08050158 CITY OF CUPERTINO
BUILDING DIVISION PERMIT Cd)NTItACTOR INFORMA�I01V -:
BUILDINGADDRESS PERMIT NO.
20609 SHELLY DR ATLAS-TRILLO HVAC 08050158
OWNER'S NAME: PERM17ISUE DATE
HUNG CHEN 1965 KYLE PARK CT 05/20/2008
E. SANITARY NO. CONTROL NO.
ARCHTfECT(ENGINEER: BUILDING PERMITINFO
RMV & RPLC FURNACE & ADD A/C -BLDG ELECT PLUMB MECH
0 o t� o
�Op LICENSED CONTRACTORS DECLARATION Job Description
C 1 hereby affirm Nm license
at I ad under Provisions of Chapter 9(commencing P
ZW with Section 7001y;f Division 3 o(dte Business,and Profeaskf Code,and my Ill..0
^<<O m in full force and exeyl
License Cl Lk.g
Contractor r—
^��y ARCHI'IELTS DEC1.aRATI r
li
D W u 1 uraferatand my plans shall W used u pubcrecords6
y yt
Licensed PNR'S{IOMI
OWNER-BUILDER m DECLARATION
a� C 1 Wmhy.(Bran Nat 1 1. exempt from d r f.mi anofs License Law o for Nc
i pe O following mason.(carrion 103 1.a Guiness and ne. amol Cods:Any city 9r minty
whim ants i ms a permit reconWuca applicant
improve.ds Permit
t or¢pair any tenure
atement
that WIuiensedpalmatto Bethe
ovisioso for such Contrarni'ro BkasLaw(ned hap=9
E QUommenccgwithSntion7Nepmviviouo(NeConmcmhlJ¢ucLawsCo,lcer9 Sq.Ft. Floor Area Valuation
that he is erg with Section and
basisom3thereeged casand pton.MynnsCede)or
Nn k u<sempt therefrom and Ne hero for the alleged exunpuon.My violation of
Section 7031.5 by my applicant for a permit subjects the applicant to a civil penalty of APNumber Occupancy N NumbT
act man Nan five hundred dellara(M). P Y YPe
1,u awnv of ttie property,a my employee with wages u Heir sok rempewJon,
via do N^vort,and Ne he Carbonates
ar o not in¢nGA ar one mo snot a(Sly.an as Buuw
and property
h bus coda:The cnnuarsom License Law dons not apply f an owner of Required Inspections
property wha Wilds mimpnvea h impr,and arms dousfh wank nimsslfer darmah formlehf.
ow em.dyeulding.d Natversim lmmmrnuan not icanndedmmQCnd fonak.lf. ,
however,Nebuilding u WpromvingthatwithinoneywormmpkdagNeawnv-
Wildm will have drc burden of paving that he did rot build or improv for purpose of
sale.).
❑1.as ow.of Ne property.am exclusively concaving with licensed ronsnnan to
mnstrocs Ne project(Sec.7044,Buskeu aha Prefeadmer Cade:)The Coou,cmr,u-
.Law does not apply to an owner of property who Wild,at improves ft..and.
who contracts for such projects with a conuamor(s)licensed pursuant to ttr Canvavo's
Iseuelsw.
I ore exrmps undo Ss ,B&PC for this recon
water Dan
WORKERS COMPENSATION DECLARATION
I hereby affirm under Pensiry of perjury aro of the following declarations:
❑.lyre andwie forbynatitm 370 of one ato self-;for ft Wurkcfsce of ft
anion, r provided for by Section 3700 of tK Labor Cade.far dto per(amurce of Ne
work for which this permit k issued.
I have and will maintain Workeh Compensation Ifurvue,as ro uirml by Section
3700 of the Labor Cods,for the performance of that work for which this Permit i,issued. '
My WorkeYs Comp. Ca oImar"" "v and Policy mk�rsbyyv are:
Carrier. Polity No.:-,e!MU/ J
CERTIFICATE OF and
FROM WORKERS'
COMPENSATION INSURANCE
Mir sceden need trot W completed if IW permit is forcechund ed dollars(5100)
err len)
I Certify that in the performance of the work for which this permit is issued.I,IWI am
employ any person in any manrcran as ba become mbject to the Wmrkerf Comp meader .
Laws of California.Date
APplicam
NOTICE TO APPLICANT:If,after making Nb Cenirtento of Exemption,you should
become subject to Ne Worker's Compewtion provisions of ted Isbm Cod,.you most
.,O fnMwidt comply with such provisions or NU Rm!itmall W deemed revoked.
'Z y CONSTRUCTION LENDING AGENCY '
'rt Ihereby-M—Nat then is amostrucunn lending agency,fm the pe,facome,of -
f� Ne wrk for which this permit B issued(Sm.3097,Civ.C.)
�W Q Lambe.Name '
Z z lender',Address
V Q 1-reify that I have mad tiffs applicadan aha sun Nu f above information I,
If, Correct-1 agree to comply with all city and County ordinances aha auto laws relating to `
.0 building construction.aha hereby authmim mpraemativex aides city to enter upon thr
W shove-menudgm propenY fors cperuf which may
G (We)agme to Can.indemnify and keep tombless the City of Cupertino against
CA incoise;lWgm fIli,Costs;and ef%I,liwhich maY in any way severe ag,lw said City
V z mconsegfnce of the gnnung of%I,limit.
