08050050 CITY OF CUPERTINO s'S 'xi'+w<
BUILOI ,G 61visioN PERMIT raCONTRACTOR NFORMA7�ON
PERMIT NO.
BUI Lp7NO.iADORESS; 08050050
GUST' LN KESTER HEATING AND AIR COND
OWNE/R`JS NNA`JME:AU PERMIT ISSUE DATE
JEN LEE 05/05/2008
14 100 NE: (408) 265-1103 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECTPLUMB MECH
roZ' LICENSED CONTRACTOR'S DECLARATION Job Description
w C 1 hereby affen saw I am licensed under pmvisimu of Chapter 9(commencing Iy
Ct wiNSauon]OIIIBofDivision3oftheBusinessaMPoulcumusCode.andmyIke=is RPLC EXISTNG FURNACE. KESTER HEATING & COOLING
w in full forte autrerten L. �-�.rel.(.'G
Dqz License Class 7o Lk.g RNEWED BUS LIC 5/5/8
t- Dow_ Coo—
Tm - "I he
use DECLARATION
ipU 1 undemand my plans shall M used u public reenrda
Is
G 1; Licensed Professional -
3 OWNER-BUILDER DECLARATION
.�,a f I beuehy alum Net I am acmpt from the Canmctors License Law to,the -
i p o following mason.(Section 703 1.5.Business and Proicssiun Cods:Any city or county
$ which requires a Permit memr swct.aim,improv.demulim,or mini,any smeto.
_iy prior m its issuance,also"ones the applicant for such Permit a file a signed mortm
< this he is licensed purwant on Ne pmvisime of the Conuutmi Lic..Law(Chapmr9 Sq.Ft.Floor Area Valuation
Yg (ems..tingwithSCCdan1000)OfDivisionSoftheBusinessandProlesslnmCade)of $3600
^ this he is exempt therefrom and the basis In,the alleged...mpuon.Any vkladm of
Section 10313 by any applicant for a Permit subjects the applicant to a civil penalty ofNumber Oeeu
out mom than Rw hundred dallan(M), 3 6 212 014 pane y Type
1,uowner of the POWO,ormy wplaym wish raga uue'v sok tampenssuon,
will do the work.and the monottre is cot intended m offered forssle sec.7044.Bmincta
Nd Pmfa iou Code:The CanVdcmYs Lune,Law deer not apply to N owner of Required Inspections
Property who WilNaimpmva thervon,and whodesssuN work himselforNmugh his
awn employees,prooldeA that such impmvments we not imemkd or offered for sale.IL
however.the building or improvement is sold within one year of completion,the Owner.
builder will low site burden of pro ng that he did rot build or improse for purpose of
sake).
❑1,as Owner of the Property,am trclunni convecting with licensed conwetms to
construct the project(See.7W.Business and Profession Cade:)The Conuseteri U.
cense Law due,not apply to an mann of property who btilm or improv memos.and
who comets for such projects with a conusec or(s)licensed putswm to the Comrsetors
License Law.
❑I...'rntumbe See .BBPCforthismasom
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby a0-umunder penalty of perjury m Of the following deeluationc
1 hsv and will maintain•Canitiaself-insure
maf C...I to for Warker'sCompea-
satian,u pmvidcd for by Section 3100 of the Char Code,for the performance of the
wells for which this permit is issued
1 have and will maimdn Workee.Compensation Insurance,as required by Secum
3100 of de Labor Cade,for the performance of the welt for which this permit is issued '
My Workers Corporation.hsaaaMa carrier and Pali,number ere:
Camer..5 Paltry No.: lger(4115 04
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This sectim lead Out be completed if the permit isforme hundreddollm($100) ,.
or hors)
I anify,that in the Performance of the work for which this Permit is issued,I dull not
employ any person in any manner se as k become subject to the Woftes'Compensation
Laws of Celifomia Dam
Applicator
NOTICE TO APPLICANT:If,after making this CcniBam of Exemption,you siuuk
become subject he the Worker's Compawtion provision of me Labor Cade.you most
.J z forthwith...ply with such provision or this pe,Tit shall be deemed narked
E 7) CONSTRUCTION LENDING AGENCY
[-i.�. I hereby slim that them is a construction lending agency for the performance of
the work for which this Permit is issued(S..3097,Ci,C.)
