08060013 CITY OF CUPERTINO
BUILNNG DINSION PERMIT CONTRACTnR INF'URMr� ION .
.,.z.*.� '.'.
PERMR NO.
BUILpIlycF3gogE3$:A RODA DR WESTSHORE ROOFING INC 08060013
OWNE
lR'
US NAME: L PERMIT ISSUE DATE
ADKINS RICHARD B AND LINDA 2814 AIELLO DR C 06/02/2008
NE: SANITARY NO. CONTROL NO.
(408) 694-0060
ARC HIIECT/ENGINEER: BUILDING PERMTTINFO
BLDG ELECT PLUMB MECH
�Op LICENSED CONTRACTOR'S DECLARATION O O O
m❑ I busby affirm Wt 1 am licensed under pmvisi"Of Oup c,9(ammeecing Job Description
�iW with sectian7ak))otoivrrion3orda Burims�arw Prote�cam cada.and myBa�� RE—RF,RMV 2 LYRS WDSHK, INSTL CLS A 28SQ GERARD
o<n U. forte and flet
��_ LiaacCla Le — Lm.g z-Z) CNYNB SHAPE
-�0 Dam Can.,
e uuy�� ARCHffECTS DECLaRAT10!
1 understand my plans shall be wood as public accords
JyU
k LLO
Licensed Pnsfcssienal
3
OWNER-BUILDER axe DER m Ce CounsON
F 1 herthy sRrm Nal I am exempt from the Canlactoh License Law far Ne
O O following¢aero.(Sadno 1117 L3,Business and Ro(essions Cale:Any city at county
which requires a permit to cnnsuuct,aloe improve,demolish.or repair any svuchma
_IQ prior to its issuance,Man requiaca the applicant for such Permit to rile a signed suumem _
m
[but ho Sq.Ft. Floor Area Valuation
yl-O (commencing with Section 7000)ofDivision 3Ofthe Businessand Professional Cadc)in $16SOO
y Net he is exempt therefrom and the basis tar the alleged exemption.Any violation of
Section 7031,5 by wry applicant for a permit subjects the applicant to a civil penalty ofNumber Occas
not mom than five hundred d.11.(ssod). 3 6 9 3 3 015 A Occupancy Type
❑Las owner of Ne property,re my emplaym wird ergo ar Ness role compcnsatirn,
wider Nasional ad thesweroreunm intended or Law
dor not apply 7W.Business Required Inspections
Nd Proproperty
who boo Cade:The Contraction's sdistant,
and
whoense Law dad not apply lf an owner is 9 P
properly who Wiprovid mpmva thereon,and who dououch work himself or through his
awn ver.th,Wilding
that such Impmwments are not ear of c m complaint.
disk If.
builder.Ne building w improvement 4 mid within on,year of completion,Ne ounce,
seof
builder will have am burden of proving Nat k did nm build m improve for purpose of
isle.).
❑1.as owner of dmproperly,am acluuvely conuaming with licensed antmmm to
wnsuoet the pmlect(sec 7W,Business and Profestions Code:)The Conmesors Li- .
ase Law dos ern apply an an owner or property who Wilds ar impmws Neuron.and.
.1w contacts for such pmjems wird sans echo(s)Iicemed p.m to the Convacloh
License Law.
❑l am aemptunderscc .03PCImdsumamn
Owner Dau
WORKER'S COMPENSATION DECLARATION
I hereby afGamunder Na iy of Kdmy oro of the following declaruionc
1 have and will noun aie•certi0au of Conscm to self insure forwerkern
s'scomp
.I...as provided fm by Section 3700 of the Labor Code.far the perforans of de
work for which Nu permit is issued.
❑1 have and will moonpan Workers Cumpensatma Worans,as required by Section
3700 of the Uttar Co@,for dm puformmce of the w forwhich this permit is issued. '
My WorIonic ampemauon llyurmtt artier and Polity number coo:
Cartier. S N T VKd Polley No.: l QUO 20G
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not wcamplemd if the permit Is Macau hundred dollars($100)
orlco .)
