08070235 (2) CITY OF CUPERTINO
BUILDINGDIVISIoi% PERMITWIMACTQRiIATr'ORMATION
BUIL INQADDRESS: PERMIT NO.
037.4 17 ESTATES DR JACK MYERS CONSTRUCTION 08070235
OWNER'S NAME: PERMIT ISSUE DATE
N CHWEN—HAO AND JEAN L 27610 NATOMA RD -07/31/2008
NE: -
(408) 761-1185 SANITARY NO, CONTROL NO.
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0
u00 LICENSED CONTRACTOR'S DECLARATION Job Description
4 U F 1 hemby affirm that,1 sac li¢nxd I under provisions of Chapter 9(commencing P
withSecdan]INIB)ofDivisan3ofdmBusineasand Professions Code,lrryli=e . POOL DEMO & BKFILL
p H in full force and cffas
jLj? License Clan Lk.0
ntDContractor
- Dam-
ARCHITECTS DECLARATION
a I uMmmmol my plans shall be used u public accords
6
s a
Licensed Professional
OWNER-BUILDER
rm the Contractor's ATON
COC I hcmby.(Bete on 11. eacmpt from the ssionsCut License city
o for the
COC fallowing firma.(Section]o LA ct,ober, and w,de am Code:Any city ser county
$ which requiresne.also
mcnres;thepier,improve,deermiti ore a sig my signed statement_Z< prior m its issuuscc,almnt to the the applicant fm Cch permit miecom sew(Chapter
00 sthahic muctracnsWpurmanuO0G)ofDslome(ft oftheBsacess;ancenselaw(CNpmr9 Sq.Ft.Floor Area Valuation
(commenring with Seeder J000)ofDivuirn]o(the Business;and Refusions Code)or $4600
t;3 that is,u exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any appilmem fIX a permit subjects,Nc applicant m•civil peachy of
tot more man hundred dellas(SSW? 3 6 9 0 7 0 2 0 .�Number Occupancy Type
I,u.of the paoperty,ar my employees with wages as their sole eompetuadon,
will do the work and the structure isnot amended or offered for ase(Sc,.70th,Business
and Pmfeasions Cao:The Contr cus's License Law does on apply in an owner of Required Inspections
property who buf Idl IX impoves tlertmn,and who does such work himxtr or through his
awn employees,provided that such improvements me net intended oroffered forsale-If.
however.Ne building or improvement issold within one year acompletion,the owner.
Wilder will have the burden of proving that he did rot build or Improve for purpose of
sale.).
❑1.as owner of the property,am eaeluaively contracting with licensed contractors to
construct the project(Sec.7064,Business and Professions Code:)Th Committees V-
cesse law dots not apply to an owner of property who bdlds or improves tkmon,and,
who contracts for such pmjems with aeoretrsstor(s)licemeed pursuant In the CansrectaYs
Licenx Cao.
❑lam eacmpt undo See .Bk PCf
Owner '
R' AP D N
by aRrm under Penalty of perjury an ache fallowing Bala sum nc
I hswandwill entl ahea Cerd!roof Cememmself-insu eforWorkee.Compen-
amen,as provided for by Scotian 370 of the labor Code,for Ne penumtmco aft
wort far which this permit is iauM
rl I have sod will mainteln Wereces Compensation Insurance,u required by Section
37W of the Labor Cade.(ser the performance of Ne work for which this permit is issued.
My Wmk s Compensation Imuamx aroused Policy number mi:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section recd not be cwnplced if tie permit is formic hundred dogam(SIM)
or ksa)
I certify Nat in the performance of site weds for which this Permit MipsshWI not
employ any person in any crs m c 'etre tieW SYfn pereadmi
Laws of CalifOmia.Dalai
t .
Appliant
NOTICE TO A f.afro cortin a y' of Eae p,. V? m dd
become subject m he Weds Camperaition provisio sof de Labor Code,yea in
.J O forthwith comply with such provisions or Nu permit me]be deemed revoked.
