08050222 CITY OF CUPERTINO
BUILDING DIVISION PERM
COAETRAGTOR IFi1E~l?'RA'IATI(7!N '`
Bu1LDff.ffRPLss1LAC WAY - CONRAD ROOFING SERVICE P080IT 50222
OWNER'S NAME: MRMTT L4UE DATE
CHAN—HSIANG HSU 332 PHELAN AVE 05/28/2008
"E' (408) 294-7615' SANTTARY NO. CONTROL NO.
ARCHITEC'OENGINEER: BUHDING PERMIT INFO
BLDG ELECT PLUMB MECH
I� 0
000 LICENSED CONTRACTOR'S DECLARATION Job Description
m 1 hereby afRrm that I am licensed under provisions of Chapter 9(commanding
°ZJ� with Section 70MofDivision 3o/deBusirc.• ProfeafonsCram.addmyRecnseis RE—RF T/0 SHKS, INSTL 1/2"CDX PLYWD,CLS A
-MainfullforteandeecL �lb5z
-'qz sl
U. y.LIM# CERTAINTEED PRES TL FBRGS SHIELDS 26SQ
Dau: ate' contractor
ARCHI'IEC 3DECLARATION ayK�n
I understand my pans shall he used as public accords
g a.o G Licensed Pmfassbna
5 OWNER-BUILDER DECLARATION
<f I bc¢hy affirm Nat 1 am exempt from the Contractors License Law for bm
o O following RaloR(Section 7
031.5,Bashers and Professions Calc:My City or county
5$ which requires a permit to rnna."alter,improve,demaksh,or repair any s=to.
i< prim to its issuance.sand requires the applicant for south permit to file a signed Statement
that le:is licensed puvuaa m Ne pmdslods of the Contractors Leeson Law(Capte9 Sq.F[. Floor Area Valuation
e w g (Common ncingwiNS coon]OW)ofDivaion3ofNeBusineaandPmfmiomCodc)or $11700
? tau he u eumpt dominoes add the basis for the alleged pd.My violation Of
Section 7011.5 by any applicant for a permit subjects the applicant to a civil penalty of 35904003 . Number Occupancy Type
not more thin fin hundred dollars ISM
I,mo nero(Nepmperty.ormyemploycawiffi gMmdeirsaewmpewdon,
add Prrhewotic and the ha Commerce,
aw does
tDa,Basirof
ane property
bas code:Ter eutheemra Lassie oes does not apply lf an through or Required Inspections
property who halos l improve thereon,andwho doessuch Musical wmk Mnael(m though hf.
own employebuiD ing or i thatnmb nt is samenu are rot arofcmMered for Manor.
however,the building or impmnment le said within arc year of completion,the owmr-
b le.). will have de WNra of proving that he did rot bulb m improv for Puryca of
sale.).
1.u..of the Property...exclusinly conhacting with licensed canuactms to
construct den project(Sec.]Oad.Business and Professions Code:)The Contracrars U.
CO.Law dons act apply to an owner of property who builds or improves thereon,and
who conuacu for such projects with a conuvrtar(s)licensed pursuant m the Conuaaors
Liceme Law.
❑lam exempt under See .BAPCfmtbumsron
Owner Dau
WORKERS COMPENSATION DECLARATION
I hembY affirm under pevally of perjury arc o(tie following declaradat¢
than and will for by
eCeNf3am of Comea orCod-imum fw Wmkcrs Comf the
suss,r provided for by Section 3700 Of tie Isar Code.Ire the performann of the
work for which this permit is ivucd.
0 1 Nn and will maintain Work s`3 Compensation Insuranco,as required by Section
3700 of the Isar Code.for the performance of the work for which this permit is Issued.
My Works+s CompntwihoCon In .Carrier and Policy numberr am:
Cartier. Nt- ry-tv-4
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Tblsremidm red nosbceanpleted if tee permit is fmonchmalsed doll's(SIM) .
