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08090115 CITYOF CUPERTINO �-;* 9v2 .r'� �' " '^^ •' s au,LD:NG DIVISION PE MIT MCOIV RACTOR IN.FQR�A'1AT ON,i PERMIT NO. B "T11'VT"?6RKSHIRE CT ALL SEASONS ROOFING SERVICES 08090115 OW NER'S�NAIME; PERMIT ISSUE DATE SIMON CHEN 1720 SMITH AVE 09/17/2008 NE; SANITARY NO. CONTROL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO RE—RF RMV EXT SHKRF& INSTL BLDG ELECT PLUMB MECH 0 0 0 0 uao LICENSED CONTRACTORS DECLARATION uf� I heathy affirm that 1 am IReream under provisions of Chapter 9(commencing ""—'' ' '^'^"" ^^""^ " ^^.Jc9b•DC.SfFIPUOn ZZ with Section 7")of Division 3 of me Business and Professions Cade.aed my license is ^?ut ld foil forme am cnect Q ,LIZ Licease Class L'e. q Dow o/l7l ei A—Conoacwr0 n�W ARCHI'IECPS DECLARATION S�yIACC 7 1 uMeraaml my p Wu YWI W used u public mentis :au c 4a C; Licensed Professional OWNER-BUILDER DECLARATION s� f i hereby affirm that 1 em caempt from the Contractors L iconse Law for the OO following mason.(Section 703 L5,Business and Profusinm Code:Any city or county 1 3 Vs which requires a permit to construct.sher,improve,demolish,or repair any structure prior u,its issuance.also nufims the applicant for such permit to Rte a signed nammenl ma he is licensed pursuant to the provision of the Contractor's bice.law(Cheper 9 Sq.Ft. Floor Area Valuation (commencing with Section 7000)of Division 3 of the Burins and Profcuinm Cade)or $ that he u commit therefrom and the basis for the alleged exemption.Any violation of Smion 7031.5 by try applicant for a Permit sobjccss the,applicant to a civil Penury of APN Number Occas not more Nan Ron ane hundred dollars($50y. Occupancy Type I,as ormer of the P.P.M.or my eroployees with wages as their vele compeasNnn, will do the work,and Ne structure Is ml Inumded or offered for sale(Sec.7044.Business and Prefeadoes Cade:The Contractors License Law doss ml apply to an owner of Required Inspections property who builds or improves Hereon,and who does such work himself or Nmugh his own emplayces,provided Na such improvements art not imended oroRecd forsale.if. however,the building or wpromnenl Is mid within one yea of complems.the,owner- builder will have the wNcn of proving that he did not build or improve for purport of sam.). ❑I.as wrcr of do property.w reclusively contracting with Beeased mntracmn m mmtruct the project(Sec 70M,Bminm am Professions Cade:)The ConuaebYs U. . cense law does not apply to an owner of property who builds or improves thereon,and who convects for such pmjcm with a cowascum(s)licensed pursuant to the Contractors License law. Cj lanecomplunderSee ,B&PCformhreasm Owner Date WORKER'S COMPENSATION DECLARATION I hereby alarm under penalty of perjury ono of the following declaaions: 1 hive and will maintain aCertifiare of Consent an self-mmon for workers Ccmprn cation,as Provided for by Section 3700 of than Isbor Code.for the p donne a of do work for which this permit is issued. C]I have ad will maintain Workers Compeasation Laurance,u nydred by Section 37M of the Labor Codc,for the performance of the work for which mu pewit is issued. My Workers ^` /n� Nsurmce canter and Polity nu bcr/a�rt: '7 /� '7 Carafe. A,e'�iC.. Policy No.- 66 o. sT ante) o(0-3/ `" CEBfIF1UtE OF E)(EMFr10N FROM WORKERS' COMPENSATION INSURANCE (ITh action need rot W compkked if me permit Is fame hmdmdeBan(SIM) orkx) 1 certify that in the performance of the work for which this pewit is bound.1 shall nor employ any person in any manoerm u b become subject to the Worsen'Compensation U..[California.Date Appliam NOTICE TO APPLICANT:If.after making Nis Ccnifieam of Exemption,you should become mbj=b the Workers Compensation provisions of the labor Code,you most .,O forthwith comply with such provisions or this permit shall w Ccemed rooked. .'za 0 CONSTRUCTION LENDING AGENCY - F+ 1 herby aRrm that then is a cum,lending agency for the performs c of ai tic work for which this permit Is issued(Sce.3097.Cat.C.) �W Q Lenders Name 0 z Lenders Address U 0 1 certify that I have read Ws application am sera that the:above information h V, ^. creme,I agree m comply with all city and county ordinances and stake laws renting m 0 SV^ building construction,and herby authorise rtpamenmadim of dew city to emerupon tic ahose.menudgm Judgments. coy for inspection Purpowhich ms Hy (We)agree to save,indemnify and keep harmless the City of Copwino agtiasl CA liabilitiesJme,ofta.eoataand of thisaswhieh mey in any way steric against sod City U'� in coasequence of tic granting of this pewit ' APPLICANT UND STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ���`� �/' SOU¢CE ;ULA ONS. /' �17eloa 74I fYLl/J � ZRe-roofs Stgnatmd of AppliaHAZA DO r D.m HAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will ft applicant or future ubuildingoccupanttrt store headmcrisi ousat ss defined by Ne Cupcnim Municipal Cede.Chapter r 9.13, Ne Health asd Safety Code.se Z532(.)