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08030182 (2) CITY OF CUPERTINO ar>? msri.ax at jx' > f 7=77- -- ,` BUnAING•DIVISION• PERMIT -`�1.V«L�2A TfT .I1�''MIAROly g�z R p TeT ,at Bm1,g111r FsfiRET AVE ALEXANDER&GALINA PERMIT08030182 OWNER'S NAME: PERhm•ISSUE DATE ALEXANDER&GALINA BELOGOLWSKY 10162 BRET AVE 03/31/2008 E: SANITARY NO. CONTROL NO. ARCHI]EC(ENGINEER: BUILDING PERMIT INFO BLDG EO PLO MEOCH �oLICENSED CONTRACTOR'S DECLARATION Ib Description 1 hereby kDm Nap I we licensed under provisions of Chapter 9(mmOBSCTIp mencinf m wiNSection]IX(f)ofDivision3oftheBusinessandPmfessionsCode,aMmyRceneu MSTR BTHRM RMDL,RPLC FIXTURES, SAM LOC r<� in full(one underfoot. C3 License Class Lk.N 0 Da¢ Corer e ARCHITECTSon DECLARATION L I mo emaml my Pines"I W usW as puhlic records C b p,d License)Professional OWNER-exempt fr DECLARATION C a F I Mchynaso.(Emu on 1 am exempt from the Convenor's License Law for tin C O O which ep myon.(Suction]IDIS,Business and Improve. dolans Cole:Any easy or roomy $jar which nits i ssu a prsmip pro cwmruct aber,Mpmw,h permit or repair any munme 3y Pat In,itsissnsnce,aiw requires thesppin o for Con Permi'm0h asiamJSWemem < that is licensed N)ofDivioneo the oftheBuinessalJcevclaw(Chaptm9 Sq.Ft. Floor Area 8000 Valuation $ (commencing axe pttherefon]anddo, iasisfision rtht alegeinecepton.and Any viCMe)err Nes io ts exempt any and Jct tam for be alleged exception.in Any it Penalty of Semon than five atry red doll fora permit subjects the applicant m a rival pmaity of Number Occupancy e cep mon Nen five bundmd dollars(S50)), 37511037!�� p y�'p 01,uownsofdopmperty,mmymploymwirdma uthekmlecampemdon, will do the work and theswnum isnotimendedmoRemd fmlaie(So..70th,ausitws Required Inspections and Preload..Cade: he Corachaters Llchum Law dm ant apply n an owner or 4 p Property who bu ilds m im prom thereon.and who does such work himaelf ear through his ..play=,provided thstsuch improvements art nap intended mrRered forsake.IF, bummum,the building or imprevemem is mid within arc year of completion,due maner- builder .will hew Jct burden of proving that he did act tabid or improve fm purpose of u I,a owns of the property.am exclusively cmranting with licensed mnuanms m mu]the project(Sec.1044,Business and Pro(esslo s Codc)The ContracWs Li. acres Law dm not apply to an owner of property who builds or hnprom Nenme.cent, IFL'.TJ�TARY JO.—r who mnlncu farsucb prvjeets wird acanpruwKa)liceusedpurwam mJct Conaetars:law. S ��., '-' m eaempp un Lr9 .Bk PCf Los uo \�91J Den 3 3 01KER'SC ENSATION DECLARATION 1 herebyBbm under penalty of perjuryseofJct following dclarations: awknd will maintain,u provided fm by Section 37W of the Labor Code,for the performance of Jct for which Nis permit is issued. erve and will maintain Workers Compensation Torrance,u required by Section f Loe IAbm Cgd,(w Jere performance of Ne work far which thn permit is Issued. mkers Co a Na Imm�nce c d Polity number am:r. =P]I ERTIFIGTE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Cl Chasse an meed not se cmnpleted lips,Permit is fwew hundred dollars(SIM) nrkxLI 1 unify that in the performance of the work for which this Permit is issued,l skull govt cnploy anype weAe myon uAo�uoMe mbjmp m the Woheri Campensadon Laws of " � �y� �%r Applicant NOTICE TO WLICANT.,If,after making thin Cenincale of Exemption,you dioui; bmome .JfoMwithhcomp comply wLoirdc such provision or this permit hall obf thdcee ImAebdm reversed.reversed.odkce,d. zO y ou muse CONSTRUCTION LENDING AGENCY tr y. 1herebyaRnm Nap men is a mpurecure lending agency far the performanceof Cx> Loo work for which tido permit Is isemd(Sec.3077,Civ.C.) A 1<ndc"s Name , z Lenders Admesa U O I cmufy that I haw read this application sed man Lord the above Information is LU corrin.I agree to comply with ail city and county endurancesand mm laws talking in O building convection,and hereby mmodre representatives of this city to enter upon the [i7 abow-mentioned pmperty for inspection purposes. Ly (We)agree to sew,indemnify and keep harmless the City of Cupertino Qaiml IA liabilities.judgmetia,eoss and expenses which may in any way accrue against said City U Z in cousequcace of Lot panting of this Permit ^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCEIV 0. I.ATIONS. 