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13030038 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21700 ALCAZAR AVE CONTRACTOR:ALI'S CONSTRUCTION& PERMIT NO: 13030038
REMODELING
OWNER'S NAME: AKHIL SAHAI 681 E BROKAW RD DATE ISSUED:0610512013
OWNER'S PHONE: 4082192196 SAN]OSE,CA 95112 PHONE NO:(408)898-6474
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License Class Lic.#_9 ,� REBUILD(E)FIRST FLOOR OF RESIDENCE(1438 SQ FT)
AND GARAGE(443 SQ FT); CONSTRUCT 593 SQ FT 1ST
Contractorate 7 FLOOR ADDITION AND 1096 SQ FT SECOND STORY
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.
1 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. Sq.Ft Floor Area: Valuation:$350000
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:35719109.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 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 1 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 DAY M LAST CALLED INSP C 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: Date:
with all non-point o cc regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 4 "3 All roofs shall be inspected prior to any roofing material being installed.If a roof is
•J installed without first obtaining an inspection,I agree to remove all new materials for I
inspection.
11 BUILDER DECLARATION
_ !
I hereby affirm tt► Signature of Applicant: Date:am exempt from the Contractor's License Law for one of ---- 4
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. 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,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authoriz gent: Date&�,Z,
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 C TRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that IHer 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 th ermit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
ertify that I have read this application and state that the above information is
,ect.I agree to comply with all city and county ordinances and state laws relating
gilding construction,and hereby authorize representatives of this city to enter
the above mentioned property for inspection purposes.(We)agree to save
unify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
wd expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
g of this permit.Additionally,the applicant understands and will comply
non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
Date
IsCONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE -CUPERTINO,CA 95014-3255 V_
CUPERTINO (408)777-3228-FAX(408)777-3333-buildingC@cupertino.org ` 3
[:]NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS
C A��O G APN# Z�C�7 G� Cj
OWNER NAME - HAI / 't0 ` 1 C -^ � E-MAIL
STREET ADDRESS CITY,STATE ZIP I _t L FAX
Z o� eoAr'� o -,,q
CONTACT NAME A(ZPHONE y4
$)9 &17JL/1 Q� E-MAIL C rn
STREET ADDRESS CITY,STATE,ZIP [� / / FAX
1,::,5 e C' 2I I Y-01
❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTORNAME LICENSE NUMBER LICENSETYPE BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP P NE
ARCHITECrlENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
8a ( USE, TYPE OCC.OCC. SQ.FT. VALUATION
EXISTL NPw FLOORDEM rOTAL
AREAIU36 AREA AREA NET AREASy ($)
BATHROOM (KITCHEN OTHER
REMODELAREA REMODEL REODELARE'W 1 U 9
1/
PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: UDETACH
3 ❑ATTACH
#DWELLING UNrrs: IS A SECOND UNITS SECOND STORY
BEING ADDED? ❑NO ADDITION? ❑NO
PRE-APPLICATIO YES K YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RE VE BY: TOT/AL VALUATION:
PLANNING ADPL# ❑NO OG R VAL LETTER EICHLER HOME? ❑NO �./�`
By my signature below,I certify to eac of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I havvided 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 relating t ilding s ction. I authorize representatives of Cupertino to enter the above-identifteyd property for inspection purposes.
Signature of Applicant/Agent: / Date:
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER B ILDINGPLANREVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑MA
SS PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ARD PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE FIR DEPT
—Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 21700 Alcazar Ave DATE: 03/08/2013 REVIEWED BY: Mendez
APN: BP#: 1,3o3003'9 *VALUATION: 1$350,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition
PRIMARY SFD or Duplex 2nd Unit? Yes .' No PENTAMATION 1 R3SFDADD
USE: OTC. 0 Yes 0 No PERMIT TYPE:
WORK Add 2nd storyaddifion of 1096 593 to 1st floor, balcony77 s ftattached garage 37 s ft. remodel
SCOPE 1300 sq ft through 1st floor, panel upgrade 200 amp, remove and replace water heater and furnace.
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
R-3 (Custom) II-B,111-B,IV,V-B 1,803 $2,640.62 1R3PLNCK $2,167.57 1R31NSP
TOTALS: 1,803 $2,640.62 $2,167.57
MECH,HOURLY 0 Yes Q No PLUMB,HOURLY Q Yes 0 No ELEC,HOURLY ( Yes ON
Mech.Plan Check hrs $0.00 Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check 0.0 hrs $0.00
0.0
Mech.Permit Fee: 1MPERMIT Plumb.Permit Fee: 1PPERMIT Elec,Permit Fee: IEPERMIT
Other Plumb Insp. E7rs $45.00 Other Elec.Insp. E7rs 1 $45.00
Other Mech.Insp. E hrs $45.00
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). Theseees are based on the prelimina information available and are only an estimate Contact the Dept/or addn 7 info.
