08080094 (2) CITY OF CUPERTINO ��L,�
BUILDIN41 DIVISION PERbIIT C�a` sllL? T�QR�`,'IffrQtct TI( ,
BUILDING ADDRESS: PERMIT NO.
1 .161.1 SEVEN SPRINGS DR CASTILLO' S ROOFING 08080094
OWNER'S NAME: PERMIT ISSUE DATE
C IIERUVU SURYANARAYANA M AND 1703 CATHAY DR 08/13/2008
Ne'
(408) 251-3565 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILOINO PERMIT INFO
BLDG ELECT PLUMB MECH
2Gp LICENSED CONTRACTOR'S DECLARATION O O O O
ldlob Description
I bmeby aflim Wt i sue licensed ander Dmvww of CNpter9(commeving
iosccuon7000)ofDlvwon3afheBusi sae ofesfdomCodc,ammylicenscle RE-RF RMV EXTNG WDSHK INSTL #30LB FLT, INSTL NEW
in full forte and effm w 3 p ,9 _5,
[Ll3 LicenseClass71 Lie 0 FAF GRNDCNYN CMP CLS A 20SQ
Dam Y "
sRC'HITECfSTD? ATION
IuMenunJ my else elWl be uaJupu a, r
to
ds
Licensed Profesoonal
h� Dat lam exempt
RDECe ConuoON
0 0 I hmaxo atom that 11, eumPt Item the Poafamioncmea Licence taw for the
0 o following moon.Permit
t ]0714 4 skier. and Improve.
demolish.
e ons Calc:Any city or county
$� which requires issuance.gems.lis moss the pidie Wpmsu dch Permit.car repair any damuro
Zi pnvaitamedptlse sWthe Wapo for Com Permit a0lcd,Law
(commis liavcJ Pursuant aW provisions of he Cantrumssnd Proe]aw lCNpw9 Sq.Ft.Floor Area Valuation
(commencing with semfue]000)of Division lf r of the
oged canept Profession Code)or $9500
Nu io u exempt b a"apps and to bads for she ctathe eeempnon Any violation of
Session]031.5 by arty applicant for a permit abject the applicant to a clvll penalty of Number Oecu enc-Type
sat mart than five hundred dollan(5500). 36652048, P Y YP
❑I,as owner Of Ne property,of my employees with wages u their seta wmpemadon,
will&W work and Ihesauclme h..thinned moRered persate(Sec.7014.Buaircv
and RaresUam Cade The Consommes Lt.law deet rot apply to an owner of Required Inspections
property who builds a Improv demon.and wW doesaueb work himselfor Waugh his
cons MPloyea,Provided that such impmveaenu are not invented croRemd for=I&If.
howev,the Wilding Or impmvemant La said within arc year of comple i s,the awner-
Witter wtli haw he had.of Prolog Wt he did Tat Wild v Improve far purpose of
use.).
❑1,As owner of the property.am exclusively contracting with llnaud connector,to
covwct the project(Sr,.7044,Business and Pott amem,Code:)The Conbaemes Li.
cove law dote not apply m an owner of pmpwy who Wilda or Improv thereon.and,
who eantraeu for such project with a conuacmr(s)lianxd pury m m
wae Conor mea
License law.
❑Iamuwpsunder See ,93PCfortJddx.n
Owner Dam
WORKER'S COMPENSATION DECLARATION
on hereby allm under pensity of perjury oro of the following declarations:
I have and will mdnuln a CeeuOnm of Come,to self-ensu.for Worker.Cermpen. -
sadem.as provided fns by Section 3700 of the labor Cade.far W performann of he
mark far which this Permit is issued. '
❑I ban and will maintain Worker's Compensation Insurance,u required by scion -
3700 of the Labor Code,for he performance ofllhe worst fnrwhich this permit awned. '
My Worker's Cao penuliun lm/^u�nul,y ores
an Poliry number te�ej: sew
Caller, ; Y Poliry No.: 2 O Qv✓
CERT3FICATE OF M P ION FROM WMERS'
COMPENSATION INSURANCE
or less)(Thu mise ward not Wcompleted If the permit is fvonc hundred nonan(Slat)
I mnifv Wt in the Performance of the work for which this permit La instant.I shall not
employ my,;.in my manncrse as in become subject to W Workare conamematon
laws of Califnmia.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject se the Worker's Compensation provision of he lobar Cade,you mum
.J z forthwith comply with such Pmvidav Or this permit atoll W daemon revoked.
