08060251 (2) CITY OF CUPERTINO """",
BUILDING DIVISION PERMIQ—(TjNF0R 'AT'-�1�0M.
PERMIT NO.
BuaRlgr„�gqR LAS ONDAS WAY TBD — TO BE DETERMINED 08060251
OWNER'S NAME: PERMIT ISSUE DATE
GLILABETH MILLER 06/30/2008
NE:
SANITARY NO. CONTROL NO.
ARCHITECTF GINEER: BUILDING PERMIT INFO
REMODEL GARAGE, LAUNDRY, NEW BLDG ELECT PLUMB MECH
non
u00 LICENSED CONTRACTOR'S DECLARATION
f�ZE Imcbyafrrmwlland lismedwholpm�ionsofChapter 9(enent-M;ng --^-----'- --.. -----^-----^--�bDescription
n<ro with Section 7")of Division 3 of dm Business and Professions Cade.aMmyJi .is
a in full force and eifecs _ / J/
i Lcense Class b.r
4;:o Date — Conusotor
pp sssyuuu ARCH CrS DECLARATION
C< I uaWcnund my pima shall W used u public records
JyU
Licensed Prefesswnal
OWNER-BUILDER DECLARATION
E 1 Wmby.Rant.n I I.S.exempt from the Comnctoh License Law for the
o O following nn es a(Sauce 7(5 1.construct,
shear and Pmfessioes Cale:Any city m roomy
j$9 which requires a guano,to"to.the
aptie imMnvu,damn it t m rt�ir my structureet
Zi prior bis,cM,cd .almrequires ihc000kneml for Hoch permit tU,nh.Loo
sutoment
xx< Ihatht lallCenredpurs0a 7to due WO)dDiaii.n3.f Bunibh lJe rmio Chaplcf9 Sq.F[. Floor Area Valuation
eee5R (ewnmenringwiNSuuon7000)MDiasisfrth theeged casand Professions Ca de)or
�`<� that heels emmpt thuefmm W sit baso for IW alkgtA ewnption.Any violation of
Scedoo 7031.5 by any applicant for a permit subjects dm applicant to a civil penalty of APN Number Occupancy Type
ootmane than I,.hundred dolWs($500). Pane Y YP
0 I,u owwr of the pmpexty.m my tmploym with worse u deG sole mmpcnaation,
will do the work.and the structure u not intended ser eifertd forsake(Sec.7W,Business
and Prode:cessions coThe Contractors Lame Law does not apply to an owner of Required Inspections
progeny who buildaurimpmvestherew and whodassuchworkhWaelrar through his
mann employm,provided that such impmvemuu art not intended oroRertd fwsale If.
bowewr,the building or improw ran.is sold within roe year of emopkuon,&a owner.
Wilder will have the burden of proving that he did not Wild or improve for purpose of '
Asks).
0 I,u arner of the progeny w exclusively contracting with licensed contractors to
..,.I one project(Sec.7Wa,Business and Professions Code:)The Contractor's Li-
ccue Law does not apply to in owner of property who builds or improves flAmew,and
who contracts for such projects with a contracton(s)licensed pursuant to the Contractors
License Law.
O lamexempturouSee .B&PCfuthtsrtsson
Owner Dat
WORKERS COMPENSATION DECLARATION
1 hereby aRrn under peaW ty of perjury one or the following declarsuou:
1 hart and will malnain•Cuuficato of Conxm b self-iesurt far WorkersCompen-
woohofor which this a
thiepemit 3]00 a!dto tubas Code,far IW perfarmana of the
is issued.
O I have and will maintain Workers Compensation Whosoa,as required by Section
3700of the Labs Case,for the perfermma erthe work for which this perdu,is issued.
My Workers Compensation htmrena canis and Polity number nae:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Nis section wed not W completod if the permit is farces hundred dollars($180)
or los)
I cenih that in the pufwmena of due wart for which this permit is Wood.l shall not
employ any person many mmncf so u labceoojg}ub'ey ld the Workers'Compenudon
Laws of California.Dip / a. !� Y
NOTICE TO APPLIC�7.IL aft,making this Ccnifa¢of Exemption,you should
become subject to the WoAces Compensation provision of the Labor Code,you most
.,O fordwilh comply with such p ods..or this permit shall W deemed mocked.
Z y CONSTRUCTION LENDING AGENCY
[-+ I hereby alRrm bur there is a construction lending agency for the performance of
Cts the work for which this pemtit is issued(Sa.3097,Civ.C.)
