08090148 (2) CITY OF CUPERTINO s s, 4ai65. cF -`�°* . �`'"•+ '
BUrLDINC DIVISION PERMIT ;,C•� TRACTOR'�INFOtMATIQN�.
BUI DRESS: PERMIT No.
�1�3�8 TIPTOE LN WESTERN ROOFING SYSTEMS 08090148
OWNER'S NAME: PERMIT ISSUE DATE
LISIN PATRICIA H AND 1328 WHITE OAKS RD 09/22/2008
rTEr cvr.wman (831) 278-1837 SANITARY NO. CONTROL NO.
ARCHITEGTiENGINEER: BUILDING PERMITINFO
BLDG EIER PLUMB MECH
0
O LICENSED CONTRACTOR'S DECLARATION lob Description
O
1ion7 )of NatIam lianrdinces pmvviomof Chapter MYit- iI, P
_ wiNllfame]dofffDivision JofNeBuvnusalkRofrssiomCode.And myliancu RE-RF T/0 INSTL 40SQ WDSHK FILL SHTNG AS ND 40LB
i full tomo and eft
Lmenm else, t7'i Lk.' FLT INSTL MTL TILS CLSA
nFp Dale �Contmnar
MCHf1ECTSD
D-V 1 uatdemunJ my Plans shall beW rtN
usu public cor
y O< Licensed Professional
wJ OWNER-BUILDER DECLARATION
i F I hereby alarm that 1 Am Attempt from the Contramars license Law for the
p O following rcmon.(Sectimh 103 1.5,Business and Pmfcasiam Cock:My lily or county
$� which requlw a pemlil to eomamc4 alma improve,demolish.or repair my svactum
-i` Prior to its issuance,also requires tion applicant for such Permit a file a signed sutemnL
that he is licensed pursuant to the previsions of the CanumwrS License Law(chapter 9 Sq.Ft. Floor Area $22000 Valuation
x (commexing with Section I00()of Division S of the Busislem and Profesiou Code)at
e 5— that he is exempt Nercfrom and the buts fm Ne alleged camptian.Any Holsdon of
Section 7051.5 by Aly applicant for a permit subjects the applicant An A civil penalty OfNumber O
not ma.Nmfivohundred dollars(s5M. 35932051 .E Occupancy P Y Type
❑1.u awtwr of tion peperty,a my mnploym with wages u ahe'v sok ampemation.
MIB Prl Monk.and NCSWmamn Ml N1AMed LswcllaformicpplyIOan,amen,Of
ma Ptlywh build,Calm The oo timmon.License uw dues net apply w an awnu is Required Inspections ,
Inaptly who s. rbirepmvuch i m o and who doessuch wank himself edNmugh his
owolves.Me Wilding
prsuch impmvemmuere not intended motioned ror Martr-
handler,tirebuildingorimprovement4hat withinasyearofcompletion,theownv-
builder will have do buNm of paving that he did rot build ar improve for puryose of
mm.l
❑1.as awner of the property.am exclusively contracting wish licensed contractors te
construct NA project(Sec.TBld.Business and PTfe4LON Cocky)TIC Contractor!Ll-
cenm Law does not apply Mae Manor of pmpenY who batilds or i sinew s NGears.md,
who convect for such projects with A mnuanoKs)lima sed pm to the Cowactors
License law.
❑l am exempt under See .B B P C for Nis moon
Owner Data
. WORKERS COMPENSATION DECLARATION
I hemby aTom under penalty of l egmy ane of the following declarations:
I have and will maimaln a Certifnam of Ganserm self-insure far Workers Campan
swan,As pmvidW fm by Sudor 7700 of the labor Code.far me pufarra.of the
work for which this pmmit is issued.
❑I have And will mainuin Worker's Compensation Insurm e.u acquired by Seetian
57W of the labor Coca,for site prrfmmaneA of the work for which this permit is issued.
My Workers Compenmtion Insurance carrier W Policy number art:
CaOriert YksAP�+Ana Nffar Policy No,U 03177'
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This seed.need ms bA Aomploted BNB permit is formmhandrW Ana].(SIM)
or lose.)
1 certify that in the parlance..of the work far which Nis pe.I,is¢mad.I shall not
employ any person in my manner so u at become subject as she Worladr'Comporeatian
laws of California Dam
Applkmt
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject as the Workers Compensation provisions of Ne labor Code,you mut
.,z forthwith comply with each provisions or this permit shall x darned revoked.
