08010098 CI'SY OF CJJPERTINO *a• 8xdmas.
BUILDING DIVISION PERNIITCON.CRA.C�TkR'�INP'QRMATIQN
k id ........�.
BUILDING AgDRESS: PERMIT NO.
20592 MC CLELLAN RD TBD — TO BE DETERMINED 08010098
OWNER'S NAME: PERMrr ISSUE DAUB
MELODY FARQUAR CHANG 01/16/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECTENGINEER: - BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
3oii LICENSED CONTRACTOR'S DECLARATION
f1 hereby 4111Mlast 1 un licensed under provisions of Caspwr 9(commencing Job Description
IN Section 7000)of Divtdon 7 ofthe Business and Professions Cade.and my license is INSTL PROPERTY LINE CLEAN-OUT. CONTRACTOR,GONE
^� in full form and.JJrt99cc�t�j � Q
Llcenso Clesa J�.2Le Lk,t !/ PRO
C'q Dau
ARCHITECTS DECLARATION SERVICES, PD BSL 1/16/8
I understand my plans"I Ie used a public ncoods
76
sea Licensed Foreuional
5 OWNER-BUILDER DECLARATION
9 O E I herthy.ame that 1 1. exempt from he Contractor's :My c Lew,. the
COO fallowing mason. emit t 7071.5.Business and ova.demolish.
e ooli Code:Any city m county
3 9
which rats issuance.ss a permit re emmrve6 alloy.ImPrOw,h Pe m t t ler repair any an roan.
iy primwsl esedprsant tothe
Neapplkaorme Con Pctor's0leasigned
aw(Cha mcnt
< that(comme licewith Srction7t )of DiviovarNe Contractor's Formations
(Chapter Sq.Ft. Floor Area Valuation
�S
that he
Section and of Divisionr of the Business and Profession Cade)or 2500
that io b campy therefrom and the bub for the alleged conation.a civil
vlolmion of
not
]0513 by any red old fm a permit objects the applicant w a rivll penalty of Number Occupancy e
nm mart than Ow hundred delWa(5500). 35918010 �� p YTyp
❑I,u owner of tie property,m my employees with wages u their sold compensation,
will do thewod,and that awaum isnot intended ter offend for sale 1146,Budnue Required Inspections
and Professions Cade:The Conancwrs License Law dean not apply N an Owner of q p
property,who huildsorimpose s thump,and whodeeaauch walk Mosseffor Wough his
Own
em.th buiproddedthansmhimpmwmmuamnotinteededorofferedforpieff.
buildo the building mImpmwment4said within arc Year of mprove frtheose of
builder NB have the burdan of Proving asp he dm not build or improve for purpose of
tate.).
❑1.u Owner of the pmpe rye am uckdwlY contracting with Ikemed mnusomrse w
museum the Project(Sec.to an Busiws and ry whsiau Cede:)Tie Cmusun. led 1111t111`1J\\\\\VLVVJt1
ewe IAO dose not apply u an owner of propmY who Wilds m improves Nemon.and, 1 \,
whocmmcuforsuchpmiemwithacmuacwr(s)limnedpursuantwthe Gnt oes V
Limns Law.
❑I oro roemps under Be, .B&P C for this reams
Owner Dau
WORKERS COMPENSATION DECLARATION
I hereby affmn under penalty of perjury ane of the fallowing declaradou:
have and will maintain•Cmditcale ofC..O[be elf-Inrvm for Worker's Comfort-
n,
ompeo-n,a Provided for by Section 5700 of the Labor Cede.for the Performance of man
work fm which this permit is unwed.
❑I Mw and will maintain Worker's Compeundon Insurance,u mgwred by Section
57W ofthe Mbar Cook.for the performance ofthe work for which this permit is isaued. '
My Worker's Compensation]man=tamer and Policy number am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(fhb account sed not becompleted If the permit is i.e.handled dollop($IBM
ler leu)
I miry Nat In tite performance of the wad ran which this Permit is issued,l"I not
employanypermainanY eMerdo�Ip bC[mne su-)eetw Ne Wortrn'GmpeuWm
Laws of Glifo 26 R,- i—
ApPlimnt '
NOTICE TD vlfP-CANT.IL after making this Ceninmte of EsmPtion,you should
become subject w the Workers Compensation previsions of the laher Cade,you most
.,O faMwith comply with such pmvidou m Nb Permit shall he domed revoked.