Py CONSTRUCTION LENDING AGENCY
(-sIhereby-111.that tine is a construction lending agency for the performance of
Uj r7 titre work for which this permit it issued(See.3097,Civ.C.)
0 Lender's Name .
D z Lenders Address
UO 1 certify Nat 1 lave read Nis applicais the den and sum toll above inlmmatiu
un
IL ^ correct.I agree m comply with all city and county ao it estcra,and maaws lrelating m
C)lr.'/ building construction.and hereby auNoria repexnadoes of Nu city to can,upno Ne
W above-mentioned property(or inspection purposes.
❑, (We)agree la ave.Indcmmify and keep herreless We City of Cupeniro against '
rn liabilities,judgment.cosy and cape•..at which may in any way accrue against aid City
U z in consequence of the$.drag athis permit.
'-"
APPLICANTUNDERSTANDS AND W CO h PLY WITH NON-POINT Issued by: Date
SOURCE R=S.
sgnam�etapSGf
ornament
Re-roofs /
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Witl Ne apple.,or future building acupantaom or handle hvardoos mamrul
as*11ned by the Copeman Municipal Code,Chapter 9.12.and the Health and Safety
caM.scalar 25632(.)7 All roofs shall be inspected prior to an roofing material beim
❑res }�Ne P P Y g g installed.
(` If a roof is installed without first obtainingan inspection,I agree to remove
Will Ute applicant or tort building acovpant use equipment m devices;which P g
OIL ha2ux air contaminants as darcd by ft Bay Area Air Quality Management all new materials for inspection.
District] ` J P
Y. Nu
I brevefial the h>aaLiu e9ubcmemsundcr Chaperb.95 aft Califor-
niaHcalthkSafnyCodc.Sasions25S05,25533 and 25534.I anderaund good the building
docs not curendy have a count,then it u my responsibility m naif pmt of de
requirements which muu bu met pd m issuata of a Ccrolic ary.
a Signature of Applicant Date
r vcda Dam All roof coverings to be Class'%}"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . : 36907020 . 00
DATE ISSUED. . . . . . . : 07/31/2008
RECEIPT # . . . . . . . . . : BS000005647
REFERENCE ID # . . . : 08070235
SITE ADDRESS . . . . . : 10324 E ESTATES DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LIN CHWEN-HAO AND JEAN L
ADDRESS 10324 E ESTATES DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3305
RECEIVED FROM . . . . : CHWEN HAO F LIN
CONTRACTOR . . . . . . . : JACK MYERS LIC # 24312
COMPANY . . . . . . . . . . : JACK MYERS CONSTRUCTION
ADDRESS . . . . . . . . . . : 27610 NATOMA RD
CITY/STATE/ZIP . . . : LOS ALTOS HILLS, CA 94022
TELEPHONE (408) 761-1185
FEE ID UNIT QUANTITY AMOUNT ' PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 4, 600 . 00 0 . 50 0 . 00 • 0 . 50 0 . 00
1DEMOPRE SQUARE FEET 0 . 00 490 . 00 0 . 00 490 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 490 . 50 0 . 00 490 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 490 . 50 VISA
---------------
TOTAL RECEIPT 490. 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
CITY OF CUPERTINO
" DEMO
0 CUPERTINO PERMIT APPLICATION FORM
APN# 30 -07 -02 D ! 0O Date: 7-31- 2000
Building Address:
032 4- e ►�t44 qqqL+
Mailing Address Cif different from building address):
Ow,nyr's Name: bri, Phone:�6s° 823 -684 ce 1 ✓
Contractor: ,p pr Phone :(+go 761 — 118�
� Ivlv_ e� C�/�B'lz5 VYuGv VK/ Fax:
Contractor License #: /3 * O
Cupertino Business License #: (� 02
Contact: Phone:
Fax:
Residential Sq Footage Commercial ❑ Sq Footage
Job Description: DD r
( l QC
�RE::
Valuation: D 00 _
Project Size: Express Lll�Standard ❑ Large ❑ Major ❑
Please complete relevant portions of the Green Building Checklist & attach it to the application
or if applicable, include on the plan set & the sheet index.