Z CONSTRUCTION LENDING AGENCY
vN-r F
I hereby annm that Nem is a construction lending e
gAecr for the peKorrnma of
W
the work for which this permit is hued(sec.71197,Civ.CJ
14
Q Landers Name
z L<Mera Mom..
C.9 C) 1 certify Nat 1 have Orad this application and sum NA the above information is
IT.!' correct.l agree to comply wish all city and county aNinanas and state laws relating to
.C) building commcdon,and hereby suNotlm representative of this city w cnmr upon the
G21 above-mentioned property for impaction purposes
"6r (We)agree an rove,indemttify and kap bamkss the Gtr of Cupertino against
Uy Ilmilitim.judpaw,tolls and expemrs which may in Anyway sameagalmt to City
Aconseguence ofthe DRSTANng of this pc WILL
Issued by: Date
^'
SOURCE
RE UNDERSTANDS AND W L COMPLY WITH ALL NON-POINT
SOURCE REGULATION
�'" Re-roofs
Si at VCowactm Dow
AZARDOUS M LS DISCLOSURE Type of Roof
Willy the Cupertino
Mum bu din6 hapttorcor Aa Use
haurle And
rial
AA dcfined by the Cupenire Municipa .Chapter 9.12,ane Ne HpIN and safety
Castle.Oy.255324)? Na All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
WIII Ne applicant ar future Wilding aaupant sex cqulpment or denims which P g
hmaNnm sit ccoumimnts u tned by Ne Bay Ama Air QaaldY Management all new materials for inspection.
V AIT
❑Yon ❑Na
1 have mad me haraOdausmamrialsmquimmew unlerChapwrd.95 of Inc Caliror-
maHWN&SafmyCode,Saliam 25505,25535 ars,n534.l aMcmmd de sane Wilding ��/J ZOO r/
Jas note unendy have a muni NA it u my ility as aroofy the axa m,or the L O
w� meals wh hmatbe orwim ar enifiAa rOAAapmey. Ignature of Applicant Date
heraalhariredagean K Da All overings to be Classor better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35932051 . 00
DATE ISSUED. . . . . . . : 09/22/2008
RECEIPT # . . . . . . . . . : BS000006155
REFERENCE ID # . . . : 08090148
SITE ADDRESS . . . . . : 7540 TIPTOE LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LISIN PATRICIA H AND ALEXANDER
ADDRESS . . . . . . . . . . : 7540 TIPTOE LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5837
RECEIVED FROM . . . . : MICHAEL D LUNNEBORG
CONTRACTOR . . . . . . . : MICHAEL LUNNEBORG LIC # 25896
COMPANY . . . . . . . . . . : WESTERN ROOFING SYSTEMS -
ADDRESS . . . . . . . . . . : 1328 WHITE OAKS RD
CITY/STATE/ZIP . CAMPBELL, CA 95008
TELEPHONE . . . . . . : (831) 278-1837
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 22, 000 . 00 2 .20 0 . 00 2 . 20 0 . 00
1REROOFRES SQ FEET 40. 00 520 . 00 0 . 00 520 . 00 . 0 . 00
--------- ---------- ---------- ----------
TOTAL PERMIT 522 . 20 0. 00 522 . 20 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 522 .20 VISA
---------------
TOTAL RECEIPT 522 . 20
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
'K-��'\� " REROOF
:UPEI�TINO PERMIT APPLICATION
CPN # Date:
2S93aate:
3uilding Address: 7 5-Y0
)wner's Name: Phone #:
Z-
-ontractor: Phone #:
Fax #.: Yc)k r3"5 i-733
__J_� _
-upertino Business License #: Contractor License #:
�o �7 Zy__
Type of Roof Covering:
:xisting: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
f Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) 76 Other (Specify)/� e f•i
Number of existing coverings ❑ Provide I.C.B.O. Report # Shy 7%, .
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
ob Description: �fAi a f� G✓�° / S� �/ T`� /� f4ewlr.,, 05
Nfe(,4 rl kJ/Sr �/f lv57�9 / /+e�4
residential Commercial ❑
I
een Building: Please complete relevant portion of the Confirmed with Planning Dept. if
seen Building Checklist & attach it to the application or if there are any restrictions: ❑
licable, include in plan set & the sheet index.
