Low -Rise Residential Mandatory Measures Summary Pipe for cooling system lines shall be insulated as specified in § I50.00)2A. Piping insulation for steam and hydronic heating §150.00)2C: systems or hot waters stems with pressure > 15 psig shall meet the requirements in TABLE 120.3-A. § 150.00)3: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Insulation exposed to weather shall either be rated for outdoor use or installed with a cover suitable for outdoor service. For §150.06)3A: example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation protected as specified or painted with coating that is water retardant and provides shielding from solar radiation that degrades the material. Insulation covering chilled water piping and refrigerant suction piping located outside the conditioned space shall have a Class I § 150.06)3B: or Class lI vapor retarding facing, or the insulation shall be installed at the thickness that qualifies as a Class I or Class II vapor retarder. Systems using gas or propane water heaters to serve individual dwelling units shall include: a 120V electrical receptacle within 3 feet of the water heater; a Category III or IV vent, or a Type B vent with straight pipe between the outside termination and the §150.0(n)l: space where the water heater is installed; a condensate drain that is no more than 2 inches higher than the base of the installed water heater, and allows natural draining without pump assistance; and a gas supply line with a capacity of at least 200,000 Btu/hr. §150.0(n)2: Recirculating loops serving multiple dwelling units shall meet the requirements of §I 10.3(c)5. Solar water -heating systems and collectors shall be certified and rated by the Solar Rating and Certification Corporation (SRCC) § 150.0(n)3: or by a testing agency approved by the Executive Director. Ducts and Fans Measures: All air -distribution system ducts and plenums installed are sealed and insulated to meet the requirements of CMC §601.0, §602.0, §603.0, §604.0, §605.0 and ANSI/SMACNA-006-2006 HVAC Duct Construction Standards Metal and Flexible 3rd Edition. Supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-6.0 (or higher if required by CMC §605.0) or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing (RA3.1.4.3.8). Connections of metal ducts and inner core of flexible ducts are mechanically fastened. Openings shall be sealed § 150.0(m)l: with mastic, tape, or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. Factory -Fabricated Duct Systems shall comply with specified requirements for duct construction, connections, and closures; joints §150.0(m)2: and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. Field -Fabricated Duct Systems shall comply with requirements for: pressure -sensitive tapes, mastics, sealants, and other §150.0(m)3-6: requirements specified for duct construction; duct insulation R -value ratings; duct insulation thickness; and duct labeling. All fan systems that exchange air between the conditioned space and the outside of the building must have backdraft or automatic §150.0(m)7: dampers. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers § l 50.0(m)8: except combustion inlet and outlet air openings and elevator shaft vents. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not §150.0(M)9: limited to the following: insulation exposed to weather shall be suitable for outdoor service. For example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation. §150.0(m)10: Flexible ducts cannot have porous inner cores. When space conditioning systems use forced air duct systems to supply conditioned air to an occupiable space, the ducts shall be § 150.0(m)11: sealed and duct leakage tested, as confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Mechanical systems that supply air to an occupiable space through ductwork exceeding 10 feet in length and through a thermal § l 50.0(m)12: conditioning component, except evaporative coolers, shall be provided with air filter devices that meet the requirements of §150.0(m)12. Space conditioning systems that utilize forced air ducts to supply cooling to an occupiable space shall have a hole for the placement of a static pressure probe (HSPP), or a permanently installed static pressure probe (PSPP) in the supply plenum. The §150.0(m)13: space conditioning system must also demonstrate airflow >_ 350 CFM per ton of nominal cooling capacity through the return grilles, and an air -handling unit fan efficacy <_ 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Zonally controlled central forced air cooling systems shall be capable of simultaneously delivering, in every zonal control mode, an airflow from the dwelling, through the air handler fan and delivered to the dwelling, of > 350 CFM per ton of nominal cooling §150.0(m)15 capacity, and operating at an air -handling unit fan efficacy of:5 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. All dwelling units shall meet the requirements of ASHRAE Standard 62.2. Neither window operation nor continuous operation of § 150.0(0): central forced air system air handlers used in central fan integrated ventilation systems are permissible methods of providing the Whole Building Ventilation. § 150.0(o)IA: Whole Building Ventilation airflow shall be confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Pool and Spa Heating Systems and Equipment Measures: Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency § 110.4(a): Regulations; an on-off switch mounted outside of the heater that allows shutting off the heater without adjusting the thermostat setting; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating. 