07 sign.aro6 PPRanVCanua� Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will theapplicant ar future building ocupantime,or haMle hazardous mamial u dented by tin Cupertino Municipal Cade.Chapter 9.11.and the Health and Safety Com.Section ss53z(,)7 ❑Yex G{na dK All roofs shall be inspected prior to any roofing material being installed. Will me applicant or future Wilding occupant use equipment or deHas Mich If a roof is installed without first obtaining an inspection,I agree to remove .It husrdnw air contsminants u)dated by the Bay Arta Air QWlly Management all new materials for inspection. ulmicp] C]W. lK I have maJ Jct hvsr rn.tmiols menimments un derChmor6.95oftheCa1ifor- HrxIdh!Safcsy Cod-.Sasiws25505.25S33w 25534.1undemaMthrdifth-Wilding note�yytu�jmly hew a¢nant that its mobility n usury the ommmt of me the whichmuubemet ' pssuvrcofaCcnifna�f/O2cml Signature of Applicant Date O9rarauthorized agent �' Dal All roof coverings to be Class'N'or better CITY OF CUPERTINO • 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 ® Sec: Twp: Rog: Sub: Blk: Lot: APN . . . . . . . . : 37511037 . 00 DATE ISSUED. . . . . . . : 03/31/'2008 RECEIPT #. . . . . . . . . : BS000004314 REFERENCE ID # . . . : 08030182 SITE ADDRESS . . . . . : 10162 BRET AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ALEXANDER&GALINA BELOGOLWSKY ADDRESS . . . . . . . . . . : 10162 BRET AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ALEXANDER BELOGOLOV CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : ALEXANDER&GALINA BELOGOLWSKY ADDRESS . . . . . . . . . . : 10162 BRET AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : • FEE ID UNIT ,QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- - ----- ---- 1BSEISMICR VALUATION 81000. 00 0 .80 0. 00 0. 80 0. 00 e1REMRESBAT SQ FEET 60. 00 429 . 00 0. 00 429 . 00 0. 00 1STPLNCK HOURS 1. 00 122 . 00 0. 00 122 . 00 0. 00 TOTAL PERMIT 551. 80 0. 00 551 . 80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 551 . 80 MC --------------- TOTAL RECEIPT 551 . 80 • b��3 0/ CITY OF CUPERTINO `f (d- ADDITION/REMODEL CUPEI0INO PERMIT APPLICATION FORM APN# 7 0 2 -7 , U U Date: 3 b� uilding Address: 0 i V nJUC OC4 9 &_01ZJ Mailing Address (if different from buildirfg address): Owner's Name: Phone# AAbEA Contractor: �'/ Phone#: SE"" r Fax #: Contractor License#: Cupertino Business License#: Contact: Phone#: Fax #: Building Permit Info: Bldg. EP Elect. ❑ Plumb. ❑ Mech. ❑ Hillside ❑ ob Description: Addition(adding sq footage): What is being remodeled? M AsTir-K 604-00M AFP �rxU s s y�- Lo6gg-E-Loi Remodel Includes Re-Roof: Yes ❑ No ❑ If yes list number of squares Remodel Includes Structural: Yes ❑ No ❑ Square Footage: Addition: Porch: Deck: Garage: Detached Attached Remodel: Kitchen Bath i Other Type of Construction (Usage Class): Occupancy Type: 1 FR, 11FR ❑ 11, 111, V-IHR ❑. 11, 111, 1V V-N 1'7- Valuation: Valuation: `.V Please check this box if the project is a 4i second-story addition ❑ Green Building Check list must be completed and Green Building Points Achieved: . ttached to the plans. *For Office Use Only*** Over-the-Counter ❑ CITY OF CUPERTINO ' ADDITION/REMODEL CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft ADDITIONS 1R3SFDADD PLLONGRNGR Long Range PL Planning/Residential 1R3INSP Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK Dwellings Hillside plan B check 1R3HREINSP Dwellings Hillside B Repeat Inspection 1R3HREPLNC Dwellings Hillside B Re eat Plan Check 1113ALTINSP Dwellings Alternate B Materials Inspection 1R3ALTPLNC Dwellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Disposal System 1PRSEWER Sewers P 1BPSPRINK Lawn Sprinkler/Backflow P 1BPWSVCS Main Water Service P 1BSEISMICRE SeismicResidential B DECKS 1R3SFDADD OR 1R3SFDREM 1DECKWOOD Deck (Wood)-Each B Each 1DECKRAIL Deck Railing-Each B Each O J CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Ft GARAGES 1R3SFDADD OR 1R3SFDREM 