Or kat)
I asdh Out in the performance of the woh for which this Permit is issued.l shall not
employ any person in any manner so as to become subject to the Wdrkeli Camperuation
Iawf of California Dam
Applicant
NOTICE TO APPLICANT:If,after making this CcaiRam of Exemption.you should
become subject to the Wormes Compensation provisions of the abs Code,You most
.J O forthwith comply with such pmwisions m ma
this permit ll he deemed daumd.
z'y CONSTRUCTION LENDING AGENCY
[ti Iherebyalfrm Nat then is•construction kndingagenry for the perfon.of
a > the work for whim Na Permit a coded(Sce.3097.Cin,Q
WM C] Lenders Name
z lenders Address
V Q I coldly that 1 han reed this application and sum Nu the ion information is
D.N ..MCL I agree to Comply with all city and COWty naimar ms and rmm laws relmag m
0 U Wilding conmwction,and hereby IU006M rePMOCM2 inn of Nu City In anmr upon the
W move-mentioned amatory for impecdon purposes
I„r G (We)agree to an,indemnify and keep homeless dm City of Cupertino against
Pry liabilities.judgments,Cosa and expenses which may,in any way accrue aganst said City
C)z APPL CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date.l�
SOURCE REGULA'1e199! J _
_ /C�w/"/(— -�--2.s.
Re-roofs
Signature OlMNicatrunContractor Date
HAZARDOUS
�--
liths=MATERIALSupaDlsaosuRE Type of Roof
WIII y t e,Cu ant or forum building s.Chapter
more or areae hruaom mamria
Coale.deSed by the Cupearto Municipal Code.Chapmr 9.12,orb the HW N aM S+(ety
section zss3zfan ,,,/ All roofs shall be inspected prior to any roofing material being installed.
❑Tei Lynn
Will to applicant of future building ocou nt ore If a roof is installed without first obtaining an inspection,I agree to remove
pp g e equipment car Mara which g P g
'mit hvaaom air cantamimnu as dcOmv by de Bay Arta Air Quality Management all new materials for inspection.
District?
❑Yen tyNo
I hen nevi Ne huadmus ro m ub requirements or&,Caper 6.95oftbs Calif.,
Mat Hal"Safety Cade,Savour 25505,23533 real 25534.1 uMCrsund and if Ne building
does not currently an a terunL Nat it IS my malerro bithy to notify the Occupant Of Ne
regaromentswh h ba OnpiorWas.ofaCcrureamofOccupancy.
S— ow Signature of Applicant Date
All roof coverings to be Class'W'
Owrmronuthm'utdgem Dam' g or better
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35904003 . 00
DATE ISSUED. . . . . . . : 05/28/2008
RECEIPT # . . . . . . . . . : BS000004913
REFERENCE ID # . . . : 08050222
SITE ADDRESS . . . . . : 7719 LILAC WAY
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . .
OWNER . . . . . . . . . . . . : CHAN-HSIANG HSU
ADDRESS . . . . . . . . . . : 7719 LILAC WY
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CONRAD ROOFING SVC
CONTRACTOR . . . . . . . : KEITH CARNAHAN LIC # 22297
COMPANY . . . . . . . . . . : CONRAD ROOFING SERVICE
ADDRESS . . . . . . . . . . : 332 PHELAN AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 294-7615
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ---------- ---------- ------ -- - ----
1BSEISMICR VALUATION 11, 700 . 00 1 . 20 0 . 00 1 . 20 0 . 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 339 .20 0 . 00 339 . 20 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 339 . 20 #12166
---------------
TOTAL RECEIPT 339 .20
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
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o
CITY OF CUPERTINO
IF6 - REROOF
OCUPEkTINO PERMIT APPLICATION
APN # 9 v 4-1 C,)U U U Date: Zg ,fig
Jr'_
Building Address:
-7-719 L; ly
Owner's Name: G)tia w _ tIN 1+3 kA Phone #: S
S 4 Z
a v�
Contractor: Cor�a,� gooG�,3 S-c Vtv Phone #: -L9y-76/f
Fax #: " 2 9 y—9 .7
Cupertino Business License #: Contractor License #:
2.ilbSZ
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles m, Asphalt Shingles
m/Wood Shakes ❑ Wood Shakes
❑ 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: T,c ,c- v SLL k, 5 1 'r"111 y>. ' kl7-
R✓"� �eC141�^(ct� �CtiJied�rrtttq� 7IL �tL ;plaSf S��ttisC�J C(crf
A
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: is /7 p
• I Have Read, /Understand
fand Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
REROOF
UITY OF
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Corrunercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2� 6 1REROOFRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
. 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
•
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 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: L 11 '+K — Ask a V.g 4I'l
