08070151 CITY OF CVPERTINO � ';aq hE4r e
Drvlslorl PERIVIIT 1CONTRACTQRTN.E'QRMA,TJON—
BUILDING .• '
BUIIDINGA DRESS: Pmoorr NO.
10588 CHACE DR T D ROOFING 08070151
OWNER'S NAME: PERMIT ISSUE DATE
'PAN HUYN11 675 TULLY RD 07/22/2008
NE: SANITARY NO. CONTROL NO,
ARCHITECTrENGINEER: BUILDING PERMIT INFO
RE—RF RMV 6HK, INSTL CMP BLDG ELECT' PLUMB MEcx
o c LICENSED CONTRACIOR5 DECLARATION O O O D
7d u1 Mrtby sufirm that L am
m li n,ed under proviakn,of comic,9(cPmmaannj , ^ "--- T Job Description
withs«dpn7gWB orOiHaon3orde ausinrssad Pronasion,Code,and my Beatma
' m in full forte and cff FL �, q
nn z ticenm CI lY.
k,q Da¢ Canusear
a 7W ARCHITIECTS 6 DEC ARA
U I undersand my Plans shall huNVsed sed as Public me s
X wo t; Lkemcd ProImmo l -
5 OWNER-BUILDER DECLARATION
2 1 Mmby affirm that 1 am ucmpt room the ConaacmYs License Law for tM
C q O following mama(Socdon 70313,Boardroom and Pmfcasioes Code:My city to,coumy
I3 V which rtquires a permit in eonsau0.as,uninnova.demWim.or mpair any swewm
_zon Prior w itsinuence.alai mqunms M applies¢for such Permit to file.sigrad naament
€<
that hcislimnmdpurnuntmdxprovistomofdcContractor's uavcLaw(Chap=9 Sq.Ft. Floor Area Valuation
3 (commencing with section 7000)of Division 3 of le Business and Pmfeuions Code)or
R that he is e¢mPt thudmas and the haws for than akgad esranpdmd Any Nolatfon of
Seulon 7031.5 by any,applicant for,pemnt sobjecu than applicant to a civil Mostly of anc APN Number Occupancy Type
ont inthea fin hummed dollen(5501). P Y YP
❑1,u.woof of the property,a my uvpkyw with pjn,u fie'v ink emnpen,Wm,
wilt da thC¢mit andme h.Cor isoat Ntended IXanC do Is 1 apply to a(,now.of
and enywho W code TM Comncalr Chatho raw dna,set apply lf m owms is Required Inspections
maPmywM build.«improvch ian,andwM ddno,Intended molnar formic.
rmic his
awnempleyees.provided that such imPmvemwtt amnotkendd araQred fm isle B.
Walder.the budding arimpmvnentg mid within arc Kar or compkom,the aviation,
Wilder w11 Nw this burden of pooling dust M did nm Wild or imitative for puryoe of
sak.l.
0 1,u owKr of than property..m exeluavely conaaning with Iian,ed conlactma a
camrott tM projau(Sec 7014,Business;mod Profession,Code:)That C000acmYs Li-
.Law does act apply a m owner of property who Milds or improv thetem,and,
wM cmtncts for such pmims with.mnoxbr(s)Itcwed Pmasunt no the Conuampfs
Licence Law.
O l am tempt undo See .B B P C for this rtamo
Owens Date
pIWORKERS COMPENSATION DECLARATION
I M ' Penaltymby aabasic,Penalty or perjury de ate sir following aeelaradone
low,and will maintain,Cenifteae cfCommnt a self-huum for WortefsCanprn-
aattm,as provided for by Saint.37M or the labor costs,for the Pertormma or the
r which this permit is Wood
hoe and will maintain Workeh Com amustion In,unnca,as rtquired by Smion
3710 or the Lahr Code,ren thin parfmmmea of the wort for which this Pmmh ns ismal. .
My WorMhryCo nea6 1 "'n"as
and Policy number art: _
Carsicr. "' PolicyNa: �f / 3 — J
CERTIFl(A n OF E7fEMP ION FROM WORKERS'
COMPENSATION INSURANCE
frons random nasi not Mcomptemd dthe Pictish is forams hurmmddo0an(3I W)
orksa)
1 cmify that in the perrumon.of tM work for which this Permit u issued.I shall was
ampley army person in any mmncrm as b become subject to the Worken'Compevadon
Lap of Caiifomia.Due
Applicam
NOTICE TO APPLICANT.If,afwr m.king this Connnesa of ExempOam.you should
become subject as the Woods Cmmpeo nation ptovisimu of the labor Code,you mum
0 O foMwith cpmP1Y with such Provisions m dons W it shall M damd rtwM
mcd.
