08070191 CITY OF CUPERTINO .s �7�.�n �'�" ">^ y�' n�,� (`�' F.g�
BUILDING DIVISION - PERMIT ��i-\'1 MIWR�lt�fi' IRMT—IV',1�N
��.R. .'
BUILDING DDRESS: P,RMII'NO.
10211*/ COLD HARBOR AVE MARANATHA PLUMBING COMPANY 08070191
OWNER'S NAME: PERM.'ISSUE DATE
BOON 15193 WOODARD RD 07/28/2008
NE: I ^ _^ O SANITARY NO. CONTROL NO.
ARCHITECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PL0 UMB 0MECH
0 0
000 LICENSED CONTRACTOR'S DECLARATION
uF I Inch,affirm that 1 am lied tender provisions; (m
of Chapter 9 mmencing Job Description
nzl my wlthsmtim 7IX1U)oroiNil.n3orumeudnev aad�rwfwsio 6. myllecueis COPPER RE—PIPE W/WTR SVC REPLCMNT
In
full form and a eel, //
Lkc n , 13c.g BSL RENEWED 7/28/8
Da� Con DEC
iI ARCHITECTS DECLARATION
TION
1 underanand my Plw small be umd as Public record
6
g Liccueo Rvfcssional
0 5 OWNER-BUILDER m Ce Conte ON
0 1 hereby.(Sero that 1 1. exempt from Ile Conmunr's !Any law for the
i°O following rev...(Section 7tommm Business and Re.dean li Cade:Any an m mune,
3 S which mauves a P.also re requires
rot alma improve,&Permit,li,pair any mucture
primmiuisuedlawaaareto the thovisio s;o for suchPermitLicense ned Law(chapter
a Wlkulingwit Pumaw mom of Division
of the,
Beat ter andPrxlaw(Chapmr9 Sq.FI. Floor Area Valuation
E ° 8500
tat he
Smtion7000)of earmsof3 w theeged exemton.Anyavi Code)u
'S 9 Nn io k exempt ranm(rom and 0m buss for we anleyA exemption.Any vlWabon of
Section.1 me 7031.5 five
hw applicant for.permit subjects the applicant m a civil penalty of Number Occu ane e
ter more Urn fie hundred dollen(5300). 36909023 .'`� P YTYP
❑I.u owner of Ile property.a my wployw with wagss u thm'v role eompewtion,
will 4o the wort.and we sense.It net intended or.Ifered fm sale(Sec.7044.Busircu
W Pmrnaon,Cadc The Comes mr's Liaw•c Law doss rot apply m an owner of Required Inspections
property who builds im prows dveon.and who daw,uN wart himself m Uuou{h his -
owo employers,provided that such improvemenu ere rot intended dreamed for sale.U.
however.the building u improvement is sold within orc year of completion.the Wmes-
builder will hove the burden of proving that k did not build or improve for purposa of
sale.).
❑1,u owner of we properly.are exclusively...misting with licensed mnmmm.an
common the project(Sec.7004.Business and Pcoreabou Cnde:)The Conuanor',U. .
muss law da.,not apply m an owner of property who huiWa or improws Wermn.anl.
who co.vma for such paojeeu with aeonuxnr(s)licensed D..I to the Conmacroe.
License law.
O l are eaempt whoa See ,B At PC for Nu man.
Owner Dam
WORKER'S COMPENSATION DECI RATION
1 hereby affirm uWr Family of nodury one of the following declarations:
'it.end will maintain a CuGnwm ofC...,to se f-Wort for Worker',Compen-
.u DroHdM for by Section 3700 of the Labor Code,for the performance of Ne
work for which tout permit u imowd.
0 I have and will maintain darters Compensation Inouanme,u requited by Section
"I of the labor Code,for the perfamunm of the wort rW which thi,permit in issued
My Worker's Compeuadon int mranm canow,and Policy number ane:
Canker. Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thi,scotim nceo rot kcompleteo if Ile petmil k Taxer hutde&done.(5100)
m ku7
I cemih WI in the Mr...N the work for which Nis it u issued 1
cmployanYpen.n o-ymm ser ' es Can
Iaw,.f Califamia Dam
Appli ant
NOTICE TO APPLICANT:IL after making mom of ssmPrion.yo s .,
become subject an the Wohu's Compau+ti provision of Ne Taber Code,you mut
.J O forthwith mmPlY with such Iuovi,iou u this Permit Mail be&awed revoked.
Zy CONSlRUCnON LENDING AGENCY
l hereby slam WU Nem is.conson.tion wralmSagency,for the perforeanaof
(x dec work fm which thin permit is named(Sec.3097,Civ.C.)
Qlender',Name .
Z z alders Add.
U Q I certify that I have end this application and sum than the show irdosmadun i,
Iy mmem I agree m comply with all city and eowhly oNinanal and ser sews mining m
building coummrion,and hereby mthorow represenutivw or Nis ci mmr upon lk
shove-mendonW property for iupenim FsrMwL
(Wer)aye to save.indcmnti(y and tap hay in t a Cv A.,s edam.
C)z Ilabilitin,jWy of a no es which wry in agilvl said city
inconseq .f ting of permit
^ APPLI NT U STA D WILL CO ALL NON-POINT Issued by: Date
SOUR N
Re-roofs
sign pr' li. --
HAZA OUSMATERIALSDISCLOSURE D'm Type of Roof
will Ile appliwnl a fusser.buildn6 oavpmlaort ahanok hnaadou material
u Amo by Ike Cupertino Municipal Code.Chapter 9.12,and the Hwld and Safety
Code.Section 25532(s)? All roofs shall be inspected prior to any roofing material being installed.
