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08040168CITY OF CUPERTINO BUILGINC61VISRON PERMIT RACT(3RTA?F-OR IAx15 �,kCONT BUILDING ADDRESS: PERMIT NO. 22129 RAE LN ADVANCED PLUMBING & ELECTRIC 08040168 OWNER'S NAME: PERMIT ISSUE DATE LEE RESIDENCE 18780 TUGGLE AVE 04/23/2008 91 NE: SANITARY NO. CONTROL NO. ARCHI'IECIIENGINEER: BUILDING PERMIT INFO CHANGE TWO FURNACES & A/C O O O O LICENSED CONTRACTOR'S DECLARATION Job Description I bereby aRrre that I w licensed under provision or Chapter 9 (commencing with Section VOID of Division 3 of the Business and Preference Code. and re'cenmu in full force arms offact License Cl DOLL' GanlfKwr Co. cxrrEcrs DEcu N 1 understand my plana Nall Ise used as public mentis Liecosed Proleaeonsl OWNER -BUILDER DECLARATION I wmby .Rete the 1 am ramp, from the Commoners License lute far the fallowing woo (Section 1851.5, Business and Profession Cade: Any city or county which mqulms • Panel, to coNmeL alt«, hnpmw, dem.liet. or reper any Nudism Prior be its iansnca, alae recut. the .'Pliant for such Permit to fk a egocd mammcem the he is licensed Furrow to the provisions of the Cormclora License Law (chapter 9 Sq. Ft. Floor Area Valuation (commaacing win Section 7") of Division S of the Business oral Profasslnna Cade) ur Ne he k amem therefrom and W bah for the alleged Nempuon Any violNun or APN Number Oe Occupancy y �'p Sceflon 1051.5 by any applicant far a Penna Nbjncts the Applicant to a civil penally or not mare the five hundred dollars (5500), ❑ Lssowmvofflkpestrun«myemplende wtNweesewe(Sam.7 mpewuon, Required Inspections do thewoand the ndad «orterddwreakpply Dan Buai«ss eCantV ase, I and Professionswhhacase The cantmnara Lsmansedwiso Law doe not apple w an awrc. and i who bolds intpress thereon, and warn wmfm« throngs h . en tdeada«n own a «aRnvtl f«ale. U, .min provided en,lding"this such Imps art not ear bewder the mid wh cafe era th orimprovemNng sue wididoroyur or coeanne fo,theowner- build« will Nw Ne burden of Interring Sul w did act hdW «impure f« purpose of have aka). ❑ 1, as owNr of the property, am emotively conume8n6 with licensed conmacwrs le censmmet that project (see. low, Business and Pmressions code:) ran Conaaewes U. cera Law don not appy m an ow«. drprapl'llr who wilds or tmpewa thereon, and who convects for sun projects with a comraror(s) license puwnt w the Commerce. Lkena Law. ❑ lamesommund«See ,B6:PCf«thiswm Owers Dee WORKERS COMPENSATION DECLARATION 1 hereby affirm under Palely or perjury aro a( that fallowing decianth«mc b ofCannl to self-Wfor War e. Camped- have and will maintain CeniBNaeR 1 tion, as provided f« by Saco.. 51W of the Labor Cade. far the p ularmance of the work for which Nis permit u Wood. ❑ 1 have and will maintain Walk e I DampcNallem I., a mgWmd by section 5100 of the LAWCode. for the Performance often work for which this Permit 1. laa4 ' My Warkers CmnpenWiN insurance carrier aM Policy number sm: Carrier Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE rrrthf see«I need tet bo completed Huse permit Is foronehmudred 00. (5100) or ins) 1 certify the, In ew perform. of that warts for which We permit is Issued. l shall am employ anyperson in ay manners as innc moabjet to orkeri am nadan Laws of Caltfaeta Dec Applicant N e M... NOTICE TO APPLIDIN�' ``. If, star matln u e 'Badu of FsemPtion, you should became subject w the Worker's Campewuon pl6Hsions of the labor Code, you men ' forthwith comply win such p mems. or this Permit shall w deems mroted. CONSTRUCTION LENDING AGENCY 1 Mmby arrmrre Wm then is a cementation lending.Snry f« the laeform. of the work for which this permit Is wood (Sec. 5097, Cin Q ' Lessees Name , Lenders Addw 