?► CONSTRUCTION LENDING AGENCY
Dvi9 I hereby affnm that Was is a condonation lending agency for Ne lerrormanz of
> the walk for which Nu permit Is issued(Sec.5097,Civ,C.)
W Q IsndmYs Name
Z)
Z Lenders Address
U 0 I coolly that 1 have read lass applkmim and fume Nm tie above mformmiun Is
LL carman.l agree to comply with all city and county Ordinances and nue lawn miming in
0 building construction,and hereby audtorea mpreunutiwa of thiacity m color upon the
W ahmomendoned property far Inspection purposes.
Pry (We)agree to save,indemniry and keep harmless the CITY of Cupertino agalut
CM liabilities,judgments.costa and expeams which may in my way amore against mid City
U in cansgmnm of time floating of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU S.
� Re-roofs /
Sigwo uof AppliesonanDam
AZSRDnVCuwr Dau
HOUS MATERIALS DISCLOSURE Type of Roof
WAR that applicant or future building mmput store Or handle hi a nota material
M dented by the Cupertino Municipal Code.Chapter 9.17.and the Health and Safety
Code,Schon 255370)7
[:3 yet, 1p No All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or fuwm{wilding Occupant us equipment m devisee which If a roof is installed without first obtaining an inspection,.1 agree to remove
t Wamnu aircmumimm,u&fl.d by the Bay Area All obesity Mat..Conent all new materials for inspection.
ct] �r''
❑Yue 6vw
Ihate mad the haau mmadw mqudrenents under hman 95OftheCalirar-
nbHcalthkSalelyCadc,Sectiats75505,25555 and 25531.I uMcrnsnd Natifde building
Once rot currently haw a amount.Nat it ts my responsibility to mdry dm accupanm of time
lequ w ' met prior to iuu---- Ccnifiulo Of Occupancy. Signature of Applicant Date
o rar.wthedvsdagent o,m All roof coverings to be Class"B"or better
bbl
CITY OF CUPERTINO
N1 REPIPE/SEWER/MAIN SERVICE
® CUPEINO PERMIT APPLICATION FORM
APN # � � � [ O . �� Date:'
Building Address:
aos-gz
Owner's Name: Phone#:
/Lt,ejo lJ
Contractor: P?U /cC� Phone#: lEU - S8o—7 g 23
Fax #: 40S
Contact: /J7�i7�1 �� Phone#:
Fax #:
Contractor License#:
Cupertino Business License#:
Job Description:
Residential Commercial ❑
Valuation:
Green Building Check list must be completed and attached to this application.
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
iBPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
1BSEISMICR Seismic Residential P
IPRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
IPCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE Plumbing Permit Fee Issuance P
iPLMBLNCK Plumbing Plan Check P
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
IBUSLIC Business License B
•
• G-�oc�� Dia ��Vi��S �S�Z ����/� 9.S�o/y
j Single Family GreenPoint Checklist date: IBJ Build ftGm6
The GreenPoint Ch"Ist is based on the various green Imtums Incorporated into the home and is the Sm ntSolutions From The Gmund Up
basis for the GreenPoint Rated program.A home can he considered green N It fulfills the prerequisites,
same at least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Ouality/
Health(5),Resources ste and Water(9).Please contact lBuildion.It Green for a IISI of qualified GreenPoint I_ -_ I _
Raters II you are interested In pursuing third-party verification. - L
® The green building practices listed below are described In the New Home Constructlon Green Building
Guidelines,available at rvww.bullditorgdfrM. .
