08090090 CITY O;ilUPERTINO -«he�sae ,�-x:, •" '"�- ' ;z
BUILDIN;r DIYi6ION PERMIT CONRACTOR INFORMATION
�. *.^ , u-s _7v,,._ .x ,..r..
BUILQIUG ADDRESS:S: PERMIT NO.
10114 POTTERS HATCH CMN STEVENS INCREDIBLE KITCHEN 08090090
OWNER'S NAME: PERMIT ISSUE DATE
BEV CRAIR 11620 AIBA RD 09/16/2008
•ONE SANITARY NO. CONTROL NO.
(408) 287-4088
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
I= O 0 Ini
Icop p LICENSED CONTRACTOR'S DECLARATION . •
Lem
I hereby affirm that I are licensed under provisions of Chapter 9(commencing Job Description
U with Section 90011)of Divi 3 afros Business and Professions Code,arwmy license is RMDL BATH(50SQ) ,NO CHNG OF EXTNG WALLS
h in full force and effect. Si7 s'
3 Z License Glass LIe s 4'(' ( G . •
3 tap Dam (6 JS ARCHITECTS DECLAt con.'IUTI N/ KIMp Los 4..k '
�g U I undersand my plans shall be used as public records a
II
I6 u.I- Licensed Professional
OWNER-BUILDER DECLARATION
.� I hereby aRnn that 1 am exempt from the Contractor's License Law for dm
_O o following reason.(Section 7031.5,Business and Professions Code:Any city or county
_C which requires a permit to construct.alter,improve,demolish,or repair any structure
-z i prior to ins issuance.also requires the applicant for such permit to Ale a signed statement
£ 'c that he is licensed panuanttothe provisions ofthe ContracmhlJcenseLaw(Chapter 9 Sq.Ft. Floor Area Valuation
P; (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $25000
Q Re that he is exempt therefrom and the basis for the alleged exemption.Any violation of .
Section 70313 by any applicant for a permit subjccu the applicant to a civil penalty ofNumber Occupancy e
not
mom than five hundred dollars(55W). 34235042 . P YTYP
0 Lan owner of lire properly.or my employees with wages utheir sole compenudon,
will do dm work and the sleucture is not intended or offered for sale(Sec.7044,Business
and Professions Code:The Contractor,License Law does not apply to an owner of Required Inspections
property who builds or im proves thereon,and who does such work himself or through his
own employees,provided that such impmvemenm are not intended or offered for We.If. •
however,the building or improvement is sold within one year of cnmpktion,the owner.
builder will have et burden of proving that he did not build or improve for purpose of •
saes.LownerBusiness• andContractor'sLi.censeLawdoesnottoorLace for projectssuch with licensedacono-actor(s) b
pursuant Contractor's
I se am exempt
0
lam pt under See .BkPCfor this mason
Owner Date wJ U
. WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
I hs.e and will maintain aCertifiicteof Consent to self-insure fm WorkersCompen-
tion,as provided for by Section 3700 of the labor Code,for des performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is Issued. ' •
My Worker:4's Compensation nsurance carrier and Policy number are
Cartier. I pi?(fa"c- Polity No221. -°IOO7
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This mule's need not be completed lithe permit is foronc hundred dollen(5100)
or less)
I certify that in the performance of the work for which this perch if issued.I shall not
employ any person in any manner so as to become subject NUN Workers'Compensation ' • •
Laws of California.Date
•
Applicant
NOTICE TO APPLICANT:If.after making this Certiliium of Exemption.you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
,J Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z C ' •' CONSTRUCTION LENDING AGENCY
[-+ thereby affirm that there is a construction lending agency for the performance of
Cd> the work for which this permit is issued(Sec 3097,Civ,C)
=zLender's Name
Lender's Address
()O I certify that I have read this application and rum that the above information is
IL F cane.1 agree to comply with all city and county ordinances and state laws relating to •
.0 V abi�-mentioedg urn,and hereby authorise roperty for inspectionp purposes of this city menta upon tic
, (We)agree to save,indemnify and keep harmless the City of Cupertino against .
y liabilities,Judgmenu,cosh and expenses which may in any way scam against said City I I�
U Z in consequence of• granting of this permit.
