08070098 CITY OF CUPF,RTINO
BUILDING DIVISION PERMIT CONTRAGTORII (?RMATIOIV
BUIL91t�%'T'96OTLAND DR BLUE MOUNTAIN AIR , P�08070098
OWNER'S NAME: PERMIT ISSUE DATE
JOHNSON WILLIAM C AND HEIDI K 707 ALDRIDGE RD STE B 07/14/2008
NE: SANITARY NO. CONTROL NO.
ARCH=fENGINEER: BURRING PERMIT INFO ,
REMOVE & REPLACE AC UNIT BLDG ELECT PLUMB MECH
D O O O
u o p LICENSED CONTRACTOR'S DECLARATION
juq I hereby alRrm that I ano licensed under provisions of Chapter 9(commencing . . Job Description
with Section 7")of Division Sof tbe Business and Pndicso ions Cods."my licca is
d Nfull force:an
j .6"t ZLICeyj ,yqq
n t- Dam 7 —Conuecm
ARCHITECTSDECG ATION
1 usalersand my plans shall M used a public records
Ou
1W In Licensed Professional
sea OWNER-BUILDER DECLARATION
a�� ,I I hemby aRrm Nat I em came pt from the Contactors Licence Law for the
En O following reason.(Section 703 1.5,Business and Profmiom Cade:Any city or county
$ which re mms a Permit to construct elms.Impmw,di m thch,or repair any someone
prior in its issuance.also requires tbe applicant for such permit to EleasienWsuLLment
a thnbeisficcuredpuruamsoNeprovisions ofthe Continuities eenon,Law(Chapter9 Sq.Ft. Floor Area Valuation
y�0 (commencing with Smion70W)of Division 3 ofthe Busioessaril Profmions Code)or
y $ Nan he is exempt therefrom anal the basis for use alleged canmption Any violation of
Section 7031.5 by any applicant for a pencil subjects the applicant r a civil penalty of APN Number OccupancyType
.t mom tha BK hundred do0ana(s5($51)[1), YP
I,uowner of the Pmprtrry,or mY emPloym with wagaauev sole wmpewuon,
will dothcwon,and N' shunoeuno'sLice sooReretl Towle(Sec.7014.Busincss
and property
huhu ns Cma�The Cantxrra «Law sores at apply m am ewer or Required Inspections
owthem who ss,pro ided Un ss Nvrun,aM who do.1 iia orkhimxeJf cd Nsonah his
ownn .rho iprovided pnowerimprowmcoLLi. not ear o(c om8esed(orale.if.
however,the Wiring o den of proms 4sold within one year errs mpPktion.tlse owonr
buil4r will love the Wrtlon of proving that h tlitl not Wild or improve for purpose of
auJ.
O 1,a owncr of the property ano eaelunwly contracting with licensed conuacnos ut
construes the pmjm(Sec.7054.Business and professions Code:)The Contactors Lt.
smash Law dao not apply to an owner of property who Wilds or improve thereon,and
who contracts for such projects with aemntricrr(s)licensed pursuant m use Contractor's
Lleena Law.
El Iamesempsunder See .8&PCrendis. an
Dwm Date
WORKERS COMPENSATION DECLARATION
ON
hi eby alBm under penalty of perjury one of the following declarations:
s:
mM will maintain a Ceniftum ofComent m self-insurefor Worker's Compere
cation,as pmvided for by Section 370(1 of Ne Leber Cade,for the performance of the
work for which this Permit is noted
hose anal will maintain Workers Comns
peotion Insurance,at kindred by Section
]00 oftheLabor Cede.for the performaunceofrhe wort fowbich than permit u issued '
My Worters CIom�p��er/rush.,burs( nes aniur and Policy number are: ff��
Cartier. L, 'Dom^ ✓/'t,N��� Policy Na.:W c zzr 0 6y 6y�'
CERIYFlGTE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
(Thu seN.nccal rot W completed link permit uroonc huadreddollaa($100)
Or less.)
1 sidly Not in the performs.ce of the work for which this permit is issued.l shall not
employ anyperson in any monnerm as in become subject to the Workers'Conpewuoa
Laws of California Dam
A"fiam
NOTICE TO APPLICANT:IL after making this Certificate of Exemption.You should
deems,subject on the Whiter.Compensation pmvis(ons of the Lebo Code,you muv
.J z forthwith comply with such prnvuimts or this mut shall be diamond mvokcd.
