08050148CITY OF CUPERTINO
'+*isaq.m+`•a'� > '' ? "•• "'
CONTRAC.T(TRINFORMATIf3:'
BUILDING DIVISICN PERMIT
x �3b:�:gcr . .9e'r` °.�.-eL .>.e-# :'L=�"i3i
BURRING ADDBFSS:
10121 JUDY AVE
TBD — TO BE DETERMINED
PERMIT NO.
08050148
OWNER'S NAME:
PERAffr LSSU (DATE
JIM CITTA & GAYLE JARVINEN
05/19/2008
ONE:
SANrrARY NO. CONTROL NO.
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELPCr PLUMB MECH
LICENSEDCONTRACnOWSderp DEsionof ON
Chapter 9
Job Description
I hvgeY Nirm wt 1 am Inecomd under provisions of hap (cwnmesming
viNSatkn lIXkl)Of Did' a 3 ofw Beumwand Prolecaioacede,andm lice�la
RE—RF T/0 3EA LYR COMP INSTL 40YR COMP CLS A 20SQ
mann mme.nd eR L 3
tie nucause C- C - Lc..
ANDREW RAIN GUTTERS PD BUS LIC 5/19/8
Do ¢ Conusaer Gam✓ 1,M #k
' ARCHrrECrS DECLAI ATION 6L,rt-5-5
I und.nand my plans dell W used a public records
Licomed Professional
OWNER -BUILDER DWIARATION
1 Wmhy affirm Nat 1 am exempt from the Contractor's License Law for the
i following mason. (Section 1011.5• Business and Pmfeaina Calc: Any city Or county
which rtquirts a permit to construct sher. improve, dcmdW, or mPoll any svuaurt
prior ut Its Issuance. also m9dms w applicant for Such permit to file a signed statement
• that W it licensed pms,nant tow provisions of the COnhmmr's License Law (Chapter 9
Sq. Ft. Floor Area
Valuation
t (commencing with Section 11100)of Division 3 of the Business and Profeaiw Cak)w
-
$6919
Nat W u exempt themBom cad w Dais for the allegrd esnmpdon. Any violation of
Section 1031.5 by my applicant fora permit subjects w applicant m a civil peaty of
ypNber
64 Number
CCU
O -Type
not mom cites five hundred dollav($50[r,
37507052
Pane Y YP
1, an owner of the pmpmy, ar my wployea with wags as their sok cmnpenadon•
will do the work. and wsmmnum Is rot intended moRemal for sok (Sec. ]f W. Busimrm
and Prnfessions Code: The Cantrsemr's Llttae law dors Out apply to an Owocr a
Required Inspections
property who builds orimproms themmn, and whodomauch work himselfurthrough his
own employees provided that such imprnvgmens art not irearal woRened for vie U.
however. the Wilding or improvement Is sold within ons Year of eempktion, w awsm,
Wilder will new the Wdm M proving that k did ant Wild es improve for pumwg of
ole.).
1, a Owner of than Impart, w exelusawly contracting with acensW mnua.ws to
construct the project (Sec. 104/. Business and Professions Conk:) TTe Canu cmr's Li-
. Law does not apply to an own. a property wW Wires or waste. Nemon, and
who contrmta for such projects wits a mntrmmr(s) Based pursuant to the ContractMs
L.iceae law.
0l am aemp moor Sec , B 3 P C fa' dsis mason
Das
WORKER'S COMPENSATION DECLARATION
1 hareby aBtrm uMgr penalty of p.jury orc of the following 4.1.6.
❑ IMaMw lmainwnac.tif mofeanusntmxlf.immfwww SCmnpm-
action. a Provided for by Section 3700 of the labor, Code. for w performance of the
wok for whim this permit u issued.
❑ 1 have and will m tion. Worker's CampmsstiOn Insurua, ai raluimd by Section
3100 of the LaWr Code, for Ne performance of w west fw which Nu permit u issued.
