08090022 CITY OF CUPERTINO �".",
r BUILDI<'GDIVISION PERMIT �C,ONTRACT-QR,IATPQRMATION,,
F
PERMIT NO.
ilDlyra,ApOfiFs$fTER WAY - GOGO ROOTER 08090022
OWNER'S
NAME: I FFRMIT ISSUE DATE
KATHY GOULD 2530 BERRYESSA RD STE 509 09/04/2008
lip N@ (408) 282-7026 TASANIRY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG QLECT PLUMB MECH
0 0 0 0
u
-Z CONTRACTOR'S DECLARATION
UM O 1 haraby aalrm deal l ma limessed under i mviaions of chapter 9(eommeneing Job Description
mz1 with section TWO)of Division 3 of the BUBness and PraI nate eode.uul itylican.ta PROP LINE CLEANOUT SEWER LINE
En full farce and a 7/
iq i Lima. IJc.M
= Do comrsnar - ra
ARCHRECI'S DECLARATION
` I understand my plans email W used u public records
;'U
g G� Licensed Prolead ..I
'' 3 OWNER-BUILDER DECLARATION
iy�E - 1 hereby airum that 1 me exam,,fro.the Contractors Licca.Law far the
OO following ma.n.(Section N31.5.Business and Professiom Cada:Any city or county
12V which requires a permit to conswcL aitee.improve,dema1WL an talent my structure
Nor frier th its issuance,also requites the applicant forsuch permiuo Glc a signed statement
pp does he he islicensed psomml Or the provisions of she Contrmwr's uemse Law(Chapter 9 Sq.Ft.Floor Area Valuation
y�g (commencing with section 7000)of Division 3 of the Business and predications Code)or $9000
—
that he is esempt dmaref Len and the basis for she alleged exemption.Any violation of
Section 703IJ by any applicant for a permit subjects the applicant to a civil perlly OfNumber Occupancy wt mart Nan five hundred dollars IS37535064 .' P yT'Pe
❑I,uowner of Ue property,car my wplayw with wguuthcv tele coinpewtion,
will dothewart,Crude:
she Co a notmmnded,Law dA s hot apply i owner
of
and progeny
who
code:The Conuacmr,umve law dem net appy ff sat owner car Required Inspections
pmlem who s.proulbil t at suBerton,and who doesouch work himselfndthrough Iso
town however.me es,pmWdedthatsuchimpmvementaman,near aff completes.
m'leered for ule.U,
builder.Ne buildingmi.pmloovinumid e did oneyeaofcompletion,theowner-
bander wits tive she burden of perms But k dna not build or impow Lar purpose of _
ask.).
❑1.as owner of the property.lytosea iso eeluairelyop property
who contracting with lizmed wnlncmra u SAN
w o cont the prjem(Sec.oats Bwiness and Pm(esslom Cade:)The Cmuxmro LinLime!caw dors sot apply m an owner of lmtopenY who Wi1N or improes therew,and YARY
who conmctafcar such pmjecu wiNacanuacmr(o)lirenxd pvrsu+nsmlhe Conlr+4ors
License few.
❑tete cacmpt undo See .BB PC fm Btta won
Owner Data
WORKER'S COMPENSATION DECLARATION
1 tensity+Rbm under porosity of perjury one of the following decimations:
1 have and will maintain a Certificate of Consent to seif-insure for wmi3Oescampen-
sation,u provided fm by Section 3700 of the Labor Cade,far she pcocrea a or the
work for which this permit is bused.
❑1 base and will maintain Workers compensation Insurance,u required by Section
37W of the Labor Code,for Bu performance of Ute mark far which this permit is issued.
My Warkere Compareadan town cc aroiu and Policy,�nuymhor are. nn//
Cartier: Poll,No.v A 41'
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ThBxctiw need noshccompleteJ dNe permit is farow hundred dolma(SIW)
.less.)