APPLT NDERSfAND flD WILL COMPLY WITH ALL NON-POINT Issued by: Date � Pci-=--y
SOU RE Th 1 V � ,�
'�/,T./ Re-roofs
S�uamsEo(ApphcanUCon
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Jan applicant s m futon Wading emupant r9 1 or haed1C Heardou material
u ds0Sed Section
ted Cupenim mipal Calc.Chapter 9.11,and the HVIN and Safety
code. on z5532(a)7
Yf All roofs shall be inspected prior to any roofing material being installed.
o
Will the applicant ortutom Willing occupant sex equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
arsine TasCnf vu air CmminanIs leaned by Ore Bay Ana Air Quality Management all new materials for inspection.
El yes `Xp{�a
I have mad the harvmus' mveriab reyuinmmts under Chapxr6.95ofNeCalifor-
nkHm�C�� aataaxxac.r.
15533 md15534.I unJcrvand Nasifthe Wilding
Jas atamy rnspofNility to Iwtify de occup,m of theeora cenira ar Signature of Applicant Date
owne oraathcdmdagrnt Y D,to' All roof coverings to be Class'1r'or better
CITY OF CUPERTINO
• 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 359 11 020
DATE ISSUED. . . . . . . : 05/20/2008
RECEIPT # . . . . . . . . . : BS000004842
REFERENCE ID # . . . : 08050158
SITE ADDRESS . . . . . : 20609 SHELLY DR
SUBDIVISION ... . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HUNG CHEN
ADDRESS . . . . . . . . . . : 20609 SHELLY DRIVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ATLAS-TRILLO
CONTRACTOR TRILLO, STEVE LIC # 4269
COMPANY . . . . . . . . . . : ATLAS-TRILLO HVAC
ADDRESS 1965 KYLE' PARK CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
• TELEPHONE . . . . . . . . : (408) 286-8931 .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 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
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 286 . 34 0 . 00 286 . 34 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
0605 0l 59
CITY OF CUPERTINO
FURNACE/AC
CITY OF
�CUPERTINO PERMIT APPLICATION FORM
0
APN # Date:
359 1 o � 0 , 0 5-20-0�--
Building Address:
�o� o q s ��
Owner's Name: 6F Phone#:
4? - d z Z/0
Contractor: Phone#:
Fax #:
Contractor License#: Cupertino Business License#:
64'm-
Contact: Phone#: y—USL G
AktV ����Ly- Fax#:
Building Permit Info:
Elect [ }� Plumb [�_ Mech
Residential Commercial
Job Description:
e—
For Residential Installations:
Attic ❑ I" floor ❑ 2nd floor ❑
Adhere to minimum setback re uirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
L d v v (Jl
Strapped On Platform Bonded LJ 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.
CITY OF CUPERTINO
S FURNACE/AC
CUPEkTINO 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 InstalI/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.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
J/ heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocateea 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
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES 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
1MECPLNCK Mechanical Plan Check M
I MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, 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/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 1 EPERMITFEE Electric Permit Fee E
IMPERMITFEE Mechanical Permit Fee M
/ 1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
CITY OF CUPERTINO
540-
FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= lOk CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1 PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
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
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
a
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. Ener Star Refrigerator, (Note/Spec.) A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
CD
fin]
0
<
)) <
O
• m
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
.srte
1.Recycle Job Site Construction&Demolition Waste i
�65%=1 point;75%= 2 points;BO°/=4 points - - up to 4 Resource pts 0
2.Salvage Reusable Building Materials 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
B.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
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=yes 0
3,Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
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
B.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 p
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 Use0S8 -------�
• a.Subfloors 1 Resource pt y=yes 0
L b.Sheathing 1 Resource of y=yes 0
. xtenor ims
INPUT Resources Energy IAQ]Health
Fl.Use Sustainable Decking MaCennls
Ja.Recycled content f 3,Resource pts y=yesF 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic I 1 IAQ/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
E.Plumbing
1.Install Water Heater Jacket 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts Y_—Yes 0
3.Retrofit all Faucets and Showerheads with Flow Reducers
a.Faucets(i 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 Filter on Showerhead 1 IAQ/Health pt y=yes 0
S.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
1 1 1
r.tiecmcai
1.Install Compact Fluorescent Light Bulbs(CFLs)
I(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy LLLCM
•
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up l0 4 points) Up to 4 Energy
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.lnstall 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
LtalfRecycled-Content,Fiberglass Insulation with
Added Formaldehyde 31AQ/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 0
I).uemngs 4 Resource pts y=yes 0
1 1
INPUT ReSDurces Energy IA011-lealth
ndows
• f1.Install Energy-Effcient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
Lc_Low.Conductivity Frames _ 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pl y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning -
1.Use Duct Mastic on All Duct Joints — � 2 Energy pts y=yes 0
_J
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
B.-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 3lAO/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 stovesfinserts 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 pis 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--yes p
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 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 Radiani Barner 3 Energy pts y=yes 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 p
• 1 1 1
M. n oor a Quality an mashes INPUT Resources Energy IAQ/Health
rf.Use Low NO-VOC Paint 1 1 IAO/Health pts y=yes 0 •
L'---- — ----'
2.Use Low VOC,Water-Based Wood_Finishes 2 AQ/Health pts y--yes 0
Use Low/No VOC Adhesives 3 IAQ/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 61AQ/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 y=yes 0
8,Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger=JJointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 31A0 Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes0
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 IAO/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pis y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1
Total Points Available: 1401 1301 57 •
Total Points Project Received: 01 01 0
G:datalpmgslgreenbuildingguidelineslremodelersigreenpointsf na1272.04paeded.xls
•
Community Development
J
Cupertino CA 95014
' Telephone(408) 777-3228
CITY OF Fax(408)777-3333
GLUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
20bv Skelf - 0&bS()(��
OWNER'S NAME: kg-kt awl PHONE # NNG
GENERAL CONTRACTOR: FAX #
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
40 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
,S 0
Owner on ignature Date