08080060 CTTY OF CUPERTINO ,xe > +=t»+ ' j, �'��
BUTLmNsG DIVISION PERNIIT CUl?I" ,A'' O`R I ULtMAT-I lee':
C
BUILDING ADDRESS: PERMIT NO.
1.213" I2:IVERSIDE DR FISHER POWER AND DATA INC 08080060
OWNER'S NAME: PERMIT ISSUE DATE
ANDY CHENG 949 INDUSTRIAL AVE 08/07/2008
NE: SANITARY NO. CONTROL NO.
(650) 325-5768
ARCHITEC(ENGINEER: - BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30 o LICENSED CONTRACTORS DECLARATION O OOF O O
I Meloy affirm that 1 sum Boast under provision of Chapter 9(Commencing lob Description
WN Section 70p)ol'Dlvison 3ofine Busimasand Pmfettiam Code.and mylianau RPLC DMG PNL W/200AMP MTR MAIN DISTRETN PNL
a a in full foo and eRep.`
[
DMZ Liana (t) Lle.I
9 Dau Camm�ar
e ARCHITECTS DECLARATION
e 1 understand my puna shall he decd u public mearm
;yU
bud
Licensed Professional -
m Oat I sons orad f DECLARATION
aE I new.(Ban on 11. ,umpl Tam the Contractors o Licca law for Eta
is p O fallowing mama.permit
t 7 consumes.
Business and improve,
anions Code:Any oily or aunty
$m which mqulma•Issuance,also m cams the plan Improve,accrh permit
t i ri mash any oder a -
Zi pdarmivandpa nL10mittima the of for signed .
<
that emiwd Smmnt tads of Division
of me Conwour'alJawaaw(C Code)at
Sq.FI. FIOOC Area $ Valuation
$ thammentlny Won Senlan,andtebasisal of mo Bosinmand pton.Any
Coda)of 2300,
that io u attempt a"ri plI and the buts it the subjects
&a exempda.Any it penalty
of
Section 700us by dry red dant rs i permit Nbjecu die applicant m a civil penally of Number Occupancy Type
rot more dun five hundred dollars(SSW). 35602004 �(�
❑1,a owty atttu property,a my wploym Wm waa u tiwv role compensston.
will Pr diction.and me he Com se rot s Licards sew red Torun(ply 70th,audneu
and Pmrorhom Code:The Comtrsenco.adw1m Law does rot apply lf an wane is Required Inspectlbns
own ertywho builds i impays mean,and who doesaucn workdioseredth r san his
ownemployes,providedduove improvements me rot eaedcmaaeeed for aver.
however.Neawbuilding hear Impmwmantuold did 1yearatLprovefrtaewner-
builds will haw my Euedm of proven{that rte tilt rot ease m improve(o purpose of
❑1,u wrcr of die properly,am exclusively caeduteg with Element conuatan in
construct the pmjen(Ste.70ca,Business am Professions Code:)1H CatnL7ars U.
cave Taw does not apply Was caner of property who builds or hnprvws Merton.and,
whoconumis for such projects with a comrscur(a licensed pursuant in me Commons
License Taw.
❑Iamacmptunder See ,Bb PCfarmurev"n
Owner Data
WORKER'S COMPENSTnON DECLARATION
I hemby a1Rm under penalty of perjury ora of me fallowing duclararione
I ham sed will maintain a CWBsu ofCnn,ent m self-inert fm Warker.Compes,
motion,an provided for by Section 1700 of me Labor Cole,for the performance of me
wank for which this permit is umed.
❑1 ban and will maintain Worlmr.Compensation Insurmce,u squired by Sonia
1703of mm Labor Code,for di1 pedom ace of ma wynk forwhich this permit a luded.
MY worker.Compewda lannoT p r�pmu"numberr
Carrier.{PI a/..v+.nom —L Polity Na.'f^7£'"X00 ,e Q
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
COtuaeti"n and iutMeomplmed time permit ufurome undmt dollars($100)
or leu)
1 cenity mol in me pufmtnana of the wart for which this permit is issued.I shall moat
employ any Noun in my mannerm as u became subject in die Woeken'Compe sudor
Laws of Caifamu.Data
Applicant
NOTICE TO APPLICANT:If.afar making this Certificate of E¢mption,you should
became Nbjeet m die Worker',Compensation provisions of me labor,Codc,you man
0 formwidi comply with such pmvlsi"e o mu permit shall be deemed revolted.
z 0 CONSTRUCTION LENDING AGENCY
Fr nom. I hemby Lfrmn than tan is a construction lending agercy for the Performance of
Wj IY> dip work for which Lou Permitu ec issued(S 7097,Cl,.C.)
