08050107CITY OF CUPERTINO T�e,�T
-axzze �`@ry�+'-1_„�'��' .g(`�"1'�T'
HCO3\1�L�CibQR'l�011Vl\.`:,
BUILDING DIVISION PERMIT
BDILD1N6ATr%TLLER AVE
TBD - TO BE DETERMINED
PERMIT NO.
08050107
'ER'S NAME:
-
PERMIT ISSUE DATE
ELIZABETH M BIALOGSKI
05/13/2008
PHONE:
SANITARY NO. CONTROL NO.
ARCHITECr/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONrRACTOWS DECLARATION
- Job Description
al 1 acounder pre ons of Chapter 9 (commencing
1 hereby dam Nm acsted i
with section 7")OfDhision 3 of the Bush. and Prokesm. Code, and my liars: u
BTHRM RMDL NON-STRUCTRL INCLDNG ELECTRCL&PLMBNG
NII forts and
Z.,
Iicena Clm - Ci . Lle. 11721
CALIFORNIA ENERGY SERVICES PD BUS LIC 5/13/8
De¢ Conlfenor I i 6 y4 �—
ARCHTEC'rSDECLARATION $rap
�, �iG
1 understand my plans Nall he used u puhlk records
Licwed Professional
OWNER-BUILDER DECLARATION
I hcmby M. Nat I am exempt from the Conuano's License law for dm
following mason. (Section 7031.5. Business and Professions Code: My city or county
which rtq.t. a permit to constitutes. .hes. i nprow. dcmol"sh, or .Pair any suaum
prior at its issue=. also rep uirn led applicant for such permit to file a signed sukmcnl
mad is licensed to of be Contranurk license law(Chaptn9
Sq. FL Floor Area
.
Valuation
pussuanl the provisions
$13000
1 (commencing with Session 7000) of Division 3 of the Business and Professions, Code) or
this he is exempt thsmfrom and Use bus for the alleged exemption My violad'm Of
37505037A?bT Number
Occupancy Type
SeNon 7031.5 by arty applicant fora permit abjOM the applicant in a 6,11 psWty of
ml m.m thn fw hundred dollar(s5=.
0I,uownerofdiepmpmy.mmywploymwi0wgnuNekmkcorn dim,
Required Inspections
the wart, and Ne sttructureunut mended arort red
toOwner
and Professions Cndn Th r. Liana law den cot apply b N owner of
am Pr apply
q p
m dere his
enywho Wilds thneonand wha
oruffeorNmueb
pounidmpmvv
Owoe me V,
we oycea oro@R4 forsalbthe
Nuacner,is umanuin not ear
ofd ow
, ft wmmt la said within one Year of cnmpncfor the owner-
however, the building or den
buil(er will haw tic Nvden of povine Nat k did cot build or Improv (a purpoa of
O
ale.).
C 1, u Owner ofdu property me exclusively canuacting wish liaised antradaa On
convect the pmjen (Sec. 7Uo4, Business; and profctians Code:) The Contractors U.
.
eena Law does not apply to an Owner of property, who builds or improves thereon. and.
who conuuu for such pmlcns with a comuanor(s) licensed purls., In the Comraeroh
License Law.
❑ l am nernp under See ,B d PC For this manse
Dau
WORKERS COMPENSATION DECLARATION
1 hereby obiter under penalty Of perjury one of the following declan dans:
0 1 ham and will trumum a CerdBcau of Covent to selr-ivum for Woolens Compeer
aadan, so provided for by Section 3700 of he labor Code. fu she pedamanco of the
wart for which this permit Is issued.
0 1 haw and will maintain Worker. Compcvadoa Insuranc. u "sued by Section
37W of Ne laborfoonrr ft pYear�froure avec of the work forwhich this Permit is Wood.
//Code,
�peread
Calder �,Jr�ilHCR M K �ey, No,: nuC- aa:
.