1 certify the I haw lead this application and sum the the above information is ' correm. I agree w comply with all city and county ordlnsncN and sum law mining b Wilding consmuction, and her by amborie representatives of this city to enter vine the thaw-menuaned Property f« INpemiw PmTWmL (We) agree to arc, indemnify uW jeep harmless flue Chy of Cupertino aatlN Babuwes,)udgmcnu.came and "Forms which mar I. say boy ammo yeNl said City in conaq«nee of the grating of this permit UNDERSTANDS AND WILL COMPLY WITH ALL Issued by: Date �NON-POINT SOUTGU 'J!/Y5f iW � Re -roofs Type of Roof slga I Data naaofA pT aDataroter HAZARDOUS MATERIALS DISCLOSURE Will flu applicant or future wilding «cupateom «hurdle harudounmaterial as defend by the Cupenim Municipal Code. Chapter 9.12. and flue Health and Safety Cade, Section 25532(.)7 roofs shall be inspected prior to any roofing material being installed. [3y.All XNo If a roof is installed without first obtaining an inspection, I agree to remove vnn the ,pptieat or fuwm wading occupant ua equipment or deem which n.nlz er commemn s u defend by the Bay Area Air Quality Management all new materials for inspection. erial ❑Yea �4u Ihavicend the herartlnm materials requirements under Chapter 6.95oftheCeifer- nia Health k SermyCotla S'Sumns 25705.25533 and 25534.1 undcnuM the!( Iw wilding does not currently haw a uro nt. IWt it mY apansthllity *notify W «cup., of the mqulmanat whichmuuWmet�^seri oracrrdneaataraadP Signature of Applicant Date ` All roof coverings to be Class'W' or better ' D ' Owner of athaM1vss ogee.' aw • • C 6 ITEMS OF 6 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35607068.00 DATE ISSUED.......: 04/23/2008 RECEIPT #.........: BS000004559 REFERENCE ID # ...: 08040168 SITE ADDRESS .....: 22129 RAE LN SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: SylviaM COPY # : 1 OWNER ............: LEE RESIDENCE ADDRESS ..........: 22129 RAE LN CITY/STATE/ZIP ...: CUPERTINO, CA 95014-4032 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 408.92 --------------- 408.92 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING RECEIVED FROM ....: XIANSHANG LI CONTRACTOR .......: XIANSHANG LI LIC # 24013 COMPANY ..........: ADVANCED PLUMBING & ELECTRIC ADDRESS ..........: 18780 TUGGLE AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 TELEPHONE ........: (408)777-0651 FEE ID UNIT QUANTITY .AMOUNT• PD -TO -DT THIS REC NEW BAL ---------- 1BSEISMICR ------------- ---------- VALUATION 10,000.00 -------==-:---------- 1.00 0.00 ---------- 1.00 ---------- 0.00 IEPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MRRAA UNITS 4.00 244.76 0.00 244.76 0.00 1PPERMITFE 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 -------------------- 408.92 0.00 ---------- 408.92 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 408.92 --------------- 408.92 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING CI OF CUPERTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM nko4r)l10S1 APN # 'Sly 0 _7 0 (vK, v� Date: `1a3 A7 8 Building Address: GV Aa I Atee. L n1 tet) �o (f, /A ctS-0r Owner's Name: Phone #: L -bog &39 31g.1 Contractor: Phone #: 4-0(3- g aa- Z y h ►v T cS-%iAw6r (Z LI -0 8 % 7 Q 6s1 Fax #: Contractor License #: 7943 11 U Cupertino Business License #: q6( Contact: G S fes- s , e Phone #: a5 l'u- see Fax #: Building Permit Info: Elect Plumb ❑� Meth ❑-- Ale � �t UrN Ct Le Residential Commercial Job Description: ,1 Iwo (WD Ale oh) For Residential Installations: Attic ❑ I" floor ® 2nd floor Adhere to minimum setback requirement '®� For Commercial Installations: Replacement same weight CR Additional weight (structural talcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction (Usage Class): �flDD O . Strapped On Platform Bonded New Location Replacement Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. -&- I'll rr o CUPERTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. I MCREPALT Commercial for the repair of alt/add to M ca heating appliance,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absorption,or evaporative cooling sys, incl install of controls regulated by this code. IMCSUSHTR Commercial Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1 PGASCOM Commerical for ca gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & not incl in an appliance permit. 1BSEISMICO Commercial Seismic B 1 MRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea 2 heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,recessed.wall htr, or floor mounted unit heater. 1MRAPPVNT Residential for the install/relocate/ or M replacement of ea appliance vent install & not incl in an appl permit. 0 J ;. CITY O •CUPERTINO CITY OF CUPERTINO FURNACE/AC FEESCHEDULE Quantity Fee ID Fee Description Fee 'Group Permit Type FURNACE FURN/AC 1PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. P 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1 MFR=<100 Furnace Syst <=100k BTU install or relocate ea forced-air/gravity type fumace/bumer, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h M 1MFRN>100 Furnace Syst> 100k BTU install or relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance over 100,000 Btu/h M 1 EPERMITFEE Electric Permit Fee E l MPERMITFEE Mechanical Permit Fee M IPPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B 0 4CGt-- CUPERTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type AIR CONDITIONING FURN/AC 1 BCAIRHAN Commercial A/C Units <= l Ok CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ea gas piping System 1-4 outlets P 1 PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. Comm/Resid P 1BREMAIRHAN Residential A/C units <= l Ok CFM B 1MRRAA Residential Mech Repair/alt/add M 1BSEISMICR Seismic Residential B 1 EPERMITFEE Electric Permit E 1MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P ITRAVDOC Travel Documentation B 1BUSLIC Business License B s is 0 I^ L_ 221 tiq� Zn COPY Plan Review Process Work Book Page -12-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 oints 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 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 1 point P. Other 1. List Green Features on Plans A-1 1 point MAMMIMMI TOTAL POINTS 40 points 221 tiq� Zn COPY 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. 1. Recycle Job Site Construction & Demolition Waste j 65%=1 point; 75%= 2 points; 60%=4 points 2. Salvage Reusable Building Materials 3. Remodel for Mixed Use, Adaptive Reuse, and Historic Preservation 4. Protect Native Soil 5. Minimize Disruption of Existing Plants & Trees 6. Implement Construction Site Stonnwater Practices 7. Protect Water Quality with Landscape Design 6. Design Resource Efficient Landscapes and Gardens 9. Reuse Materials/Use Recycled Content Materials for Landscape Areas 10. Install High -Efficiency Irrigation Systems 11. Provide for On -Site Water Catchment / Retention 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 2. Use Recycled Content Aggregate 3, Insulate Foundation/Slab before backfill C. Structural Frame 11. Substitute Solid Sawn Lumber with Engineered Lumber 2. Use FSC Certified Wood for framing (For every 10% of FSC lumber used = 2 points, up to 10) 3. Use Wood I -Joists for Floors and Ceilings 4. Use Web Floor Trusses 5. Design Energy Heels on Trusses 6' or more 6. Use Finger -Jointed Studs for Vertical Applications 7. Use Engineered Studs for Vertical