PROJECT `
A 6IT8 Points Available Per Measure
7.Probst Topsoil and Minimize Disruption of Existing Plante 6 Trees
❑ a.Protect Topsoil tram 6mlon and Reuse after Construction __D _ }_ _ __ 1
El h.limit and Delineate Construction Footprint for Madmum Protection- 0 1
2.Decanter Instead of Demolishing Existing Buildings On SiteD 3
3.Recycle Job Site Construction Waste(Including Green Waste)
FI -
❑ a.Minimum 50%Waste Diversion by Weight(Rarycling or Rouse)-R9puimd p R
❑ b.Minimum 65%DNarsion by Weight(Recycling or Reuse) p - ----�-- -- ---- -
❑ c.Minimum 80%Diversion by Weight Recycling or Reuse) p 2
_._. ffi_. 4.Use Retyclsl Content Aggregabgiinimum25%)____ __ --_
❑ a Walkway end Drkewey 0 .
❑ b.Roadway Bese —. p --
Total Points Available in Site=12 0
8.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flymh or Slag
❑ a.Minimum 2D%Flyash or Slag 0
E] b.Minimum 25%Flash or Slag _ _p ' T_ 7
2 Use Frost-Protected Shallow Foundation in Cold Arms(C.E.C.Climate Zone 16) D 3
3.Use Radon Resistant Construction On At-Risk Locations Only) D }
4.Design and Build Structural Pest Controls
❑ e.Instep Termlb Shields a Separate All Exterior Wood.*Conuete Connections by Mend!or Plastic FaimmersNNiders D 7
b.All New Plants Have Tmnk Base,or Stem Located At Least 36 Inches from Foundation p I 1
Total Points Available In Foundation=B 0
C.LANDSCAPING Points Available Per Measure
1.Construct Rmource-Efficient Landscapes
❑ e.No Invasive Species Listed by Cel-IPC Are Planted 0
❑ b.No Picot Species Nil Require Hedging0
•
El c.75%at Plante Are Drought-tolerant California Nerves,Mednenane9n,dONer Appropriate Species _ p
2 Use Rre,Safe Landsmping Techniques 0 1
3.Minimize Tod Arms in Landscape Installed by Builder
❑ a All Tod Will Have a Water Requirement Less than or Equal to Tall Fescue(50.6 plant is." 0
❑ b.Tod Shall Not Be Installed on Slopes ExceeNng 10%or In Areas Less Nen B Feet Wide 0 2
❑ c.Tod Is S33%of Landscaped Area(lobi 2 points) 0 --7-7----'- --
E) d.Tod is 510%of Landscaped Area(total4 polms) p -' "---- 2
❑ 4.Plant Shade Trees D 3
5.Group Plante by Water Needs(Hydrozoning) 2
S.Install High-Efficiency Irrigation Systems
❑ a.System Uses Only Low-Flow Drip,Bub!bers,or_rn Ilcw Sprinkles p
❑ b.System Hes Scion Controllers -- 2
d� 3
❑ 7.Incol, Two Inches of Com tist in the To 6 to 12 inches of Soil 3
B.MuichAll Plantln Beds to the Greater of 2Inches or Local Water Ordinance Requirement Obi n .I 2
9.Usa 50%Selvegetl or fleryGetl-Content Materials for 50%of Non-Plant Landscape Elements
ID.Roduce Li ht Pollution by Shielding Flxturm andror Directln Li ht Downward 0 /1� 1 t
Total Poins Avallable In Landscaping=31 0
D.STRUCTURALFRAMEh BUILDING iii Total
Available Per Measure
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 24-Inch On Cantor Framing 0
❑ d.Shea Dom and Window Headers for Load — - �-- ---- 7
❑ c.Use Only Jack and Cripple Studs Required for Load p
2 Use Engineered Lumber
❑ a Beams and Headers D
❑ b.Insulated Engineered Header —p -- - - --
❑ C.Wood Worst or WebTmsses for Floors -'--
❑ U _
tl.Wootl-Joists for Roof Rafters _ __-- --_ _
_r
❑ e.Engineered or Finger-Jointed Stutle for Vetllcel Applicetiom
❑
I.Oriented Strand Board for Suldoor —