I cattily that in the performance of the work for which this permit is issued.l shell not
employ any person in any mmurm as b become mbject to the Workers Compensation '
Laws of California.Dam
Applicant
NOTICE TO APPUCANP.If,after making this Certificate of Exemption,you should
become subject to the Worker Compensation provisions of are Labor Code,you muss
.J O foMprovisionsNu m
with comply with such Or permit shall W deemed revoked.
z 51 CONsrRUcnON LENDING AGENCY
[+ Iheo:bli ally dul there ua construction lending agency for the perforans of
C > We wart for which Nis perh is iarwed(sec.7(197.Cm.Q
WM O Lenders Name .
z Lander's Address
U O 1 only Nat I Iuw read this application and sum this the above inf.tion is
Fcoram 1 agree In comply with all it,and county ordinances said sum laws elating to
.OU Wilding construction,and hemby authnise mpremnua dvof Nu city m crow upon the
aWw-mentioned properly for Inspectionpes purposes.ma
F y (We)ages to ave,indemnify and keep harmless the City of Cupertino against
rn Imbilitimjudgments,costs and expenw which may in any wyamsagaimtsaidCity
U z in consequence of the granting of this permit.
^ APPLICANT UNDERSTANDS AND W} OMPL 1111 ALL NON-POINT Issued by: Date -
SOURCE REG NS. /L�
s. m pyheanuCan err �oaT Re-roofs
HAZARDOUS
MATERIALS DISCLOSURE Type of Roof
Will the applicant or room Wilding ampantseom orhandle haandows makrad
an defined by the Cupertino Municipal Code.Chapkr 9.13, it dm H
dalth and Safety
Code,Schon 35333(a)?
Ya /0</ All roofs shall be inspected prior to any roofing material being installed.
❑
Will the applicant or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
pad`va' Otis air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection.
C]le. Nu
I have mut the hvndoa mskrlals requirements under Chapter 6.95 of the Califor-
diesnithdaSausyhawaWnCOdc.SacMLwoiti3My Bm13551g.l in.0ry'the
o Occupant
Wilding ,
alasnot curntiyhewsmmol.Nathis55 y mnoify IWaifthe of the
requirements which most be met prior m is cc Calif of Occupane
2 gnatureofApplicant Dat l
OVEroe illidmailitilagent D All roof coverings to be Class alga,or better
6 _ ,
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36933015 . 00
DATE ISSUED. . . . . . . : 06/02/2008
RECEIPT # . . . . . . . . . : BS000004971
REFERENCE ID # . . . : 08060013
SITE ADDRESS . . . . 10646 LA RODA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ADKINS RICHARD B AND LINDA
ADDRESS . . . . . . . . . . : 10646 LA RODA DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4416
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . . . . . : PAUL FOWLER LIC # 21417
COMPANY .. . . . . . . . . . : WESTSHORE ROOFING INC
ADDRESS . . . . . . . . . . : 2814 AIELLO DR C
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 694-0060
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- -- - ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 16, 500 . 00 1 . 70 0 . 00 1 . 70 0 . 00
1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 365 . 70 0 . 00 365 . 70 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- ---------------
CHECK 365 . 70 #4532
---------------
TOTAL RECEIPT 365 . 70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
D"Po (: o0%3
CITY OF CUPERTINO
REROOF
•CUPEkTINO PERMIT APPLICATION
APN # 310933 0�,�. Date: 6 og
Building.Address: a6 y 6 Lu go d ct d ,
Owner's Name: i G AC[ K;KS Phone #: �C$c 2 5
Contractor: V,� St-Sho✓'C jz oof �5 Mc _ Phone #: �t '{56 — 02-W
Fax #: `�j'01i 6 9`1 - oosj
Cupertino Business License #: Contractor License #: 7tq� Z y 1
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes o Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) )�, Other (Specify) C_,crc�/d. Cun uvi 5A4 14
Number of existing coverings "L ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Veyt,,pv2 Z 1ayGrs woad - PtctPe, jkx5tcjj
GxruVrd Cuwypvl SkWtJ4-C Zg ,� 164,00 e(dsj- A_
ResidentialCommercial
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: 16 X500
•I Have Read Understan d Will Comply with Cupertino's Tear-Off Policy:
A ".