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
Tru motor aced not W emnpkad if the peomil'u for one hundred dolWs (SIM)
or less)
1 certiry WI in thc perfomance of the work for which this permit is Leaned, I Nall not
employ any person in my sumer so as th become object he f Workcn' Compensation
Laws of Gallfomi6 Due
Applicant
NOTICE TO APPLICANT: IL afar making this Certificate of Eaempdon. you NouW
become .ubjm On he Worker's Compewtion provisions Of the labor Code. you must
forthwith comply with such provisions or this permit shall W deemed revoked
j CONSTRUCTION LENDING AGENCY
I hereby affirm tha dem u a cammumim lending agency for the nerforma en of
dm wort for whiten this permit in issued (See 309'1. Civ, C.)
-
Landers Name
Lenders Address
1 mdfy that I haw sad Nis application W .tau that the above iMornation is
cornn, I agree In comply with all city aid county Ordinances and surd laws missing to
Wilding construction, and hereby mshoure rtpresenuuvn or Nis city a tour upon da
show-es.jWg d c for .
ponm
indemnify
(We) agree m ave, and keep harmless the City of C.pmim against
Iiacoidalu nu. costs expcNos which m
and cxpcs.ea which cony In my way amoc aguvt aid City
,
tee of the
Aconsequence of Ne granting or this D WILL
UNDERSTANDS AND WILL COMPLY WRH^ALL
SOU
Issued
Issued by: Date
.
/NON-POINT
Re-roofs
Type of Roof
silmadimafAppiicandCOm Dau
HAZARDOUS MATERSAuS DISCLOSURE
WIII the applicant no future Wilding ott.pant atom or handle hesardou material
dUmd the nO Mmsici 1 Cade. Chapter 9.12, and sire Fica1N and Safny
Scrim
. io 33s1z(a)±
32(.)?
CY
All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building ocoupant use equipment or devicea which
If a roof is installed without first obtaining an inspection, I agree to remove
it hNous sir contaminates defined by the Bay Ma Al, Quality Mamagcmenl
OD1ara
all new materials for inspection.
/a
C Y.
I have read the haudmsmskriab requiremcw under Chapter6.95 ofthe Califon
m HcaiNh Safely Cade, Smiorsts 35505.25533 and35534. lunderaand thaifthe building
deco mol it haw a unapt, not it is my remensiibbiilmity On notify Us:occupant of the
req. poor hlk o ca¢or Oo,o/p�avy.
Signature of Applicant Date
r'G
C S ^( ,Dam
All roof coverings to be Class'W' or better
Owmet aNo
auri>rd ages
0 4 ITEMS OF 4
•
0
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk:, Lot:
APN ........: 37505037.00
DATE ISSUED.......: 05/13/2008
RECEIPT #.........: BS000004753
REFERENCE ID # ...: 08050107
SITE ADDRESS .....: 10466 MILLER AVE
SUBDIVISION ....... .
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
662.30
---------------
662.30
.• REFERENCE NUMBER
--------------------
#5614
OWNER ............:
ELIZABETH M
BIALOGSKI
ADDRESS ..........:
10466 MILLER AVE
CITY/STATE/ZIP ...:
CUPERTINO,
CA 95014
-
RECEIVED FROM.....:
CALIFORNIA
ENERGY
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 13,000.00
----------
1.30
----------
0.00
----------
1.30
----------
0.00
1BUSLIC
FLAT RATE 1.00
110.00
0.00
110.00
0.00
1REMRESBAT
SQ FEET 48.00
429.00
0.00
429.00
0.00
1STPLNCK
HOURS 1.00
122.00
----------
0.00
122.00
0.00
TOTAL PERMIT
662.30
----------
0.00
----------
662.30
----------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
662.30
---------------
662.30
.• REFERENCE NUMBER
--------------------
#5614
ti-/� -
CITY OF
CUPEkTINO
CITY OF CUPERTINO
ADDITION/REMODEL
PERMIT APPLICATION FORM
Oj'05 0/07,
♦ 47``
APN # / o S 0 37, U 0Date: S^=
Building Address:
Mailing Address (if different from building address):
Owner's Name: ni8� �J o
Phone #
�97y
Contractor:�1I F i rb�„a Evt e1Jy Sew�FCaS
,
Phone #: 5
wN a 1 (3 N
Fax #: a
Contractor License #: % / I I O
Cupertino Business License #:
Contact:
Phone #:
Fax #:
Building Permit Info:
Bld . ❑ Elect. 0 Plumb. 21 Mech. ED' Hillside ❑
Job Description: /� r
SOA6,00/, " �e.s�—t.D,�h ( 4-4,t4J S�i� 7e,., f
Addition (adding sq footage): �Z1
)-Ace144ef \
What is being remodeled?
