08090066 CITY OF CUPERTINOR
BUILDING DIVI9}ON PERMIT C®NTRACTCQR INFORMATIONH.
BUILDIriG I)FESS: PERMIT NO.
ly'%SU MERRITT DR SOUTHWEST ELECTRIC 08090066
OWNER'S NAME: PERMIT ISSUE DATE
RAJ TUPLUR 14510 BIG BASIN WAY 09/12/2008
NE: (408) 999-8721 SANITARY NO. CONTROL NO.
ARCHITEC rENGtNEM: BUILDING PERMIT INFO
BLDG ELECT PLUMB MFLH
3Oo LICENSED CONTRACTOR'S DECLARATION O O O
4 t F 1 hereby vffirm that I am licensed under provisions of Chapter 9(commencing Job Description
Mnz1`, wbhScedonTDnD)ofoiw..3ordcBuvneu,nlProfecdan,Code.,ndmylkmtcu GRN 5RCPTCLS,ADD2RCPTCL IN KTCHN,CHNG KTCHN
n full torte and ecL
3qz L'...CLI - O L¢.• 7 �bH I LIGHT,ADD CEILNG FAN,ADD FLUORESCNT CEIL FIXTO
n l„p Dau cornomm, r-..mw)f�,w1�1
q7W ARcxITEcrsDEcuRAnon .R.&RPLC PLUGIN IN BATHS TO GFI ' S
WU I underwnd my plans shall be orad As public records
.g
`G t; Licensed PmfcuionaI
y� OWNER-BUILDER DECLARATION
1 hereby vRrm Nn I Am..pt fmm Ne Cantracme.Ldcrosc law for the
i O O following bonen.(Section 703 1.3,Bbad. and Professions Cmlc:Any city or county
which requires A Permit to ctmswu,slur,impo m,demo!W,nr mP.4 my stmnme
Prior its issuame.Alan requim mc.pplkam for inch permit to file.wgrnd suument
F� that he Is licensed putmant to the pmvislom of Ne Contractor's license Law(Chap=9 Sq.Ft. Floor Area Valuation
�F5 (eommeming with Section 7000)of Divbion 3 of the Busina,r and Pmreniou Code)m $1000
Y _
and he is exempt therefrom and Ne basis for the alleged cameptimL My violaden of
Sedan 7031.3 by arty apPlinem for.permit mbjecu the applicant to A ivll penalty of
ml come than ave hmlred dollars ISM 31629045ff Number Occupancy T'Pe
❑I,u ewoer of the prvpmy,m mY eroDlrm wIN mgu u their mk compnmdm,
will do the work and the.mnurt is notinuaded moRered forsalc(Sec.7044,Business
And Pmfeatim xcomm ecoThe Cmra I i.law does net apply m m 0w or err Required Inspections
own emY wed buildsmimpmwsd impro M who do notfin wok Acr emedthmuih Iter
own emploYcm,provided that mch imPmvemmuart not intended moRered forsie.IL
however,Ne Wiring m impmwnenn u mad within one year or emopkdon0e ryower-
ox
Ask.). will love the buNan of proving Nu he did cot Wild m improve Ito puof
Sale.).
. ❑1.u owe of the pmpmsy.An,cacluzs dy contracting with OconrA mnimnon to
comtmn the Mjen(Sec.7014,Becomes;and Profusion Code:)The Cmtracuv's U.
came taw does not apply m an owner of proper who Wilds or imposes Nercon,and.
-1W comncu for such projects with Acontrxmr(s)licensed punmm m the Cmvmgor's
License law.
❑Iamuemptunder See ,B&PCfm Nisreamn
Owner Dau
WORKER'S COMPENSATION DECLARATION
I hereby Mm under panne try of perjury oof the following decimation:
IAAnd will minuin•Cerdfiuu of Commas m self-rum for Wmma,Camper-
'm,As.
provided for by Seetwn 3700 of the lahor Code.Ito she peRormmne of the
wort for which this permit is issued.
'I have and will mainuin Wmkeh Compensate.I..As required by Sari.
3700 of Ne Labor Code.for the per(mmAn.of the wort for which mis pe.it is wood.
My Work^efsICamppenwien Inurana mmiuW Policy number are:
tinier.�r-f'z7'.14 I�Ws/s Policy No.:�y i 9 K 7 Z
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Dtu aenien need tmt W completed if the permit is froom hundred dollars(SIM)
or less.)
I certify that in me pnformance of the,wool,for which mi.Permit is issued.I lull nm
employ any person in my manner an as to become subject to the Worker'Compensation
".A of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject as the Wm& s Compensation prevision of the labor Cole,yon mus
.J z forthwith comply with ach prevision m this permit shall he dmemad remkcd.
Z q CONSTRUCTION LENDING AGENCY
[+ I hereby aRm dun Nen is a construction lending agency for the performance of
gL
the work for which this permit is issued(Sec.3097,Civ.C.)
C Undoes Name
O z Lenders Add.
