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08060089 CITY OF CUPERTINO t�sy ^'.�'r.»as BUILDING DIVISION PERMIT CCNT,"C ,0X,1NFORMATIgN,'u ,. re:we.Wi BUILi5��1 ADDRESS: PERMIT NO. OLD TOWN CT LEON MASONRY INC 08060089 OWNER'S NAME: PERMrr ISSUE DATE BOB HUETT 240 MOSELLE CT 06/11/2008 NE: SANITARY NO. CONTROL NO. (408) 365-1660 ARCHnECT/FdiGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH u o ij LICENSED CONIRACIOR'S DECLARATION m❑ 1 hereby affirm Nal I sic licensed under provisions of Chapter 9(commencing Job Description W wiNSemon7IX1U)ofDivision3of thn Buainm ane Prafcssium Code.and myliccnc is REPAIR CHIMNEY -��s in fun force and Clime.-2� 6 2 33r$p License ClClose. Lk.• Dam Jr. //-6F' .Contractor L �os� /1/d So.U.C✓ J - 5W1 ARCHITECT'S DECLARArbobf W U 1 undenund my plans must bo teed as public records s C H Licensed Professional 3 OWNER-BUILDER DECLARATION f 1 kmby affirm Nat 1 am exempt form the Contractor's License Law far the E p O following reason.(Section 70 i.S,Business and ProfDsioes Cade:Any city or Motor $ which requires a permit or eensam:t.alter,improve,demolish,or mini,any metum prior m its issuance.also mqums Nemplicatt for such Permit to file.signed staumem ss< that he a licensed pu.1tothe pmvisiansofthe Conucmhl�e.Law(Ch.,.9 Sq.Ft. Floor Area Valuation xl-to (commencing wish Section 7000)of Division 3aftheBusinesssodProfessiomCode)or $3000 y at he is exempt therefrom and the basis for the alleged exemption.My violation of Section 1031.5 by any applicant for a Permit subjects she applicant to a civil penalty ofNumber OGGG trot mate roan five hundred"Ims(M). 3 5 6110 4 0 .� Occupancy T'Pe 0 1,as amour of the luapery,or my.,]eye.wish wages as their sok cemp<Dadon, will da de was and tbo structure u.1inheaded«onemd for sale(Sec.7044.Business and Ptoressmas Cade TIB Coruscate,License law does an,apply to an owmr of Required Inspections property,who Wilda orimproves th mom.and who domsuchmalchimuselfor through his own employees,provided Nat such improvements am not intended mofremd forsals.If. hmwever,she building or improvement is sold within one year of completion,she owner- builder will have tm burden of proving Na,Le did rot Wild or improve for purpose of cam). 0 1,as owner of the property.am Delusively conversing with licensedmnuacmn to , .i.the project(See.1014,Business and Freiman.Code:)The Cmanscmes U. . came law does no,apply In an owner of property who Wilds or improves thereon,and, who concocts for such projects with a cormactor(s)licensed pursuant to the,Cona¢mfs License taw. O l am exempt under See ,B&P C for this reason Owner Dam oWORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of she following declantiorts ' 1hawandwillmainuina Ce FicamofConcntmself-imumfarWarkeesCompcn- sation,as provided for by Section 3100 of the labor Code.for the Performance of the work for which Nis permit is Towed. 0 1 have and will maintain Worker's Compensation Insurance,as acquired by Section 3700 M ted labor Code,for the performmceofthe work forwhich this permit u owed. ' My Warkepes Campenutio.Who.carrier and Policy number tee: Carrier. .]�G1r !-e��d Policy Na.D On �-174 CERTIFICATE OF4EMPRON FROM WORKERS' COMPENSATION INSURANCE (flus eredon need not bo completed if Ne permit uforrem hundred donors(SIMM m IDs) I unify Our in the permrmare.of the work for which Nis permit is issued.I shall net employ anyperron in any mmmcrse as m become subject to the Worken'Compem adon Laws of California.Date Applicant NOTICE TO APPLICANT.If,after making this Ccnifma a of Esemption.you mould become auhim W Ne Worker's Compensation provisions of On fatter Code you must .JO foMwith comply wish such provisions or this Permit shall W deemeA evoked. z I CONSTRUCTION LENDING AGENCY F+ 1 hereby aMom that then is a convection lending agccy for flue perfurrn et of !Yi the work for which this permit is issued(Sec.3097,Civ.C.) QLet&,',Name =z Lender's Address U O 1 certify that 1 have mad Nis mplic rs.W sou shat to above Wformaumu W U. F cormct,l agree In comply with all city and county on ioncom and sum laws relating to pU Wilding construction.and hereby someonerepmxneum of fluscity m enter upon the above-m.judg dntopany for inspection purposes. F 4 (We)agree to save,indemnify and krop herculean the City of Cupertino against stn in encs of swung this ,which may in any way accrue ailment said City V z APPLI AlTr of DegranA of this Knob. ^� APPLICANT UNDERSTANDS NO WILL CONfply W'Try ALL NON-POINT Issued by:s4oDate G- ��-12 S REGULATfONS.