08080036 CITY,OF CUPERTINO
BUILDINC'OIVISION PERMIT �Ci)I�E�TR .CTQRINI''OILMATION ,.=
ill.A=.�,8!�A�ss .e. R`ma^c4Ytii�ef.�,4'"+ -F•�'
BUILDING ADDRESS: PERMIT NO.
10480 N BLANEY AVE A & H HEATING 08080036
OWNER'S NAME: FERMIT ISSUE DATE
ItOGAL,SKT EDWARD 770 CHESTNUT ST 08/05/2008
NE: SANITARY N0, CONTROL N0.
(408) 279-0722
ARCHIECl7ENGINEEIL BUILDING PERMIT INFO
BLDG ElEL7 PLUMB MECH
0 � 0
sop
LICENSED CONIRACfOWSDECLARATION IobDe5Ci1 Description
wi1 hertbY a1Rmm this 1 w limnsed unJer pmsisiou of CNpar 9(commencing P
< withSection7M)orDivision3afdmBuainuuandProfessionsCode,andmylicenseis RLCT FURNC TO ATTC, NEW DUCT SYS& INSTL CNTRL A/C
<
j�w Ilin full farce and if -77
Dam _ Lk.Y
=q TSDECCanr
pp 7W7W ARCNROn use DECLARATION
3 C< I undes.nJ my Mira shell he used u public records
JyU
g G Licensed Professional0
OWNER-BUILDER DECLARATION
Cont tON
9y9y I hereby.Sero o n I am exempt from Ne fession C s e:Any
taw for Ne
`O o following arson.(Section 7031.5,Business and Pmfcsaium Code:Any city or manly
S$ which its co a permit ra cuswcl.aper.improsx,h permiN, fl repair any swmum
_za
prior mits issuance.also requires Reappliesnlforsuchpermitw tilt asigrcd wsemem
< Nnhe4licensrdpursuantm Nc pmvisiou of Ja Conuacmh license Law(chapter9 Sq.Ft. Floor Area Valuation
Y�$ (commencing with Section 7000)of Division 3 of the Business and Rofcosions Cade)or $10000
C�R Nat M 4 exempt thcmfrom and the bas's for the alleged exemption.Any violation or
Section 70IJ by a y.pplicanl fora pmm4 subjects than applicant m.civil Mostly Of
rotNumber Occupancy T more Nan five hundred dallam ISM 31630002 Pant y ype
0 1.u owns of dee prop ny,m my moploy=with urgesu Neo mk compewdon,
will do the work.and Ncamo sum 4 unintended oroffered formic soc.'fo14,Business
and Pmfeuku Cade:The Consomme.Lunn¢taw does Out apply to.n owner of Required Inspections
property who builds«improv Neaman,and who decosuch work hisoself m O mugh h4
ownemployaa.prodded that such improsammts am notinunded oroRrsN far sale If, -
hwevv,me building or improvement 4 cold within..year of completion,lie owner
builder will hart the burden of proving that he did tit build or improve far purpose of
sky
❑1,u wmr of Ne Mopmty,am oclusively,counseling with licensed mnummn m
coutnat tion project(Sec.]Old,Business and Proleamoru Cade:)T)a Contractor's U.
cele law does not apply m an owner of property who Wilds or improve thereon.and
who convects for such projects with acmtramr(s)licensed pursuant to the Consacmr'a
Licewe law.
❑lamexemptumoesec. ,8&PCI-th4reuom
Owner Date
WORKER'S COMPENSATION DECLARATION _
I herby affirm under Mosby or perjury arc of the following decIervlme,
1 ham and will maintain•Cetifiate of Conant to stir-kswe for Worker'sCompen-
.lion,as provided ror by Section 3700 or the tabor Cade.for don perrarmmmm of the
work for which this permit is issued.
I blase and will maintain Worker's Compensation Insurance,u mquired by Section
700 of On tabor Cade.for the pefmmane.of the work fm which dabs permit is issued. '
My Worker's Computation
Insunme carrier and Policy number
Ca Tier. l�c '/t�5 Polity No.: L[yye
Z
CE1ME EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
rlMsmctlon used not M completed if tW permit is fora.hundred Mhua(6100)
or kms)
I certify that in the perrwma ce of dee wok for which this permit is issued.l shall tit
employ any person in my manner an as at becomefubjecl m Ne Wahc s,Compensation
Laws of Ca4fo�rma.Date / -
Applicant
NOTICE Nr:If.after making N4 Certificate of BIlemption.you should
haome subject to dte Worker's Compensation provisions of the tabs,Code you must
wJ O foMwlth complY with men provisims.104 permitmall nd diamond mvdked.