2011 Law -Rice Residential Mandatory Measures Summary Any pool or spa heating equipment shall be installed with at least 36 inches of pipe between filter and heater or dedicated suction §I 10.4(b)1: and return lines, or built-up connections for future solar heating. § 110.4(b)2: Outdoor pools or spas that have a heat pump or gas heater shall have a cover. Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or pro - § 110.4(b)3: rammed to run only during off-peak electric demand periods. § 110.5: Natural gas pool and spa heaters shall not have a continuous burning pilot light. §150.0(p): Residential pool systems or equipment shall meet specified pump sizing, flow rate, piping, filters, and valve requirements. Lighting Measures: § 110.9: All lighting control devices and systems, ballasts, and luminaires shall meet the applicable requirements of § 110.9. Installed luminaires shall be classified as high -efficacy or low -efficacy for compliance with § 150.0(k) in accordance with TABLE §150.0(k)IA: 150.0-A or TABLE 150.0-B, as applicable. When a high efficacy and low efficacy lighting system are combined in a single luminaire, each system shall separately comply §150.0(k)IB: with the applicable provisions of § 150.0(k). The wattage and classification of permanently installed luminaires in residential kitchens shall be determined in accordance with § 130.0(c). In residential kitchens, the wattage of electrical boxes finished with a blank cover or where no electrical equipment has § 150.0(k)1C: been installed, and where the electrical box can be used for a luminaire or a surface mounted ceiling fan, shall be calculated as 180 watts of low efficacy lighting er electrical box. §150.0(k)1D: Ballasts for fluorescent lamps rated 13 watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. Permanently installed night lights and night lights integral to installed luminaires or exhaust fans shall be rated to consume no §150.0(k)IE: more than 5 watts of power per luminaire or exhaust fan as determined in accordance with § 130.0(c). Night lights do not need to be controlled by vacancy sensors. Lighting integral to exhaust fans (except when installed by the manufacturer in kitchen exhaust hoods) shall meet the applicable § 150.0(k)IF: requirements of § 150.0(k). § 150.0(k)2A: High efficacy luminaires must be switched separately from low efficacy luminaires. §150.0(k)2B: Exhaust fans shall be switched separately from lighting systems. § I50.0(k)2C: Luminaires shall be switched with readily accessible controls that permit the luminaires to be manually switched ON and OFF. § 150.0(k)2D: Controls and equipment are installed in accordance with manufacturer's instructions. § 150.0(k)2E: No control shall bypass a dimmer or vacancy sensor function if the control is installed to comply with § I50.0(k). § 150.0(k)2F: Lighting controls comply with applicable requirements of § 110.9. An Energy Management Control System (EMCS) may be used to comply with dimmer requirements if. it functions as a dimmer § 150.0(k)2G: according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in §150.0(k)2. An Energy Management Control System (EMCS) may be used to comply with vacancy sensor requirements of § I50.0(k) if. it § 150.0(k)2H: functions as a vacancy sensor according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in § 150.0(k)2. A multiscene programmable controller may be used to comply with dimmer requirements of this section if it provides the § I50.0(k)2I: ftinctionality of a dimmer according to § 110.9, and complies with all other applicable requirements in § 150.0(k)2. § 150.0(k)3A: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. Kitchen lighting includes all permanently installed lighting in the kitchen except internal lighting in cabinets that illuminate only §150.0(k)3B: the inside of the cabinets. Lighting in areas adjacent to the kitchen, including but not limited to dining and nook areas, are considered kitchen lighting if they are not separately switched from kitchen lighting. Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated § I50.0(k)4: cabinet. A minimum of one high efficacy luminaire shall be installed in each bathroom; and all other lighting installed in each bathroom § I50.0(k)5: shall be high efficacy or controlled by vacancy sensors. Lighting installed in attached and detached garages, laundry rooms, and utility rooms shall be high efficacy luminaires and § 150.0(k)6: controlled by vacancy sensors. §150.0(k)7: Lighting installed in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy, or shall be controlled by either dimmers or vacancy sensors. Luminaires recessed into ceilings shall: be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; have a label that certifies that the luminaire is airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; be sealed with a gasket or caulk between the luminaire housing §150.0(k)8: and ceiling, and shall have all air leak