08040208 (2) CUPERTINOCITYIOF PERa •.•z•:: x ,-j 7 .Y rBULF,:DIV33ION X -
.
BUILTPERMIT NO.
�""ERRITT DR A PERFECT CLIMATE 08040208
OWNER'S NAME: "" PERMIT ISSUE DATE
RAJ TUPLUR 8375 BRENTWOOD BLVD STE' B 04/29/2008
NE: SANITARY NO. CONTROL NO.
(408) 861 9545
ARCHITECr/ENGINEER: BUILDING PERMIT INFO
' BO BO PLUMB MOECH
upQ LICENSED CONTRACT'OR'S DECLARATION - Job Description
1 hereby nybe,Nat I am licensed under provisions of Chapter 9(commencing P
with Section]000)ofDiviaion 3 of the Business and Profcmmat Code,and my license is R/R WITH NEW FURNACE IN GARAGE
in full fame end ettOce
j M, Leen a Class Lk.N
? Dau
ARCHITECTS DECLARATION
1 understand my plans shall be used as public records
]aU
yo licensed Professional'
OWNER-BUILDER DECLARATION
< 1 hereby.(Tiro that 1 am1. exempt from the Con ours,Co License c Law for the
D O fallowinguats a (Section 1117 str Busher. and ere,de a i Coda:Any city or county
$� which rtqulros a permit m construct,alar,hnpmw,damnikh,or repair any svuctein
i Y prior an its Woman,also mqulms the applicant farsuch permit to Bk aaiCncd suumant
< thatheIslicensedparwammueprvision,offtCanaaatOeSULS.Low(Chapmr9 Sq.Ft. Floor Area $1500 Valuation
$ (commencing with Section/000)NDivkion 3 ofthm Business and Professions Code)at
r3— that heI.exempt thamf can and t e bask for the Waged esempdon.Any violation of
Santo]0313 by any applicant for a permit subjmn the applicant to a civil penalty of 'CV'e,,T]N Number Occupancy Type
not mom than fan hundred doll.(5500), 316 2 9 0 4 5 .
❑1,as owerr of the property,or my employees wits wages as dub Sale eampevadon,
will do dewaik.and use auueumknutIntendeda,ofreredfor age(Sec.7044.Business Required InsP actions
and Professions Cade:The Co mbar',Lk+ • es
"•Law duact apply he an Owner ar
property who builds vim prove,themon,and who dues such work himsel f ar through his
awn employees,provided thttsech improvements ere not intended vottered Persona IL
however,the Wiwi.&an improvement is Sold within ane year of eompletion.the ower-
Wilder will have the burden of proAh,that W did tet build or improve far purpose Of
ask.).
E1,as owner of die property me exclusively contacting,with licensed rnntaoSars to
awn the project(See.1014.Beslnw and Professions Code:)The Contactors Li- -'
o nse raw does not apply w an Owner of propeny who builds or improves thereon,and.
whocantncu for such projects with a contractor(s)licensed pursuant m the Contvter's
License law.
❑Iran esemp ndv See .B A P C for this reason
Owner Ye Data
ORKPR'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury ee of dna fallowing dCCIMdaN:
I baw end will maim!.a Cardinale of Consent he self-insum for WarkeesCooper.
radius,u provided for by Suction 3700 of the Labor Code,for the peAmmsece Of the
work for which this permit is issued.
-11 have and will maintain Workers Compensation buursntt,u required by Section
3700of the Lobar Code.for the performance of the work fanwhich this permit IS lasted.
My Workees Compensation Insurance carrier and Policy number am:
Carrier, Policy Na.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thissamion need ass he completed!true permit Is fes ane hundred dollars(S I OU)
or lna)
1 cenifv that in the performance of the wank Iv which this Pettit is brand,l,hall am
employ any person in any myn�v become Sabjutmthe Worken'CompensWan
Laws of Catifomte
1144
ia Da
APpllcamy'y
NOTICE TO APPLICANT:If.aft m g this Conilinto of Exemption.you should
Income subject a the Warkerl Comyy titian provisions of NO Ichor Coda you must
�J.. foMwith comply with such proviaahs an this permit shall he deemed invoked.
„Z,O CONSTRUCTION LENDING AGENCY
[—i I hereby Wirt that more is a construction lending agency for the performance of
a> the work for which this Permit Is!need(See.3097,Civ.C.)
W Q Lattices Name
lendees Address
U Q I Omely dust I have read this application and slate that the shove information is
LL correct 1 agree to comply with all city and county Ordinances and sou laws minting to
.� Wilding wnSouction,and hereby authorize rtpresenuuwa of this city to enerupnn the i
W shove-menfi mul property fan insPeNan Purposes,
(We)agree to save,iMcmnify and keep lenders the City of Cupertino against
i.r C4 ILabilides.judgments.costs aM expenses which may in any way aceto against said CityU in /y rr]]
APPLn ICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date L..5C--
SOU REGULATIONS. /-2,9/p
Re-roofs
SignSUTApplicarofC.hummo, Dim
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant Or future Wilding Occupant nom or handle hazardous material
as deRned by the Cupertino Municipal Cade.Chime 9.12.and the Health and Safety
Code,Section 25s32(4)1 All roofs shall be inspected prior to any roofing material being installed.
Cl Y. No
Will the applicant or forum building om,upam use equipment or device,which If a roof is installed without first obtaining an inspection,I agree to remove
I Incautious air conuminants as defined by the Bay Am,Air Quality MannCmcnt all new materials for inspection.
