08080151 CITY OF CUPERTINO
BUILDING DVISION PERNUT Wow,
o R�a C<c,gTQ„ RINFOR�MATIQN*, µ
BUILDING A DRESS: PERMIT NO.
/82 CREEKLINE DR GRIDLEY COMPANY 08080151
OWNER'S NAME: PERMIT ISSUE DATE
jIa, G.! !.:13! RT NANCY AND CHEW ROLLIN 122 ORCHARD CITY DR 08/20/2008
NE: (408) 374-0900 SANITARY NO, CONTROL NO.
ARCHITECT/ENGINEER-
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
�oij LICENSED CONTRACTOR'S DECLARATION Job Description
m 1 ltereby afiam that T me licensed under peenumns of Chapter 9(eommNng
O� wlthsection 7000)afo�lvL'�on 3ofJte Busneaaed Professioe Code, mylkuhsem RPLC ALL WNDWS, LIKE4LIKE W/ (N)DBL PANE LOW(E)GLS.
^ a m full fa�meka�nd e_r�fm6�7/ Q7V
�q- Limn V Lk.0 NO STRCTRL WK; ALL WNDS TO MT EGRESS
^F p Date Conlnebr _
e q'Js t _ ARCHITECT'S DECLARATION
W U I undermined my putts shall be uud as public record
0
g
0,0 to Licensed Pmfastiaual -
5 OWNER-BUILDER DECLARATION
1 I hereby,from Nat I am exempt from the Contractors Uccna Law far the
OO fallowing reason.(Section 703 1.5.Business and IYofmicum Cat:Any city or county
12 6� which require a permit to cm sln c4 alter,improve,demol'ssh,or repair any concern
prior an its is umx.alsurtquiru theapplicam for such permit as fileasignM statement
Inst M is licensed panuant to the provisions of the Camtracars License Law(chapter 9 Sq.Ft. Floor Area Valuation
i O (Command,with section'/OUu)M ...
Division3 al Box and FrofassionsCade)or $10000
Q 9 Jut W is exempt therefrom std the ban fa the alleged eernpuon.Any violation of
Section 7031.5 by any applicant for a pcomh subjects the applicant to a civil penalty of
Ml Tam mafive hundred dollar (M). 36217065 mNumber Occupancy Type
❑I.asownaofinepeputy.amymaployeawimwg uttmbmks pc ow.
will do the wo&and the machine is notimended or offered terrain(SeeTci Business Required Inspections
and Professiam Cade:The Contractors License law dem not apply a e an owner of q P
property who build or becomes thereon.and who ems such wart hinwlf a shrough his
awn employees.provided Jutsuch improwemenu tie Mt inutded aoRered furi If. .
hownwer,the Wilding or improvement is sold within ane Into of completion,the owner-
Wilder will haw Jte WNea of proving mat he did mh Wild or improve for puryoae of
ale.).
[3 1,as owner of the property ant exclusively contracting with]!mused comaxetoas in
construct the project(Sec.70".Bea nm and Profession Code:)TW Contractors V-
ane Law does not apply a M owner of property who Wilds or improves dxmon,Md.
who contracts fa such projects with a comancar(s)licensed pursuant a the Contractors
Lkenae law.
❑lamaeeptaidersen ,09PCfarthifreamn
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 homby afftrm under penslty of pedury minor the following deaarai.
I hew and will maintain a Cerdfimm of Consent to self-]num fa Workers Compen.
salon,a provided far by Section 3700 of due labor Cade,for We performance of the
wale for which Tis permit is iauM
❑I haw and will maintain Workers Compensation Insurance,as required by Section
3700 of the,Labs Cade,for sheperformaxe ofthe work
-for
which mis/permit is issued. '
My Workers Comoematon� �ad policy number
MI cyNo.: r/!7 ��
Gorier. �d CUTIFIr FXEMP
CERTIFl CO OFEXEMPTION FROM W00.KER5'
COMPENSATION INSURANCE ,
(Thu scctlon need not Im completed if ted permit is forone hundred dalton($100)
or ka)
1 acrdfy that in dte performance of the work for which this permit is found,I shat am
cmp]uy any person m any anummsea in a hocome mbject to Je Warman'CMmMdan
Laws of CaEfomis.Dace
Applicmh
NOTICE TO APPLICANT:If.,far making this Certificate of Exemption,you should
become subject to the Worker!Compensation provisions of me labor Cade,you moat
.J O forthwith comply wish such provisions or this permit shall W dwked
deemed re .
z� CONSTRUCTION LENDING AGENCY
(-+ � I Wmby affirm construction that them is a cotruction lending agency far perfunnaac of
C > the work for whim Nu parent is aimed(Sax.3091.Civ.C.)
