08030183 CITY OF CUPERTINONEM
BUILDING DIVISION PERMIT CONTRACTQR�INZ+'URMATION. -`.
_ � ak.,� _
aulLl rdP6ff"bELESTE CIR A PERFECT CLIMATE PERMIT 08030183
OWNER'S
NAME: PERMIT ISSUE DATE
CARRIE MUSSO 8375 BRENTWOOD BLVD STE B 03/31/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING FERMITINFO
R&R FURNACE 60K BTU, AC 2 . 5 BLDG ELECT PLUMB MECH
m�0 LICENSED CONRACTOWS DECLARATION IPGN
Job Description
td 1 hereby slow Wt 1 am luenscd muter Pmvluans of CMpmr 9(commencing . ...—
Tj I flit tionrm erof Divlrion]of WC BudnessanO Profrssions Code,aM mylkenm is
n n Tutt fame and e
Dicena Y, Is.g
Dam Con
RCHf1ECI'S DEC
I understand my pl...hall be used As public recnNs
k u� Namd Prresumil
bis OWNER-BUILDER DECLARATION
ZOO 9 I hereby ahem that 1A.1. ucmpt from the Contras ofs License nY taw for me
following mason(Saito IDmam Business and ve.de um Code:Any city stceunry
$
V. which rryvima a Permit m conwuq alcor.impmw.demist W,a¢pair YY.venture
—�v, prior in its issuance.abu reeuima tie applicant for such permit to file a signed statement
�<
that Wis licensed pursuanttothe provisions ofMeContrscmtsLicensLaw(Chapter 9 Sq.F[. Floor Area Valuation
?E 9 (commeming with section 7000)or Division 3 of me Business and Profecsions CMe)ar
I.a
S that he empt theem And the basis for the alleged exemption Any violador of
section 7031.3 by any applicant for a permit subjects the applicant to a civil Penalty of APN Number Occupancy Type
nm mom than five hundred dollars(ML
❑I.u owner of the pmp my.m my mployw withwga u th it mk mmpenudm,
and do Newmk.Yft The Cum4nmsLicense Lawrtdr L apply NY.Baioeof Required Inspections
and propProerty
who
bis Cana The C Mancemr License taw closer ant apply lf an owmr is 9 P
own em who builds i ed Mans los mon Ydwho Arenoahwaek wofffmthmuah his
awn employees,Provided tut such impmwmentt am not Trammed molfered me axle H.
however,thebuilding
au Impmvemmt4hat withinoneyou or mproefur the owner.
builder will luw the burden of ProHng NY he did net build or improve(or purpose of
Y10.).
1,As ower of the property,am ealusively contracting with licensed contractors In
construct the project(Sec.704,4,BYineas am Pmreadons Cada:)1th Commuters u.
certain Law dean not apply in an owner of property who builds or improv.thereon,and
who contactsfor such prejecta with a contractor(a)licensed Foruunt in the Comrs tots
License Law. -
0Iuoaamptunder5ec. .B&PCfmthismason
Owner Date-
WORKER'S
amWORKER'S COMPENSATION DECLARATION
I hereby afllrm under penalty of perjury one of the following declarations:
1 haw and will mountain•Cedncae ofctntcnt m Ylf-Wure faworkee.cempen-
sad .u Provided fm by Section 3700 of the Labor Cade.for ft performance of the
fgaor whieb this permit is issued. _
0/ve and will mairdam Wmkeh Commutation Irtsuesnce.u required by section
of the Labor Cade,for dte performance of t e work for which this permit is Issued.
War oAnP..a..loan.curia and P Iky"..her sm:
P.
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
i 7th section Met!Am mcampleted Ethe permit Is f«one hundreddollm(51m)
or tees)
I cldtify tut in the perfomaae of out.,it fa which this Permit is Wood.l shall nm
employ any Person in any Ammer an as An became subject m the watkeei Compensation
Law of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption.you should
become subject an the Worker's Compensation provision.of Ne labor Cade,you most
,J O forthwim comply with such provisions or this permit shall be drrmed revoked.