Remodel Includes Re -Roof: Yes ❑ No T If yes list number of squares
Remodel Includes Structural: Yes ❑ No gl
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen at t-' p Other
Type of Construction (Usage Class):
Oc��cppupancy Type:
IA, 11, 111, V -A ❑ 11, 111, 1VV-B
to 3
Valuation:
3
Please check this box if the project is a
el
second -story addition ❑
Please complete relevant portion of the Green Building
Checklist & attach it to the application or if applicable,
Green Building Points Achieved;
include in plan set & the sheet index.
**
v
*For Office Use Only***
Over -the -Counter ❑
CITY OF CUPERTINO
S-eu.- ADDITION/REMODEL •
CUPEkTiNO FEE SCHEDULE
Quantity
Sq Ft
Fee ID
Fee Description
Fee Group
Permit Type
ADDITIONS
1R3SFDADD
PLLONGRNGR
Long Range
Planning/Residential
PL
IR3INSP
Dwellings Inspections
B
1 R3PLNCK
Dwellings plan check
B
1R3REPINSP.
Dwellings Repeat
Inspection
B
I R3REPPLNC
Dwellings Repeat Plan
Check
B
1R3HINSP
Dwellings Hillside
inspection
B
1R3HPLNCK
Dwellings Hillside plan
check
B
1R3HREINSP
Dwellings Hillside
Repeat Inspection
B
1R3HREPLNC
Dwellings Hillside
Repeat Plan Check
B.
IR3ALTINSP.
Dwellings Alternate-
Materials Ins ection
B
1R3ALTPLNC
Dwellings Alternate
Materials Plan Check
B
1PCESS
Cesspool
P
1PPRSEWG
Ea. Private Sewage
Disposal System
P
1PRSEWER
Sewers
P
1BPSPRINK
Lawn Sprinkler/Backflow
P
1BPWSVCS
Main Water Service
P
1BSEISMICRE
SeismicResidential
B
DECKS
1R3SFDADD OR
1R3SFDREM
1DECKWOOD
(Each)
Deck (Wood) -Each
B
1DECKRAIL
(Each)
Deck Railing -Each
B
e
0
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee Group
Permit Type
Sq Ft
GARAGES
1R3SFDADD OR
1R3SFDREM
1GARDTW<=1K
Wood Frame up to
B
1,000 SF -
.-
1GARDTM<=1K
Masonry up to 1,000 SF
B
BCONSTAXR
Construction Tax Res
(new detached garage)
PATIO'S OPEN
1R3SFDADD OR
1R3SFDREM
1PATIOWOOD
Wood Frame up to 300
B
SF
1PATIOMETAL
Metal Frame up to 300
B
SF
1PATIOOTHER
Other Frame up to 300 SF
B
PATIO'S CLOSED
1R3SFDADD OR
IR3SFDREM
1PATIOENCLW
Enclosed Wood up to 300
B .
SF
1PATIOENCLM
Enclosed Metal up to 300
B
SF
IPATIOENCLO
Other Enclosed Patio up
B
to 300 SF
1COVPORCH
Porch Covered -Each
B
Each)
IREROOFRES
Residential Re -roof Each
B
100 SF
REMODELS
1R3SFDREM
1REMRESKIT
Kitchen Remodel up to
B
(Deduct "$"for ea plan
300 SF
check
U�
1REMRESBAT
Bath Remodel up to 300
B
«
SF
1 REMREOTH
Other Remodel up to 300
B
«
SF
REMODEL PL
1 STPLNCK (1-3 for
Standard Plan Check
B
NOT FOR OVER THE
remodel)
COUNTER PLAN CKS.