---- —i—i--'--_'
❑ g.Onentetl Strand Board for Well and Roof 5h9ethinp 0 r 1
3.Use FSC-Cemfied Wood JAN Il uou
❑ a Dimensional Lumber,Studs end Timder.Minimum 40% p 2
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% -`- - -- ----
❑ c.Panel Products:Minimum 40K �+�,
❑ tl.Panel Products:Minimum 70°6 Y ;L •/ "'� D- - - --- ' — -�-----
D I 1
02007 Build It Green Single Family GraenPDIN Checklist 2007 Version Page I of 4
ENTER PROJECT NAME
' - � t
4.Use Solid Welt Systeme(Include,SIPS,ICFs,A Any Non-Stiok Frame Assembly)
❑ A Floors 0 2 2 _
❑
It.Wells D _2 2
❑
C.Roof$ —0 2 2
5.Reduce Pollution Entering Me Home from the Serape
❑ a Tightly Seal the Air Senior between Garage and Living Area _ D 1
❑ b.Install Garage Exhaust Fan OR Build a Detached Goal 0 1
LJ 6.Design Energy Heels on Trusses V5%of Atte Insulation Height at Outside Edge of Extedor Well 0 1
1.Design Root Trusses M A=MmDdtle Ductwork ' 0 1
&Use Recycled-Content Steal Stal for 90%of Interior Well Foaming 0 1
S.Thermal Meu Wells.What,Drywall on All Interior Wells or Wells Weighing more than 4D Iblcu.R 0 1
10.Install Overhangs and Ounces
❑ AMinlmum 16-Inch Overhangs and Gutters a ]
❑ b.Minimum 24-Inch Overhangs and Gunter$ 0 1
Total Points Available In Structural Bulichrit Frame and Envelope=38 D
B.HICTBRIOR FINISH Points Available Per Measure
1.Use RecycledContant(No Virgin Plastic)or FSC-GNOetl Wood Docking D 2
2.Insall a Rein Screen Well System 0 - 2
7,Use Durable and Noncombulllble Siding Materiels D I
4.Select Durable and Noncombustible Roofing Metadeb 0 2
Total Pork Available In Exterior Rniw a 7 0 _
F.INSULATION Points Available Per Measure
1.Install Insulation with 15%RacyGed Content
❑ a Walls enNor Floors 0
❑
It.Ca a 0 7
2.Install Insulation that is Low-Endr(Grdfied Section 0131
❑ t Walls andror Rowe _0_
E:1 b.GMn 0 1
3.Insect Duality of insulation Installation before Applying Drywall 0 I
Total Forms Avallace In Insulation=5 0
G.PLUMBING Points Avellable Per Manure
1.Distribute Domestic Hot Water Efficiantly(Maximum 7 Points)
❑ e.Insulate HW Worst Pipes from Water Heater to Klichom 0 1 1
❑ In.insulate All HM Water Pipes 0 7 _ 1
❑ c.Use Engineered Fell Piping _ 0 _ _ _ _ 3
❑ d Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0 _ 7
❑ e.Use Structured Plumblng with Demand Controlled CI=*on Loop 0 1 2
❑ I.Use Central Cole Plumbing0 1 1
❑ 2.Install Only High Efficlm Toilets(DuaFFluch or W k~;P00 4
Tote)Points Available In Numoin .Total 12 0
H.HRATIN6 VENT[LAT10N R AIR CORM•ON[NO Points Available Per Measure
❑ 1.Design and Install HVAC System to ACC nual J,D.and S Recommendations 0 q
2.Insist Sealed Combustion Units
❑ e.Furnaces 0 0 I
❑ b.Water Heaton 0 2
9.Install Zoned,Hydronic Radiant Keating with Slab Edge Insulation 0 1 1
4.Install High E9ldenoy Air CondWoning with Environmentally Responsible Refrigerants 0 1
5.Design and Install ENeclive Ductwork
❑ a instal HVAC Unit and Ductwork within CondAiorad Space _a 3 _
❑ b.Use Duct Mal on All Duct Joms and Seams
❑
I.Install Ductwork under AWc Insulation(Surat Ducts) _ D ]
❑ d.Pressure Selal the Ducnsmrk System 0 1
❑ e.Protect Ducts during Construction and Clow All Ducts before Occupancy 0 1
