08090113 (2) CITY OF CUPERTINO :�
BUILD;NG U1VIs3oN PERMIT . CONTRACTORINFQRMATION
_..k.
BUI ING ADDRESS: PERMIT NO.
0094 MERRITT DR ALL SEASONS ROOFING SERVICES 08090113
OWNER'S NAME: PERMR ISSUE DATE
CHENG TAN 1720 SMITH AVE 09/17/2008
—PINE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RE-RF RMV EXT SHKRF, INSTL BILEGO ELECT PLUMB
O 0
O o LICENSED CONTRACTOR'S DECLARATION
r6 U G I hmcby arEr,n wt.I,m Ii¢vctl unxr Pmvidane arai.plu 9(cammemng "^••-- ^-•-- ^-- lob Description
n�to with SedeandClofDiviaion3afthe Budnms antl Profasiom Code,and myliceme is
- in full forte and ettal. -7�/;,f
j�? Date Class Lk.t SLC/ ��
Dau 9//7T Conuacmr �wn9dH Yue fauns
ARCHITECTS DECLARATION ScYVI C¢9
? U I udoi my pluu"I tan mad As public memos
0.
y Licensed Professional
,5 OWNER-BUILDER DECLARATION
aE<i I Malo,(Eect Nal I a.5 exempt from d r Conlns Co i Any c Law for do
(]O (allowing moron,(Scion 703 a.r Business and Professions Cale:Any city or county
S_ which mquirn a Culture,Also re tauten,elm,impmsu nsch ormil t or repair any mismum
-zy Oat kior as uensedpaBumgo the lhovisiosofcant for Contratoi'tafilea Law(ed sulemem
< (comme em,with
Somon7000)ofDiaiomoftheConuutor'Wcensclaw(Clupm9 Sq.FC Floor Area Valuation
y�s (ca W I.comint Sed.)000)ndth Division name Business And Prof Any vICons)or
- that he u exempt IMae(rom and dm Ensu ra Ne ailegctl exemption.Any violation of
Section 7ONu fnbc yapmptllaan orollars r=�it subjects the applicant In a Civil Penalty of APN Number Occupancy Type
Cl I,u owner or the property.or my employees with wsga As their sole campcmadon,
will do IEC work,AM the slrlcluse Is Out Intended or erferCd for sale(Ser.]014.Budmss
And Pmfeuimu Cede:The Contractors Lt..Lt.doeson nApply to An manor of Required Inspections
proputy who builds a impmwa durcan,aM who does sort work himml f err through hu
have ver.On Wilding
idot roto impmsemenu in not ieuMN oroRennd toe Neu.
builder.Ne Wildingor imProwmuntis soldwithinone year or improvti.,tlmowmr-
builder will nate the When of proving Nal W did ort buite or improv for pugom of
ule.I.
0 1,as Owner of the property,am exclusively contracting with Rcemed conmctoaa b
.mula't the Project(Sec.7041.Business and Nafesdam Cate:)The Contractors U.
Come law dors Cal apply to an Owner of progeny who Wilds or improves demon,and
who Contracts for such projects with a Com accr(s)licensed punuanl to One Contractors
Lic.law.
O luneaeroplundeaSse. ,B&PCfeadd. aaen
Owner Dale
WORKER'S COMPENSATION DECLARATION
Ihembya unnsrper tyofpedj omofthefolb intdecludom
I ham and will maintain a CerdfiamofCommnuo self-Insure forWorkers Compen.
unite, provided for by Section 3]00 err dm faWr Code.fw dta perfo.ac a(Ne
won for
which Nis permit is issued
0 1 base and will maintain Workers Campemation Insurance,As required by Section
3)(IUel the lab.Cans,for the,Nuformwun of the work for which this permit is
MY Workers Cm�yel liv npjrArsv eamee and Policy number tae:
Cartier, �A''(( � Policy No.: ERS :?Z2<1— O 7
CERTIFICATE, EXEMP ION FROM WORK
COMPENSATION INSURANCE
(Thin men.need rot W cwnple"Ifthe pewit is for arc hundread down(SIOD)
.Its)
I certify that in the Perfo.ame or the work for which this permil Is issued.I shall an
employ any person in any mamm,An As An become subject in lW Wodbi CosrA,,A m
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,afar making this Ceri fiuu of Eaemption,y.Ali
became subject to tho Wertor's Compensation provisions of Ne,later Code-you must
.,O forthwith comply with such provinces or Nu pnem,shall W demand rtwkcd,
Lia y CONSTRUCTION LENDING AGENCY
IWmbyA(Imn Nal then Is.cmutruction moom'agere,for lW pofoema cul
LYi dm wok for which this permil I.issued(Sec.3097,Civ.C.)
