08080100 CITY OF CUPERTINO sT♦ `- x�d'x-taxi' *�' *""` ` '
BUILDING DIVISION PERMITCO
- NXRACTOR.INFQRMATIQN
�.vr�.�;. Lk
BUILDING ADDRESS: PERMIT NO.
:'.0866 JOLLYMAN LN TBD - TO BE DETERMINED 08080100
OWNER'S NAME: PERMIT ISSUE DATE
'PSOU REX C ET AL 08/14/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
uOp LICENSED CONTRACTOR'S DECLARATION Job Description
rd m 1 Imeby an.that l sm licensed under Provisions of Chpur 9(commencing l P
with Section 7000)off)='.r3althe Bacinm and Professions Cade,and my'fee—b RE—RF RMV EXT WDSHK&INSTL OSB DBLFLT
in full face and enpcL
�qz License am I -39 Lk.a3 UNDRLYMNT&BAITS & INSTL MALIBUEAGLELITE LITE
w F q Dau e'f 6.-f —�v ConuaemrIt_
7th wncxrtEcrs DECLARATION WEIGHT CLSA 32SQ
< 1 understand my plans Mall W used u public records
Jn'U
L u.I' Wcenumd professional
505 OWNER-BUILDER DECLARATION
iE I Icreby aRrm that I em exempt from use Comractars Licenso Law for use
i p following mason.(Section 7011.5,Business and Professions Calc:Any city or county
which requires a permit"h,cm swc4 alkr,improve,demolish.an mpalr any someone
prior us its issuance.also requir=We applicant for such permit m file a signed statement
< that he i.licensed pursuant tothe provisions ofuse ConaavtarsUecmeLaw(Chapter 9 Sq.Ft. Floor Area Valuation
1- (commencing with Section 7000)of Division 3 of the Business and Professions Codc)or $16897
e 5 2 that lis is exempt therefrom and to Wsis for to alkgrd exemption.My violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty ofNumber Occupancy Type
not mom than flus hundred dollars($500} 35925045 ,•t
L the
worof die property,re my of micr m with wag=u e's".&e usinum
will da thewart.end the he Core.tosLismd Law do forsafe(Sec.to an wnero.
Nd professions,CWe:The Contractors ndwho law does Ml apply ff an rouge(is Required Inspections
progenywhobuilds aimposesthimpr anile is amensuch work himselfmerthrough Ito
awoemployecaiproNdedthvtsuchimpm to wit in not intended ofcuronmrd for ole If.
IIWder.WCii,duemer ImplrKmNllabid did011eilderemnpkdM,WCmwm!-
builder w101uw hW burden of poHni this W did not build or impmw fa purpose of
ukJ.
tJ 1.u awusr of the popen,w esGusimy conuactigg with licensed conuuwrs as
construct the project(Sec.7044.Business;and professions Code:)The Contrac.r's Li.
emcee Law does an,apply.an owner of property who Wilds or improves thereon.and.
wW contracta for such pmjecta with a conusc ur(s)licensed pursuant.We Contractors
Lice"law.
❑Iamemeninunder See ,113Peformbreason
Owner Dau
40 WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Porosity of perjury one of the following decimations,
I hs.s and will maimin•Certifies.of Cove.,to self-insure fa Worker's Coupon-
cation,as provided for by Section 3700 of the labor Code,fu the perf smome of the
work for which Wb Permit in iuneC ,
❑1 have and will maintain Workers Compensation Insurance,as required by Section
3700 of the lalmr Cade,for the imfolman&e of tW work for which this Rrmil is issued
My Workers Can nsatiaa Wu once caroler end Policy oumWr tae: fes,
Cartier. -IL'�s.L o Policy No.:
CERTIFlGTE F EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Ihbseelion used net W&anplemd lime Permit is faam homarrdl dollen(5100)
or kst)
I cmify that in the performance of the work for which this Permit in issued,l Mal lout
employ any Person in any muusrso u.become subject to the Workers'Compenotion
Laws of California.Da.
