08040214 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATIfl1V r
PERMIT NO.
Bm1,DIj�QApD LILAC WAY C & C ROOFING 08040214
OWNERS NAME: PERMrr ISSUE DATE
FENG LI-CHIEN AND ALICE A 89 S 21 ST 04/29/2008
NE: (408) 298-1868 SANffARY NO. CONTROL NO.
..
ARCH=tENGINEER: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0 0 0 0
'S'oo LICENSED CONTRACTOR'SDECLARAnON , JobDescri [ion
1 hereby affirm that 1 am licensed under provisions of Chapter 9(mmmcncing P
n withSedon7OXBofDivirion3ofonBusinessmdProfesdomCode,aMmylzecon,is RE-RF,T/O SHKS& ADD1/2 CDX PLYWD 40YRCMP CLS A
in full loran aM
if
jai License Clan _ Lick - Z 25SQ
=q Da¢ Conuwar
7W7W ARCHr1ECTS DECLARA ON
D U I uMmLanJ my Olans Nall W umd a Public mmrtis
a
go� Licensed Pmfcssicnal
5 Oat I son UITDER DECLARATION
2 R I hereby caller that 11. exempt from 1W ComonsCo License Law for UK
O O following tenon.(Scotian RD I.S,Business and Nofessimi Code:Any city or wary
which requires•issuance.also
re cores the ahv.Improve,h Permit
t at asig any strumum
5zi priwmits ensedursua mquirtetW applicant for ToCConummi'lLiec Ilk a,Law(ned Catement
< thaneisfietveapum,malhcpmaiaionaorthecumtmar,Lia<nsehw(Ch.pmr9 Sq.Ft.Floor Area Valuation
z�D (cmmencingwith$cnion]OW1mDivision SoftW Businessand Pmfessinna Code)or $9900
s. $ that hOis exempt therefrom and dte basis for the alleged eampnon.Any violauon of
Section 7051.5 by any applicant for a Permit subjects the applicant to a civil penalty orNumber
not moa them five hundred dollars(113M). 35904009 .E Occupancy P Y Type
0 1,as ownv of the progeny.or my cmpinyee+with wages as theh ale compensation.
will do the work and the auunure is Out intended arafrered for ale(Sec.]Desi,Bes
and Pmrealnns Code:The Comn sera License Law does nal apply a an usiowxr of Required Inspections
propedy,who builds c rimprom thereon,and whndoessuch work hiavdfor through his
awnemployees,provided that sW improvements see ratinaMed vmRered losable.If.
however.the building or improvement is aid within one year ofcompletion,the ownv-
buildm will law the wedan of proving that he did Out build or Improve for Purpose of
sate.).
1,a wnv of the Property,am exclusively cunusom,with Demand mmramors on
eonatmn the penjee(Sec.7044,Business and Professions code:)nab Cam,ora u-
cove Law does not apply to an owner of property who Wild or improves thereon.and.
who contracts fvsuch projects with acentrannt(s)licensed pursm ion the Cartraah '
Lice.law.
❑I am exempt modes See ,B&P C for this rearm _
Ower Date
WORKER'S COMPENSAnON DECLARATION
I hereby afftm under Penalty of perjury One of on,following declaratiav:
1 bare and will..low.a Certificate of Conant an self-insure forworkefaC.Pem
sedum.as ProvidW for by Section 7700 of the Labor Code,for the perfomance of dte
wart for which this Permit is issued.
0 1 have and will maintain Wca e a Coapmuetimn Ivunnce,a recruited by Suction
5700of the Labor Code.for the perfomae of Ne work for which this Permit isI.& '
My Workd�sr.Coommpenna—don Incomes carrier and Policy number. art:
Carrier: )!R'f G"I—fJ lsf l/ Polity No.:I y27Lfi
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSAnON INSURANCE
mus action nttd ootbecorapleted if the Permit isfa one hundundeadd s(SIM)
or less)
I certify that in the Pvlormamre of de work for which Nis Permit is issued.I mail not
employ any pecan in my maneera a an become abject a the Wortm e'Compensation
Laws of Califomia.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject in the Worker's Compevetion Provisions of the Labor Cede,you mum
.J O foMwith eomPly with such Provision v this Permit shall be doemrA revoked.
'z y CONMUCrION LENDING AGENCY
[--i I hereby affim this there isacovtructinn lendingagenry,for don perfomarcc of
a > the ,it for which this Pemit is issued(See,5D97,Civ.C.)
QLcndels Name .
z Undoes Addreab
U O 1 certify that I Mw rad this W icatimn and sate this tie above afomutiun is
(.E correct 1 agree to comply with all city W county ondimanes and state laws elating On
0 building construction,and hereby authorize repteunanim of this city Outman,upon the
r{Il more-mentioned Property for bapceded prrpo
(We)agree to ave,iMcmnifY and trap hamlet/the City of Cupenino against
`yy liabilities,Judgments.costs and eximmas which may in any'w'ay acerae against said City
L
Uin consequence Of IM timing Of ft Permit. �^
^
APPLICANT UNDERSTANDS WITH ALL AND WILL COMPLY WIALL NON-POINT Issued by: _ Date 2
SOU REGUTATTO
-z?
Signature 0� Re-roofs
Signature rinppDeamrcontraear
Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the Applicant or future building occupant store Or,hock harallov material
as defined by the CuPenina Municipal Cede.Clagter 9.1;and the Hcalth and Safety
Cale,Section 25551(x)7
❑Yea 894a_ All roofs shall be inspected prior to any roofing material being installed.
