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08050156 CITY OF CUPERTINO -0.issi +a^;a -t` e405 = a BUILDINcDrv)S)Ofr PERMIT ONTRAC`NTQRI,NFURMATIO BUILDING ADDRESS: PERMIT NO. 11445 CHARSAN LN R H BATHROOM REMODELING 08050156 OWNERS NAME: PERMIT ISSUE DATE LEE HIRSCH _ 20149 THOMPSON RD 05/20/2008 NE: SANITARY NO. CONTROL NO. (408) 354-1911 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O O C I= u 000 LICENSED CONTRACTORS DECLARATION • Job Description us I hereby arm that I ant licensed under provisions of Chapter 9(commencing p ice; _=� with Section 7IXg0ofDivision 3ofthe Busincasand ProfcuiOSCde s�iceneu RMDL MSIR BTH,RPLC FXTRS LIKE4LIKE IN EXSTNG n=D• in full force and effect (�/��`�u')V S iq? License Class /3 Lica LOCS, PLMBNG/ELEC/MECH,' R H BATHROOM REMODELING 5k-� Date raJ/O Contractor I' AM14 memg 4 ARCHITECT'SDECLA ATION RENWD BUS LIC 5/20/8 IIA1 understand my plans shall be used as public records Licensed Professional ' C 3 OWNER-BUILDER DECLARATION Pc.I I hereby alarm that I am exempt from the Conuanah License Law for the p 0 following mason.(Section 7031.3,Business and Professions Code:Any city or county 3 e which requires a permit to construct.alter.improve.demolish,or repair any mauve u z i prior to its issuance,also requires the applicant for such permit to file a signed statement < that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Ft. Floor Area Valuation Ya (commencing with Section 7000)of Division 3ofthe Business and Professions Code)or $25000 e 5n that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of p�,,ppNN Number Occupancy Type • mom than five hundred dollars(5503). 36210049 .tl(7' p y 0 I.as owner of die property.or my employees with wages as their sole compenndon. . will do the work,and the awctme is not intended or offered for sale(Sec.7044.Business and Professions Code:The Contractor's License law does not apply to an owner of Required Inspections' property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements an not intended or offered for sale.If. • however,the building or improvement is sold within one year of completion.the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). • o I.as owner of the property-am exclusively contacting with licensed contractors to , construct the project(Sec.7044.Business and Professions Cale:)The Contractor's Li- - cense Law does not apply to an owner of property who builds or improves thereon.and, who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's • License Law. ❑Iamexempt underSec. ,B&PCfaNisreason 4ierDau WORKER'S COMPENSATION DECLARATION I hereby affim under penalty of perjury one of the following declarations: ❑I have and will maintain a Cerdfrcare of Consent to self-insure for WorkefsCompen- sation,as provided for by Section 3700 of the Labor Code,fur the performance of the work for which this permit is issued. - ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3703 of the Labor Cale.for the performance of the work for which this permit th issued. ' My Worker's Compensation llosuranc{e'osier and Policy number are: • Carrier. S'y e A/t1 Policy No.: /lie 27q4 3 ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This scab need not be completed if the permit is for one hundred dollars($100) or less.) 1 certify that in the performance of the work for which this remit is issued.I shall not employ any person in any manner m as to become subject to the Workers'Compensation ' Laws of California.Dau ' Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must 0 Z forthwith comply with such provisions or to permit shall be deemed revoked. ? O ' CONSTRUCTION LENDING AGENCY N I hereby affirm that there is a con{tmclion the work fur whichlending a Ili ri Lender's