U O I mcfy than I haw rad this application W sou the the shove iNommW,u
U, mmsL I agree to comply with it city and county m liwsea and suer laws relating m
.O Wiring comtruuion,and hereby authorize reprmenutiwa or this city m cow upon Ne
„ ashove-mentioned pmperny for inpeNen purymea
(We)agree to Save.indemnify and kecp hamlet Ne City of Cupertino agia,
I,, liabilities,cmw.c..nuA.o,mm andenpemnook. may in any-1 A.aginstand City
U z inconregmnee ofDERSTAN SAND WILL
APP A UNDERSTANDS AND WILL COMPLY WITH AIS.NON-POINT Issued by:qjtQ� Date
SO TfONS.
11"19(;.0 Re-roofs —
Sli ppliartr'Cimnmm Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will t e applicant m future building aecupant von m handle haasdou material
de0ned by Ne Cupudrm Municipl Code,Cbaper 9.13,and the Health and Safety
Code.Section 25533(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yn G1No
I7� If a roof is installed without first obtaining an inspection,I agree to remove
Will the aPPlicmt or factum building occupant use equipment or devicu which g p
ihaiaNnuerr..i.m u defied by the B.,Arta Air Quality Management all new materials for inspection.
❑Yu
I low read Ne hvaNas materials requirtmenu under Clupw G93 of Ne Crifor
doml
es wnyCwanme303h2m57]and 23334.1undcrswr NuifNc Wiring
my rmporuihilinY to ratify a eccupmt of dr
require which mag W met prior to icxumcoota Ccn 0.m cap n'. Signature of Applicant Date
ow r ar;,<a,gamn v Dam' All roof coverings to be Class'W or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 31629045 . 00
DATE ISSUED. . . . . . . : 09/12/2008
RECEIPT # . . . . . . . . . : BS000006062
REFERENCE ID # . . . : 08090066
SITE ADDRESS . . . . . : 19730 MERRITT DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RAJ TUPLUR
ADDRESS . . . . . . . . . . : 19730 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2440
RECEIVED FROM . . . . : SOUTHWEST ELECTRIC
CONTRACTOR . . . . . . . : LA RITA A WILKENS LIC # 21488
COMPANY . . . . . . . . . . : SOUTHWEST ELECTRIC
ADDRESS . . . . . . . . . . : 14510 BIG BASIN WAY
CITY/STATE/ZIP . . . : SARATOGA, CA 95070
TELEPHONE . . . . . . . . : (408) 999-8721
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BREMFIXT NO. FIXTURES 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00
1BREMRECEP NO. OUTLETS 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BSEISMICR VALUATION 1, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1EPERMITFE FLAT RATE 1. 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 294 . 06 0 . 00 294 . 06 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 294 . 06 #1015
---------------
TOTAL RECEIPT 294. 06
•
Sam
CITY OF CUPERTINO
CITY OF
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # � Date:
.3r� a9 oy5 , oo
Building Address:
Mailing Address (if different from building address):
Owner's Name: Phone#:
si 0
Contractor. Phone:
64Z-1
Fax: ko - —011
Contractor License#: •7 f t) wA
Cupertino Business License #:
Contact: Phone:
Fax:
• Residential Commercial
Job Description: G"wu� 6- " 6-c W AA -L r-C-Q-g " LA .
\ t �
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy�Type:
]-A, 1-B ❑ III/III/V-AE] I11/111 B, IV-HT, V-B ❑_- Ig` 3
Valua on: Square.Footage:
� a
Project Size: Ex ress EfliStandard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
to the application or if applicable, include in plan set& the sheet index.
Points Achieved:
• For help, contact Build it Green at www.builditgreen.org
Revised 7/01/08
` CITY OF CUPERTINO
I OF
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
113130ILERI For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw
IBBOILER2 Installation /relocation of ea M
boiler/compressor over 3 horsepower
to.& incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1 BBOILER3 Instal lation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1 13130ILER4 Installation/relocation of ea M
boiler/compressor over 30 hosepower •
to & incl 50 horsepower, or for ea
absorption sys over 1•,000,000 Btu/h to
& incl 1,750,000 Btu/h
IBBOILER5 installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
IBAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
1 ELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
IPLMBINSP Other Plumbing& Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B •
is
CITY
CITY OF CUPERTINO
CITY°F GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
1 FENCE>6FT Non-masonry, over 6 ft in height B
I FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
I FLAGPOL>20 Flag pole (over 20 ft in height) B
1 MODUSTRU Modular Structures B
FOUNDATIONS
1 FOUNDREP Foundation Repair B
1 PILECAST Pile Foundation Cast in place concrete B
IPILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
Sun CITY OF CUPERTINO
CITY of GENERAL BUILDING APPLICATION
CUPEI�TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50')
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1 SIDEST/BK Siding, Stone & Brick Veneer B
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<l0 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
7SRR-ACKS>8
KS<=8 Storage Racks 0-8' high (up to 100 sf) B
Storage Racks over 8' high (up to 100 B
st)
4of5
5,,�L , CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEIZ,TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group ]GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 so B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
/ 1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
/ 1TRAVDOC Travel & Documentation B
% ( 1BUSLIC Business License B
s of s
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 pints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood IJoist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 paints
S. B. OSB Sheathing, detail S-2 2 dints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec, A-4 2 aints
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 paints
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal.Tank, Note/S ec 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 Dint
P. Other 1. List Green Features an Plans A-1 1 point
TOTAL POINTS 40 points
Plan Review Process Work Book Page-12-Revised 325/08
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 1ADIHealth-
A.Site
1 Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts D
!2.Salvage Reusable Building Materials 4 Resource pts y=yes D
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y--yes D
4.Protect Native Soil 2 Resource pts y--yes D
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes D
6.Implement Construction Site Stormwaler Practices 2 Resource pts y=yes D
7, Protect Water Quality with Landscape Design 2 Resource pts y--yes 0
18.Design Resource-Efficient Landscapes and Gardens _ 4 Resource pts y--yes D
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 p
1 1 1
B.Foundation
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 D
11
C.Structural Frame 1
1.Substlfuta Solid Sawn Lumber with Engineered Lumber 3 Resource pts y--yes p
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 1 D) up to 10 Resource pts. D
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 D
5.Design Energy Heels on Trusses 6"or more 2 Energy pts y--yes D
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes D
7.Use Engineered Studs for Vertical Applications 2 Resource pts y--yes D
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes D .
