08050246 CITY OF CUPERTINO a� r`p^ = �,*',.?� -
BUILDING DIVISION ' PERMIT iEo URACTOR INFORM TIQ
BUI : PERMIT NO.
7��8 ROBINDELL WAY JAMES & MARGARET DORAN 08050246
OWNER'S NAME: PERMIT ISSUE DATE
JAMES & MARGARET DORAN 7738 ROBINDELL WY 05/30/2008
ONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ElFL7 PLUMB MECH
0 0 0 0
u00 LICENSED CONTRACTOR'S DECLARATION Job Description
r� 1 hereby sRirm that 1 am limned under p owisam of Chapter 9(Commencing P
wiN Sce'.1 XBaf Divisian3 of the Business and Profcssiaru Code,and my licensea INSTL NEW WTR HTR(REPLC OLD)
u in full to=and effort
p 73 s Licene Class Lm.N
=� Dam Comamo
rr
ARCHITECTS OECLARATION
U rs
1 undeand my Plans drill the e.Ns
e decd as Puhlie te
id
iso Licensed Prefcssional
3OWNER-ROMPER DECLARATION
f I hereby,flim Net 1 am accept tram to ConuwctoYs License law for the
y o O following reason.(Section 1031.5,Basin.and Prefer.Cade:Any city or County
which requires a pce rk m construct,alter,improve,demolish.or repair my swdure
prior to in issuance.also requires tW applicant for such pemiuo rile a signed statement
£ < thetheislicenedimmearttotheProvisiomuftoContractor''sUmmclsw(Charter9 Sq.Ft. Floor Area Valuation
y�s (mmmendng wi h Sectim 700M) f Divui..3.f to Bush and Pmfe om Code)or _ $350
— Nu he isexempt thertfrom and she basis for the alleged e..mptlm.My violation of
Section 7031.5 by any.,Ibcant fm a permitmbjc.the applicans m a evil penaty ofNumber Occas
act mate don me hundred dollars ISM 36223012 . Occupancy Type
Las owner of the Property,army employces with wages m to"v sole compemaron,
will do He ser.,and eta shumure la Comatose,
Lnacde Law des net (Seer.7014, owner of
and erormaom case:The Conmcmn,and
taw deco not apply if ri owner is Required Inspections
pme anywho buildserrimpmvrs Hereon,and who arses suchwart oroffe or IluougM1 his
owner,,to ipmvded Natsuch impmsemenbatenot ear ofaaroBerad for owlso-
Wilder to building or impromnmt asold within ot yearofmmplefarPuowm-
buildm will love to Wmcn of peering that ha did not build m improve for puryde of '
ask.).
9ece1,u owner of to pmpeny,am make vely teaming with licensed Conmaman t
ded the pmjm(Sec.7044.Business;and Professions Code:)The Comomer's Li-
came Taw does not apply m an owner of pm,my who builds an improves Hellon,add.
who contracts for such pmjecta wit a contractor(s)licensed puns ant to the Camnetots
License Law.
❑Ism aserept volas ,Bf$PCItisjessand
wuer
Data S
ORKER'S COMPENSATION DECLARATION
1 hereby alfim under Pemlty of perjury one of He following declarations:
❑I have and will maintains Certificate of Comenuo self-insuRfaWartcisCampen-
cards,m pmvidcd for by Section 37M of to Labor Cade.for He performance of to
wort for which to pmnft is issued.
O 1 have sed will common Wtatce,Cmmpectudan I...u required by Smaim
3700 of to labor Code,for to Performance ofthc wart for which His permit is issued '
My Work,h Cmnmcmaron Laurance carrier aha Policy number ate:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu s omm need rot be cempkA W if to permit is fm om hundred dollar($100)
or lac)
1 certify tot I.to perfammm of to welit for which tis permit is issued.I"I not
employanyperm.many mespe , re" .mbjjc1m He Wmken'Compemad.
Ian of C a.Dam v� I
APPlicros ( jl�&A '-
NOTICETO APPLICANT:If.after malcinj this Certificate of Esempron.you abould
became subjca an the Workafa Compemktion provisions of We(alwr Cade ym moa
.,O fordwit Comply wit each Providons m Hu peanit shall W ticemed revrskm.
zN CONmucrION LENDING AGENCY
F" I hereby afOm that ten,is a common at lending agenry,for to pMormmm of
5 to wash for which has permit is issue)(Sec.3097,Civ.C.)
