08060014 (2) CITY OF CUPERTINO *rt,. .;i„
BUILDING DIVISION PERMIT � OYNTtItA TOIL 1V� RMATIO•,1V
BUIt,pIM&8REM$� DR ATLAS–TRILLO HVAC 08060014
OWNLER''S�1NlA�ME: M. MRMI[ISUEDA'[E
LAI JACK K AND GLORIA H 1965 KYLE PARK CT 06/02/2008
NE: (408) 286-8931 SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
u U mthatILICENSED CONTRACTORS DECLARATION _ Job Description
1 hereby affirm Nn 1 am li¢nsN under provisions of Chapter 9(commencing - p
ZZ iNSccum70011)orDivlaion3orNCBuvncuartProrcssiomcane.anamyliamcu ADD A/C ,UNIT
°?usin full rade and err
)n z License Clean, Lie.0
eF, Dow cmuranor
e ARCHITECTS DECLARATION
,r rc 1 understand my Plans shall he used as public records
JyU
yG Licenses Professional
O.11 ma asemptf DECLARATION
'C 2 0 I hmso M.o n I e1.eumpt Bum Ne contrProfession
License c Law for the
C20 o O fallowing roman.(Section 703 L5,Business and Rafessiuu Code:Any city or county
3_�
which mquima a permit to n+nwmL Wer.vngove,demolish,or repair any suumuro '
prior to its issuance.than requires she appliesm for such permit o file a signed statement
sC Nnmm
he is licensed pursuant wNeprovisions oftiteConmmorslieuLaw(Chapter 9 Sq.FC Floor Area Valuation
ss�
(command,with section Division Sar am But.and Prafeuim oCode)or
s $3800
9 that he is exempt shemfrom and the bnsks for be alleged exemption.Any violation of
section 7031.5 by arty applicant for a Permit subjects the applicant m a civil prralty,of Number Occupancy mm mom than It.hundred dollars(5500). 32645010 .x$ pane
yType
1,u axon of the papery,m my moployw with wages u dteb sole cmnpenssdon,
wille0 Newark,and Nesweureu not inserted car oRero l forsah(Sec,1044,Business
and ProfeWans Coda The Comas wes License Law dans act apply to an owner of Required Inspections
property who builds car im gores thereon.art who ata such wet himsrlf or through his
awn employaes,pmWded that such improvements are not intended oraffered for We If,
however.are building or improvement usold within arc year of comp action.the owner-
builder wig have Ne haemo of proving that M did ms build or improve for puryo¢of
sale.).
❑I.as owner of Ile Property.am achusivehy contrac(ing with licensed cembach rs to
mew¢the project(Sec.70,14.Bnsinass and Professions Cade:)The Coobaem/s U.
cense Law dean mot apply to an owner of propmny,who builds or improves theme,art,
who contracts for such pmjceu with a comnmar(s)licensed pursuant in the Co rmactats
License Law.
❑I an,tempt under,See ,B ds P C for this reason
Owner Dam
WORKER'S COMPENSATION DECLARATION
40 1 hereby air=under penalty of perjury,we of the following dccharuianm
El Ihaveandw0lmtintsina Ce r]i mafca=ntwwlf-inumfmwoftesCampen-
sWm.as provided par by Sateen 37M of the Inbar Code.for the performance of the
work for which this Permit is issued.
❑1 bare and will mtimam Workces Compensation InsWmce,as cultured by Section
3'/00 of am labor Code.to,the gdomeance of Ne work for which this permit is issued.
My Worker's Compewude brume.arricr and Policy number am:
Cacrier. Policy No.:
Ica CCEERTIMCA
OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
Clhis acctim need rot be completed if Na permit u fora¢hunMd dollars(SIO')
or leas.)