3 of 3
CITY OF CUPERTINO
ADDITON/REMODEL
FEESCHEDULE
E
Quantity
Sq Ft
Fee ID
Fee Description
Fee Group
Permit Type
WINDOW/SLIDING
1R3SFDREM
GLASS DOOR
1 WINREP
Replacement windows
(ea 8 windows)
B
1 WINNEWNSTR
New Window (non-
structural)
B
1 WINMEWSTR
New Window (Structural
Shear Wall/Masonry)
B
1 WINBAYSTR
Bay Window (Structural)
B
SKYLIGHTS
1R3SFDREM
1 SKYL<l0 SF
Skylight less than 10 sf
B
1 SKYL>10SF
Skylight greater than 10
sf or structural
B
1STAIRS
Stairs -first flight/ea addt'l
B
IEPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
1PPERMITFEE
Plumbing Permit Fee
P
IELCPLNCK
Stand Alone Electric Pln
Ck ourl
E
1 MECPLNCK
Stand Alone Mechanical
Pln Ck (hourly
M
1PLMPLNCK
Stand Alone Plumbing
Pln Ck (hourly)
P
1BSEISMICRE
Seismic Residential
B
1TRAVDOC
Travel & Documentation
B
1BUSLIC
Business License
B
4of3
•
•
Assessor's Parcel Number: `T7 S—oS O3 —2
Name of owner.
Project address.
Contact person. Cd " iyt eEws G-vr, ne. �z S ^ f 2.fr - 2 3 7l
Fax. z�— zc'
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
ee there at least two 10 foot by 20 foot clear spaces inside the garage? Y 1
Is privacy protection planting required for the project? )� N
On what floor(s) is work being done? /Is.: j
Brief description of work.
Code editions: 2008 CBC
2008 CPC
Effective 1/1/08
•
l J N)2008 CFC
N)2008 NEC
(Y - N)2008 CMC
Plan Review Process Work Book Page -8 -Revised 1/1/08
SUBMITTAL
#1
E --
C,Fr
RVEYED
I uY : 3 2008
SUBMITTAL
#1
oUT .,�—LuiNc�
CP -
i
oUT .,�—LuiNc�
CP -
r -
� t a 1
-:PRG:
Assessor's Parcel Number: S-oS–01 %
Name of owner.
Project address.
Contactperson.` .�rtx �br�G1J �ryvt one. qzs^ 82S 237/
Fax. 9ZS– r- KZ A
Net square footage of lot.
Existing
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Proposed
Oe there at least two 10 foot by 20 foot clear spaces inside the garage? 1
Is privacy protection planting required for the project? Y> N
On what floor(s) is work being done? l s—
Brief description of work.
Code editions: 2008 CBC Y N)2008 CFC
2008 CPC N)2008 NEC
Effective 1/1/08
f(Y - N)2008 CMC a- N)
( N)
31099 SUBMITTAL
#1
OFMCE COPY
Plan Review Process Work Book Page -8-Revised 1/1/08
+
L1
l0 5 �t1 GFS _
110 #
mamens
- AS,.
j BOOI E ��
MAO
Acl
qU, ___
! -Community Development
• it
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
CUPEkTINO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality And public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities'
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees. .
For more information on construction -related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
htti)://www.cupertino.org/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
• Municipal Code, which can be accessed at http:ZZwww.amlegal.com/cui)ertino ca/
Greg Casteel
Building Official
•
Plan Review Process Work Book Page A2 -Revised 3/25/08
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.
A4
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
1oint
P.
Other
1.
List Green Features on Plans
A-1
1 paint
MMEMM
TOTAL POINTS
40 points
•
Plan Review Process Work Book Page A2 -Revised 3/25/08
Green Points Rating System for Remodeling Projects
46 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. .