1GARDTW<=1K Wood Frame up to B 1,000 SF 1GARDTM<=1K Masonry up to 1,000 SF B BCONSTAXR Construction Tax Res (new detached garage PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 SF B PATIO'S CLOSED 1R3SFDADD OR 1R3SFDREM 1PATIOENCLW Enclosed Wood up to 300 B SF 1PATIOENCLM Enclosed Metal up to 300 B SF 1PATIOENCLO Other Enclosed Patio up B to 300 SF 1COVPORCH Porch Covered-Each B Each 1REROOFRES Residential Re-roof Each B 100 SF REMODELS 1R3SFDREM 1REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan 300 SF check 0 1REMRESBAT Bath Remodel up to 300 B " SF 1 REMREOTH Other Remodel up to 300 B « SF REMODEL PLNCK 1 STPLNCK (1-3 for Standard Plan Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. ® 3 of 3 CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE • Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1 WINREP Replacement windows B ea 8 windows 1 WINNEWNSTR New Window (non- B structural 1 WINMEWSTR New Window(Structural B Shear Wall/Masonry) 1 WINBAYSTR Bay Window (Structural) B SKYLIGHTS 1R3SFDREM 1SKYL<10 SF Skylight less than 10 sf B 1 SKYL>10SF Skylight greater than 10 B sf or structural ]STAIRS Stairs-first flight/ea addt'l B O 1EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P IELCPLNCK Stand Alone Electric Pln E Ck (hourly) 1MECPLNCK Stand Alone Mechanical M Pln Ck hour] 1PLMPLNCK Stand Alone Plumbing P Pln Ck(hourly) / IBSEISMICRE Seismic Residential B / 1TRAVDOC Travel &Documentation B 1BUSLIC Business License B . 4 of 3 9 E L. C G-©GO rlS KY /L,F - T.L ]0162 BRET AVE/LIVE 14A-5'rt/Z b47-9 C'UPKTzrvO�C-A 9so14 ,;� qOF ® r 0` GFT Tz (Z�FLFAr1 � Ex LSTLNG- r w t,2�NG I�IaeeE��S'� TN�- SWIiCM ,, 11H 0C(OPAtVC< • C( C-C F17xvg-e-5 L 1- 0C4T'l0 tJp j®S'���/� TN G CCJP �FR�NQ OgTF pOOFSq�HTyf�i Sl _? NO OR 0/ MAR 31 10 0 AV"set°f � /�q�Of6 dPJ k°Pt Plans On wit/�°n7a theof c7/1a�Paciti�ati Thi /d/a6 D°ut wrid�an�18 and tiMUS; J//q nipin At., Ci n Per alterati un ! ° AD 0 OT ba�h sP/an at�UPartssf°n /r°n anvCpa�e°�ennoj n�oPt b do . n Srata fawr0wsion Community Development %%� •;F,/- - 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 � CITY OF , 1 PEkTINO Fax(408)777-3333 Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; • Construction debris, including dirt, concrete.and paint; ® a Landscaping runoff containing pesticides or weed killers; and Any material dumped or spilled into streets or storm drains The property owner and the contractor share ultimate responsibility for activities occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of the City of Cupertino web site at: htti)://www.cupertino.org/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • Typical construction work hours are: - Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street construction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise levels from complaint site - 65 dBA For more information on noise control, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at httr)://www.amlegal.com/cupertino ca/ • Greg Casteel Building Official 10162- Bpi A-V E-AJVc 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 tham 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 11.Recycle Job Site Construction&Demolition Waste 1.65%=1,point;75%,= 2 points; 30%=4 points. j up to 4 Resource pts 0 i2 Savage Reusable Building Materials 4 Resource pts y--yes D 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 D 5.Minimize Disruption of Existing Plants&Trees 1 Resource pt yryes 0 6.Implement Construction Site Storrnwater Practices 2 Resource pts y=yes 0 7,Protect Water Quality with Landscape Design 2 Resource pts y--yes 0 Lbbesign Resource-Efficient Landscapes andGardens 4 Resource ptsy--yes D 9.Reuse Matedals/Uss 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 Wafer 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=yesl;;F 0 1 1 1 C.Structural Frame 1.Substitute Solid Sawn Lumber with EngineereLumber _ 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 D 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 1 D.