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15060118I� 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10270 MIRA VISTA RD CONTRACTOR: XU MING AND LIANG PERMIT NO: 15060118 XIAOC HUN OWNER'S NAME: XU MING AND LIANG XIAOCHUN 10270 MIRA VISTA RD DATE ISSUED: 09/01/2015 OWNER'S PHONE: 4087188991 CUPERTINO, CA 95014-2705 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL CONSTRUCT NEW 2 STORY SFD (3319 S.F.) WITH License Class Lic. # ATTACHED 2 CAR GARAGE (494 S.F.) Contractor Date 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. 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: $400000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35702026.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 IO 180 D YS FROM LAST ALLED INSPEC N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, �✓� costs, and expenses which may accrue against said City in consequence of the Issued by: lJ6 �1� Date: granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. RE-ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION Signattire of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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 havelread 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, Sectio 2 505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there 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 this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, 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. i Signature Date f CUPERTINO 9NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION IS506C)I I'S COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildinQ(a-)CUDertino.orQ ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION 1 DEFERRED ORIGINAL PERMIT n PROJECT ADDRESS APN l 6 2� O •i"t i "1= a� �./ 1S `�� 2 �. � `� ^I-- OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX ( C) 2"z � �-t ( r� 'v ', s C, � C v_ vii ; 0 n C �� G1 5z K CONTACT NAME PHONE E-MAIL STREET ADDRESS ss (� co, -t I f� Ur. ra CITY, STATE, ZIP c f' v"f e FAX ❑ OWNER ❑ OWNER-BuT LDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS, LIC R COMPPNY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGI-NEER NAME LICENSE Illrub BER BUS. LIC R COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C � v V �� G� IS 3. 3 19 4- -4- el -r- (4 ) ( (2ti.) is i EXISTING USE PROPOSED USE CONSTRTYPE N STORIES - --_ , 7Z> USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR, DEMO TOTAL AREA AREA 1; , �GI .� AREA NET AREA BATHROOM. KITCHEN.. OTHER. REMODEL AREA REMODEL AREA REMODEL AREA ' PORCH AREA DECK AREA i TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH ' AirACH R DN'ELLINGUNII'S: 15 A SECOND UNITYES SECOND STORY ❑YES BEIN'GADDED? O ADDITION? E]NO PRF. -APPLICATION YES IFYES, PROVIDEcopy OF IS THE BLDG4IQ ❑YES IVED.$ ''-� --. TOTAL VALUATION: PLANNING APPL -, ❑ NO ' PLANNING APPROVALLETTER I EICHLER HOME? \CJlnO 3 ; -;;� r; C, 4•C, By my signature below, I certify to each of the following: I am the property mvrIer or authori d agent to act on the property owner's behalf. I have read this application and the information I have provided 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 relati lding construction. thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: -- — SUPPLEME TFORMATION REQUIRED -01i . �f New SFD or Multifamily dvellings: Apply for demolition permit forte fl BiJILDIIrnG`P1REVIEF4us }ti, existing building(s). Demolition permit is required prior to issuance of building` permit for new building. OVEZZ3ICOIIhTER r _ �xPiEssRM r �AI�fi�rLREvzEiY { cwo>z�cs _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTNDAxD�� I�PUB M4 5 form if any Hazardous Materials are being used as part ofthis project. DTA Copy of Planning Approval Letter or Meeting with Planningprior to c _ submittal of Building Permit application. �y �~ . -� x'�-•,..u.�`-�����.