paths between conditioned and unconditioned spaces sealed with a gasket or caulk; and allow ballast maintenance and replacement without requiring cutting holes in the ceiling. For recessed compact fluorescent luminaries with ballasts to qualify as high efficacy for compliance with § 150.0(k), the ballasts shall be certified to the Energy Commission to comply with the applicable requirements in § 110.9. For single-family residential buildings, outdoor lighting permanently mounted to a residential building or other buildings on the same lot shall be high efficacy, or may be low efficacy if it meets all of the following requirements: i. Controlled by a manual ON and OFF switch that does not override to ON the automatic actions of Items ii or iii below; and § 150.0(k)9A: ii. Controlled by a motion sensor not having an override or bypass switch that disables the motion sensor, or controlled by a motion sensor having a temporary override switch which temporarily bypasses the motion sensing function and automatically reactivates the motion sensor within 6 hours; and iii. Controlled by one of the following methods: 2013 Low -Rise Residential Mandatory Measures Summary a. Photocontrol not having an override or bypass switch that disables the photocontrol; or b. Astronomical time clock not having an override or bypass switch that disables the astronomical time clock, and which is programmed to automatically turn the outdoor lighting OFF during daylight hours; or c. Energy management control system which meets all of the following requirements: At a minimum provides the functionality of an astronomical time clock in accordance with § 110.9; meets the Installation Certification requirements in § 130.4; meets the requirements for an EMCS in § 130.5; does not have an override or bypass switch that allows the luminaire to be always ON; and, is programmed to automatically turn the outdoor lighting OFF during daylight hours. For low-rise multifamily residential buildings, outdoor lighting for private patios, entrances, balconies, and porches; and outdoor lighting for residential parking lots and residential carports with less than eight vehicles per site shall comply with one of the §150.0(k)9B: following requirements: i. Shall comply with § 150.0(k)9A; or ii. Shall comply with the applicable requirements in § 110.9, § 130.0, § 130.2, § 130.4, § 140.7 and § 141.0. For low-rise residential buildings with four or more dwelling units, outdoor lighting not regulated by § 150.0(k)9B or 150.0(k)9D § 150.0(k)9C: shall comply with the applicable requirements in § 110.9, § 130.0, § 130.2, § 130.4, § 140.7 and § 141.0. Outdoor lighting for residential parking lots and residential carports with a total of eight or more vehicles per site shall comply § 150.0(k)9D: with the applicable requirements in §110.9, § 130.0, §130.2, § 130.4, §140.7 and § 141.0. Internally illuminated address signs shall comply with § 140.8; or shall consume no more than 5 watts of power as determined §150.0(k)10: according to §130.0(c). Lighting for residential parking garages for eight or more vehicles shall comply with the applicable requirements for § I50.0(k)l 1: nonresidential garages in § 110.9, § 130.0, § 130. 1, § 130.4, § 140.6, and § 141.0. In a low-rise multifamily residential building where the total interior common area in a single building equals 20 percent or less of § 150.0(k)12A: the floor area, permanently installed lighting for the interior common areas in that building shall be high efficacy luminaires or controlled by an occupant sensor. In a low-rise multifamily residential building where the total interior common area in a single building equals more than 20 percent of the floor area, permanently installed lighting in that building shall: i. Comply with the applicable requirements in § 110.9, § 130.0, § 130. 1, § 140.6 and § 141.0; and § 150.0(k)12B: ii. Lighting installed in corridors and stairwells shall be controlled by occupant sensors that reduce the lighting power in each space by at least 50 percent. The occupant sensors shall be capable of turning the light fully On and Off from all designed paths of ingress and egress. Solar Ready Buildings: Single family residences located in subdivisions with ten or more single family residences and where the application for a § 110.10(a)1: tentative subdivision map for the residences has been deemed complete, by the enforcement agency, on or after January 1, 2014, shall comply with the requirements of § 110.10 through § 110.10 e . § 110.10(a)2: Low-rise multi -family buildings shall comply with the requirements of § 110.10(b) through § 110.10(d). The solar zone shall have a minimum total area as described below. The solar zone shall comply with access, pathway, smoke ventilation, and spacing requirements as specified in Title 24, Part 9 or other Parts of Title 24 or in any requirements adopted by a local jurisdiction. The solar zone total area shall be comprised of areas that have no dimension less than 5 feet and are no less than 80 square feet each for buildings with roof areas less than or equal to 10,000 square feet or no less than 160 square feet each for § 110.10(b)1: buildings with roof areas greater than 10,000 square feet. For single family residences the solar zone shall be located