�W Q Lenders Name '
z Lenders Adtlmas
V 0 1 certify Nu I have mad Ods appiieuiom and stsm d.On aWw ofmmWon I, -
J, ^. cornet I agree to Comply with all city and county aNimrccs and sum laws totaling to
0 kS.�J Wilding emmm line And latereby.tolvrise¢prventatives of Nu city to Cottonton N0)
Lia •bow-mentioned property for inspendon purposes.
(we)agre to uw,indemnify and bop harmless dm City of Cupertino agaiml '
Iiabilides,JudgmenCosa but Coand expemes which may in AnY�w'ay accom Against said Cry s
C) Z to consequence of to gnarling of this permit.
^-' APPLICANT UNDEWANDS AND WILL COMPLY WITH ALL NON-POINT Issued
lgnuum nfrA/pplrafrllVyCDanuxtor 9/,1P/2/Q
by
:S
SULADate
Date�O8 .Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will do applicant or future Wilding occupant team orhandk haurdom material
As defined by the Cupeni.Municipal Code.Chapter 9.11,and ftHealth and Safety
Code.OYoean25332(A)? iii All roofs shall be inspected prior to any roofing material being installed.
Will No applicant or future Wilding occupant mac equipment or dcvicm which If a roof is installed without first obtaining an inspection,I agree to remove
seaadnm air ronwu
ninns�As defined by On Bay AMA Al,Quality Management all new materials for inspection.
0y. $Nu
1 haw mad the hvard.smamriau rtquWmenu under Clupue6.95 of Ne Califor-
niaHealth&SArmyC di Soi 25545,25533 And 25534.1 understand Nuif N0)Wilding
does..,Currently hawam��t.Wt it u ra
my pamibility in nedty Near to
rtqummcnu ankh m�a�`mel primtoissnane err Crnirm,m err oaaganey VIP, - Signature of Applicant Date
hams on,cdagorn Dato ' All roof coverings to be Class'%W`or better
CITY OF CUPERTINO
• 2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31633105 . 00
DATE ISSUED. . . . . . . : 09/17/2008
RECEIPT # . . . . . . . . . : BS000006117
REFERENCE ID # . . . : 08090113
SITE ADDRESS . . . . . : 20094 MERRITT DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER CHENG TAN
ADDRESS . . . . . . . . . . : 20094 MERRITT DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2011
RECEIVED FROM . . . . : ALL SEASONS ROOFING
CONTRACTOR . . . . . . . : GORSHTEIN, VLADISLAV LIC # 21035
COMPANY . . . . . . . . . . : ALL SEASONS ROOFING SERVICES
ADDRESS . . . . . . . . . . : 1720 SMITH AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 971-4455
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 9, 900 . 00 1 . 00 0 . 00 1 . 00 0. 00
1REROOFRES SQ FEET 23 . 00 299 . 00 0 . 00 299 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 300 . 00 0 . 00 300 . 00 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
0
CITY OF CUPERTIN.O
REROOF
CIT1rOF
CUPEkTINO PERMIT APPLICATION
APN # 3`6, 3 JS ; 7) Date
V
Building Address:
Owner's Name: Phone #:
Contractor: Phone # -1\-4ASI SS
✓ -D Se ctio CSS Fax #: , 1i a& L-11-I
Cupertino Business License #: �\ o'3S Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles
pX Wood Shakes ❑ Wood Shakes
• ❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings I ❑ Provide I.C.B.O. Report#
-� ( To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
9-:bo 05t> 1.\ \ �3t� 5 C- Q.Dw.p c ooF C(c rf/1
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
�UPEIJTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2�3 1RER00FRES Re-roof Residential B 1SFDWLROOF
/ 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF
IBSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION
APN # Date:
Building Address:
Owner's Name: Phone #:
Contractor: Phone #:
Fax#:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ 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:
Residential ❑ Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
•
Signature
Revised 6/16/08
v - Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
. Fax: (408)777-3333
Budding 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 thejob 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:
Job Site Address: P_ O l` ��-��}. (Nv-
Roofing Company Name: A\\ su&sr nS
Applicant's Signature: �— i Yf'- ice Date: 0
• 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
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
•
•
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.
