08080232 CITYOF CUPERTINO -«x&« - R wRf�r x'�, 2� * �� ^• ' '
But?
DIIASION PERMIT CONTRACTOR�INFORMATION
'
PBUILOINGA DRESS: PERMIT NO,
D / 4 GASCOIGNE DR TBD — TO BE DETERMINED 08080232
OWNER'S NAME: PERMIT ISSUE DATE
-HED 1'PITSINGER 08/29/2008
NE: SANITARY NO. CONTROL NO.
1A1CHITEC`f1ENGlNFER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0
uoij LICENSED CONTRACTOR'S DECLARATION
a 1 beroby amrm TNI I am Tweed under provuiov of Chapter 9(commencing Job Description
Z� w)IhS '.. Bpi)' DivlsiI 3afthe Business and Notice..Cotle.ad my license is RPLC BTHRM FBRGLS W/NEW FBRGLS&TEMPRD GLS SHWR
n full force aM effut
'qz In uone as Lktructr
Co..g DR,
s
ARCHITECTS OECE ON TWO 5 ' SHWR/BTHRB ENCLS& NW CLNG FN& NW FLRSCNT
to< 1 understand my plansshall be used as public records
tau FXTR IN KTCHN, INSTL SMK DTCTRS RMV WD BRN
o t; Licensed Professional
OWNER-BUILDER DECLARATION -
I hereby allirm No,1 am exempt from the Conutt
ao/s Uccnw Law for,he
jI
O O following maser.(Section ifll 1.5,Business and Professions Code:Any city or county
$ which rtquines a permit to rnnLrvct sher.Improw,dcmelie.m repair any usumum
iy Prior to its issuance.also requiress,M applicant for such Permit o rile signed statement
Y < that he is licensed pursuanuu the provisimu of the Conuutoru License Law(Chapter 9 Sq.Ft.Floor Area Valuation
�$ (commencing wids Section 7")of Division 3 of We Business and Prorasiov Code)., � $5000
Nat he is exempt therefrom and We basis for the alleged uxemptiu.My violation of
Section 7031.5 by any applicant for a pewit subjects the aWlksnt to a civil penalty of Number Oceu
tet mom than five hundred dudish,(55802 37529043 Parc Y Type
1,u owner of the phaperty,a my employee wiN vngn ss Ne'vale compenadon,
will do We.,it.and to,swctu e at has intended"offered for sale(Sec.70".Business
and Profesdcos Code:The ContranoYs Lierna Law does cot apply to an overs of Required Inspections
property who Wildsorimproves Wereen.and wNduessucbwark himalfm Waugh his
own cmployccs.provided that such improvements are not intended oroQered for ale H,
however.We building or improvement b sold within orc year of completion.the owner-
Wilder will have the burden of proving that hm did not build of improve for purpose of
.In.).
❑1.as owner of due property am exclusively commuting with licensed contrxbn so
centered the project(Sec.7044,Business and Rofesdots Cede:)The Canuactim's U. .
came Law does not apply 0 in owner of property who builds or improves thereon.and
wN conmcu for sorb pmjees wild a conueear(s)Ikensed pursuant b W Conuseah
Licolsu Law.
I am exempt under Sec ,B&P C for this moron
Owns Data
WORKERS COMPENSATION DECLARATION
1&why afilw under penally of perjury enc of the following declaadome
I los-and will maintain a Certificate of Covent to xIf-mm.for Wo kee,Compen-
a ton,u provided for by Sutton 3700 or the labor Cede.for We performance of the
work for which this permit is issued.
0 I have and will maintain Worker's Compensation Inaraa,as required by Section
3180 cruse Labor Code,for W performance.(the wodc for which Nu pe wit u issued. '
My Worker Compensation Insurance carrier ad Policy number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need notbecumplcted if tie permit Is frown hundred dollen(SIM)
or cas)
I comfy that in the performance or We war for which this Permit is issue,1 shall not
employ any person in any to r bbrmmc abject W the WorkerCompensation
La ve of Csh o
Applicant
NOTICE TO ct ltCANL I1,after making this CcdOeae of Eumption,you ushould
raw
.,Obttome comp y it WehefoCom s or this pmnatav of We Labor Cede.you mum
forNwiN comply with ash provisions or Wu pewit Nall be dccntee hawked.
Z v'•' CONSTRUCTION LENDING AGENCY
I thereby affirm dot then tea construction lendin a
Ix� We work fur which Wu T pemY for W pelfowana of
pewit is issue(Sec.3(91,Civ.C.)
4 0 LandcY,Name
w7 z LcMeYSAddmas
IJ 0 1 certify that 1 have read his application and .in that the show Information is
w cormcL I agree W comply with JI Ory and county mdillN?a ad son laws Rifling in
Wilding consuuction,and hereby athodu minesenuliws of this city to enter upon the
[I.1 show-mentiwed property for inspection purposes.