� 6r/l/r2t QiNv�� Re-roofs ( r.. Sure of Appbcant/C1ontractor F Dau/-U¢ HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tui applicant ar future Wilding occupant tome or handle hanndous material ss defined by the Cupenmr Municipal Cade.Chapter 9.13,and she Health and Safety Code.sec2ss32(a)? ❑Y.Yes Milt- All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding emrpant use equipment or dcvim which If a roof is installed without first obtaining an inspection,I agree to remove 1m11 heDNous air contaminantsy she Bay Area Air Quality Management all new materials for inspection. District? 0 Yes Imam real the Instead—marm iila mquimmems under Chapter 6.95 of the Glifm- nuHWth&SafnyCade.S.6.255W.25533a M34.Iumerstnnd NnifNc WildWg does.,,..fly have a.k this b u my mapavry m tmufY tie mupant of to nimmert, hiehm prior anus aracmdBc,maraDImecy. Signature of Applicant Date Owner c'manairc age., DamAll roof coverings to be Class 14s'or better CITY OF CUPERTINO • 2 ITEMS OF- 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35611040 . 00 i DATE ISSUED. . . . . . . : 06/11/2008 RECEIPT # . . . . . . . . . : BS000005078 REFERENCE ID # . . . : 08060089 SITE ADDRESS . . . . . : 910 OLD TOWN CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BOB HUETT ADDRESS . . . . . . . . . . : 910 OLDTOWN CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4024 RECEIVED FROM . . . . : DAVID LEON CONTRACTOR . . . . . . . : DAVE LEON LIC # 17323 COMPANY . . . . . . . . . . : LEON MASONRY INC ADDRESS . . . . . . . . . . : 240 MOSELLE CT CITY/STATE/ZIP . . . : SAN JOSE, CA 95119 TELEPHONE . . . . . . . . : (408) 365-1660 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 3 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1CHIMNEYRE EACH 1 . 00 490 . 00 0 . 00 490 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 490 . 50 0 . 00 490 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 490 . 50 VISA --------------- TOTAL RECEIPT 490. 50 • ' J CITY OF CUPERTINO CITY OF CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM J (� I V UV u ,) c - dg Building Address: 51D 01 -wo �-I- Mailing Address (if different from building address): Owner's Name: Phone#: y31 - 666 Contractor: Phone: V y 7_ 3 y� Lem SiwR Fax: 26S-- Contractor 6S—Contractor License#: 6 Z 33 8"y Cupertino Business License#: • Contact: Phone: 36s 1 660 � -AV � Leo Fax: 66 Residential 7 Commercial Jo�b1 Description: �2P66f- Building Permit Info: Bldg [1---- Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ IUIII/V-A ❑ IUIII B, IV-HT, V-B [ Valuation , 000 Square Footage: Project Size: Standard E7" Lar e ❑ Major • Revised 5/21/08 CITY OF CUPERTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1BTEMPPER Temporary Building Permit (good for. B 30 days) 1 BBOILERI 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) 1 BBOILER2 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 Installation/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 BBOILER4 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 1BBOILER5 Installation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h 1 BAPPLOTH 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) 1PLMBINSP Other Plumbing& Gas Inspections P • ( er hour 1MEETINGIHR Application Meeting B (G CITY OF CUPERTINO CITY°rGENERAL BUILDING APPLICATION CUPEkTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1 GENCOM ACOUSTICAL REVIEW 1 ACOUSFDW SFDWL/Duplex New B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B 1ACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1CHIMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES qWr 1 FENCE>6FT Non-masonry, over 6 ft in height B I FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1 FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1 FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1 FOUNDREP Foundation Repair B 1 PILECAST Pile Foundation Cast in place concrete B 1PILEDRIV Pile Foundation Driven (steel, pre- B stressed concrete) CI hnne� C d— 3 of 5 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPERTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1 GENCOM RETAINING WALL(CONCRETE OR MASONRY IRETSTN Standard (up to 50 ft) B IRETSP310 Special Design, 3-10' high(up to 50 `) B 1RETSPI0 Special Design, over 10' high (up to B 50') IRETCRB< Gravity/Crib Wall, 0-10'high (up to B 50 ft) 1RETCRB> Gravity/Crib Wall over 10' high (up to B 50 ft) SIDING 1 SIDEST/BK Siding, Stone & Brick Veneer B (interior/exterior) 1 SIDEOTHER Siding all other B SKYLIGHTS 1SKYL<10 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 1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B 1SRACKS>8 Storage Racks over 8' high (up to 100 B st ISTUCOAP Stucco Applications (up to 400 sf) B additional stucco application • 4of5 CITY OF CUPERTINO CUP TYOf O GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 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 1 MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E Ah MV 1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M i PLMBLNCK Stand Alone Plumbing Pln Ck (tiny) P I 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 IBUSLIC Business License B • 5of5 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 q, 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 oints E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points 4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 oints 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 oints 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 oint P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS1 40 points • 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. A.Site 1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;80%=4 points i up to 4 Resource pts 0 �2.Salvage Reusable Building Materials _j 4 Resource pts y--yes 0 3.Remodel for Mixed Use,Adaptive Reuse,and Historic Preservation 4 Resource pts y=yes 0 4.Protect Native Soil 2 Resource pts y=yes D 5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0 6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes D 7.Protect Water Quality with Landscape Design _ 2 Resource pts y=yes 0 (8.Design Resource-EfAcient Landscapes and Gardens _ _ _ 4 Resource pts y=yes 0 9.Reuse Materials/Use Recycled Content Matarials for Landscape Areas 2 Resource pts y=yes 0 10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0 11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0 1 1 I 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 Aogreoate 2 Resource pts Y=yes 0 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0 1 1 I C.Structural Frame F.Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes 0 2.Use FSC Certified Wood for framing (For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0 3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0 4.Use Web Floor Trusses 2 Resource pts Y=yes 0 5.Design Energy Heels on Trusses 6"or more 2 Energy pts yyas 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 B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts 2=yes 0 ' 9.Use Structural Insulated Panels(SIPS) a.Floors 3 Ener is Energy y—y25 0 b.Wall 3 Energy pts Y=as 0 c.Roof 3 Energy pts y=yes p 10.Apply Advanced Framing Techniques 4 Resource pts y=yes p 11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0 - ' a.Subfloors 1 Resource pt y=yes 0 • b.Sheathing 1 Resource pt Y=Yes 0 D.Extenor Finish INPUT Resources Energy IAO/Health 11.Use Sustainable Decking Materials a.Recycled content 1 3 Resource ptsy=yes 0 b.FSC Certified Wood 3 Resource pts y--yes 0 2.Use Treated Wood That Does Not Contain ChromiumlArsenic 1 IAO/Health pt y--yesD 3.Install House Wrap under Siding j 1 IAO/Health pt y=yes 0 4.Use Fiber-Cement Siding Materials 1 Resource pt Y--yes 0 1 1 1 E.Plumbing 1.Install Water Heater Jacket _ 1 Energy pt y--yes 0 2.Insulate Hot and Cold(Nater 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 Ib.