A.Site
1.Recycle Job Site Construction&Demolition Waste
I65%=1 point;75%= 2 points;B0%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials - 4 Resource pts y=yes D
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 D
6.Design Resource•Eff tient Landscapes and Gardens _ 4 Resource pts y--yes D
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/Retention2 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 0
3.Insulate Foundation/Slab before backfill 3 Energy pts Y--yes0
1 1 1
C.Structural Frame ,
1.Substitute Solid Sawn Lumber with Engineered Lumber _ 7 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 1 D) 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 Ener
c.Roof 9Y Pts y=yes p
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
I72.Use OSB
a.Subfloors y 1 Resource pt y=yes
• � b.Sheathing 0
— -- -- -- — --'-------- ---- 1 Resource pt Y=Yes 0
1 I
INPUT ResDurces Energy IATHealth
D.Exterior Finish
11.Use Sustainable Decking Materials ,
a.Recycled content 3 Resource pts Y--yes 0 •
b.FSC Certified Wood 3 Resource pts y--yes 0
12.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 [AD/Health pt y--yes 0
13.Install House Wrap under Siding 1 IAD/Health pt y=yes D
14.Use Fiber-Cement Siding Materials 1 Resource pt Y_—yes 0
E.Plumbing
T.Install Water Heater Jacket _ _ J 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. D
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) _ J Up to 3 Resource pts. 0
5.Install Chlorine Filler on Showerhead 1 IAQ(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
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
1 1 1
r.tiecmcar
1.Install Compact Fluorescent Light Bulbs(CFLs) . f
(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. D
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. D
1 i 1
G.Appliances
1.Install Energy Star Dishwasher ----� 1 Energy of y--yes 0
2.Install Washing Machine with Water and Energy R
Conservation Features R 1 Energy pt y=yes 0
3.Inslall Energy Star Refrigerator 1 Energy of y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes D
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yas 0
b.Ceilings 2 Energy pts y=yes D
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Gmte6t,Fiberglass Insulation witli
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 D
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
D.uemngs 4 Resource pts y=yes D
1 1
INPUT Resources
I.Windows Energy IADIHmtth
ll.Install Energy-Efficient Windows -
• i a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts Y--yes p
c.Low.Conductivity Frames 2 Energy pts y--yes 0
2.Install Low Heat Transmission Glazing J 1 Energy pt y=yes 0
1 f 1
J.Heating Ventilation and Air Conditioning
(1.Use Duct Mastic on All Dud 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 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 0
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
J.Water Heaters 31AQ/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 vnth Non-HCFC Refrigerants 2 Resource pts y=yes p
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Fumace 2 Energy pts y=yes p
13.Retrofit WODd Burning Fireplaces
• a.Install EPA certified wood stovas(nserts 1 IAO/Health pt y=yes 0
b. Install/ReplaceDampers 1Energy 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 41AQMealth pts y--yes
16.Install Heat RecoveryVentilation Unit HRV 0
( ) 5 IAQMealth pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ Health pts y=yes
0
K.Renewable Energy and Roofing 1 I 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=yes7 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=16 points)_ Up to 16 Energy pts 0
6.Select Safe and Durable Roofing Materiels - - ---'
L :-___ 1 Resource pt y=yes 0
7.Install Radiant Barrier -- " - - —" ---- - 3 Energy pts y=yes 0
L.Natural Heating and Cooling
1 1 1
1.Incorporate Passive Solar Heating 5 Energy pts as
2.Install Overhangs or Awnings over South Facing Windows 3 Energ is y-y 0
3.Plant Deciduous Trees on the West and South Sides y p y-yes 0
3 Energy pts y=yes 0
1 1 1
•
M.In oor Alr Quality and Finishes
INPUT Resources EneW 1AWHealth
Fl.Use LOWM N06 Paint 1 [AD/Health pts y--yes 0
i.Use Low VOC,Water-Based Wood Fnishes _ 2 IAQ/Health pts y=yes 0 •
i3_Use Low/No VOC Adhesives _ —. 31AQ/Health pts y--yes 0
4.Use Salvaged Materials for Interior Fnishes 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 AQ/Health pts y=yes 0
i Seal all Exposed Particleboard or MDF _ 4 AQ/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 IAC/Health pts y=yes 0
1 1 1N.Flooring
1.Select FSC Certified Wood Fwring 770
pts y=yes 02.Use RapidlyRenewable Flooring Materials pts y=yes 03.Use Recycled Content Ceramic Tiles pts y=yes 04.Install Natural Linoleum in Place of Vinyl lh pts y=yes 05.Use Exposed Concrete as Finished Floor pts ycyes 06.Install Recycled Content Carpet with Low VOCs pts y=yes 0
1 1
Total Points Available: 1 1401 1301 57
Total Points Project Received: 01 0 0 •
G:deta/pmgstgreenbuildngguidelines4emodelerslgmenpoims5ne12.12.04prmected.xls
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPE(�TINO
Building Department
JOB ADDRESS: PERMIT #
2 d {RerYi{ r r �Q
OWNER'S NA4E: K PHONE # 5 -
GENERAL CONTRACTOR &I4 a FAX# Q _
SeYGccES
I am not using any subcontractors: 9
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