1 Moddy Nal in to ponfo musen of the work for which this permit is issued,l shall ma
employ anype,.n in my.enact.as to Mcamesubject to the Workass'CompemaBan
laws of California.Dam
Applicant
NOTICE To APPLICANT:If.after making this Certificate of Enormous you should
become subject On Lie Workers Compemation provisions of the Lab.Cede,you much
.J z forthwith comply wish such porlso.m or this permit shall ho contract invoked.
z.,O CONSTRUCTION LENDING AGENCY
[—m I hereby affirm Wl Bert ua conswction leading agency fm Be perform.of
W
the work for which this permit Is issued(Sec 3097,Civ.c.)
A Leaches Name
Z)z homes Address
U O I certify that 1 have read Nis+pplicuion veld moth that Be+boa Warned.u
V4 ^ mmamL I Agree m comply with all city and county orcioanm and state laws mlating in
5 SV" building construction,and hereby uNorine repmsmuBm of this city in mm,upon Nee
+hme-mentioned property for inspection purposes.
CLO (Wee)Agrm to save.indemnify and keep harmless the City or Capactins agaiml
t)rat liabilities,judgments.Costs and expenses which may in my way acme Mme,said City
z in consequence of the granting of this permit. r
^ APPLICANT UNDERSTANDS AND WIL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGUIAIM
Re-roofs /
Smgn of pplicanUConuacmrOf 'Et
�J/
HAZARDOUS MATERIAIS DISCLOSURE ate Type of Roof
Wi0 Be applicant er fMuni building o.Chaphhore and
th hvaNmu maerW
u deBoed by IM Cupenine Municipal Cedc.CMpmr 9.13.and Ne HcaiN and Safety
Coca.Sectionus3u+It All roofs shall be inspected prior to any roofing material being installed.
❑Ym //s�y�p�o
Will Nc applicant or fuwm building Occupant use muip.em of devices which If a roof is installed without first obtaining an inspection,I agree to remove
DistrinT�ou ail Conummmu u defined by the Bay Arta Air Omlily Management all new materials for inspection.
❑Ym /�N`a
1 have read the hvardmusmamri d,mquiremmtaunder Chepmrfi.95 aide odife.
Ona lkalNk Sifety Cade,Sevata 25505,25533 and 25534.Iunderand thhifshe Wilding
does net mmemly ham•mnanL dos it u my responsibility m wor,the aeeumum of the
require is which lquh detect 'or m ismveeofa Ccrollmte of I
��y�j Signature of Applicant Date
a..,alalddimdullml Data All roof coverings to be Class'%W'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Elk: Lot:
APN . . . . . . . . : 37535064 . 00
DATE ISSUED. . . . . . . : 09/04/2008
RECEIPT # . . . . . . . . . : BS000005996
REFERENCE ID # . . . : 08090022
SITE ADDRESS . . . . . : 18844 HUNTER WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KATHY GOULD
ADDRESS . . . . . . . . . . : 18844 HUNTER WAY
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : J ADRIAN HODGES
CONTRACTOR . . . . . . . : DUARTE TADEU LIC # 28801
COMPANY . . . . . . . . . . : GOGO ROOTER
ADDRESS . . . . . . . . . . : 2530 BERRYESSA RD STE 509
CITY/STATE/ZIP . . . : SAN JOSE, CA 95132
TELEPHONE . . . . . . . . : (408) 282-7026
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------ ---------- ---------- ---------- ---------- ----------
1.13SE:I:SMICR VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
l.i?RSEWER UNITS 1 . 00 20 . 40 0 . 00 20 . 40 0 . 00
1'f'RAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 102 . 88 0 . 00 102 . 88 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 102 . 88 VISA
---------------
TOTAL RECEIPT 102 . 88
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
1.06 SEWER & WATER 202 UNDERFLOOR PLUMBING
301. ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
•
�go9 0� as
-;, CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPEkTINO PERMIT APPLICATION FORM
APN # 3-J 5 L1/ U Date: Wy/o,
Building Address:
i8$qy ev c
Owner's Name: Phone #:
��Qttiv (j o i l k yo 9V6 707S-
Contractor:
n Phone#:yoa, 2k2- '702,6
C
(50(50 C)0 Q Fax #:
Contact: Phone#: Y1p4�' Z 3c7 708'9
S��ln Fax #:
Contractor License#: 6.56
Cupertino Business License#: Quo
Job Description:
Prope747 ha e c/o se wea 1(n-e
Residential ] Commercial ❑
Valuation:
900—
Project Size: Express ❑ Standard LargeEl Major
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Grou
IPCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
113PREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
IBSEI5MI COM Seismic Commercial p
/ 113SEISMICR Seismic Residential p
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
G
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEkTiNO 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
1PPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
1BUSLIC Business License B
Revised 6-16-08
•
1
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 Points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec) L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrierator, (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 Book Page A2-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is
• not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
A.Site
I1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;60%=4 points up to 4 Resource pts 0
2_Salvage Reusable Building Materials 4 Resource pts y--yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt Y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y--yes 0
!B.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment!Retention 2 Resource pts y=yes 0
! 1 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=yes 0
! 1 !
