08090105 CITY OF CUPERTINO
BUILDING DIVISION PERMIT ,CONTx&CTOR INk'OItMA.TI N
T
PERMIT NO.
Bm.l1dp4.plHESSMPERIAL AVE M & S ROOFING CO. 08090105
OWNER'S NAME: PERMn'ISSUEDATE
TOMY CHANG 208 COPCO LN 09/17/2008
NE: (408) 314-0870 SANITARY NO. CONTROL NO.
ARCNIIER/FNGINEER: BUILDING PERMIT INTO
BLDG ELECT mum MECH
3a o LICENSED CONTRACTORS DECLARATION JOb Description
4 u 1 hcrtby affirm Net 1 an limmod under provisions of Ckaper 9(commencing P
with Section 7011)m'Divuion7oftheBudcar
oandProfessionsCode.andmylittumu RE-RF RMV EXT SHK INSTL OSB SHETHNG INSTL LNDMMRK
ON m full Torte andef1m. s�tjp(—Z,r e3
DRz Lkmunclasa C-3-'r Lic.g TL CMP RF CLS A 34SQ
Dame+�'P Conuacbr
ARCHTIECTS DECLARATION —
I understand my Plans Mall be umd as public mortls
g Liceitsd Profc st...I
3OWNER-BUILDER DECLARATION
if I Icroby.,.that 1 am emmpt from me Contractors License Law for tho
E
00 following rtamo.(Station 701.5.Business and Ptaficaiom Code:My city or not,
m which mauirts a permit to cm mar t.alcor,improv.demolish,or minor any stnrotum
zy prior m is iummct.also mauim ft applicant for such permit to rile a Silicon!summcrn
< that he4liceved norsuantmNepmvisimsofda,Commuter U..Law(Ch,=9 Sq.Ft. Floor Area Valuation
E O (commnttcing with Scclion 7(1)(3)of Division 3 of the Bmamm and Prormims Cade)or $14000
$ tha he is emtnpt tbercfrom and the Esu fm the•il ndi•xomptiou My violitu n of
Section 7031.5 by any applicant for a permit subjects me applicant to a civil penalty of �.pr� Number Occupancy e
not mom Nan fiw huadtaE dollars(MS 35719089ff P yT'P
L as owner of the property,or my moploycea with wage as Neo rule compensation,
will do thework,and the t.,.s not inmaded oroRertd(oracle IS".70/4,Busirm
and Promsdone Cone The Contranoh Limase law does not appy in an owner of Required Inspections
progeny who builds mIto mown thoeon,and who doessuch work himselferr through but
own employm,provided that such impmvemens ere not tnmMed armlored fmsak.if.
however,de building or Improvement s mid within one year acompledon,me awmu-
builder will haw Nm burden of proving that he did trot build or improv for purpou of
tam.).
❑1.u owner of the propcnY•am emludwiy cantr,ming with licensed moectun m
cmutmct the Project(Sec.7D44,Bustmss and Professions Code:)Tie Contractor'Lt. .
ccom taw does not apply to an owttc of property who builds or improves common.and,
who contracts for such Projects with a contractor(s)licenacd paramount to the Contractors
Lie'.law.
❑l am mumps undo sec ,B B PC for Our roamn
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby efErm under penalty of perjury arm of tlm folkwing dxlma iom:
1 how,and will rammi n a Certificate of Com un,to m1(--how.for WorkersCompen-
color.u provided for by Section 3700 of me lahm Code.for dm per(ormme of the
work for which this Permit is utumL
❑1 have and will maintain Workers Compensation Insurance,as nn uired by Sccoun
3700.f the Labor Code,fru cot per(mmance of the wok for which only permit u issued. '
My Workers Compensation Inmranco atria and Policy number an:
Cartier. 6—�CgE F= gj A '7/ 7�.-Pi
OF X ON FROM WORS _
COMPENSATION INSURANCE
(ITIS aecdm read rot be cmnpkmd time permit Is far one h mtmvA deRam(S 100)
or coal
I certify that In the perrmmatee of me work for which thio permit u issued.I shall not
employ any person in my manner an an to become mbjcot to than Worion Comperoadon
laws of California Dam
Applicant
NOTICE TO APPLICANT:IL after madd,this Cenifiam of Emmption.you should
become subject to the Worker's Compeosetion Provisions of the Labor Cade,you moa
.J O forthwith eomP1Y with such provisions or Nu Monk Shall be deemed tewkcd,
y CONSTRUCTIONLENDINGAGENCY
Gai Q wort for which tthhiis tlpuctrtconctrt Is
bound(Sec. Civ.
