08050159 (2) CITY OF,CUPERTINO �€' - ,F w�of •��(" * " ry '" '
BUILDING DIVISI73N PERMIT xCO1�ITRACTOIr'INk;ORMATION,
BUILI�(NppQDLIPSS�HELLY DR ATLAS-TRILLO HVAC 08050159
OWNEWSS NAME: PERMIT ISSUE DATE
HUNG CHEN 1965 KYLE PARK CT 05/20/2008
ONE: SANITARY NO, CONTROL NO.
ARCHITER/ENGINEER: RNV & RPLC FURNACE & ADD A/ -BLDG BELECTGP UMBO MECH
TAiirp t� (� (� 0
u0' LICENSED CONTRACTORS DECLARATION Job Description
with Se
g d C 1 hetcby affirm that t a e licensed under provisions of Chapter 9(commencing
t, ction7M)of Division Sof the Businest and Professions Cask,mall my license
O N in full force and effect,n /1 6.
j rg Z License C1 <–✓ Lk.t
Dau:�� _�Conlrases�[( r�/I�1%A
epp ARCHI'ECPS DECLARATION
W< 1 untleaunJ my plansMall nodded as public rectos
gy
S Licensed Professional
y3
OWNER-BUILDER DECLARATION
I hereby.(firm Net 1eaemp,from liveConoanofa Limnee law for Inc
i O O following mason.(Section 103L1.5,Business and Po(uwiuw Code:Any city m county
$
which rtquirus s permit to construct.aper.Impaw,hdemolish.itsire a sig any amenule
_i< that Ice its issued e.pom o requires Novisio sof forthe sucCom permit w reents,Law
(Chmmem
m (C meningwiit pSewant more pmvieionsofeWConusucksa Jccnsclaons Code)
Sq.Ft. Floor Area Valuation
yl–$ (courts Is examp, erefousand of Dirmion3 arrivealleged exemptind on.
Any
Cade)of
Nat ha u essmp,therefrom and IW buil far the alleged exwpoam Any Nolaum of
Semon 1831.5 by any applicant for a permit subjects Nc applicant to a civil Mostly of APN Number Occupancy Type
Trot mom than few hundred Galan(MR P Y YP
wi Lo aro rk,fdicproperty,armycmployeeswithwagesuaLc(S lecm .Be Costs
and do Ne wvrk-and Ne he Ccre ra nom's License
Law
does
net apply
10 N,Owner of
and nywh ow Code me improves
tlecwrr l.icoem law dnw oro appty lf an owacr or Required Inspections
propertywhit Wntlsetimposes ch improvements docssammo chw deo or oelforfor ultzWe hu
owncer.the Wilding
or ithatsuesimprosemmtsarenot ouoftlorlenm4 for sales,
however.the building aImpronemmnis gsoldwithinoacyearormprvfarNeowacs-
Wilder will have the OUNar of proving not W did rot Wild et improve lor purpose of '
❑1,as owner of Ne property,am exclusively ctsnoac,ing with licensed mntr6wn to
construct the project(Sec.1044,Bovines and Professions Code:)The ComrracNrs U.
cense law dors not apply w an owner of property who Wilds or impmma Noreen.and
who contracts for such ponjects wit,a eo mancwl(s)licensed pluevenl an the ComrscwYs
Liceaa law.
C] ro l oexempt under See ,B&PC for Nu wen
ser Dale
W ORICE RS COMPENSATION DECLARATION
"cm"aRsm under penalty of perjury one of dta following declarations:
eaw and will maintain a CerGfiww of Co.n,w self-iwum for Worker's Compen-
.as provided for by Second 3100 or the Labor Code,ret she Md...of the
eco for which this permit is issued.
I have and will maintain Wadmes Compensation Insurance,as required by Section
of the labor Coda for the prfmmancc ranee work for caber are;Nu permit is kVacQ
My Worker's Compensation Wursna wmi'and Policy number are:/�/ .
Carrier. ��_>w/i( i� PoHCYNo.:kVaa&2O–tYZs
CERTIFICATE O�UEMP ION FROM WORKERS
COMPENSATION INSURANCE
(This aenlw aced Out W Completed if lbe permit Is We=hundred dollars(5100)
or less)
I mthly Net in to Performance of the work for which data Permit Is issued.I shall Trot
employ any Person in any maa arse as w Mcome mbjml an the Workers Compensation
Laws of Califomu.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Eacmp,ion,you should
become subjen In the Workers Compensation provisions of the labor Code,you most
.J O fuMwilb comply with such provisions or this permit shall W dcemed rowkcd. -
`" CONSTRUCTION LENDING AGENCY
I–t Thor which
Wl Nemuaed(Ses.3n leading spay,for the performance of
(Yi> dse work for which this pray u inuW(Sa.3091.cin.C.)
�W Q lender's Name
z Leadeea Addruw
C)Q 1 cedify that 1 law read this applicaion and sate Nu IW aWse information u
cermet,l agree on comply with all city and county nNNam'es and a=lawn misting w `
Q building cowoucdon,and hereby ambodho mpsemnladves of this city to enter upon the \
aBove-menoac
ad property for inspection purposes.
try 4 (We)agree to Can.indemnify and kap harmless the City of CupeNn t against
h Iiabili0 menu,Casa aM wpeww which may in any way.against said City
U z Ism wnce dvc9 UM—which
Issued b
APP IC U ERSTANDS AN ILL COMPLY WITH ALL NON-POINT y: Date
50 RE ULA ONS
Re-roofs
Sign AppliunUConuac Dew
HAZARDOUS ALS DISCLOSURE Type of Roof
Will lW applieantor(u,uro Wndiog accts eamre.RrhaMk narurtlow maronal
as dol"d by the CuMobaO Municipal Code.Chapter 9.12e H.111,and Safety
ode.QYn 23533(a)1\ nn ,and NAll roofs shall be inspected prior to any roofing material being installed.