CONSTRUCTION LENDING AGENCY
[r lheahy affirm this there is a cowtmninn lending agency for tk pert...of
Ci Ne wish for which Nin permit 4 issued(Sce.3097,Civ,C.)
0.A Lender's Nene
7 z Lemder'n Address
U O 1 casl(Y con I base mad thus application and slate this the above inramadm 4
^ colrm I agrm m comply wide all city and county ormirmacs and stem lawn mlaling m
.� building construction.and hereby mtharim mpsscnuliws of this city to toter upon tite �k
above-mcntiomnd property far inspection purposes
'y
(WO)agre t m.w,indemnity and keep I armku Oa City of Cupertino agsiut
LAA in COitia,jutOfttecoauand espouses which may in ter'war'salve agsiutssid City -
UZ mcontc ANT of UNDERSTANDS
this permit.
APPLICANT UNDERSTANDS AND WIL COMPLY WITH ALL NON-POINT Issued by: Date (�J�
sou CEREGULATIONS.
Re-roofs
Signuum of AppliaData
HAZARDOUS
DataNA2AR
DOUOUS MATERIALS DISCLOSURE Type of Roof
Willy the Cticant or smfMu i Wilding Cg ecmpantsom or handle HcaN and Safety
a ety
u defied by Irk Cupertino Municipal Code.Chapter 9.1;and On HcsiN.d Safety
Cade.section 25533(,)? All roofs shall be inspected nor to an roofing material being installed.
Will the applicant or future building occupant um equipment a devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit hvasdnu air contaminants u dclincd by the Bay Area Air Quality Management all new materials for inspection.
Divot
❑Yen
I have mal Ne huardms materials requimmc es under Chapter 6.95 of Ne Califor.
rm4l4alth&Safety Cade.Seen=25505.25533 aro 25534.1 unocco and that if the building
does til curmndy hast•arrant.that It 4 my T li.'y b anuI"the oampanl Olson
aquiame which most be met prior m iuu •Ce as of Oc . .
Signature of Applicant Date
owner w arir ,sen, Dow. All roof coverings to be Class'n"or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31630002 . 00
DATE ISSUED. . . . . . . : 08/05/2008
RECEIPT # . . . . . . . . . : BS000005689
REFERENCE ID # . . . : 08080036
SITE ADDRESS . . . . . : 10480 N BLANEY AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER : . . . . . . . . . . . : ROGALSKI EDWARD
ADDRESS . . . . . . . . . . : 10480 BLANEY AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2334
RECEIVED FROM . . . . : DALE PHELPS
CONTRACTOR . . . . . . . : PHELPS, DALE LIC # 12079
COMPANY . . . . . . . . . . : A & H HEATING
ADDRESS . . . . . . . . . . : 770 CHESTNUT ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95110
TELEPHONE . . . . . . . . : (408) 279-0722
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --------- ------ ------ ---------- ---------- ----------
IBSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
IEPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
IMPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
I.PPERMITFE 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 286 . 54 0 . 00 286 . 54 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--------------- --------------------
CREDIT CARD 286 . 54 . MC
---------------
TOTAL RECEIPT 286 . 54
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
v�02�� 3�
CITY OF CUPERTINO
` FURNACE/AC
• P `
CUERTINO PERMIT APPLICATION FORM
APN# Date:
/(v OUva . vv g - S og
Build' Addr s:
119
Owner's Name: I Phone#:2- 5-7- 5g ,37_ 13g 3
t3
Contracto : 1 Phone #: Z 7 9 -p 7 2 Z
�f f/��—�a-1—r�c9�— Q
Fax #: L71 10(
Contractor License#: ]� Z Cupertino Business License#:
Contact: ` P 5 Phone#: F z-3 - ( f$ 7
Fax #: Z7 (19(
Building Permit Info:
Elect [ Plumb. Mech
Residential Comme tial
AM
Job Description: P_(zLdctl-rn )..r4aWP4e-ff— '7V p¢�T/L' �V��uy LfO>r3r
tff5-r0-« e 5407 -AL
For Residential Installations:
Attic ® I" floor ❑ 2"a floor ❑
Adhere to minimum setback re uirement,9] .
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural talcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: 1D,190,U;, Type of Construction (Usage Class):
Strapped On Platform Bonded El New Location eplacement
Project Size: Express �andard ❑ Laze ❑ Major❑
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.