Alenders Nuns
z Lenders Add.
U Q I certify mal 1 haw read this application and sum that the above info dM is
U2 E colons.1 agree to comply with all city and county ordinances;and ram laws misting to
O building constrction,and hereby authatir,mpn.xnutiws of this city to enter upon the
F yabov-mendoned property for impsNan purports
(We)agree to saw.indemnify and keep humins the City of Cupertino aj unt
In liabilities,judgments.costs and expema which may in any way carne against said City
C)z in consequence of me granting of this permit. m
'-" APPLICANT UNDERSTAN S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date J.v
SOURCE REGULATIONS_
S-S Z'$ Re-roofs
Signature of ApplianVCOnuseur pare /
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m future building occupant stem or handle havrdan material
as de inN by the Cupenim Municipal Codc.Chapter 9.13,and the Health and Safety
Code.Section
.2ssutal+ Ej< All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building Occupana six eq tipmcot ar dcAces which If a'roof is installed without first obtaining an inspection,I agree to remove
n hrrudoa air conuminants IS de0led by the Bay Area Air Quality Management all new materials for inspection.
,Bouin?
❑Ya E
I ban mad the harardovamamriaism9uiremcnu under Cluperb.95ofthe Califor-
nis Halth @ Safety Cade,Section 235n5,25533 and 23534.1 umkrstsnd uut if the building _
dna out cwrentlY hew a moan.this it u my responsibility u notify sic occupant of the
paimmmenu whin ust be met prior u issuance of a Certificate of occupency.
3. s,og Signature of Applicant Date
Owner Or mmormd agcm Dam All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT .RECEIPT OPERATOR: pdtg .
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36212014 . 00
DATE ISSUED. . . . . . . : 05/05/2008
RECEIPT # . . . . . . . . . : BS000004664
REFERENCE ID # . . . : 08050050
SITE ADDRESS . . . . . : 7919 AUGUST LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JEN LEE
ADDRESS . . . . . . . . . . : 7919 AUGUST LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : DAVID KESTER
CONTRACTOR . . . . . . . : KESTER, DAVID M LIC # 22101
COMPANY . . . . . . . . . . : KESTER HEATING AND AIR GOND
ADDRESS
CITY/STATE/ZIP . . . : SAN JOSE, CA 95136
TELEPHONE . . . . . . . . : (408) 265-1103
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ------ --------- ----------
1BSEISMICR VALUATION 3 , 600 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 1 . 00 61 . 19 0 . 00 61 . 19 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 224 . 85 0 . 00 224 . 85 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- ---------- ---------------
CREDIT CARD 224 . 85 VISA
---------------
TOTAL RECEIPT 224 . 85
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ------------------------ --- --------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
40
CITY OF CUPERTINO
FURNACE/AC
• CU4"k7lN0 PERMIT APPLICATION FORM
APN # 3 U/o� I a O/ Y !) Date: S
Building Address:
•Owner's Name: Phone #:
za r--o � `)-4 (., � � 62v
Contractor: Phoney�e.t-to -,,a
Imo" % Fax #:u bjZ- i 2-1 r
Contractor License#: Cupertino Business License#:
7 Ss�t(� o o�� / O/
Contact: Phone#:
I4S Fax#: 1.4 i z—
Building Permit Info:
Elect E9. Plumb 8' Mcch _
Residential Commercial El
Job Description: QT_ yl y;„�� �J At-) �
For Residential Installations:
Attic ❑ 1st floor 2"d floor ❑
Adhere to minimum setback re uircment ❑
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural cales) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: 3 Type of Construction (Usage Class):
Strapped On Platform LJ Bonded New Location Replacement
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist& attach it to the
application or if applicable, include in plan set& the sheet index.