0 Lender.Name
z Leader,Addy*..
U 0 I certify urn I haw red this application and sum mat to above Information is
ta+ coned.I.time to comply with all City and county anlinanm and outs Ewa mlammis in
0 building communion.antl hereby indicate representatives ofthis city to enarupon me
W .how-mandoxd property for indication purpaal
a (we)agree to an,indemnify and kap humus.da City of Cupertino against
fn Iishilidea jddgmenu.coed and upeme which may m any way acme a,Wt did City
in()z APPLICCA ro of 1791 ERSTAN S ANp of WIISCOMPjs 4TH- NON-POINT Issued by: Date
SOURCE GU ONS /
Re-roofs
SignatureofAppliynpCon Data
/ HAznRDou ATERIAIS DISC1.osuRE Type of Roof
da applianlmfuturo buil {oadparfll or Nn die huaedou materia
u dcM by die Cupertino Mdnicipa ode.Chapter 9.13,and die Health and Safely
Cade
❑[3Ys jffN. All roofs shall be inspected prior to any roofing material being installed.
Will me applicant or lama building occupant use equipmcot w devices which If a roof is installed without first obtaining an inspection,I agree to remove
It huueduus ser contaminated u deft ad by Iho Bay Area Air Quilty Management all new materials for inspection.
suia7
❑Yn / I
I bow mad me haurdou.ma mri5. mquimm 5534:t ClupurQ i f bulli g
nu HcalthkSaer dos.2y5Jl and LSsla:l vndemand Nssirme builtluti .
don rot nveen Nw a owns.Eutu 4 myesPona—bB��y me oauPmt of me
mgaimmc"a '°""'°""°a`"ss:-_`�e"p'""'' Signature of Applicant Date
owne ,mnariaad. not Dna All roof coverings to be Class'RT'or better
CITY OF CUPERTINO
® 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35602004 . 00
DATE ISSUED. . . . . . . : 08/07/2008
RECEIPT # . . . . . . . . . : BS000005725
REFERENCE ID # . . . : 08080060
SITE ADDRESS . . . . . : 22434 RIVERSIDE DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ANDY CHENG
ADDRESS . . . . . . . . . . : 22434 RIVERSIDE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3959
RECEIVED FROM . . . . : ANTHONY FISHER
CONTRACTOR . . . . . . . : ANTHONY FISHER LIC # 21713
COMPANY . . . . . . . . . . : FISHER POWER AND DATA INC
ADDRESS . . . . . . . . . . : 949 INDUSTRIAL AVE
CITY/STATE/ZIP . . . : PALO ALTO, CA 94303
TELEPHONE . . . . . . . . : (650) 325-5768
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 2, 300 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
ITRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 82 . 08 0 . 00 82 . 08 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-------- --------------
CREDIT CARD 82 . 08 AMEX
---------------
TOTAL RECEIPT 82 . 08
O(, 4 O
CITY OF CUPERTINO
azm
CUPEVINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # J 6 C) ), 00q, d o Date: O O / OR
Building Address:
� a- q3 `I 1vws; ,�-c
Mailing Address (if different from building address):
Owner's Name: Phone#:
C �,, 5� C � 4k 1 .65b - (4 - s
Contractor: Phone: 6 5-0 ._ 6 ce _ / a v
' Fax:
Contractor License#: 6 O ti 3
Cupertino Business License #:
Contact: Phone:
� Fax:
Residential Commercial
Job Description:
C n �ti Ce, D� � i?,' v 9 I•ti 1
V
I1ti�w h �; rJ ;s 4 LL K
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-B ❑-- tL —J
Valuatio 2,3p o Square Footage:
Project Size: Express Q Standard ❑ 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: _A-
• For help, contact Build it Green at www.buildit reen.or
Revised 7/01/08
CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BBOILERI 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
1BBOILER2 Installation /relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
11313OILER3 Instal I ation/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
11313OILER4 Instal lation/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
1 BBOILER5 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.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPERTINO
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi=Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
IFLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1 PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3of5
;C�. 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
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSPIO 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
IS KYL<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
I SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
I SRACKS>8 Storage Racks over 8' high (up to 100 B
st
4 of 5
GD , CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPER,TINO
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee)
IEPERMITFEE Electrical Permit Fee E
/ 1 MPERMITFEE Mechanical Permit Fee M
I PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK 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
5 of 5
Green Sul Plan Check Dries
lding PointslCateg points
Index of Green Building
Ian Sheet or Page
Example of an Index or Table of Green
P
be
A. Category Building Points Categories that must
shown and referenced on we project d
below 2 points
Plans See L-1 2 oints
detailslspecr LA 5 points
g, Install H.E.lmgatlon,( S-1
sable Pavin Note 2 points
g. Site 11 Perm 5-2 2 points
1. Use 15 y,Flyash Concrete,(note) 5-2
See Spec.) 2 Dints
C, Foundation 3 Uses Wood LJohe I ,(detail) S'2 2 points
D. Stru r 5 Use Truss V," detail Aa 2 oints
5 B.OSB Sheathln , NotelSpec.) A-4 2 points
Finish 1. Composite Decking,( p-1 2 pointy
EB.Fiber OtelSpec.)
