08090053 CITY OF CUPERTINOr.-d -
BUILmNCDIV191ON PERNIIT CO 4,"GF0RjNF0RMATI®N R
.a ..�„�z;tm.....<r9t+i *a?e�ro„�F�,.,
BUILDItdC�DDB E PERMIT NO.
TE AVE ELLIOTT ROOFING 08090053
OWNER S NAME: PERMIT ISSUE DAIS
DONALD LINDEN P OBOX 7066 09/10/2008
lipNE: (831) 423-0675 SANITARY NO. CONTROL NO. '
ARCHTIECr(ENGiNEER: BUILDING PERMIT IWO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
4 m� 1 Wroby af0m Net 1 un limnacd under provision of Chapmr 9(commcaing Job Description
_o "mithSuction70MI)ofDivisan3ofNeBudneavbProfessionsCode.aMmylicenseis RE—RF RMV EXTNG COMP &REINSTL 40YR ELK CLS A 23SQ
0 fora and.Ilse.
z_ Ll...CW. Lk.M
Do Conmumr .Ts
e p A C CTS DECLARATION
W U I undersand my photo Nall W asul as public mmN. ., .
101 Licensed Pmfe]on.l
10 5 OWNER-BUILDER m CLARATION
0 F 1 Mmby,.(Tiro din 1 1. cs.myt from Um C sauna Coale:
License Law for dm
p O which ng muga(Saito C.1.7, k shoo. and Nafeniou Code:Any city or county
$ which its isss.pa so,ra.oras d1 L alar.improve,de armit to
or.pair any sanctum
pdorbs Recounse..dtnato tho theapplicana forstachtha Contractor's
fk...Lnedxupter9
NetWcnclnwit pursuanuothc pmvisioosof thew Buxar'andPoselaonts Cade)or
Sq.F[. Floor Area Valuation
E�G 10858
r, (commcnelnawithhud.]Bndth Division]nftWBusmen and.An vilation of
S 9
thatSwam,
m u 31.5 b theafrom and the basis for Ibe subjects
the
tl eumpuan.Any l ponaen of
sr for a tmhxcume.ppliemtw.civtlPen.Rrar Number
set mom than fire hunmrtd aollam(ssrm. 3 6 92 7 04 6 .W Occupancy Type
❑1.u owner of tW prnpvty,a my wplaycef with wages u t1u'v role mmpewtian,
will do dm wart,and tW sanuum is set mandedor ortertd for sale(Sec.ro ,Business
and Prnfe]mu Cade:The Ctu uactors amuse law d.ml apply to an awn.of Required Inspections
property who Wiltlaorimproves N.eon.and whudoesauch work himselfortlmugh his
own employ..,PraHded Wt such improvemerds sae set inreMCL oroRered for sale B.
howev.,Ne Wilding or improvemrnt Is sold within arc year of compleam.One owner-
builder will love the Wrden of proving Nat W did not Wild or improve for purpose of
sale.).
1.as owner a do,property.am exclusively commanding with IianxA conaa.an to
muurnct the pmjem(Sec.7014.Business and professions Cade:)The Cmtr.cmr.Li.
cave Law docs not apply to an owner of property who Wilds or improves then on.sad.
who mnmaeu for such projects with aemuaemr(s)liatsxd pursuant ta tW Conuantals
License law.
❑I mam.not under Sea .B&PC far this rtuo.
Owner Mae—
WORKER'S
auWORKER'S COMPENSATION DECLARATION
I touchy of im under per]tY of perjury..of the following tlalanamu:.
I ha,a and will..law..Cerafkame.f Consort in self-iuum rmwarkae.c.p..
anion,u provided for by Section 3700.1'the Labor Code.far tW peframarue of than
work for which this pcmil is issued.
❑1 have ark will main]n Worken's Compensation Wurana,u ruquimd by Section
37M of the Labor Code.for the parformanec ofthe work fofwbich this permit i.issued. '
My Warkef.Compamalion/hum.carrier and Poli.,number art:
Grriar,'n2 a 1./n l/.� Poli.,N..:In tT,6 CJ5—) 5r -
CEIm O EXEMPr10N FROM WORKERS'
N COMPENSATION INSURANCE
Crus secmm neeE antbecompleud irthe pewit u foram hunrhW Wilma($100)
m less)
I cmafy Not in the porrours.of the work for which this .it is issued.I shall not
..play any person in any mannerse as to Wmme subject to the Waradn'Campenadm .