APPLICANT U'LiERSfANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: -. 1ra 4)1q. Date 76.'''2'
SOURCE RE a ' ONS.
1--1.-0 V Re-roofs
Signature of Appli dL onuumr Dam
�R •DOUS MATERIALS DISCLOSURE Type of Roof ���
Will the appy ill.r future building occupant sore or handle brimless material .
. as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Code,Section 25532(,)' All roofs shallbe inspected prior to any roofing material being,�— installed.
If a roof is installed without first obtainingan inspection,I agree to remove
or
Will the applicant or(mum building occupant um equipmentdevices which peC
,son ktzardous air conuminanu u defined by Ne Bay Arca Air Quality Management all new materials for inspection.
0Yns iiirro .
!have re a hazardous materials requirements under Chapter 6.95 of the Cali(or.
nk Health&Sk Code,Sections 5(15,25533 and 25331.1 umkntand thatifdc building
does not cum a ten is is my responsibility to notify the occupant of the
requlreme whic t prior to issuance of a Certificate of Occupancy. Signature of Applicant Date
Owner or authorized agent Date' . All roof coverings to be Class 7 •or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN • 34235042 . 01
DATE ISSUED • 09/16/2008
RECEIPT # • BS000006094
REFERENCE ID # . . . : 08090090
SITE ADDRESS • 10174 POTTERS HATCH CMN
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • BEV CRAIR
ADDRESS • 10174 POTTERS HATCH CMN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM • STEVEN'S INCREDIBLE
CONTRACTOR • STEVEN KATKOWSKY LIC # 21828
COMPANY • STEVENS INCREDIBLE KITCHEN
ADDRESS • 11620 AIBA RD
CITY/STATE/ZIP . . . : BEN LOMOND, CA 95005
TELEPHONE • (408) 287-4088
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
1BSEISMICR VALUATION 25, 000 . 00 2 . 50 0 . 00 2 . 50 0 . 00
1REMRESBAT SQ FEET 70 . 00 429 . 00 0 . 00 429 . 00 0 . 00
1STPLNCK HOURS 1 . 00 122 . 00 0 . 00 122 . 00 0 . 00
TOTAL PERMIT : 553 . 50 0 . 00 553 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 553 . 50 #1691
TOTAL RECEIPT : 553 . 50
•
0809007 c)
CITY OF CUPERTINO
ADDITION/REMODEL
• CUIWINO PERMIT APPLICATION FORM
APN# ya 5 5 0 I/07Date:
Building Address: e1)L si
toti`I P0rr4rs E t [o►.&,.tc . G-Ftc..(Oc f.– .$I• as to
Mailing Address (if different from building address):
Owner's Name: Phone# :
t.2CoQ,£� Cs PSR cal log Wolf 31:2-
Contractor:
ntractor: Phone #:
St ')4,5 l,- v2Zvhte k .Tn\ . cLFax #: Lfl \9is6
Contractor License#: q57 0 S
•
Cupertino Business License#:
Contact: Phone #:
STe✓€A Fax #: t€ CI°C‘
Building Permit Info:
Bldg. a Elect. Plumb. V Mech. Er Hillside ❑
Job Description:
Addition (adding sq footage):' p k€s.°a— r{a C 1.-ptt lig 3- U C1C4-s'n.4s '.uA\k'S
What is being remodeled (not including addition)? CXR S t�'s R"
Remodel Includes Re-Roof: Yes ❑ No ❑ If yes list number of squares
Remodel Includes Structural: Yes ❑ No
Do you have the pre-application planning approval? Yes ❑ No ❑
If yes,please provide a copy of your planning approval letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen Bath jD? Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ Il/III B, IV-HT, V-B ❑ s irb-Le L
Valuation: Please check this WTI if the project is a
second-story addition ❑
Project Size: Express Erciadard ❑ Large ❑ Major❑
Please complete relevant portion of the Green Building
Checklist& attach it to the application or if applicable, Green Building Points Achieved:
I include in plan set& the sheet index.