on the roof or overhang of the building and have a total area no less than 250 square feet. For low-rise multi -family buildings the solar zone shall be located on the roof or overhang of the building or on the roof or overhang of another structure located within 250 feet of the building or on covered parking installed with the building project and have a total area no less than 15 percent of the total roof area of the building excluding any skylight area. § 110.10(b)2: All sections of the solar zone located on steep -sloped roofs shall be oriented between 110 degrees and 270 degrees of true north. No obstructions, including but not limited to, vents, chimneys, architectural features, and roof mounted equipment, shall be § 110.10(b)3A: located in the solar zone. Any obstruction, located on the roof or any other part of the building that projects above a solar zone shall be located at least twice § 110.10(b)3B: the distance, measured in the horizontal plane, of the height difference between the highest point of the obstruction and the horizontal projection of the nearest point of the solar zone measured in the vertical plane. For areas of the roof designated as solar zone, the structural design loads for roof dead load and roof live load shall be clearly § 110.10(b)4: indicated on the construction documents. The construction documents shall indicate: a location for inverters and metering equipment and a pathway for routing of conduit § 110.10(c): from the solar zone to the point of interconnection with the electrical service (for single family residences the point of interconnection will be the main service panel); a pathway for routing of plumbing from the solar zone to the water -heating system. A copy of the construction documents or a comparable document indicating the information from § 110.10(b) through § 110.10(c) § 110.10(d): shall be provided to the occupant. § 110.10(e)1: The main electrical service panel shall have a minimum busbar rating of 200 amps. The main electrical service panel shall have a reserved space to allow for the installation of a double pole circuit breaker for a § 110.10(e)2: future solar electric installation. The reserved space shall be: positioned at the opposite (load) end from the input feeder location or main circuit location, and permanently marked as "For Future Solar Electric". HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Date Pearl Residence 9/15/2015 System Name Floor Area Res HVAC 1,622 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL CFM Total Room Loads 1,021 Return Vented Lighting Return Air Ducts Return Fan Ventilation 0 Supply Fan Supply Air Ducts COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output per System 55,000 21,076 911 777 29,762 Total Output Btuh 55,000 0 Output Btuh/s ft 33.9 956 1,653 Cooling System 0 0 Output per System 36,000 0 0 0 0 Total Output Btuh 36,000 0 0 Total Output (Tons) 3.0 956 1,653 Total Output Btuh/sgft 22.2 TOTAL SYSTEM LOAD 911 Total Output s ft/Ton 540.7 22,988 33,067 Air System CFM per System 1,050 HVAC EQUIPMENT SELECTION Airflow cfm 1,050 Res HVAC 27,752 6,475 55,000 Airflow cfm/sgft 0.65 Airflow cfm/Ton 350.0 Outside Air %) 0-0% Total Adjusted System Output (Adjusted for Peak Design conditions) 27,7521 6,4751 55,000 0.00 Outside Air cfm/sgft TIME OF SYSTEM PEAK Aug 3 PM Jan 1 AM Note: values above given at ARI conditions HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 28 OF 67 OF 67 OF 105 OF Outside Air 0 cfm Supply Fan Heating Coil 104 OF 1,050 cfm --22 ROOM 67 OF 68 IF COOLING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Cooling Peak 88 / 68 IF 76 / 62 OF 7676 /�62 OF 55 / 54 OF f Outside Air Ar_ 0 cfm Supply Fan Cooling Coil 56 / 54 OF 1,050 cfm 46.3% ROOM 76 / 62 OF 75 / 61 OF EnergyPro 6.7 by EnergySoft User Number: 5748 RunCode: 2015-09-15T15:17:05 ID: 23803 Page 14 of 14 STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O„ BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 " FAX (408) 777-3333 • building recupertino,oro SITE ADDRESS APN BP# Owner.. ..!. ..r...... .......... ��5 Contractor....................................................................................................... .................... Address/Q.1§-(a..., .5b� Address...................................................................................................... City/St a�4R ....... �.,42.... ( s!J.... Zip.. q.50....t.... Phonk". City/St................................................. Zip ................... Phone ....,.......... ..... Owner Name: / Applicant .......� 4•�i....�... �................................................. BCA Structural Engineers Inc. Engineer/Architect ......................... ................................. ...... 1 Address /D.aa! ., -....'a ..1.......4�r..................................... �r.�/..`... SA Address... 1300 Industrial Road Suite 1 ...... City/St.11,tJ�.R!'