,zi Z7 CONSTRUCTION LENDING AGENCY '
[� Thereby affirm Wt hem is a covuuNnn lending agency for the performance of
ai
can work for which this permit Is wued(Sec 3097,ON.C.)
0.A Lcndeea Nana
z Iandees Addreu
U O[ I artily that I have real this application mod same sdon move ove information U
U.U cormem coarm
L I agree comply with all City county an lamas and awe Laws misting to
C Wilding eanswction.and hereby satiation mPcescrutiv of this city to enter upon the
� W ahove-menudgm progeny for a pcNan purposes
y 6w (We)agree m save,indemnify and kap hamlet the City of Cupertino against
rq in coo mono of thents.e
treating
uind expenses which may in any way urneagdw said City
U.7a A APPLICANT
ofD granting ShieDWIL )
r7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH AL NON.POINf Issued by: Date
SOURCE S.
6 Re-roofs
n um ofAPPliun anlr Date
HAZARDOUS MATERIALS tstand Os Re Type of Roof
WilltheCap"'i'rlulus WBdinguecoputsmmnrNMm hemd and Suety
u defined by the Cupenlna Muniripa ode.Chapter 9.11.and the Health and Safety
Code.Section ss53z(a)7 All roofs shall be inspected nor to an roofing material beim installed.
❑nem o P P Y g g
Will W applicant h future Wilding by the B um c&Air Qu or Mara which
If a roof is installed without first obtaining an inspection,I agree to remove
11 hvaNnua air canuminanu u do nen by W Bay Ama Air Quality Management all new materials for inspection.
District?
Oyer e<
I have real me husrdtancoamnals mqunemcnb ander Chapen6.95 often Califm-
mAHulthg:SafnYCedc Smu.255M.25533 aW25534.I uMcwnd thndata building
dao cum ve a mtanl and it u my wnpondbitity m nmify Ute aceupanr of the
sen uabemet aeaxiumecorac r. 3�ay�k Signature of Applicant Date
GS /ODamm All roof coverings to be Class'"or better
Owns mmilonxed, cm
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot: . ..
APN . . . . . . . . : 36652048. 00
DATE ISSUED. . . . . . . : 08/13/2008
RECEIPT #. . . . . . . . . : BS000005779
REFERENCE ID # . . . : 08080094
SITE ADDRESS . . . . . : 11611 SEVEN SPRINGS DR
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . CHERUVU SURYANARAYANA M AND VI
ADDRESS . . . . . . . . . . : 11611 SEVEN SPRINGS DR
CITY/STATE/ZIP . . . : CUPERTINO CA, - 95014-5126
RECEIVED FROM . . . . : CASTILLO' S ROOFING
CONTRACTOR . . . . . . . : JOSE CASTILLO LIC # 25850
COMPANY . . . . . . . . . . : CASTILLO' S ROOFING
ADDRESS 1703 CATHAY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE . . . . . . . . : (408) 251-3565
• FEE ID UNIT QUANTITY 'AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 9, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 20 . 00 260 . 00 0 . 00 260 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 261 . 00 0 . 00 261 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 261. 00 #15269
---------------
TOTAL RECEIPT - 261 . 00
VOICE IO DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO X4009 y
REROOF
•CUPETIi; INO PERMIT APPLICATION
APN # Date:
C)
Building Address:
Owner's Name: Mr +�y vn Phone #:
MoI I S-evenS rin 5 Ian- • �C
Contractor: CAs-r i L to S Q-00c r.J� Phone #: (q 25 I - 35
Fax #:
Cupertino Business License #: Contractor License #:
y 301!i5�
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles sfAsphalt Shingles
U' Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles I1
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installat}on Specs.
