08070215 (2) CITY OF CUPERTINO i.iki s44*.k...** + 4r n•:f� � Ai
BUILDING DIVISION PERMIT = CaNTRAaC�TOR INFORMATION '
BUILDING ADDRESS: • PERMIT NO.
• 20284 VISTA CT SAGES IRENE C 08070215 .
OWNER'S NAME: PERMIT ISSUE DATE
SAGES IRENE, C 20284 VISTA CT 07/30/2008
�NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
C O C C
O p LICENSED CONTRACTOR'S DECLARATION
i u 5 with I hereby stains this I am licensed under provisions of Chapter 9(commencing Job Description
xx etion7010)ofDivision 3ofthe Business and Professions Code.and myliccnsela REPLC SNKS&FCTS IN KTCH ELCTRC OUTLTS W/GFI NO
n j e4 in full force and effect
stl& License Class Lie.g NEW
E r p Date Contractor
7W ARCHITECTS DECLARATION WIRNG, NO NEW LTNG
D untie undmyplatushall heumdas public recnrd ku *NOTE THIS PERMIT FOR DUPLEX 20284 & 20286 VISTA
tit3t Licensed Professional
N5 OWNER-BUILDER DECLARATION
f I hereby affirm that I am exempt from the Contractors License Law for the .
at o following reason.(Section 7031.5.Business and Professions Code:Any city or county
3 g which requires a permit to constme4 alter.improve,demolish.or repair any immure • '
_i y prior b its issuance,also requires the applicant for such permit to file a signed statement
p"C that he is licensed pursuant to the provisions of the Contractor's license LAW(Chapter 9 Sq.Ft.Floor Area Valuation •
(commencing with Section 7000)of Division 3ofthe Business and ProfessionsCode)or $300
e E$ that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 70313 by any applicant for a permit subjects the applicant to a civil penalty of p,p�Number Occupancy Type
not mom than five hundred dollars($503). 31625032 .-CIV' P y
Las owner of the property,or my employees with wages as their sole compensation,
will do the work,and the sanctum Is not intended or offered for sale(Sec.7044,Business
and Professions Code:The Contractors License Law does not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improat
vements e not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion.the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑I.as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044.Business and Professions Code:)The Contractors Li-
•
cense Law does not apply to an owner of property who builds or improves thereon,and,
who contracts for such pmjecu with a contracmr(s)licensed pursuant to the Contractor's
License Law.
❑lam exempt um ,B&P C for this reason
Owner C wtelf5V/t r
•' ER'S COMPENSATION DECLARATION
I hereby alltm under penalty of perjury one of the following declarations:
le
I have and will maintain a Cenifcateof Consent to self-insure for Workers Compen- '
sauon,as provided for by Section 3700 of the Labor Code,far the performance of the
work for which this permit is issued.
❑I have and will maintain Workers Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit Is issued '
My Worker's Compensation Insurance artier and Policy number are:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
•
(Thu section need not be completed if the permit li for one hundred dollars(SIX)
or less)
I certify that in the performance of the work for which this permit is Issued,I shall no '
employ any person in any w res u to become 'Ee to 'Compensation -'
Laws of California.Da
Applicant
NOTICE TO APPLICA ,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
.J Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z OCONSTRUCTION LENDING AGENCY•
.�. I herebyaffirm that there is a consrmctian lending(-' agency for the performance of -
C46 Lederrs for which this permit uissucd(Sec. Civ.X07, C.)
•
7 z Leona Lenders
Name
'
t.) ra
O I certify that I have d this application and state that the above information is .
LT. - correct.I agree to comply with all city and county onlinances and state laws relating to
.0 IS.^J building construction.and hereby authoda representatives of this city to Cot upon the .
above.mentioned property for inspection purposes.
H Lu
agree to save,indemnify and keep harmless the City of Cupertino against
res r 3 liabilities,judgments,costs and expenses which may in any way accrue against said City 7111111111.1��
V z in consequence of the granting of this permit.
"" APPLICANT U ERS ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: �4k AYI// Date<-7/3 c--c
SOURCE RE ONS.
Ile of a S Re-roofs
Signature o rcantCansamo Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof e-----1/
Will the applicant or fin=building occupant store or handle hazardous material •
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(+)7 C All roofs shall be inspectedprior to anyroofing material beim
pyo IG P g installed.