.Ae.AV... - zip..11.59..1..'yE......... Phone .. ..... City/St..San Carlos, CA Zip94070.., phone PROJECT DESCRIPTION: 220 s.f. room addition and home remodel This "STATEMENT OF SPECIAL INSPECTIONS" is submitted in fulfillment of the requirements of CBC Sections 1704 and 1705. is form is structured after and used by permission from the Structural Engineer Association of Northern California's (SEAONC) mode statement of Special Inspections. Also, included with this form is the following: von ❑ "LIST OF SPECIAL INSPECTION AGENCIES (page 2). A list of testing agencies and other special inspectors that will be retained to conduct the tests and inspections for this project ❑ "SCHEDULE OF SPECIAL INSPECTION" (page 3 —6). The Schedule of Special Inspections summarizes the Special Inspections and tests required. Special Inspectors will refer to the approved plans and specifications for detailed special; inspection requirements. Any additional tests and inspections required by the approved plans and specifications shall also ' be performed.' ` Special Inspections and Testing will be performed in accordance with the approved plans and specifications, this statement and CBC Sections 1704, 1705, 1706, 1707, and 1708. Interim reports will be submitted to the B�iing Official and the Registered Design MU Professional in Responsible Charge In accordance with CBC Section 1704.1.2. t t' A Final Report of Special Inspections documenting required Special Inspections, testing and correction o(Zt )iscrepancies noted in=. the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). The Final Report will document: • Required special inspections. 49L- • Correction of discrepancies noted in inspections. The Owner recognizes his or her obligation to ensure that the construction complies with the app -permit documents and to implement this program of special inspections, In partial fulfillment of these obligations, the Owner will retain and directly pay for the Special Inspections as required in CBC Section 1704.1. This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special inspection activities on the job site to assure that the Special Inspectors are qualified and are performing their duties as called for in this Statement of Special Inspection. • Review submitted inspection reports. • Perform inspections as required by the local building code. £ have read and agree to comA£Y with the terms and conditions of this statement Prepared By: I' Project Engineer Ll Architect S3662 9/16/15 Registered Des Professional in Charge Signature ................. ................ ... ..... — ...... ........... Llc.#....................................... Date:.......................... Owner Name: Authorization 21 SinaturOwners Date: _ 1r.`.*P..r �..�?. Inspection Agency! Inspector Name: Ins ions HP ect P . Sign ature --Y .. • .a....... ................ Lic.#....................................... Date:....... Building Official or designee: Signature............................................................................... Date:...........,.............. =IV6?rn 70Atrf vised 09/06/12 f LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Each special inspection agency, testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency's listed on this form must be pre -approved and listed on Cupertino's approved Special Inspector's list. Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspection Agencies. No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order" and possible permit revocation. To be pre- approved by the City of Cupertino, refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process. The fo!!owinn are the testinn anri ,npnial insnertion agencies that will be retained to conduct tests and inspection on this project: EXPERTISE FIRM / INSPECTOR INFORMATION 1. Special Inspection (except for geotechnical) Firm.HP It15peCtIOt15.................................... city.. san JOS2 Addr.69Q.SUng15T .Bldg,,H........................................... .. State .CA ... Zip .95216 Telephone. 4P8.-.28.8.-.8.4.6.0 ...... Fax.408, 271 0902 Email.. jOS�.y..@.ilp.'ll?.Sp.e.G.IQ.n.S.IC?.G,G 2. Material Testing Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone.......................................Fax............................................ Email......................................................... 3. Geotechnical Inspections Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax............................................ Email......................................................... 4. Other: Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... *All agencies specified on this form must be pre -approved and listed on the City of Cupertino's Approved Special Inspector's List. SEISMIC REQUIREMENTS (Section 1705.3.6) Description of seismic -force -resisting system and designated seismic systems subject to special inspections as per Section 1705.3: The extent of the seismic -force -resisting system is defined in more detail in the construction documents. 1NINU KtUUIKtMtN I J Description of main wind -force -resisting system and designated wind resisting components subject to special inspections in accordance with Section 1705.4.2: The extent of the main wind -force -resisting system and wind resisting components is defined in more detail in the construction documents. SpeeialnspectionForm_2012.doe revised 09/06/12 M SCHEDULE OF SPECIAL INSPECTION SITE ADDRESS 10336 E. Estates Drive APN 235-10-022 BP# PROJECT DESCRIPTION: 220 s.f. room addition and home remodel Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X Is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. --- Denotes an activity that is either a one-time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTIONC P REFERENCED IBC REFERENCE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control _ 1704.3 procedures. INSPECTION OF STEEL 1. Material verification of high-strength bolts, nuts and washers. ❑ Identification marking to conform to ASTM stds AISC 360, specified in the approved construction documents. --- X Section A3.3 and applicable ASTM material standards ❑ Inspect fabricator's fabrication and quality control procedures. 