?s32(.)7 ❑y. C&'o All roofs shall be inspected prior to any roofing material being installed, Yu wall me applicant or future wilding occulsom one equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove haaardous ata eanamimmus.kr,..d by Ne Bay Area Air Quality Management all new materials for inspection. ❑Yo /No I have mal me hawdousmauriaismquimmmaunderC per6.95 ofthe Celifor. rite Hcalthd:Safny Coe.Seeuoru25F35.75533 and Vi5M.1 understand t aifNc wilding doss not curmnnly here a comp,man II h my mapourNlily m nW r,use acu,am of me nulmrors which Calx reel pimmiaaalce oft Certificate of acvPanmy. Signature of Applicant Date owner uthedvedagmt [ eke' All roof coverings to be Class'1�"or better CITY OF CUPERTINO • 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : TWp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36211008. 00 DATE ISSUED. . . . . . . : 09/17/2008 RECEIPT # . . . . . . . . . : BS000006117 REFERENCE ID # . . . : 08090115 SITE ADDRESS . . . . . : 1191 YORKSHIRE CT SUBDIVISION . . . . . . : CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SIMON CHEN ADDRESS . . . . . . . . . . : 1191 YORKSHIRE CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4967 RECEIVED FROM . . . . : ALL SEASONS ROOFING . CONTRACTOR . . . . . . . : GORSHTEIN, VLADISLAV LIC # 21035 COMPANY . . . . . . . . . . : ALL SEASONS ROOFING SERVICES ADDRESS . . . . . . . . . . : 1720 SMITH AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 971-4455 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 28, 000 . 00 2 . 80 0 . 00 2 . 80 0 . 00 1REROOFRES SQ FEET 42 . 00 546 . 00 0 . 00 546 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 548 . 80 0 . 00 548 . 80 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • of(, q � �! CITY OF CUPERTINO SON- REROOF CITPOP CUPERTINO PERMIT APPLICATION APN#2 i A/ ` v U F D Date: Building Address: \r'1� dock 5 of o Owner's Name: Phone #: Contractor: Phone #: a\-t l -�I�-t5 5' \\ Ser�so�\S (L�orrnj ��P�c-v�OGS Fax #: Cupertino Business License #: Contractor License #: a\o3s Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles X Wood Shakes ❑ Wood Shakes • ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) Other(Specify)'Me=\c,\ T�\e- Number of existing coverings ❑ Provide I.C.B.O. Report# FS(L 15N To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: N-tom \ \ ua8 0eiGClV( 1\e. � 1C �Innearn\ � �' leivoto, .N 'Elie. /&- 6q Residential '�< Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if 'there are any restrictions: El applicable, include in plan set & the sheet index. Valuation: ,, �L$I OO O I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 6/16/08 . Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 • Fax: (408) 777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City, the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nail inspection is required. 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The reinspection fee must be paid before another inspection can be scheduled IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: W,,� Job Site Address: \-(C;-C \1�_5\n�� p C7°C 1 ���\• Nc� Roofing Company Name: /fes\ Applicant's Signature: it ! - Date:, • Greg Casteel Building Official c Revised 11/2/04 A CITY OF CUPERTINO REROOF �PEOF RTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2 1RER00FRES Re-roof Residential B 1SFDWLROOF IBSEISMICRE Seismic Residential B IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 • CITY OF CUPERTINO �' REROOF CITY OF CUPEkTINO PERMIT APPLICATION APN # Date: Building Address: Owner's Name: Phone #: Contractor: Phone #: Fax#: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Residential H Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: • Signature Revised 6/16/08 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 4 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 ooints 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 1oint P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS 40 points • 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. A.Site 1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;BD%=4 points up to 4 Resource pts 0 12.Salvage Reusable Building Materials 4 Resource pts yeses 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 i8.Design Aesource-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 D ! i 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 LL 2.Use Recycled Content Aggregate 2 Resource pts y=yes 3.Insulate Foundation/Slab before backfill 3 Energy pts. y=yes t C.Structural Frame rSubstitute 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. D . 