Laws of California.Data
Applicant -
NOTICE TO APPLICANT:11,after making this Ccuiliiam of Exemption•you shau d
baoma udjun m the Workce.Compeunlon provisions of the lahm Code you mux
.J O forthwith comply with Such provisions or this pannit shall W ticemad rtwkcm.
z pj) cONmucr10N LENDING AGENCY
F IWmbY affirm that dura is a mnxnactlnn leadial;Marcy for site parfomm.x of
a the wart fur which this permit is annual(Sec.7097,Cin Q
W� Q Landauer Name '
z Lendefs Address
[J Q I cmdfY that I have mad this application and suns than the.Wna informadu,is
IT. Comm I Man,ta comply with all City and county mt1I0x1R.and state laws Rlsang us
.C) Wilding eonuntcdon,arW bertby authodm mprvmutives of this city to anus upon the
above-mendmrtd properly for inspemiw purposes.
F 4 IWO.gra to save•indemnify sod kap hamlets the City of Cuperum Mdut
fin luddli0es,judgmanu.costsshot espenses which may in any way acme Malut said City
V? in P CANT UNDER
Asn"Of this fulnuh.
PPSSTANDS AND WDLL COMPLY WI ALL NON-POINT Issued by: Date l/'O
SOURCEg6GI S. y
G — Re-roofs
sienuam w
HAZARDOUS MATERIALS DISCLOSURE D Type of Roof
WiB the appfiant a futurt Wilding gaup+vet mom or haMk huallocs material
as defined by the Cupertian Municipal Come.Chapter 9.13.and da,Health and Safety
cora,Y�Y.25572(.)] All roofs shall be inspected prior to any roofing material being installed.
Ya sept
If a roof is installed without first obtaining inspection,I agree to remove
Will Ne applicant or future W ildine Occupant usa equipment of devices which
which g an Pe
.t bmardnu it Contaminants as defined by the Bay Amo Air Quality Management all new materials for inspection.
]ric@
❑Yes u
I have mad huarawsou Mxcnals mquircmenu and.Chapter 6.95 of Lac Califor.
nu WAhh&s rlade.S=6=25SC3.25533and25534.1.nty.WthnifftWilding
docs not c Y ha vane that it is my responsihilit - reify dx occuPmt of doe
.qui whin mat arm ;ar ,GetirKamaroaapartey. Signature of Applicant Date
caner sir than mage. Dam All roof coverings to be Class')W'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 " PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot: '
APN . . . . . . . : 36927046 . 00
DATE ISSUED. . . . . . . : 09/10/2008
RECEIPT #. . . . . . . . . : BS000006043
REFERENCE ID # . . . : 08090053
SITE ADDRESS . . . . . : 865 BETTE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DONALD LINDEN
ADDRESS . . . . . . . . . . : 865 BETTE AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4548
RECEIVED FROM . . . . : JIM ELLIOTT
CONTRACTOR . . . . . . . : JIM ELLIOTT LIC # 25914
COMPANY . . . . . . . . . . : ELLIOTT ROOFING
ADDRESS . . . . . . . . . . : P OBOX 7066
CITY/STATE/ZIP . . . : SANTA CRUZ, CA 95060
TELEPHONE . . . . . . . . : (831) 423-0675
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----------- ---------- ---------- ----------
1BSEISMICR VALUATION 10, 858 . 00 . . 1 .10 0 . 00 1 . 10 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 23 . 00 " 299 . 00 0 . 00 299 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 410 . 10 0 . 00 410 . 10 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 410. 10 #1281
---------------
TOTAL RECEIPT 410.10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO
REROOF
•`CUPEI?INO PERMIT APPLICATION D� 3
APN # C-) 7 r - o (3Dat
W _ Q
Building Addres
Owner's Name: Phone #:
Contractor: Phone #: /`
Fax#:mp
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
o Built-Up Roof ❑ Built-Up roof
,p� Asphalt Shingles 41 Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify)
Number of existing coverings a Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Residentia Commercial Lj
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable include in plan set & the sheet index.
Valuation:
I Have Re d, nderstand and Will Comply%with Cupertino's Tear-Off Policy:
Si ature
Revised 6/16/08
�,d� CITY OF CUPERTINO
REROOF
CUPER,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2� 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B •
iIBUSLIC Business License B
Revised 6/16/08
•
Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City,the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
• a) Spark arrester installation.