Applicant
NOTICE TO APPLICANT.If,a0er making this Certificate of Exemption,you Mould
become subject in the Workab Compensation prevision of We labor Coda you muse
.,z foMwith comply with such provision a Nb Permit Mall W dzmend mrokrd.
CONSTRUCTION LENDING AGENCY
F. I Wmby affae,dtal them b a consuuction kndint agency for use perfamaax as,
use work fur which this Permit is Wood(Sec.3097,Civ.C.)
SLamers Name
.7 z Lemlers Address
U C) I certify Nat 1 haw rad this application and sum that the those information in
Ltr^ c.I agree u ith comply wall city and county ordinances and soon lows muting u
Q SCJ: Wilding construction,and hereby authorive mpre.ntativa of Wb city to cric"pon the
ahow-mcnuousd poPeny fa inspection wuryaxa
(We)agree.ow.indcmnif old keep harmless the Cil of C
F..,.a r p r upenilw swat
t,iZ Iincoitiesience fthe&=fend nxpevu which may in any way accrus.galm said City
U z A consequence Ofthe of Nb permit. ^1
'—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �— ✓"�
SOURCE REGU�fATIONS. �r
M";�l,cl /f^a zl dara...�.iz dB-IY-OY Re-roofs
Signsionfiroof Applican omrDOU Dau �J
HAZARDOUS MATERIALS DISCLOSURE Type of Roof v
WIII the a Cupol or f=urs Wilding e.Chapmr 9.1 ns,handle hauNO=maurial
u dcunc0 by the Cupertino Municipal Code.Chapter 9.12,and the H=IW scot Safety
Cork.Section 25532(a)?
❑* �Nr All roofs shall be inspected prior to any roofing material being installed.
Will thea scan,or Enure Wilding occupant If a roof is installed without first obtainingan inspection,I agree to remove
PP d p equipment or devices which P
Itrict? ns air conuminanf u dc0nea by the Bay Area Air Quality Mangerscol all new materials for inspection.
Diawa? P
C3 you qNu
I hive read the hvvda=ma.rlab mquir mems under Chmurd95 of the Califor.
nb HeaiWkSafcty Calc,Sava.255115,25533 sand 25534.IUMersund titillate Wilding
does no curmnty haw a LLTan&that it is my r=pamybili,y b notify fin a&up.,of the
mqulmmenu which must met gamer luaance an cenificauofoecupwuy. Signature of Applicant Date
L "L fe 1 ��✓`R`� All roof coverings to be Class'1?"or better
owmeraa hamca agent Dau' -
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35925045 . 00
DATE ISSUED. . . . . . . : 08/14/2008
RECEIPT # . . . . . . . . . : BS000005785
REFERENCE ID # . . . : 08080100
SITE ADDRESS . . . . . : 20866 JOLLYMAN LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TSOU REX C ET AL
ADDRESS . . . . . . . . . . : 20866 JOLLYMAN LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4349
RECEIVED FROM . . . . : MIGUEL A NOYOLA
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
---------- ------------- ---------- ---------- ---------- ---- ---
J.BSEISMICR VALUATION . 16, 897 . 00 1 . 70 0 . 00 1 . 70 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
IREROOFRES SQ FEET 32 . 00 416 . 000 . 00 416 . 00 0 . 00
------ ----- -------- ----------
TOTAL PERMIT 527 . 70 0 . 00 527 . 70 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--- --------- ---- ----------
CREDIT CARD 527 . 70 VISA
---------------
TOTAL RECEIPT 527 . 70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
---------------------------- ---- ---------- -----------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
SAM REROOF
CITY OF
•CUPERTINO PERMIT APPLICATION
APN # t�3 `J 9d2 ,—U � . 6 U Date:
Building Address:
Owner's Name: Rey, C, TSe Ck Phone #: X08 ate_
Contractor: o Phone #: tfoP 8 9D-,
t q 6
Noy k Force P oO(Xn � � R
� Fax #: tQoB �/Ko-laea.