1 Q Undoes None
z finders Address
U Q 1 coolly that 1 have read this application and sats that IW above infotmadun is
, ^ camcL 1 agree b comply with all city and county undinucu and ms laws mladng to
-0 Wilding construction,and hereby anthorin,repancnutiru of this city to en=upon the
W above-mtnuened prnpc a for
And As tion purposes
(~ LL (We)agree to save.indemnity and keep h Wo the
'y of Cupertino Against
to liabiliue;judgmcns.cam and upeuu which may in any autuc agalmtseid City
V Z in ceuequute of theLmnung of ran
^�
APRS1 W L CO WITH ALL NON-POINT Issued by: Date
SO REGULA NS.
Re-roofs
Signa pplicanUCon r Das
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will the applicant or to,.Wilding wcup n shore or lundle haumoes motorial
As defined by the Cupertino Municipal Codc.Chapter 9.12.and the Ifcaph and Safety
Cak,Section 25532(a)? All roofs shall be inspected nor to an roofing material being
Oyer MN. P P Y 8 g installed.
Will the applicant or comm Wilding oatrpent arc tqulpment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
.mit humiou air common,ds as defined by the Bay Arta Air Quality Manabmmenl all new materials for inspection.
District?
0Yes [gym
(hare maJ the hmallousmatoriab mquirtmm rCWptor 6.93ofthc Cilifor-
niceHcelth&Safety Sectio ,t S33 and 34.Iundersundthuif the Wilding
does nal. how ml 1 y ibilllYbwdfY site wnupanl of the
rtquimme which W ssu afactnifcatoofRagmq.jo nature ofApplicant Date
Owwr ushorivcd agent ((�'Dow All roof coverings to be Class'%Q."or better
CITY OF CUPERTINO
• 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36932030 . 00
DATE ISSUED. . . . . . . : 06/30/2008
RECEIPT # . . . . . . . . . : BS000005299
REFERENCE ID # . . . : 08060251
SITE ADDRESS . . . . . : 20071 LAS ONDAS WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ELIZABETH MILLER
ADDRESS . . . . . . . . . . : 20071 LAS ONDAS WY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3132
RECEIVED FROM . . . . : JAN EISENBACH
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS
CITY/STATE/ZIP . . . .
TELEPHONE . . . . . . . . :
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BREMFIXT NO. FIXTURES 2 . 00 61 . 19 0 . 00 61 . 19 0 . 00
1BREMRECEP NO. OUTLETS 4 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BSEISMICR VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1EPERMITFE FLAT RATE 2 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 375 . 64 0 . 00 375 . 64 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 375 . 64 MASTER CARD
-------------- ..
TOTAL RECEIPT 375 . 64
•
CITY OF CUPERTINO
ADDITION/REMODEL
CIT• CUPEI,TINO PERMIT APPLICATION FORM
0�Oco02S�
APN# 32 620 , x, 1 Date: 6 r
—3a_O
Building Address: lJV a
-2"00 71 s- O
Mailing Address (if different from building addres :
Owner's Name: Phone # :
'64— 7 6 —07/7
Contractor: Phone #: Spv� �655-fz
Contractor License #:
Cupertino Business License#:
Contact: JPhone #: p _ � g� ig / 3S 7
Fax #:
Building Permit Info:
Bldg. R Elect. Plumb)a Mech. Hillside ❑
Job Description:
Addition (adding sq footage):
What is being remodeled?
GnkA6E lAulcoeltq f� 3 -Ssst Llia Gun.FG6 4'K15,17N6
AhFi i 2c�dM�o cPE//1 Ur GE �/1<iytYt9 tf/�/6
Remodel Includes Re-Roof: Yes No If yes list number of squares
Remodel Includes Structural: Yes ❑ No
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen Bath Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B Wk II/III/V-A
❑ IUIII B IV-HT V-B t`❑ ...—
Valuation: Please check tbis box if the project is a
second-story addition ❑
Project Size: Ex ress ❑ Standard ❑ Lar e ❑ Major ❑
Please complete relevant portion of the Green Building
Checklist & attach it to the application or if applicable, Green Building Points Achiev
ed-
include in Ian set & the sheet index.