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes D
b.Wall
c.Roof � 3 Energy pts y=yes D
3 Energy pts y=yes D
10.Apply Advanced Framing Techniques 4 Resource pts y=yes D
11.Use Reclaimed Lumber for Non Structure I Applications 3 Resource pts y=yes D
12.Use OSB
— -'.
a.Subfloors 1 Resource pt y=yes D
It.Sheathing 1 Resource pt y=yes p
:INPUT Resources Energy D n
xtenor imsh
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 IAQ/Health pt y--yes 0
13.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0
14.Use Fiber-Cement Siding Materials 1 Resource pt y--yes 0
- - 1 1
E.Plumbing
`.Install Water Heater Jackef _` J 1 Energy pt y--yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
3.Retrolff all Faucets and Showerheads with Flow Reducers
a.Faucets(t 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 Filler 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
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.crecmcar
11.Install Compact Fluorescent Light Bulbs(CFLs)
L(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 par 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 Enemy pts. 0
i 1 1
G.Appliances
ii.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
�4.Install Built-In Recycling Center _ 3 Resource pts y--yes 0
1 1 1
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 witli
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(Colton,spray-foam)
a.Walls 4 Resource pts y=yes C
D.L:enings 4 Resource pts y=yes 0
1 1 —
• INPUT Resources Energy IAD/liealth
I.Windows
1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes D
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Hiiat Transmission Glazing 1 Energy pt y=yes D
11 1
J.Heating Ventilation and Air Conditioning
-1.Use Duct Mastic on All Duct Joints - _ 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 D
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7 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 D
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 9D%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stovesMserts 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 4 IAQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) . 5 IAQ/Health pts y=yes D
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 1 p
1 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=16 points) Up to IS Energy pts 0
6.Select Safe and Durable Roofing Materials_ _ _ 1 Resource pt y=yes 0
7.Install Radiant Berner 3 Energy pis y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes D
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 D
1 1 1
•
INPUT Resources Energy IAO/Health
M.Indoor Air Quality and F as
i.UseL64-N640C 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 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y--yes D
J.Seal all Exposed Particleboard or MDF. _ _ 41AQ/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 D
1 1
10.Install Whole House Vacuum System 3[AD/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y--yes 0
(2.Use Rapidly Renewable Flooring Materials _ _ _ 4 Resource pts y=yes D
3,Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Hsalth 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=yesl D
1 1
Total Points 1 1401 1301 57
Total Points Project Received: 1 01 0 0 •
Gdetalpmgslgreenbuildngguidelineslmmodelersrgreenpointsfinat212.e4prole,-tedxls
•
50 F72 SAM nt 4
,g
Assessor's Parcel Number:
Name of owner. R1 41 �✓r G 4
Project address. �9 -73-g Ar,,-"T
Contactperson. Phone.
Fax.
Net square footage of lot. ><
Existine Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
e there at least two 10 foot by 20 foot clear spaces inside the garage?
Is privacy protection planting required for the project? Y
On what floor(s) is work being done? [—(a Q
Brief description of work. A41 i",%
Code editions:2008 CBC (Y - N)2008 CFCN)2008 CMC (Y- N)
2008 CPC (Y- N)2008 NEC <::CT-N)
'd E
Effective 1/1/08 A%CE OFFCE COPY
CODES P1�
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on so" 191thou ev' 0-
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Plan Review Process Work Book Page-8-Revised 1/1/08
Community Development
'S l Ex
10300 Torre Avenue
Cupertino CA
14
Telephone 08)777-3228
CITY OF Fax(408)777-3333
4UPE�TINO
Building Department
JOB ADDRESS: PERMIT #
GI 3.0 2 G �l0 Off`
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: FAX # o _ -7 -7 k_a
I am not using any subcontractors: z
Signature ate
Please check applicable subcontracto s and complete the followin information
60 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