I certify that in lm performance or the wort far which this permit u issued.I marl not
employ any Watch in my mannerm as to become subject to Ne Worked Compensation
Laws of California Data
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Eacmption,you should
become subject in the Worker's Campeossuon provisiona of the UIxt Coda you muse
.J z fonhwidi comply with such providers or this permit shall W deemed re elmd.
z O CONSTRUCTION LENDING AGENCY
[•+ thereby affma Nat Nem its communion lending agency for the performance of
CLa > the work for which this Permit u issued(Sm.3097,Civ.C)
0.0 Lender's Name
z Lcndeh Address
U C) I cannily Nos 1 have mad this application and sum Nn sm above information is
tLi F CORCCL I agRe w emllply with all city me COWty aN;nanCee and Guam lava,cluing m
O C) building constmctian,anehembY mtiwnre mpaxnuuvea of Nu cirymrnmrupnn tint
Onve-mentioned property for insmcuan purposes
H y (We)agree to save.indemnify and trop harmless the City of CMnsw again'
V? liabilitimjuslgmenu.eosu and express which may in any way umm again'Wa City
V z in center; rantingaf Nis ML /
APPLIC U Sr' WILL COMPLY WITH A11.NON-POINT Issued by:
SOUR Date I — 2 2
Re-roofs
Signaw¢car ApplicanUCon De
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding¢cupanl'me or handle haaammas material
as defined by Ne Cupertino Municipal Code,Chapter 9.13,and Ne Heath and Safety -_
Code.Section s3ze)7 All roofs shall be inspected prior to any roofing material being installed.
Yon a
Sin thea Ban(or wan buodin wee sat tea If a roof is installed without first obtainingan inspection,I agree to remove
pp g W uluipmrnt car dcvim which p
nil harardnm air contaminants ss fined by the Bay Ama Air Quality Management all new materials for inspection.
D u est
❑Yes o
Itevemal Neharml materivumq nmenuumferL apmr6.95of Na Caliror.
nia HuiNds Surely Coit.SeeuomUS05,25533a Z534.1uMersmnd Nariftite building
does
tro
myimainnarmerssy ¢ fwabcelmY a wary Nae omuPant of e? v
Signature of Applicant Date
Owner manmamcdagent All roof coverings to be Class'.){."or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . .. 32645010 . 00
DATE ISSUED. . . . . . . : 06/02/2008
RECEIPT # . . . . . . . . . : BS000004973
REFERENCE ID # . . . : 08060014
SITE ADDRESS . . . . . : 10400 MANN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. LAI JACK K AND GLORIA H
ADDRESS . . . . . . . . . . : 10400 MANN DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-1141
RECEIVED FROM . . . . : ATLAS-TRILLO
CONTRACTOR . . . . . . . : TRILLO, STEVE LIC # 4269
COMPANY ATLAS-TRILLO HVAC
ADDRESS . . . . . . . . . . : 1965 KYLE PARK CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 286-8931
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 3, 800 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0. 00
1MRRAA UNITS 1 . 00 61 . 19 0 . 00 61 .19 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 224 . 85 0 . 00 224 . 85 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 224. 85`' #9520
---------------
TOTAL RECEIPT 224 . 85
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
o� �C-)i �
CITY OF CUPERTINO
FURNACE/AC
�CUPEk'flN0 PERMIT APPLICATION FORM
APN #a2 a v Date:
Building Address: b
lG�lO D �Y'
Owner's Name: Phone#:
Contractor: Phone ?�3q—os)
Cp - b �v � Fax #:
Contractor License#: Cupertino Business License#:
Contact:
�YL� Fax #: U
Building Permit Info:
41 Elect ellPlumb Mech
Residential NY Commercial
Job Description:
Mld//- 0- w✓tti�
For Residential Installations:
Attic ❑ 0 floor ❑ 2nd floor ❑
Adhere to minimum setback re uirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
Strapped On Platform Bonded New Location Replacement
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist& attach it to the
application or if applicable, include in plan set& the sheet index. �c
CITY OF CUPERTINO
E FURNACE/AC
OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1 MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
1 MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by •
this code.
IMCSUSHTR Commercial Install/Relocateea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
I PGASCOM Commerical for ea gas piping System P
1-4 outlets
I BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
IBSEISMICO Commercial Seismic B
1 MR IIA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
IMRSUSHTR Residential Install/Relocate ea M •
suspended heater,recessed.wall htr, or
floor mounted unit heater.