W A
Leader"Name
z Lmdce3 Address
U Q I ..tify tat 1 have read His application and,tam tat the shove inrarmadm is
gL Pcanon I agme In Comely wit all city and cmnry ordinances; ad sure Ian relating to
0U Wilding contraction.and hereby autorim mpreactom s of to city m cant upon ft
yatrose-mentioned property,for impecrm Pontotoc,
We)agree to o.a.indemnify and Imp been seas the city or C,pcnino agme,
lZ Iiabilitics,judgmed,tests and expenses which may in my way cmc&gaunt said City
U z in cone umm of He gram of to permit.
F-I APPLICANT UNDE NO WILL COMPLY WITH ALL NON. OlµµµTTT Issued by: Date S
SOURCE REGUL/y7t �—
rl/C.r��...(((j((------ a Re-roofs
SIgnYYR OfA Ilean✓COARDOU Dim
HAZARDOUS MATERIALSDISCLOSURE
or URE Type of Roof
Will ft applicantmfurorebuilding mmpmtsmre or hasudommamriat
C defined by Ice Cupertino Municipvl Code.Chapter 9.11,and He HcaIN and Safety
Cork,Section 255J2(aI? . All roofs shall be inspected prior to any roofing material being installed.
❑Yes o
If a roof is installed without first obtainingan inspection,I agree to remove
40 croltWill tc-,caro err aurum building by ft B vac cyvi it Q S1 devices which P
Dive haram.as air cmtamimnta as defined by He Bay Area Air Quality Management all new materials for inspection.
D m ctT
Ym
1 have real He luum
aammamrialsmquimencnu under Cham er 6.95 oft,Califor-
nia Heal"Safery Cade,Strom 25505.]5533 and23534.1 understand taif to Wilding
Jues not cumenry ham•mnm4 tat it u my Repawbiliry m natty Ice accts9�^t o
reydremc.ta wok bendrmcc rsf,c,rrrmte of Occypagty. Q Signature of Applicant Date
Owncr.mt ved.Sm1 5 wte� All roof coverings to be Class'W'or better
CITY OF CUPERTINO
t4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36223012 . 00
DATE ISSUED. . . . . . . : 05/30/2008
RECEIPT #. . . . . . . . . : BS000004954
REFERENCE ID # . . . : 08050246
SITE ADDRESS . . . . . : 7738 ROBINDELL WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JAMES & MARGARET DORAN
ADDRESS . . . . . . . . . . : 7738 ROBINDELL WY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5013
RECEIVED FROM . . . . : JAMES DORAN
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY JAMES & MARGARET DORAN
ADDRESS . . . . . . . . . . : 7738 ROBINDELL WY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5013
TELEPHONE . . . . . . . . :
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 350 . 00 '0 . 50 0 . 00 0 . 50 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PRWHEATR UNITS 1. 00 24 . 48 0 . 00 24 . 48 0. 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 . 56 0 . 00 106 . 56 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 106 . 56 VISA
--------------- . ._.
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
518 WATER HEATER
•
-. - oz q (P
CITY OF CUPERTINO
WATER HEATER
*cuPEkTINO PERMIT APPLICATION FORM
APN # Date:
3 (Pa,;-3 � � 5/3 0/2 oo Q
Building Address:
'-1-7 2og`. om(� wa7
Owner's Name: Phone #C:
tlr -. MAn-fRr- T ✓02R rJ 7 O 0 2 S 7 b b y
Contractor: /n Phone #:
O` 0 Fax #:
Cupertino Business License #: Contractor State License #:
Contact: Phone #:
Fax #:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Residential Commercial ❑
Job Description: /
trh-2K l�--Q'4�L2 Tn-S'.s �f 1--e rz-9-F, (44-0
Strapped On Platform Bonded ❑ New Location ❑ Replacement
Valuation: So
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.
Green Building Points achieved:
CITY OF CUPERTINO
,,i-5 WATER HEATER
CUPEkTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
IPCWHEATR Commercial Water B PCWHEATR
HeaterNent
1BSEISMICOM Seismic Commercial B
/ 1PRWHEATR Residential Water B PRWHEATR
HeaterNent
` 1BSEISMICRE Seismic Residential B
1PPERMITFEE Plumbing Permit P .