F 6. (We)sag.to saw,indemnify and keep harmless the City of Cupertino agsivt
VI Imbilidcs,judip ens.cvu and expwu which may in any way accrue .I.(said City
C.)z in consequence of the granting of Wi wit.
APPLICA ER ST AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR a
Signuurt ofA li mr
'0o Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or forum building Co ac hence,townorhandle Hardov material
as detinue by de Cupedw Municipal Calc.Chapter 9.13.sae the HeaIN and Safety
Code.Seedon 255I3(a)? yyy /
C]Y. yS,Na .All roofs shall be inspected prior to any roofing material being installed.
win W a rant or future bandit sae If a roof is installed without first obtainingan inspection,I agree to remove
pp 6 pfnt use mt Air Qu of Mara which Pe
.it hnardnm air canuminanu u defined by dte Bay Are Air Quality Management all new materials for inspection.
Wn?
C]Y. �o
1 haw rad We hvadws materials mquirmems under Chapter 6.95 offt Califof-
nu Halth&SafelyCude,Sections 25505,25533 and Z534.I uedeemand That if the,building
don utC ly That iI u m respansibilill W notify W occupalo'W
mo' ualheme( o as ecanCedrtealeofaRapa-mycyy7 ,o Signature of Applicant Dale
I (l/7
o r�rt ,sen, Date All roof coverings to be Class'As*or better
ISM CITY OF CUPERTINO
CITY OF
CUPERIINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN !37672 90 . 00 Dater
Building Address: J,
1078? 6 4 SCOI &IUE DR. C UOeAT-.vo, CR 950/q
Mailing Address (if different from building address):
Owner's Name: Ph o e#:
F F_D 1T5 N&E2 Y 17q/- 513
Contractor: 00t)6:- S C H E IOC T Phone(cf 13)q�g foo
OE cSCHE/OT CONSTRVGTION I
Fax:
Contractor License#:86 S319
Cupertino Business License#:
C4 b0u& SCHIFI DT Phone' (�D
• Fax:
Residential V1 Commercial
Job Description: RFJ✓IOVE EXISTING F11jERG/k55 ' S7HCC SNowG(Zq vO W5TAU-New v.vjr
TEMI'e/ 9 6/ASS SH6WER 00o2. TWO 5"VPw&?1347r7u6 E�q,fC/USv�tE$', n1E41 CEIUdICr
F,+N ,tN D NEW F/002FSCENT F/XTV2E�4,1 Kl-c-�� . I N STAu SMOKE O�tE crag S.
A6,n6VE VOOO fjkNj,,Vb- STOVE 9W OFITLH CMP05ITcv RooF, Sewer may
Building Permit Info:
Bldg ❑ Elect ® Plumb [R Mech n'
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-B Eq"� ' 3
Valuati • Square Footage:
5, 000
Project Size: Express ff 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
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
1 BBOILER2 Installation /relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys 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
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.
IELECINSP Other Electrical Inspections (per hour) E
1 MECHINSP Other Mechanical Inspections (per M
hour)
1 PLMBINSP Other Plumbing & Gas Inspections P
(per hour)
1MEETINGIHR Application Meeting B
�SC
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
1 CHIMNEY Chimney B
I CHIMNEYR Chimney Repair B
FENCES
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
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
IPILECAST Pile Foundation Cast in place concrete B
IPILEDRIV Pile Foundation Driven(steel,pre- B
stressed concrete)
3of5
SUM CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEkTINO
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
1 RETSP310 Special Design, 3-10' high (up to 50 `) B
IRETSP10 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
1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<l0 SF Skylight less than 10 sf B
1 SKYL>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
._ Q , CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEkTINO
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
IEPERMITFEE Electrical Permit Fee E
I 1MPERMITFEE Mechanical Permit Fee M
/ 1 PPERMITFEE Plumbing Permit Fee P
IRV
1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK 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
1BSEISMICO Seismic Commercial B
i1TRAVDOC 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 as below
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 72points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
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.) 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.) A-3 1 point
3. Energy Star Refrigerator, (No te/S ec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
•
•
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 ]AWHealth
A.61te
1.Recycle Job Site Construction iDemolition Waste
65%=1 point;75%= 2 points;60%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials - 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stonnwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
F8.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 t 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=yesF 0
1 1
C.Structural Frame 1
(1 Substitute Solid g-a n Lumber with Engineered Lumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC(umber used=2 points,up to 10) up to 10 Resource pts. 0 -
3.Use Wood kJoists 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
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 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
92.Use 0SB — — —_—--
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes 0
1 1 1
xff rborfffin is INPUT Resources Energy AQ/Health
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 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials _ 1 Resource of y=yes 0
1 1 1
E.Plumbing
1.Install Water Heater Jacket _� 1 Energy pt y=yes 0
2.Insulate Hol 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 Flush Toilets -