{C.)
Lenders ie
nry for the perfortnanco of
Name
z 4ndelc Mdsess
U O 1 certify met I haw mad 0u a,mllaauon oW Stam and the above Inlmm,tiun is
gL ^" mom..I a{ree m comply with all city and cowry on inotYa and sum laws mladng m
.C)SV' buildinLronswnio.and heroby authorim mPsescnutiw of Nis city to on=upon the
yabove-mmnuoracd dgmaprogeny for oxi,man puryaaca
(We)agme m taw,indemnify and amp harmlm Ih City of Cupertino against
TA incoitiauoracc enta.cc=no a pen ms which may in anyway acmeagaitst said City
U z in conequence Of alto 6rtnunL a(Nu permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
� '�� Re-roofs
Si{nuurt a(ApplicanUCon mr C Data,
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tic applicant or futme With.,occupmtstom or book ha and.material
u definen by tiro Cupmntoo Muntci al Cods.Chapter 9.M and the Health and Safety
Cwt.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
0y. No
rum tk a licant or futum building occupant cm If a roof is installed without first obtainingan inspection,I agree to remove
PP L P equip Q s m devkas which pe
;�ha'rarMne air cmmminmta u JcfncE,by Ne Hay Ama Air Quality Managcmcm all new materials for inspection.
❑Yo
1 haw road the hnallos memria13 MmArcmens under ctupmr 6.95 of the Califon.
ria Norm&SafmyCcdc,Smote 25505.25533 uW 35534.I commua dtha ifde holding
dm of euncntly hoc a mnane that it u my nom uribility w naury the occupant of dm
rtyuumunt.h.h.unbcmelp. miss.ancoofaccrtirtamaraenpamy. Signature of Applicant Date
Omor.r,nthod7zddaagent Dam All roof coverings to be Class'%?"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35719089 . 00
DATE ISSUED. . . . . . . : 09/17/2008
RECEIPT #. . . . . . . . . : BS000006108
REFERENCE ID # . . . : 08090105
SITE ADDRESS . . . . . : 10450 IMPERIAL AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TOMY CHANG
ADDRESS . . . . . . . . . . : 10450 IMPERIAL AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5930
RECEIVED FROM . . . . : SAFET KRAJINIC
CONTRACTOR . . . . . . . : MIRSAD KRAJWIC LIC # 28360
COMPANY . . . . . . . . . . : M & S ROOFING CO.
ADDRESS 208 COPCO LN
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : (408) 314-0870
eFEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 14, 000 . 00 1 . 40 0 . 00 1 . 40 0 . 00
1REROOFRES SQ FEET 34 . 00 442 . 00 0 . 00 442 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 443 . 40 0 . 00 443 .40 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 443 .40 VISA
---------------
TOTAL RECEIPT 443 . 40
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
/ CITY OF CUPERTINO 9 U
eavi 11) REROOF
OF
:CUPEkTINO PERMIT APPLICATION
APN # n�• � � Date:
Building Address:
104Sd / r-( PCrL>� c v
Owner's Name:. Phone #:
Tc9 ,`-' y CP-st �I-lib, g9�-7Q8g
Contractor: Phone #: 3 �� �0$7%o
M -1;
Fax#:
Cupertino Business License #: Contractor License #:
Sol 21$
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
V, Wood Shakes ❑ Wood Shakes
41 ❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings / ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: CZE `' S H/ric �, /.v�:f/c L O S"
ty i it 5: /j Z c L It i� r-> 7 L coma,/o JZ
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: /
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
RCITY OF CUPERTINO
REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
IREROOFRES Re-roof Residential B 1SFDWLR00F
/ IBSEISMICRE 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 Raid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 "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: 70
Job Site Address: /n �j Su / p r Edi^ASGy
Roofing Company Name: � e7i �/�r2CJo F
Applicant's Signature: �.osyC�( �L��7� Date: 9 -
• Greg Casteel
Building Official
Revised 07/30/08
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) 5-2 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 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, (Note/Spec. A-3 1oint
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.
A.Site INPUT ReSDUTMS Energy IAQIHmhh
1.Recycle Job Site Construction 6 Demolition Waste !