2. Inspection of high-strength bolting: ❑ Snug -tight joints. --- X ❑ Pretensioned and slip -critical joints using turn -of -nut with matchmarking, twist -off bolt or direct tension --- X AISC 360, indicator methods of installation. Section M2.5 1704.3.3 ❑ Pretensioned and slip -critical joints using turn -of -nut without matchmarking or calibrated wrench methods X --- of installation. 3. Material verification of structural steel and cold -formed steel deck. ❑ For structural steel, identification markings to conform X AISC 360, to AISC 360. _ _ Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved --- X material standards construction documents. ❑ Manufacturer's certified test reports. --- X SpecialnspectionForm_2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE 4. Material verification of weld filler materials: ❑ Identification marking to conform to AWS specification in the approved construction documents. -__ X AISC 360, Section A3.5 and applicable AWS A5 documents _ ❑ Manufacturer's certificate of compliance required. --- X --- --- 5. Inspection of welding: a. Structural steel and cold -formed steel deck: ❑ Complete and partial joint penetration groove welds. X --- AWS D1.1 1704.3.1 ❑ Multipass fillet welds. X --- ❑ Single -pass fillet welds > 5/16" X --- ❑ Plug and slot welds. X --- ❑ Single -pass fillet welds <= 5/16" --- X ❑ Floor and roof deck welds. --- X AWS D1.3 b. Reinforcing steel: ❑ Verification of weldability of reinforcing steel other than ASTM A 706. ___ X AWS D1.4 ACI 318: Section 3.5.2 ❑ Reinforcing steel resisting flexural and axial forces in intermediate and special moment frames, and boundary elements of special structural walls of concrete and shear reinforcement. X --- ❑ Shear reinforcement. X --- ❑ Other reinforcing steel. --- X 6. Inspection of steel frame joints details for compliance: ❑ Details such as bracing and stiffening. --- X --- 1704.3.2 ❑ Member locations. --- X ❑ Application of joint details at each connection. --- X VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. --- X --- 1704.3 2. ❑ Welding of cold -formed steel framing members. --- X 3. ❑ Welding of stairs and railing systems. --- X SpecialnspectionFor•m_2012.doe revised 09/06/12 VERIFICATION AND INSPECTION C p REFERENCED STANDARD IREFERENCE IBC INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing --- X ACI 318: 3.5, 7.1-7.7 1913.4 tendons and placement. 2. ❑ Inspection of reinforcing steel welding in accordance AWS D1.4 ACI 318: --- with Table 1704.3 Item 5b. -- 3.5.2 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowableACI X --- 318: 8.1.3, 1911.5, 1912.1 loads have been increased or where strength design 21.2.8 is used. 4. ❑ Inspection of anchors installed in hardened concrete. --- X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. --- X ACI 318: 1904.2.2,1913.2, 1913.3 6. ❑ At time fresh concrete is sampled to fabricate ASTM C 172 specimens for strength tests, perform slump and air X --- ASTM C 31 1913.10 content tests and determine the temperature of the concrete. ACI 318: 5.6, 5.8 7. ❑ Inspection of concrete and shotcrete placement for X --- ACI 318: 5.9, 5.10 1913.6, 1913.7, proper application techniques. 1913.8 8. ❑ Inspection for maintenance of specified curing --- X ACI 318: 5.11-5.13 1913.9 temperature and techniques. 9. Inspection of prestressed concrete: ❑ Application of prestressing forces. X --- ACI 318:18.20 ❑ Grouting of bonded prestressing tendons in the X --- ACI 318: 18.18.4 seismic force -resisting system. 10. ❑ Erection of precast concrete members. --- X ACI 318: Ch. 16 --- 11. ❑ Verification of in-situ concrete strength, prior to stressing of tendons in posttensioned concrete and --- X ACI 318: 6.2 --- prior to removal of shores and forms from beams and structural slabs. 12. ❑ Inspect formwork for shape, location, and dimensions --- X ACI 318: 6.6.1 --- of the concrete member being formed. 13. ❑ Bolts Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. --- X See ICC ES Reports form special inspection requirements for proprietary ❑ Direct tension testing of new bolts. --- X ❑ Torque testing of new bolts. --- X products ❑ Prequalification test for bolts and other types of --- X anchors. 14. IN Other: Installation of epoxy holdown rods into existing foundation stem walls. SpecialnspectionForm_2012.doc revised 09/06/12 SpeciabispectionForm_2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/A CE 6 INSPECTION OF LEVEL 1 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals shall be verified. 2. ❑ Verification of fR, and franc prior to construction --- X --- --- Art. 1.413 except where specifically exempted by this code. 3. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.513.1.b.3 the site for self consolidating grout. 