-��=� _ �� �i,�ol:'n�xTA�,xEa%xa - BldgApp_2011.doc revised 06/21/11 ���,--,�� CITY OF CUPERTINO I,.'iZi! FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10270 Mira Vista Rd DATE: 06/17/2015 REVIEWED BY: Paul PC FEE ID APN: 357 02 026 BP#: 01 *VALUATION: 1$400,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: SFD or Duplex 2nd Unit? - Yes '; No PENTAMATION PERMIT TYPE: 1 R3SFDW WORK Construct new 2 Story SFD 3319 S.f. with Attached 2 Car Garage 494 S.f. SCOPE Suppl. Insp. Fee:Q Reg. Q OTT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 3,813 $3,252.54 IR3PLNCK ff $3,440.82 IRMNSP Permit Fee: $3,440.82 Suppl. Insp. Fee:Q Reg. Q OTT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new units $677.77 Adininistr otive Fee: 0 E) Work Without Permit? 0 Yes (F) No $0.00 TOTALS: 3,813 _F$3,252.541 Select a Non -Residential E) Building or Structure 0 A --l' ' $3,440.82 Strom Motion .Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public words, tire, sanitary newer district ocnuut n:..f— ,� 1 W. "Foo " A—,/ — A..—I- u; ---Y infnrma in" availablo and are an1v an estimate. Contact the Dent for addn7 into. FEE ITEMS (Fee Resolution 11-053 E•ff 7/1/13) Ifech. Plan Check 11hnnb. Plan Cheek Eke, Plan Chec(r ;Wech. Pef,mit Fee. Plumb. Permit Fee: 1s'1ec. Permit fire: Other ec•h. Insp. Other Phimb Insp. Li Other L'Ice. Insp. ED-L- ii.,Iech Imp. Fee: Phanh. hasp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public words, tire, sanitary newer district ocnuut n:..f— ,� 1 W. "Foo " A—,/ — A..—I- u; ---Y infnrma in" availablo and are an1v an estimate. Contact the Dent for addn7 into. FEE ITEMS (Fee Resolution 11-053 E•ff 7/1/13) FEE I QTY/FEE MISC ITEMS Plan Check Fee: $3,252.54 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F)Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,440.82 Suppl. Insp. Fee:Q Reg. Q OTT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new units $677.77 Adininistr otive Fee: 0 E) Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee.- IPLLONGR $533.82 Select a Non -Residential E) Building or Structure 0 A Tr urvel DOCUlneralatiOrl Fees: Strom Motion .Fee: IBSEISMICR $52.00 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $16.00 x t `SiTBTOTALSc $7,972.95 $0.00 TOTAL FEE $7,972.95 Revised: 05/07/2015 I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10270 MIRA VISTA RDI COONOTRACTOR: XU MING AND LIANG RW I PERMIT NO: 15060118 I OWNER'S NAME: XU MING AND LIANG XIAOCHUN 10270 MIRA VISTA.RD DATE ISSUED: 09101/2015 OWNER'S PHONE: 4087188991 CUPERTINO, CA 95014-2705 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL Q COMMERCIAL CONSTRUCT NEW 2 STORY SFD (3319 S.F.) WITH License Class Lic. # ATTACHED 2 CAR GARAGE (494 S.F.) Contractor ,- Date 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. 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 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 permit is issued. APPLICANT CERTIFICATION 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 to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). _ I hereby affirm under penalty of perjury one of the following three 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. 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 ,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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed r "v ked. APPLICANT CERTIFICATION 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 to building construction, and -hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. B /r If Sq. Ft Floor Area: I Valuation: $400000 APN Number: 35702026.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 D YS FROM LAST ALLED INSPEC ION. Issued by:u Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, EUCTION ELENDING 25534. Owner or authorized agentDate. C' �l CONSGENCY I herebyaffirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec.. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERT INO ❑ NEVV CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPIdIENT DEPARTMENT • BUILDING DIVISION 0300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingo1cuDeriino.org f i ADDITION ALTERATION t TI VISIO. EFERRED 0RlGIN?.L PEP.h6IT = PROTECT ADDRESSI 102-70 MoL UI'S P31~ r 01YNEtRe r � ] ,n baI PHONE t� v STR ET.ADDPESS& 0- q / F�L - CITY; STATE, ZIP `yy� meg_ (� I FAX POT \ I E -ham TL CONTACT �ha- VI I STREET ADDRESS I CITY, STATE, ZIP FAX �t —4 u lu~ ❑ m , -R ❑ o@,'?;fit-BLZLDER ❑ 0-W.NBRAGENT ❑ CONTRACTOR: ❑ CONTRACTORAGENT ❑ 1,CHnECT ❑ RN-GINEE ❑ DE\c.LOPER ❑ i'=NANT C01� iACTO P.N" / ��—j- LICENSE 1Z71�ER LICEI�SETYPE 3liS.LICr com'PAmy N mE I E_l rL I FAX STREFT.