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Job Description: ? nova �Aj W n9 vva�d Shakes �, S-F>,i 1 ��-
s�w 11 QRL L) GPra G�rc�ncJ cany6h Corv�P • ..
I'i a0 S0.
Residential M Commercial
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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:
'Cl .5M 0
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
c_ -
i ture '
Revised 6/16/08
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CITY OF CUPERTINO
REROOF
6PM.1N0 FEE SCHEDULE
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Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREI OOFCOM Re-roof Commercial B ICOMMLROOF
1BSEISMIC0 Seismic Commercial B
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1REgOOFRES Re-roof Residential B ISFDWLROOF
2
1BS IISMICRE Seismic Residential B
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1REROOFMRES Re-roof Multi-Family B IMFDWLROOF
1BSISMICRE Seismic Residential B
1B4LIC Business License B
Revised 6/16/08
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Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
I
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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 the job 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: Mr . U
Job Site Address: I Ro I I Se JP-n S j2 i nl S DP—
Roofing Company Name: CA d_
SSi l L�LO S 20or-1 /_n(A
Applicant's Sign . C:t d Date: a 3
• Greg Casteel
Building Official
Revised 07/30/08
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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 t
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 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
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Plan Review Process Work Book Page-I2-Revised 3/25/08
Green Points Rating System stem for Remodeling Projects
yfriendly is
ts
Due to the diversity of remodeling project types,assigning a"total pointa to a project to be effort should be made to incorporconsidered envitdate them into your
not feasible. However,25 measures have been highlighted to signify that every
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"youilproject. '
ai
"item ,
1.Recycle Job Site Construction&Demolition Waste 0
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials 4 Resource pts y=yes
3.Remodel for Mixed Use,Adaptive Reuse,and 0 1
Historic Preservation 4 Resource pts y--yes
is es 0
2 Resource
4.Protect Native Soil p y=y �
5.Minimize Disruption of Existing Plants&Trees 1 Resource of y=yes 0
6,Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0 I
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 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes i
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes I C
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 1
3,Insulate Foundation/Slab before backfill 3 Energy pts y=yes 1 0
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
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes D
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 of y=yes 0
1 1 1
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INPUT Resoutces Energy IADIHealth
U"txter or Iran '
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
3.Install House Wrap under Siding 1 IAQ/Heallh pt y--yes i 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 yryes 0
2.Insulate Hol 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 AQ/Health pt y=yes 0
6.Coned 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/Hsalth pts. 0
6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
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t%etectncar I
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 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.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
4,Install Built-In Recycling Canter 3 Resource pts y--yes 0
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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 pis y=yes 0
3,Install Recycled-Content,Fiberglass Insulation with
No 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
D.Uenings 4 Resource pts y=yes 0
1 1 1
INPUT Resources Energy A011-lealth
m owe
• 1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts yges i 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes I 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on 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 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Heallh 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
6.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 31AQ/Hea1th pts y--yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heal Pumps 3 Energy pts y=yes 0
10.Install 13 SEERM 1 EER or higher AC Wth 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 wood stoveslnserts 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 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=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pis 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 pis 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1
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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 pis y=Yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pis y=yes 0
• 1 1 1
114PUT Resources Energy 1ADIHeafth
. n oor r ue ty 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 IAC/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=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6IAQ/Health pts y=yas 0
6,Use Exterior Grade Plywood for Interior Uses 1 IAO/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 78Resource pts y=yes 02.Use Rapidly Renewable Flooring Materials rce 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 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 yryes 0
1 1
Total Points Availablel1 1401 1301 57
Total Points Proiect Received: 0 01 0 •
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G:datdprogsrgreenbuldngguldellneshemalelers/greenpointsMal2.t 2.e4proreded.ds
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Community Development
10300 Torre Avenue
Cupertino CA 95014
, Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
I l u I I Se-Ven S H n S j2 . C22 0 9 v a 9
OWNER'S NAME: "r , 6 n PHONE #
GENERAL CONTRACTOR: C_ s � ��d 5 Zw' FAX # ({W? - 2,S t—3S co S
I am not using any subcontrk- ors.
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
(=/3-DF
Owner/Contractor Signature Date