ZQuantityFee ID Fee Description Fee Group Permit Type
1DEMORES Demo-Residential B 1SFDWL-DEM
DEMOPRES Pool Demo Residential B 1SFPOOL-DEM
BSEISMICRE Seismic Residential B
Revised 6/16/08
Zan
CITY OF CUPERTINO
DEMO
Of
CUPE(ZTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group Permit Type
1DEMOCOM Demo-Commercial B 1COMML-DEM
1DEMOPCOM Pool Demo Commercial B 1CPOOL-DEM
1BSEISMICOM Seismic Commercial B
IBUSLIC Business License B
•
•
Revised 6/16/08
Single Family GreenPoint Checklist date: ^ 3« ,C� Suitd ft Grnii
P4�`J f ,(xryy rc,
The GreenPoint Checklist Is hosed on the various green features incoryoreted into the dome and is the
• basis for the GreenPoint Rated program.A home on be considered green If h f rfifis the prerequisites,
eams at least 50 points,and meets the minimum points per category:Energy(30),Indoor Nr Oual'dyf
Health(5),Resources(6),and Water(9).Please conoid Budd It Green for a dais of qualified GreenPoint
Raters if you are Interested In pursuing thir"arly verification.
Tree;leen huilJino pradhI s ii:lec below are described in the New Home Conslmdion Green Building
rxi:delines available aM»w bnidltoreen one
F.11111 I F-F% PROJECT NAME
mogul
A.SITE ,.. _ :,.
._I u ^",i. '" .tPdinteAvadeble'Per Meaaai'e' '.':
1.Prada Topreal and Mlnlmaa Damption d Eaanng Plants&Tract
a.Rota Topsoil ban Enamor and Reuse after CaaNtllon a 1 ( I 1 1
b.Llml end DMteat Construction FootpMt lar Mazamum PMaudan
2 De..."d moats of Demolishing Edaep earlier,On area 0 i 3 1
I Reryca Jab Stu Conabucaan Waste(Including grown Wata)
a.MInimum M Manor Oianim by Mohr(Recycaa,or Reun)47eqlnb 0 ! R
b.Maarum0%(Nvasnn by Weims Recreant,or Rouse) 0 —_. �
c.Wnlmum BJ%bursas by Wright(Recycles or Ranee) .._0
a Wa R.,.W Content Aggrap to(Mlnbnum a%)
a.Wdarey W OMsxey 0 r 1
Ir,Rndaay arae —D --t----'---i_.1_.._____.
1
Tad Point Avamh6 on Site 1: 0
B.FOUNDATION :poinla Avalfabla Pdy Measure'.+
1.Rept.Portland Comm In Carinal arkr RacyaN Rush or are --
I.MaNum 20%Flush a Sip 0 1 1
a,Maimmn B%Flysh a$tp O
L U.FrsLRatctd shrew Foundation in Card Ansa(C.EC.Camara Zom 16) p
i 3
].U.Radon Rnlasnt CaOaWalOa(In AbRIaA LouDom Onlp 0
• A Design and fluid atruclur hal Coneoa
a,lease Tamale Shleds&Stant N Easels Ns "meets Connealons by Abd Is Pasic FestmnDNden D
...___ ._.._.....__l._1..__..
b.N Now Went Haw Trunk,Bass,arSon LmWNlesl3alMwtorn Foundation D —}--
Total Pnaa Aveeable N Fotaduan-8 D
C.LANDSCAPING.