'
My Workers ComPenseGm I... cam. and Policy, nuumbber cart:
Carder. r77DC PVtkM Polity
O�/!
CEICfIFlCATE OF INN FROM WORKERS'
SAnON
COMPENSATION INSURANCE
Mdsseaion wed nohccanpleted if the permit Is forme hundred nitrates ($100)
Or less)
I c.tify wt in use pafesmence of IW work for which this Permit is issued. I shall no
employ any person In my counter so as m become sobjecl us Ne Work.} L•anpwilla0
Laws of California. Dns
Appllaru
-
NOTICE TO APPLICANT: If, after mLLing NR certificate or Exemption, you should
become subject m w Worker's Compensation pmvwons or the later Code, you meet
rermwith comply with such provision Or this permit shall W dammed revalued.
CONSIRUCDON LENDING AGENCY
I tomboy allirre dust vert k a constructiun landing apenry for the perfores. of
the work for which the permit is issued (Sec. 31191, Civ, C.)
Lender's Name
'
fancier's Add.
I comfy wt 1 have mad thio application W We wt me above Turn medm is
cwmct 1 Agree to comply with all city and county ordinances and sees Ire missing he
Wilding cnnetmman, and herby auNoiae mepusmmatives of this city to center upon IW
'
above-mentioned property, for inspection purposes
(We) agree m save. indemnify and kcep hannlw the Cry of Cupertino against
Iiaeilidw.lWgmens.ewu and Of which may k anY war' care axial said City
this pa
Acunsognence Of ranting SNis Permit
APPLICANT 111111jjjjjjND ANDS A{!D WILL COMPLY WITH ALL NON -POINT
SOURCE RE 0 S. I\
ml//`•Y\4.�
Issued by: Date S
�<.m-J 5-- 19-0-
Sttnsmus of ApplwntlContracmr Date
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or room building ommpant emus or handle teammates material
UVnew by Ila Copeniw Municipal Code. Chapter 9.11. aced the Health and Safety
C. o . us3z(.)1 No
All roofs shall be inspected prior to any roofing material being installed.
W01 the applicant or suture Iadlding asuram o, Nuipmeat w dcviaa which
it hvudoo air contaminms defined by w Bay
If a roof is ' lled without first obtaining an inspection, I agree to remove
a Area Air Quality Management
Diurial
all new ma ori 5 for' 1 CtiOn.
OYo 10th
I he - readhaaduurm
duhassuc Oaxecondshr
rt r
mustan lChmund .95 th
an Nee Hfor-
am,1
(dingda HvlIhe-rea
At SX)5, 33
A3an 5534.1 dcus thesir Wilding
f
Jos rot corm Y have • some. Nat it u my responsibility m IW
nosiry ..Wt of nW
m9airtr ta nmatW Ipdarmiaa oraC.tificamOrOccupancy.