1TRAVDOC Travel & B
Documentation
1BUSLIC Business License B
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent, spouse or child) will perform:
• A. - All the work authorized by this permit
B. _ A portion of the work
C. _ None of the work
If B or C is checked, complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. _ All of the work
B. _ A portion of the work (complete section below)
Contractor Address/City Phone # State License # Type of work to
be performed
• 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number Type of work to be
performed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature: Date:
Job Address: 773q �oR;�n��� wg C� �jSo Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
Department.
z.
City of Cupertino Building Departmen
CITY OF t
C U f®E k9 I I{� O Phone:
Torre Avenue
(408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself,you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer,you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes,workers' compensation insurance,disability insurance costs, and unemployment compensation*
contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own.employees,without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit,erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department,
City of Cupertino .
Printed on Recycled Paper
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 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/S ec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
L
-7?.3e- 40 R-L,6-;^da-fit
MAY 3 B
qP ?�06
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 IAQ/Health
0..Srte
I •Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials I 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.DeDesign Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Matedals/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 1 1
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=yes0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesF--::F 0
1 1 1
C.Structural Frame
i1.Substitute Solid Sawn Lumber with Ergineered 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
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
12.Use USB -�— -- -- I
a.Subfloors
b.Sheathing 1 Resource pt y=yes p
• ` _ _— _ —
1Resource pt y=yes 0
1 1 1
INPUT Resources Energy IAQ/Health
.Exterior Fffffii Use Sustainable Decking Materials - •
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 IAQ/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
1 1 1
E.Plumbing
tt.InstallWaterHeater Jacket -- -- Energy ply=yes V 0
P.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
F3.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(1 point each,up to 2 points) Up to 2 Resource pts. 0
�4.Replace Toilest with Ultra-Low Flush Toilets
,(1 point each,up to 3 points) __ Up to 3 Resource pts. 0
5.Install Chlorine Filteron Showerhead _ 1 IAQ/Health pt y=yes 0
6.Coned 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
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
I%necmcai
�1.Install Compact Fluorescent Light Bulbs(CFLs) j
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(4 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
1.Install Energy Star Dishwasher 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 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 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
13 Install Recycled-Content,Fiberglass Insulation with
� Added Formaldehyde 1 3 IAQ/Health 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 o
I).Cenings 4 Resource pts y=yes 0
1 1
INPUT Resources Energy IAQIH,.a
1.Win ows
• 1.Install Energy-Efficient Windows I
a.Double-Paned
1 Energy pt y=yes 0
b.Low-Emissivity,(Low-E) 2 Energy pts y=yes 0
c.Low,Conductivity Frames j 2 Ener is
_ ___ _ Energy p y=Yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on AllDuct Joints
_ _ _ j 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 IAQ/Health pt 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
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health 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 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 stoveslnserts 1 IAQ/Health pt y=yes p
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy of 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 3 IAQ/Hsalth pts y=yes p
1
K.Renewable Energy and Roofing 1 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
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
T.Select Safe and Durable Roofing Materials � 1 Resource of y=yes 0 0
7.Install Radiant Barrier 3 Energy pts y=yes 0-
L.Natural Heating and Cooling 1 1 1
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
. ndoor i ivahty and Finishes
'1'.Use LowMo-VOC Paint - 1 IAQMealth pts y=yes 0
2.U •
se Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y=yes 0
R.Use Low/No VOC Adhesives 3IAQ/Health'pts y=yes 0
4.Use—Salvaged for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses _ 1 IAQ/Health pts y=yes 0
t7.Seal ell Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
r2.Use Rapidly Renewable Flooring Materials __ 1 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
6.Install Recycled Content Carpel with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Available: 1 1401 130 57
Total Points Project Received: `7 01 01 0 •
G:datatprogs/greenbuildingguidelinestremodelersrgreenpdntsfinal2.12.04protected.xls
•
f, Community Development
10300 Torte Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
SCUPEkTINO
Building De zutment
JOB ADDRESS: PERMTT #
OWNER'S NAME: ,, ,� Q,— ( PHONE # 5 7 S
GENERAL CONTRACTOR: / FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
61 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
er/Contractor Signature Date