08050041 (2) BUILDING DIVISION PERMITQ4� ftrgO3 '�! MI7r NO.v
Buagf�c��(E ESTATES DR BUENTIEMPO ROOFING PER 08050041
OWNER'S NAME: PERMIT ISSUE DATE
CHARLES FU 412 HERSHNER WAY 05/02/2008
lipNE: SANITARY NO. CONTROL NO.
ARcxrrEcrfENCINEFx: RE—MOVE SHAKE ROOF— INSTALL BLDG BUILDING
UIMBO MECH
OO LICENSED CONTRACTOR'S DECLARATION
�U I hereby afrrm Wt l and licenvA anis'provisions of chapo 9(ummcnung -Job-Description
with Section 7")of Division 3 of dm Business and Pmfe>sou Code,aw my Ikons u
InfulmtcemdeffeaC. 3f C' a S4 Z H z
>'qns
: Licee Class L1c
n F q Daec Contractor
W7 (( e ARCHI] Q'$DEC 'RATI
U W dp enunJ• ,s snap 1r:1 as Ise reFosdl
Dl!
s o t'S UccnmdVVPruffasum .1 c
3OWNER-BUILDER DECLARATION
f 1 herehy firm that I am exempt from the Comnnws Lleense Law for the
o following mason.(Seed ]031.5,Businessi and Prat.. as Code:Any city or only
which requires•permit m ceramics,alter,rpm's,demolish.nr repur any swetum
_i y prior to its issuance,the,tequirea the applicant for such permit to rile a signed statement
< dutheisliccesedpmaeanttothe previvoasnfthe Centraewr'aLicenrtlow(Cnapta9 Sq.Ft. Floor Area Valuation
x.° (eommcrwing with Sccdon7two)ofthoision Intone Busincessand Profauimu Cods)"
y`<3 that he B exempt therefrom and the basis fa use alleged aemption My violation of
Schon 7031.5 by my oppllunt for a permit mbjav the aPPl1CLm 1.a civil puulty Of APN Number Occupancy Type
n"mom dean Bre hundred dolt,(SMP Y YP
❑L u wtter elthe ryoprny."mY wployw with wage u the'v ale compewuon,
will do um work.and the,wntm is notmmnded or oRere l foredo(Scc.70tt,Biomass
and Profcs.tions Code:The Comranors Liat os law does Out apply to on owner or Required Inspections
property who tilde an imp rem thermos and who does oath work himself m uueugh his
mwempdoyced,proridcd that such improwe emu an,tmtimewed"offered f"ssla If.
Netnews.the Bolding or improwmertt usodd within ane year Mcompletion.the ownu-
builder will lure the tNra of paring that he did wt build or impmre for purpose of
sole.).
0 1.an owner of but property,,m exclusively Connecting with licensed eonmctun On
construct the pmjen(Sec.7044.Business and Profcaiom Code:)Than CoOvacmri Li.
cove Law does not apply to an owner of property who builds or improws thereon,and
who contracts for such projects with,convacmKs)lienmed p"a"nt to the Convenors
Uomse taw.
0 tem...".a close. ,B&PCI"mlsmawn I
Owner Dau
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury o"of the following deuaratioru
1 how and will munuin a Certificam of Camara to self-imam f"Workers Compco-
salon,as provided f"by Section 3700 of the tabor Code,f"the performance of The
work for which this permit is issued.
0 1 have shod will maintn Worker,Compensumn Insurance,as required by Section
7700 ufthe Labor Code.for tha performance ofthe work f"whieh bunts Permit B toad. .
My Wmiso'.cconpenssmi.Inger. carrier sand Policy number re
Carrier :
l�� T� � :KLZTyj .
CEIMFICATE OF EKEMMON FROM WORKERS'
COMPENSATION INSURANCE
r@u,ection trend Out he completed lithe permit in f"ou hundred duties(SIOo)
or ba)
1 unify,that in the perf"ma"e of the work for which this Permit is issued.I shall oat
employ any person in my manner m as in heceme mbj"t to the Workera'Comperuauon
laws of Colifomia.Dam
Applicant
NOTICE TO APPLICANT:IL after mating mu CeNftase of Exemption.you should
become subject to the WOrkcrs Competwtion provisions of the Labor Code.you muse
.J O forthwith comply with such Provisions" s permit shall W deemed mroked.
'z 0 CONSTRUCTION LENDING AGENCY
Ther ely which nn Peed rmit
is a Wood(ee.3Wkin lending agency l'"me Perfunnanu of
N. me work for which Nb permit B turd(Sec.709],Civ.C.)
W� z Landers Name
� Z rant',Mdresa
U O I comfy that 1 horn read wa application and,lam that the shorn information is .
