08080011 CITY OF CUPERTINO 777777=
7=
BUILDING DIVISION PE ; , NTRACTOR.I�NIOR0INWTATIN
BtBLpltAcngpgRFs3PERMIT NO.
YRNE CT RIGHT ROOFING 08080011
OWNER'S NAME: PERMIT ISSUE DATE
SM I'I'H MARCIE L 467 SARATOGA AVE STE 1460 08/01/2008
uNE; (408) 254-4439 SANITARY NO. CONTROL NO.
ARCHI'IECfrENGINEER: BUILDING PERMnINFO
BLDG ELECT PL"JMB MECH
saes
LICENSED CONTRACTOR'S DECLARATION IObDCSCTI IIOn
C I bertbY.((lose Nat 1 am Ihxnsed umber proverload of Chapter 9(commencing P
G wiNseeuon�aDB)nroivise.3.1tCBusne Lftfusinme,m/e.ammyliaveu RE—RF RMV WDSHNGLS& INSTL 1/2"PLYWD ON GRG/HSE
N k full fora and efhxt C-WY
j'A� Lke ma Clan — Lk.N g INSTL
Da¢ d Ceruse_ Z, /rzy
ARCHITECTS DECLARATION 30LB FLT NEWRF MTL&PRES TL SHNNNNGLS CLS A 22SQ
2< 1 understand my plans shall be used a public records
OdU
EG Licensed Professional a
OWNER-BUILDER DECLARATION
i hereby&Rem that I am exempt from the Contractees License Law for dee
cc fallowing reason.(Section 70713,Bust.and Proftm..Cade:Any city or county
S$ which requires a Permit m ena struct,aikn improve,demolish,or mini,any.wmure
prior u its issuuue,also requires the applicant(orsuch permitmfil...igacd suMo..,
<
this he is licensed Pa.(to the Provisions of the Contractors License Law(Chaplct 9 Sq.Ft. Floor Area Valuation
x�$ (commencing with Section 7000)of Division 7 of the Bucirmer and Professions Code)or $10800
Nal he is exempt therefrom and Ne basis for the alleged eaempdon.Any violation of
Section 7071.5 by any applicant for a permit subjects the applicant to a civil Penalty of y,p�Number Occas Type
and seam Nan five hundred dollars(0011). 35716141 .'l7V' Occupancy YFe
I,u ewncr of Ua Nopc+tY,a my wployces with wages u da'vsak cempensstion,
will do the wort.and thestruc,um Is nos intended oroffertd Imsale(Sec,7DW,Business
and Inamoiom Cade:The Commuter's License Law dace not apply to an owner of Required Inspections
Property wW build er improves dares.,and who doessuchwork himselfmihmugh his
own employees,provided that such improvements tie rot imedd oraQertl tensile.K.
however,Ne Wilding mimprovement is said within ane yea of completion,the uwoa-
builder will have dee Wrdem of proving W,k did not build or improve for purpose of
ask.).
❑1.as owmr of the profanity.am exclumvely convecting with licensed Cont aeurt no
conswct the project(Sec.TWA,Business and Professions Code;)The Contramrs Li-
cense Law does not apply be an owner of property,who Wilds or improves desmon.and,
who contracts for such projects wits a conlncer(s)licensed purauam as the Conuanors
Irma Law.
El I sm ucmpa undm See ,B k PC for this reason
Owns Date
WORKER'S COMPENSATION DECLARATION
1 hereby afB,m under penalty of perjury arc of the following declarations:
1 him and will maintain•Cenifiate of Carmen,in self-insure for Workers Compen- '
sauan,as provided far by Section 3700 of tis Labor code.for lite performance of the
work for which this permit is issued
❑I have and will maintain Workers Compensation Insurance,as required by section
77W of Ne Labor Code,for NC Performance of the work for which this permit Is issued '
My Wmluss' Coy pains i".b/u+euu¢a.nior W Polity mmoaW�r ase: -
Caner.;/ /-7C' ZX/V Polity No.: IR:;Ly3L -
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
intersection need not keomplemd if the permit Is farms hundred dollars(SIW)
or lou)
1 cvruC- umt in the Mr..nce of the work for which this permit is issued I shall raw
employ any Person in any manmrso as to become subject a the Wortut Compensation
Laws of Califon..Due
Appli.,
NOTICE TO APPLICANT.If,u)cr making this Certificate of Exemption,you should
became subject he the Workers Compensation provisions of the Labor Cede,you muss
.,O foMwith comply with inch pnevidmm or Nis permit shall k dcemed revoked.