� yt :P
t.c.ma . Mntlsnaa dlnfn'Aveilable Per Measure`:'-::>�•
N.W Inales Spades Ldetl by C KAre Reread 0
b.fk Pant Spmbs We Require Nadgh
c.75%ol RantM DroupNwWennl Wltomt Nares,Medllemnesn,orONm ApaopMb Sprls
L U.FIwIfora Landscaping Techniques D
1.Mlnmtra Tod Ass In LanN.pa Insisted by funds,
a.N Turf We Its.a Walter Requirement Lou Nan a Equal a Tal Fesarf0z plantbdad0 u
b.Tr SMF Not Be Insisted onSbpes Eaaedhg l0%aIs,Araa lees acne Fed Coke _..1-------- _...
c.Tud 433%at LardArea ltd 2poles) —� ----_ I_..__• _._ _2_
s.pb
0 (
d.Tad aI m Leadsogd Ana ltd 4 Onto) D
avant snag Tana D
&Group Pants by Water NeMa(Hyd.nlnp) p 1
2
&Insall HIghERrary lMpalon ayatrna
a.Spam Una Only L Fbw Drip,Bubbbn,a.o Spreaders D 1
b:seam qua smart corootn —0.... ._.__1..._.e...._....}_......y..?.... .
3
T.lncospena iw Inches at Cempoat In ftTop P W 12lncMa at soli D 3
a.duan NI Panning Bad to tic Groats,of 2lnclra or Lor Water Ordlmn.RapulewM 0 2
e.Ues0%Badged on ResyabCOMmastronautastronautfar 50%of NonPaM Leri".Fbmant
1a R5bu.UpM PoOutiaa
an by ahNlolp HdurennNr 01.0,Llgbt Dwward D
Taal Palms Avahae In Landscaping 31 D
D.STRUCTURAL FRAME&BUILDING ENVELOPE;.,,_ i 7d- -
-%i. 'pr;p °;;1 It .? _:.:• I5! •%PoInlsAvallable Per Measure r;"�:':
1,Apply optional truss Enphmamp
Ir.Pan Rahn W Ston at 24-Irur On Canter Framing 0 r I 1 1
•
Is.Ste DsrW wlMw Haase,of Lod
...__.,
c.
use OMy Joni W Cripple Sbtls Reath fa Load
Z Un Engin rood Lumber
a.Beams ab Habeas
Is.Iwdnled Enoneered Hebn ......._. _...._i.__. _.. . .. .........!..-....
� c.wood l.bbaaweb rneses MFtoas 'D i J
0 2007 Build It Green Single Family GreenPolnt Checkist 2007 Verden Page 1 of 7
s e
tl.Wootl hbhnbPmlRaMn p I I 1 •
ENTER PROJECT NAME
a.EngbaWetlWFeyaJo'udad SOW bVONoI PPpeutlona p 1 I__
f.Ol SOad BwNb SubAoor
g.Or6aetl Strut BoaNbWY eM Rool SOplOing p � ] •-
].
U.FSOCarM.d Wood
a.OFwns Lumbar,SOW and Tmber.\gN lO% a
b.Oimwiwbnel Iu .SOW aM Tfty.b9Nmen 70% 0 2
c.Pawl PmduW:Minimum 40% 0
d.Panel Pm 7M m 7 0 I t
•
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0 2007 Build It Green Single Family GmenPBint Cheddist 2007 Version Page 2 of 7
ENTER PROJECT8
• ♦ux SoIM wa SyeYm.PMuau sire,ICFs,g Anv xaadUck Frmne Aea.meyl .
■ aFl..
.....0_.. .._-_.r.-2 '_..Z......__..
■ b.vasa ....-......----__....�._.._�-. -..
■
C.Roth D 2
S Reduce F.1VUm Entering tli Name horn tit Wnp
■ dTipltly Sxltlw Ak BerM Mteeen Wrepe is lM1vg Nee '
■ b.IUYl Garage Fare,Fan OR Build a OeYdbd Gwap
■ S.Design Enagy Nelson 1..(75%of ANC lnauWoo hlehpMa Outside Ed,M Exledor Wall) 0 i 1
■ T.Dealgn Root Tmaxa Y Aocom.W.1,Duclnork 0 1
■ I.W.ReryGe6Con4nI SIM Sto a for 90%of Inlander Wall Fnming 0 j I
■ 9.Thermal Mau Willa:WrIch Drywall on NI Intsdar WGY or Walls Weighing mon than 0 RAW.R. 0 l I j i
10.MI Oxdunp arM dogma
■ a.IOYMim 161n lh Oxrliys end Guiana 0 ,
■ b.Mbbwm 24rch OvadunOs an4 GuOen
1 ,
TOW Pant AvaYbk In Structural Build,Frame and Exebpo•36 0
Ei EXTERIOR FINISH , .P0166 Avelahle freiUerq... .