5. If plywood is installed,a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be Paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: T�4 eaa� /I
job
7
Job Site Address:
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 07/30/08
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
- k
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1. 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
•
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is
not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
INPUT ResDurces, Energy IAQ/Health
A.Srte
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials J 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=yas 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
6.Design Resource--Efficienl.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 p
1 1
B.Foundation 1
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 p
3.Insulate Foundation/Slab before backfill 3 Energy pts y--yes0
1 1 1
C.Structural Frame
1.Substitute Solid Savor Lumber W Engineered Lumber _J 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
S.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yas p
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Ener
b.Wall 9Y Pis Y=Yes p
3 Energy pts y=Yes 0
c.Roof 3 Energy pis Y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pis y=yes p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes p
a.Subfloors 1 Resource pt Y=yes 0 -
• b.Sheathing 1 Resource of y=yes p
1 1 1
D, xtenor Finish
114PUT Resources Energy :IAQMeafth
t.Use Sustainable Decking Materials
a.Recycled content 1 3 Resource pts y=yes 0
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y=yes 0
i
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
_ __ T J Energy pt y=yes D
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3.Retrofit all Faucets and Showerheads with Flow Renucers
a.Faucets(1 point each,up to 2 points) i Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. D
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) _ . Up to 3 Resource pts. 0
5.Install Chlorine Filler 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 4 IAQ/Health pts. 0
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.tlecmcal
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 pbinis,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 pis. 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 Sfar Dishwasher 1 1 Energy pt y=yes . 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
3.Instail Energy Star Refrigerator 1 Energy pl y=yes 0
Llnstall Built-In Recycling Center ; 3 Resource pts y=yes 0
1 1 1
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
C3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde i 31AQ/Health pts y=yes .0
-- ---- - - - -
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
D.Ceilings 4 Resource pts y=yes 0
1 1 1
INPUT ResDurces Energy IAWHeallh
.Windows
1.Install Energy-Efficient Windows - —
—----
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) i 2 Energy pts Y--yes 0
I c.Low.Conductivity Frames
__^� _Y _____ ___ __ 2 Energy pts Y--yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 i 1
J.Heating Ventilation and Air Conditioning
r.Use Duct Mastic on All Duct Joints ( 2 Energy pts Y--yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts Y--yes 0
3,Vent Range Hood to the Outside 1 IAQ/Health of y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt Y--yes 0
7.Install Whole House Fan 4 Energy pts Y--yes p
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters - 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stovesNnserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14,Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y--yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ Health pts y=yes
0
1
K.Renewable Energy and Roofing 1 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
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=16 points) Up to 18 Energy pts 0
I6:Select Safe and Durable Roofing Materials —' 1 Resource pt
Insyq es 0
7. tall Radiant Barrier 3 Energy pts y=yes 0
1
L.Natural Heating and Cooling 1 1
1.Incorporate Passive Solar Heating 5 Energy pis Mas 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yss 0
3,Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yesLMMJ
D
1 1 1
•
INPUT Resources Energy IAQ?Hmlth
.Indoor Air Quality and Finishes '
r1.Use LowMo VOC Paint 1 IAQ/Health pts y=yes 0
2.Usa Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 0
i3.Use Low/No VOC Adhesives _ _ 3 IAQ/Health pts y=yes 0
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
5.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
j�.Seal all Exposed Particleboard or MDF _ 4 IAQ/Health pts y--yes 0
B.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
:,cc N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yesr.Use Rapidly Renewable Flooring Materials. —_—' 4 Resource pts y=yes3.Use Recycled Content CeramicTiles 4 Resource pts y=yes4.Install Natural Linoleum in Place of Vinyl 51AQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes6.Instal Recycled Content Carpet with Low VOCs 4 Resource pts y=yes. 1
Total Points Availa 1 :1 401 1301 5711
Total Points Project Received: 01 01 0 •
G:datarpmgsrgreenbuildno uidelinestremodeierslgreenpantsfinal2.12. proecte .xis 1
Community Development
10300 Torre Avenue
s
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
*UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
G o
O R'S NAME: --� PHONE # '
GENERAL CONTRACTOR: "" FAX #
I am not using any subcontractors:
Signature
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 R
T'
• o
Owner/Contractor ignature Date