Z h CONSTRUCTION LENDING AGENCY
I hereby JErm Mal them is.mnsuvctinn lending agency far to performance of
a> the work for which thin Permit is issued(Sec.3097,Cm.C.)
W�Q Lenders Name
Z handers Address
U Q 1 certify that 1 have mad this application and sue that the above information is
Ly town.I.gree to comply with all city and county oniinances and aisle lam mladn5 to
.p building commection,and hereby anthorirz mpresentstim of this city to enter upon the
W ahold.-mentioned property for Inspection purpML _
gy (We)agree to save.indemnify Nd kap harmku de Cly of Cupertino spinel
was y liabilities,judgments,case and expenses which may In any my smite against said City �a
U 7
APP
a Scanting of cols pc.IL.
m� APPLICA U ERSfANDS AND W COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE ONS. nn
Xuoy Re-roofs
SignatureSignatureof ApplicanUContractwcnor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant a future building ocenp omme or hurdle Awards.material
As dented by the Caperuno ricipal Code.Chapter 9.11.and the Heald,And Safety
ceM.Section 23331(.)7 All roofs shall be inspected prior to any roofing material being installed.
Ya
Will the applicant or future building occupant use equipment or devlaa which If a roof is installed without first obtaining an inspection,I agree to remove
It haardnns air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection.
isticG
❑Yca a(fJn.'s1�1�
Ihavemad thedasSecau ma5D5. 553i 75534.1 Mpmr6 ofdmbildi.g
anawasar coat.secdmazss0s.2Ssvand2333a.IwdvstYddmKtheladltling
or
curt a Mw•tmmant lost it is my hems mihllity m unify time oavpant of the
irementapte toll met nmof.cmneateafoecupanry. Sig nature of Applicant Date
JS X31�g All roof c"s to be Class'J¢"or better
Owner or authmioed agent Dam
CITY 0F CUPERTINO
0
6 ITEMS OF 16 PERMIT RECEIPT OPERATOR: patg
COPY # 1
• Sec: Twp: Rng: Sub: Blk: Lo
APN . . . . . . . . : 326589*. 00
DATE ISSUED. . . . . . . : 03/31/2008
RECEIPT # . . . . . . . . . : BS000004316
REFERENCE ID # . . . : 08030183
SITE ADDRESS . . . . . : 206 CELESTE CIR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CARRIE MUSSO
ADDRESS . . . . . . . . . . : 20684 CELESTE CIR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144
COMPANY . . . . . . . . . . : A PERFECT CLIMATE
ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B
CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513
TELEPHONE . . . . . . . . : (408) 861 9545
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ---------- ---------- ---------- ---------- ----
1BSEISMICR VALUATION 8, 604 . 00 0 .90 0. 00 0.90 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
ITRAVDGC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 225 .25 0 . 00 225 .25 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 556 .76 MC
---------------
TOTAL RECEIPT 556 .76
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
506 FINAL MECHANICAL
•
0 03 043
al
CITY OF CUPERTINO
FURNACE/AC
® CUPERTINO PERMIT APPLICATION FORM
APN# C7 5,l 7 0 . Date: 3-3108
Building Address:
Z
C l le s
Owner's Name: Phone#:
Contractor: ^ P � Phone#:
H Br 2G i w�a e.
Fax #:
Contractor License#: .. Cupertino Business License#6�7/ Yy
z 3I ?
Contact: n S Phone#:f/,,O_ y�—
/�/ Fax #: 410a'-
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Residential Commercial ❑.
Job Description: v� rU
AG za' Tom
For Residential Installations:
Attic ❑ l"floor x 2"a floor ElAdhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑.
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: S 6 O Y Type of Construction (Usage Class):
Strapped ❑ On Platform ❑ Bonded ❑ New Location L Replacement
lei Valuation: c 96 Y
Green Building: Must attach Green Building Check list to this application
CITY OF CUPERTINO
aloFURNACE/ACCUPRiNO FEE SCHEDULE •
•
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Coinmercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
-install ation_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
113PGAS 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.
113SEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
I cooling unit,absorption unit,or ea
lreating,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 ¬ incl in an applpen-nit.
CITY. OF CUPERTINO
FURNACE/AC
cl OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
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.
LBSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
famace/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
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAiRHAN Commercial A/C Units<= l Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Conunercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
-IPGASRES 72esidentiaFfor ea gas piping em —P— -of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAHMAN Residential A/C units <= 10k CFM B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B
I IEPERMTTFEE Electric Permit E
/ 1MPERMTTFEE Mechanical Permit M
1PPERMTTFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
• PERMIT INVOICE OPERATOR: patg '
• Sec: Twp: Rng: Sub: Blk: Lot:
APN 32658998. 00
INVOICE DATE. . . . . . : 03/31/2008
REFERENCE ID # . . . : 08030183
SITE ADDRESS . . . . . : 20684 CELESTE CIR
SUBDIVISION . . . . . . .
, . CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER CARRIE MUSSO
ADDRESS . . . . . . . . . . : 20684 CELESTE CIR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144
COMPANY . . . . . . . . . . : A. PERFECT CLIMATE
ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B
CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513
TELEPHONE . . . . . . . . : (408) 861 9545
FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE
SEISMIC RESIDENTIAL PRINTING PERMIT 0. 90 0. 00 0.90
ELEC PERMIT ISSUANCE PRINTING PERMIT 40.79 0. 00 40.79
MECH PERMIT ISSUANCE PRINTING PERMIT 40.79 0. 00 40 .79
RES MECH REPAIR/ALT/ADD PRINTING PERMIT 61 .19 0. 00 61 .19
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40.79 0. 00 40 :79
TRAVEL & DOCUMENTATION FEE PRINTING PERMIT 40.79 0. 00 40.79
---------- ---------- ----------
225 .25 0. 00 225 .25
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
` Single Family GreenPoint Checklist dam:`3 �Z d' Build It Gree1i
1
The GreanPoim Checklist is based on the various green features Incorporated Into the home and Is the Sun Solu6wd From The Ground Up
halls for the GreenPoint Rated program.A home can be considered green If It fulfills the prerequisites,
some at least 50 points,and meets the).Please
points per category:Energy list
of Indoor d Quality/
•
Raters
(5),Resources ste and Waley(g).Please contact Build It Green for a list of qualified GreenPoint JI IL JI
Raters if you are Interested In pursuing third-party verification.
The green bulli ing practices listed below are described in the New Home Construction Green Building
Guidelines,available at v8ww.bj_12 raenoro.ENTER
PROJECT
s
NAME
n Q U Q 2
A 61TE. .'Y ./cam / U Pouds Avallafsle Per Measure:_
1.Protaq Topsoil and Minlmin irruption of Existing Plants 6 Tr – If n
❑ e.Protect Topsoil from Erosion and Reuse after Construction 'r I1.
❑ It.Limit and Delineate Construction Footprint for Maximum Protection r 0 r 1
2 Deconstruct Instead of Demolishing Existing Buildings On Site 0 3
3.Recycle Job Site Construc0on Waste(Including Green Waste)
❑
a.Minimum 50%Waste Dhrentou by Weight(Recycling or Rouse) Required 0 _ R
❑ b.Minimum 65%Diversion by Weight(Recytfmg or Rouse) 0 2
❑- c.Minimum BD%Drite ion by Wil(Recycling w Reuse) 0
2
d.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and DMeway 0
❑ b.Roadway Base 0 1
Total Points Available In Site 12 0
S.FOUNDATION'. - - 'Polms Avallable Per Measure e. .