■ 1.U.Roro loo onYM(No Virgin PIWodd.r FS6gNOM Wood Detling 0 i
�I 2 �
■ 1 Miall.Rain Screen WMI Syawn 0 2
■ SUx Dunbls and NmoaarrusUble Sidlnp Materials 0 I
■ a.Salad Durable and Noncombustible Roofing MaYdaY 0 1 2
Tole Pdnb Available In Eldodor Bran• 0
F.INSULATION '...:',.. .}. r...p nr :_''i".G
! r •'y,r"'.,1YiJv :_ .. ,polnN Avvlablli Per Measiue.atr;<g .
1.hibY Ya.Won MW 75%RntypW CmteM
a.Wats anchor Roore
■ O.Glbp ....0.. _.._.__�......._._._...._._...I__:..._..
L Install InauYUon that Y Lx Emlllbg(Contend Section 01 Me)
■ a.Walls anchor Poona 0 1
a I ;
SYapMDuaAye,IxaWmInstallation bGa.AauMngDryw.R D
TOW Paas Available b Imdxtlm• 0
G.PLUMBING , ...
. .' - ..•:..'. '....;, . , . . .,':; ' ..• , . .;.:%'Polnld AS%gaDle Per Measuiefar^'.
1.OYWbut,DOmxOc NW Water EfSGanly(MUMum 7 Points)
■ a.Insiders ft Wafer Pipes horn Wader Hxlsr to l0ldin 0 I ( 1
■ b.InWtsY as Not water Pipe
■ a un,EvIraned parad Piping '—'----'__.:_.-----j---,.----i-'i—
D
■ d.Ux Ergkwend Parael Piphq Mm Oenind GonVoled Grmbbm Lapp
■ a.Uu slnobnd Plumbkg Mb Oamand Gerdtltsd Grood on Loop .1------j. 2_
■
I.Uva Carta Can Pbmbkg 0 _..'...
2 h II Only No Efficianry T.IlsY IDuaWivah"M go 0 r 1 1 t 4
TOW Pdnlspvahtse b PYmbtrg•Ina I 0
H.HEATING;VENTILATION
- .. Palriti,A�90a61e Per Maasuiet 3il,!'
■ 1.OMpn and Ystsll NVAC 9yatsm Y ACG Manwl J,0,mtl S RecommaMaUou 0 4 )
Z Inaba&.Intl Combwtlon Unit
■ a.Fumws
b.WeM Haden ..._...___-y__...._.
■ x ImU0I2nxa Hydrant Radlid HMing vnIW Slab Ede Inaalapm D I I I !
■ A lutsll Nigh Elfidnmy Nr Conditioning won En.Irenmantally Rxponalble N.Idgnranta 0 I I I )
S DMgn and Install EfiacUnn.Ductwork _
■ a.In"HVAC Unit eM Dadaark MIMn CoWWW spoor D } 3
__ .__..__._.__..L__. .:.,._.
■ b.U.DW Masi,on All Dud Adna and Seems 0 I .{-_..-....
■ cWm ouddan mdw AtlkWWUon i&vtd oie) 0 1—I—_,1_.___}_. _.
■■
__._ ._...—i.__._...____.r___.._._.d.Pmsun Balanm a.Dalwak system PmYd Dmts Ndng CwWam and clan AS opw beton oppaprey
a
■ SlmYll Nlph E0lGenry"VAC FIIYr(MERV d•) 0 1
■
7.Dart bntati Fireplace or natal Shed Gas Dreptscea MW Efficiency Wong Na Lau Thin deo% 1
Mng CSA SYndvds 0 ,
i
' Llutsll EfiedNaEWwl9yaYmaln SaNrewn+aM ptMu
■ a.IrmYI ENERGY STAR Be0v0om Farm Vented btlw QM1lMe 0
■ O.AS Betlroan Fors MmTlmoror NumbisYl
_._l._„�._�.___._,____..