Cupertino Business License #: Contractor License #:
y16C� 33
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
k Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) pd Other (Specify) i q L,� { ty tt,,- h,� -h �e
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: �� tvoC� S��e roDr' r�•f-q�l 0SrS ;
lea �l 6, , l-e Fe-I� L,_,� e �a � ,ti-� Cab IT- 36'x) /�a� �s� a �c�l Z,-I,40
M alb ��1 �� I q� ��,� �1� Cle r 4 32
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
CITY OF CUPERTINO
REROOF
CUPERTINO FEE SCHEDULE •
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
32
/ 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
+ IBUSLIC 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: I€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 1/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:
Job Site Address: .P-0�(o I, �Lo l 4 y,-\ 4, y (,h
Roofing Company Name: W p o(V -011r C e ZOa- � w F�
q
• Applicant's Signature: M l q�P I 2-� 't1� M L Date: D g— N -b Q
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
f
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 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.
Srte
I11.Recycle Job Site Construction&Demolition Waste
65%=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 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
B Design Resource Efficient Landscapes and Ga dens 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
B.Foundation 1
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Ryash=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 Foundatiori/Slab before backfill 3 Energy pts y=yes p
1 1 1
C.Structural Frame
1 ubstitute Solia Sawn Lumber with Engineered lumber 3 Resource pts y=yes p
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=yas 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
J.Wall 3 Energy pts — es
c.Root Y—Y 0
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 p
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes p
1 1 1
D.Exterior Finis
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/Arsenio 1 IAQ/Health pt y=yes 0
k3.Install House Wrap under Siding 1 1 IAQ/Health pt y=yes 0
14.Use Fiber-Cement Siding Materials 1 Resource pt Y_-Yes 0
i 1 1
E.Plumbing
�1.Install Water Heater Jacket _ 1 Energy pt Y--yes 0
2.Insulate Hot 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
14.Replace Toilest with Ultra-Low Flush Toilets
It 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
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r-.tiecmcar
11.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 Flxtures 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 ) 1 Energy pt y=yes 0
12.Install Washing Machine with Water and Energy
!Conservation Features 1 Energy pt y=yes 0
3.lnstall Energy Star Refrigerator 1 Energy pt 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.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-Content,Fiberglass IrisDation with
INo Added Formaldehyde 31AQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yas 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes D
b.Ceilings 4 Resource pts y=yes C •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.t;eilings 4 Resource pis y=yes 0
1 1 1
- � I. rndows
1.Install Energy-Efficient Windows
• j 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.Instill Low Heat Transmission Glai ng 1 Energy pt y=yes 0
1 1 e
J.Heating Ventilation and Air Conditioning
`1,Use Duct Mastic on All Dud 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 IAO:alth 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
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
J.Water Heaters 3 IAQ/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 stovesrnserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy of 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[AD/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
1.7.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1
K.Renewable Energy and Roofing 1
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=16 points) _ _ Up to 16 Energy pts 0
k Select Safe and Durable Roofing Materials_ 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes p
L.Natural Heating and Cooling 1 1 1
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
•
M.Indoor Air Qua rty and Finishes
1.Use LOW/ND-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IALUHealth pts y--yes 0 •
3:Use LowMo 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 61A0lHealth 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 D
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=yes0
j2.Use Rapidly Renewable Flooring Materials 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 IAO/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 1301 57
Total Points Project Received: 01 01 0 •
G.dalalpmgsrgreenbulldinoguidelineslremodelerslgreenpointsf na12.12.04prolacled.xls
•
Community Development
10300 Torre Avenue
r- Cupertino CA 95014
-" T Telephone(408)777-3228
-PTY Fax(408) 777-3333
OCUPERTINO
Building De artment
JOB ADDRESS: C,? , { PERMIT #
,10 & X011 �2f^ t_n 73-0,y C,)(?
v / o
OWNER'S NAME: Q,--k PHONE # e{op
GENERAL CONTRACTOR: Y e FAX # koy _ kYo-lzo
I am not using any subcontractors: M� o P
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
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