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09100160 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 940 MILLER AVE CONTRACTOR:ATLAS-TRILLO HVAC PERMIT NO:09100160 OWNER'S NAME: WEST VALLEY PRESBYTERIAN CHURCH 1965 KYLE PARK CT DATE ISSUED: 10/23/2009 IER'S PHONE: 4082530735 SAN JOSE,CA 95125 PHONE NO:(408)286-8931 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r— ELECT f— PLUMB License Class C_" Lic.# y 72 J67L (— MECH RESIDENTIAL COMMERCIAL Contractor /`t``� f2,IG1Sl�ate A) 2�-v�' I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE 2 WALL HEATERS (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:$2000 performance of the work for which this permit is issued. 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:37541008.01 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 by: Date. with all non-point source regulations er th upertino Municipal Code,Section 9.18. / Signature G ate / L)` RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is G OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree to remove all new materials for inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: Signature of Applicant: Date: 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, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain a Certificate of Consent to self-insure for Worker's compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material. performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air I have and will maintain Worker's Compensation Insurance,as provided for by contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Section 3700 of the Labor Code,for the performance of the work for which this Health&Safety Code,Sections 25505,25533,and 25534. permit is issued. I certify that in the performance of the work for which this permit is issued,I shall Owner or auth a ,+ G' not employ any person in any manner so as to become subject to the Worker's ate:` Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) APPLICANT CERTIFICATION Lender's Name 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 Lender's Address to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION i• nify and keep harmless the City of Cupertino against liabilities,judgments, C, 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 with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO 7 ITEMS OF 21 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN 37541008 . 01 DATE ISSUED. . . . . . . : 10/23/2009 RECEIPT #. . . . . . . . . : BS000009024 REFERENCE ID # . . . : 09100160 SITE ADDRESS . . . . . : 940 MILLER AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER WEST VALLEY PRESBYTERIAN CHURC ADDRESS 940 MILLER AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : TRILLO RENOVATIONS CONTRACTOR TRILLO, STEVE LIC # 4269 COMPANY ATLAS-TRILLO HVAC ADDRESS . . . . . . . . . . : 1965 KYLE PARK CT CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 286-8931 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 2, 000. 00 1 .00 0. 00 1. 00 0 . 00 1BSEISMICR VALUATION 2, 000. 00 0 .50 0 . 00 0 . 50 0 .00 1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 .00 1MPERMITFE FLAT RATE 1. 00 42 . 00 0 . 00 42 . 00 0 .00 1MRRAA UNITS 2 . 00 126 . 00 0 .00 126 .00 0 . 00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0.00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 .00 0 . 00 42 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 295 .50 0 . 00 295 . 50 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY 0, F C UPERTIN 0 FURTNACE/AC C U Kj I N(D PE RMIT -N-P-PL1C AT ION FORAM civ or -I_J-ld na Address: o- Z-7 via, 4: Contractor Li.cense 4: Cupertino Business-License-�: Contact: U Phone 25 -3 P-T-L t,4 Fax 9: Building Permit Info:' Elect Pium&-Fzi--- Mech Residential V1 Commercial Job Description: C- For Residential Installations: Attic El I't floor� 2nd floor El Adhere to minimum setback requirement E] For Commercial Installations: Replacement same weight 1-1 Additional weight (structural calcs' F-] Structural Calculations required for new installation El New installation Planning Approval Required ❑ Cost of Project: Type of Construon (Usage Class): 10 "Z C) 0 6 uu Strapped F-1 On Platform F-1 Bonded ©-New Location E] Replacement Valuaticn: Green Building: T.Wast attach Green Building C%eck List to Tis applicatuen JTNC) CITY OF CUPERT FURTNACE IINC I F 1�1PEkT]' ,,i FEE SCHEDULE 7-e type ttY F e DFe- _ V-,7Ti -q IJ 4 AC E tvf i r c a I er . ,-a li_tiatung aeating,coo fillg,ab soi ption or cvaporativa cooling systern,incl -installation Qf_c�ontroIs_reguIated_b,-,j-this code. I NICREPALT Commercial for the repair of alt/add to IM ea heating appliance,refrigeratiol'.1 umt,coolilig uiu't,VAV boxes, absorption unit or ea heathing, cooling ID 1__1j absorptioli,or evaporative cooling sys, incl install of controls regulated by this code. IMCSUSHTR Commercial histall/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. IPGASCOM Commerical for ea gas piping System P 1-4 outlets IBPGAS For each gas-piping system of 5 or P more per outlet. IMCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & not 'MCI in an