08080108 CTTY OF CUPERTINO ;d «*ss A3»t� r'„�:..a��"^" ' 3•�F4'�:<. �s
13UTLDING DI-VISION PERMIT COAITI2ACTQR INFORMATION
BUILDING ADDRESS: PERMIT NO.
201.1.9 C14AVOYA DR JON R CRASE CONSTRUCTION 08080108
"NEWS NAME: INC PERMIT ISSUE DATE
I.,I'N SHENG—TZ AND PI—YING H 164 GILMAN AVE 08/14/2008
NE SANITARY NO. CONTROL NO.
(408) 370-1485
ARCHITECTfENGINEER: BUILDING PERMMNFO
BLDG ELECT PLUMB MECH
0 0 0 0
300 LICENSED CONTRACTOR'S DECLARATION lob Description
rd E 1 ids 7 affirm Net 1 ire li¢vN miler and
Piumu of Chador 9(commencing P
_gymNNs«tionsalio)oroivivan3orthe BudnessandPmfcasiomCode.mdmylkenmts RPR STRCTRL FRM LIKE4LIKE @FRNT WNDW, RPLC WNDW
full farce and en / //eJ
z (f J7 LIKE4LIKE, INSLT, SHTRCK & PAINT
P�_ Liccns Class Lk.a
e—pppp
Data TSDECLA E CduS)X.aC'n0
Y
ARCHITECTS DECLARATION
t 2 I uMcrsunJ roti Pkns shall he dead as public mentis
It
at; Licmved Profeummul
3 OWNER-BUILDER DECLARATION
I 1 hereby affirm Nal a
1 am empt from the ha
c Cantrector's License w for Ne
p o following mason.(Section 111.5.Business and PnefeWom Code:Any city Per county
$� which requires a Permit to cmdande.JNr,impmnt.dcomum.or repur any swctum
-Zi prim m its issuance.also requires theapplkam for cash Permit to Bk,signed statement
E xx< Net he is licensed pursuant m lite Provisions of tic Contractor's U¢ruse Law(Chador 9 Sq Ft. Floor Area Valuation
yF (commencing with Sermon 7MR)of Division 3 oftim ma Businand Professions Cada)or $2500
f R$§ Nat hd Is esensm therefrom and the buns fm dm alleged esempdon.Any violation of
Section 7031.5 by atry applicator for a permit subjects the applicmt no a civil penalty of
roNumber Occas TypeOccupancy
Luowvterof raid the.ny,nr myemployea with wage ualeisale(sok emnPenastion,
and Pr gamin.he ,and tier sw Clu Is not intended License
raw do s not
T04,1,Business
and property
wh dtu Cade The Canmctm's Liatue Ism dao not apply N rl owner is Required Inspections
progeny who busprsorimpmves Nemaq and a ho dao suchwort hivuelfedINough his
awn wer,the
or i Nat such improvements ase not eaendnd mortmnd rm sala.our s..
however,Ne Wilding ra Mpmvdmmt k veld within aro year of comovefar thd ownaf
Wilder will have dte WNen of proving that he did ret build a improv far puryau of
sok.). ..-
❑1.as owner of the property,and conclusively contracting with flamed mnuxun to '
muvuct the pmjea(Sea 7044,Busiaa,nd Professions Cade)The Comracmta U. .
come law does not apply N an owner of properly who Wilds or improves Nemon.and.
who contracts for such projects wish a contractors)licensed pursuant to Use Con ractoh
Licease law.
❑lamaemptundmsec ,Bd•.PC fm Nu won
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby afNm under penalty of perjury one of the fallowing declarations:
�1 hsve,nd NI maimun a tion37M of me Labor
Coca.for a Workeh ce of the
most, r pro h thi far mt Section 3]00 of tic lahar Code.for du Performance Per du
caret for which Nu Pewit is issued.
0 1 have and will month Winter's Compensation Insurance,as required by Scetim
3700 of the labor Cade.for the perfowame of the work for which this permit u issued
My Worker's Compensation insurance Amer W Policy number ace:
Cartier.sS�2 Cha'//g- Policy No.: 7/3 0o 2 3 9tf o°
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
0aaclm nail mtbe completed ifthe Permit is fmmchundud dolian(5100)
or kat)
1<mufy that in the perfomume of Use wart for which this permit k issued.I shall out
employ any person in any mamuran as to become subject to the Waken Compearauon
Laws of Caifmua.Data
Appliom
NOTICE TO APPLICANT:If.after malting this Certificate of Eacmpden,you should
became subject N the Wmkm's Compounder,previsions of tic Labor Code you muss
0 O furlhwith comply with such provision,or this Permit shall W dared o mkad.
z CONSTRUCTION LENDING AGENCY
r
[-� I hereby-from that Vert u s ed(m.30 finding agency fa tite performma of
Pei i La war's for which this Permit is issued(Sec.3097,Civ.C.1
WM Q Lender's None
= z lancer's Addmas
V O 1 certify that I have mad this application and some that the shave itdorn.um is .