Signature
CITY OF CUPERTINO
" �` REROOF
OF
•CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROIIF
IBSEISMICO Seismic Commercial B
Z� 1REROOFRES Re-roof Residential B 1SFDWLROOF
/ IBSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408)777-3228
Fax: (408) 77'-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 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: E i v- AA K I Yl C
Job Site Address: .106 !Y& LeA &Jo, Jr.
Roofing Company Name: WPS-f5hare J Q5>_ rl c, 1-n
4_
Applicant's Signature: /5 . ' Date: 6 2 Og
• Greg Casteel // __
Building Official
Revised 11/2/04
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
A ,k
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 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
( 66 Y
JUN 0 2 2000
CD
p1_
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
Fycle Job Site Construction&Demolition Waste
=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
vage Reusable Building Materials _1 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 Gardens 4 Resource pts y=yes 0
9.Reuse Matedals/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 61
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 LL
2.Use Recycled Content Aggregate 2 Resource pts y=yes
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes
1
C.Structural Frame
i.Substitute Solid Sawn Lumber with Engineered 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 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 p
9.Use Structural Insulated Panels(SIPS)
a.Floors
b.Wall 3 Energy pts y=yes p
c.Roof 3 Energy pts y=yes C
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
fl2.Use0SB — -- - —
a.Subfloors
1 Resource pt y=yes 0
• b.Sheathing
1 Resource of y=yes p
1 1 1
xtenor Fimsh
I1.Use Sustainable Decking Materials ; •
a.Recycled content y 3.Resource pts y--yes 0
1 b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood Tliat Does Not Contain ChromiurrJArsenic 1 1 IAO/Health pt y=yss 0
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt Y--yes 0
- --- -— - -- — ---- 1 1 1
E.Plumbing
1.Install Water Reeler 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3.Retrofit all Faucetsand 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) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
S.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
r.rieccncai 1
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulb,s=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 - 1 Enercy pt y=yes 0
2.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
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 pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
rInstall Recycled-Content,Fiberglass n Insulatiowth
o 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 O
b.Ceilings 4 Resource pts y=yes 0
6.Altemative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
o.uenings 4 Resource pts y=yes C
1 1 1
.Windows -
•
1.Install Energy-Efficient Windows l
a.Double-Paned i1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) ' 2 Energy pts y--yes 0
c.Low.Conductivity Frames __ 2 Ener is es 0
2.Install Low Heat Transmission Glavin 9Y P y--yes
9 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints }} 2 Ener is
—.._--..�J 9YP Y=Yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts yeses 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 21A0/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
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
It.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 Refgerants 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 stovesrinserts 1 IAQ(Health of 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 4IAQ/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 1 1
(2)enewable 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-Vire 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
:I Select Safe and Durable Roofing Mnenals �_ 1 Resource pt y=yes 0
7.Install Radiant Barrier �� 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
M. ndoor Air Qua ity and Fnishes
.'Use LowMo-VOC Paint �~ 1 IAQ/Health pts yryes p
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 0
3: •
� Use LowMo VOC Adhesives 3 IAQ/Health pts yryes 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 yryes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAO Health pts y=yes 0
L.Seal all Exposed PaztOeaoard of MDF `1 4 IAQ/Health.pts y=yes D
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 6 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials �_ 4 Resource pts y=yes 0
3.Use Recyclod Content Ceramic Tiles4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5IAQ/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 1
Total Points Available: 1 1401 1301 57 •
Total Points Project R 1 01 01 0
G:datalprogdgreenbuildngguidelines/mmodelers/greenpointsfinal2.12.g4prolemedxls
•
Community Development
—mq10300"Corre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
qWUPERTINO
Building Department
JOB ADDRESS: 6 y 6 �o dog PERMIT #G)j
OWNER'S NAME: rZ c k PHONE # LJOg 2 cj
GENERAL CONTRACTOR: w _ FAX # �/ 6q� po •�
I am not using any subcontractors•4, i , � D�
Signature Date
Please check applicable subcontractors and complete the followin information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICIiNSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood ,
Glass/ Glazing
Heating _ r-
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
-Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
• Tile
z/v3
Owner/Contractor Signature Date