Applications B. Use Recycled Content Steel Studs for Interior Framing 9. Use Structural Insulated Panels (SIPS) a. Floors b. Wall c. Roof 10. Apply Advanced Framing Techniques 11. Use Reclaimed Lumber for Non Structural Applications 12. Use OSB a., Subfloors b. Sheathing up to 4 Resource 4 Resource pts y= 4 Resource pts 2 Resource pts 1 Resource pt 2 Resource pts 2 Resource pts 4 Resource pts 2 Resource pts 2 Resource pts 2 Resource pts up to 5 Resource 2 Resource pts y 3 Enerav ots v 3 Resource pts up to 10 Resource pts. 2 Resource pts y=yes 2 Resource pts y=yes 2 Energy pts y=yes 2 Resource pts y=yes 2 Resource pts y=yes 2 Resource pts y=yes 3 Energy pts y=yes 3 Energy pts y=yes 3 Energy pts y=yes 4 Resource pis y=yes 3 Resource pis y=yes 1 Resource pt y=yes 1 Resource of v=ves 1. Use Sustainable Decking Materials a. Recycled content 3 Resource pts y=yes b. FSC Certified Wood 3 Resource pts y=yes 2. Use Treated Wood That Does Not Contain ChmmlumlArsenic 1 IAO/Health pt y --yes 3. Install House Wrap under Siding 1 IAD/Health pi y --yes 4. Use Fiber -Cement Siding Materials 1 Resource pt y --yes E. Plumbing G. Appliances 1. Install Water Heater Jacket 1 Energy pt y --yes 2. Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 3. Retrofit all Faucets and Showerheads with Flow Reducers 1 Energy pt y --yes 4. Install Built -In Recycling C& a. Faucets (1 point each, up to 2 points) Up to 2 Resource pts b. Showerheads (1 point each, up to 2 points) Up to 2 Resource pts 4. Replace Toiled with Ullra-Low Flush Toilets y=yes 6. Alternative Insulation Products (Colton, spray -foam) (1 point each, up to 3 points) Up to 3 Resource pts 5. Install Chlorine Filter on Showerhead 1 IAD/Health pt y --yes 5. Convert Gas to Tankless Water Heater 4 Energy pts Y_—Yes 7. Install Water Filtration Units at Faucets (2 points each, up to 4 points) Up to 4 IAO/Health pts B. Install On -Demand Hot Water Circulation Pump 4 Resource pts y --yes r. tiecmcar 0 1. Install Compact Fluorescent Light Bulbs (CFLs) 1. Upgrade Insulation to Exceed Title 24 Requirements (6 bulbs=2 pointe, 10 bulbs =3 points, 12 bulbs = 4 points) Up to 4 Energy pts. 2. Install IC -AT Recessed Fixtures with CFLs (1 point each, up to 2 Energy pts 5 points) Up to 5 Energy pts. 3. Install Lighting Controls (1 point per fixture, up to 4 points) Up to 4 Energy pts. 4. Install High Efficiency Ceiling Fans with CFLs 4 Energy pts (1 point each, up to 4 points) Up to 4 Energy pts. G. Appliances 1. Install Energy Star Dishwasher 1 Energy pt y=yes 2, Install Washing Machine with Water and Energy 4. Use Advanced Infiltration Reduction Practices Conservation Features 1 Energy pt y=yes 3.Install Energy Star Refrigerator 1 Energy pt y --yes 4. Install Built -In Recycling C& 3 Resource pts y=yes H. Insulation 0 0 1. Upgrade Insulation to Exceed Title 24 Requirements a. Walls 2 Energy pts y=yes b. Ceilings 2 Energy pts y=yes 2. Install Floor Insulation over Crawl Space 4 Energy pts y=yes 3. Install Recycled -Content, Fiberglass Insulation with No Added Formaldehyde 3 IAO/Health pis y=yes 4. Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 5. Use Cellulose Insulation a. Walls 4 Resource pts y=yes b. Ceilings 4 Resource pts y=yes 6. Alternative Insulation Products (Colton, spray -foam) a. Walls 4 Resource pts y=yes u. ue ings 4 Resource pts y=yes 0 0 0 K. Renewable Energy and Roofing 1. Pre -Plumb for Solar Water Heating 4 Energy pts 2. Install Solar Water Heating System 10 Energy pts 3. Pre -Wire for Future Photovoltaic (PV) Installation 4 Energy pts 4. Install Photovoltaic (PV) System (1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =18 points) Up to 18 Energy 6. Select Safe and Durable Roofing Materials 1 Resource pt y= 7 Install Radiant Barrier 3 Energy pts y= 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 West and South Sides 3 Energy pts • T. Install Energy -Efficient Windows _ - • a. Double -Paned ! 