08080177 (2) CTTY OF CUPERTINO
BUILDING DIVISION PERMIT mCp�N`TRACT�,R�T4N�O
BUILDING AD FSS: PERMIT NO.
11.13 IIUNTERSI'ON PL LIGHTHOUSE ELECTRIC 08080177
NEWS NAME: PERMITT ISSUE DATE
CiiAHI,IsNE LEW 236 BURNING TREE DR 08/22/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHfrEC/ENGINEER: BUILDING PERMITINFO
REMOVE & INSTALL BATHROOM RLDG EO PLUMB MECH O
U o 0 LICENSED CONTRACTOR'S DECLARATION EXHAUST fp2Vq
in
i hereby alma s wt I son licensed ander Provisions of chapter 9(Commenemg Job Description
U withsectimT
OfkB ofOivialon Jaf dx Buurcss ata Prafesswns Cndc.and mY licmx u
Llc.nin full ons sodercca ^ to tb60521
JY�JZ License$19sa Connector.Dam Zai/rECSDIECL
�y ARCxll W=i DECLARATION
W U I undersunJ my Piw mlWl w used u Public recortls
g G Licensed Professional
3 OW NER-BUILDER DECLARATION
I Malay aRnm that I em exmpt from the Comnnafa license law(or the
E D O following xaaun.(Section?UJ 1.5,Business and Protections Code:Any city or County
$ which requires a permit to construct,alma improw,demolish.or repair my,Imnum
prior to its issuance.,Lm requires hM applicant for such permit$rite a signed mmemem
<
that hculicensed Formal mthe provisions orthe Cmm:twaLice.Law(Chap=9 Sq.Ft. Floor Area Valuation
att�a (commencing with Section 7")9Division 3oftheBusiness and Professions Cods)or
that he Is exmpt therefrom and tau buss for the alleged exemptoa Any violation at
Section 7031.5 by any applicant for,a Permit subjects the applicant to a civil penalty of APN Number Occupancy Type
Kt mote tum five hundred dollua($X10). p y yp
0 I,as aswvs of the property,or my employees with wages as their auto compensation,
will do the wok and the mostux is not intended o offered for sale(Sec.111m.Business
and ProreWons Coda The Cosmonauts Litre Law does Kt apply In an owner of Required Inspections
properly who builds or improves thereon.and who does melswart himself or through his
Own employees,provided that inch improvements tie not intended oroffered for We If.
however,the building a improvement is mid within one year of completion,the Owner-
builder will haw the remain of proving that M did net fluid or improve for purpose of
sale.).
0 I,as Owner of the property,am exclusively contracting with licensed rontrmdtts in
,..Met the prt(sec Tao.Business and Pronasions code:)IT.Contamrs Li-
cense Law does mot apply m an owner of property who builds Or improvee memen,and.
who convicts fa such pmjcm with a commamr(s)Ikensed pursuant m the Conaxme.
Liana Law.
❑l mat eacmpt under see. .B At P C for this mason
Dam
40— WORKER'S COMPENSATION DECLARATION
1 hereby affirm,under Penalty of perjury ane Of the fallowing detlatadomc
Ih,w vnd w0l malnuinaCemtifiom o/Consemmxlf-insure fo Wamkels Camper
,ation,u provided for by Section JTDD of tau Labor Code,fa the perfarouKe of the
work for whim this Permit is issued.
0 1 haw and will maintain Walm's Compensation Insurance.as required by Section
5700uf me Labor Code,fa the performance.(da,wal for wbi<h this Permit u issued. '
My WorkrYs COmpensauon Ina$.artier and Palic,mumkr tie:
Grtier.��ramoe Rn,Aro,rw Piney No.: t.�e'1Voo3I S__ /
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
rnhis.xethm Ked ant bo completed if the Permit is form hundred dollars(SIM)
.less)
I costly that in the performance Of the work for which this Permit is issad.I shall not
employ any Person in my meaner so u to became aubjet to thus Workmn'Compensation
Laws of Califomia.Dam
Applicant
NOTICE TO APPLICANT:IL aA,,making this Owifiam or Emrapdort.you shout
baame$Object in the Winters Compensation.provisions of Ne L.M.Code,you must
,JO forthwith comply with such Provisions a this pormit shall w dominant revoked.