='.DDRESS I CITY, STATE, ZiP I PHO?�'E ?ARCY1TECT/EIeGLN'EER1 A,4E I LICENSEMJ -HER ( BLS. LIC- COMP W. NAM--: I E-ILkIL I FAX STREET ADDRESS -- I CITY, STATE, 7iP I PHONE DESCRIPTION 0'r \k%ORF + - y ,,qp 3 FL--?V'3 Fala�> I CA0 ' Ea15TIN USE PROPOSED USE CONSTR.i�PE., i _ $TORTES j I USETYPE I OCC. I SQ.FT, I VALUATION (S) EXISTG htW FLOORDEI,Sp TOTAL I. I AREA I. AP.EA I hREA I AEf.ARFA BATI-R00?,i KITCHnT' OTTR R�40T�EL ARTA RF, R A3ODEL AREA I PORCr.:_REA DECKAREA TOT.ALDECK?ORCHA:EA. G.L3AGEAREA:- ❑DETACH I. ❑ ATTACH DWE—LNGT20TS - ISASECOND L IT LJ YES SEC OND STORY ❑YrS EELNG.4DDED? E3 --N-0 ADDITION? EIKO PR11 PLICA -10N ❑YES r}ES,PROVDECOPYOF ISTHEBLDG.LK' ❑1. Ei1ED - _ - "T 7" 'MON: PL.A.\">\'L"G.2PL- ❑NO PL.-M":�.L�G.`3PROVALLETTER EICHLERHOASE? ❑'` -; '� rYY By lry signature below, I certi--� to each of the following: I am the prop.,ry owner or authorized agent o act on the property ov:•ner's behalf I have :read this and the information I have govided is correct. I have read the Description of \Mork and \ erify ;t is accurate I agree to comply with all applicable local application oanues agate Ts7e� t ng to i di e cors�lction. I au hon_ze represen �tives of Cuae; ino to enter the aboveria ntlxied prone; y for inspection proposes. tie: ' S sn2ture of Applicantr'A genu I?�FOR_A2ATION RE UIRED ' ,�, _ � W _ r Eh�ENT�L � p\ rR TF-� COL"'�TER C I] BLiLDI1G PL4'� R£STE\S •. r Ae\\� Si -D err ��iultifalm]}% d\\ellin�S �,p_ lv for demolition pernil� for �1�uDg bu Idlllg(s). DemellLon peil'lrt 7S !—Our --d prlCr to issuanceO: 1JLIICIng-. permit i0r ilE\3' bL11d17Q. E1PRE�Sxxl- PL ��iL GPL4 RE\ IE\i x - i15CL~ 1 -: e GOl???ll Cl Clal'Bldgs: Provide a. completed Hazardous 1\4ateilG...s 'J _C:� ❑ ST4 D RD. -. DL�LIC \\ ORhS r _ Tor -_n if airy Hazardous NfFterlals are b :1 g used as pal i c2 th:_ p- OjeCt. i' ; ❑ .: _A RGE rIRE DEPT s Copy of Planning Approval Letter or Meeting -,vitb Planning prior to 3 S Ll�ll.l`� t^ = Oi lllldlilg Perl?llt application. l $ ' EN\IRON TENTAZ EE_4LTi3. Bld.-App-2011.doc revised 06/21/11 CUPERTINO %NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION 1!3C)601113 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • buildingacupertino.oro ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROIECf ADDRESS (02-70 M 1 %� t( IS T� 1� n APN # 3 S -7— a 2 --ZS 2— 4L, OWNERNAME iCt cCtk L T Gi't!) PHONE p n (-4-68) 7 j8.�S4 E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX �b27 f"1tI•q V, n R� CcJ rv►ri C., Q CONTACT NAME �I 1 f�PHONE^� QB �1 ` a E-MAIL STREET ADDRESS c+ (Z6 -IS �Q0de �DY; (d CITY, STATE, ZIP e.. FAX ❑ OWNER ❑ OWNER.BunmER ❑ cwNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCMTECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 19 f- -4-1.4 (,--r .) t�1r 20 _T f 2wd ) .�II��a •3 2 ! 1 SAF � EXISTING USE PROPOSED USE CONSIRTYPE #STORIES . ,Q ­5t—.T> `R 2 USE TYPE OCC. I SQ.FT. VALUATION S ( ) E3ISTG NEW FLOOR- DEMO TOTAL AREA AREA; , -3 /19_.+ AREA NET AREA . BATHROOM. KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA; EIDETACH ATTACH I # DwELI.ING UNITS: ISA SECOND UNIT JWYES SECOND STORY ❑ YES BEING ADDED? 79Z0 ADDITION? ❑NO PRE -APPLICATION XYES IF YES, PROVIDE COPY OF PLANNINGAPPL# ❑NO PLANNING APPROVALLETTER ETCHLERHOME? t[vI0 IS THE BLDG AN ❑ YES40-5,Pi VED�B - — - TOTAL VALUATION: PL-2o(S._p 7T\By my signature below, I certify to each of the follo�aring: I am the property o��mer or authgent to act on the property oti per's behalf. I have read this application and the information I have provided 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 lays relat: ding construction. Ir thorize representatives of Cupertino to enter the above -identified property for inspection purposes. ` Signature of Applicant/Agent: Date: — �^— SUPPLEORMATION REQUIRED New SFD or Multifamily d«,ellingS: Apply for demolition permit for I] O� ERTHE Y i3LhTER REi existing building(s). Demolition permit is required prior to issuance of building permit for new building. .. = �• �=� �� �., .