***For Office Use Only***
Over-the-Counter ❑ Revised 7/15/08
CITY OF CUPERTINO •
D J ADDITION/REMODEL
CUPER INO FEE SCHEDULE
•
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
ADDITIONS 1R3SFDADD
PLLONGRNGR Long Range PL
Planning/Residential
1R3INSP Dwellings Inspections B
1R3PLNCK Dwellings plan check B
1R3REPINSP Dwellings Repeat B
Inspection
1R3REPPLNC Dwellings Repeat Plan B
Check
1R3HINSP Dwellings Hillside B
inspection
1R3HPLNCK Dwellings Hillside plan B
check
1R3HREINSP Dwellings Hillside B
Repeat Inspection •
1R3HREPLNC Dwellings Hillside B
Repeat Plan Check
1R3ALTINSP Dwellings Alternate B
Materials Inspection
1R3ALTPLNC Dwellings Alternate B
Materials Plan Check
1PCESS Cesspool P
1PPRSEWG Ea. Private Sewage P
Disposal System
1PRSEWER Sewers P
1BPSPRINK Lawn Sprinkler/Backflow P
1BPWSVCS Main Water Service P
1BSEISMICRE SeismicResidential B
DECKS 1R3SFDADD OR
1R3SFDREM
1DECKWOOD Deck (Wood)-Each B
(Each) •
1 DECKRAIL Deck Railing-Each B
(Each)
CITY OF CUPERTINO
ADDITON/REMODEL
• FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
GARAGES 1R3SFDADD OR
DETACHED 1R3SFDREM
1 GARDTW<=1K Wood Frame up to B
1,000 SF (each)
IGARDTM<=1K Masonry up to 1,000 SF B
(each)
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
• & SUN ROOMS 1R3SFDREM
1PATIOENCLW Enclosed Wood up to 300 B
SF
1PATIOENCLM Enclosed Metal up to 300 B
SF
1 PATIOENCLO Other Enclosed Patio up B
to 300 SF
1COVPORCH Porch Covered-Each B
(Each)
REMODELS 1R3SFDREM
1REMRESKIT Kitchen Remodel up to B (Deduct"$"for ea plan
300 SF check)
1 REMRESBAT Bath Remodel up to 300 B 66
�6 SF
1 REMREOTH Other Remodel up to 300 B 44
SF
1 REMRES2 Remodel Residential B
Greater than 1000 sq ft
1REMRES3 Remodel Residential
• B
Greater than 2500 sq ft.
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
REMODEL PLNCK
I STPLNCK(1-3 for Standard Plan Check B NOT FOR OVER THE
remodel) COUNTER PLAN CKS.
IREROOFRES Residential Re-roof Each B
100 SF
WINDOW/SLIDING 1R3SFDREM
GLASS DOOR
1 WINREP Replacement windows B
(ea 8 windows)
1 WINNEWNSTR New Window (non- B
structural)
1WINMEWSTR New Window (Structural B
Shear Wall/Masonry)
I WINBAYSTR Bay Window (Structural) B
SKYLIGHTS 1R3SFDREM •
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 B
sf or structural
ISTAIRS Stairs-first flight/ea addt'l B
1EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pln E
Ck (hourly)
1MECPLNCK Stand Alone Mechanical M
Pln Ck (hourly •
1PLMPLNCK Stand Alone Plumbing P
Pln Ck(hourly)
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
i 1BSEISMICRE Seismic Residential B
1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
•
•
•
• 1
1
Green Building Plan Check
Index of Green Building Points/Categories
•A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)• L-1 2 points
11. Permeable Paving,_(Note) L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points -
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, (detail) S-2 . 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 paints
F. Plumbing 1. Insulate all H.W.pipes, (Note/Spec.) 13-1 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.) A4 1 point
3. Energy Star Refrigerator,{Note/Spec.) A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point _
1542',.% ,., -:,.2, - TOTAL POINTS_ 9-- 40 points
•
•
•
0 .