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber - 3 Resource pts y=yes p
2.Use FSC Certified Wood for iraming
(For every 10%of FSC lumber used=2 points,up to t 0) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilinos 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=Yes 0
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource p'S y=yes p
3.Use Recycled.Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPs)
a.Fioors 3 Ener is
9YP y-yes
b.Wall 0
3 Energy pts y=yes C
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
b.Sheathing 1 Resource pt y=ye; p
• 1 Resource pt Y_-Yes 0
1 0
.6rtenor Ems t
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yes D •
J.FSC Certified Wood 3 Resource pts y=yes 0
`2.Use Treated Wood That Does Not Contain ChromiundArsenic 1 IAQ/Health pt y--yes 0
3.Install House Wrap under Siding 1 IAO/Health pt y=yes 0
14.Use Fiber-Cement Siding Materials 1 Resource of y=yes 0
E.Plumbing
Fl.Inatall Water Heater Jacket _ 1 Energy pt y=yes D
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
I3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
j4.Replace Toilest with Ultra-Low Flush Toilets
Ill point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y--yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts Y--yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAO/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes D
1 1 !
r.t,ecmcar
1.Install Compact Fluorescent Light Bulbs(CFLs)
1(6 bulbs=2 points,10 bulbs=3,points,12 bulbs=4 points) Up to 4 Energy pts. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to •
5 points) Up to 5 Energy pis. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. D
1 ! 1
G.Appliances
1.Install Energy Starbishwasher 1 Energy pt y=yes 0
!2.Install Washing Machine with Water and Energy '
Conservation Features 1 Energy pt y=yes 0
'3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
;4.Install Built-In Recycling Center 3 Resource pts y=yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Enemy pts y=yes 0
'3.Install Recycled-Content,Fiberglass Insulation with
,No Added Formaldehyde 31AQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-ioam)
a.Walls 4 Resource pts y=yes 0
D.Uenings 4 Resource pts y=yes 0
1 1
J I,Windows
1,Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames 2 Energy pts Mas 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes D
11 1
J.Heating Ventilation and Air Conditioning -
1.Use Duct Mastic on All Duct Joints _ 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes D
3.Vent Range Hood to the Outside I IAQ/Health of y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
8,Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes D
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEERl11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrioerants 2 Resource pts Y--yes; D
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yas 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoveslnserts 1 IAQ/Hsalth pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes D
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 4 IAQ/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 0
1
K.Renewable Energy and Roofing 1 1
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 1 B Energy pts
0
6.Select Safe and Durable Roofing Materials _ 1 Resource pt y=yes 0
7,Install Radiant Barrier 3 Energy pts y=yes 0
1 1 1
L.Natural Heating and Cooling
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
D
1 1 1
•
M.In oor it Quality and Finishes d
'1.Use Low/No-VOC Paint 1 IAQ/Health pts y--yes 0
E.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Hsalth pts y=yes 0 •
'3.Use LowNo VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
.7.Seal all Exposed Particleboard or MDF 41AQ/Health pts y--yes D
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
f 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource p!s y=yes0
L2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y--yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y--yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
i 1 !
Total Points Av 1 1401 1301 57
Total Points Project Received: F--T-61 0 •
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•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
4WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
' S72Nk vg 0 cI oaa
OWNER'S NAME: at PHONE # O£S iltP_ cZp 5
GENERAL CONTRACTOR: a o0 4j4 FAX #
I am not using any subcontractors:
Signature / DRte
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
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing o Gro 07 fly
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
ontractor Signature Date