E') CONsrRUCT1oN LENDING AGENCY
t-a r I hereby of has Wt them is a construction lending agency for the Performance of
C > the was sur whim this Permit b Issued(Sec.3097,civ.c.)
WM Gj )enders Name
z Lattice,Adore,
V Q 1 unify Nal 1 haw tad this application and seam dam the show infarmatm Is
ly,^. Contest.I agree w comply with all city and county ordinances and aux laws missing in
pE wilding convmttion.and hereby mmodro nptesmatim alibis city to main upon use
�" W shove-nxnudgm property for impaction which may
gy (We)agree to maw,indemnify and loop hamlCIS the City of Cupertino against
lA iiabilid,umug Of
costs and of this
may In any ay,ttnm agalnu telt City
U Z m COrtmegKKa of the grmtng of th6 penrnlL
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 1--T-)IQ-
SOURCE REGULATIONS.
_ `2L ofi Re-roofs
Shgnuurt OfA,fictuaXorturamb,HAZARDM.J D,ai
xAZARDOUs MATERIALS,slam oSURE - Type of Roof
Will the applicant or(rum wilding Kcupant mum.handle h alloua matea
ri
u
".it by Cupertino Municipal Cade.Chapter 9,11,and tau Health and Safely
or,Section 26532(q? .
prod
C] All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment Or&vim which If a roof is installed without first obtaining an inspection,I agree to remove
emit ha>ardou air cmuminams as derinnd by tin Bay Axa Air Quality Management all new materials for inspection.
Duvict?
Oyes &Nr
I haw road the huamdous rtumrials requircmmot under Chapter6.95 of du Califor.
nu Haulm&SaslYCade.Secvats 25X15,255]]sad!25534.1 ahh pad that dthe loading
does WE currently haw a xnam,mat it is my ma,edbilhy m Kufy the occupant of the
requiremontshichMostWOCLpriortoWantOfaCcmufxamofOccupmry.O Signature of Applicant Date
S 2Z 8
Owner or wtharisd agent Dam 0 All roof coverings to be Class'%W'Or better
t �,am"
CITY OF CUPERTINO
• CUPEI�TINO GENERAL BUILDING
PERMIT APPLICATION FORM
4MQ/ 7�
APN # Date:
ODS
Building Address:
/I/ 3 T � ,/-/l.z/714-- AV b (�
CuP6e7-1A)o cA 's-0/
Mailing Address (if different from building address):
Owner's Name: Phone#:
Sh1WL6&0 Limit 410S - S T 3-/o �(
Contractor: Phone: L10�r-,S-,70— 7's%S
L/E,NTfpuSE EZEC7WC
Fax:
Contractor License#: C-/0 LSA sW
Cupertino Business License#:
Contact: CtS7oPlf �J Phone:
Fa
/12x:
Residential Commercial
Job Description: f� /
(3a�rao/r.? C KA 2-" '{ Fa i
Building Permit Info:
Bldg ❑ Elect F Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, I-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-B4 S)nste TLm l'J'
Valuation: Square Footage:
Project Size: Express E� Standard ❑ Large ❑ Major ❑
EForhelp,
ilding: Please complete relevant portion of the Green Building/LEED Checklist& attach it
• to the application or if applicable, include in plan set & the sheet index.
hieved:
contact Build it Green at www.builditgreen.org
Revised 7/01/08
CITY OF CUPERTINO
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 BBOILERI For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h (29.3kw)
1BBOILER2 Installation /relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to &incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h •
1BBOILER4 Installation/relocation ofea M
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
&incl 1,750,000 Btu/h
1 BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1 BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
1 ELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour •
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
aCITYF GENERAL BUILDING APPLICATION
• CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
1 FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
IFIREPLFAB Fireplace Pre-Fabricated/Metal B
1FLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete)
3 of 5
F'
LCCA% CITY OF CUPERTINO
CITY°fGENERAL BUILDING APPLICATION
CUPEI�TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
IGENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 ') B
1RETSPIO Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft)
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft)
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1 SIDEST/BK Siding, Stone& Brick Veneer B
(interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
IS KYL<10 SF Skylight less than 10 sf B
1 SKYL>1 OSF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B'
st) •
4of5
CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
• CUPEkTINO
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door (ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck'fee)
I EPERMITFEE Electrical Permit Fee E
/ IMPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5of5
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 as below
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 point
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.