Name thisteensy'for the performance of W Q permit is issued(See.3097,Civ.C.) CL z fender's Address ' 0 0 I certify that I have mad this application and suss that the above information is 4. coney.I agree to comply with all city and county ordinances and state laws relating to K '0 SVS building onswcdon.and hereby sutorim representatives of this city to enter upon Inc al above-mentioned property for inspection purposes / y, hamlets(We)agree to save,indemnify and keep haless the City of Cupertino against rel liabilities,judgmenu,costs and expenses which may in any way accrue against said City _11. („)z cPLe ofDeRToS thipermit. 1 �Za te> ^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 4a Air�� Date SOURCE REGULATIONS.r Signature Re-roofs 'of Apptican aurae • .�Date J HAZARDOUS MATERIALS DISCLOSURE Type of Roof • Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Code.CaY" Na Section 25532(x)? • All roofs shall be inspected prior to any roofing material being installed. Will tin,applicant or future buildingoccupantequipment If a roof is installed without first obtainingan inspection,I agree to remove pp use a tai ut or which l� emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ltl��� ❑Yes No • I have read the Wankel'materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand low if the building does not currently have a tenant.that it is my responsibility to notify the occupant of the ✓equire:nem which must be met prio • tee of a Cadfcate of Ckcupanry. Signature of Applicant Date CaOwner or brim agent Dam' coverings All roof verin s to be Class'yr or better I C. • CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec : Twp: Rng: Sub: Blk: Lot: APN • 36210049 . 00 DATE ISSUED • 05/20/2008 RECEIPT # • BS000004837 REFERENCE ID # . . . : 08050156 SITE ADDRESS • 11445 CHARSAN LN SUBDIVISION CITY • CUPERTINO IMPACT AREA OWNER • LEE HIRSCH ADDRESS • 11445 CHARSAN LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4981 RECEIVED FROM • RICHARD A HORTON CONTRACTOR • RICH HORRON LIC # 23649 COMPANY • R H BATHROOM REMODELING ADDRESS • 20149 THOMPSON RD CITY/STATE/ZIP . . . : LOS GATOS, CA 95033 • TELEPHONE • (408) 354-1911 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL 1BSEISMICR VALUATION 25, 000 . 00 2 . 50 0 . 00 2 . 50 0 . 00 1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00 1REMRESBAT SQ FEET 122 . 00 429 . 00 0 . 00 429 . 00 0 . 00 1STPLNCK HOURS 1 . 00 122 . 00 0 . 00 122 . 00 0 . 00 TOTAL PERMIT : 663 . 50 0 . 00 663 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER CHECK 663 . 50 #1432 TOTAL RECEIPT : 663 . 50 411 � r 0?05 0 /56 CITY OF CUPERTINO cf ADDITION/REMODEL • CUPERJINO PERMIT APPLICATION FORM APN # LO / 0 0 L/ 9, v 0 Date: Building Address: //' 'C Gl, I In • Mailing Address (if different from building address): Owner'sName: / Phone# : // /ee /rn0{ I onn7 /-(Jrch 1(c6 qq ; 111/4Contractor: - r Phone#:/70e 35-a( mit j jA-7 hf (Lown. Q2 iv-ea-c c:I Fax #: 4103" 3S7-/ 7113 Contractor License #: 675-02C Cupertino Business License it: a 3 (p (.{-9 Contact: r ca nor( Phone#: A/pg A/7Z 96 5-6 Fax #: 4/03 357-172((5 Building Permit Info: Bldg. Elect. 71 Plumb. a Mech. ® Hillside ❑ Milr Job Description: Addition (adding sq footage): What is being remodeled? /i- — /� .ser l3Arz reit/26e 1,5crvre5 //Ke Fir l'ke I.-? ext,-r$ /oc/firvns, 471e9 Remodel Includes Re-Roof: Yes ❑ No M If yes list number of squares Remodel Includes Structural: Yes ❑ No Square Footage: • Addition: _Porch: - Deck: Garage: Detached Attached Remodel: Kitchen Bath x Other /21 % Type of Construction (Usage Class): Occupancy Type: 1A, 11B ❑ 11, Ill, V-A ❑ 11, 111, IVV-B Valuation: Please check this box if the project is a ZS.GAG, second-story addition ❑ Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable, Green Building Points Achieved: / include in plan set & the sheet index. ***For Office Use Only*** Over-the-Counter ❑ CITY OF CUPERTINO ADDITION/REMODEL 10111.! cuPERJINO FEE SCHEDULE • Quantity Fee ID Fee Description . Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD PLLONGRNGR Long Range PL Planning/Residential 1R3INSP Dwellings Inspections B 1R3PLNCK Dwellings plan check• B 1 R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check • 1R3HINSP Dwellings Hillside B inspection 1 R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Inspection • 1R3HREPLNC Dwellings Hillside• B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials Inspection 1 R3ALTPLNC Dwellings Alternate B Materials Plan Check IPCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service . P 1BSEISMICRE SeismicResidential B DECKS 1R3SFDADD OR 1R3SFDREM IDECKWOOD " Deck (Wood)-Each B • (Each) 1DECKRAIL Deck Railing-Each B (Each) CITY OF CUPERTINO ADDITON/REMODEL • FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft , GARAGES 1R3SFDADD OR 1R3SFDREM • 1GARDTW<=1K Wood Frame up to B 1,000 SF 1 GARDTM<=1 K Masonry up to 1,000 SF B BCONSTAXR Construction Tax Res (new detached garage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER •Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR . 1R3SFDREM IPATIOENCLW Enclosed Wood up to 300 B SF • 1PATIOENCLM Enclosed Metal up to 300 B SF 1 PATIOENCLO Other Enclosed Patio up B to 300 SF 1COVPORCH Porch Covered-Each B (Each) • • 1 REROOFRES Residential Re-roof Each B 100 SF REMODELS 1R3SFDREM IREMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check) 1REMRESBAT Bath Remodel up to 300 B " SF 1REMREOTH Other Remodel up to 300 B 64 SF • REMODEL PLNCK / I STPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE I remodel) COUNTER PLAN CKS. 3 of 3 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE • Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B (ea 8 windows) 1 WINNEWNSTR New Window (non- B structural) 1WINMEWSTR New Window (Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window (Structural) B SKYLIGHTS 1R3SFDREM I SKYL<10 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 B sf or structural 1STAIRS Stairs-first flight/ea addt'l B . 1EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1ELCPLNCK Stand Alone Electric Pln E Ck (hourly) 1MECPLNCK Stand Alone Mechanical M Pln Ck (hourly 1PLMPLNCK Stand Alone Plumbing P Pin Ck(hourly) IBSEISMICRE Seismic Residential B I TRAVDOC Travel & Documentation B • 1BUSLIC Business License B 4 of 3 ,41,54 5rer o4/moit, enrc�(e,(c6 /i� d /dof/9�e e,os %te/Ln ( �onie /� �S/ (�/b$)91Re nn�e — sivi/J - oc,91?bi sProjeI : , e / aFt'rvres ,Sixr//V'/$ Gh/ S74i Wim/ 95-0/1, /217z SqFM Cv/e ,—,no J L'c rrykror f . M• Cvsro�r IZ�mccf .L:r3 (L/o8) 3sZ//c. // .2x/4/9/ /7o�npso�r /2c,C , /1,Yf'nsc W ,75'Z�ZS— rrq APPROVED Ao S 6 n-rz�s CA- '7 5Z3 3 CCNOOCODES ACE ITH THE ND ORDINANCES or /------;/. � GUPERTINO -- ;: ~ Ze9 try e) r0: IA o c ReeIn- :at IVEUir (::::5 cii-iSf? "rssetUIplans andGAG,Yns+3/ / Gi3 kept onthe sPe fixationsIC + ul to lob at all times MUST � �� r 5 make any chap and it is Un mi same Without changes or alteration, ai same n :oaf De written permission fron. i i+i scam pth' City of Cupertino. }I/ Prb of this plan and sPepfications l�t'PLjPc� L 1101 be held to permit or • /fit �� 'r Wal of the violation of . to be ar l l /c-"�� v Crry 0 mna °ny Prours,on q v Ir. am (w) I� ii nce or kale Law 1` Cr�) a . iir7) • (Aura) ici a iv k g . 