FEE ITEMS(Fee Resolution 11-053 a.' %1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,640.62 999 s.f. Remodel,Other
Suppl. PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $601.00 1REMRESOTH
PME Plan Check: $0.00 = s.£ Remodel,Kitchen(<=300 sf)
Permit Fee: $2,167.57 $600.00 1REMRESKIT
Suppl. Insp. Fee:Q Reg. Q OT 0,0 1 hrs $0.00 = # Plumbing
PME Unit Fee: $0.00 $27.00 1PRWHEATR Water Heater
PME Permit Fee: $135.00 200 amps Electrical
Collmoliction .7ir.r: T-7 $45.00 1BELEC200 Services
�dirainisttcrtitie l'_�c. 1 ## Mechanical
Work Without Permit? C) Yes (F) No $0.00 $133.00 1MFR=<100 Furnace,Forced-Air G
Advanced Planning Fee: 1PLLONGR $234.39 Select a Non-Residential 0
Travel Documentation Fee: ITRA VDOC $45.00 Building or Structure 0
Strong Motion Fee: 1BSEISMICR $35.00 Select an Administrative Item
Bldg;Stds Commission Fee: 1BCBSC $14.00
SUBTOTALS: $5,271.581$1,406.001 TOTAL FEE:; $6,677.58
Revised: 01/01/2013
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
C O P E RT I N O Telephone: 408-777-3228
Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: 21-100 A CAZ,a.t -AV& PERMIT# 5- 0 0()I
OWNER'S NAME: ht\ PHONE# j -D j-
GENERAL CONTRACTOR:AM is 01(1 BUSINESS LICENSE # L) L' 33
ADDRESS: p S. \v CITY/ZIPCODE: 19a.I1jvy- $(.2- C
*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 Date
Please check applicable subcontractors and complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing S 1(\C 0q 37j
Electrical s qoq;
Excavation S �' Oq q253
Fencing
Flooring /Carpeting qo C q
Linoleum/Wood N /�
Glass/ Glazing jj
Heating ',!
Insulation A A q N 5043 �U
Landscaping N�N .�y
Lathing P�ws> (�, � (J 1 3-:�>
Masonry IJ
Painting/Wallpaper S (�
Paving `S (qs( UCA1Dy)
Plastering I)Sa D Vim`) Qz , 3q
Plumbing bdrhood Umk)(- G 51 q 3 (1
Roofing `'j
Septic Tank t9 '
Sheet Metal NIA
Sheet Rock5(� T
Tile S n
ner/Contractor Signature Date
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR SUBCONTRACTOR LIST
kit
JOB ADDRESS: PERMIT#
OWNER'S NAME: PHONE#
GENERAL CONTRACTOR: 10BUSINESS 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 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 fi'
j -
Masonry
Painting Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile/
Owner Contractor Signature Date
a
I 3�
2010 CALGREEN CHECKLIST - MANDATORY ITEMS
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B;O., BUILDING OFFICIAL
CUPERTlNO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(406)777-3228•FAX(408)777-3333•buildingpcupertino.org
PURPOSE:
The 2010 CalGreen Code applies to all newly constructed hotels, motels, lodging houses, dwellings,
dormitories, condominiums, shelters, congregate residences, employee housing, factory-built housing and
other types of swellings with sleeping accommodations and new accessory buildings associated with such
uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the
requirements of CALGreen.
Project Name: AKHIL & NEHA
Project Address: 21700 ALCAZAR AVENUE
Project Description: SINGLE FAMILY REBUILD .
Instructions;
1. The Owner or the Owner's agent s e p li e f siotafil experienced with the 2010 California
Green Building Standards Codes to veri y re t t a e wprk described herein is properly
planned and implemented in the project.
2. The licensed professional, in collaboration with the owner an deign professional shall initial Column
2 of this checklist, sign and date Section 1 -Design Verification at t�ie,end of this checklist and have the
checklist printed on the roved plans for the project.
P PP P P 1
3. 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.
I
Column 2 Column 3
MANDATORY FEATURE OR MEASURE Project Verification
Re uirements
A4.1 PLANNING AND DESIGN
Planning and Design -Site Preservation
4.104.1 A site plan and inventory of the site is developed and used to minimize
j site disturbance in order preserve desirable existing natural resources and 0 ❑
minimize future adverse effects on the proposed structure.
Planning and Design -Site Development
4.106.2 A plan is developed and implemented to manage storm water ❑ ❑
drainage during construction.
4.106.3 The site shall be planned and developed to keep surface water away
from buildings. Construction plans shall indicate how site grading or a drainage 0 ❑
system will manage all surface water flows.
Pave I of 5 Ca7Green 2010.doe revised 02114/11
r
A4.2
General
4.201.1 Low-rise residential buildings shall meet or exceed the minimum
standard design required by the California Energy Standards.
A4.3 WATER EFFICIENCY AND CONSERVATION
Indoor Water Use
4.303.1 Indoor water use shall be reduced by at least 20 percent using one of
the follow methods.