4. As masonry construction begins, the following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar. --- X --- --- Art. 2.6A ❑ Construction of mortar joints. --- X --- --- Art.3.313 ❑ Location of reinforcement, connectors, --- X --- --- Art. 3.4, 3.6A prestressing tendons, and anchorages. ❑ Prestressing technique. --- X --- --- Art. 3.613 ❑ Grade and size of prestressing tendons and --- X --- --- Art. 2.413, 2.4H anchorages. 5. During construction the inspection program shall verify: ❑ Size and location of structural elements. --- X --- --- Art. 3.3F ❑ Type, size, and location of anchors, including Sec Sec . 1.2.2(e), other details of anchorage of masonry to --- X --- 1.16.1 structural members, frames or other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- --- --- ❑ Preparation, construction and protection of masonry during cold weather (temperature below _ X Sec. 2104.3, -__ Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.613 force. 6. Prior to grouting the following shall be verified to ensure compliance: ❑ Grout space is clean. --- X --- --- Art. 3.2D ❑ Placement of reinforcement and connectors and --- X --- Sec. 1.3 Art. 3.4 prestressing tendons and anchorages. ❑ Proportions of site -prepared grout and --- X --- --- Art. 2.613 prestressing grout for bonded tendons. ❑ Construction of mortar joints. --- X --- --- Art. 3.313 7. Grout placement: ❑ Grout placement shall be verified ensure X --- --- --- Art. 3.5 compliance. ❑ Observe grouting of prestressing bonded X --- _-- --- Art 3.6C tendons. SpeciabispectionForm_2012.doc revised 09/06/12 SpecialnspectionForm_2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be --- X 2105.2.2, --- Art. 1.4 observed. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals. 2. ❑ Verification of f'm and f,Ac prior to construction and for every 5,000 square feet during --- X --- --- Art. 1.46 construction. 3. ❑ Verification of proportions of materials in premixed or preblended mortar and grout as --- X --- --- Art. 1.513 delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X --- --- --_ Art. 1.5B.1.b.3 the site for self consolidating rout. 5. The following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar, grout, and --- X --- __- Art. 2.6A prestressing grout for bonded tendons. ❑ Placement of masonry units and construction of --- X --- --_ Art. 3.36 mortar joints. ❑ Placement of reinforcement, connectors and -_- X --- Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. ❑ Grout space prior to grouting. X --- --- --- Art. 3.2D ❑ Placement of grout. X ___ ___ --- Art. 3.5 ❑ Placement of prestressing grout. X --- --- --- Art. 3.6C ❑ Size and location of structural elements. --- X --- --- Art. 3.3F ❑ Type, size, and location of anchors, including other details of anchorage of masonry to X --- _-- Sec.1.2.2(e) --- structural members, frames and other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X--- --- Sec. 2.1.9.7.2, --- 3.3.3.4 (b) ❑ Preparation, construction, and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, ___ Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.66 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be X --- 2105.2.2, --- Art. 1.4 observed. 2105.3 SpecialnspectionForm_2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE INSPECTION OF WOOD 1. ❑ Inspect prefabricated wood structural elements and --- assemblies in accordance with Section 1704.2. ___ -_- 1704.6 2. ❑ Inspect site built assemblies. --- --- 3. Inspect high -load diaphragms: ❑ Verify grade and thickness of sheathing. --- 11 Verify Verify nominal size of framing members at adjoining __- ___ panel edges. --- 1704.6.1 ❑ Verify nail or staple diameter and length, --- --- ❑ Verify number of fastener lines, --- --- ❑ Verify spacing between fasteners in each line and at edge margins. 4. ❑ Metal -plate -connected wood trusses spanning 60 feet or greater: Verify temporary installation restraint/bracing and the permanent individual truss --- X --- 1704.6.2 member bracing are installed in accordance with the approved truss submittal package. REQUIRED VERIFICATION AND INSPECTION OF SOIL 1. ❑ Verify materials below footings are adequate to --- X achieve the desired bearing capacity. 2. ❑ Verify excavations are extended to proper depth and ___ X have reached proper material. 3. ❑ Perform classification and testing of compacted fill -__ X materials. --- Table 1704.7 4. ❑ Verify use of proper materials, densities and lift thicknesses during placement and compaction of X --- compacted fill. 5. ❑ Prior to placement of compacted fill, observe subgrade ___ X and verify that site has been prepared properly. REQUIRED VERIFICATION AND INSPECTION OF DEEP DRIVEN FOUNDATION ELEMENTS 1. ❑ Verify element materials, sizes and lengths comply X --- with the requirements. 2. ❑ Determine capacities of test elements and conduct X --- additional load tests, as required. 3. ❑ Observe driving operations and maintain complete X --- and accurate records for each element. 4. ❑ Verify locations of piles and their plumbness, confirm type and size of hammer, record number of blows per --- Table 1704.8 foot of penetration, determine required penetrations to X --- achieve design capacity, record tip and butt elevations and document any damage to foundation element. 5. ❑ For steel elements, perform additional inspections in --- accordance with Section 1704.3. 