1Z8()l/1CC s S4 ,weir Rer�lo-ce 1Zeplgr� err (eJ�c l Ce) <lccc 5 CG) COv7nxr(Q I ✓it.1 x �- • �v i7>7� L-L std (��, - &)weir Jot Shocc et Vl}ly. X _ ('ea�f it o m, Fr. !sr IS"' t vn,n vn,'n I; '- 1 r + i b 64re,„irrn I Eau&r we'' wtarecicerRi., r kg)131 I Community Development 10300 Tone Avenue Cupertino CA 95014 • Telephone(408)777-3228 CI OF Fax(408)777-3333 CUPERJINO Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; • • Construction debris, including dirt, concrete and paint; • Landscaping runoff containing pesticides or weed killers; and • Any material dumped or spilled into streets or storm drains • The property owner and the contractor share ultimate responsibility for activities' • occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of the City of Cupertino web site at: http://www.cupertino.orq/city government/departments and offices/ environmental services • COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • • Typical construction work hours are: - Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street construction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise levels from complaint site - 65 dBA For more information on noise control, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at http://www.amlegal.com/Cupertino ca/ • Greg Casteel Building Official 1 �l i-ti-a71 5;)1 . a ,we--; J Y5 ASSESSOR COPY I. 9 , 11 �,. 0 �,u, i „_5i )131 .g `f1 " aNUl('a J )( 4111/1 -h�"no9 f Q01...Uri'?0 FGII /t1S a/ ►N t, 0 U'w - )� 7r y ut.noo (e7 t ?1-U1d a 55277Ij (a) r di0 ,, � i -- 9-'1das/ Ja °' till 2. Wr I . ?Ili/daa Ke10 4 ti / . r(1/) (ra � Al L � `;d , 0 , . 511Y^VJ st.y'' O 's7lu 5 5' J ' ' -J9 r �� , lece) _____" (d 'J c}z? C .(-2_S& -10 saty9 507 >' _52.c15E9#25t2 'R'tt 'yZ, vocp'Gc.oy/ 6/7/o • // ?'//Z.Sj (SOb) Tw)K-a om-td-N.t-Dcu5(1) 'W 'el 1 Jal"°.<u '-'d bS //r/ sz-at11.170/- CL�IS�aa �/ sa.in-x,�/ ,4/oS/2 ' 0UUC ',3 / L d/'2 / -Ne5da a-�9//tea S/ pt[6i 'a�'oU'a2/ AV(r tAt/5Jf/99 J , / • ;- t2- ' r° -a 'L('b'2 J4_ /5-6"/iL/ by._94609b) y5.�,y/ a,vvop rvt' n : ,2COJd 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) ,..-.:M1.,.; <*'�SR.!" r .. ?�s.:�.'sn'�rS v¢Y'r.,�Yt�','R � { Y al,+y$'in>, I ° P`H„ . ,.rS� 7r,. . � .N.p ir':l;u7+x+i+,kv & >",,.a , r,[.5�;xf,:' 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) 5-1 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.) 12-1 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 +=* K;c 'l,,;, TOTAL POINTS 40 points 7(LICIs Ckcr1ai GI • • OFNICE Cop ops Rso:11,, , a A NAY zil vMos • • 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 Resources Energy IAQ/Health A.Site 1.Recycle Job Site Construction 8 Demolition Waste 1 i 65%=1 point;75%= 2 points;B0%=4 points i up to 4 Resource pts 0 2.Salvage Reusable Building Materials .i 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 8 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 8.Design Resource-Efficient Landscapes and Gardens 4 Resource y=y pts es 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 U • 0 0 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 . 0 0 0 C.Structural Frame h.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 Stn ctural Insulated Panels(SIPs) a.Floors • 3 Ener b.Wall Energy pts y=yes 0 3 Energy pts y=yes 0 c.Roof • 3 Energy pts y=yes 0 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 2.Use 058 - ---- --- --- w a.Subfloors ( 1 Resource pt y=yes 0 • b.Sheathing 1 Resource pt •y=yes 0 . . f 0 0,, 0 INPUT Resources Energy .IAD/Health D.Exterior Finish 17.Use Sustainable Decking Materials. -- • a.Recycled content a Resource pis y=yes— 0 b.FSC Certified Wood 3 Resource pts y=yes— 0 12.Use Treated Wood That Does-Not Contain Chromium/Arsenic : 1 IAQ/Health pt y=yes 0 13.Install House Wrap under Siding 1 1 IAQ/Health pt y=yes— 0 14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0 0 0 0 • E.Plumbing 1.Install Water Heater Jacket — --- _J 1 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 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 Toilest with Ultra-Low Rush Toilets (1 point each,up to 3 points) t 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 IAQMealth pts. 0 8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 . 