'z
CONSTRUCTION LENDING AGENCY
IWreb .rase,that lkrt u a construction Imnim a Y g gem for Ne performance of
rL Nc work for which Nis permit Is Iaslaed(Sec.7091,Ci,CJ
W Q lenders Name
Z;)z Landers Address '
U O 1 m,ify 0.11 hire mad Nis.PplieaWn ad sate Nu the shove lad.ien is
Iy ^ Correct-1+Era N comply with all city and county ordinances and sum laws relating N
.C) rV" Wilding conswction,and hereby authorise repmmentlim of this city u enter upon Ne
aWve-mentioned
gm property for inspection Purposes
pW, (We)agree a save.indemnify and keep ha mless the City of cupc lino again,
In inconseque consequence
of the licensing expenses which may in enYw'+Yamue against said City
U z APPLICANTeUNDegMmNDSng of this NO WILL COMPLY WITH ALL N0 -0 In Issued by: Date
SOURCE REGU
�� Re-roofs
Signature of IianVC er .Date
HAzARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or futum Wilding aavpant mm se Wdle banrdous mauaiai
as defined by Ne Cupertino Municipal Cade.Chapter 9.13,and da Health and Safety
code,Adan 15572(.)7 All roofs shall be inspected prior to any roofing material being installed.
Yes kA No
r/� If a roof is installed without firs[obtainingan inspection,I agree to remove
Will nhc applicant m num Wilding by ft Bt use Area
Air Qu or Mann which P
i,hvArgoas air conuminanu u defined by Nc Bay Arta Air Quality Management all new materials for inspection.
uicG
❑Yes IRINu ,
Ihatsmad NehvSucumaatM requirements under Unite,M93of Ne Wilding
stun asncm Safety Cade,4cho,dmaitz337 J2353A.I undcnunde occup Wilding
dao not cuncndY ha din it pof8 Certificate
ic mtify da lmaCy. of tea
myuircmcm,,.hkh Iii cera Ccrtifaate of Occupancy.
Sign4oplicant Date
Owner ar..th. Cftjn, Date' All roof coverings to be Class'%Q."or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35716141 . 00
DATE ISSUED. . . . . . . : 08/01/2008
RECEIPT #. . . . . . . . . : BS000005665
REFERENCE ID # . . . : 08080011
SITE ADDRESS . . . . . : 21884 BYRNE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SMITH MARCIE L
ADDRESS . . . . . . . . . . : 21884 BYRNE CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1156
RECEIVED FROM . . . . : RIGHT ROOFING
CONTRACTOR . . . . . . . : LOSTRIE, JEFFREY LIC # 20696
COMPANY . . . . . . . . . . : RIGHT ROOFING
ADDRESS . . . . . . . . . . : 467 SARATOGA AVE STE 1460
CITY/STATE/ZIP . . . : SAN JOSE, CA 95129
TELEPHONE . . . . . . . . : (408) 254-4439
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -- ----- ---- ---------- ---------- ---------- -----------
1BSEISMICR VALUATION 10, 800 . 00 1 . 10 0 . 00 1 . 10 0 . 00
1REROOFRES SQ FEET 22 . 00 286 . 00 0 . 00 286 . 00 0 . 00
---------- ---------- ---------- ------ ----
TOTAL PERMIT 287 . 10 0 . 00 287 . 10 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--------- --------------- --------------------
CHECK 287 . 10 #3872
---------------
TOTAL RECEIPT 287 . 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- --------- ------------------ -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
0 0 i
CITY OF CUPERTINO
p� REROOF
•CUPEI�TINO PERMIT APPLICATION
APN # 2�5 , // � Date: C
7
Building Address: o
w blAe
Owner's Name: Phone #:
YOB-2r_3 - SS90
Contractor:1�)Xll /�au�/ Phone #: YOu -Z YY-1119
J Fax #: YOB- ZX - 63 0 ;2'
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles >d- Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
41 qf_ Wood Shingles a Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report # _
To be Removed ❑ Provide Mfgr. Installation Specs.
Job besc/ript n:k11wdv-? woo Siplot// . fa/S/n��[ lA /XWj //�"
�S f/ K�JyS�3�� 70Y // f Aes-,'XP4h1 _ T L . Se�il pJ
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or it, there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuatio
/D
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: .