'Z" CONSTRUCf10N LENDING AGENCY
V
F IMrtby N'um that thereumod Sc.d 097,lending agenry for the pMwmanaN
ai
the wart for which Ida Rrmit V iuud(ScJ09],Civ.C.I
4 A LaName
�z lanmice.defs Add.
U Omaw
1 tify that 1 hrid this aPplic Sim e 1M
and sufind At information is
I5. FC.) cbamm.I ajma an comply with all city and cowry ordinances ad awe lap¢lain{to -
O Wilding conswdon,attd Mrtby amhodr rtpamntstiv ofthis city to caro upon tM
abow-mentioad pmpany fm inspection parpoma
F y (Wa),gme to save,indcmntry and kap hamkss the city of Cuputim against
r-,y liabilities,judgmens.costs and expenv whichmry In any way acme again,t said City
U z in cwwgaae of ting of that pewit.
m"t APPLICANT N STANDS ANO WILL COMPLY WITH AL NON-POI Issued by: Date
SOURCER U ONS. .Z-Z
e-roofs
sijvumee Apps Man
HAZARDOUS M4FIALS DISCLOSURE 'type of Roof
Will rte applicant or rawer building Co aaupmr nasi m nndgk hmNom maenai
m.Bond by 1e capemmM aisp,f coed.LT,aPta,9.1z.and the xdam arta s.rmy .
cute.Session 25532(7)7 ("°) All roofs shall be inspected prior to any roofing material being installed.
❑res
Will Ne apPlicmt or forum building occupant use equipment or devise which If a roof is in talled without first obtaining an inspection,I agree to remove
t hmvMm air cmtsmi to defined by the Bay A.Air Gualily Menagammt all new mat al f inspection.
Di ,i3O
[I Yo SNo
Ihawnad fieh wsmmdalsmquimmemfunda,CMpw6.95offie Caiifar-
nu HralN9Safay Cade Sr.'dw 25505.25533 ad25534.1.,d..a finif de building
does not cosmic. enmo Wt it or my nummibifity to Poor the gaup or fie
rtgaminno taw in MmetPrior attsom"aeraCrofaamo0cutpscy. SignatureofApplicant Dale
-7 �2 O
Owmraauthan td agent m' All roof coverings to be Class'%¢"or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32613132 . 00
DATE ISSUED. . . . . . . : 07/22/2008
RECEIPT # . . . . . . . . . : BS000005534
REFERENCE ID # . . . : 08070151
SITE ADDRESS . . . . . : 10508 CHACE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TAN HUYNH
ADDRESS . . . . . . . . . . : 10508 CHACE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1010
RECEIVED FROM . . . . : LESLIE A HOANG
CONTRACTOR . . . . . . . : LESLIE HOANG LIC # 23155
COMPANY T D ROOFING
ADDRESS 675 TULLY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE (408) 892-8872
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
1REROOFRES SQ FEET 35 . 00 455 . 00 0 . 00 455 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 456 . 50 0 . 00 456 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 691 . 10 VISA
---------------
TOTAL RECEIPT 691. 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
� D7 o/_s
CITY OF CUPERTINO
REROOF
*CUPERTINO PERMIT APPLICATION
APN # 2-� (P/ / 3 O C) Date:' ' 1
log
Building Address:
1 0 S o '$ ch Cx (-Q.-
Owner's
.tZOwner's Name: Phone #:
i q� Y\ V\ OSS 1 ,25v
Contractor: 1 Phone #:
D C o A � L{ 08 % y9
Fax
x #:
Cupertino Business License #: Contractor License #:
SL4Ssq1
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles t( Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: ff
frer,\ ode Sk0- lc� 716
pS 6
. 30 # fi
Residential 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 S (S1D
•I Have Read, U rstand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
-� CITY OF CUPERTINO
REROOF
CIT OF
CUPERTINO FEE SCHEDULE ,
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLROOF
�S
/ 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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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 1/4" 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: .