0 a r.tieczricai - • 1.Install Compact Fluorescent Light Bulbs(CFCs) (6 bulbs=2 points,10 bulbs 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. 1 0 3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. liq y 0 • 4.Install High Efficiency Ceiling Fans with CFLs (1 point each,up to 4 points) Up to 4 Energy pts. 0 . 0 0 0 G.Appliances • 1.Install Energy StarDishwasher 1 Energy pt y=yes— 0 2.Install Washing Machine with Water and Energy . Conservation Features . I 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 0 0 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.Instill'Recyclbd-Content,Fibe}glass Insulation witf Lo Added Formaldehyde _ 1 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 y=yes,4 Resource pts es 0 6.Alternative Insulation Products(Cotton,spray-loam) • a.Walls 4 Resource pts y=yes 0 o.uenmgs 4 Resource pts y=yes 0 0 -.0 - 0 • . INPUT Resources Energy 1AO/Health I.Windows :1.Install Energy-Efficient Windows • . a.Double-Paned 1 Energy pt y=yes 0 b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0 ' c.Low.Conductivity Frames _ 2 Energy pts y=yes 0 2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0 0 0 0 J.Heating Ventilation and Air Conditioning • r.Use Duct Mastic on All Duct Joints1 2 Energypts --.. 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=yes0 4.Clean all Ducts Before Occupancy 2 IAO/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 B.Install Sealed Combustion Units a.Furnaces 3 IAO/Health pts y=yes 0 b.Water Heaters 3 IAO/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 stoveslnserts 1 IAO/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 4IAO/Health pts y=yes 0 16.Install Heat Recovery Ventilation Unit(HRV) 5 IAO/Health pts y=yes 0 17.Install Separate Garage Exhaust Fan 3 IAO/Health pts y=yes 0 . I . 0 0 0 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=1 8 points) Up to 18 Energy pts 0 g 1 Resource ty=yes 6 Select Safe and Durable Roofn Materials 7.Install Radiant Barrier 3 Energy pts y=yes 0 - - . Q U Q L.Natural Heating and Cooling - - 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 0 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes , 0 • ` � • 0. • • INPUT Resources Energy IAO/Health Indoor Air Quality an. Finishes 1.Use Low/No-VOC 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 Low/No VOC Adhesives ptsy=yes I 3 1A0./Health — es D 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQMealth pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 ;7.Seal at Exposed Particleboard or MDF . 4 IAQMealth 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 0 0 0 • N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 [2.Use Rapidly Renewable Flooring Materias 4 Resource is es 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5!AO/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 0 0 0 Total Points Available: 1401 1301 57 • Total Points Project Received: ill 01 Ol 0 G:datarprogslgreenbuildingguidelineslremodelerslgreenpoinisfinal212.o4protected.xis • • • • Community Development 10300 Torre Avenue I .! `' J Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 OUPERTINO Building Department JOB ADDRESS: PERMIT # //4"6"C C/4/-7/-;,9n ,4 oeosors ' OWNER'S NAME: T ejnn,Y �/ee Al;,-5,4 PHONE # 4477 ;Sz//eri( GENERAL CONTRACTOR:0 f-f cc '5 7znn QCm �( ndii,, FAX # %,3 3sra7 -j // 3 /2 I am not using any subcontractors: f/r�Q C/ / n a' 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