LL^ correct.1 agree N comply with all city and county ambulances am suer Ire muting to
O Wilding crosoucuon,and hertbymNodm mpresomenves of this city to emkr uponme
W above-mentioned property,fm inspeadon purposes.
H Ov (We)agree to save,indemnify and keep harmless the City of Cupertino against
fA li,biliva,judgments,costs addeapenus which may I.any way a ass aguut said City
V Z in consequence of Ne granting of this permit.
^' APPLICANT UNDERSTANDS AN COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS
6?// Re-roofs
Signature of AppliaNZoa or ,ERIALT DISCLOSURE te Type of Roof
Will tic appliamo tm6'6yllding ocuupmt some orsmdlc baumms materia
as dented by the Cupertino Municipal Code.Chapter 9.13.and the Health and Seely
Code.section M532(.)? , / All roofs shall be inspected prior to any roofing materia(being installed.
❑Ya
If a roof is installed without first obtaining an inspection,I
Will the applicant a factum building occupant tau equipment or dcvim which g agree to remove P
nit haraNnu air contaminants as darned by IW Bay Am,Air Quality Management all new materials for inspection.
U sure'?
❑Ya
I have mad the materials rewhememsmus,ChapW6.95oftite Calif..
out H.M&Safcty Code.Seedaas755u5,35533 and]5534.1 understand Netifthe Wilding
does net currently have a tenW k-uaI It u my responsibility to redly Ne occupant of tic
remmoments whk uRWrh y'dma iss.of a Canifusse ofC, ey. Signature of Applicant Date
Owner or aatha�fired Peg i Dote All roof coverings toR.
be Class' "or better
CITY OF CUPERTINO
•
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31623065 : 00
DATE ISSUED. . . . . . . : 08/14/2008
RECEIPT # . . . . . . . . . : BS000005795
REFERENCE ID # . . . : 08080108
SITE ADDRESS . . . . . : 20119 CHAVOYA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER LIN SHENG-TZ AND PI-YING H
ADDRESS . . . . . . . . . . : 20119 CHAVOYA DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2303
RECEIVED FROM . . . . : JON R CRASE CONSTR
CONTRACTOR . . . . . . . : JON R CRASE LIC # 22250
COMPANY JON R CRASE CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 164 GILMAN AVE
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 370-1485
• FEE ID UNIT QUANTITY AMOUNT ,. PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ------ ---------- ---------- ----------
1BSEISMICR VALUATION 2 , 500 . 00 0 . 50 0 . 00 0 . 50 0 . 00
IFOUNDREPA EACH 1 . 00 734 . 00 0 . 00 734 . 00 0 . 00
---------- ---------- ---------- ----------
'DOTAL PERMIT 734 . 50 0 . 00 734 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------------------ --------------- --------------------
CHECK 734 . 50 #50823
---------------
TOTAL RECEIPT 734 . 50
•
C�� CITY OF CUPERTINO
CI OF
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN #� (oa 3 0(0 s. U U Date: 8 iv v s
Building Address:
Goll 'J (�,M-"OYA 'l-)2 6Up&12-771vo (ZA L/
Mailing Address (if different from building address):
Owner's Name: Phone#:
S1+LN&7-Z- Ln1 X08 2S5- y89a
Contractor: Phone: 4108 . 370 • Iq SS-
CR-AS& CopisTawcrl onl Fax: V08 37a • op-38
Contractor License#: 6/1 -5-47
Cupertino Business License #:
Contact: Phone: '{OB 5'j, S • 0,--V 7
RNY .7U4(
Fax: `fU $ • 370 • 023$
Residential LACommercial
IT—
Job Description: 4701;�,e }L�Lvn/T
G�//N.�aw . /2 c��.vcc a✓i.�Dow uK�'�o�C u�-- /•✓sd�'�J Si1z2ti� �
/*)A-iNT,
Building Permit Info:
Bld Elect ❑ Plumb ❑ Mech ❑
T e of onstruction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-B -�
Valuation: sy.( Square Footage:
so a
Project Size: Express Standard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
Points Achieved: to the application or if applicable, include in plan set& the sheet index.