❑X ❑
0 Water saving fixtures or flow restrictors shall be used per Table 4.303.2.
ElA 20 percent reduction in baseline water use shall be demonstrated per 7/01/2011
Table 4.303.1.
4.303.2 When using the calculation method specified in Section 4.303.1,
multiple showerheads shall not exceed maximum flow rates.
7/01/2011
4.303.3 Plumbing fixtures (water closets and urinals)and fittings(faucets and
showerheads)shall comply with specified performance requirements.
7/01/2011
Outdoor Water Use
4.304.1 Automatic irrigation systems installed at the time of final inspection
shall be weather-based.
A4.4 MATERIAL • • t RESOURCE
Enhanced Durability and Reduced Maintenance
4.406.1 Joints and openings.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 Where a local jurisdiction does not have a construction and demolition
waste management ordinance, a construction waste management plan shall
be submitted for approval to the enforcing agency.
Building Maintenance and Operation
4.410.1 An operation and maintenance manual shall be provided to the © E3
building occupant or owner.
Page 2 of 5 CalGreen_2010.doe revised 02114111
A4.5 -O
Fireplaces
4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑ ❑
burning fireplace,or a sealed woodstove.
Pollutant Control
4.504.1 Duct openings and other related air distribution component openings ❑ El
be covered during construction.
4.504.2.1 Adhesives,sealants and caulks shall be compliant with VOC and ❑ El
toxic compound limits.
4.504.2.2 Paints,stains and other coatings shall be compliant with VOC limits. © ❑
4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑X ❑
weighted MIR Limits for ROC and other toxic compounds.
4.504.2.4 Documentation shall be provided to verify that compliant VOC limit ® ❑
finish materials have been used.
4.504.3 Carpet and carpet systems shall be compliant with VOC limits. ❑X ❑
4.504.4 Fifty(50)percent of floor area receiving resilient flooring shall comply
with the VOC-emission limits defined in the Collaborative for High Performance 117771 ❑
Schools (CHIPS)Low-emitting Materials List or be certified under the Resilient
Floor Covering Institute(RCFI)FloorScore program.
4.504.5 Particleboard, medium density fiberboard (NIDF), and hardwood
plywood used in interior finish systems shall comply with low formaldehyde ❑X ❑
emission standards.
Interior Moisture Control
4.505.2 Vapor retarder and capillary break is installed at slab on grade
foundations. f 0 ❑
4.505.3 Moisture content of building materials used in wall and floor framing is ❑ ❑
checked before enclosure.
Page 3 of 5 CalGreen 2010.doc revised 02/14/11
Indoor Air Quality and Exhaust
4.506.1 Exhaust fans which terminate outside the building are provided in
every bathroom.
Environmental Comfort
4.507.1 Whole house exhaust fans shall have insulated louvers or covers
which close when the fan is off. Covers or louvers shall have a minimum ❑X
insulation value of R-4.2.
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.
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 INSPECTOR QUALIFICATIONS
Qualifications
702.1 HVAC system installers are trained and certified in the proper installation
of HVAC systems.
702.2 The Licensed Professional responsible to verify CALGreen compliance
is qualified and able to demonstrate competence in the discipline they inspect
and verify.
Verifications
703.1 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 MX
Building Department after implementation of all required measures and prior to
final inspection approval.
Page 4 of 5 ColGreen_2010.doc revised 02114111
CALGREEN SIGNATURE DECLARATIONS
Project Name: AKHIL & NEHA
Project Address: 21700 ALCAZAR AVENUE
Project Description: SINGLE FAMILY REBUILD
SECTION 1 - DESIGN VERIFICATION
Complete all lines of Section 1 —"Design Verification"and submit the completed checklist(Columns 1 and 2)with the
plans and building permit application to the Building Department.
The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and
certify that the items checked above are hereby incorporated into the project plans and will be implemented into the
project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as
adopted by the City of Cupertino.
Owner's Signature Date
Owner's Name (Please Print)
Design Professional's Signature Date
f}Miyp b l l 3
De ' �r fessional's a (Please Print) ell
04/23/2013
Signature of Licpns Professional responsible en compliance Date
Miles Hancock (650)424-1189
Name of License Professional responsible for CalGreen compliance(Please Print) Phone
energy@pacbell.net
Email Address for License Professional responsible for CalGreen compliance
SECTION 2 - IMPLEMENTATION VERIFICATION
Complete, sign and submit the competed checklist, including column 3,together with all original signatures on Section
2 to the Building Department prior to Building Department final inspection.
I have inspected the work and have received sufficient documentation to verify and certify that the project identified
above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of
the 2010 California Green Building Standards Code as adopted by the City of Cupertino.
Signature of License Professional responsible for CalGreen compliance Date
Name of License Professional responsible for CalGreen compliance(Please Print) Phone
Email Address for License Professional responsible for CalGreen compliance
Page 5 of 5 CalGreen_2010.doc revised 02/14111