El 9.Install High Efficiency HVAC Filter(MERV ea 0 1
❑ 7.Dont Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Leas Than 50% 0 1
using CSA Standard$
S.Install Effective Exhaust Systems In Bathrooms and Kitchens
❑ e Install ENERGY STAR Bathroom Fors Vented to the Outside 0
❑ b.Al Bathroom Fans Are on Timer Is Humidistal 0_ _ _ 1 _
❑ c.Instal Kitchen Range Hood Vented to the Outside 0 ]
9.Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ a.Instal ENERGY STAR Calling Fane It Lighl Ka In Living Area 6 Bedrooms _0 _ ]
❑ It.Install Whole House Fan with Variable Speeds
❑
I.Automatically Controlled Integrated System _ 0 2 _
❑ d.Automatically Controlled Integrated System with Variable Speed Control
10.Install Mechanical Frah Air Ventilation System(MMimam D Points)
❑ a.Any Whole House Ventilation System That Meeh ASHRAE all 0_ 2
❑ D.Install Alr-Ia�k Heal Exchanger that mats ASHRAE 922 D I 2
11.In..It
Carbon Monoxide Alarms) 0 1
Total Points Avalable In Heading,Ventlatlon and Ab Conditioning=30 0
02007 Build 11 Green Single Family GreenPoinl Cheddls12007 Version Page 2 of 4
I.RENEWABLE ENILRGY PENTER PROJECT NAME
oinls Available.Par(Measure
LJ 1.Pno-Plumb for Solar Hot Water Headingp 4
LJ L Install Solar Water Hearing System 0 10
• 3.Install WringConduit for Future Photovoltaic Instedaeon 6 Provide 200 fe of South-Foin Roof 0 $
4.install Photovoltaic(PVI Panels
❑ a 3D%of almeic needs OR 12 AW(tons]6 points) p 6
❑ b.60%of electric needs OR 24kW(total 12 points) '-
❑ C.9D%of electric need OR 3.6 kW(total 16 points) 0 6
Total Available Points In Renewable Energy 28 0
J.BUILDING PERFORMANCE Points Available Par Measure
1.Diagnostic EvaIIIIII
❑ A.House Passes Blower Dom Test 0
b.House Passes Combustion Safety Backdrefl Test p - —`
20esign and Build High Performance Homes-%above Titie24-minimum 15%Required 0 >_30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Piml Measure(Total 45 point;read comment) 0 2
Total AvailaMa Pdmin BuDcin Pedonnance=39 0
E.FIN SHES Points Available Pel Measure
l-DiRsign Enbyways IF Red6ce Tnacked in Conterninants` —""' - "--'-"- - - - - ' -- "
2.Use Low-VOC or Zero-VOC Paint(Maximum 3 Points)
❑ t.Low-VDC Inlenm WaIVCeging Palnh(60 go VOCs(Flag and o50 got VOCs(Nmr-Flap) 0 I '
❑ b.Zem-VOC:Interior WaXering Paints(d 0 VOCs Fled,) 0 - ------3-- --
❑ 3.Use Low VOC,Waley-Based Wood Finishes Q50 gpI VOCs) p
❑ 4.Use Low-VOC Caulk and Construction Adhesives J<70 gpI VOCs)for All Adhesives p Z
❑ 5.Use Recycled-Content Paint 0 1
6.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,of Reclaimed,C)Rapidly Renewable,D)Racyded-Content
or E)FngerJointed
❑ a Centrists(50%Minimum) 0 3
❑ b.Interim Tnm(50%Minimum) "-"-
❑ u Shelving(50%Minimum)
❑ d.Doors(50%Minimum) -
❑ e.Countul (50%Minimum) '"--
7.Reduce Formaldehyde in Interior Finish(CA Section 01350)
❑ a.Subfiooi 6 Stair Treads(SD%Minimum) 0 3
❑ b.Cabinsts 6 CDunteri(50%Minimum)
❑ D-
I.Reliving 50%Minimum) D 1
❑ 6.After Installation of Finishes,Test of Indoor Ali Shows Formaldehyde Level d7ppb 0 3
Total Available Points In Finishes=21 0
L.FLOORING Points Available Par(Museum
1.Use Environmentally Preferable Flooring:A)FSC-CeNfied Wood,B)Reclaimed or Refinished,C)Rapidly Rernmabie,D)Rarycled-Content,EI