S -- t of -n%
Signature of Applicant Date
. All roof coverings to be Class'%¢ or better
OWOOT Or mthOH7.0d agent Date
• 3 ITEMS OF 3
•
U
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 37507052.00
DATE ISSUED.......: 05/19/2008
RECEIPT #.........: BS000004824
REFERENCE ID # ...: 08050148
SITE ADDRESS .....: 10123 JUDY AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
,METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
370.70
---------------
370.70
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
#248
VOICE ID DESCRIPTION
--- ----------------------------
602 ROOF PLYWOOD NAIL
605. FINAL REROOF
OWNER ............:
JIM CITTA &
GAYLE JARVINEN
ADDRESS ..........:
10123 JUDY
AVE
CITY/STATE/ZIP ...:
CUPERTINO,
CA 95014
RECEIVED FROM ....:JOHN
L ANGELO
JR
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
IBSEISMICR
VALUATION 6,919.00
----------
0.70
----------
0.00
----------
0.70
----------
0.00
1BUSLIC
FLAT RATE 1.00
110.00
0.00
110.00
0.00
1REROOFRES
SQ FEET 20.00
'
260.00
0.00
260.00
0.00
TOTAL PERMIT
----------
370.70
----------
0.00
----------
370.70
----------
0.00
,METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
370.70
---------------
370.70
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
REFERENCE NUMBER
--------------------
#248
VOICE ID DESCRIPTION
--- ----------------------------
602 ROOF PLYWOOD NAIL
605. FINAL REROOF
OCUPEkTINO
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION
APN # & 77� 7 OS � 0 0
v
Date:s
Building Address:
10,23 JvbY ►4U�
,
Owner's Name:j i m G i f r A
Phone #: �.A d C6
G J 4,e- vi vx eAA
333- IgS
Contractor:�0 1/1�,�r�y
Phone#: LApc6-6Z1- OS}�-
Fax #: `-1 M - 37-0 — 19212
Cupertino Business License #:
Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑
Built -Up roof
,a --Asphalt Shingles ❑
Asphalt Shingles
❑ Wood Shakes ❑
Wood Shakes
❑ Wood Shingles ❑
Wood Shingles
❑ Other (Specify) ❑
Other (Specify)
Number of existing coverings ❑
Provide I.C.B.O. Report #
xr(To be Removed ❑
Provide Mfgr. Installation Specs.
Job Description: ..Fq,,4w _ J1=1= -3 e44 . I-"
Ll o yK.
CU*"/iq
Residential
Commercial
Green Building: Please complete relevant portion of the
Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in
plan
set & the sheet index.
Valuation:
• I Have
Signature
Understand and Will Comply with Cupertino's Tear -Off Policy:
A
Sm-
OCU
PERTINO
CITY OF CUPERTINO
REROOF
FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BSEISMICO
Seismic Commercial
B
20
1REROOFRES
Re -roof Residential
B
1SFDWLR00F
I
1BSEISMICRE
Seismic Residential
B
1REROOFMRES
Re -roof Multi -Family
B
1MFDWLROOF
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business License
B
n
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 1997 UBC Standards
and manufacturers specifications on re -roofing.
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 $176.18. The re -inspection fee must
be paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of Ya " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re -roofing.
J.1 ". C,rt-✓4-
Homeowner's Name: 6 Ryi L- J &-4- V
Job Site Address: 10 [T-3 3 J
Roofing Company Name:
Applicant's Signature:
• Greg Casteel
Building Official
�,,J RW,
Revised 11/2/04
Date: 5- J o/ -U$
E
Plan Review Process Work Book Page -12-Revised 3/25/08
A
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
4
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
11.
Permeable Pavin Note
L -1C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
72points
D.
Structural
3.
Uses Wood 1 -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, (Note/Spec.
A-3
1 pint
P.
Other
1.
List Green Features on Plans
A-1
1 point
TOTAL POINTS
40 points
E
Plan Review Process Work Book Page -12-Revised 3/25/08
A
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.
1. Recycle Job Site Construction & Demolition Waste
3 Resource pts
y=yes
65%=.1 point; 75%= 2 points; 60%= 4 points
t up to 4 Resource pts .
12. Salvage Reusable Building Materials
4 Resource pts
y=yes
3. Remodel for Mixed Use, Adaptive Reuse, and
2 Resource pts
y=yes
Historic Preservation
4 Resource pts
y=yes
4. Protect Native Soil
2 Resource pts
y --yes
5. Minimize Disruption of Existing Plants & Trees
1 Resource pt
y=yes
6. Implement Construction Site Stormwater Practices
2 Resource pts
y=yes
7. Protect Water Quality with Landscape Design
2 Resource pts
y=yes
6. Design Resource -Efficient Landscapes and Ga dens
� 4 Resource pts
y=yes
_
9. Reuse Materials/Use Recycled Content Materials
y=yes
for Landscape Areas
2 Resource pts
y=yes ,
10. Install High -Efficiency Irrigation Systems
2 Resource pts
y=yes
11. Provide for On -Site Water Catchment / Retention
2 Resource pts
y=yes
B. Foundation
• 1. Incorporate Recycled Fiyash in Concrete
25% Recycled Ryash = 2 points; Add 1 point for every 10%
increase of Flyash, up to 5 points up to 5 Resource
2. Use Recycled Content Aggregate 2 Resource pts y=
3. Insulate Foundation/Slab before backfill 3 Energy pts y=
C. Structural Frame
Ll1. Substitute Solid Sawn Lumber with Engineered Lumber
3 Resource pts
y=yes
2. Use FSC Certified Wood for framing
3 Energy pts
y=yes
(For every 10% of FSC lumber used = 2 points, up to 10)
up to 10 Resource pts.