Will tiro applinnl sir(umm WilJint aruparn ase equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
emit haraNnw air conuminsnts u Jcfad by dm Bay Area Air Quality MawgCmcnt all new materials for inspection.
Dis0icsl
❑ b P
rex
1 have road the haanJms materials requimments under Chapter 6.95 of the Califor.
.is Health&Salcey Cede,Satins 25305.25533 and 25534.1 undersand that ifft Wilding
docs no dY base.wtanL Ince it u my responsibility w madly ore oentpant of the
rcyui Gnu mu or brwosumcc.r.c'tilnc9rue wy.'i Signature of Applicant Date
4�26
owner or mNoriad agcnr I Date All roof coverings to be Class'A!'or better
CITY OF CUPERTINO
• 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35911021 . 00
DATE ISSUED. . . . . . . : 05/20/2008
RECEIPT # . . . . . . . . . : BS000004842
REFERENCE ID # . . . : 08050159
SITE ADDRESS . . . . . : 20619 SHELLY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER HUNG CHEN
ADDRESS . . . . . . . . . . : 20619 SHELLY DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2923
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 8, 000 . 00 0'. 80 0 . 00 0 . 80 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 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
ITRAVDOC FLAT RATE 1 . 00 40 .79 0 . 00 40 . 79 0 . 00 _
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 34 0 . 00 286 .34 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 572 . 68 #9509
---------------
TOTAL RECEIPT 572 . 68
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- ------ ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
arm FURNACE/AC
OCUPEkTiNO PERMIT APPLICATION FORM
APN # ( O I Date:
O O
Building Address:
lq She/ Iq Pk---
Owner's Name: Phone#:
Contractor: Phone#:
VAC Fax#:
Contractor License #: Cupertino Business License#:
Contact: Phone#: P - vSW
A�,kl- Fax #:
Building Permit Info:
Elect n-�' 11 Plumb Mech
Residential Commercial
Job Description:
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 Pr iect• Type of Construction (Usage Class):
�D 6. 0
Strapped On Platform Bonded New Location Replacement
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist& Aarh it to the
application or if applicable, include in plan set & the sheet index.
1
CITY OF CUPERTINO
"a FURNACE/AC
CITY OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA 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.
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 SeismicT
1MRRAA Residential Repair/Alterat
ea heating appliance,refrig
cooling unit,absorption unheating,cooling,absorption
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocateea M •
suspended heater,recessed.wall htr, or
floor mounted unit heater.
1 MRAPPVNT 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
*CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description tFePermitType
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of
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
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
IMPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
I
/ 1TRAVDOC Travel Documentation B
IBUSLIC Business License B
•
CITY OF CUPERTINO
S FURNACE/AC
CITYCUPEI�TINO 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 ca 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
1BREMAIRHAN Residential A/C units<= 1 Ok CFM B
1MRRAA Residential Mech Repair/alt/add M
•
1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC 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. t
MOM
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 72oint
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 oints
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 oints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1oint
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
q
O
O
•
Plan Review Process Work Book Page-12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
• Due to the diversify 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 incoordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
'INPUT Resources Energy ]AWHertith
Site
[2Salvage
Recycle Job Site Construction d Demolition Waste I
5%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
Reusable Building Materials J 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 8 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
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=yes 0
1 1 I
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 OS
a.Subfloors
1 Resource pt y=yes p
b.Sheathing f t
--- — P Y=Yes
1 Resource 0
.Exterior rms
INPUT Resources Energy IAO/Health
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 4 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt Y--yes 0
E.Plumbing
C.Install Water Heater Jacket _ __ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes J 2 Energy pts y=yes 0
I3.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
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 Filter on Showerhead 1 IAO/Health of y=yes0
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
6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 1
r.electrical
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 1 1
G.Appliances
i1.Install Energy Star Dishwasher !� 1 Energy pt y=yes0
'2.Install Washing Machine with Water and Energy j
Conservation Features 1 Energy pt y=yesTC
0
13.Install Energy Star Refrigerator 1 Energy pt y=yes0
14 Install Built-In Recycling Center _ f 3 Resource pts y=yes
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
13.Install RecycledContenl,Fiberglass Insulation with
INoAdded 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 4 Resource pts y=yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
n.t;eilings 4 Resource pts y=yes 0
INPUT Resources Energy IA01Health
I. in ows
• i1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
L c_Low,Conductivity Frames — 2 Energy pts y=yes 0
2.Install Low Hui Transmission Glazing 1 Energy of y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
L 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 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
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes / 0
b.Water Heaters 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 pts Y--yes 0
13.Retrofit Wood Burning Fireplaces .
a.Install EPA certified wood stovesfinserts 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 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
11.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
16.Select Safe and Durable Roofing Matenals v , 1 Resource pt y=yes 0
7 stall Radiant Ba Tier 3 Energy pts y=yes p
L.Natural Heating and Cooling 1 1 1
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
. n oor rr Qua Iry an Frms es
INPUT Resources Energy IAG/Health
r1.Use Low/No VOC Paint -- - 1 IAO/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAO/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 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
i7.Seal all Exposed Particleboard or MDF f _ 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 Contef 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 y=yes 0
1 1
Total olnts Aval a le: 1401 1301 57
Total Points Project Received: 01 O=
G:datalprogsigreenbuildingguidelines4emodeleygreenpointsfinal2.12.04proteded.xls
•
Community Development
' 10300 Torre Avenue
M1 Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
& I q Sho II v o X0-5- 0 l s-`?
OWNER'S NAME: Cl ckAf PHONE #
GENERAL CONTRACTOR: 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
Owneror-Signature Date