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0 f4,Replace Toilest with Ultra-Low Flush Toilets I(1 point each,up to 3'points) _ _ _� Up to 3 Resource pts. 0 5.Install Chlorine Filter on Showerhead 1 IAO Health pt y=yes 0 6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0 7.Install Water Filtration Units at Faucets (2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0 6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 1 1 1 r.erecmcai F1.Install Compact Fluorescent Light Bulbs(CFLs) 3 1(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 - [2. .Install Energy Star Dishwasher —'� J 1 Energy pt y yes 0 Install Washing Machine with Water and Energy Conservation Features 1 Energy pt y=yes 0 '3.Install Energy Star Refrigerator 1 1 Eneroy pt y=yes 0 14.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 Eneroy pts y=yes 0 2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0 9.IH-stall'Recycled-Content,Fibi6r6litis-iniuliition wit No Added Formaldehyde _ ! 31AQfHealth 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 o.ueaings 4 Resource pts y=yes 0 I.Windows '1..Install Energy-Efficient Windows - i a.Double-Paned i 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.Inafall Low Heat Transmission Glazing 1 Energy pt y=yes D 1 1 1 J.Heating Ventilation and Air Conditioning 1.Use Dud Mastic on All Duct Joints_ 1 2 Energy pts y--yes 0 2.Install Ductwork within Conditioned Space 3 Energy pts yryes 0 3,Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0 4.Clean all Ducts Before Occupancy 2 IAQ/HeaAh 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 yryes 0 6,Install Sealed Combustion Units a.Furnaces 31AQ/Health pts yryes 0 b.Water Heaters 31.AQ/Health pts y=yes p 9.Replace Wall-Mounted Electric and Gas Heaters with Through=the-Wall Heat Pumps 3 Energy pts yryes 0 10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0 11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0 12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0 • 13.Retrofit Wood Burning Fireplaces a.Install EPA certified wood stoves4nserts 1 IAQ/Health pt y--yes 0 b. Install/Replace Dampers 1 Energy pt y=yes 0 c.Install Airtight Doors 1 Energy pt y=yes 0 14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y--yes 0 15.Install High Efficiency Filter 4 IAQ/Health pts y=yes 0 16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0 17.Install Separate Garage Exhaust Fan 31AQ/Health pts y= as 0 1 1 K.Renewable Energy and Roofing 1 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.Pra-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0 4.Install Photovoltaic(PV)System (12 kw=6 points,2.4 kw=12 points,3.6 kw=16 points)__ Up to 16 Enercy pfs 0 IT.Select SafW and Durable Roofing>JMateriWls_ __ __ - 1 1 Resource pt y=yes p 7.Install Radiant Berner - -• - ~ 3 Energy pts y=yes 0 1 L.Natural Heating and Cooling 1 1 1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0 0 2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 • 0 1 1 M.In oor Air Quality and Finishes INPUT Resources Energy IAD/Heafth Use LowND-VOC Paint _ 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 3.Use LowMo VOC Adhesives _ 3 IAO/Health is es I— -- — P Y Y 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61A0/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Exposed Particleboard or MDF 41AQ/Health pts y=yes 0 B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yas D 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 ! ! N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y--yes 0 2.Use Rapidly Renewable Flooring Mate_ nals.i Y _ 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 S.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 Total Points Available: 1 1401 1301 57 • Total Points Project Received: 0 0 0 G:data/pro?s�green6uildngguidelineslremodelers�gmenpointsFlna@.7 2D4prmectedxis • Community Development �f 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 IWUPERTINO Building Department JOB ADDRESS: PERMIT # lD l 6 �o ooh OWNER'S NAME: Q u PHONE # GENERAL CONTRACTOR: L c A) o v t2 v FAX # I am not using any subcontractors L Signature Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing x Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date