■ p.Insletl Nknen Range nape vanb0 b m.atw. . .D.:.
9.IrmYII Madinlcel VeMIYUon Syatsm M Cooling(MWmum 1 Points)
■
a.broad ENERGY SEAR GDng Fans b Lief AIY b IMq Ann S9eer no 0 ) ,
■ b.road WMa Hada Fan MW Variable seeds U
0 2007 Build It Green Single Family GrsenPolnt Cheddlst 2007 Version Page 3 of 7
e
"ENTER PROJECT NAME
. -login e S 2
0 c kft..k*cueOaea lntspaba syamn 0 ( Z j 1
In J.Aubma1 • .
llaly Conboha Na —LJ—
IeT Syalem aiN Vaaabb Speed COMB _ 0 j 3 I
10.InahO llwhanipl FmM Mr Ventilation Spbm(M ltnum 7 Pointe)
a.Amita Hoaea V@Wat Sytam that Mwis ASHRAE U.2
b.1rWAb.y diel Eaderyertnit eASHRAE62.2 0 __-�-- 1 1 2 j
11.Imhll Ghon NoretlM Nnm(a) 0 1
TOW Penh AvandeM MeeWO.Vamh4m and Ab ContlOknbq=SO 0
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0 2007 Build It Green Single Family GmenPaba Cherkllst 2007 Velslbn Page 4 at 7
2
,:ENTER PROJECT NAME
.............
• L RENEWAIS:
PoinLv�mls Per Mae u i.,-
■ 1.P�urmb for Soler Hot Water Heating 0
4
■ I Install Solar Water Herfing,Systere 10
0 i 2
t Install Ph.hoiftsl.(PV)Phial.
30%of hada OR 12 W(WW 6 poorer) 0 1 6
■ b.0%Of loldIC IN10(hi OR 2.4M(WW 12 parts) - 0
-
90%el alsofec hood OR 3S W(ntal 18 pb)
6
TOW M.Raleh,Poiner In R..abl.Energy•28 0
J.BUELDrNG PERFORMANCE
-'PIiI66A4wIa"I
1.Efinignoolic Ehniluation.
■ ..House DcI 0
b.House Proune Cwrburtoon Safety Baddooll Tee
D % eer.Me U-arel...15W.,irve 230
.Ign.nd.B.IW High ftft...H.. 0
■ 3.Na...OWIn.ENERGY UM van Indoor Ar Piolug.C.Mcation-Pilot U-1—(ictal e,5 pl.1%;need....nt) 0 5 2
Total Anlatele P,hnti In Wang Porionnounce 1 0
YL FINISHES m .--,P6InIsA IaLle'pivwhourer-'
m 1.D"in Eftyinays to Reduce Triolumal In(Iontealrorto
0
2.Use Ww�VOC or Zer>I00C Paint(litherehum 3 Points)
■ a. w VOC Interne,WaVAIng Prier(450 nol VOCs(Flap w q50 Sol (Nahreii)
to bno- C.Intone,Waffl,Uelkog hints(<i,S4 VMe(AaQ) 0
1 Um I.ow VOC,Vfotrrdssmd Woocl Finlishes(oZ50 Sol VOCs)
0
4.U....VOC Cook eM Cond.d.Mhonshni.(,70 pi VOCs)to,NI ASM.W.
