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08080075 (2) CITY OF CUPERTINO BUILIJI�G DIVI''MON PERNUT ` t1f'iITR �TQRI t?Rl�'.IA.TIE'1 .� ' BUILDING ADDRESS: PERMIT NO. 711.09 MANITA CT S BAY BATHROOM 08080075 OWNER'S NAME: PERMIT ISSUE DATE S11ROF HOSHANG D AND VERA H 1468 FERGUSON WAY 08/11/2008 NE: SANITARY NO, CONTROL NO. (408) 865-0381 ARCHIT iENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p �1o0 CONTRACTOWS DECLARATION Job Description eA� 1 hereby alarm that 1 em Ikenso under Pmvwiom of Chapter 9(commencing ... p With socdon]ales)oronwon3orthe Business adProfessions cam,ad my license is SHOWR STL RPLCMNT LIKE4LIKE 36"X60" CULT. STONE n In mu race and affect. Licensecl�a MTRL; NO LIGHTNG,NO ELCTRCL,NO MECHNCL aa- Dau Canuuar r .w ARCHITECTS DECLARATI BSL RENEWED &NAME CHG TO BAY BATHROOM (26625) 1 undcrsund my plana shall W used as public records `yU yud Licensed Pnowesional - y Oat I Me s oarept p orDECLARATION ai 1 Wrohy reason.(Ern thus 11. uempl from Ne Canuanah :Any c Law sof Nc I O O following onceI(Section]031.3,Business and improve, demolish, Cale:Any city or county $lei which wquima a permit a cmmmL alar.Wprove,de ermit t or mpcle cd NNmere prior wslicensedpalso mquirte lW applicant for such ContranrilwakaeLaw(uumat F� wman isingwit pursuant in the of Division ar thehe Busucwr'flJwms,law(Chapwr9 Sq.F[. Floor Area $ Valuation $ (cam he ixem it therefore adtfDiviaior3 the exempton.Any Code)nor1(]225 .+ that io u exempt b Bwrerrom and the buts it Ns,alleged gumption.Any l penalty of Scotian then five airy red dons refs permit objects the applicant u a civil penalty of Number Occupancy Type not mom Nan five hundred dmWs(5500). 3 6 2 2 3 0 4 6 .� 0 1.a owner of the properly,or my employees with wagon as their sale compensation, will do Nework,and thsamown m Is estinuMed or offered foraaw(San.7W,Buemem and Profnalou Cadc:The Conuacurs License Law does at apply to an owner of Required Inspections property who bu ilds or im proves dn:rwn,and who does such work himmif or through his own employees,provided thaauch improvements em nm enhanced aro@red forsane If. however,the Wilding or improvement is mid within am year of completion,she owner- builder will have the books of proving that k did ml Wild or improve fa purpom of saes.). ❑1,as owner of the properly,am exclusively contracting wish licensed contractors to constmcl the proJka(Sem.70<4,Busiewu and Proreaeiou Code:)M Conmcmw's U. ounce Law does not apply ban owner of property who Wilde or improves thereon,sad. who contracts for such projects with a cons actors)Iimued Formal w the Camractor's Litems,Lew. ❑I an eeemptunder See. ,B B PC for this rtsson Owner Dau WORKER'S COMPENSATION DECLARATION I hereby same under penalty of perjury was of the fallowing conclusions: 1 ham end will maintain a Cutiacam ofConaem he ulf mare for Waiter'sCamper- ution,We provided for by Section 3100 of the Labor Cade,far to peRormame of the - work for which this permit is Wood. .,.. &I I haw ad will maintain Worker's Compensation luunna,as required by Section of the Labor Cocks,for Ne performance of the work for which Nis permit Is Issued. My Worker's Compensation Insures cartiv ad Policy number art: Grtier. w><t �a/�� Polley No.: go 263?21App CERTIFICATE OF EKEMPTION FROM WORKERS' COMPENSATION INSURANCE new motion need wt We mplewd Umk permit is form=hundred dellen(5100) nruu) , I certify that In the performance of the work for which this persalt is issued,I Nall not employ any persan in any mannersa an an became subject to dem Wortrss'Computation Tawe of Califamia.Dew Applicat NOTICE TO APPLICANT:If,a0cr making thin Certificate of Excmpllon,you should become subject to the Worker's Compensation provisions of the Law,Code.you most .JO forthwith comply with such provisoes or Nu permit Nall W deemed revoked. Z CONSTRUCTION LENDING AGENCY [—� hereby which than Vert iWood(uuctim7,Clending agency for Ne perfannanw of CL 2�.s Lu week for which them permit H wsmd(Sec.3(197,Civ.C.) ZD A Lendeh Name � z Lendeh Add. U Q 1 certify Nm I have read We application and sum Nu the show informadon Is ly H canon I agree in comply with all city ad county ordinances and mw awe reining w U building convection,ad hereby•utharlm representatives or this city uawr upon the aw.