1.Replace Portland Cement in Concrete with Recycled Flynn or Slag
A.Minlmum 20 FIFash a Slag - 0
❑ h.Minimum 25%Flash or Slag 0
2 Use Frost-Protected Shallow Foundation in Cold Aran(C.E.C.Climate Zone 16) 0 3
a Use Radon Resistant Can=eben on AbRisk Locations Only) 0 ( 1
4.Design and Bund Structural Past Controls '
❑ a.Install Termss Shields a Separate All Exterior Wood-IoConcrete Connections by Metal or Plastic Fasteners0Niders 0 1
1771 b.All Now Plants Have Trunk,Base,a Stem Located At Least 35 Inches from Foundation 0 1
Total Points Available In Founder=5 0
C.LANDSCAPING - - - - _ '–Points Available Per Measure
1,Construct Resource-Efficient Landscapes
❑ a.No Inversive Species Listed by Cil Are Planted 0 ,__ 1._
❑ b.No Plant Species Will Require Hedging p 1
• ❑ C.75%of Plaids Are Drought-tolerard Calilomla Natives,Madtemannn,or Other Appropriate Species 0 —� 3
2 Use FirnSsfe Landscaping Techniques 0 1'
3.Minimize Tud Aran In Landscape Installed by Sunder
• ❑ a.MI Turf Will Have a Witter Requirement Less than or Equal to Tall Fescue(60.8 plant fachl 0 2
❑ b.Turf Shall Not Be Installed on Slopes Exceeding 10%or in ken Less than 5 Feet Wide 0 i 2
❑ c.Turf is 533%of Landscaped Area(total2 points) 0 _ 2
❑ d.Told Is 510%of Landscaped Area(total 4 points) p Z
❑ 4.Plant Shade Trees 0 3
S.Group Plants by Water Needs(Hydroxoning) 0 2
S.Install High-Efficianry Irrigation Systems
❑ it.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers 0 2
❑ b.System Has Small Controllers 0 T 3
7.Incorpono a Two Inches of Compost in the Top 6 to 12 Inches of Soil 0 r 3
❑ 6.Muleh All Plantin Bode to the Greater of!Inches or Local Witter Ordinance Requirement 0 ( r 2
LJ g.Use 50%Selvaged or Recycled—Content Metal for 5D%of Non-Plant Landscape Elements 0 1
10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0 1
Total Points Avalleble In Landscaping=31 0
D.STRUCTURAL FRAME at BUDDING ENVELOPE _... "... . _ . ,.1 _. . ..... _ _'' Points Available Par Measure:
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 244nch On Center Framing 0 1
❑ b.Size Door and Window Headers fa Load 0 1
❑ c.Use Only Jack and Cripple Studs Requited for Load 0
2 Use Engineered Lumber
❑ a Beams and Header 0
E] b.Insulated Engineered Headers 0 _—L
❑ C.Wood Wissts or Web Trusses for Floors 0 _ 1
❑ d.Wood I-Joists for Roof Rafters 0
❑ e.Engineered or FingeeJointetl Studs for Vertical Application p
❑ I.Oriented Strand Board for SubOoor p 1
❑ g.Oriented Strand Board for Well and Roof Sheathing 0
3.Use FSCCertifrotl Wood
❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 2 _
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% 0
❑
C.Panel Products:Minimum 4D% 0
❑ d.Panel Products:Minimum 70% 0 1
0 2DD7 Build It Green Single Family GreenPolm Checklist 2007 Version Pagel of
€6 S 1
ENTER PROJECT
• • t tl
� Ia
4.Use Solid Well Systems(Includes SIPS,ICFs,A Any Non-Sdck Frame Assembly)
❑ a.Fibers 0 2 2 1__
❑ b.Wille 0 2--f-- 2
❑ c.Fears 0 2
S.Reduce Pollution Entering the Home from the Garage
❑ A.Tightly Seel the Air Barmr between Garage and Laing Area 0 I 1 I
❑ b.Install Gere a grants Fan OR Build a Detached Damage � 0
Lj S.Design Energy Heels on Trueness,(75%of Attic Insulation Height at Outaide Edge of E minor Wal 0
7.Desi Roof Trussss to Aerommodals Duchvork D
Lj L Use RecyededContsm Steed Stade for 00%of Interior Well Framing D I 1
6.Thermal Mese Wells:SIS•IDch Drywall on All Interior Wells or Wells Weighing more than 40lbicu.IL 0 1
10.Install Overhangs and gutters
❑ e Minimum 10-Inch Overhangs and Gutters 0 ! 1