■ S.U*s Recychd6Cphloned Palo
6.U.EvonnormindmIly P,.%.bW etnedon;ho,leraid.,Mon:A)FW4ariffisd Weed,8)Ricialmore,C)Rapldly Rwronoeble,D)lucyck"ontont or
F P,4.inoro
Datinels(5 mh1rourn) 0
■ b.Internet Tm(M Wrinor)
■ c.sinahi,(S minne,urn)
d.Doort(50%kinknuno)
■
Octoderm,(M Mhi.m) -- ----
0
7.ReduceFormuthdolriew In Interior nnierh Sactk,�at=)
■ a.Subfllw&See,Thiredhi(50%Minlroure) 0 t
■ I.❑Ownsets&Coortargo,,g(M uohIr,o,,)
■ aIftmorTrnn(50%MInin%an) 0
L al Sholirthp(M Uhhum --I
t_J
S.Aftor lmtalhtiw of Finish.,Toot of Indoor Ali Shaws F.rroildehycle Lval Q7ppb - 0
Total A"Itigbio Parts in Pnihjhon& 2 0
L FLOORING' 77�t;5 V.
I.Um Enrlmmnenh0y prierman Reeding:A)FSC rlfflrhl Wc4 B)Rectatrood w Re11n4Mq C)Rooldry Ronsonflote,D) E)Eqce,e
C-c.W.RftAdh.IvosN.tMan cWgpjVOCs.
■ a.M*wm%5%ofFWkhm
■ I.henoroon 30%of Floor kaa
--0.--
c.Meo.moflRaa,�
rl.Minimum 75%ofFloorNea
2.Therroolkhoo, Flow Cmdh;Ot1HUhen C"t.n 50%-mmoIC.W Fl.
M.APPLIANCES AND LIG Tolial AbW 0
KTING
.:,. i�� ,�, ,�:!777T7777777T7. Per Measure
1.Instill Merrier!Energy Effloont Dishereohm,
ENERGY STM(Ictio I point) 0
■ b,Doineashor Uses No Mons nen 6.5 GoexisCyolm(towl 2 pha)
2.honee ENERGY STAR Clotho-W--W.l Moohins Mai WiflarF.correfortau
■ a.Meeh Ehogy Shr end CEE TW 2mpubemn4lmodlMdehoRy odor 2.O,WeW Fedor B.Of(WM]po'mb) 0
2
b.■ M��qyS�WCEE�3M�W4(�"W%�22,W�F�4,5��) ,___._...i____
(WW15,dnb) D 2
3.Ineell ENERGY STAR Rarfingerebor
■ a.ENERGY STM Ohmillfloo a•25 Cuej,Fort Cpcky
■ b.ENERGY STM Q.&w A c 20 OoWc Feet Caumny
A Install We Recycling Cinder D
Gul,in Rocyck,Oarre, 2
0 2007 Build It Green Single Farridly GreenPoint Cheddlst 2007 Version Page 5 of 7
...... ... . .. .....
ENTER PROJECT NAME
j b.13.111-0 Cm tng Conlar 0
Total A.&uW Points in Ap*.and Ugh" 1: 0
MOTHER
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02007 Build It Green Single Fornity CgeanPont Cheddist 2007 Version Page 5 of 7
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4.Innovation:List innovative measures that meetthe green building objectives of the Guidelines.Enter up to a Build It Green Che,ld sts and
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right. Gud,lln,�
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�Sumrrfiajry
Total Available Palms in Specific Categories' 42+ 166+ 43+
Minimum Points Required in Specific Categories 9�+
01
Total Points Achieved 0 0 0 1 0 0
Project has not yet met the following recommended minimum requirements:
- Total Project Score of At Least 50 Points
-Required measures:
-93a: 50% waste diversion by weight
-J2: 15%above Title 24
-NI:Incorporate Green Point Rated Checklist into blueprints
-Minimum points in specific categories:
-Energy(30 points)
• -IAQIHealth(5 points)
-Resources(6 points)
-Water(9 points)
•
0 2007 Build It Green Single Farfy Gaanpojnt Cheddat 2007 Version Page 7 of 7
d Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
4VUPEkTINO
Building Department
JO ADDRSS: G5 Q,y'( 010 PERMIT#
OWNER'S NAME: PHnNE #(a0)qz3::i6Zf7 F69)
GENERALCONTRACT PAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following ' o=ation:
60 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/ ontractor Signature ate