. E 4• Cement Sldln Note1S ec. A-2 10 Dints
1• Insulate all H.W•pipes,(N
NotaiSpec.) L'1 4 points
F. Plurrtbing 5. Tankless W•H ' ( Note1S ec A 3 1 point
11.A 2500 Gal.Tank, A-3 1 dint
4. F.Ceiling Fans, NotelSpec.
A�
t1 point
G. Electrical 1 Energy Star Dishwasher,lNote/s eC. AA 40 points
Ft. Appliances 9. Ene Star Rehr Orator,
p, ether 1. List Green FeaturesToTpnL POINTS
•
Green Points Rating System far 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 ReSOUTMS Energy ]AWHeafth
to
1� Rscycle Job Site Construction&Demolition Waste kt'
65%=1 point;75%= 2 points;60%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials _ Y 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
9.Nesip Resource-Effidient Landscapes and Gardens _ 1, 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
1 I 1
3.Foundation
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of fiyash,up to 5 points up to 5 Resource pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes D
I 1 I
C.Structural Frame
1.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 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
6.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
12.Use OSB ' —
a.Subfloors I 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0
. xtar Dr n a
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y--yes 0 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
3.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0
4.Use Fibar-Cemant Siding Materials 1 Resource pt Y--yes 0
1 i 1
E.Plumbing
1.Install Water Heater Jacket 1 Energy pt Y--yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pis Y--yes D
3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads It point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Tollest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/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
v.necrncai
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pis. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Ughting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pis. 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
'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
I
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pis 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 with
No Added Formaldehyde 3 IAQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes D
5.Use Cellulose Insulation
a.Walls 4 Resource pis y--yes 0
b.Ceilings 4 Resource pis y--yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pis y--yes 0
D.uenings 4 Resource pts y--yes 0
in ows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy of y--yes 0
b.Low-Emissivity 2 Energy y=yes 0
c.'Lbw.Conductivity Frames 2 Energy pts y=yes 0
2.Insta CLo'w Heal T ansmissio'n Glazing 1 Energy pt y=yes 0
1 f 1
J.Heating Ventilation and Air Conditioning
�1.Use Duct Masticon All DuctJointi - - - 2Energy pts y=yes 0
Install all Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health of y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health 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 3 IAQ/Heaith 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 yryes 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 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
1 1 1
K.Renewable Energy and Roofing
1. Pre-Plumb for Solar Water Heating 7yess7-
0
s Y--yes 0
2.Install Solar Water Heating System s y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation ts yryes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points)_ 1 B Energy pts 0
6.Select Safe and-Durable Roofing Materials _ pt y=yes 0
7.Install Radiant Berner _ s yryes 0
1 1 1
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 Energy pts y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
1 1 1
•
INPUT Resnirces Energy 1ADNealth
. n oor r ue Ity en n s es
1.Use Low/No-VOC Paint 1 IAO/Health pts y--yes D
2.Use Low VOC,Water-Based Wood Finishes 2 IAQMealth pts y--yes 0 •
9.Use Low/No VOC Adhesives 3 IAO/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 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts yryes 0
6.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
10,Install Whole House Vacuum System 3 IAQMealth pts y=yes 0
1 i 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 Resource pts y=yes 0
2.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
B.Install Recycled Content Carpet with Low VOCs 4 Resource pts y—yes 0
1 ! !
Total olntsvela e: 1 1401 130 57
Total Points Project Received: 01 0 0
e:daWpmps/gmenWIldngguidalines/mmodelemigreenpdntsfinal2.IP Upmleded.ds
Community Development
10300 Torte Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEI�TINO
Building De artment
JOB ADDRESS- PERMIT #
.Dr- Ufa e-G�6G
OWNER'S NAME: Cl.a„ PHONE # 65-b- y -
GENERAL CONTRACTOR: F FAX # Gso - us y - S-6
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' ormation:
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
T'
er/ or Signature Date