1. Recycle Job Site Construction & Demolition Waste
65%=1 point; 75%= 2 points; 80%= 4 points
up to 4 Resource pts
'2. Salvage Reusable Building Materials _
4 Resource pts
y --yes
3. Remodel for Mixed Use, Adaptive Reuse, and
2. Use FSC Certified Wood for framing
Historic Preservation
4 Resource pts
y --yes
4. Protect Native Soil
2 Resource pts
y=yes
5. Minimize Disruption of Existing Plants & Trees
1 Resource pt
y=yes
6. Implement Construction Site Stomwater Practices
2 Resource pts
y=yes
7. Protect Water Quality with Landscape Design
2 Resource pts
y=yes
a besign Resource -Efficient Landscapes and Gardens _
4 Resource pts
y=yes
9. Reuse Materials/Use Recycled Content Materials
2 Resource pts
y=yes
for Landscape Areas
2 Resource pts
y=yes
10. Install High -Efficiency Irrigation Systems
2 Resource pts
Y --yes
11. Provide for On -Site Water Catchment / Retention
2 Resource ots
v=ves
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
2. Use Recycled Content Aggregate 2 Resource pts y=yes
3. Insulate Foundation/Slab before backfill 3 Energy pts y=yes
C. structural Frame
1. Substitute Solid Sawn Lumber with Engineered Lumber's
3 Resource pts
2. Use FSC Certified Wood for framing
y=ye:
(For every 10% of FSC lumber used = 2 points, up to 10)
up to 10 Resource pts.
3. Use Wood I -Joists for Floors and Ceilings
2 Resource pts
y=yes
4. Use Web Floor Trusses
2 Resource pts
y=yas
5. Design Energy Heels on Trusses 6" or more
2 Energy pts
y=yes
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=yes
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=yes
B. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts
y=yes
9. Use Structural Insulated Panels (SIPS)
a. Floors
3 Energy pts
y=yes
b. Wall
3 Energy pts
y=yes
c. Roof
3 Energy pts
y=yes
10. Apply Advanced Framing Techniques
4 Resource pts
y=yes
11. Use Reclaimed Lumber for Non Structural Applications
--
3 Resource pts
y=yes
12.UseOSB - --
• a. subfloors
1 Resource pt
y=ye s
b. Sheathing
-
1 Resource pt
y=yes
1. Use Sustainable Decking Materials
a. Recycled content
b. FSC Certified Wood
2. Use Treated Wood That Does Not Contain Chromium/Arsenic
:3. Install House Wrap under Siding
4. Use Fiber -Cement Siding Materials r
E. Plumbing
+1.Install'Water Heater Jacket
2. Insulate Hot and Cold Water Pipes
F3. Retroft all Faucets and Showarheadswilli Flow Reducers
a. Faucets (1 point each, up to 2 points)
i
b. Showerheads (1 point each, up to 2 points)
4. Replace Toilest with Ultra -Low Flush Toilets
(1 point each, up to 3 points)
5. Install Chlonne Filter on Showerhead
6. Convert Gas to Tankless Water Heater
7. Install (Nater Filtration Units at Faucets
(2 points each, up to 4 points)
S. Install On -Demand Hot Water Circulation Pump
r. tieccncei
,1. InstallCompact Fluorescent Light Bulbs (CFLs)
L( bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points)
2. Install IC -AT Recessed Fixtures with CFCs (1 point each, up to
5 points)
3. Install Lighting Controls (1 point per fixture, up to 4 points)
4. Install High Efficiency Ceiling Fans with CFLs
(1 point each, up to 4 points) .
G. Appliances
11: Install, Energy Star Dishwasher
2. Install Washing Machine with Water and Energy
Conservation Features
3.Install Energy Star Refrigerator
4. Install Built -In Recycling Center
H. Insulation
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls
b. Ceilings
2. Install Floor Insulation over Crawl Space
'.3. Install Recycled -Content, Fiberglass Insulation with
No Added Formaldehyde
4. Use Advanced Infiltration Reduction Practices
5. Use Cellulose Insulation
a. Walls
b. Ceilings
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls
a Ueuings
3 Resource pts
y=yE
3 Resource pts
y=yi
1 IAQ/Health of
y=yE
1 IAQ/Health pt
y=yE
1 Resource pt
y=yes
1 Energy pt y=yes
2 Energy pts , y=yes
Up to 2 Resource pts
Up to 2 Resource pts
Up to 3 Resource pts
1 IAQ/Healih pt yges
4 Energy pts y=yes
Up to 4 IAQ/Health pis
4 Resource pts y=yes
Up to 4 Energy pts.
Up to 5 Energy pts.
Up to 4 Energy pts.
