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08090140 (2) CITY OF CU PERTINO BUILDINGDIVISS/JN PERMITC� RACTQRINF'ORMATIONNN _ :U—W, u 11.glriG�s511HELLY DR TNT ROOFING CO PERMIT08090140 OWNER'S NAME: PERMIT ISSUE DATE YIN WEI—SHIN AND YU—CHU 1610 BLOSSOM HILL RD STE 6C 09/22/2008 NE: SANITARY NO, CONTROL NO. ARCHI]ECrfENGINEER: - BUDDING PERMIT INFO RE—RF RMV SHKRF INSTL BLDG ELECT PLUMB MECH O O O O as w E LICENSED CONTRACTOR'S DECLARATION ofClb Job Description UC thereby affirmtNl1amfhe Buunder nd I'mmuar Chapin.9l(myli.ci is ^•^.... ... .. . ........ p jZ,t� viN Secuon]IXIU)of Divisfan loaf Ne Butlnev and Prafeuiom Cade,aM mylittnscu to is full lffarm and effem G37 lie• o Z —p Dam e pp 7W ___77 ' QRS DECLARATION y C I uMenunJ my plass shill is,used as public coeur& JyU `off Licensed Pmfusianal OWNER-BUILDER DECLARATION ��I I hcmby alum Nal I am cacmp from tw Contractors License Law for the OE following mason.(Sccdun PD 1.5,Business and Pmfusi..Cods:Any city car county K 51� which rcquiru a permit m construct.alcor,improw,&mol&h.or¢pair any mucro= Lz< prior of its issuance,aim raluims the applicant for such permit m 01st asigned summenl - ESG Nash=islmcnscdpubsualtoNcpmvisioibofthe ConuacmrsLicansoLaw(Chapur9 Sq.Ft. Floor Area Valuation Y s-$ (commencing with Section 7MO)NDiviaion 3 affix Business and Professions Code)or - .- that he is exempt twrefrom and the basis for tw alleged exemption.Any violation of Section 7031.5 by any applicant fora permll subjects thc applicant in a civil penalty of APN Number Occupancy e am come Nan fro hund=d dollua(5300). P Y `�Ty J'P ❑1,na ownv of tK pmpeny,a my rmplaym with ng.u thou role comprtsation, and do thewart altathe OOC rouroes sued Law dual not (Sac.70th,Bu Of and Rofwho.Galla:The w nuarmra ndwite law dam not appy lf rt owner is Required IDSPCC[IODs propertyloy buildsvicdponesthereon,andw sdoessuchwork confirm through bas Wraawc.th WiproM&dthatsuchimprowmwt me not ear orcmoRered fm sale Ir, h fild .the building m iam Of l mens 4 mid within one you of improve for Ne awmr- builder wW bane the burden of proNng that w did rot wiw or improv fm purpam of ❑1.an Owner of the pmpsny am exclusively contracting with licensed antrarors to construct tw project(Sec.7061.Business;and Rafessimu Cade:)The Contractor's U. cc=Law dou not apply ta an owns of property who builds or improm themon,and who contracts far such projects with a conummr(s)Iica.ed puuvaal of the Contnerafs Lkenm law. 0 lsm.emptumkt See ,B&PCforddsfeason Ownm Data WORKER'S COMPENSATION DECLARATION 1 hcmby an.under penalty of perjury one of the following declua6o.: i ham and will maintain a Ccrtirman of come.to self-i.um forwminnes Compn- nation,u provided for by Station 3700 of the lab.Code.for the perfa marc of dm _ work for which this prmit is issued. ❑I haw and will maintain Worker's Comp.ation Insurance,as rafthed by Section 37W of Ne labor Conic.for Ne po formantt of the work for which this permit is issued. My Workers Com ad nImmou ,carficr and Policy number ue:, � Cartier. Policy No.: 7f/l) T C�PnON FROM WORKERS' COMPENSATION INSURANCE (Thlsmmlon mad maWcarnplaud if Ne permit is Forane hunthddallan(5100) Or kit) 1 mrtify drat in tw perfars.of the work for which this Iurmit u issued,l shall trot employ any person in my mantmrm M to become subject to Ne Warkma Campeobsom Laws of California.Dau Applicant NOTICE TO APPLICANT IL after making this Cenificau of Fa=mption,you should Income subject to the Warkafs Comperaadon prorivam of than labor Code,you most .J z fmthwith camPly with such pmvisiov Of Nu permit Nall w docau d rewked. z CONSIRUCION LENDING AGENCY .mow Ih=mb affirm NU Nem u a...oucd.O loading a for tits F r . Foe/ performanttor IV > dm murk for which Nu permit ts issued(Sc.709'j,Civ.C.) U.1 A LcndeYa None iD. z Lender's Address V Q 1 certify that I hate mad this application and soon that the aww i..madan is Lp ^ Conal.1 agme in camplY with all City and County Ordinances and scan laws misting N C) building construction,and hcmby auNmin mprcamarives of Nu city to mur upon the F 4 ahove-mentioned property for i.pecdan purposs (we)agree to naw,indemnify and temp harmless the City af,Cupnino against rq liabilid.,judgmcnts,costs and espe.na which may in my w,ya..li ainat said City U in,......c.of Nm granting of Nis permit. APPLIC UNDERSTANDS ANO WILL COMPLY WITH ALIT,,NON-POINT Issued b SOU RE AT NS. y:S41 Date Eigaahac p/ pplicadfCo.rmmrr a / Dam RC-COOTS `` HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will th=applicant or run=Wilding mcupant sort ofhandle haurdous mamrial as&R.d by the Cupertino Municipal Cod,Chipler 9.13,and tw Huhh and Sultry Coda.Scotian 25532(.)