L' P coma 1,g.to comply wills all city and county ordinances and sum laws rtlaung to
OU building construction,and hereby wthorim rtptcxnuures of this city to enter upon the
r W show-mandonw prepeny for inspection purposes
E•,t a. (We)agree to now.indemnify and keep beardless ale City of Cupertino again,
W liabilities.judgments.tolls and expn"ea which may in any only acerae against mid City
U z m conewspirme of the granting aide pcwri
`-'
APP L ANT Ut�F ZAND A W L COMPLY WITH ATI.HON-POINT Issued by: Date
SOU REGULNf10�s. �-(
-l-S]I' Re-roofs
Slgmuurt of Applian«Contracsor " Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will ate applicant"future tiding ncempet now or handdc harandous material
as defined by ale Cupertino Municipal Cade.Chapter 9.13.W the Health and Safety
Code.s Y.us7zp17
❑ !Jose All roofs shall be inspected prior to any roofing material being installed.
Ya
Will thea licant or future building Occu ant use a u; If a roof is installed without first obtainingan inspection,I agree to remove
pp g p y it Qu,Ot Mann wheat P
Duu¢aatdnus air conmminen`uss�JcOtmd by the Bay Area Air Quality Management all new materials for inspection
❑Yes L4 w atom `e `
Ihow r"Jmehaarmwnkj
.25s materials IrememI unJerdeaman6.95ofine Caliims ��g✓)� I �
do Hcalmh SaictyCwc,Seeuons ,75 l aw 25534.1 understand muifmc buiiJing 6
Java not mnJy M1 a mnvn4 y rt,powbifay o_4 Je"cupent of the
rtyvim tswnien b tl sun [CCC /6 SignatureofApplicant Date
A !!.'�I
Owncr"emhonxe egcm �am� All roof coverings to be Classor better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36925031. 00
DATE ISSUED. . . . . . . : 05/02/2008
RECEIPT #. . . . . . . . . : BS000004655
REFERENCE ID # . . . : 08050041
SITE ADDRESS . . . . . : 10498 E ESTATES DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CHARLES FU
ADDRESS . . . . . . . . . . : 10498 E ESTATES DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4506
RECEIVED FROM . . . . : ERNIE BUENTIEMPO
CONTRACTOR . . . . . . . : ERNIE BUENTIEMPO LIC # 24464
COMPANY . . . . . . . . . . : BUENTIEMPO ROOFING
ADDRESS . . . . . . . . . . : 412 HERSHNER WAY
CITY/STATE/ZIP . . . : LOS GATOS, CA 95032 '
TELEPHONE . . . . . . . . : (408) 371-1879
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 15, 400. 00 1. 60 0. 00 1 . 60 0. 00
1BUSLIC FLAT RATE 1. 00 110. 00 0. 00 110. 00 0. 00
1REROOFRES SQ FEET 36 . 00 468 . 00 0. 00 468 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 579 . 60 0. 00 579 . 60 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- -------------- -------------------- -
CREDIT CARD 579 . 60 MASTER CARD
---------------
TOTAL RECEIPT 579 . 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
_0*� CITY OF CUPERTINO
K REROOF
•CUPEf�TINO PERMIT APPLICATION
o�osooy/
APN # 2 ,l 2/ Date: - 0
Building Address: U`J
Owner's Name: Phone #:
<10 664, - i23i
Contractor: Phone #:
Fax #: '�A -
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ uilt-Up roof
❑ asphalt Shingles eAsphalt Shingles
Wo d Shakes ❑ Wood Shakes
41 ❑ 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: r� i'Yt�1fL ,4 16_& reTI j' 34/'C•6�1 NC-
1,45 ffi1—I j� i,� �' is �t'r;:awl 5/ �tCEs <r/s,� ' Cl��r -
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in plan
set & the sheet index. zs—
Valuation:
• I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
/y--
Signature
a7v%
CITY OF CUPERTINO
REROOF
•CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
G 1REROOFRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
AdIkk
1BSEISMICRE Seismic Residential B
1 BUSLIC Business License B
•
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 re-inspection 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: "�'i/t — ��S i&vt .-e
Job Site Address: / 0 c/Q��
Roofing Company Name: ftV1�1 ( (y�h�
Applicant's Signature: �y Date: -�
• Greg Casteel
Building Official
Revised 11/2/04
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
'gg Plans See below
R Y
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. Energy Star Refrigerator, (Note/Spec. A-3 1 Epont
P. Other 1. List Green Features on Plans A-1 1
TOTAL POINTS 40 ts
/OY dr r
ev
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 Remurces Energy lAaftahm
de
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 p
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 p
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 Matedals/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes , 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes p
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y--yes 0
B.Foundation
1 1 1
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 F4�0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes p
C.Structural Frame
1 1 1
I.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 .