❑ b.Minimum 24-Inch Overran s and GuDers 0 -
Total Points Available In Structural Setting Frame and Erwelape.30 0
E.EXTERIOR 111,11PESH Points Available Per Measure
1.Use Re cledComem No'Argin PII or FSC-Certified Wood Decking 0 2
2.Install a Rain Sween Well System D 1 2
77 3.Use Durable and Noneombusgble Siding Materials D 1 1
4.Select Durable and Noncombustible Roofing Materiels D I 1 2 1
Total Points Available in Ectoror Finish.7 0
P.INSULATION Pointe Available Per Measure
1.Install Insulation with 75%Recycled Content
❑ a Wells and/or Floors 0 1
—Q—h:Collin 0i-- -
2.Install Insulation that is Low-Emitting(Certified Section 01350)
❑ a Walls and/or Fibers 0
❑ b.Ceilings D
3.inspect Ouelity of Insulation installation before Applying Drywall 0 1 I
Told Prams Available In Insulation.5 0
G.PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efrciantry(Maximum 7 Points)
❑ e.Insulate Hot Water Pipes from Water Harder to Kikhen 0 1 1
❑ b.Insulate All Hot Water Pipes _0
❑ c.Use Engineered Parallel Piping
❑' d.Use Engineered Parallel Piping with Demand Controlled Orcuhdon Loop 0 I __
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop 0
❑ I.Use Central Cort Plumbing 0 I 1 I 2
❑ ZInstall Only High EfficiancyTolle!,(Dual-Flush or 51.26 0 ( ( 4
Total Polo Available In Plumbing=Total 12 0
R.HEATING VENTILATION Sa AIR CONDITIONING Pointe Available Per Measure
Lj 1.Design and Install HVAC System to ACCA Manual J,0,and 9 Recommendetibrh D 4 ;
2.Install Sealed Combustion Unite
e.Furnaces 0 2 -
D.Water Heaters 0 2
].Install Zoned,Hydronic Radiant Hearing with Slab Edge Insulation 0 1 1 I
Lj 4,Install High Efficiency Air Conditioning with Environmentally Raspomlble Refrigerants D 1
S.Design and Install Effective Ductwork
❑ L Install HVAC Unit and Ductwork Whin CondNcned Space 0 3 I
❑ h.Use Duct Mastic on All Duct Joints and Seems D 1
❑ c.Install Ductwork under Attic Insulation(Surfed Ducts) D
❑ d.Pressure Balance the Ductwork System 0 _r 1 _
E] a.Protect Ducts during Construction and Clean Ail Duch before Occupancy 0 — 1
6.Install High Efficiency HVAC Filter ERV 6t 0 1 1
❑ 7.Dont Install Fireplace or Install Sealed Gas Firepleces with Efficiency Rating Not Leas Than 60% 0 1
using CSA Standards
a.Install Effective Exhaust Systema In Bathrooms and Kitchens
❑ e.Install ENERGY STAR Bathroom Fans Varsetl Io the Ouhide 0
❑ b.NI Bathroom Fane Are on Timer or Humidslal 0
❑ c.install Kitchen Range Hood Versed to the Oulsitle 0 1 I
6.Install Mechanical Ventllefon System for Cooling(Maximum 4 Points)
❑ a.Install ENERGY STAR Calling Fans S Light Kits In Living Areae A Bedrooms _0 _� 1
❑ / b,Install Whole House Fad with Variable Spends 0 — —
�ry+ C.ANOmallCally Controlled Integrated System p 1 2 —r-
❑ d.Automatically Controlled Integrated System with VadaGS Speed Control 0 �
10.Install Mechanical Freer Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventilation System That Meeh ASHRAE 022 0 ___ _ _I 2
El b.install Ab-lo-Ab Heal Exchanger That meals ASHRAE 622 0 I 1 2 T
11.Install Carbon Monoxide Alarms) 0 1 I
Total Points AveOable in Heating,Ventilation and Air Condlionin .3DI 0
O
02007 Build It Green Simple Fam6y GreenPoInt Ch rcidis12D07 Version Pane 2 of 4
s
Community Development
ItCO0 Torre Avenue
pOrtinoCA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
z d �0 /�s>l
OWNER'S NAME: e clSS PHONE # oP-36 6-/s3 V
GENERAL CONTRACTOR: FAX # *>oe— jPiO S 6
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
t/ Heating 47ec4 0 V
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
T'
Owner/Contractor Si Date