(1 point each,up to 3 points) I Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yas 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 pis. 0
6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 I 1
r.tiecmcai
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 1
G.Appliances
1.Install Energy Star Dishwasher! I Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy of 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
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pis y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Content,Fiberglass Insulatior with
No Added 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
o.ueilings 4 Resource pts y=yes 0
1 1
INPUT Resources Energy IAO/Health
I.Win5ows
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
1 1 1
J.Heating Ventilation and Air Conditioning
i1.Use Duct Mastic on All Duct Joints _ _ 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts Y--yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health of y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/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=yes7 0
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts yges 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 stovesfnseds 1 IAC/Health of 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/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 51AQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar 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=18 points)_ Up to 18 Energy pts 0
i6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install RadiantBarrier 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 p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1
•
.In oor it uahty and rms es
INPUT ReSOUTCeS Energy lAOlHeafth
rt.Use LowMo-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 LowMo VOC Adhesives 3 IAQ/Healthis e
- --- — - P Y=Y s 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
L.Seal all Exposed Particleboard or MDF _ , 4 IAQ/Health pts y=yes 0
8.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 1 1
N.Flooring -
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials _ 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles J 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 51AQ/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
Total Points Available: 1 1401 130 57
Total Points Project R 1 01 0 0 •
G:dalalprogsigreenbuildingguidelineslremodeleVgreenpoimstinal2.12.04proleded.xls
•
CITY OF CUPERTINO
• 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37529043 . 00
DATE ISSUED. . . . . . . : 08/29/2008
RECEIPT # . . . . . . . . . : BS000005940 _
REFERENCE ID # . . . : 08080232
SITE ADDRESS . . . . . : 10784 GASCOIGNE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : FRED FRITSINGER
ADDRESS . . . . . . . . . . : 10784 GASCIONGE DR.
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : GINA SCHEIDT
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . .
TELEPHONE . : . . . . . . :
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- ---- ---------- ----------- ---------- ---------- ----------
113PFTXTURE NO OF FIXTURE 1 . 00 8 . 16 0 . 00 8 . 16 0 . 00
1.BREMFIXT NO. FIXTURES 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00
IBREMINHOO NO UNITS 1 . 00 10 . 26 0 . 00 10 . 26 0 . 00
IBSEISMICR VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1.I:;PIF,RM:LTFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1.MPERM:ITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
ITRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ------- ------- ----------
:'0'PAL PERMIT 243 . 27 0 . 00 243 . 27 0 . 00.
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----- --------------- --------------------
CREOIT CARD 243 . 27 MC
---------------
'i'OTAL, RECEIPT 243 . 27
•
A"p
lw`
qAssessor's Parcel N!umber: SHEET
Name of owner. FRc--u Fg1rst1tj6--e1?,
Projectaddress. IOZRq 6�5CQIEltl� 01Z,, CQA&ATX)Q, C4, 9-501zl
Contact person. 0006- SCHEI 0 7- Phone. (��O- 9��
Fax.
Net square footage of lot. ----7
... Existiniz Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
e there at least two 10 foot by 20 foot clear spaces inside the garage?----Y��N
Is privacy protection planting required for the prcj'd—ct7---Y-),-<
On what floor(s) is work being done? S7-ok
Brief description of work. AEM'15 11A)d &M&E 3YX 3y//
5� 6z 5tyou)eiz- vl*r# F113 /,#
))0,4-P 6',0 G1ASS 4;1U0,9—WX 6-1A1.5;r",1 —1 VO A)F
GEIUNCr FRN: EW IOU 1TtFIXTORI—i/v Kt7G -jiA jS
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s��266�Clc < CF N)2008 CM N) ZrP651-rtolv p-ooirz-
Code edition *�" 84-Tcl" L
IF
20 - CPC NY2008 NEC
08 P I
APPROVED
11111 AMORDANCE WITHTHE CITY Of
Effective 1/1/08 GW.MNO CODES AND ORDINANCES �Op�
lel
SIBIIEU
M 90 of plan:. Era�specifications MUS-,
De kept on the i P at as times and it is un
181*1 to make zri, '-lnqes or alteration,
On SM withOul w liicn Pe,mission iron AV z
the building Dept., C t) (f Cupertino.
• The stamping of the p i, nc, specification,
'HALL NOT be herd t. P, mit or to be ar
1pprowil of the violation of any Provision,
I %ftv City Orairutrice nr swp, 1-;iw
Plan Review Process Work Book Page-8-Revised 1/1/08
Community Development
,yi f 10300 Torre Avenue
Fi Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
107 Seo e E DRco iN c 4501 a? o�
OWNER'S NAME: N6 PHONE ?'q1 513 F
GENERAL CONTRACTOR OF Cry FAX # q??- 900
I am not using any subcontractors-.
tune Date
Please check applicable subcontractors and complete the followin 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