6.Use Finger-Jointed Studs for Vertical Ag lications 0
P 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resources
B.Use Recycled Content Steel Studs for Interior FramingP y-yes 0
2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Ener
b.Wall 9Y Pts Y=Yes 0
c.Roof 3 Energy pts y=yes 0
3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes
11.Use Reclaimed Lumber for Non Structural Applications 0
PP 3 Resource pts y=yes 0
a.Subfloors 1 Resource pt y=yes
• lb
— --- - -- - — --- - - -- - 1 Resource pt y=yes 0
1 1 1
114PUT Resources Energy 1AWHealth
D.Exterior Frmsh
ii.Use Sustainable becl(ng Materials
a.Recycled content 3.Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
`2.Use Treated Wood That Does Not Contain ChromiunJArsenic 3 1 IAO/Health pt y=yes 0
13.Install House Wrap under Siding l 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource of 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 FlowReducers
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 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
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 41AQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
r.tiecmcar ( 1
f1.Install Compact Fluorescent L ght Bulbs(CFCs)
(6 bulbs=2 points,l0 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. D
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to O
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. D
1 1 1
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.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center Y 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 D
2.Install Floor Insulation over Crawl Specs 4 Energy pts y=yes 0
`3.IF-stall Recycled-Content,Fiberglass lnsulat&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 pts y=yes 0 •
6.Alternative Insulation Products(Colton,spray-loam)
a.Walls 4 Resource pts - y=yes 0
o.Ueiings 4 Resource pts y=yes 0
L, rgdows
I.Install Ene gy-Efficient Windows
• a.Double-Paned
1 Energy pt Y--yes p
b.Low-Emissivity(Low-E) 2 Energy pts Y--yes 0
c.Low.Conductivity Frames 9Y P 2 Ener is
Y=Yes 0
�2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
R.Usee Duct Mastic on All Duct Joints - 2Energy pts y=yes p
2.Install Ductwork within Conditioned Space - 3 Energy pts y=yes p
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts yeses 7
0
5.Install Solar Attic Fan 2 Energy pts y=yas 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes p
7.Install Whole House Fan 4 Energy pts y--yes p
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Healthis
P Y=Yes 0
b.Water Heaters 3 IAQ/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 stoves/inserts 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 p
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes p
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 0
K.Renewable Energy and Roofing 1 1 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pis y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes p
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:Selea Safe and Durable Roofing Materials __ _—_,� 1 Resource pt y=yes p
7.Install Radiant Barrer 3 Energy pts y=yes
0
1 0 1
• 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 0
INPUT ResDurces Enemy MOMBalth
.Indoor Air Quality and rrntshes '
!1.Use Low/No-VOC Paint - f 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
3.Use LowMo VOC Adhesives - _ P Y=Y 3 IAQ/Health is es 0
4.Use Salvaged Mater ais 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
L.Seal all Exposed Particleboard or MDF N 4 IAQ/Health pts y--yes D
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes 0
9.Use Finger-Jointed or Recycled-Content Tdm 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes
JO
1
N.Flooring
1.Select FSC Certified Wood Flooring 7-yes7t pts y=yes 0
C2.Use Rapidly Renewable Flooring Materials pts y=yes 0
--- - ii --- - - -
3.Use Recycled Content Ceramic Tiles pts y--yes D
4.Install Natural Linoleum in Place of Vinyl h pts y=yes D
5.Use Exposed Concrete as Finished Floor pts y=yes 0
6.Install Recycled Content Carpel with Low VOCs pts y=yes 0
I 1 !
Total Points Availa le:l 1 1401 1301 57
Total Points Project Received: 01 01 0 •
G:datarprogsigreenbuildingguidelines remodelersjgreenpointsfmal2.12.04proteded.xls
•
Community Development
'� 4 10300 Torre Avenue
Its
`; � Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
Sf,UPEkjINO
Building De artment
JOB ADDRESS: PERMIT#
IG' q Gess' �iTGs D vso ��c
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: EU) I& d 4�' FAX #
c (�
I am not using any subcontractors: QYTIa C
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