08080159 CITY OF CUPERTINO
BUILDINQDIVISION PERMIT Co NTRACTQRIN `ORMATION
BUIL41I�,.G /
'S/ Ifl'"1 S PERMR NO.
)I:rL,YHE;AD LN COSMOS ROOFING
08080159
OWNER'S NAME: PERMrf ISSUE DATE
SIIOSIIANA SOFIA 1901 OLD MIDDLEFIELD WAY 08/21/2008
NE r•mo OO SANITARY NO. CONTROL NO.
(650) 969-7663
ARCH=/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
.Op LICENSED CONMACTOR'S
under
DECLARATION
1 hereby.rrrm that I am licensed ander Proviaien,of Chapter 9(mmmertemg lob Description
with Satim)00o)ofDivision 3o the Business and Praf ,dvSCode.andmylicensc is RE-RF T/0 EXTNG CMP RF 2 LYRS NEW 30#kFLT 30YR
u in full forte cosi
Lianv' _ kuc.g LNDMK CMP SHNGLS CLS A'
pro Dam Conuanar
CHr1ECTS DEC
W U I underraml my plans still W used as public records
6
gtier In Reeved Professional
3 OWNER-BUILDER DECLARATION
a��M I Wreby sRrtn that 1 am exempt Imo the Contrmmfa lila.Law for the
a O following mason.(Section 1031.3.Business and Pmfessiuu Cade:Any city or county
i$Inti which reports a permit to eonsouet alter,improve,demolish,m repair any rmaum
prior to in issuance,site requires dm applicant for such Permit to rile a signed statement
<
that he is licensed norma to thn provisions of the Contrames Luxnm Law(Chapms9 Sq. Ft.Floor Area (- Valuation
ction
y�$ (commencing with Se7000)of Division Sof the Business and Prefussiov $
Cade)or 8785
Wthat he is esempi therefrom and Ne bus fm de alleged eaempdon.Any violadan of
Section 7031.5 by airy applicant for a permit subjects the appileant c a civil penalty of
not mare than five hundred dollar(1100). 36226013 �Number Occupancy P y Type
❑I.u owma of the pmperty,m my employe with wage u N k mie compevadon,
will do the work.and themuccre Or Out intended oraBered for rdo(Sec.7(164,Bonuses
and Profession,cads The commences Licence,law cora not apply or an Owner of Required Inspections
property who Wildserimpmves thereon,and he deesauchworkhimselfor through his
own employees.provided that such improvements as not intended oroRe a for We.If.
however.the Wilding or improvement is sold within an year of completion,Ne owner-
Wilder will have On,burden of proving that K did not Wild or improve for burnesse of
uk.).
❑1,u owner or the property,am eaclusinly contracting with Ilecnxd maracce e
co stmct the projca(Sec.7044.Business and Professions Cade:)The Conwcces Li-
cove Law docs m,apply man owner of property who Wilda or improv Neeon,and —-
whoconmcuforswehproject with a conmwor(s)licensed pursuant to the Contractor'.
License Law.
❑I am exempt under See ,B At PC for this moon
Owner Dam
WORKERS COMPENSATION DECLARATION
t1I hemby affirm under penalty of perjury ane of the fallowing decimation,:
hew and will maintain a CenlOcate of Covent to su f-0mu ,for Wormer Common.
now.as,provided for by Section 3100 of the Labor Code.for the performance of the
wart for which this permit is issmd. v
❑1 have and will maintain Warker's Compensation In,uran¢,u inquired by Section
3700 oftic labor Code,for the performance ofthe work for which this permit is intend. '
My Workds Compensation Insurance curio and Policy number am:
Carrier. c t/2•T4' erQA10 Polity No,:Ug plf)r3
CERTIFICA OF�EXEM'P ION FROM WORKERS'
COMPENSATION INSURANCE
('This elm weed sotbecanplacd If Ne permit is mane hundred donna(1100)
m leas)
I ennify that in the performance of on,work for which this Permit is issued.I shell not
employ any person in any mmvrm as se become subject be the Wokrss'Compevuim
Laws of Califomii Dam
Applicant
NOTICE TO APPLICANT:If,after making this Cenirteam of Exemption,you should
baome subject be to Workers Corepewhion provisions of Ne Iabo Code,you roue
.Jz fanhwith comply withsuch provisions a Nu permit 3111111 the dccmcd rewkcQ
zCONSTRUMON LENDING AGENCY
(-+� I hereby alluch this then uaeodtavuctim lending agency,for tic orformanauf
C the work for which this Permit is issued!(Sec.3097,Civ.C.)