***For Office Use Only***
Over-the-Counter ❑ �� e �^ CO�Nfee Revised 6/16/08
CITY OF CUPERTINO
Sofa ADDITION/REMODEL
CITY OF
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
ADDITIONS 1R3SFDADD
PLLONGRNGR Long Range PL
Planning/Residential
1R31NSP Dwellings Inspections B
1R3PLNCK Dwellings plan check B
1R3REPINSP Dwellings Repeat B
Inspection
1R3REPPLNC Dwellings Repeat Plan B
Check
1R3HINSP Dwellings Hillside B
inspection
1R3HPLNCK Dwellings Hillside plan B
check
1R3HREINSP Dwellings Hillside B
Repeat Inspection •
lR3HREPLNC Dwellings Hillside B
Repeat Plan Check
1R3ALTINSP Dwellings Alternate B
Materials Inspection
1R3ALTPLNC Dwellings Alternate B
Materials Plan Check
1PCESS Cesspool P
1PPRSEWG Ea. Private Sewage P
Disposal System
1PRSEWER Sewers P
1BPSPRINK Lawn Sprinkler/Backflow P
1BPWSVCS Main Water Service P
1BSEISMICRE SeismicResidential B
DECKS 1R3SFDADD OR
IR3SFDREM
1DECKWOOD Deck (Wood)-Each B
(Each) •
1DECKRAIL Deck Railing-Each B
(Each)
CITY OF CUPERTINO
ADDITON/REMODEL
FEESCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
-
Sq Ft
GARAGES 1R3SFDADD OR
1R3SFDREM
1GARDTW<=1K Wood Frame up to B
1,000 SF
1GARDTM<=1K Masonry up to 1,000 SF B
BCONSTAXR Construction Tax Res
(new detached garage)
PATIO'S OPEN 1R3SFDADD OR
1R3SFDREM
1PATIOWOOD Wood Frame up to 300 B
SF
1PATIOMETAL Metal Frame up to 300 B
SF
1PATIOOTHER Other Frame up to 300 SF B
PATIO'S CLOSED 1R3SFDADD OR
1R3SFDREM
IF 1PATIOENCLW Enclosed Wood up to 300 B
SF
1PATIOENCLM Enclosed Metal up to 300 B
SF
1PATIOENCLO Other Enclosed Patio up B
to 300 SF
1COVPORCH Porch Covered-Each B
Each
1REROOFRES Residential Re-roof Each B
100 SF
REMODELS 1R3SFDREM
1REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan
300 SF check
1REMRESBAT Bath Remodel up to 300 B Lf
SF
REMREOTH Other Remodel up to 300 B «
SF
REMODEL PLNCK
1STPLNCK (1-3 for Standard Plan Check B NOT FOR OVER THE
remodel) COUNTER PLAN CKS.
f 3 of 3
y
0 U:A-f, Ito • 1�
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
WINDOW/SLIDING 1R3SFDREM
GLASS DOOR
1 WINREP Replacement windows B
ea 8 windows)
1 WINNEWNSTR New Window (non- B
structural
1WINMEWSTR New Window (Structural B
Shear Wall/Masonry)
1WINBAYSTR Bay Window (Structural) B
SKYLIGHTS 1R3SFDREM
I SKYL<10 SF Skylight less than 10 sf B
]SKYL>10SF Skylight greater than 10 B
sf or structural
ISTAIRS Stairs-first flight/ea addt'I B
•
IEPERMITFEE Electrical Permit Fee E
I IMPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pln E
Ck (hourly)
IMECPLNCK Stand Alone Mechanical M
Pln Ck hour]
1 PLMPLNCK Stand Alone Plumbing P
Pln Ck(hourly)
1 1BSEISMICRE Seismic Residential B
1TRAVD0C Travel & Documentation B •
IBUSLIC Business License B
4of3
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 1-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 Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
•
Plan Review Process Work Book 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 Resources Energy JADIHealth
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;So%=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.ImplementConstruction Site Stormwaler 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 I
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 pis y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesl;; 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumtier 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 kJoists 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 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 pts y--yes 0
6.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
b.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 I.A011tealth
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 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 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 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
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
6.Install Sealed Combustion Units
a.Furnaces 31A0/Health pts y--yes 0
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 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 pis 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 4IA0/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/Heallh pts y=yes p .
1 1 1
K.Renewable 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=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes0
7.Install Radiant Barrier 3 Energy pts y=yes p
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 p
• 1 1 1
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
IOCUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
as O� o� o� � �
OWNER'S NAME: $ ifit//E,c PHONE #
GENERAL CONTRACTOR: Q E FAX #
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
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date