? ❑Y. 5"*� All roofs shall be inspected prior to anyroofing material being installed. Will the applicant or fulum wilding omupam use equipment or&vie.which If a roof is installed without first obtaining an inspection,I agree to remove ithacardous air contaminants ss&lined by tw =a Bay AAir Quality Management all new materials for inspection. pr'. ❑� I haw=cal f WardwsrrweriN=quem er.un&r(]upms6.95 da.not cy a una.Naz u rcapo m ratiof mCaliror- nuHca1N&Safst .Sradw 23055 yLttEifu building mgammcnb cerdr¢me0rfSignature of Applicant Date o— con ad,s=nt Dam All roof coverings to be Class'%"or better CITY OF CUPERTINO • 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . . 35911022 . 00 DATE ISSUED. . . . . . . : 09/22/2008 RECEIPT #. . . . . . . . . : BS000006146 REFERENCE ID # . . . : 08090140 SITE ADDRESS . . . . . : 20629 SHELLY DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . .. YIN WEI-SHIN AND YU-CHU ADDRESS . . . . . . . . . . : 20629 SHELLY DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2923 RECEIVED FROM . . . . : MICHAEL D WILLIAMS CONTRACTOR . . . . . . . : WILLIAM TYLER LIC # 22988 COMPANY . . . . . . . . . . : TNT ROOFING CO ADDRESS . . . . . . . . . . : 1610 BLOSSOM HILL RD STE 6C CITY/STATE/ZIP . . . : SAN JOSE, CA 95124 TELEPHONE . . . . . . . . : (408) 277-0800 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ------ --------- ---------- ------ ------- 1BSEISMICR VALUATION 11, 250 . 00 1 .20 0 . 00 1 . 20 0 . 00 1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 365 . 20 0 . 00 365 .20 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 704 . 00 VISA --------------- TOTAL RECEIPT 704. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • v� o� o � yo CITY OF CUPERTINO smiREROOF CITY OF •CUPERTINO PERMIT APPLICATION APN # 9� O � Date: /5 / � �_ ac� Building Address: Owner's Name: Phone #: SNQ 2S-S-- 2 530 Contractor: TIAT 9_oo`� i\ Phone #: yUq) Z72— O fjOo I Fax #: U,!�' �_6rj " 210 3 Cupertino Business License #: Contractor License #: So/ Z5 Z_ Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof o Asphalt Shingles r"Asphalt Shingles obd Shakes ❑ Wood Shakes 41 ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings o Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description:RJ-01<e. JtUu�. �NJ {-p 1( lr( 4a /J1 y ,)out) 3 ��, Fel C�,kr u J i }z orf SG Ncl G/9�� 14 Residential Commercial Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application o.r if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: I Have Read, Understan and Will Comply with Cupertino's Tear-Off Policy: *Si Wna i Revised 6/16/08 CITY OF CUPERTINO REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2— F F 1REROOFRES Re-roof Residential B ISFDWLROOF 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B IBUSLIC Business License B Revised 6/16/08 Community Development Department Building Division City of Cupertino • 10300 Tone Avenue Telephone: (408)777-3228 Fax: (408)777-3333 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: i job Site Address: 4c)-(Z/cJ Roofing Company Name: • Applicant's Signa Date: `1 u Greg Casteel Building Official Revised 07/30/08 Community Development Department Building Division City of Cupertino • 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building Department REROOF TEAR OFF POLICY 1. You must schedule an inspection for the tear off the day before you wish the inspection to be made. The procedure is to call the Building Division (408) 777-3228 between the hours of 7:30 a.m. and 3:30 p.m. to request a next-day inspection. • 2. When the roof is torn off, the nails have been removed or driven in, and all of the dry-rotted wood has been replaced, you must call the City Building Division. An inspector will be there within one hour. There are special hours for this service: from 7:30 a.m. to 10:30 a.m. and 1:00p.m. to 3:30 p.m., Monday through Thursday and from 7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note: Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m. and will not be called during that time. City Hall is closed between 12:00 and 1:00 p.m. daily.) 3. If you call for a tear-off 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 • Greg Casteel Building Official. Revised 8/13/04 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 INPUT Resoumes Energy 1ADIHmith �1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;80%=4 points ` up to 4 Resource pts 0 �2_Salvage Reusable Building Materials 4 Resource pis 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 D 1 1 1 B.Foundation 6m 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 D 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 1 C.Structural Frame 1.SubstihAe Solid Sawn Lumber with Engineered Lumber __J 3 Resource pts y=yes p P.