CITY OF CUPERTINO
FURNACE/AC
OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M '
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
1 MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code. •
1 MCSUSHTR Commercial Install/Relocate ea M .
suspended heater,recessed wall htr, or
floor mounted unit heater. .
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
f heating,cooling,absorption or
l evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed.wall htr, or •
floor mounted unit heater.
=IMRAPPVNT Residential for the install/relocate/ or17 M
replacement of ea appliance vent
install & not incl in an a 1 ennit.
CITY OF CUPERTINO
FURNACE/AC
•CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1 PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
/ IBSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
I MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
IBUSLIC Business License B
•
an
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Units<= 1 Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 PGASRES Residential for ea gas piping system P
of 1-4 Outlets
IBPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
IBREMAIRHAN Residential A/C units<= lOk CFM B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B •
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
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
d?� 72points B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 11. Permeable Pavin Note L-1C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
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. Ener Star Refrigerator, (Note/Spec.) A-3 1 oint
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
ocpoSO o' —O
•
HAY D 51008
J�
'• v 'i
o�
•
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.
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points I up to 4 Resource pts 0
2.Salvage Reusable Building Materials 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts Y--yes 0
B.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 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 pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with'Engineered Lumber 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 I-Joists 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
8.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
I12 sUsU e OSB `—
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes 0
xtenor Fms
INPUT Resources Energy IAQ/Health
11.Use Sustainable Decking Materials
a.Recycled content ; 3 Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain ChromiumlArsenic 1 IAQ/Health pt y=yes 0
3.Install House Wrap under Siding i 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials { 1 Resource pt y=yes 0
E.Plumbing
1.Install Water Heater Jacket
_ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y--yes 0
3.Retrofit all Faucets and Showerheads w th Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toilest with Ultra-Low Flush Toilets
I(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts Y--yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 41AQlHealth pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.tiecmcai
i.Install Compact Fluorescent Light Bulbs(CFCs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to .
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
!Conservation Features 1 Energy pt y=yes 0
13 Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built In Recycling Center 3 Resource pts y--yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2,Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
IS.Install Recycled-Content,Fiberglass Insulation w th
o Added Formaldehyde 3 IAQ/Health pts y=yes 0
4,N- -----
4.Use-Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y--yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
c.Ueilings 4 Resource pts y=yes 0
INPUT ReSDUrCeS Energy, IAQIHealth
1.Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 1 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts Y--yes 0
L__�.___ ___--__
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes D
11 1
J.Heating Ventilation and Air Conditioning
CUse Duct Mastic on All Dud Joints 2 Energy pts y=yes D
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7
0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0 "
8.Install Sealed Combustion Units
a.Furnaces - 31AQ/Health pts y=yes 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 SEEM 1 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 pts 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 i Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Heallh pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
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 of y=yes 0
7.Install-Radiant Barney 3 Energy pts y=yes D
1 li 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 0
1 t
INPUT Resources Energy IAD/Health
M.Inuoor Arr uallty and Frnis es
Lrt.Use LowMo-VOC Paint _j 1 IAQ/Health pts y=yes 0
2.Use Low VOID,Water-Based Wood Finishes 2 IAQ/Health pts y=yes D •
3.Use Low/No VOC Adhesives 3 IAQ/Health is es 0
F3. `-- _D — -- --- — P Y'Y
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
f,7.Seal all Exposed Particleboard or MDF __ 4 IAQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource'pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes0
2.Use Rapidly Renewable Flooring Mate als _ 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1
Total Points A 1 1401 130 57
Total Points Project R 1 0 0 0 •
G:datalprogstgreenbuildngguidelines4emodelers/greenpoimsfinal2.12.04proladed.xls
Community Development
e 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
fOUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
0805005-6
OWNER'S NAME: PHONE # -f L4 - ctI620
GENERAL CONTRACTOR: Cx%PUAY- FAX #
C -Zb
I am not using any subcontractors: -,5--
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
v
Owner/Contractor Signature Date