Up to 4 Energy pts,
1 Energy of
,
1 Energy pt
1 Energy of
3 Resource pts
2 Energy pts y=yes
2 Energy pts y=yes
4 Energy pts y=yes
3IAQ/Health pts y=ym
2 Energy pts y=ye
4 Resource pts . y=yas
4 Resource pts y=yeE
4 Resource pts ygae
4 Resource pts y=ye:
0
0
0
Mill
2 Energy pts y=yes
2 Energy pts y=yes
4 Energy pts y=yes
3IAQ/Health pts y=ym
2 Energy pts y=ye
4 Resource pts . y=yas
4 Resource pts y=yeE
4 Resource pts ygae
4 Resource pts y=ye:
Ci
0
0
1 0
Mill
Ci
0'
0
0
-
Ci
1. Install Energy -Efficient Windows
a. Double -Paned 1 Energy pt y=yes
b. Low -Emissivity, (Low -E) 2 Energy pts y=yes
c. Low. Conductivity Frames 2 Energy pts y=yes
2. Install Low Heat Transmission Glazing 1 Energy pt y=yes
J. Heating Ventilation and Air Condltioning
1. Use Duct Mastic on All Duct Joints -
2 Energy pts
y=yes
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1 IAQ/Health pt
y=yes
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
y=yes
5. Install Solar Attic Fan
2 Energy pts
y=yeS
6. Install Attic Ventilation Systems
1 Eneroy pt
y=yes
7. Install Whole House Fan
4 Energy pts
y=yes
B. Install Sealed Combustion Units
a. Furnaces
3IAO/Healthis
p
y=yes
y y
b. Water Heaters
31AO/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y=yes
• 12. Install 11% Annual Fuel Utilization Efficiency (AFUE) Furnace
13. Retrofit Wood Burning Fireplaces
2 Energy pts
y=yes
a. Install EPA certified wood stovesfinserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAQ/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Haalth pts
v=ves
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar Water Heating
4 Energy pts
y=yas
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy pts
y=yes
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =18 points)
Up to 16 Energy
pts
:6. Select Safe and Durable Roofing Materials
1 Resource pt
y=yes
_
7. Install Rant Barrier
adi
3 Energy pts
y=yes
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts
3. Plant Deciduous Trees on the (Nest and South Sides 3 Energy pts
1. Use Low/No-VOC Paint
2. Use Low VOC, Water -Based Wood Finishes
13. Use Low/No VOC Adhesives
4. Use Salvaged Materials for Interior Finishes
5. Use Engineered Sheet Goods with no added Urea
Formaldehyde
6. Use Exterior Grade Plywood for Interior Uses
J7. Seal all Exposed.Particleboard or MDF
6. Certified Use FSC Matanals for Interior Finish
9. Use Finger -Jointed or Recycled -Content Trim
10. Install Whole House Vacuum System
N. Fiooring
1. Select FSC Certified Wood Flooring
'2. Use Rapidly Renewable Floor"ing Materials
3. Use Recycled Content Ceramic Tiles
4. Install Natural Linoleum in Place of Vinyl
5. Use Exposed Concrete as Finished Floor
6. Install Recycled Content Carpet with Low VOC
1 IAQ/Health pts y=yes
21AQ/Health pts y=yes
31AQ/Health pts y=yes
3 Resource pts y=yes
6IAQ/Health pts
y=yes
1 IAQ/Health pts
y=yas
41AQ/Health pts
y=yes
4 Resource pts
y=yes
1 Resource pts
Y--yes
3 IAQfHaalth pts
y=yes
8 Resource pts
s
y=yes
4 Resource, pts
y==yes
4 Resource pts
y=yes
5 IAQ/Health pts
y=yes '
4 Resource pts
y=yes
4 Resource pis
y=yes
Total Points Available:
Total Points Project Received:
IAQlHealth
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0
IlkCil T -Of
UPERTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: PERMIT #
r C A "lie I- W v• 1 0 ko-rot'O�
OWNER'S NAME: L PHONE # P=zf_- 82f- 7
GENERAL CONTRACT l' AX # �S
I am not using any subcontractors:
Signature Date
Please check apulicable subcontractors and rmmn1,-fP FhP
Owner/ Contractor Signature
Date
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