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 D 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 to Wall 3 Energy pts y=yes D 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.Subfioors 1 Resource pt y=yes 0 • b.Sheathing I 1 Resource pt y=yes 0 0 1 1 INPUT Resources Enetgy 1ADIHealth ztenor wish 1.Use Sustainable Decking Materials a.Recycled content 3 Resource pts y=yes 0 • b.FSC Certified Wood 3 Resourceis es 0 P Y=Y 2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Hea th of y=yes 0 13.Install House Wrap under Siding 1 IAQ/Health of y--yes 0 14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0 E.Plumbing (t hs—tall WaterHeateiJacket _ 1 Energy pt y--yes 0 2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0 3.Retrofit all Faucets and Showe lead's 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) i 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.instal Chlorine Filter 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 6.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 1 1 1 r.trecmcar [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 eatoch,up 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 of y=yes 0 2.Install Washing Machine with Water and Energy Conservation Features 1 Energy pt y--yes 0 13.Install Energy Star Refrigerator 1 Energy pt y=yes 0 4 Install Built-In Recycling Center 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 0 13.Install Recycled-Content,Fiberglass Insulation-witli - �No Added Formaldehyde 3 IAQ/Health pts y=yes 0 4.Use Advanced Infltration Reduction Practices 2 Energy pts y=yes . 0 5.Use Cellulose Insulation a.Walls 4 Resource pts yeses 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.ueoings 4 Resource pts y=yes 0 INPUT Resources Energy AQ/Heafth endows I1.Install Energy-Efficient Windows • a.Double-Paned 1 Energy of y--yes 0 b.Low-Emissivity(Low-E) I 2,Energy pts Y--yes D c.Low.Conductivity Frames _ 2 Energy pts y=yes 0 2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0 1 1 f J.Heating Ventilation and Air Conditioning 1.13se Duct Mastic on All Duct Joints r -_ 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 D 6.Install Attic Ventilation Systems 1 Energy of y=yes 0 7,Install Whole House Fan 4 Energy pts y=yes 0 8.Install Sealed Combustion Units a.Furnaces 31AQ/Health pts y=yes 0 b.Water Heaters 3 IAQ/Health pts y=yes D 9.Replace Wall-Mounted Electric and Gas Heaters with Through-the-Wall Heat Pumps 3 Energy pts y=yes D 10.Install 13 SEERl11 EER or higher AC with a TXV 3 Energy pts y=yes D 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 D 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 D c.Install Airtight Doors 1 Energy of y=yas D 14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes D 15.Install High Efficiency Filter 4 IAQ/Hsalth 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 D 1 1 1 K.Renewable Energy and Roofing . 1.Pre-Plumb for SolarWater Heating 4 Energy pts y=yes 0 2.Install Solar Water Heating System 10 Energy pts y=yes D 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-Dumtile Roofing Materials _ 1 Resource pt y=yes D 7 Install Radiant Barrier- - - 3 Energy pis y=yes 0 1 1 I L.Natural Heating and Cooling 1. Incorporate Passive Solar Heating 5 Energy pts y=yes p 2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes D 3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0 1 1 1 INPUT Resources Ener M. ndoor Airuahty and Frmshes ti.UseLowMo-VOC Painf�2.Us _ 1 IAO/Health pts y=yes 0 e Low VOC,Water-Based Wood—Finishes Finishes 2 IAQ/Health pts y=yes 0 • 3_Use LowMo 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=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Seal all Ex�sed Pa icleboard or MDF 4 IAQMealth pts y--yes D 6,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 31AQ/Health pts y=yes D 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 5 Resource pts y=yes 0 12.Use Rapidly Ren'ewable.Floonng 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 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 1 Total Points A 1 1401 130 57 Total Points Project Received: 0 0 0 • G:datelprogsrgreenbuildingguidellnesiremodelersigreenpoinlsfinal2.12.04proteded.zls Community Development 10300 Torre Avenue Ik -i Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 &UPEkTINO Building De artment JOB ADDRESS: PERMIT� 00 " OfD (1-(0 OWNER'S NAME: 2 n/ PHONE # 2 —D QO GENERAL CONTRACTOR: FAX # Z 3 I am not using any subcontractors: ZO 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 O�W� z ne tractor Signature Date