IAS Q Lenders Name
0 cn
z Lders Address
U O 1 mnify Nat 1 have and this appliicau.and sus that ted show information is
conch.I agree to comply with all city and county ominances had sum laws relating as
O Wilding conmuction,and hereby mMorim repvxntatiwa of this city to enter upon the
F 1 above-mentioned pmpcny for immedon puryaea
(we)ape to saw.indemnify tap haamkss Ih Cry of Cupcartirm against
to limilitic judgmcnu,eosuandexpe which mayin anY way amme ageataid City
U,Zz, in conaquence of the ung of this rank Q
LIC an UND AN COMPL WITH A -polorr Issued by: Date
sou u o
Re-roofs
sig titer �1. HAZARDOUS MATERIALS DISCLOSURE am Type of Roof ` L--
W the applicant"future building occuFantstore or hanme hemadous manila
a de rad by ted Cupenme Municipal Cade.Chapter 9.13,sad the Heath and Safety
code.O onus33(,)7 _ A All roofs shall be inspected prior to any roofing material being installed.
Ya (✓ 7 No ,
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or tutu ilJinL occupant tie equipment or devices Mich P g
.it hwvsml xi sit contemitunu a defined by the Bay Ara Air Quality Management all new materials for inspection.
Diataict7 P
CYea Nu
I have real the Nmmoosmmriau iremrnuunder Chapter 6.95 of the eaifor.
nice Hc,lth&SactyCodc,Sections 35505. 33 anJ 35534.1 undemm�d Ulu ifft Wilding
don not curenJY W 6 this It uiNl'tY a nail the anv of Jr
nnwh1C ° °m °`" Signature of Applicant Date
ow no th doge m All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• Z ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN 36217065 . 00
DATE ISSUED. . . . . . . : 08/20/2008
RECEIPT # . . . . . . . . . : BS000005846
REFERENCE ID # . . . : 08080151
SITE ADDRESS . . . . . : 7828 CREEKLINE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : GILBERT NANCY AND CHEW ROLLIN
ADDRESS . . . . . . . . . . : 7828 CREEKLINE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4154
RECEIVED FROM . . . . : JOE SMART
CONTRACTOR . . . . . . . : GRIDLEY, LINDA LIC # 17555
COMPANY . . . . . . . . . . : GRIDLEY COMPANY
ADDRESS . . . . . . . . . . : 122 ORCHARD CITY DR
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE (408) 374-0900
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- --------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
IWINREP EACH 8 1 . 00 367 . 00 0 . 00 367 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 368 . 00 0 . 00 368 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--- --------------- --------------------
CREDIT CARD 368 . 00 MC
---------------
TOTAL RECEIPT 368 . 00
•
t- CITY OF CUPERTINO
CITY OF
CUPEI�TINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # Date:
Building Address:
Mailing Address (if different from building address):
Owner's Name: Phone#:
Contractor: Phone:
Fax:
Contractor License#: 5'75 Q�ro
Cupertino Business License#:
Contact: Phone:
• Fax:
Residential71 Commercial
Job Description:
ctj� -,bovgL-E- Qy�kNG- ►,,4z3u3ce, )
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ IUIII/V-A ❑ IUIII B, IV-HT, V-B ❑� —�
Valuation: Square Footage:
Project Size: Express K Standard ❑ 'Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
to the application or if applicable, include in plan set & the sheet index.
• Points Achieved:
-
For help, contact Build it Green at www.buildit reen.or
Revised 7/01/08
CITY OF CUPERTINO
IN Or
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BBOILERI 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)
1 BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
abso tions s over 100,000 Btu/h
1 BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ca
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1BBOILER4 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 Install ation/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.