•
Signatur
Revised 6/16/08
1 CITY OF CUPERTINO
REROOF
CUPEkT`INO FEE SCHEDULE •
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
22— 1RER00FRES Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC 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: �+r(i c/iyy
Job Site Address: _21(99Y ,B rfte Cf.
Roofing Company Name; f i
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
.41 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 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 1. List Green Features on Plans A-1 1 point
TOTAL POINTS c! 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 friendty 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 -®
11.Recycle Job Site Construction 8 Demolition Waste i
650/, =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
6.Design Resource-Ef icient Landscapes and Gardens _ 4 Resource pts y=yes D
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 D
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every D%
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
C.Structural Frame 1
.1.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
B.Use Recycled Content Steel Studs for Intedor Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes p
b.Wall 3 Ener is
c.Roof gyp y-yes 0
3 Energy pts y=yes D
10,Apply Advanced Framing Techniques 4 Resource pts y=yes D
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pis y=yes D
112.Use 6—SB
a.Subfloors 1 Resource of y=yes 0
• b.Sheathing 1 Resource pt y=yes D
1 1 1
.Exterior Frmsh
INPUT ResDurces Energy [AWHeafth
1.Use Sustainable Decking Materials
a.Recycled content 3.Resource pts y=yes 0 .
J.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
13.Install House Wrap under Siding 1 IAC/Health pt y=yes p
14.Use Fiber-Cement Siding Materials i 1 Resource pt Y--yes 0
1 1 1
E.Plumbing
1.Install Water Heater Jacket - _ -
L_-------- --- - -' 1 Energy pt Y=Yes 0 I
2.Insulate Hol 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) i Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
I4.Replace Toilest with Ultra-Low Flush Toilets i
I(1 point each,up to 3 points) _ _ Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showarhead ' 1 IAO/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 41A0/Health pts. 0
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
1 1 i
r.trecmcai
I1 Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs�points,12 bulbs=4 points) ( Up to 4 Energy pts. 0
L��- --- - — — — •
Y.Install[C_AT Recered Fixtures with CFLs(1 point each,up to
5
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
f 1 1
G.Appliances
11.Install Eneigy'SarDishwasfiei 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy 1
(Conservation Features t 1 Energy pt y=yes 0
I3.Install Energy Star Refrigerator i 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 0
1 1 1
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Wails 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
r3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAO/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-ioam)
a.Walls 4 Resource pts y=yes 0
D,t;emngs 4 Resource pts y=yes 0
1 1
• .Widows •'
i1.Install Energy-Efficient Windows
• I a.Double-Paned 1 Energy pt y--yes 0
b.Low-Emissivity(Low-E) I 2 Energy pts Y--yes0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
P.Install Low Heat Transmission Glaiing 1 Energy of y=yes D
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Dud 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 IAO/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAO/Health pts y--yes 7 0
5.Install Solar Attic Fan 2 Energy pts y=yas 0
6. Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units -
a.Furnaces 31AQ/Health pts y--yes D
b.Water Heaters 31AQ/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
1 D.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes D
11,Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes D
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burring Fireplaces
• a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt Y--yes p
c.Install Airtight Doors 1 Energy pt y=yes D
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes D
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes D
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts yeses 0 .
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pis 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 D
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points)_ _ Up to 16 Energy pts D
16.Select Safe and Durable Roofing Materials -_ 1 Resource pt y=yes 0
7.Install Ralant Barrer 3 Energy pts y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yas 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes D
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
•
INPUT Resc,urces Energy [AWHealth
M.Indoor Air Quality andFinishes
1.Use LowMo-VOC Paint - 1 IAQ/Health pts y--yes D
2.Use Low VOC,Water-Based Wood Fnishes 2 IAQ/Health pts y=yes D •
i3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Fjnishes 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
;7.Sealall Exposed Particleboard or MDF 4 IAO/Health pts y=yes - D
B.Use FSC Cert fled Materials for Inte or Finish 4 Resource pts y=yes D
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 B Resource pts y=yes0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes D
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 01 0 0
C:datalprogslgreenbuildngguidelines/ramodalemlgmenpointsfmal27 2.D4prote.ted.xls
•
:b. Community Development
r iss 10300 Torre.Avenue
G' Cupertino CA 95014
~^ Telephone(408)777-3228
CITY OF Fax(408) 717-3333
LO-UPEkTINO _
Building Department
JOB ADDRESS:2/8oy � oytP PERMIT #
6d�2d�-41Dl
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: If 41 AAkf FAX # yog --2 yy-W
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
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing— ;!�,/ _ O ""4,1 a 0
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date