7---]
1MRAPPVNT Residential for the install/relocate/ or M
replacement of ea appliance vent
install & not incl in an a 1 ermit.
CITY OF CUPERTINO
FURNACE/AC
OCU CM
FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1 PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
IMFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
IMPERMITFEE Mechanical Permit Fee M
IPPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
1BUSLIC Business License B
•
CITY OF CUPERTINO
f�4'�, FURNACE/AC
�, .,
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Units <= l Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 PGASRES Residential for ea gas piping system P
of 1-4 Outlets .
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1 BREMAIRHAN Residential A/C units<= 1 Ok CFM B
1MRRAA Residential Mech Repair/alt/add M
L1BSEISMICR Seismic Residential B •
1 EPERMITFEE Electric Permit E
IMPERMITFEE Mechanical Permit M
I PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
111USLIC Business License B
•
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 See below
a
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 7points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
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 1point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
�Gy
49
�ooB
0
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 with
ease of implementation and relative low cost. These measures can be used as a starting point for"greening'your project.
A.Site INPUT Resources Energy
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;60%=4 points I up to 4 Resource pts 0
2.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 D
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes D
B.besign Resource-Efficient Landscapes and Gardens _ 4 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 D
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
• 25%Recycied 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=yes p
1 1 !
C.Structural Frame
Fl Substitute Solid Sawn Lumber with Engineered Lumber 3 Resource pts y=yes D
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(S)PS)
a.Floors 3 Energy pts y=yes D
3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes D
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
2.Use OSB _
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing _
1 Resource pt y=yes p
/ 1 1
INPUT Resources Energy IAD/Health
. xtenor rms
1.Use Sustainable Decking 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
i3.Install House Wrap under Siding 1 IAO/Health pt y--yes D
14.Use Fiber-Cement Siding Materials 1 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 Eneroy pts Y_—Yes 0
F3.Retrofit all Faucefs 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
14.Replace Toilest with Ultra-Low Flush Toilets
I(1 point each,up to 3 points) _ Up to 3 Resource pts. 0
5.install Chlorine Filler 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 Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 t
Ir.trecmcar
I1.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 l
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
G.Appliances
't.Install Energy Star Dishwasher i 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy l
Conservation Features 1 Energy pt y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt Y--yes 0
A.Install Built-In Recycling Center I 3 Resource pts y=yes 0
1 1 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 D
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 31AQ/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 4Resource pts y--yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
I).t;elungs 4 Resource pts y=yes 0
INPUT ReSIDurces Energy IIA011-lealth
I.Wmows
1.Install 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=yes D
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes D
1 1 1
J.Heating Ventilation and Air Conditioning
,1.11se Duct Mastic cn All Duct Joints _ 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 IAO/Health pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAO/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 D
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heater 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)Furnace 2 Energy pis y=yes 0
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoveslinserts 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 D
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 I 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 D
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 _ _ f 1 Resource pt y=yes 0
7.Install Radiant flamer - - - 3 Energy pts y=yes D
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 0
• 1 1 1
INPUT RgSDurces Energy IAD/Health -
Indoor rr ua rty and Fmshes
5.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Finishes 2 IAWaalth pts y=yes 0
3.Use LowNo VOC 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 IAQ/Health pts y--yes 0
`7.Seal all_Ezposed Particleboard or MDF - 4 IAQ/Health pts y=yes D
8.Use FSC Certifad Materials for Interior Finish 4 Resource pts y--yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0
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 y=yes 0
-L Use Rapidly Renewable Flooring Materials - 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pis y=yes 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 0
1 1
Total Points Available: 1 1401 1301 5719
Total Points Project Received: 01 0 0
Gdatalprogsrgreenbuildngguidelines4emodeleNgreenpointsf naIL12.04prmeged.xls
Community Development
*" 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4�UPEkTINO
Building. Department
JOB ADDRESS: �.�� PERMIT # (��� 0(D/
a Y
OWNER'S NAME: C��' ( PHONE # -$�1(-
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signatur bate
Please check applicable subcontractors and complete the followin orma"on:
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
•
G
Owner/Contractor Signature bate