job Site Address: _7-7 k 01 l\\ ( 4 C l A y
Roofing Company Name: V f L. _ �
Applicant's Signature: /L-- Date:
•
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
■
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
W-MMEMM M, / A TOTAL POINTS 40 points
.7 '� (Q C..1—mac L"r _
•
00
r 1
•
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 IA011-lealth
Sde
1.Recycle Job Site Construction 8 Demolition Waste
65%=1 point;75%= 2 points;80%=4 points I up to 4 Resource pts 0
I2.Salvage Reusable Building Materials _J 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 of 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
8.Design Resource-Efficient Landscapes and Gardens _ 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
B.Foundation
• 1.Incorporate Recycled Flyashin 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=yes 0
1 1 1
C.Structural Frame
L_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
8.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 0
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
j72.Use SB -----
a.
—ja.Subfloors 1 Resource pt y=yes 0
b.Sheathing
1 Resource pt y=yes 0
INPUT Resources Energy IAD[Health
xterior mis
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 IAO/Health pt y=yes 0
13.Install House Wrap under Siding 1 IAQlHealth pt y=yes 0
j4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
11.Install Water Heater Jacket _-J 1Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3 Retrofit all Faucets and Showdrheads 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
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.tiecmcar
1.Install Compact Fluorescent Light Bulbs(CFCs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) I 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
L Install Energy Star Dishwasher 1 Energy pt y=yes 0
`2.Install Washing Machine with Water and Energy
(Conservation Features 1 Energy pt y=yes 0
13.Install Energy Star Refrigerator i 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 pis y=yes 0
2,Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
13.Install Recycled-Content,Fibe—glassl6sulation with
INo Added Formaldehyde 31AOJHealth pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes
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).uenings 4 Resource pts y=yes 0
INPUT Resources Energy IAO/Health
f-Windows
I1.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 _ J 2 Energy pts y=yes 0
-2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
F.Use Duct Mastic on All Duct Joints !Ji 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 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 31AQ/Heallh pts y=yes 0
b.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 stoves4nserts 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 3 IAQ/Health pts y=yes 0
I 1 1
K.Renewable 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-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=18 points) Up to 18 Energy pts 0
16.Select Safe and Durable Matedals — —�� 1 Resource pt y=yes 0
7.Install-Radiant Barrer 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 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
• 1 1 1
INPUT Resources Energy IAQ/Health
-Wi
ndoor Air Quality and Finis es
r1.Use lowMo--VOC Paint _ 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3IAQMealth 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 61AO/Health pts y=yes 0
6,Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
7.Seal all Exposed Parfioleboard oor 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 8 Resource pts y=yes 0
2.Use Rapidly Renewable Floonsg 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 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
Total Points Aval a le: 1401 1301 57 •
Total Points Project R0 0 0
V°1 LiWay
G:data/progstgreenbuildngguidelineshemodelersrgreenpointsf nat2.12.04prOec ed.ds
•
Community Development
°1 10300 Torre Avenue
Cupertino CA 95014
N _ Telephone(408)777-3228
CITY OF Fax(408)777-3333
VUPEkTINO -
Building De artment
JOB ADDRESS: -7 '7 ) 0) L i I a c- Way PERMIT # O
OWNER'S NAME: t- n v.. — 91-vvv 1-vv44,4, PHONE # x,01=S'�y Z
GENERAL CONTRACTOR: G�r`<4 d o E k,�( —FAX # -71
6
I am not using any subcontractors: w 5-- Ze O g
Signature Date
Please check applicable subcontractors and complete the followin 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