� _r e _ IE `� � �. ,� gyp` J�ANNLNI:TI4N;REiIEW gcompleted=� Commercial Bld s: Provide a Hazardous Materials Disclosure __R� Pude w oxxs fo_rm if any Hazardous Materials are being used as part of this project. -h- -_ Copy of Planning Approval Letter or Meeting with Planning Prior to ��EIItEDEI'7 a- _ submittal of Building Permit application.OR _ �,oR'zssTlucr w BldgApp_2011.doc revised 06/21/11 Fm--] CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10270 Mira Vista Rd DATE: 06/17/2015 REVIEWED BY: Paul PC FEE ID APN: 357 02 026 BP#: ' 'VALUATION: 1$400,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: SFD or Duplex 2nd Unit? Yes No PENTAMATION PERMIT TYPE: 1R3SFD WORK Construct new 2 Story SFD 3319 S.f. with Attached 2 Car Garage 494 S.f. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 3,813 $3,252.54 /R3PLNCK $3,440.82 IR3INSP $0.00 PME Plan Check: $0.00 Permit Fee: $3,440.82 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 3,813 $3,252.54 Construction Tax: IBCONSTAXR $3,440.82 # new units NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS (free Resolution 11-033 Eff 7/1='13) Mech. Plan Check Plumb. Plan Check Elec. Plan Check _„ Permit Fc:e Plumb. Permit Fee: hlec. Permit /: h.E17-- iiher Plumb Insp.E17- Other Elec. I up, I" umb. hisp 1 Elec. Insp. /,,,, NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS (free Resolution 11-033 Eff 7/1='13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,252.54 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. Q OT FO.OThrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,440.82 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # new units $67777 Idministrative P'ee: Work Without Permit? © Yes (j) No $0.00 Advanced Planning Fee. IPLLONGR $533.82 Select a Non -Residential Building or Structure 0 � 7ruvet L)uc°utn�:irhaliora I'e7eS: Strong Motion Fee: IBSEISMICR $52.00 X Select an Administrative Item Bldjz Stds Commission Fee: IBCBSC $16.00 SUBTOTALS: $7,972,95 $0.00 TOTAL FEE: 1 $7,972.95 Revised: 05/07/2015 IK CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10270 MIRA VISTA RD CONTRACTOR: XU MING AND LIANG PERMIT NO: 15060118 XIAOC1-1UN OWNER'S NAME: XU MING AND LIANG XIAOCHUN 10270 MIRA VISTA RD DATE ISSUED: 09/01/2015 OWNER'S PHONE: 4087188991 CUPERTINO, CA 95014-2705 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ CONSTRUCT NEW 2 STORY SFD (3319 S.F.) WITH License Class Lic. # ATTACHED 2 CAR GARAGE (494 S.F.) Contractor Date j )x I hereby affirm that I am licensed under the provisions of Chapter 9 1�� `^ W(► r" (commencing with Section 7000) of Division 3 of the Business & Professions Code license is in full force J /� and that my 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: \'aluation: $400000 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: 35702026.00 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 D YS FROM LAST FALLED INSPEC 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: IJYV Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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. 1 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, Sectio/2 505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Datc:(, C permit is issued. I certify that in the performance of the work for which this permit is issued, I shall VUCTION 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 CONS LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed rev ked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 to building construction, and -hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERT[N0 1 (Z (408) 777-3228 • FAX (408) 777-3333 • buildino�cuaertino.orct ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TIVISIO: EFERP-ED ORIGD-,IAL PERA4IT r 150(Do I 1 y PROJECTADDRESS 10->-70 OZ d M jYA. / I PHONE ( _ l Q _ QR J '-""IL OW' TP. N.41`� kM4 L i a)4 I L k-/ � A %I � O /� jZIP ST2ET. DDPESS l ^ q / CITY, STATE,LUi o 64 'k p . C��/ I FAX `^! f -70CONTACT ?; ),1iF L� PHONE Q J �O � Q I E -J, STREET.4DDRESS I CITY, STATE, ZIP FAJX OWNER ❑ OWNER-BLZLDER ❑ OW'NERAGE-'T ❑ CONTRACTOR ❑ CONIRACTORAGENT ❑ ARCHITECT ❑ ENGMER ❑ DE\ELOPER ❑TENS_ -T COT'TRACTOR NA ; LIC SE ?.'LIBER LICENSE TYPE BUS. LIC # CONPANYNP.Iffi I E-NIAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE .ARCFJTECT/E`NGINEER X -A -ME LICENSE NUABER BUS. LIC 4 CON WNY NAME — E-Ai-iL I FAX STREETADDRESS CITY, STATE, _TIP I PHONE