3. Use Wood I -Joists for Floors and Ceilings
2 Resource pts
y=yes
4. Use Web Floor Trusses
2 Resource pts
y=yes
5. Design Energy Heels on Trusses 6' or more
2 Energy pts
y=yes
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=yes
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=yes
S. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts
9. Use Structural Insulated Panels (SIPS)
y=yes
a. Floors
3 Energy pts
y=yes
b. Wall
3 Energy pts
y=yes
c. Roof
3 Energy pts
y=yes
10. Apply Advanced Framing Techniques
4 Resource pts
y=yes
11. Use Reclaimed Lumber for Non Structural Applications
3 Resource pts
h2. Use OSB
y=yes
I a. Subfloors
b. Sheathing
{I 1 Resource pt
y=yes
-- _
1Resource pt
y=yes
F1. Use Sustainable Decking-Mitarials
Up to 2 Resource
b. Showerheads (1 point each, up to 2 points)
Up to 2 Resource
4. Replace To0est with Ultra -Low Flush Toilets
«'
(1 point each, up to 3 points)
a. Recycled content
3. Resource pts
y--yesF
0
4 Energy pts y=
7. Install Water Filtration Units at Faucets
0
b. FSC Certified Wood f
3 Resource pts
y=yes
0
2. Use Treated Wood That Does Not Contain Chromium/Arsenic i
1 IAQ/Health pt
y --yes
0
3, Install House Wrap under Sidling
1 IAQ/Health pt
y --yes
0
4. Use Fiber -Cement Siding Materials
1 Resource pt
Y --yes
0
E. Plumbing
1. Install Water Heater Jacket 1 Energy pt y=
2. Insulate of and Cold Water Pipes 2 Energy pts y=
3. Retrofl all Faucets and Showerheads with Flow Reduce s - i
a. Faucets (1 point each, up to 2 points)
Up to 2 Resource
b. Showerheads (1 point each, up to 2 points)
Up to 2 Resource
4. Replace To0est with Ultra -Low Flush Toilets
«'
(1 point each, up to 3 points)
Up to 3 Resource
5: Install Chlorine Filter on Showerhead
1 IAQ/Health pt y=
6. Convert Gas to Tankless Water Heater
4 Energy pts y=
7. Install Water Filtration Units at Faucets
0
(2 points each, up to 4 points)
Up to 41AQ/Health
B. Install On -Demand Hot Water Circulation Pump
4 Resource ots v=
r, tiecmcar
[,—.[Install Compact Fluorescent Light Bulbs (CFLs)
(6 s=22 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 Energy pt
(1 point each, up to 4 points) Up to 4 Energy pts.