6596=1 point;75%= 2 points;80%=4 points up to 4 Resource pts D
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 D
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes D
S.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
B.Design Resou ce-Ef6cisnt Landscapes and Gardens __ ; 4 Resource pts y--yes 0
9.Reuse Mater aWUse 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 10%
increase of flyash,up to 5 points up to 5 Resource ptsTOO 2.Use Recycled Content Aggregate 2 Resource pts y=yes
3. Insulate Foundation/Slab before backfill 3 Energy pts y=yes p
1 1 I
C.Structural Frame
f1 Substitute Solid Sawn Lumber with Ifngineered 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 1 D) 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 Finger-Jointed Studs for Vertical Applications 2 Resource ptsY=yesE D
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 Ener
b.Wall 9Y Pts )'=Yes 0
c.Root 3 Energy pts y=yes 0
3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes p
I12.Use OSB
a.Subfloors 1 Resourcet Y=Yes
b.Sheathing p y_y 0
• - --- -- - — _._.---- --- --— 1 Resource pt Y=Yes 0
1 1
INPUT ReSDUMES Energy LAOMeafth
D.Extenor Fimsh
1.Usa Sustainable Decking Materials
a.Recycled content 3_Resource pts y=yes 0
1 b.FSC Certified Wood 3 Resource pts y=yes D
12.Use Treated Wood That Does Not Contain Chromium/Arsenic i 1 IAQ/Health pt y=yes 0
13.Install House Wrap under Siding 1 IAQ/Health pt y=yes D
14.Use Fiber-Cement Siding Materials _ 1 Resource pt Y--yes 0
E.Plumbing '
nstallWaterHeaterJacket _ _J 1Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3.Retro f t 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 i
(1 point each,up to 3 points) Up to 3 Resource pts. D
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 IAO/Health pts. 0
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
1 1 1
r,.tiecmcar
1.Install Compact Fluorescent Light Bulbs(CRs) i
1(6bulbs= 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
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y--yes0
2.Install Washing Machine with Wster and Energy
Conservation Features i 1 Energy pt y=yesTo
0
3.Install Energy Star Refrigerator 1 Energy of y=yes0
4.Install Built-In Recycling Center 3 Resource pts y=yes
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
(((n"""I.Install Conten
Recycled- t,Fiberglass 6sulation with
N[o Added Formaldehyde __ i 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 •
S.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes D
D.ue ings 4 Resource pts y=yes D
I 1 1 1
I.Windows
INPUT Resources Energy IADIH�ith
1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes p
b.Low-Emissivity(Low-E) 2 Energy pts y=yes p
c.Low.ConductivityFrames y--yes;
_ ______ 2 Energy pts p
2.Install Low Heat T ansmission Glazing 1 Energy pt y=yes p
1 1 1
J.Heating Ventilation and Air Conditioning
I7 Use Duct Mastic on All Dud Joints j 2 Energy pts y=yes p
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes p
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 p
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y yes p
S.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 p
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes p
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes p
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 stovesfinserts 1 IAO/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 3 IAQ/Health pts y=yes 0 -
1
K.Renewable Energy and Roofing 1 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
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 16 points) _ _ Up to 18 Energy pts p
'6.Select Safe and Durable Roofing Materials l 1 Resource pt y=yes p
--- — ----
7.Install Radiant Barriar "-"'--- --
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 p
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
0
1 1 1
•
INPUT ResDuTze
M.Indoor rr Quality and Finishes •Ith
r Uee LOW/NO-VOQ Painl _ 1 IAO/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y=yes 0
3.Use Low/No VOC Adhesives _ _ _ 3IAQ/Health pts y=yes D
4.Use Salvaged Matedals 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/Heal.h pts y=yes 0
7.Seal all Exposed Particleboard or MDF _ - __ 4 IAQ/Health pts y=yes D
B.Use FSC Certified Materials for Intedor Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Tim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 AQ/Heath pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Matedals i_ 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 i 1
Total Points Available: 140 130 57
Total Points Project Received:1 Ps 1 01 01 0 •
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•
Community Development
c 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT # L 9/
/go h j. / A- I;,E/tr� "o t/ O 0
OWNER'S NAME: 7' ?-' c ,,, PHONE # G 7 g
GENERAL CONTRACTOR ,�-.- S inn FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' ormation:
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/Co tractor Signature Date