lELECINSP 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 •
,. 1 CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
]CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
Ak
Mr 1 FENCE>6FT Non-masonry, over 6 ft in height B
I FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
iFIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1 FLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
IFOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
- CITY OF CUPERTINO
CITY OfGENERAL BUILDING APPLICATION
CUPEf�TINO
FEE SCHEDULE
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'
1RETCRB< Gravity/Crib Wall, 0-10'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
1 SIDEST/BK Siding, Stone & Brick Veneer B
(interior/exterior)
ISIDEOTHER Siding all other B
SKYLIGHTS
IS KYL<10 SF Skylight less than 10 sf B
I SKYL>1 OSF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'1 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
Sam CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
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
I door (ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee)
IEPERMITFEE Electrical Permit Fee E
1 MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pin Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pin Ck (hrly) M
1PLMBLNCK Stand Alone Plumbing Pin 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
113SEISMIC0 Seismic Commercial B
1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5 of 5
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 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 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/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.) A3 1 point
3. Energ Star Refrigerator, (Note/Spec. A3 1 point
P. Other 1 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
Plan Review Process Work Book Page-12-Revised 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 IAD/Heafth
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80°/=4 points up to 4 Resource pts D
P 2.Salvage Reusable Building Materials__ ^_ 4 Resource pts y=yes D
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 Stonnwater Practices 2 Resource pts y=yas 0
7. Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
IB.Design Resource-Efficient 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 1D%
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=yasF1 0
1 1 1
C.Structural Frame
f1.Substitute Solid Sawn Lumber with Engineered Lumber . J 3 Resource pts y=yes 0
2.Use FSC Certifed 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 D
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 FingerJointed 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 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes D
10.Apply Advanced Framing Techniques 4 Resource pts y=yes p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.Use Off ---- —
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing _ 1 Resource pt y=yes p
xtenor Fimsh
INPUT Resoumes Energy [ADIHealth
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yesF 0 •
b.FSC Certified Wood 3 Resource pts y=yes D
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 AQ/Health pt y yes 0
13.Install House Wrap under Sidng 1 IAQ/Health pt y=yes D
14.Use Fiber-Cement Siding Materials 1 Resource of y=yes D
E.Plumbing
�1.Install Water Haa'ter Jacket _ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
F3.Retro—fit all Faucets and Showerheads with Row 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 Toiiesl with Ultra-Low Flush Toilets
I(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 IAQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes D
1 1 1
r.tiecmcar
(1.Install Compact Fluorescent Light Bulbs(CFLs)
L(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. D
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher ` 1 Energy of y=yes 0
2.Install Washing Machine with Water and Energy
(Conservation Features 1 Energy pt y=yes D
13.lnstall Energy Star Refrigerator I 1 Energy pt y=yes D
j4.Install Built-In Recycling Center I 3 Resourcepts y--yes 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
13.Install Recycled-Content,Fiberglass Insulation witli ,
,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 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes D
o.Ue ings 4 Resource pts y=yes D
1 1 !
INPUT FtimDurces Energy 1ADtHeafth
I. endows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts Y--yes D
c.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Heait ransmission Glazing 1 Energy of Y--yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
7.Use Duct Mastic on All Duct Joints - -- l 2 Energy pts y=yes 0
i 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 IAQIHealth pts y=yes 7
0
5.Install Solar Attic Fan 2 Energy pts Y--yes D
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes D
B.Install Sealed Combustion Units
a.Furnaces 3IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ,(Health pts y=yes D
R.Replace Wall-Mounted Electric and Gas Heater with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEERr11 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 D
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoveslnserts 1 IAQlHealth pt y=yes D
b. Install/Replace Dampers 1 Energy pt y=yes D
c.Install Airtight Doors 1 Energy pt y=yes D
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 D
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 Water Heating 4 Energy pts yges 0
2.Install Solar Water Heating System 10 Energy pts y=yes D
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 18 Energy pts D
6.Select Safe and burable Roofing Materials 1 Resource pt y=yes 0
7 Install Radiant Barrier 3 Energy pts y=yes 0
1 1 1
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
1 1 1
•
V. ndoor Air Quality and FlmsheS
'1.Use LowMo-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOID,Water-Based Wood Finishes , 2 IAQ/Health pts y=yes 0 .
t3.Use Low-No VOC Aa esives 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 y=yes 0
.7.Seal all Exposed Particleboard or MDF _ __ _ _ _ 4 IAQ/Health 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
1 F 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes0
f2.Use Rapidly Renewable Mate
Floonng rials ' _ 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=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 1
Total Points Available: 1 1401 1301 57
Total Points Project Received: 1 01 OF-01
•
G:daWpangs/greenhuildngguidelines4emodelersrgreenpolntsfinal2.12.e4pmis.1ed.ds
•
_ Community Development
t10300 Torre Avenue
X.^M Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPEkTINO
Building De artment
JOB ADDRESS: PERMIT6 cp-Eff :LA oz PERM���
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: 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 Ar Rcc)N&CR- W l NQEstzpa
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
a
UOwTqr/ Signature bate