1 Energy pt b. Low -Emissivity (Low -E) 2 Energy pts c. Low. Conductivity Frames 2 Energy pts 2. Install Low Heat Transmission Glazing 1 Energy pt — Heating Ventilation and Air Conditioning FUse Duct Mastic on All Duct Joints — 2 Energy pts 2. Install Ductwork within Conditioned Space 3 Energy pts 3. Vent Range Hood to the Outside 1 IAQ/Health pt 4. Clean all Ducts Before Occupancy 2 IAQ/Heaith pts 5. Install Solar Attic Fan 2 Energy pts 6. Install Attic Ventilation Systems 1 Energy pt 7. Install Whole House Fan 4 Energy pts 8. Install Sealed Combustion Units a. Furnaces 31AQ/Health pts b. Water Heaters 3 IAQ/Health pis 9. Replace Wall -Mounted Electric and Gas Heaters with Through -the -Wall Heat Pumps 3 Energy pts 10. Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts 11. Install AC with Non -HCFC Refrigerants 2 Resource pts 12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace 2 Energy pts 13. Retrofit Wood Burning Fireplaces a. Install EPA certified wood stoveslnseds 1 IAQ/Health pt b. Install/Replace Dampers 1 Energy pt c. Install Airtight Doors 1 Energy pt 14. Install Zoned, Hydronic Radiant Heating 3 Energy pts 15. Install High Efficiency Filter . 4 IAQ/Health pts 16. Install Heat Recovery Ventilation Unit (HRV) 5 IAQ/Health pts 17. Install Separate Garage Exhaust Fan 3 IAQ/Heaith pts K. Renewable Energy and Roofing 1. Pre -Plumb for Solar Water Heating 4 Energy pts 2. Install Solar Water Heating System 10 Energy pts 3. Pre -Wire for Future Photovoltaic (PV) Installation 4 Energy pts 4. Install Photovoltaic (PV) System (1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =18 points) Up to 18 Energy 6. Select Safe and Durable Roofing Materials 1 Resource pt y= 7 Install Radiant Barrier 3 Energy pts y= 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 West and South Sides 3 Energy pts • 1. Use Low/No-VOC Paint 1 IAO/Hsallh pis y=yas 2. Use Low VOC, Water -Based Wood Finishes 2 IAO/Health pts y=yes 9. Use LowMo VOC Adhesives 3 IAO/Health pts y=yes 4. Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 5. Use Engineered Sheet Goods with no added Urea Formaldehyde 61A0/Health pts y=yes 6. Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes 7. Seal all Exposed Particleboard or MDF 4 IAC/Health pts y=yes 8. Use FSC Certified Materials for Interior Finish 4 Resource pts y --yes 9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pts y --yes 10. Install Whole House Vacuum System 3 IAO/Health ots v=ves N. Flooring 1. Select FSC Certified Wood Flooring 6 Resource pts 2. Use Rapidly Renewable Flooring Materials 4 Resource pts 3. Use Recycled Content Ceramic Tiles 4 Resource pts 4. Install Natural Linoleum in Place of Vinyl 5 IAO/Health pts 5. Use Exposed Concrete as Finished Floor 4 Resource pts 6. Install Recycled Content Carpet with Low VOCs 4 Resource pts Total Points Availablej Total Points Project Received: r 0 1401 1301 57 01 01 0 G:delairrogsrgreenbuildingguldelinesimmodelerslgreenpoinlsfinal2.12.e4pmtedod.ds JOSIa-'TADDRESS: Q e 1 A' -A ?Y Community Development OWNER'S AME: t W— kw�S'J PHONE # LW 9 ,.J Cupertino CA 95014 Cabinets & Millwork Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 4UPEkTINO Building De artment JOSIa-'TADDRESS: Q e 1 A' -A ?Y PERMIT # OWNER'S AME: t W— kw�S'J PHONE # LW 9 GENERAL CONTRACTOR: Z 9'N ,7l�fa I z FAX # (408- 7 e 61' I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: • 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