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 1 Resource pt y=yes 0 • J.Sheathing 1 Resource pt y=yes 0 D.Eztenor Frmsh -1.Use Sustainable Decking Materials a.Recycled content 3 Resource pts y=yes 0 • b.FSC Certified Wood 3 Resource pts y--yes 0 I2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y=yes 0 3.Install House Wrap under Siding 1 IAO/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 13.Retrofit all Faucets and Showerheads with Flow Reducers a.Faucets(1 point each,up to 2.points) Up to 2 Resource pts. 0 It.Showerheadspo' each,1 int u ( p to 2 points) Up to 2 Resource pts. 0 14.Replace Toilest with Ultra-Low Flush Toilets I(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 D 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 1 f ! r.tiecmcai 11.Install Compact Fluorescent Light Bulbs(CFLs) (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 1.IIn-still-En ergy Star Dishwasher 1 Energy pt y=yes 0 12.Install Washing Machine with Water and Energy Conservation Features 1 Energy pt y=yes 0 3.Inslall 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 13.Install Recycled-Content,Fiberglass Insulation with iNo 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.Colinas 4 Resource pts y=yes 0 • 6.Alternative Insulation Products(Cotton,spray-foam) a.Walls 4 Resource pts y=yes 0 b.ceilings 4 Resource pts y=yes 0 1 f 1 INPUT FeSDUMeS Energy M01ilealth I.Windows 1.Install Energy-Efficient Windows a.Double-Paned _ 1 Energy pt y--yesD b.Low-Emissivity(Low-E) 2 Energy pts Y--yes0 c.Low.Conductivity Frames 2 Energy pts Y--yes0 2.Install Low Heat Transmission Glazing 1 Energy of y=yes D 1 f 1 J.Heating Ventilation and Air Conditioning , 1.Use Dud Mastic on All Duct Joints 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 IAQlHealth pt 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 0 B.Install Sealed Combustion Units a.Furnaces 31AQ/Health pts y=yes 0 b.Water Heaters 3 IAQ/Haalth pts y=yes 0 9.Replace Wall-Mounted Electric and Gas Heaters with Through-the-Wall Heat Pumps 3 Energy pts y=yes D 10.Install 13 SEERM 1 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 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/Heallh 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 0 1 I f K.Renewable Energy and Roofing 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=16 points) Up to 16 Energy pts p �6.Select Safe and Durable Roofing Materials _ _ 1 Resource pt y=yes 0 7.InstalhRadiant-Barrier - - 3 Energy pts y=yes p L.Natural Heating and Cooling 1.Incorporate Passive Solar Heating 5 Energy pts y=yes p 2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 1 1 • INPUT Resoumes Energy 1ADIHealth M.Fn-LM a Quality and Finisfies '1.Use L6w/N6NbC'Paint - 1 IAQ/Health pts y=yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 • 13.Use Low/No VOC Adhesives 31AO/Health pts y--yes 0 4.Use Salvaged Mate als for Interior Finishes 3 Resource pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61A0/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 IAO/Health pts y=yes 0 8.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 IAQ/Health pts y=yes D 1 { ! N.Flooring 1.Select FSC Certified Wood Flooring 8 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 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts --yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes D 1 ! t Total Points A 1 1401 130 57 Total Points Project R 1 01 01 0 • G:datalprogsrgreenbuildingguidelinesiremodelersrgreenpointstinai2.12.04pmtectedxls • 4YOF Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 Fax(408)777-3333 4JUPEkTINO Building Department JOB ADDRESS: PERMIT# 11 S -t �- o\� 'rte c e'Y--iHO D� U °/ o OWNER'S NAME: SSV,, PHONE # GENERAL CONTRACTOR: /1FAX# Seruice4 I am not using any subcontractors: (9//,7 O Signature Date Please check applicable subcontractors and complete the following information 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