.ZiOCONSTRUCTION LENDING AGENCY
C" I hereby affirm than there is a construction lending agency for the Performance of
C the work Ief which this permit u ivtrd(Seca 3097,Civ.C.)
W 0 lenders Name
z Lenders Add.
U Q 1 certify Nat 1 have rad this application and sum than Use&hove information is
!7. ^ correct.I agree to comply with sit city and county aNinances and sum laws mlating to
.c) rU^ Wilding comwction.and hereby mNamm kprarautives of this city to color upon he
r ldwetim Jodnad Pmpent for inspection.-K.purymses
(we)agree m ave.indemnify and tap hansoless tete City of Copertom against
h inconsequence enWcoaLLaM eapmueswhich mryin any way ettruc agsiat aid City
C) of the grunfing of this parmit.
APPLn C NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR UI.ATION$
9A 2421,E '7/KEW Re-roofs
Signanme of ApplianUCantmor Date
HAZARDOUS MATERIALS SURE Type of Roof
Will Ne applicant or form Wilding occupant store or handle haallous materul
m dcfncd by Use Cupertino Municipal Code.Chapter 9.13,and Ne Health and Safety
Code.Section 25532(&)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes for
Will the applicant o futwe Wilding occupant sec cquipmem o ucvias which If a roof is installed without firs[obtaining an inspection,I agree to remove
it h
Y.
air'conumm nts u dcfncd by the Bay Am.Ail QalitY Managcmcnt all new materials for inspection.
District?
❑Yes u
I haw mad the hoard/ons materials ociuimmcnu under Chapue6.95 ofthe Califon
nu Health&SalmyCadc.Sstians 25505.25533u n534.1.rAnm duwirde Widi.t
I nal,haw a usank Nat It a my responsibility m redly the ottupmt of de
Is which m be feelf. In'.of•Cenifeate of Ocaprncy.
7(y. ' Signature of Applicant Date
Owner or authorinecoV U DamAll roof coverings O e Class c Cir or better
i
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36229018 . 00
DATE ISSUED. . . . . . . : 07/14/2008
RECEIPT # . . . . . . . . . : BS000005465
REFERENCE ID # . . . : 08070098
SITE ADDRESS . . . . . : 1153 SCOTLAND DR
SUBDIVISION . . . . . . : ..
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOHNSON WILLIAM C AND HEIDI K
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5061
RECEIVED FROM . . . . : EDWARD GREGORY
CONTRACTOR . . . . . . . :' GREGORY S. OWEN LIC # 29600
COMPANY . . . . . . . . . . : BLUE MOUNTAIN AIR
ADDRESS . . . . . . . . . . : 707 ALDRIDGE RD STE B
CITY/STATE/ZIP . . . : VACAVILLE, CA 95688
TELEPHONE . . . . . . . . : (707) 451-8111
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 2 , 972 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE 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 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
IPPERMITFE 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 286 . 04 0 . 00 286 . 04 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 286 . 04 MASTER CARD
---------------
TOTAL RECEIPT 286 . 04
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
'Stu- FURNACE/AC
• OF
CUPEkTINO PERMIT APPLICATION FORM
APN # 3(�Z d��•�(� Date: 7`/L/ G�zj>
Building Address:
�,-
Owner's Name: Phone#:
-3L' ! Z / �/�Ci
Contractor: J Phone#:
70
Fax#: ;7dj-5'i16_7D26
Contractor License#: Cupertino Business License#:
SPY 60 0 �r6m
Contact: //-- Phone#:
��(/JC GGA! 707
Fax #:
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Residential Commercial
Job Description: n C ��`�
h'i�► �� Sf'��
For Residential Installations:
Attic ❑ iso floor [� 2nd floor ❑
Adhere to minimum setback requirement �r
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: ^Q 7 Z Type of Construction (Usage Class):
Strapped (9977-
/ On Platform Bonded New Location Replacement
Valuation: a5 7Z
Green Building: Please complete relevant portion of the Green Building Checklist & a4act it to the
application or if applicable, include in plan set& the sheet index.
-� CITY OF CUPERTINO
FURNACE/AC
CUPERTINO 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.
1 MCREPALT Commercial for the repair of alt/add to M
ea 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. .
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1 PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 BPGAS For each gas piping system of 5 or P
more per outlet.
IMCAPPVNT Commercial for the install/relocate/ or M '
replacement of ea appliance vent
installed & not incl in an appliance
ermit.
113SEISMICO Commercial Seismic B
1 MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit or ea
heating,Sin ,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 ¬ incl in an appl permit.