INPUT Resources Energy JAWHealth
Site
1.Recycle Job Srte Construction&Demolition Waste
65%-1 point;75%= 2 points;Bo%=4 points up to 4 Resource pts 0
L2.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
j8_.Design Resource-Efficient Landscapes and Gardens4 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 F;; 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 I 1
C.Structural Frame
1.Substitute 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. 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
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 - ---- --- -- -- ---- --
• I a.Subfloors 1 Resource pt y=yes 0
b.Sheathing 1 Resource pt y=yes 0
1 1
.Exterior imsh '
INPUT Resources Energy AD/Heelth
1.Use Sustainable Decking Materials •
a.Recycled content 3 Resource pts y=yes 0
1 b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 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
i.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(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 IAO/Health of 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 IAQ/Health pts. 0
6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r,.riecmcai
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
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.Install Energy Star Dishwasher ^I 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 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 3 IAQ/Health pts y=yes 0
L--
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).cenmgs 4 Resource pts y=yes 0
1 1
I.windows INPUT Resources Energy ]AD/Health
• 1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt Y--yes 0
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 Glezing 1 Energy pt y=yes - 0
1 1 1
J.Heating Ventilation and Air Conditioning
-1.Use Duct Mastic on All Duct Joints _ _ _J 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 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7 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/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 win 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 stoves4nserts 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/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
1 1 1
K.Renewable Energy and Roofing wo
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
(12 kw=6 points,2.4 kw=12 points,3.6 kw=16 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing __7 1 Resource of y=yes 0
'7.Install Radiant Barrier -- - 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
INPUT ReSDurces Energy IA011-le'afth
Indoor Air Qualityand Flmshes :-
1.Use LowMo-VOC Paint 1 IAQMealth pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
�3.Use LowMo VVOC 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 IAOJHealth pts y=yes 0
If.Seal all Exposed Particleboard or OF J 4 IAQ/Health pts y=yes 0
B.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 10
I 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yes0
2.Use Rapidly Renewable Flooring Materials - _ _J 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 IAC/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 0
1 1
Total Points Available: 1401 1301 57 •
Total Points Project Received- 01 01 0
G:datalprogsrgreenbuildingguidelineslremodelerslgreenpointstina12.12.04protOcted.xls
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
�UPEI�TINO Fax(408)777-3333
Building Department
JOB ADDRESS: PERMIT#
1115 14un)T1^JC)S?c») PL4t .& 69,�f 0&--0 1 r7 7
OWNER'S NAME: SHg2L&&-Q Lc—V PHONE # 909r-S-7 3-1088
GENERAL CONTRACTOR:L/(47//mcE EZezr/e/c FAX#
I am not using any subcontractors: -zz- C
-
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
• 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
Z g— 22-0
Owner/Contractor Signature Date
CITY OF CUPERTINO
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36221008 . 00
DATE ISSUED. . . . . . . : 08/22/2008
RECEIPT # . . . . . . . . . : BS000005870
REFERENCE ID # . . . : 08080177
SITE ADDRESS . . . . . : 1113 HUNTERSTON PL
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CHARLENE LEW
ADDRESS . . . . . . . . . . : 1113 HUNTERSTON PL
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5068
RECEIVED FROM . . . . : TERRY MAH
CONTRACTOR . . . . . . . : ALAN FORTIN LIC # 27871
COMPANY . . . . . . . . . . : LIGHTHOUSE ELECTRIC
ADDRESS . . . . . . . . . . : 236 BURNING TREE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95119
• TELEPHONE . . . . . . . . : (408) 590-7565
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 1, 250 . 00 0'. 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40: 79 0 . 00 40 . 79 0 . 00
IMPERMITFE 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 122 . 87 0 . 00 122 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- ---- ---------------
CREDIT CARD 122 . 87 AMERICAN EXPRESS
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TOTAL RECEIPT 122 . 87
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