08090110 CITY OF CUPERTINO >
BUILDING DIVISIaN PERMIT CONTRACTOR INFORMATIOPERMIT NO.N
BUIL�IttG/.JJQR E ESTATES DR DELTA ELECTRIC 08090110
OWNERS 4NAME; PERMIT I5SUEDATE
SMITHSON ROBERT C AND SUSAN D 724 COLLEEN DR 09/17/2008
SNE: SANITARY NO. CONTROL NO.
(408) 224-0176
ARCHI3ECrrENGiNEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
S o p LICENSED CONTRACTOR'S DECLARATION O O O O
Job Description
1 hubby affirm used an Headed under pmviainu of CWpmr 9(commencing
with Sccdon7")of Division 3 ofd.Business and Prtfcssiom Code,and my lkmae is ELEC SVC UPGRAD FRM 100 TO 200A
n in full fame and effect.
j tRz Licensc Clog Lk.0
=—q Dam Contractor
e31- ARCHITECTS DECLARATION
t o u I undersand my plans shut be used u public commis
g a,
S0� Lkcmsed Pefeuion.l - .
5 OWNER-BUILDER DECLARATION
Conor ON
C<O 1 hmea arBrm Nat 11. exempt from the CasionsC s e:Any taw for to
y O O fallourwhich
mean. emit t 7hersom Business and Proimprove.
dcdmu Cale:Any city or county
$ which rtquiru a Permit ne ennsuthe Wer.impmw,@eolith or minor my structure
-zi priabia ionamcc.umrtquime thovishooroffor s.hndmou'1.filene,Lawstatement
E�G Nat mencin twit poamt rodx pm.idnu of the Coroaculs Licomnlaweaapw9 Sq.Ft. Floor Area Valuation
(commencing with Section m(o)of Division 3 of Ne B ed exemption.
mtl Professions CMb)of $2150
e3$
than a h camps themlrom and do aura ut Nems doo uempdam Any violation of
Section thous five
airy red d.nt rte a pcmhir subjects Nc applicant o a evil penalty of Number Occupancy e
rot marethafiwnnnaredaaila.asno). 36913046 . P Y�'P
❑Luownerof dm pro perry,neyutlocate withw.guudsevalo c .Busidan,
will aothe
ate..Cos:ad as Cor srot located Law data
for sale,Iy 7014,Basic of
and property
who u Coda:The Conhemem.License Law don.r hun lf an owner of Required IDSPCCIIOns
property who loutprovided
ro vi e d prows Nemoo,ad who aan n ouch waek himseu ed through his
Own ncer.m eu.peoMo r imprower chair such improwmmts sire not ou seedof completion.
or offered for We.U.
hutIder.theave on, uimprovcmctOusoldwithino.yearofmproecifrtheowrcr-
am). rola have Ne bath.of inert OR that he did Out build n improv for purpose of
ales.
y/
Ls 1,u owner of the Sec.7property,.msin.exclusively contracting with )11.C mnu.cmn U.masr.t the Project(Seco a urear of and property
who but Cade:)The Cmramrs W- .
ewe law data sat apply a ts oith. of pmpeny who builds or jmpevns thereat,and
who cm Law. for such gojeets withaconrseRs)lid punwmmNe Convamfs
Lleene Law.
l un lee t .08 PCIn Nb
p n
owner /than as
WO ER'SCOMPENSATIONDECIARATIa
1 bucby.(r=under last of pmjury arc of the following dcclustioes: .
1 have and will maintain a CcNfiuse ofConsenuo self-imure for Worker's Contract.
ation,u provided fur by Secdm 3700 of the Labor Code,for the perfarmsmco of the
work for which this permit is issued.
❑1 have shad will munuin Workui Compenmlon Inco...u myuirod by Sma n
37(10 of due Latour Cad=.fa Ne pulmmamof da work far which Nis permit is tabod '
My WaWeYs Computation Ingram earlier ad Policy number are:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This sOOd.reed Out be completed ilthe permit Is lora.hundred doll.(Siad)
or less)
1 mnify Nm in Ne performs..a the work for which this permit Its iu.d,1 shall not
employ Capendsinuc m> bttome subject��l aWorker'Compewdm
emplLaurof ypers personin
Applicant � //�+•-
NOTICE TO APPLICANT:If,after mating this Certificate or Exemption,you should
homes subject in Nb Worker's Compmaidon provision a the labor,Code,you.tut
.J O forthwith comply with such provision m Nurmmall all be deamnd revoked.
rjj CONSTRUCTION LENDING AGENCY
F 1 hereby aRrm Nu de.era construction lending agency fm the performance of
C'
the and for which this permit Is issued(Sce.3097,Ci,C.)