Will tie aPPlimt or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit haam-nd air contaminants u dcfnrted by the Bay Area Air Quality Management all new materials for inspection.
J saict7
❑Ycs 81f,
Ihaw mad see Wad.materials requiremeas under Chapter 6.95 of the Califor.
rias rahh&Safety Cod e,SeeLoom had 1,i, myo533 anJ2555d.lt nosily t reentrant
Wilding J��_ `,
dans not currently Mw a tenal thm 1,is my tvponsibility a nmtify dK cougar of the LU iwff�C� 7 C s J
mqu�i nab which matl 6e met priofbiSSuaKC tufa Cenl(Kaa OlQNpvKy. -
1/.�.��a—Z, 4--Z9-Ol- Signature of Applicant Date
Ownerm mmmrisdagcnt Date All roof coverings to be Class';q`or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35904009 . 00
DATE ISSUED. . . . . . . : 04/29/2008
RECEIPT # . . . . . . . . . : BS000004621
REFERENCE ID # . . . : 08040214
SITE ADDRESS . . . . . : 7783 LILAC WAY
SUBDIVISION . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : FENG LI-CHIEN AND ALICE A
ADDRESS . . . . . . . . . . : 7783 LILAC WY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4533
RECEIVED FROM . . . . : OSVALDO CAMARA
CONTRACTOR . . . . . . . : OSVALDO CAMARA . LIC # 22982
COMPANY . . . . . . . . . . : C & C ROOFING
ADDRESS . . . . . . . . . . : 89 S 21 ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95116
TELEPHONE . . . . . . . . : (408) 298-1868
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 9, 900. 00 1 . 00 0. 00 1. 00 0. 00
1REROOFRES SQ FEET 25 . 00 325 . 00 0 . 00 325 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 326 . 00 0. 00 326. 00 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 326 . 00 MC
---------------
TOTAL RECEIPT 326 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS . 605 FINAL REROOF
•
CITY OF CUPERTINO
So- REROOF
•CUPEkTINO PERMIT APPLICATION
APN # Date:
U ► { DOq
Building Address:
FizLI wva
Owner's Name: Phone #:
G!-CGrtbr/ Fc�v �Z/—�3 �L
Contractor: Phone #:yi P-Z 9f- /969
Cupertino Business License #: n n Contractor License #:
el 9z8z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles < Asphalt Shingles
Ig ( Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
X To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: K
SI�fIi1t6 ��D /VZ e D
eo vvk e C1C-_Vt /—
Residential N 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:
, ay
• I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
�al am__ REROOF
COf
IOCUPERT1NO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
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 /-Cti i N rENG-
Job Site Address: :7-7 k 3 L L I4 L w r4
Roofing Company Name: C-9 0ct V
Applicant's Signature: ,n�O/�y �/„ Date: y-2- 'd
• 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.) A3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1point
TOTAL POINTS 40 points
• C u F E(z 71 'r— a
CD
19 z
CD
0 �
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 IAD/Heafth
.Brie
1.Recycle Job Site Construction&Demolition Waste I
i
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
12.Salvage Reusable Building Materials _ { 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Histodc Preservation - 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pis 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
8.Design Resource-Efficient Landscapes and Gardens 1 4 Resource pts y=yes 0
9.Reuse MatenaWUse Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irdgation 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 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 p
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes F1 0
1 1 1
C.Structural Frame
r.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 kJoists 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 Ener is
9Y P Y=Yes 0
b.Wall
3 Energy pts y=yes 0
c. Roof 3 Energy pis 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
12.Use0SB --- ---
a.Subiloors
1 Resource of y=yes 0
• b.Sheathing __ , 1 ResourceY
P t =Yes 0)--------
INPUT ReSDurces Energy IAQ/Health
rtenor ims
1.JI( Use Sustainable Decking Materials a.Recycled content ! 3.Resource pts y=yes 0
I b.FSC Certified Wood 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 Siding I 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
t 1 1
E.Plumbing
1.Install Water eater Jacket V—� 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
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) I 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 Healer 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-.trecmcar
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 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 1 1
G.Appliances
1.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
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
I4.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 Insulation with
No 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
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
n.Cemngs 4 Resource pts y=yes 0
1 1
indows
INPUT ReSDurces Energy A011-lealth
11.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 _ 2 Energy pts y=yes 0
L-- oW — --
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
F1.Use Duct Mastic on ATI Duct Joints 2 Energy pis 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 71 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
S.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health 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 stovesAnserts 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 pis y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y=yes 0
16.Install Heal Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 31A0/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
i6 Select Safe and Dureble Roofng Mate als �_] 1 Resource pt y=yes p
7.Install Radiant Bamar _ ---- 3 Energy pts y=yes 0
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 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1 1
INPUT Resources Energy IAQ/Health
.Indoor Alf Qua rty an Imshes
i1.Use LOW/No-VOC Paint - - — 1 1 IAQ/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 _ _ 3 IAQMealth is es
------ — —_ P y=y 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 y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQfHealth pts y=yes 0
7.Seal all Exposed Particleboard or MDF _ 4 IAQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes0
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
PAUse Rapidly Renewable Flooring Materials __ J 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 1
Total Points A 1 1401 1301 57
Total Points Project Received: Q 01 01 0 •
G:datalprogs/greenbuildngguidelinestremodele.-Jgreenpolntstinal2.12.e4protected.xis '
Community Development
e 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
4UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
Gi w C)Ro ct,on-( LA
OWNER'S NAME: G r'.- C t cn/ PHONE # U P-
GENERAL CONTRACTOR FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' o=ation:
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