'aluation:
ZZ Gvu�
Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
gnature
Revised 6/16/08
CITY OF CUPERTINO
""m REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit.Type
Squares Group
1RER00FC0M Re-roof Commercial B ICOMMLROOF
1BSEISMICO Seismic Commercial B
l/6 1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC 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 Raid 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 complywith/the above stated policy on re-roofing.
Homeowner's Name: 4// L j/7i✓ /
Job Site Address: 7� �� /7/p/� -e Gi✓
Roofing Company Name: �Ol�✓
Applicant's Signature: Date: ?
• Greg Casteel
Building Official
Revised 07/30/08
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. Enerqv Star Refrigerator, (Note/Spec. A-3 1 oint
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS ��L 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.
INPUT Resources Energy [AD/Heafth
A,Site
'1 Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;60%=4 points up to 4 Resource pts 0
2.Salvage 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 Qualify with Landscape Design 2 Resource pts y=yes 0
d.bnign Resource-Efficient Landscapes and Gardens _ 4 Resource pts y=yes D
9.Reuse Materials/Use Recycled Content Materials .
for Landscape Areas 2 Resource pts y=yes D
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 pts0
2.Use Recycled Content Aggregate 2 Resource pts y=yes D
3. Insulate Foundation/Slab before backfill 3 Energy pis y=yes 0
1 1 1
C.Structural Frame
it.Substitute Solid
Sa%W Lumber with Engineered Lumber J 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 Haels 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
6.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 p
b.Wall 3 Energy pts y=yes p
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 of y=yes 0
• b.Sheathing +
1 Resource pt y=yes p
! 1 1
:INPUT Resources Energy [AD11-lealth
D. ztenor Frms
1.Use Sustainable Decking Materials
a.Recycled content 3.Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
X12.Use Treated Wood That Does Not Contain ChromiunUArsenic 1 IAQ/Health pt y=yes 0
13.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0
14.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 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. 0
4: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 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 41AQ/Health pts. 0
8,Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes 0
1 1 1
r.trecuncai
I1.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
i7.Install Energy Star Dishwasher - - 1 Energy pt y=yes 0
4.Install Washing Machine with Water and Energy i
IConservatiion Features 1 Energy pt y=yes 0
13.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
',4.Install Built-In Recycling Center 3 Resource pts y--yes 0
1 1 i
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 .
3.Install Recycled-Content,Fiberglass Insulation with
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 0
b.Ceilings 4 Resource pts y=yes C •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
I).uemngs 4 Resource pts y=yes 0
1 1
INPUT Resources Energy AQ/Heafth
endows
1.Install Energy-Efficient W ndows
• a.Double-Paned 1 Energy of y=yes D
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames _ 2 Energy pts Y_—YesD
2.Install Low Heat Transmission Glazing 1 Energy of y=yes 0
1 1 t
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 IAO/Health pts y=yes D
5.Install Solar Attic Fan 2 Energy pts y--yes 0
6.Install Attic Ventilation Systems 1 Energy of y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes D
B.Install Sealed Combustion Units
a.Furnaces 3 IAO/Health pts y=yes D
b.Water Heaters 3 IAO/Health pts y=yes D
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 D
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves(nserts 1 IAO/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy of y=yes D
c.Install Airtight Doors 1 Energy pt y=yes D
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes D
15.Install High Efficiency Filter 41AO/Health pts y=yes D
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAO/Health pts y=vas D
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 Enercy 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=1 B points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes D
1
01 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 75Energy pts y=yes2.Install Overhangs or Awnings over South Facing Windows gy pis y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes D
1 ! 1
•
n
M. ndoor Air Qualdy an Frntshes
_ INPUT Resources Energy IA011-lealth
1.UsetowiNb-VOC Paint- - - 1 IAQ/Health pts y--M 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=yes - 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Hsalth 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 OF 41AQ/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 31AQ/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yes 0
12.Use Rapidly Renewable Flooring Materials 4 Resource pts y--yes 0
3.Tse Recycled Content Ceramic Tiles 4 Resource pts y--yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pis 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 Points A 1 1401 130 57
Total Points Project Received: 0 0 0
G. ta/Pro Igreenbui dingguidelin srremod^ enpmntsfinat212ebprotededxls
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPERTINO
Building De artment
JOB ADDRESS: 7T-1/0PERMIT # 0 0/ 0 1��
i, .� LN
OWNER'S NAME: Je2LOIL,f, PHONE # 2S2 l
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:
*natuK Date
Please check applicable subcontractors and complete theLollbwing 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
y=LZ-t-ay
Owner/Co 'ctor Signature Date