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects •
Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is
• not feasible.However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
INPUT Resources Energy, IAO/Health
.Site
1 Recycle Job Site Construction 8 Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
�2.Salvage Reusable Building Materials 1 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 0 .
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
18.Design Resource-Efficient Landscapes and Gardens __ 4 Resource pts y=yes 0
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 0
0 0 0
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- 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes_ 0
0 0 0
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber 1 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 y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
I12.Use OSB -
a.Subfloors 1 Resource pt y=yes 0
• ` b.Sheathing • 1 Resource pt y=yes 0
0 0 0
INPUT Resources Energy IAUIHealth , •
I.Exterior wish -
p.Use Sustainable Decking Materiels
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 IAC/Health pt y=yes 0
3.Install House Wrap under Siding 1 1 IAC/Health pt y=yes 0
[4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
0 0 0
E.Plumbing
11.Install Water Heater Jacket — _ 1 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
13.Retrofit all Faucets and Showerheads with Flow Reducers I
a.Faucets(1 point each,up to 2 points) 1 Up to 2 Resource pts. 0
1 b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0 •
14,Replace Toilest with Ultra-Low Flush Toilets {
1(1 point each,up to 3 points) __J Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAC/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 IAC/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
0 0 0
r.rlectncal
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) 1, 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
o 0 0
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes— 0 .
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt - y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes— 0
4.Install Built-In Recycling Center 3 Resource pts y=yes— 0
L___- -- ---- 0 0 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
[3.Ins'tell.Recycled-Content,Fiberglass Insulation with -I
iNo Added Formaldehyde 3IAC/Health ptsy=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.We 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
D.ceilings 4 Resource pts y=yes 0
0 0 0
INPUT Resources Energy IAQ/Health
I. in•ows
It.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames i 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
• 0 0 0
J.Heating Ventilation and Air Conditioning
ft.Use Duct Mastic on All Duct Joints 1 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 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQMealth pts y=yes 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 0
B.Install Sealed Combustion Units
a.Furnaces 3IA0Mealth pts y=yes 0
b.Water Heaters 3 IAO/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves/inseds 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 41AQ/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 3 IAO/Health pts y=yes 0
. 0 O 0
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials —', 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energypts
Y=Yes 0
0 0 0
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Ene(gy pts . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
0 0 0
•
INPUT Resources Energy IAD/Health°
.Indoor Air Qua ity and Finishes
(1.Use Low/o-VOC Paint - 1 IAQMealth pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Finishes 2 IAO Health pts nes 0 411•
13.Use Low/No VOC Adhesives • 3 IAO/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea—
Formaldehyde 6 IAQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQMealth pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQMealth pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
a Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 31AQMealth pts y=yes 0
o 0 0
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
•
12.Use Rapidly Renewable Flooring Materials _ _ 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 IAQMealth pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
0 0 0
I Total Points Available: I 1401 1301 571
ITotal Points Project Received:I I 01 01 01 •
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Community Development
10300 Torre Avenue
�ry Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
•UPERJINO
Building Department
JOB ADDRESS: frpc Apt, PERMIT #
/ol7y ?oTi4rs fk v \ Copv,40,1/4 *23`lc. OcY--6 eoofo
OWNER'S NAME: (3£J GrAtP-- PHONE # t( a ({aatgas'b
GENERAL CONTRACTOR:9r'Jeotnc f-jScJ w -c FAX # '! 4 t 33 4203
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
i - Plumbing 'ruby pt.ifrill w is Tg p
Roofing
Septic Tank
Sheet Metal
VSheet Rock 11-61-450., tr•1 t,*U T&t>
tV Tile h A#•-vkAi Co TjgT
•
• er/Contractor Signature Date