UJ A Lender's Nam=
a z
Lender's Addmss
U Q I cutily that 1 have read Ws application snd seem that the.bow iNmmadon is
IL ^. Mon.l.I agree to comply with til city ad minty well co and sera I.eking in
_Q SV' Wilding contraction,and heebyauNoria mpaimancmal.fNu city in mcaupnn N=
.hmu-mentioned propery for Inspection purposes-
F W (We) I.to save,indemnify mol LOOP hmmless the City of Capertina against
Vl lumilitiu,Judgmcros,eoiu ad upenes which may to myway amtc aguntaid City
V z in camSy.nce at NC gracing Of this permit.
roan SOULIC -J,INDERS+S NDS D WILL COMPLY WITH ALL NON-POINT Issued by: Date
Sigmmure as ApplicamMosr.cmr I Once:
Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will ft applicant or forum Wilding occupatame n Mr. hauutlou mamiil
a defined by the Cupertino Municipal Code.Chapter 9.13,and Ne Health,ad Suety
Code.Section Y.25332(.)?+
❑ All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or room building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
64hmardans at commissions a defh.d by the Bay Ara Air Quality Management all new materials for inspection.
❑Yu
I baro road the herardauma¢riaHroquimntenu ander Clupmra.95 ofthe Califor-
meHeal"SuctyCade,Sections 25505,25533 ad 25534.1 understand thuilthe building
des not 1-1"-m-Whom.that it my responsibility m.or,du acupat of Ne
�"rognire npbe tprimrm 0,a(:crtrpeara Signature of Applicant Date
- All roof coverings to be Class'/q"
Owner nautho tl,C=m $ or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36913046 . 00
DATE ISSUED. . . . . . . : 09/17/2008
RECEIPT #. . . . . . . . . : BS000006113 .
REFERENCE ID # . . . : 08090110
SITE ADDRESS . . . . . : 10421 E ESTATES DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER SMITHSON ROBERT C AND SUSAN D
ADDRESS 10421 EAST ESTATES DR
CITY/STATE/ZIP . . . : CUPERTINO, 95014-4505
RECEIVED FROM . . . . : ROBERT C SMITHSON
CONTRACTOR SANDY FRANKS LIC # 24971
COMPANY DELTA ELECTRIC
ADDRESS 724 COLLEEN DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE (408) 224-0176
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 2 , 150 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1ERT>lK UNITS 1 . 00 71 . 39 0 . 00 71 . 39 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 153 . 47 0 . 00 153 . 47 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 153 . 47 VISA
---------------
TOTAL RECEIPT 153 . 47
•
CITY OF CUPERTINO
CITY OF
• CUPERIINU GENERAL BUILDING
PERMIT APPLICATION FORM
APN # / n/ � � , /� . 6 0 Date:
Building Address:
G u r-errivo C,1 iso/v
Mailing Address (if different from building address):
Owner' Name: Phone#:
o/;ZW 7-
Contractor: 0,
Contractor: ) FL7-,q L L ECTp/e Phone: fpr_ 22zJ-li/76
t72 �/ L-1o64.CEN 9
,v To •,6F- Cit 95'/23 Fax: 2Z3e';Z�
Contractor License#: z1:2 1"172
Cupertino Business License #: 20/9 7/
Contact: 5,,p,vDy lt7?A. l,�-s Phone:
• Fax:y�off- 22'/-.�vZB
Residential Commercial
Job Description:
SLEcllZA 7-o ZooA
Building Permit Info: —/
Bldg El Elect Er Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/IIUV-A ❑ II/IIl B, IV-HT, V-B 2 /�7,?
Valuation: s IS-22 py— Square Footage:
Project Size,:/Express [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.builditgreeL.org
Revised 7/01/08
` Cf, CITY OF CUPERTINO '
CITY OF
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
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
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
1 BBOILER5 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.
lELECINSP Other Electrical Inspections (per hour) E
I MECHINSP Other Mechanical Inspections (per M
hour)
1 PLMBINSP Other Plumbing& Gas Inspections P
(per hour)
1MEETINGIHR Application Meeting B •
CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEkTINO
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group ]GENRES 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
1CHIMNEYR Chimney Repair B
FENCES.