❑Yw �do
Will thea applicant or future Wilding omen am mere If a roof is installed without first obtainingan inspection,I agree to remove
PP 6 e equipment Qu or Mann which P g
r hmaNnu air contaminants u donned by the Bay Arose Air Quality Management all new materials for inspection.
Di,micR
❑Yss ANm
I have read we huudas mammals enquire m Pmrd95oflonCalifW-
niaHWNBSaf 75505.25533 UndcmandlMJws Wilding
does r< Nuitum, 'ItY to mtifY tofths
r" mcn ich rpriun, 'Joe, of O� /
�C/ Signature of Applicant Dale
r ma amthmi>nd em Dam All roof coverings to be Class'A}'or better
CITY OF CUPERTINO
• 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36909023 . 00
DATE ISSUED. . . . . . . : 07/28/2008
RECEIPT # . . . . . . . . . : BS000005600
REFERENCE ID # . . . : 08070191
SITE ADDRESS . . . . . : 10217 COLD HARBOR AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BOON
ADDRESS . . . . . . . . . . : 10217 COLD HARBOR AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3326
RECEIVED FROM . . . . : JOHN WALLACE
CONTRACTOR . . . . . . . : JOHN J WOLLACE LIC # 22457
COMPANY . . . . . . . . . . : MARANATHA PLUMBING COMPANY
ADDRESS . . . . . . . . . . : 15193 WOODARD RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE . . . . . . . . : (408) 292-5699
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-------- ---------- ---- --------- ----- ---- -------
1BPWATER UNIT 1. 00 40 . 79 0 . 00 40 . 79 0 . 00
].BPWSVCS WATER SERVICE 1. 00 20 . 40 0 . 00 20 . 40 0 . 00
1BSEISMICR VALUATION 8, 500 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PRREPIPE NO OF FIXTURE 11 . 00 112 . 20 0 . 00 112 . 20 0 . 00
ITRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 365 . 87 0 . 00 365 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 365 . 87 MC
---------------
TOTAL RECEIPT 365 . 87 '
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
----- ---------------------------- ------ -------------------------
301 ROUGH PLUMBING 507 FINAL PLUMBING
•
CITY OF CUPERTINO
San REPIPE/SEWER/MAIN SERVICE
CUPERTINO PERMIT APPLICATION FORM
APN # (D / o �3 , J J Dater
Building Address- Z ' —7 / ) n ��
Owner's Name: Phone#:
C�
Contractor: / % Phone Y94 3a7� -9.S 7 67
Fax #:
Contact: n Phone#:(440"5 -07s?0
(�"�✓1 Fax #:
Contractor License#: '7 /L4 6
Cupertino Business License#: -7,z4s77
Job Description:
Residential Commercial ❑
Valuation:
Project Size: Express Standard ❑ Large Major
Green Building: Please complete relevant portion of the Green Buildin Checklist & attach it to the
application or if applicable, include in plan set & the sheet index. _
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1 BPREPIPE Commercial re-pipe per fixture P 1 CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial p
1BSEISMICR Seismic Residential p
1PRSEWER Residential'building —P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
ZEN- REPIPE/SEWER/MAIN SERVICE
CITY OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
// 1PRREPIPE Residential re-pipe per fixture P 1RPRP
// 1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMTTFEE Plumbing Permit Fee Issuance P
IPLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
/ 1TRAVDOC Travel & Documentation Fee B
f1BUSLIC Business License B
Revised 6-16-08
•
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
e
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11.A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refri erator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
•
Plan Review Process Work Hook Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a"total points"value to a project to be considered environmentally friendly is •
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
INPUT ReSDurces Energy MQ/Health
A. rte
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points_80%=4 points up to 4 Resource pis 0
2.Salvage Reusable Building Materials 4 Resource pts y--yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Matedals/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
B.Foundation
1,Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10% •
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesF;; 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pis y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9,Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
It.Wall 3 Energy pts y=yes 0
C.Roof 3 Energy pts y--yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12,Use OSB
a.Subfloors 1 Resource pt y=yes 0 •
b.Sheathing 1 Resource pt Y--yes 0
1 1
INPUT Resources Energy IAQIHeafth
.Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt yryes DO J.Low-Emissivity(Low-E) 2 Energy pts y=yes
c.Low.Conductivity Frames 2 Energy pts y=yes
2.Install Low Heat Transmission Glazing 1 Energy of y=yes
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Dud Mastic on All Duct Joints 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1.IAQ/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y--yes 0
S.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y--yes 0
b.Water Heaters 31AQ/Heallh pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Healers with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y--yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts Y--yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
ffid
1 I 1
KRenewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=1 B points) Up to 16 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1
L.Natures Heating and Cooling 1 1
1,Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
• 1 1 1
Community Development
10300 Torre Avenue
�J Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
/ca 17 /d or�9( 0io2DI 9i
OWNER'S NAME: �/�/ PHONE
GENERAL CONTRACTOR: h o g C FAX #
I am not using any subcontractors:
"Sign/atiAe Date
Please check applicable subcontrctors 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
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
T'
7 z c
r/ ontractor Signature Date