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 b.Sheathirig • '- ' 1 Resource pt y=yes 0 er or n s 1.Use Sustainable Decking Materials • a.Recycled content 3 Resource pts y=yes 0 b,FSC Certifed Wood 3 Resource pts y--yes 0 2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAD/Health pt yeses 0 3.Install House Wrap under Siding 1 IAOMealth pt y=yes 0 4.Use Rber-Cament Siding Materiels 1 Resource pt y=yes 0 1 1 1 E.Plumbing 1.Install Water Heater Jackal 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(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 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 IAO/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 IAD/Health pts. 0 8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 r.eiecrncar 1.Install Compact Fluorescent Light Bulbs(CFLs) (6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. 0 O 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 t.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 H.Insulation 1.Upgrade Insulation to Exceed Title 24 Requirements a.Walls 2 Energy pts y=yes 0 b.Ceilings 2 Energy pis 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 0 5.Use Cellulose Insulation a.Walls 4 Resource pts y=yes 0 b.Ceilings 4 Resource pis y=yes 0 6.Altemative Insulation Products(Cotton,spray-foam) a.Walls 4 Resource pts y--yes 0 D.uemngs 4 Resource pis y=yes 0 1 1 1 O INPUT ResDurces Energy 1ADIHealth b Y' n ows 'i'.Install Energy-Effidient Windows • a.Double-Paned 1 Energy pt y=yes D b. Low-Emissivity(Low-E) 2 Energy pts y=yes 0 c.Low.Conductivity Frames _ 2 Energy pts y=yes 0 2.Install Low Heat Transmission Glaiing 1 Energy pt y=yes D • 1 1 1 J.Heating Ventilation and Air Conditioning It Use'15d Ma—stic on All buct Joints _ _ 2 Energy pts y=yes0 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 IAO/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 0 11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0 12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Fumace 2 Energy pts y--yes 0 13,Retrofit Wood Burning Fireplaces • a.Install EPA certified wood stovesrnsens 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(H RV) 5 IAQ/Health pts y=yes 0 17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y--yes 0 I 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 8.Soled Safe and Durable Roofing Materials 1 Resource pt y=yes 0 T.Install Radiant Barrier 3 Energy pts y=yes D 1 1 1 L.Natural Heating and Cooling 1.Incorporate Passive Solar Heating 5 Energy pts y–ryes D 2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=Yes D 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes D 1 1 • • . n oor r ue ry an n s es ' 1.Use Low/ND-VOC Paint 1 IAO/Health pts y--yes 0 2.Use Low VOID,Water-Based Wood Finishes 2 IAO/Health pts y=yas 0 3.Use Low/No VOC Adhesives 31A0/Health pts y--yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts yryes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AO/Hsalth pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Hsalth pts y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAO/Hsalth pts y=yes D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0 10.Install Whole House Vacuum System 3 IAO/Health pts y--yes 0 1 1 t N.Flooring 1.Select FSC Certified Wood Flooring 6 Resource pts y--yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pis y--yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts yryes 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 pts y=yes 0 . 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y--yes D I I 1 Total Points Available] 1 1401 130 57 S Total Points Project Received: 0 .0 0 O • a:date/progsrgreenbuildingguidelineslmmodelenJgmenpolntsfina1212Uprotected.xis 12, E Cu -©Z-0 vsK-Y P- sr 1016'2- 8 P-T A V EN U L P A-57-1 p- 84T)l cup-EF-TI �� / E-Kt,5 -� GFS y Ex LSTTNG- r i w-1 P-1 NG pace eX=SOI ?N4- swr�CN wr.It-I 0etu(f�PfCY � CIP p✓ Z-T(; IY i 1 a1G� L cc� PC ORG 55 PSS I Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 *�UPE�TINO Building De artment JOB ADDRESS: PERMIT# 10162 DCF0 3g/ fi a OWNER'S NAME: (Z� rDF(Z PHONE # 47rOR GENERAL CONTRACTOR: FAX # I am not using any subcontractors: U� 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