CITY OF CUPERTINO
FURNACE/AC
a OF
• CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1 PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
IMECPLNCK Mechanical Plan Check M
1 MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fnmace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
IEPERMITFEE Electric Permit Fee E
1 MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
1 CITY OF CUPERTINO
FURNACE/AC
C1TY OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
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 P
1-4 outlets
1 PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more peToutlet. Comm/Resid
1BREMAIRHAN Residential A/C units<= l Ok CFM B
1MRRAA Residential Mech Repair/alt/add M
IBSEISMICR Seismic Residential B •
I 1EPERMPFFEE Electric Permit E
1 1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
r
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
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 g. Install H.E. Irrigation, (details/spec)' L-1 72points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
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 1Bpo
t
P. Other 1. List Green Features on Plans A-1 1t
TOTAL POINTS S' ,L 40ts
573 3CvfewC( D, _
Plan Review Process Work Book Page-12-Revised 3/25/08
3 co
.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 INPUT Rewurces Energy 1AGII-lealth
i1.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 _ _ 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
(8.Design Resource-Efficient Landscapes and Gardens _ f 4 Resource pts y=yes 0
9.Reuse MatedalsNse 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
I 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=yes 0
3.Insulate FoundatlonrSlab before backfill 3 Energy pts y=yes 0
1 1
C.Structural Frame 1
j'1.Substitute Solid Sawn Lumber with Engineered Lumber _ J 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
S.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 Structwal Applications 3 Resource pts y=yes 0
12.Use 0813-
a.
58a.Subfloors 1 Resource pt y=Yes p
• b.Sheathing 1 Resource pt y=yes 0
1 1 f
rtenor rms
INPUT FresDurces Energy ]AD/Health
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y-yes D •
b.FSC Certified Wood 3 Resource pts y=yes 0
i2 Use Treated Wood That Does Not Contain ChromiumlArsenic r 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0
14.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 Hol and Cold Water 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
It.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toilest with Ultra-Low Flush Toilets t
�(1 point each,up to 3 points) _ ( Up to 3 Resource pts. 0
5.Install Chlonne 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
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
r,.ciecmcai
11.Install Compact Fluorescent Light Bulbs(CFLs)
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
it.Install Energy Star Dishwasher ), 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy I
Conservation Features 1 Energy pt y=yes 0
I3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
:4.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 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts Y--yes 0
3.Install Recycled-Content,Fiberglass Insulation witli
:No Added Formaldehyde 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 C •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
0.t;eilings 4 Resource pts y=yes 0
1 1 !
I.Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames _ 2 Energy pts y=yes D
2.Install Low Hest Transmission Glaiing 1 Energy pt y=yes 0
MM1 1 1
J.Heating Ventilation and Air Conditioning
1.UseDuct Massc on All Duct 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 IAO/Health of y--yes 0
4.Clean all Ducts Before Occupancy 2 IAO/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 D
8.Install Sealed Combustion Units
a.Furnaces 31AQ/Health 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 3 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yesjC 2. 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 stoveslinserts 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 3 IAQ/Health pts y=yas D
1 1 1
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 D
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 of y=yes 0
7 Install Radiant Barrer 3 Energy pis Y--yes D
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes D
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 D
1 1 1
•
.In oor Air ua rty an Finishes
INPUT ROSDurces Energy MO/Health
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y--yes 0 •
f3.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 61AQ/Health pts y--yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes D
7 Seal all Exposed Particleboard or OF 4 IAQ/Health pts y=yes 0
B.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
1 1
10.Install Whole House Vacuum System 31AQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring __ 6 Resource pts y=yes 0
L.Use Rapidly Renewable Flooring Materials, _ _ 4 Resource pts y=yes 0
3.Use Recycied Content Ceramic Tiles 4 Resource pts y=yas 0
4. Install Natural Linoleum in Place of Vinyl 51AO/Health 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 D
1 1
Total Points Available: 1 1401 1301 57
Total Points Pro'ect R 1 0 0 0 •
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•
Community Development
0 Torre Avenue
)/` Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: � >�SC'a 7,7C,.,La/
/ PERMIT # cif-'.o7 O U /Q
Q n
OWNER'SNAN4E: ere PHONE #
GENERAL CONTRACTOR: ,t,-f 4, FAX #
I am not using any subcontractors:d,.k
Signature Date
Please check applicable subcontractors and complete the following information:
21 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 V
Roofing
Septic Tank
Sheet Metal
Sheet Rock
' e
Owner/Contractor Si - a Date