appliance Permit- IBSEISMICO Commercial Seismic B-7 INIRRAA Residential Rep air/Alteration/Add to M ea heating appliance,refrigeration unit, 0 cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1 01 -S Tj S HTR Rcsidential _Tns tall/R elocate �a ,suspended heater,recessed-,;val.l I-Ar, or -Floor mounted unit heater. __R_,_-s'de7,_t;a1 for the Msta1l/­(_- or-atz/ tl_cllac�7_nCnt of'a appliance -,icnt, .int inti 1'ii an a­te CITY OF CUPERTINO FURN-ACE/AC CITY OF FEE SCHEDULE FURINAC'E_ T i 1-4 Outlets _1 7"r -as onrim, 1t I--f" e r llL I MECPL__N_CK Mechanical Plan Check IMFR=<100 Furnace Syst <=100k BTU install or M relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h INFRN>100 Furnace Syst > 100k BTU install or M relocate ea forced-air/gravity type ftu-nace/bumer, incl ducts/vents attached to such appliance over 100,000 Btujh IEPERNTITFEE Electric Permit Fee E 1WERAHTFEE Mechamical Permit Fee M IPPERMITFEE Plumbing, Permit P ITRAVDOC Travel Documentation B IBUSLIC Business License B 'ENTER PROJECT NAME I.Use Solid Wall Systems(Includes SIPS,ICFs,,g;Any Non-Stick frame Assembly) ❑ a.1:10ors i.`,halls ) j HDWS j 5.Reduce Pollution Entering the Home from the Garage t.Tightly Seal the Air Barrer between Garage and Living Area 0 i �.Install Garape Ghaust Fan OR Build a Detached Garage ❑ 5.Design Energy Heels on Trusses(75%of Attic Insulation Height at Outside Edge of Exterior Wall) 7.Design Roof Trusses io Accommodate Ductwork 3.Use Recycied-Content Steel Studs for 90%of Interior Wall Framing !� D 3.i hermal Mass Walls:518-Inch Drywall on All Interior Walls or UNalls`Neighing more han 0.Install Overhangs and Gutters 1.!Ai16 Inch'wcrhanns and Gudem 0 �.Minimum 24-Inch Overhangs and Gutters _ _ 0 t 01al Points:available in Structural i3uildinn Frame and Envelope 3,61 0 �. <.T R10R sTI1VISii 11 %nl rl r y s,rr Use Recycled-Content(No Virgin Plastic)or FSC-('Drt.ified Wood Deckirg u install a Rain Screen}Nall System i❑ Use Durable and Noncombustible Siding Materials 0 _l a.Select Durable and Noncombustible Rooting Materials ) Total Points Available in F-.lerior Finish=71 0 j P'.INSL-LATION —.__--._.-_---- — j Points Availabllr Leasure - 1.Install Insulation with 75%Recycled Content — I a.Walls and/or Floors ❑ l 2.Install Insulation that is Low-Emitting(Certified Section 01350)- —---- -- - - � O ❑ a.'Walls and/or Floors 0 7 ❑ b.Ceilings F F7 3.Inspect Ouality of Insulation Installation before Applying Drywall j 0 1 Total Points Available in Insulation=51 D G.PLUMBING —__ -- _ -- —_ 1 Points Available Per Leasure 1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points), — ❑ a.Insulate Hot Water Pipes from Water Heater to Kitchen 0 1 1 ❑ b.Insulate All Hot Water Pipes _ 0 ❑ c.Use Engineered Parallel Piping ❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop D 1 ❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop 0 1 2 ❑ f.Use Central Core Plumbing 0 1 1 2 ❑ 2.Install Only High Efficiency Toilets(Dual-Flush or 51.28 gpf) 0 T Total Points Available in Plumbing=Total 121 0 H.HEATING,VENTILATION&AIR CONDITIONING —,—, - I Points Available Per Leasure j ❑ 1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendations D 4 2.Install Sealed Combustion Units ❑ a.Furnaces p 2 ❑ b.Water Heaters 0 _ ❑ 3.Install Zoned,Hydronic Radiant Heating with Stab Edge Insulation 0 1 1 ❑ 4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1 5.Design and Install Effective Ductwork ❑ a.Install HVAC Unit and Ductwork within Conditioned Space0 3 Elb.Use Duct Mastic on All Duct Joints and Seams 0 1 ❑ c.Install Ductwork under Attic Insulation(Buried Ducts) 0 1 ❑ d.Pressure Balance the Ductwork System D 1 ❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy ❑ S.Install High Efficiency HVAC Filter(MERV 6+) 0 1 ❑ 7.Don't Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Less Than 60% 0 1 using CSA Standards B.Install Effective Exhaust Systems in Bathrooms and Kitchens ❑ a.Install ENERGY STAR Bathroom Fans Vented to the Outside _0 1 __ ❑ b.All Bathroom Fans Are on Timer or Humidistat ❑ c.Install Kitchen Range Hood Vented to the Outside 0 1 9.Install Mechanical Ventilation System for Cooling(Maximum 4 Points) ❑ a.Install ENERGY STAR Ceiling Fans&Light Kits in Living Areas&Bedrooms 0 1 ❑ b.Install Whole House Fan with Variable Speeds _0 ❑ c.Automatically Controlled Integrated System I- 0 _ ❑ d.Automatically Controlled Integrated System with Variable Speed Control p j 10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points) j ❑ a..Any Whole House Ventilation System That Meets ASHRAE 62.2 0 ❑ b.install Air-to-Air Heat Erchanoer that meets ASHRAE 62.2 _ 0 11.Install Carbon Monoxide Alarms) I 0 _ Total Points Available in Heating,Ventilation antl,Air Conditioning=30� 0 �„ Community Development Y 10300 Torre Avenue {E' ' Cupertino CA 95014 "^ Telephone(408)777-3228 CITY OF Fax(408)777-3333 .:UPEKTINO Building Department JOB ADDRESS: _ PERMIT # OWNER'S NAMEtor-- PHONE # :5, ^3 6 7 GENERAL CONTRACTOR WTL.A- Z, c FAX # I am not using any subcontractors: Signature Date Please check applicable subcontrac s and com lete 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