14 PP ]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
IMODUSTRU 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 ,
_.-
CITroF GENERAL BUILDING APPLICATION
CUPEI�TINO
FEESCHEDULE •
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1 RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 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
1SIDEST/BK Siding, Stone & Brick Veneer B
interior/exterior)
ISIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1SKYL>10SF 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
altv CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEI�TINO
. FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 so B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee)
1 EPERMITFEE Electrical Permit Fee E
( 1 MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
III P,
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
IMECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1PLMBLNCK 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
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
1BUSLIC , Business License B
1jYw Z2 666 %, 6U, 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
MERE
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 IJoist, (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.) A4 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 oints
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. EnergyStar Refrigerator, (Note/Spec.) AJ 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 paints
Plan Review Process Work Book Page-12-Revised 3/25/08
it
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
X11.Recycle Job Site Construction&Demolition Waste f
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
I— is
2.Salvage Reusable Building Materials 4 Resource--- -- ----- P 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 D
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
B.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 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=yesl;;F 0
1 t
C.Structural Frame 1
i1.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 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
S.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes C
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 p
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes D
b.Wall
c.Roof 3 Energy pts y=yes p
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.Use OSB -- - " -
a.Subfloors 1 Resource pt y=yesp
• b.Sheathing
1 Resource pt y=yes 0
1 1 f
T
INPUT ReSDunces EneTgy ]AD/Health
Extenor rmsh
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 IAWealth pt y--yes 0
�3.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
it.Install Water Heater Jacket - 1 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
F1 RetroAt 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) I Up to 2 Resource pts. 0
4.Replace Toilest with Ultra-Low Flush Toilets
1(1 point each,up to 3 points) _ Up to 3 Resource pts. D
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
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r,tiecrncai
I1.Install Compact Fluorescent Light Bulbs(CFLs)
I(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 1
G.Appliances
It Install Energy Star Dishwasher 1 Energy pt y=yes 0
12.Install Washing Machine with Water and Energy
,Conservation Features 1 Energy pt y=yes D
13.Install Energy Star Refrigerator 1 Energy pt y=yes 0
L4.Install Built-In Recycling Center _ 3 Resource pts y=yes 0
N 1 i
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-Conlent,Fiberglass Insulation witti
LNo 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
It.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes D
o.uewngs 4 Resource pts y=yes 0
INPUT ReSDUMeS Energy IAQ/Hmtth
I. endows
1.Install Energy-Efficient-windows
. a.Double-Paned 1 Energy pt y=yes D
b.Low-Emissivity(Low-E) 2 Energy pts Y--yes D
c.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
I 1 1
J.Heating Ventilation and Air Conditioning
71.Use Duct Mastic on All Duct Joints _ 2 Energy pts y=yes D
2.Install Ductwork within Conditioned Space 3 Energy pts y--yes 0
3.Vent Range Hood to the Outside 1 IAQMealth of y--yes 0
4.Clean all Ducts Before Occupancy 2 IAD/Health pts y=yes 7
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
S.Install Sealed Combustion Units
a.Furnaces 3 MO/Health pts y--yes 0
b.Water Heaters 3 AQ/Health pts y=yes D
9.Replace Wall-Mounted Electric and Gas Heater 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 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 pts y=yes 0
15.Install High Efficiency Filter 4 IAQ/Hsalth pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Hsalth pts 'y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQMealth pts y=yes p
1 1 1
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 - 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 0
6.Select Safe and durable Roofing Materials 1 Resource of y=yes 0
7.Install Radiierit Barrier 3 Energy pts y=yes p
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
•
_ INPUT Resources Energy IAQ/Hmlth
M. ndoor Air Quality an Finishes
'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.Use Low/No VOC 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 y--yes 0
,7.Seal all Exposed Particleboard or OF 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
1 1
10.Install Whole House Vacuum System 31AQ/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
f2.Use Rapidly Renewable Flooring Materiels 4 Resource pts yryes 0
3.Use Recycled i5ontent 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=yesk. 0
1 1
Total Points 1 1401 1301 57
Total Points Project R 1 01 01 0 •
G:dataipmgstgreenbuildngguidellnes4emodelerstgreenpointsfnal212.D4pmtecled.xls
Community Development
r J 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: I0312/ — —sTarEs PERMIT #
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: �L7 —(i #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the followm 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 f Date