-mkntiomd property for wspentian purposes (we)agree to saw,indemnify and keep humwaf 0w City of Cupertino against liabilities,judgments.cath ad expects which may in my way aeemk al and City U APPIICANTeof the grating of this UNDERSTANDS AN/DWILLy CO LY WITH ALL NON-POINT Issued by: Date - SOURCE REG ATIONS. Re-roofs Signature aliApplicaniCtsounctor Dow HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will du applicant ar futures Wilding occupatatart or handle haaa w,materml as leaned by the Cupertino Municipal Code.Chapur 9.13,ad dem Health ad Safely Cole.Section 33373(a)T ❑Yes ONO All roofs shall be inspected prior to any roofing material being installed. VIII the applicant or future Wilding acupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it Wvaonus air cone emanty u defined by dw Bay Arta Air Quality Management all new materials for inspection. Nlet7 ❑Yes ON. 1 have read the hosaoaus mawriW requirements under LTapurb.95 ofdte Califor- niaHealth&SafetyCode,Secdom 25505,25533 am125534.l understood thwifam Wilding Jou sat,wrcnlly have•venom.and it k my me mihility w 0oufy the¢typal or am requirements wh' un W mel prior w' f Ona of Occupwxy w fit/—off Signature of Applicant Date Owner of autharixed aggro Dam' ' All roof coverings to be Class'A"or better CITY OF CUPERTINO • 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36223046 .00 DATE ISSUED. . . . . . . : 08/11/2008 RECEIPT # . . . . . . . . . : BS000005750 REFERENCE ID # . . . : 08080075 SITE ADDRESS . . . . . : 21109 MANITA CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : SHROFF HOSHANG D AND VERA H ADDRESS . . . . . . . . . . : 21109 MANITA CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5074 RECEIVED FROM . . . . : BAY BATHROOMS INC CONTRACTOR . . . . . . . : TOM TODD LIC # 26625 COMPANY . . . . . . . . . . : S BAY BATHROOM ADDRESS . . . . . . . . . . : 1468 FERGUSON WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95129 TELEPHONE . . . . . . . . : (408) 865-0381 FEE ID UNIT QUANTITY AMOUNT, PD-TO-DT THIS REC NEW BAL --- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 10, 225 . 00 1 . 10 0 . 00 1 . 10 0 . 00 1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00 lINSPREIFE HOURS 1 . 00 122 . 00 0 . 00 122 . 00 0 . 00 1PPERMITFE 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 314 . 68 � 0 . 00 314 . 68 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ---------- --------------- -------------------- CREDIT CARD 314. 68 MC --------------- TOTAL RECEIPT 314 . 68 • aloCITY OF CUPERTINO • CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # � oZ a� � Date: Building Address: 0 //09 Me,ni �a G � Mailing Address (if different from building address): Owner's Name: Phone#: ,-, i Ito 6 25-7 —o 116 Contractor. ,,/ o e A 2g-N Aar ihone: lgog 6123 . 4Sfr o S 1` fJfl7/� ax: Contractor License#: C6.2 3 5-6 Cupertino Business License#: 02 Contact: Phone: L/,v s, 6 A 3 -4 s sr Fax: lfo'R� 3,3 -//-A7 • Residential DQ Commercial Job Description: S h,o ,.P-. 5 /, //// Nt/J/4Oe. -6• L -. L., k--t- . " AA.,,, �. . 4 l — no i:�K+� vlu e_\,a coo nn. Building Permit Info: Bldg 2' Elect ❑ Plumb p� Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ 11/111 B, IV-HT, V-Bz�l Valuation: /o"2 1 O21 5, d „ Square Footage: Project Size: Express Standard ❑ Large ❑ Major ❑ Green Building: 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. Points Achieved: • For hel , contact Build it Green at www.buildit reen.or 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 1BBOILERI 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 1 BBOILER2 Installation/relocation of ea M boiler/compressor over 3 horsepower to & incl 15 horsepower, or ea absorption sys over 100,000 Btu/h 1 BBOILER3 Instal lation/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 Instal I ation/rel ocation of ea 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 Install ation/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 iMEET1NGIHR Application Meeting B • sm CITY OF CUPERTINO CITY Of 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 lip 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 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1 FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1FOUNDREP Foundation Repair B 1 PILECAST Pile Foundation Cast in place concrete B 1PILEDRIV Pile Foundation Driven (steel, pre- B stressed concrete 3 of 5 Stn CITY OF CUPERTINO ; CITY OF GENERAL BUILDING APPLICATION CUPEIi,TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM RETAINING WALL(CONCRETE OR MASONRY 1RETSTN Standard (up to 50 ft) B IRETSP310 Special Design, 3-10' high (up to 50 `) B 1RETSPI O 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 e SIDING 1 SIDEST/BK Siding, Stone & Brick Veneer B interior/exterior 1 SIDEOTHER Siding all other B SKYLIGHTS 1 SKYL<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 so B 1 SRACKS>8 Storage Racks over 8' high (up to 100 B st 4of5 CITY OF CUPERTINO CUPEf�TINO GENERAL BUILDING APPLICATION • FEE SCHEDULE 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 IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P IELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1PLMBLNCK 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 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 