6. ❑ For concrete elements and concrete filled elements, perform additional inspections in accordance with --- --- Section 1704.4. SpecialnspectionForm_2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in --- --- --- Table 1704.8 responsible charge. REQUIRED VERIFICATION AND INSPECTION OF CAST -IN-PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X --- accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X --- --- Table 1704.9 adequate end -bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. ___ HELICAL PILE FOUNDATIONS 1. ❑ Record installation equipment used, pile dimensions, X -_- 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE-RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire - resistance design and the approved manufacturer's --- --- written instructions. ❑ Verify minimum ambient temperature before and after ___ X application. _-- 1704.12.1 ❑ Verify ventilation of area during and after application. --- X 2. ❑ Measure average thickness per ASTM E605 and Section 1704.12.4. 3. ❑ Verify density of material for conformance with the approved fire-resistant design and ASTM E605. (Ref. --- --- Section 1704.12.5) 4. ❑ Test cohesive/adhesive bond strength per Section -_ 1704.12.6. --- 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire -Resistant Coating. --- --- --- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing --- --- --- 1704.14 substrate. 3. Special Cases --- --- --- 1704.15 4. Smoke Control System --- --- --- 1704.16 5. Seismic Resistance ❑ Suspended ceiling systems and their anchorage. --- --- --- 1705.3 [4.3] SpecialnspectionForm_2012.doe revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED ST--F--ANDARD IBC REFERENCE 6. Wind Resistance ❑ Roof cladding and roof framing connections. --- --- --- ❑ Wall connections to roof and floor diaphragms and framing. ❑ Roof and floor diaphragm systems, including collectors, drag struts and boundary elements. ❑ Vertical wind -force -resisting systems, including braced frames, moment frames, and shear walls. ❑ Wind -force -resisting system connections to the foundation. ❑ Fabrication and installation of systems or components required to meet the impact resistance requirements --- --- --- of Section 1609.1.2. SPECIAL INSPECTION FOR WIND REQUIREMENTS 1. Structural Wood ❑ Inspect field gluing operations of elements of the main X wind -force -resisting system. --- 1706.2 ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the main windforce-resisting --- X system, including wood shear walls, wood diaphragms, drag struts, braces and hold-downs. 2. Cold -Formed Steel Framing ❑ Welding of elements of the main wind -force -resisting --- X system. ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the main --- 1706.3 wind -force -resisting system including shear walls, --- X braces, diaphragms, collectors (drag struts) and hold- downs. 3. Wind -resisting components ❑ Roof cladding. --- X --- 1706.4 ❑ Wall cladding. --- X SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE 1. ❑ Special inspection for welding in accordance with theX _ 1707.2 quality assurance plan requirements of AISC 341. 2. Structural Wood ❑ Inspect field gluing operations of elements of the X --- seismic-force-resisting system. ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the seismic -force -resisting 1707.3 system, including wood shear walls, wood --- X diaphragms, drag struts, braces, shear panels and hold-downs. 3. Cold -Formed steel light -frame construction ❑ Welding of elements of the seismic -force -resisting X 1707.4 system. SpecialnspectionForm_2012.doc revised 09/06/12 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- - X force -resisting system including shear walls, braces, diaphragms, collectors (drag struts) and hold-downs. 4. Storage racks and access floors ❑ Anchorage of storage racks 8 feet or greater in height _ _ X 1707.5 and access floors. 5. Architectural components ❑ Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet --- X above grade or walking surface. ❑ Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade --- X or walking surface. --- 1707.6 ❑ Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or --- X walking surface. ❑ Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher --- X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components ❑ Inspect anchorage of electrical equipment for X emergency or stand-by power systems. ❑ Inspect anchorage of non -emergency electrical X equipment. ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or --- X --- 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains X hazardous materials. ❑ Inspect installation of vibration isolation systems X where required by Section 1707.7. 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance __- 1707.8 when mechanical and electrical equipment must be seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation --- X --- 1707.9 system per ASCE 7 — Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, --- --- --- 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance ___ 1708.3 requirements in AISC 341. 11. ❑ Obtain certificate that equipment has been seismically 1708.4 qualified. -_- 12. ❑ Obtain system tests as required by ASCE 7 Section 1708.5 17.8. __- --- --- SpeciabispectionForm_2012.doe revised 09/06112