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CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21700 ALCAZAR AVE CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 13030038 REMODELING OWNER'S NAME: AKHIL SAHAI 681 E BROKAW RD DATE ISSUED:0610512013 OWNER'S PHONE: 4082192196 SAN]OSE,CA 95112 PHONE NO:(408)898-6474 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License Class Lic.#_9 ,� REBUILD(E)FIRST FLOOR OF RESIDENCE(1438 SQ FT) AND GARAGE(443 SQ FT); CONSTRUCT 593 SQ FT 1ST Contractorate 7 FLOOR ADDITION AND 1096 SQ FT SECOND STORY 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. 1 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:$350000 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 APN Number:35719109.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 1 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 DAY M LAST CALLED INSP C ION. 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: Date: with all non-point o cc regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 4 "3 All roofs shall be inspected prior to any roofing material being installed.If a roof is •J installed without first obtaining an inspection,I agree to remove all new materials for I inspection. 11 BUILDER DECLARATION _ ! I hereby affirm tt► Signature of Applicant: Date:am exempt from the Contractor's License Law for one of ---- 4 the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for 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 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 Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authoriz gent: Date&�,Z, permit 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 C TRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that IHer 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 th ermit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address ertify that I have read this application and state that the above information is ,ect.I agree to comply with all city and county ordinances and state laws relating gilding construction,and hereby authorize representatives of this city to enter the above mentioned property for inspection purposes.(We)agree to save unify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION wd expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. g of this permit.Additionally,the applicant understands and will comply non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional Date IsCONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE -CUPERTINO,CA 95014-3255 V_ CUPERTINO (408)777-3228-FAX(408)777-3333-buildingC@cupertino.org ` 3 [:]NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS C A��O G APN# Z�C�7 G� Cj OWNER NAME - HAI / 't0 ` 1 C -^ � E-MAIL STREET ADDRESS CITY,STATE ZIP I _t L FAX Z o� eoAr'� o -,,q CONTACT NAME A(ZPHONE y4 $)9 &17JL/1 Q� E-MAIL C rn STREET ADDRESS CITY,STATE,ZIP [� / / FAX 1,::,5 e C' 2I I Y-01 ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME LICENSE NUMBER LICENSETYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP P NE ARCHITECrlENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES 8a ( USE, TYPE OCC.OCC. SQ.FT. VALUATION EXISTL NPw FLOORDEM rOTAL AREAIU36 AREA AREA NET AREASy ($) BATHROOM (KITCHEN OTHER REMODELAREA REMODEL REODELARE'W 1 U 9 1/ PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: UDETACH 3 ❑ATTACH #DWELLING UNrrs: IS A SECOND UNITS SECOND STORY BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATIO YES K YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RE VE BY: TOT/AL VALUATION: PLANNING ADPL# ❑NO OG R VAL LETTER EICHLER HOME? ❑NO �./�` By my signature below,I certify to eac of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I havvided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating t ilding s ction. I authorize representatives of Cupertino to enter the above-identifteyd property for inspection purposes. Signature of Applicant/Agent: / Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER B ILDINGPLANREVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑MA SS PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ARD PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIR DEPT —Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 21700 Alcazar Ave DATE: 03/08/2013 REVIEWED BY: Mendez APN: BP#: 1,3o3003'9 *VALUATION: 1$350,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? Yes .' No PENTAMATION 1 R3SFDADD USE: OTC. 0 Yes 0 No PERMIT TYPE: WORK Add 2nd storyaddifion of 1096 593 to 1st floor, balcony77 s ftattached garage 37 s ft. remodel SCOPE 1300 sq ft through 1st floor, panel upgrade 200 amp, remove and replace water heater and furnace. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 1,803 $2,640.62 1R3PLNCK $2,167.57 1R31NSP TOTALS: 1,803 $2,640.62 $2,167.57 MECH,HOURLY 0 Yes Q No PLUMB,HOURLY Q Yes 0 No ELEC,HOURLY ( Yes ON Mech.Plan Check hrs $0.00 Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check 0.0 hrs $0.00 0.0 Mech.Permit Fee: 1MPERMIT Plumb.Permit Fee: 1PPERMIT Elec,Permit Fee: IEPERMIT Other Plumb Insp. E7rs $45.00 Other Elec.Insp. E7rs 1 $45.00 Other Mech.Insp. E hrs $45.00 NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prelimina information available and are only an estimate Contact the Dept/or addn 7 info. FEE ITEMS(Fee Resolution 11-053 a.' %1112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,640.62 999 s.f. Remodel,Other Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $601.00 1REMRESOTH PME Plan Check: $0.00 = s.£ Remodel,Kitchen(<=300 sf) Permit Fee: $2,167.57 $600.00 1REMRESKIT Suppl. Insp. Fee:Q Reg. Q OT 0,0 1 hrs $0.00 = # Plumbing PME Unit Fee: $0.00 $27.00 1PRWHEATR Water Heater PME Permit Fee: $135.00 200 amps Electrical Collmoliction .7ir.r: T-7 $45.00 1BELEC200 Services �dirainisttcrtitie l'_�c. 1 ## Mechanical Work Without Permit? C) Yes (F) No $0.00 $133.00 1MFR=<100 Furnace,Forced-Air G Advanced Planning Fee: 1PLLONGR $234.39 Select a Non-Residential 0 Travel Documentation Fee: ITRA VDOC $45.00 Building or Structure 0 Strong Motion Fee: 1BSEISMICR $35.00 Select an Administrative Item Bldg;Stds Commission Fee: 1BCBSC $14.00 SUBTOTALS: $5,271.581$1,406.001 TOTAL FEE:; $6,677.58 Revised: 01/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C O P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 21-100 A CAZ,a.t -AV& PERMIT# 5- 0 0()I OWNER'S NAME: ht\ PHONE# j -D j- GENERAL CONTRACTOR:AM is 01(1 BUSINESS LICENSE # L) L' 33 ADDRESS: p S. \v CITY/ZIPCODE: 19a.I1jvy- $(.2- C *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing S 1(\C 0q 37j Electrical s qoq; Excavation S �' Oq q253 Fencing Flooring /Carpeting qo C q Linoleum/Wood N /� Glass/ Glazing jj Heating ',! Insulation A A q N 5043 �U Landscaping N�N .