WictT
❑YosffiNu
I have inM de hvardoua materials requirements undo,Chapm,6.95 of the Cali for-
nkHc. 85afemyCMo,Sections 25505.25533 and 25534.1 umkrsund On ifde building
arcsn u1ar,;hawa home,dot It is my responsibility to unary Ne=Want of the
.4.i.iinawhkh.wmtpdorwk...f.C.nr.MoroccuPan . Signature of Applicant Date
Owner thorbsdagenl Dae I 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 . . . . . . . . : 31629045 . 00
DATE ISSUED. . . . . . . : 04/29/2008
RECEIPT # . . . . . . . . . : BS000004613
REFERENCE ID # . . . : 08040208
SITE ADDRESS . . . . . : 19730 MERRITT DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RAJ TUPLUR
ADDRESS . . . . . . . . . . : 19730 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2440
RECEIVED FROM . . . . : RAJ K TUPLUR
CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144
COMPANY . . . . . . . . . . : A PERFECT CLIMATE
ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B
CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513
TELEPHONE . . . . . . . . : (408) 861 9545
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- - ---
1BSEISMICR VALUATION 1, 500. 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 #1414
---------------
TOTAL RECEIPT 224 . 85
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- -------------------------- ------ ----------------------------
505 FINAL ELECTRICAL - . 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
a CITY OF CUPERTINO
FURNACE/AC
�CUPEf�TINO PERMIT APPLICATION FORM
APN # 3 J Z� O / 00 Date: / 2,5
Building Address: �6�3� m er-2r rr Dk ,
CEJ f 6p,rloW CA :K%(
Owner's Name: K/J J -7 �LU Phone#: S
�
Contra r: �pyrr�CT CLi MA-rC— Phone#: 4 OR —/ p��
Vc
Fax #: ` 09-9 6) --"-7S/J
Contractor License#: Cupertino Business License#:
23158
Contact: Phone#:
Fax#:
Building Permit Info:
Elect 01---�. Plumb [ZY' Mech
Residential & Commercial
Job Description:
r4V3 FOPNAcE- rod
For Residential Installations:
Attic ❑ 1st floor � 2 a floor El
Adhere to minimum setback requirement ❑
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):
1
S�
Strapped On Platform 4L Bonded New Location Replacement
Valuation: I W
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.
I
r
CITY OF CUPERTINO
I FURNACE/AC
CUPEkTINO FEE SCHEDULE S
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
l 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. a
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1 PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 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.
1BSEISMICO Commercial Seismic B
1MRRAA 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.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed.wall htr, or •
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install ¬ incl in an appl permit.
CITY OF CUPERTINO
FURNACE/AC
OCUPERTiNO 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
IBPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1 MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
/ IEPERMITFEE Electric Permit Fee E
1 MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
^� CITY OF CUPERTINO i
G � FURNACE/AC
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Units<= lOk CFM B
IMCRAA Commercial Mech Repair/alt/add M
IBSEISMICO 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 <= l Ok CFM B
1MRRAA Residential Mech Repair/alt/add M
IBSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
IPPERMITFEE Plumbing Permit P
1TRAVD0C Travel Documentation B
IBUSLIC 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
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
a
APR 2 9 TODB RJI,
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 RDSDurces Energy M/Health
to
F/eb
ycle Job Site Construction&Demolition Waste
=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
vage 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
8.Design 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 0
1 1 1
B.Foundation
is 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 pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
11 1
C.Structural Frame
1.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 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
B.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 0
• b.Sheathing 1 Resource pt y=yes 0
1 1 1
'1
NPUT Resources Energy AWHealth
xter or n s
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 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAO/Health pt y=yes 0
4.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 Hol and Cold Water Pipes 2 Energy pis 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
A.Replace Tollest 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 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 IAO/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
r.erecmcai
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.11 0
1 I 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 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 pis Y--yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Content,Fiberglass Insulation with
INo Added Formaldehyde 3 IAO/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
o.Callings 4 Resource pts y=yes 0
1 1 1
INPUT Resources Energy A01ricalth
n ows
1c.
nstall Energy-Efficient Windowsa.Double-Paned ` 1 Energy pt y=yesb.Low-Emissivity(Low-E) 2 Energy pts y=yes Low.Conductivity Frames i 2 Energy pts y=yes D
2.Instalr Low Heat Transmission Glazing 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
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes G 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 woodstovestiinsens 11AQ/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 4 IAO/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
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
.elect Safe and Durable Roofing Materials �� 1 Resource of y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1 I
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
` 4
114PUT BOSOM CBS Energy lAO/Health
n oor r ua ity en n s es
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y--yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes0
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 Exposed Particleboard or MDF 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 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
2.Use Rapidly Renewable Flooring Materials 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 IAQ/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 1
Total Points Avat a e: 1 1401 1301 57
Total Points Project Received: 1 0 0 0 S
G:date/progstgreenbuildingguidellneshemodelerslgreenpoints9nal2.12.04protededxls
Community Development
t% e
p
0 Torre Avenue
Crtino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT # nn C) I O �OS
f9�3CD M�;RRfT7 W-WL5 1JD "[
OWNER'S NAME: W TU( L UR. PHONE # Sr/0-46 RQ
GENERAL CONTRACTOR: Pc,'RFSC1 A7 L FAX #
I am not using any subcontractors:
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
er/Contractor Signature Date