Q undas Name
0.Z)z lumdeef Address -
U O 1 anti%than I have rad Nis application and mute Nu the shove information is
VLF comes.1 sine m comply with all city"ol county adi.and sum laws relating to
0U Wilding cousuucoun,tib hemby au11011M leponalatiws of Nu city a enter upon lie
aWw-menuowedproperty for inspection which b
H a (We)agree to eve,indemnify W kap harmine Om City or Cupertino against —
In liabilities Jadgmcnh,cmuand ng Ofthisuwhich may in any nyacauc agaiM card City
U z APPLI quencc NDERS``f the rANDSNisD WILL
ti APPLIC UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU U[.A710N
ALAI Ol �"fJ.(.,J dJ
sdgnawre or Apmhvn ont �te Reproofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof ✓/
Will tiro C.pemrmfutureipal Cede.Chapter
or and Health
tanmamriai
u de,Sao..
by Om Cupertino Municipal Codc.Chapter 9.I2,and tet Health and Safety
code,ScUCtion25s32(a)7 All roofs shall be inspected prior to any roofing material being installed.
Yu
Will Nc applicant r future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
t hauamnv air contaminants u Mined by the Bay Area Air Quality Management all new materials for inspection.
'strict] - 2
❑Yes I��'(1/ja
1 have read the huartlons materhls mgeimmcns under Chapter 6.95 of ft Califar-
nu Hall"�fS�'afctyCedc,section 25505,25533 and 25534.1 understand that ifNc Wilding
d=i w�nh�ics how a mnemic that Itis my mapouicem a notify tic occupant of Ne (� a
re9ei wnehmu�u� mcrynrm;,aa,aner.cahirreatearaeePmey. Signature of Applicant Date
Owne,wauthon'r as D,m All roof coverings to be Class'J?."or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36226013 . 00
DATE ISSUED. . . . . . . : 08/21/2008
RECEIPT # . . . . . . . . . : BS000005858
REFERENCE ID # . . . : 08080159
SITE ADDRESS . . . . . : 1107 HOLLYHEAD LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER SHOSHANA SOHA
ADDRESS . . . . . . . . . . : 1107 HOLLYHEAD LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4941
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : COSMOS, RICHARD LIC # 18844
COMPANY COSMOS ROOFING
ADDRESS 1901 OLD MIDDLEFIELD WAY STE 2
CITY/STATE/ZIP . . . : MOUNTAIN VIEW, CA 94043
TELEPHONE . . . . . . . . : (650) 969-7663
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ---------- ---------- ---------- ---------- ----------
1.I3SEISMICR VALUATION 8, 785 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1REROOFRES SQ FEET 23 . 00 299 . 00 0 . 00 299 . 00 0 . 00
---------- ---------- ---------- ----------
'DOTAL PERMIT 299 . 90 0 .00 299 . 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---- --------------- --------------------
CREDIT CARD 299 . 90 MC
---------------
TO`T'AL RECEIPT 299 . 90
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
--- ------------------------- --- -----------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
Ud-
CITY OF CUPERTINO
REROOF
CITY OF
•CUPERTINO PERMIT APPLICATION
O/ CSZ�
APN # Date:
Building Address
Owner's Name: Phone #: yo p_ 676- O/O Y
s Wos llklu-4 -90 /-/4
Contractor:' 04 y -1-?vJ F,4s Phone #: 6SW-r;69- 766 3
Fax #: Co SD - 9,6 -5 o I'
Cupertino Business License G/y Contractor License #:
�� yY
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
?` 0 Asphalt Shingles � Asphalt Shingles 3,0y r
_0 Asphalt
Shakes ❑ Wood Shakes
41 ❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
g�To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Go .Uo �� Sc Z ( ayes,
30yr tawA—q�K a�wP skixbl" Cfcp�114_ � 3�
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application
or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: g7i
I H eRead, Understand and Will Comply with Cupertmco s Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPEkTINO FEE SCHEDULE •
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
• a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of /a "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: �7lS/y/� /�}� /301, 4
Job Site Address: t h)7 /'!7�/c/ e-E O ��-`��t --
Roofing Company Name: (?0,5$440
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 07/30/08
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
3:30 p.m. to request a next-day inspection.