DESCP,IPTION OF 1;'ORK EX1S?i2G L'SE PROPOSED USE CO STRTYPE R STORIESTY us PE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DE3.,0 TOTAL AREA P3tEA AREA NET.4REA I BATEIROOM KITCHEN OTHER REMODELAREA REMODELAREA I REMODEL AREA PORCH.iREA DECK AREA TOTAL DECK'PORCH AREA GARAGF P.RE4: 0 DETACH [].ATTACH DN4'ELLD:G L',\1T5: 15 A SECOND UNIT ❑ YES SECOND STORY ❑YES BELNGADDED? NO ADDITION? ❑NO PRE -.APPLICATION [])-ES IF ITS, PROV DE COPY OF 1S THE BLDG AN ❑ SE Ell ED - .. % 7]ON: ❑A'.' NO PLNLNG.4PPROVALLETTER EICHLERHOME? ❑ NC— r te , I By my si-g-nature below, I certify to each of the folloN; ng: I am the properly owner or authorized agent o act on the property owner's behalf. I have read this application and the in1 uatioa I have p vided is correct. I have read the Description of \�%ork and verify it is accurate. I agree to COLIply with all applicable lo -:al o Eff ing to ' ding construction. I authorize representatives of Cupertino to enter the above -identified pope for inspection purposes. S i of Applicant/Agent.. gnature MENTAL INFOR11ATION REQUIRED N CHECK T PIU _ :. r. ;;e%v SFD or l`4ultifa13iily &vellings: Apply for demolition pen -it for -- .. ,.'z CO[.:'�TEFSLS - — ' `o > lBun-- ,. e Xisting building(s). Demolition pen-llt Is required prior to issuance oI bulldinP permit for new building. permit _ Colnme-Tial Bldzs: Provide a cen;pleted Hazardous Materials Disclosure STANDARn form if any Hazardous Nf2terials are being used as parts of this pro}ect. LARGE i _.. Copy of Planning Approval Letter or b\ eeting with Planning prior to submittal of Building Pennit application. MAJOR E\l'IRO ZuE1TAL F_E.4LT$ Bld.a1pp_2011.doc revised 06121111 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: / 0 2 (J1 r're, V,Stj, 6qv rt,',jPERMIT # j3`©� a // OWNER'S NAME: r4-hL,'evt-t PHONE # 4 D — / — �- GENERAL CONTRACTO : l,�J gr BUSINESS 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 Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork i'S (f �' S yz Cement Finishing AAA $� �'GtC , O2.ExElectrical 3-�' 3o2 - Excavation cavation 3 / -'3 2 Fencing Flooring / Carpeting C4:5*Af l p Q Q Linoleum / Wood '/ ��• -0 4! Glass / Glazing Q rs O q6 / Heating ea 'e Insulation Landscaping y j t 44 OS 7 7 Lathing % �,%31 Masonry Painting / Wallpaper L ',se", ` f-' Rtz 4 0,3 4}4�' Paving Plastering I Va irA p( C a," 3 1441 Plumbing , Q �� Roofing f ' (,✓ YO Septic Tank Sheet Metal , i tiL 3 - Sheet Rock/i� 4- 600,5 t'ru -� ;' f% 3 Q Tile ' ✓GIGf LaMoab a� / % J b Owner / Contractor Signature Date CUPERTINO PURPOSE UTILITY RELEASE REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(a-)cupertino.org For residential single family or duplex construction, there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign -off of the building. INSTRUCTIONS 1. Download this form at: http://www.cupertino.org/index.aspx?page=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax, E -Mail, Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino, CA 95014 building(a),cupertino.org 4. Schedule a Gas Meter Release inspection (#403) and/or Electric Meter Release inspection (#404). Please note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN ?)Eq 0_2 0_�) BLDG PERMIT #: /sobO 6s DATE: SITE ADDRESS: /0-2&) i Ya- Vi S i l'� ✓u I h O �- S01 OWNER'S NAME:' j- Io T, FAX #E #• go — Tt t8 MAILING ADDRESS (if different from site address): CONTRACTOR: PHONE #: FAX #: CONTACT: PHONE #: FAX #: I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they receive all of the required final sign -offs and the City has issued a certificate of occupancy for the building. 7 Owner:.. ................................. Print:.l La ................................... Date:.z ..�..(..I1........... Contractor: ............................ ................................................. Print:......................................................................... Date:.............................. UtilityReleaseForm_2011.doc revised 08/09/11 .rt CUPERTINO PURPOSE: CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION :,kS ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 1, Nnr 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinq(cDcupertino.org The 2013 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing, factyriltusing and other types of swellings with sleeping accommodations and raw accessory buildings agsociav uch uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject the requirements of CALGreen. Project Name: LIANG'S RESIDENCE Project Address: 10270 MIRA VISTA RD. CUPERTINO, CA. Project Description: TWO STORY NEW HOUSE 46in Instructions: The Owner or the Owner's agent shall employ a licensed professional experienced with the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 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. Column -2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Reauirements Planning and ,Design - Site Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ® El site grading or a drainage system will manage all surface water flows. Page] of 5 CalGreen 2014.doc revised 01115/14 I .2 ENERGY EFFICIENCY General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum standard design required by the California Energy Standards. ./ .3 WATER E Indoor Water Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: ❑ 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank -type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank -type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen 201 a.doc revised 01115114 Outdoor Water Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather -based. ❑ 4.304.1.1 Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ 4.304.1.2 Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. A4.4 MATERIAL Enhanced Durability and Reduced Maintenance 4.406.1 Rodent proofing. 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 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a 0 construction waste management plan shall be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building occupant or owner. A4.5 ENVIRONMENTAL Fireplaces 4.503.1 General. Install only a direct -vent sealed -combustion gas or sealed wood -burning fireplace, or a sealed woodstove. Pollutant Control 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air ❑X distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks M shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be M compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic OX compounds. Page 3 of 5 CalGreen 2014.doc revised 0015/14 4.504.2.4 Verification. Documentation shall be provided to verify that M compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with a VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHPS) Low -emitting QX Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall OX comply with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Concrete slab foundation. Required vapor retarders and capillary breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building materials used in wall and floor framing is checked before enclosure. Indoor Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 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. El 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- QUALIFICATIONS Qualifications 702.1 Installer training. HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the QX El discipline they inspect and verify. Verifications 703.1 Documentation. 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 Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen 2014.doc revised 01/15%14 &I M1151", toIMI 'e. * E wra l 'w wit's I tit 1 „ DOmf#" vr,i f altm arta sutmro the. rtimplectw*la t (Wurnn 1 and ) orith t2 Arld I�Odwq E r it apt- 1'�.�e llfe I q DL r1mertt, The o*T r w. fa rt; g temwanal Pesfti'fnsi te, for compllanW vvAh CalGreen StarlOwds Maft rMWO the plans a'X1} oaty IhM the farm caked abovo ate hereby jacwWrolat toto it t ptolod plant ana *A be 00famomod into the waled 4IN a ci,, ro amv* wait the r6 utrem r i W1 forth in tt 20 1 aldurrua for r, Buildong S. tandards Code 4A @gig tf Gs1 ofxrl�rc. NXO uVaglilLs mm �i���#��I' ant P to- �r1t Fusel itt�c6m Invedw e sv ur* and have, f. vwj "fWWO � t t �. rsto v 1 41A iiia] ly 11t.d111"f0f., 'ibove was cotstructed In atuvd.WA with ih Gram .w ' _ " wo in dean * with `the f 11rrICr N, n! Tim tt 0-alifortia Go*nSudding StalAafft Code its adowed ]by the CO.O.CoPwAro PI'Mr""Mal rq—spr 544v lt;, '.- G en ga 71 Sts<;s�=