Exposed Concrete Flooring Adhesives Must Hem 60 gpI VOCs
❑ a.Minimum 15%of Flom Area 0 3
❑ It.Minimum 30%of Floor Area p _----"�----
❑ c.Minimum 50%of Floor Area p -
❑ d.Minimum 75%of Floor Area'
0 1 7
❑ 2 Thermal Mau Floors:Floor Covering Other than Carpet on SD%or Mora of Concrete Room 0 i 1
0-3 Flooring Meets Section 01350 or CRI Green Label Pius Requirement 5D%Minimum) p ) 2
Tmal Available Points in Flooring=7 0
M.MPLIANCE9 AND LIGHTING Points Available Per Measure
1.install Wets;and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total 1 point) 0
❑ b.Dishwasher Uses No More than 6.5 GallonsCjcle 0=12 int) D i
2.Install ENERGY STAR Clotho Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier requirements(modified energy factor 20,Water Factor 6.0)(total 3 points) p _ _L 7 ._ Z
❑ b.Meats Energy Star and CEE Tier 3 requirements(modified energy factor 2.2,Water Factor 4.5 or less) 0 _Z
totals Points)
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Oualided 6<25 Cubs Feet CapaClry 0 3
❑ b.ENERGY STAR Qualified 6<20 Cubic Feet Capacity 0 I
L Install Built-In Reryciing Center 0
❑ a.Built-In Recycling Center - 0
❑ b.ButHn Composting Center - ----- -'- '---
D r I 7
Total Available Points in Appliances and Lighting 12 0
N.OTHER Points Available Per Measure
❑ 1.Incorpmem GreenPoint Rated Checklist in Blueprints Required 0 R
2 Develop Homeowner Manuel of Green FeaturewBenefla
3.Community Design Measures 6 Local Priorities:See the Community Planning 6 Design section In Chapter 4 of Na New Home Guidefnes fm
® measures.Matlmum of 20 points for suggested measures.Local requirements may also be listed here.
E3
0 2007 Build It Green Single Family GreenPolnl Checklist 2007 Version Page 3 of 4
ENTER PROJECT Muni is
i
❑
Enter tlemrgdion hare,and enter grins eveaehle la meeuaa M gyrtixsle caleporin to the dphL 0 0 0 D D 0
Enter dncrptwn here,and enter poinb nalta0le ler measure in appropriate cespones to the right. 0 0 D D 0 D
Enter desorlption ham,and enter point$available for measure in appropriate castiMn 10 the right. D 0 D 0 0
❑ Enter description ham,and onto,proms avalleWe he measure In entropies categories to the right. 0 0 0 0 0 0
4.Innovation:List Innovative measures that most the green building objectives of the Guidelines.Enter up to a fBulld It Green Checklists and
maximum combined total of 20 ots.See Innovation Checklist for suggested measures,using the link to the dent Guidelines
LJ renovation in Community:Enter de ion hen,and ender parnto ovallable ler monun In appropriate,adagorms to the right D 0 0 D 0 D
'Naon In En :Enter dear Ion hare,and enter rine available IN measure in 'ate vale nriea to the right, D D 0 0 0 0
Innmetion In IAOMalth:Enter desert Ion ham,and inter ohne evallabs ID measure in ate vas erin to On One. 0 0 0 0 0 0
LI w
InnatiDn In anourtn:Ener dimenotion here,and order points moods for
manure In orin late we to ins fl l. 0 0 0 0 0 0
Imrvad,on In Water Enter description here,antl ampoints available ter manure m appropriate caspons s the right D 0 0 D D 0
Total Available Points in Other•43 D
Total Available Points In Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required In Specific Categories 0 30 5 6 B