• 2. When the roof is torn off, the nails have been removed or driven in,
and all of the dry-rotted wood has been replaced, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this service: from 7:30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from
7.30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear-off inspection and the job is not ready, you will
be charged a re-inspection fee of $176.18. The re-inspection fee must
be paid before another inspection can be scheduled
• Greg Casteel
Building Official
Revised 8/13/04
r<07 1�lD�l 4 e i c( /1,11
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, (detaiWspec)' L-1 2 points
11. Permeable Paving, Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 paints
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 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.) A3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A3 1 point
3. Enerqv Star Refrigerator, (Note/Spec. A3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS .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 IAQ[Health
Sde
I1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;60%=4 points up to 4 Resource pts 0
12.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 Stormwater 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 MateriaWUse 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 1 1
C.Structural Frame
`t1.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
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 p
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
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing _ 1 Resource pt y=yes p
1 1 1
INPUT Resources Energy lAOlHeafth
.Extenor Frmsh
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/Health 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 of .y=yes 0
--� 1 1 1
E.Plumbing
(1.Install Water Heater Jacket _ _ _ y 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Plpes 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
I
14.Replace Toilest with Ultra-Low Flush Toilets
i(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) Up to 4 IAQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.eiecrncar
It.Install Compact Fluorescent Light Bulbs(CFLs) j
(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.11
1 1 1
G.Appliances
ilsstall Energy Star Dishwasher 1 Energy pt y=yes 0
12.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
13.Install Energy Star Refrigerator 1 Energy of y=yes 0
14.Install Built-In Recycling Center 3 Resource pts y=yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.wails 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
IS.Install Recycled-Coment,Fiberglass Insulation with
L 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 0
I).ueuings 4 Resource pts y=yes 0
1 1
INPUT Resources Energy
IHealth
• 1 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 of y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
i 1.Use Duct Mastic on All Duct Joints _ __ ________ 2 Energy pts y=yes 0
2.Install Dctwork uwithin 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 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=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 31AQ/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 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 pts y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 31AQ/Health pts y=yes 0
I 1 1
K.Renewable Energy and Roofing WN
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,2A kw=12 points,3.6 kw=18 points) ' _ _ _ Up to 18 Energy pts 0
i6. tact Safe and Durable Roofing Materiels_ _ ___ _ 1 Resource pt y=yes 0
Install Radiant Barrier - - - 3 Energy pts y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts Zy=yes
0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts 0
1 1 1
•
INPUT ReSOUTces Energy AQ./Heafth
'it.Wu oor a Qua tty an Fmshes
1.Use LowMo-VOC Paint - _ 1 IAQ/Health pts y=yes 0
2.Use LowVOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes D •
j3_Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Intedor 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
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 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yes 0
21 Use Rapidly Renewable Flooring Matedals _ J 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 =Yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes D
1 1
Total Points A 1 1401 1301 57
Total Points Project R 1 01 0 0 •
G:daWprogsrgreenbuildingguidelines4emodelersrgreenpointsf na127 2.Daprrnected.xls
•
Community Development
anCupertino
10300 Torre Avenue
CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
SCUPEkTINO
Building De artment
JOB ADDRESS: PERMIT' #
x/07 /�Y�ezd L� 0(:f�4)11r?
OWNER'S NAME: 3 Q H �O/n g PHONE # Yui•-67b—Ealy
GENERAL CONTRACTOR:Cod mos �! ;w FAX #
I am not using any subcontractors: (e
Signattu( 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 S N+os g Y y
Septic Tank
Sheet Metal
Sheet Rock
T'
•
Owner/Contractor Si a Date