�y Lathing P�ws> (�, � (J 1 3-:�> Masonry IJ Painting/Wallpaper S (� Paving `S (qs( UCA1Dy) Plastering I)Sa D Vim`) Qz , 3q Plumbing bdrhood Umk)(- G 51 q 3 (1 Roofing `'j Septic Tank t9 ' Sheet Metal NIA Sheet Rock5(� T Tile S n ner/Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR SUBCONTRACTOR LIST kit JOB ADDRESS: PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: 10BUSINESS 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 INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing fi' j - Masonry Painting Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile/ Owner Contractor Signature Date a I 3� 2010 CALGREEN CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR,P.E.,C.B;O., BUILDING OFFICIAL CUPERTlNO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (406)777-3228•FAX(408)777-3333•buildingpcupertino.org PURPOSE: The 2010 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing, factory-built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. Project Name: AKHIL & NEHA Project Address: 21700 ALCAZAR AVENUE Project Description: SINGLE FAMILY REBUILD . Instructions; 1. The Owner or the Owner's agent s e p li e f siotafil experienced with the 2010 California Green Building Standards Codes to veri y re t t a e wprk described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner an deign professional shall initial Column 2 of this checklist, sign and date Section 1 -Design Verification at t�ie,end of this checklist and have the checklist printed on the roved plans for the project. P PP P P 1 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. I Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements A4.1 PLANNING AND DESIGN Planning and Design -Site Preservation 4.104.1 A site plan and inventory of the site is developed and used to minimize j site disturbance in order preserve desirable existing natural resources and 0 ❑ minimize future adverse effects on the proposed structure. Planning and Design -Site Development 4.106.2 A plan is developed and implemented to manage storm water ❑ ❑ drainage during construction. 4.106.3 The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage 0 ❑ system will manage all surface water flows. Pave I of 5 Ca7Green 2010.doe revised 02114/11 r A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. A4.3 WATER EFFICIENCY AND CONSERVATION Indoor Water Use 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the follow methods. ❑X ❑ 0 Water saving fixtures or flow restrictors shall be used per Table 4.303.2. ElA 20 percent reduction in baseline water use shall be demonstrated per 7/01/2011 Table 4.303.1. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not exceed maximum flow rates. 7/01/2011 4.303.3 Plumbing fixtures (water closets and urinals)and fittings(faucets and showerheads)shall comply with specified performance requirements. 7/01/2011 Outdoor Water Use 4.304.1 Automatic irrigation systems installed at the time of final inspection shall be weather-based. A4.4 MATERIAL • • t RESOURCE Enhanced Durability and Reduced Maintenance 4.406.1 Joints and openings.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. Construction Waste Reduction, Disposal and Recycling 4.408.2 Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 An operation and maintenance manual shall be provided to the © E3 building occupant or owner. Page 2 of 5 CalGreen_2010.doe revised 02114111 A4.5 -O Fireplaces 4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑ ❑ burning fireplace,or a sealed woodstove. Pollutant Control 4.504.1 Duct openings and other related air distribution component openings ❑ El be covered during construction. 4.504.2.1 Adhesives,sealants and caulks shall be compliant with VOC and ❑ El toxic compound limits. 4.504.2.2 Paints,stains and other coatings shall be compliant with VOC limits. © ❑ 4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑X ❑ weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit ® ❑ finish materials have been used. 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. ❑X ❑ 4.504.4 Fifty(50)percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance 117771 ❑ Schools (CHIPS)Low-emitting Materials List or be certified under the Resilient Floor Covering Institute(RCFI)FloorScore program. 4.504.5 Particleboard, medium density fiberboard (NIDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde ❑X ❑ emission standards. Interior Moisture Control 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. f 0 ❑ 4.505.3 Moisture content of building materials used in wall and floor framing is ❑ ❑ checked before enclosure. Page 3 of 5 CalGreen 2010.doc revised 02/14/11 Indoor Air Quality and Exhaust 4.506.1 Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum ❑X insulation value of R-4.2. 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-D(Manual D)or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S (Manual S) or equivalent. INSTALLER AND SPECIAL INSPECTOR QUALIFICATIONS Qualifications 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect and verify. Verifications 703.1 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 MX Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 ColGreen_2010.doc revised 02114111 CALGREEN SIGNATURE DECLARATIONS Project Name: AKHIL & NEHA Project Address: 21700 ALCAZAR AVENUE Project Description: SINGLE FAMILY REBUILD 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 have revised 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 2010 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date Owner's Name (Please Print) Design Professional's Signature Date f}Miyp b l l 3 De ' �r fessional's a (Please Print) ell 04/23/2013 Signature of Licpns Professional responsible en compliance Date Miles Hancock (650)424-1189 Name of License Professional responsible for CalGreen compliance(Please Print) Phone energy@pacbell.net 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 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2010.doc revised 02/14111