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 B. B. OSB Sheathing, detail S-2 2 oints 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 Doint P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS 40 points Plan Review Process Work Hook Page-12-Revised 3/25/08 i 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 EnDTM' 1ALIHenhh rte 1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;60%=4 points j up to 4 Resource pts 0 12.Salvage Reusable Building Materials _ _ i 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 8 Trees 1 Resource pt y--yes 0 6.Implement Construction Site Stonnwater Practices 2 Resource pts yryes 0 7.Protect Water Quality with Landscape Design 2 Resource pts y--yes 0 B.Design Resource-Efficient Landscapes -ind Gardena 4 Resource pts y=yes 0 9.Reuse MateriaW[Jse 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 I 1 B.Foundation 1.Incorporate Recycled Flyashin 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 yryes 0 3.Insulate FoundatiordSlab before backfill 3 Energy pts y=yes 0 1 1 1 C.Structural Frame 1.Substitute Solid Sewr 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 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 D • I b.Sheathing _ _ 1 Resource pt yryes 0 1 1 1 r INPUT ReqDulces Energy 1ALTHealth 'Lrtxtenor File 1.Use Sustainable Docking 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 Chromium/Arsenic 1 IAQ/Health pt y--yes 0 3.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0 4.Use Fiber-Cement Siding Materials i Resource pt y=yes 0 1 1 1 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 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 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 4 IAQ/Health pts. 0 B.Install On-Demand Hol Water Circulation Pump 4 Resource pis y--yes 0 r.erectncai 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 pis. 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 I 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 3 Resource pts y=yes 0 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 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 pts y--yes 0 6.Alternative Insulation Products(Cotton,spray-foam) a.Walls 4 Resource pts y=yes 0 D.Ceilings 4 Resource pts y=yes 0 1 1 1 INPUT Resources Ener_qy m ows 1.lristall Energy-Efficient 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=yas 0 2.InstaTLow Heat Transmission'Glai-ng 1 Energy pt y=yes 0 1 1 1 J.Heating Ventilation and Air Conditioning 1.Use Duci Mastic on All Duct Joints 2 Energy pts Y--yes D 2.Install Ductwork within Conditioned Space 3 Energy pts y--yes D 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 B.Install Sealed Combustion Units a.Furnaces 31AQ/Health pts y=yes 0 b.Water Heaters 3 IAQ/Hsalth 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 9D%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes D 13.Retrofit Wood Burning Fireplaces • a.Install EPA certified wood stoves/inserts 1 IAQ/Heallh 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(HRV) 5 IAQ/Health pts y=yes 0 17,Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yesl 1 0 1 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 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=18 points) Up to 18 Energy pts 0 6.Select Safe and Durable Roofing Materials — 1 Resource pt y=yes 0 —7.Install Radiant Barrer - 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 0 2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y--yes 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 1 1 1 • . n oor r ua Iry en n s es 1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes D 2.Use Low VOC.Water-Based Wood Finishes 2 IAQ/Health pts y=yes D • 3.Use Low/No VOC Adhesives 3 IAQ/Health pts yryes 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/Hsallh 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 OF 4 IAQMealth 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 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts yryes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes D 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAO/Health pts y--yes D 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 I 1 ! Total Points A 1 1401 130 57 Total Points Project R 1 01 01 019 G:data/pmgslgmanbuildngguidellneslremodelerslgreenpointsf na1212.D4pmlectedads Community Development 10300 Torre Avenue It SLoO Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 *UPER,TINO Building Department JOB ADDRESS: II PERMIT # x //09 MahItg G�- I Veo86o7f OWNER'S NAME: Veiy No5-he,_,C, Slir644 PHONE # jog' 2 - 0116 GENERAL CONTRACTOR: (j> 4, ,,,, s FAX # I am not using any subcontractors: Fs- Signature Date Please check applicable subcontractors and complete the followinginformation: 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