Total Points Achieved 01 a e a a
Project hes not yet met the IWIsnvtng recommended nstn4mum requirementpt__
- Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-J2: 15%above Title 24
-Nl:Incorporate Green Point Rated Checklist into blueprints
-idinimum Doints in specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(5 points)
-Water(9 points)
02007 Build It Green Single Femlly OresnPoint Checklist 2007 Version Page 4 of 4
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
.Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35918010. 00
DATE ISSUED. . . . . . . : 01/16/2008
RECEIPT # . . . . . . . . . : BS000003707
REFERENCE ID # . . . : 08010098
SITE ADDRESS . . . . . : 20592 MC CLELLAN RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MELODY FARQUAR CHANG
ADDRESS . . . . . . . . . . : 20592 MCCLELLAN RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95015
RECEIVED FROM . . . . : GONE PRO SERVICES
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
---------- -------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 2, 500. 00 0.50 0. 00 0.50 0. 00
1PRSEWER UNITS 1. 00 20.40 0. 00 20.40 0. 00
1TRAVDOC FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 61 . 69 0. 00 61 . 69 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 61. 69 #1085
---------------
TOTAL RECEIPT 61 . 69
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- - -------- ----------------=-----------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 507 FINAL PLUMBING
> Community Development
10O
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�CUPEf�TINO
Building De artment
JOB ADDRESS: PERMIT#
OWNER'S NAME: PHONE # VO-,-6, 590—
GENERAL
O 5Bo—GENERAL CONTRACTOR: /�,e�, FAX # oB a 7 7 !7a
I am not using any subcontractors:
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
tj Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
FRCM :CUPERTINOSANITRRYDISTRICT FAX NO. :4082535173 Jan. 30 2008 08:22RMM P1
1�I 0
`,'a SAMIr�q�.0
I
® DISTRICT MANAGER�ENGINEER _j� L•�'} .G.� BOARD OF DIRECTORS
MARK THOMAS&COM ANY,INC. 1 WILLIAM A.BOSW017TH
RICHARD K.TANAKA y JOHN M.GATTO
DISTRICTCOUNSEL YFARC OT CURTIS S.HARRISON
f,�SF4Z �s WENDELL H.KERR,JR.
ATKINSON FARASVN,LLP, 54811a8F.0~� CHRISTOPHER C.LEE
HAROLD S.TOPPEL
ROSSI STEVENS CREEK 60ULEVARD,SUITE 104
CUPERTINO.CALIFORNIA SS0142184
(408)2837071 PHONE • (40812535 173 FAX
www.cup ortlnosanitarydistrict.corn
Tile: CuSD—MOP
Building Dept.--Cupertino
City o1'Cupertino
Attn.: Building Department
10300 Tone Ave.
Cupertino, CA 9501 -3202
Subject: Install Pro erty Line Clean out
Name: Chang Residence
Address: 20592 Mel Aellan Road
APN: 359-18-010
Permit No.0801009
■ Videotape a d Property Line Cleanout inspected.
No additional condidons/requirements by the District
Inspector: George Santos/Roger Santos.....�........ , . . .. ....., ....
Date:...01- 0-2008................... Sanitary Sewer Location:
cc: Property Owner
S:\WORDS\CUSD\ l rTERS\BUILI)INC+DEPT LE'TTFRS\CuSD 2008. TV
• Inpection_0801009 _20592 McCellan Rd_OI-30-2008.doc
SUPPLYING SANITARY SEwE GE SERVICES FOR:CRY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND
SURROUNDING UNINCORPORATED AREAS