•
For help, contact Build it Green at www.buildit reen.or
Revised 7/01/08
NCITY OF CUPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 BBOILERI . For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw)
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1 BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1 BBOILER4 Installation/relocation of ea M •
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1•,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1 BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour) •
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
CITY°F GENERAL BUILDING APPLICATION
• CUPERTINO
FEE .SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
1ACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
Ah
IMF 1 FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1 FLAGPOL>20 Flag pole (over 20 ft in height) B
1 MODUSTRU Modular Structures B
FOUNDATIONS
/ 1FOUNDREP Foundation Repair B
( IPILECAST Pile Foundation Cast in place concrete B
I PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
,CCS- CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSPIO Special Design, over 10' high (up to B
50')
1 RETCRB< Gravity/Crib Wall, 0-1O'high (up to B
50 ft)
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft)
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1SIDEST/BK Siding, Stone & Brick Veneer B
interior/exterior)
1 SIDEOTHER Siding all other B
SKYLIGHTS
IS KYL<10 SF Skylight less than 10 sf B
-FS-KY L> 00SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st)
•
4of5
G0 CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
0 FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group . 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door (ea 8 windows
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck"fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
Inv
1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
IBSEISMICO Seismic Commercial B
1TRAVD0C Travel & Documentation B
1BUSLIC Business License B
5of5
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 an 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 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood kJoist, (See Spec.) S-2 2 points
5: Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 pints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 pints
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 cints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 paint
3. Energy Star Refrigerator, (No te/S ec. A-3 1 pint
P. Other 1 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
Plan Review Process Wark Book Page-12-Rcvised 325/08
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 ResDurces Energy D -
afth
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts D
�2.Salvage Reusable Building Materials 4 Resource pts Y--yes D
3.Remodel for Mixed Use,Adaptive Reuse,and
Histodc 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
(8.Design Resource-Efficient Landscapes and Gardens _ 4 Resource pts y=yes 0
9. Reuse Matarials/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 pts0
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
�1.Substitute Solid Sawn Lumber with Engineered Lumber _1 3 Resource pts y=yes p
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
gypis 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
12.UseOSB --
a.Subficors
b.Sheathing Resource pi y=yes 0
•
1 Resource pt y=yes p
1 1 1
INPUT Resources EneTgy IADIHeafth n
.Ertenor mis
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Hsalth pt y=yes 0
I3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
14.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
r.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 Flush Toilets
(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) I - Up to 4 IAQ/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes D
1 I 1
r,.trecvrcar
(1.Install Compact Fluorescent Light Bulbs(CFLs)
;(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
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
�2.Install Washing Machine with Water and Energy
.Conservation Features 1 Energy pt y=yes 0
I3.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y--yes 0
t 1 1
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
13.Install Recycled-Content,Fiberglass Insulation wiffi
iNoAdded Formaldehyde 31AQ/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-foam)
a.Walls 4 Resource pts y=yes 0
n.cemngs 4 Resource pts y=yes 0
1 1
. 114PUT Resources -
I.lanclows
-1.Install Energy-Efficient Windows
. a.Double-Paned 1 Energy pt y=yes D
b.Low-Emissivity,(Low-E) 2 Energy pis Y--yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Heat Transmission Glaiing - 1 Energy pi y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
'1.llse Duct Mastic on All Duct7oints -- .- _ _ 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Spaca 3 Energy pts y=yes D
3.Vent Range Hood to the Outside 1 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Hsalth 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 D
7.Install Whole House Fan 4 Energy pts y=yes D
B.Install Sealed Combustion Units
a.Furnaces 3 IAO/Health pts y=yes 0
b.Water Heaters 3 IAQ/Hsalth pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pis y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pis y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pis y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y_y�es 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves/inserts 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.Install Zoned,Hydronic Radiant Heating 3 Energy pis y=yes D
15.Install High Efficiency Filter 41AQ/Health pts y=yes D
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQMsalth pts y=yes D
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts =yes D
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 pis y=yes D
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pis y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=1 B points) Up to 16 Energy pts 0
6.Select Safe antl Dureble Roofing Materials __ _ _ ' 1 Resource pt y=yes 0
7.Install Radiant Bamer 3 Energy pts y=yes - D
1 i 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes D
1 1
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pis y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy ptsy=yes D
1 1 1
•
M. n oor Air Qua Ity and Inlshes
�1.Use LowMo-VOC Paint - - _ 1 IAO/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
'3.lJee Low No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Matarials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61A0/Health pts y=yes D
6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAD/Health pts y--yes D
B.Use FSC Certified Materia s for Interior Finish 4 Resource pts y=yes D
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAD/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y--yes 0
,2.Use Rapidly Renewable Floo ing 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/Hepllh 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 !
Total Points A 1 1401 1301 57
Total Points Pro'ect Received: 1 01 0 0 •
G:datarprogslgreenbulldingguidelinesl2modelerslgreenpointsfina12.12.04prmecled.rJs
•
.. Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
1 /9
OWNER'S NAME: S.fGwG TL L/N PHONE # 08• `I6 8 .0117
GENERAL CONTRACTOR e,r�E e FAX # y08 '370 Oa3
I am not using any subcontractors:
i e 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/C retractor Si ,nature Date