Revised 6/16/08
CITY OF CUPERTINO
a,OF
FURNACE/ACCUPEkINO 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.
1MCREPALT 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.
1MCSUSHTR 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
1BPGAS For each gas piping system of 5 or P
more per outlet.
IMCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ 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
C heating,cooling,absorption or
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.
1MRAPPVNT Residential for the install/relocate/ or M •
replacement of ea appliance vent
install & not incl in an nnnl ne... it.
Quantity Fee ID Fee Description Fee Permit Type
,r
CITY OF CUPERTINO
6' FURNACE/AC
•CUPERTINO' FEE SCHEDULE
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR 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
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
lEPERMITFEE Electric Permit Fee E
IMPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
IBUSLIC Business License B
•
uantity Fee ID Fee Description Fee I Permit Type
CITY OF CUPERTINO
FURNACE/AC
CITY OF
CUPEkTINO FEE SCHEDULE
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= 10k CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Conn /Resid
1BREMAIRHAN Residential A/C units<= I Ok CFM . B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B •
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
I
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
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 pints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 _Lpoints
D. Structural 3. Uses Wood IJoist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 --.?-Ppints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) AJ 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 oints
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 ooints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A3 4n
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 paint
3. Energy Star Refrigerator, (No te/Spec. A-3 1 pint
P. Other 1. List Green Features on Plans A-1 1 paint
TOTAL POINTS 40 points
I
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 INPUT Resources Energy A1111-lealth
1.Recycle Job Site Construction 8 Demolition Waste
65%=1 point;75%= 2 points;80%=4 points 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
L__Design Resource-Efficient Landscapes and Gardens _ _ 4 Resource pts y=yes D
9.Reuse Matisnals/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
I 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every 1096
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
rt Substitute Solid Sawn Lumber with 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
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 D
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resourceis
�— —' --- - - — — - - P Y=Yes 0
12.Use-OSB
a.SubFloors
1 Resource pt y=yes 0
• i b.Sheathing - 1 Resource or Y--yes 0
1 1 1
D.Exterior finish
_ INPUT ReSDUrCeS Energy IAD/Health
(7.Use Sustainable Decking Matedals
a.Recycled content 3 Resource pts y=yes 0 •
to.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 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 with 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 Toiled 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 4 IAO/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.tiecmcai
1.Install Compact Fluorescent Light Bulbs(CFLs) j
(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 �I 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
3.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
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAQ/Health pts y=yes 0
47Use an
se Advced 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 C •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
I).uemngs 4 Resource pts y=yes D
1 1
INPUT Resources Energy M011-lealth
i. mdows
Install Energy-Efficient Windows
• a.Double-Paned 1 Energy of y=yes EO
b.Low-Emissivity(Low-E) 2 Energy pts y=yes
c.Low.Conductivity Frames _ 2 Energy pts y=yes
2.Install[Low Heat Transmission Glazing 1 Energy pt y=yes
1 1 1
J.Heating Ventilation and Air Conditioning
F1_Use Duct Mastic on All Duct Joints J 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 IAO/Health pt 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 0
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 31A0/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 stoveshnse4s; 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.InstalliZoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AO/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 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
i6.Select Safe and Durable Roofing Materials_ 1 Resource pt y=yes 0
7.Install Radiant Barrier - _ -— --- - 3 Energy pts y=yes p
L.Natural Heating and Cooling 1 01 1
I
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 p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
1 1 1
•
M.Indoor Air Quality and Finishes INPUT Resources Energy IAQIHeafth
,`1.Use 1-6w9o4 C Paint _ _ 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes _ __ 2 IAQ/Health pts y=yes 0 •
3.Use LowNO VOC Adhesives 3 IAO/HealthY=y is es 0
-- -- -- - - P
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 D
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
h
t— P Y-Y Seal all Exposed Particleboard or MDF 4 IAQ/Health is 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 D
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 Materials _� 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 1
Total Points A 1 1401 130 57
Total Points Project Received: 01 01 0 •
G:data/progs/greenbuildingguidellnesrremodelerslgreenpointsfinal2.12.04proiected.xls
•
r, Community Development
10300 Torre Avenue
! i1 Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
$CUPEkTINO
Building Department
JOB ADDRESS: PERMIT #�d��U E ^ ��
sz)&gO
OWNER'S NAME: G— PHONE # Z- Ci—b7 Z Z
GENERAL CONTRACTOR: At 9 FAX # —
I am not using any subcontractors:
Signature � Date
Please check applicable subcontractors and complete the following ' ormation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date