Job Site Address: f O S U $ C,N R Ce LQ1(
Roofing Company Name:
Applicant's Signature: Date: /1 /�
• Greg Casteel
Building Official
Revised 11/2/04
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 tints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 _j_points
D. Structural 3. Uses Wood Woist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathin 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 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/S ec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A3 1 point
3. Energy Star Refrigerator, (Note/Spec. A3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
Plan Review Process Work Book Page-l2-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 Reqvurces Energy IA011-lealth
A.Sita
1.Recycle Job Site Const action&Demolition Waste �I
i
65%=1 point;75%= 2 points;BO%=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
B.Design Resou ce-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 1
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
I ! 1
C.Structural Frame
Fl—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 O
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 Interior Framing 2 Resource pts y=yes 0
9.Use Structural insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes C
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes O
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
12.Use OSB _ -- --' -"-1
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing_ _^ -- 1 Resource of y--yes 0
1 1 1
D.Extenor Finish
INPUT nesDumes Energy [AWHealth
11.Use Sustainable Decking Materials - --
i .a.Recycled content i 3 Resource pts y--yes 0 •
b.FSC Certified Wood 3 Resource pts y--yes 0
j2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Healfh pt y=yes 0
I4.Use Fiber-Cement Siding Materials _ { 1 Resource of Y--yes 0
E.Plumbing
i.Install Water Heater Jacket
_ V„ 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 Row 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) i Up to 2 Resource pts. D
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) _ _ _ _J Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showamead� 1 IAQ/Health of 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,uo to 4 points) Up to 4 IAQPHealth pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
I 1 1
r,.twcmcai
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs--2 points,l0 bulbs�points,12 bulbs=4 points) Up to 4 Energy pts. 0 182.Install IC-AT Recessed Fixtures with Ci(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. D
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yesTo
0
.2.Install Washing Machine with Water and Energy - 1
Conservation Features j 1 Energy of y-yYes0
3.Install Energy Star Refrigerator i 1 Energy pl y=yes0
4.Install Built-In Recycling Center i ' 3 Resource pts y=yes
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 Insulali6nn with
No Added Formaldehyde _ ( 3 IAQ/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 C •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.cewungs 4 Resource pts y=yes 0
INPUT Resources Energy IA01ficaims
I.Windows
1.Install Energy-Efficiant Windows -
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) I 2 Energy pts y=yes 0
c.Low.Conductivity Frames __ 2 Ener s es
r__ � 9Y P� Y=Y- D
2.Install Low Heat Transmission Glazing 1 Energy of y=yes 0
11 1
J.Heating Ventilation and Air Conditioning - '
�1.Use Duct Mastic on All Dud 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 pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yas 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
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y--yes 0
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=yas 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 Buming Fireplaces
• a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy of 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 4 IAQ/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(Nater Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Virire for Future Photovoltaic(PV)Installation 4 Enaroy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2A kw=12 points,3.6 kw=16 points)_ Up to 18 Energy pts p
r6.SSelect Safe and Durable Roofin Materials
!__.�_� 9 - _ _ _ � 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes p
1 1
L.Natural Heating and Cooling 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
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 Quahry and Finishes INPUT ResDurces Energy IAOIHmlth
11.-Use LowM640C Paint - _ 1 IAQ/Health pts y--yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
i3.Use Low/No VVOC 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
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts yeses 0
;7.Seal all'Ezposed.Particrd'o
leboar MDF _ _ 4 IAQ/Health pts y=yas 0
B.Use FSC Certified Matedals for Interior Finish 4 Resource pts y==yes 0
9.Use Finger-Jointed or Recyclad-Content Trim 1 Resource pts yeses 0
10.Install Whole House Vacuum System 31AQ/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yes 0
12.Use Rapidly Renewable Roofing Materials _^ S 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=yas 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yas 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 i t
Total Points A 1 1401 130 57
Total Points Project Received: 1 01 0 0 •
Gaata�procygreenbuil3noguidelinshemodeleNg2enpoiMsfina1212.04prmehed.xls
•
affl
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
1o540 S Cce Xr 6 &D21
OWNER'S NAME: -t n R wV I N PHONE # g-u 5 S p
GENERAL CONTRACTOR: i FAX #
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
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date