0
G. Appliances
Install Energy Star Dishwasher
1 Energy pt
Install Washing Machine with Water and Energy
«'
mservation Features
0
0
0
0
1 Energy pt
nstall Energy Star Refrigerator
1 Energy pt
Install Built -In Recycling Center ._
3 Resource pts
H. Insulation
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls 2 Energy pts y=yes
b. Ceilings 2 Energy pts y --yes
2, Install Floor Insulation over Crawl Space 4 Energy pts y=yes
3. InstallRecycled-Conten[, FiberglassInsulation with
IjNo Added Formaldehyde 3 IAQ/Health pts y=yes
4. Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes
S. Use Cellulose Insulation
e Walls 4 Resource pts y=yes
%b. Ceilings 4 Resource pts y=yes
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls 4 Resource pts y=yes
0. Ceilings 4 Resource pts y=yes
«'
0
0
0
0
0
0
0
0
0
1. Install Energy-Efficiant Windows
a. Double Paned
1 Energy of
b. Low -Emissivity (Low -E)
2 Energy pts
c. tow. Conductivity Frames
--------
2 Ener is
,i Energy
2. Install Low Heat Transmission Glazing
_
1 Energy pt
J. Heating Ventilation and Air Conditioning
(1. Use Duct Mastic on All Duct Joints-�
2 Energy pts
y--ye,,
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1 IAQ/Health pt
yqe<.
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
yges
5. Install Solar Attic Fan
2 Energy pts
y=yes
6. Install Attic Ventilation Systems
1 Energy pt
y=yes
7. Install Whole House Fan
4 Energy pts
yges
8. Install Sealed Combustion Units
a. Furnaces
3 IAQ/Health pts
y=yes
b. Water Heaters
3 IAQ/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEEW11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y=ye=-
12. Install 90 Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
y=ye.
13. Retrofit Wood Burning Fireplaces
a. Install EPA certified wood stovesrnserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAQ/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
S IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
y=yes
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar (Nater Heating
4 Energy pts
y=ye-
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy pts
y=yes
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =18 points)
Up to 16 Energy pts
I6. Select Safe and Durable Roofing Materials
1 1 Resource pt
y=yes
7. Install Rarrieradiant B ~
- 3 Enerov ols
v=ves
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
0
r. Use LowMo-VOC Paint V 1 IAO/Health pts y=yes
2. Use Low VOC, Water -Based Wood Finishes 2 IAQ/Health pis y=yes
tt-3. Use LowMo VOC Adhesivas 31AQ/Health pts y=yes
4. Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes
S. Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AOMealth pts y=yes
6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
t7. Seal alCEzposed Parti& board6 MDF _� 41AQfHealth, pts y=yes
B. Use FSC Certified Materials for Interior Finish 4 Resource pts y--yas
9. Use Finger -Jointed or Recycled -Content Tim 1 Resource pts y=yes
10, Install Whole House Vacuum System 3 IAQ/Health Dts v=ves
8 Resource pts
0
D
D
2. Use Rapidly Renewable Flooing Materials
—Recycled
0
.0
0
D
D
y=yes
3.—Use Content Ceramic Tiles
4 Resource pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQfHealth pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y=yes
6. Install Recycled Content Carpel with Low VOCs
4 Resource pts
0
N. Flooring
1. Select FSC Certified Wood Flooring
8 Resource pts
y=yes
2. Use Rapidly Renewable Flooing Materials
—Recycled
4 Resource pts
y=yes
3.—Use Content Ceramic Tiles
4 Resource pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQfHealth pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y=yes
6. Install Recycled Content Carpel with Low VOCs
4 Resource pts
y=yes
Total Points Av 1 1401 1301 57 •
Total Points Project R 1 01 0 0
G:daiarprog-dgreenbuildingguidelineshemodeleNgreenpointsfna121204pm1scted.sls
CIN OF
*UPEkTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
/012-3 v
PERMIT #
6FOS-o/.K<4---
OWNER'S NAME: c mA G a.« -3rw i v e,,,
PHONE # y 09-373— IS -5
GENERAL CONTRACTOR: A*,t,4,�
FAX # fl - 37o- 92Z
I am not using any subcontractors: 3t-,� a�-6
Signature Date
Please check applicable subcontractors and complete the following information:
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Owner/ Contractor Signature
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Date
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
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Owner/ Contractor Signature
S— i� —C'A
Date