Will the
If a roof is installed without first obtainingan inspection,I agree to remove
all new materials for inspection.applicant or future building occupant use equipment or devices which
III P g
l hazardous air contamians as defined by the Bay Area Air Quality Management
trim
❑yes No
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&SafetyCade,Sections 25501 25533 and 25534.1 understand Naz if the building
does not cunentlyy a tenon that it is my responsibility to notify the occupant of the
requirements Ice met prior toissuanceofaCertificate ofOccupancy.alp
Signature of Applicant Date
L 1�30���
Owner or authorized agent Dab' g
All roof coverings to be Class'Yror better
CITY OF CUPERTINO
40 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # : 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN • • 31625032 . 00
DATE ISSUED • 07/30/2008
RECEIPT # • BS000005629
REFERENCE ID # . . . : 08070215
SITE ADDRESS • 20284 VISTA CT
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • SABES IRENE C
ADDRESS • 20284 VISTA CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM • ALBERT M SABES
CONTRACTOR LIC # *OWNER*
COMPANY • SABES IRENE C
ADDRESS • 20284 VISTA CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
1I3SEISMICR VALUATION 300 . 00 . 0'. 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
TOTAL PERMIT : 122 . 87 0 . 00 122 . 87 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CREDIT CARD 122 . 87 MC
TOTAL RECEIPT : 122 . 87
•
•
•
•
dt7070� /c .5
CITY OF CUPERTINO
CUPEIQTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # Date:
3t Co z1—o - g t 32. 00 r:10 ca.
Building Address:
-2_o-2..;q /sc )t S T A CT-
Mailing
rMailing Address (if different from building address):
1 �T 2-73 C'-tT2u S C-.v SA.aaern,G•4- CAR- `r So T o
Owner's Name: C .Sc l-r Sn.scc -r-r, ,rt... ) Phone#:(4-438 cF&q wys
T1LaNe G S#-aec . Ta .srt—
Contractor: Phone:
ou. c✓ g . LOQ _ 468. 9-9524433
Fax:
Contractor License#:
Cupertino Business License#:
Contact: Phone:
Fax:
• Residential ® Commercial U
Job Description:
r�ep(AC St w Ci -i- ffA-)C.-t-c. I n /Ct1-c.&iq q
(si..t -a. Cjj.. . o.z.7-(&X w,tct G Ft. n 0 ts21-1 c a^rr.
ez'to raw I;nth)t�,� '
Building Permit Info:
Bldg ❑ Elect 111.7 Plumb R- Mech 0
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV-HT, V-B EH- 12-- 3
Valuation: ,y Square Footage:
3nc.
Project Size: Expresstandard ❑ Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application'or if applicable, include in plan set & the sheet index.
Points Achieved:
• yC,
For help, contact Build it Green at www.builditgreen.org CT
Revised 7/01/08
CITY OF CUPERTINO
itror
CUPERJINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BBOILER1 For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h (29.3kw)
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1 BBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
IBBOILER4 Installation/relocation of ea M •
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
•
1 ELECINSP Other Electrical Inspections (per hour) E
1 MECHINSP Other Mechanical Inspections (per M -
hour)
•
IPLMBINSP Other Plumbing& Gas Inspections P
(per hour)
1MEETING1HR Application Meeting B •
CITY OF CUPERTINO
° °F GENERAL BUILDING APPLICATION
cukni(TINO
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
1ACOUSFDW SFDWL/Duplex New B
I ACOUSRESAD SFDWL/Duplex-Addition/Alteration B
I ACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
• 1 FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
IFIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1 FLAGPOL>20 Flag pole (over 20 ft in height) B
1 MODUSTRU Modular Structures B
FOUNDATIONS
1 FOUNDREP Foundation Repair B
1 PILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
• stressed concrete)
3of5
CCG CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CURE iNO
FEE SCHEDULE •
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY)
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSPIO Special Design, over 10' high (up to B
50')
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft)
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft) •
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
•
1 SIDEST/BK Siding, Stone & Brick Veneer B
(interior/exterior)
I SIDEOTHER Siding all other B
SKYLIGHTS
•
1 SKYL<10 SF Skylight less than 10 sf B
I SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st)
•
4 of 5
• I , CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
cursio
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
1WINREP Replacement windows/sliding glass B
door (ea 8 windows)
1 WINMEWSTR New Window-structural shear B
wall/masonry(includes plan ck fee)
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P •
•
1ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1 MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
ITRAVDOC Travel & Documentation B
• I 1BUSLIC Business License B
5 of 5
•
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
6 Building Points Categories that must be
shown and referenced on the Project
yy,�.yPlans See below)
totalitf9%Y. T�,,��qq",is t:Ji ; r4T;irk '✓.M1.x�, ,A, l' a r J:c:',4 j+ ,:nl ,,.tf Fir°+'PrK..: ` ."'a: .£,,Iv .l'^ 4 7 i s 7,. 9 ,rs%4,>SF
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
a;: ik;i241f,;-alOk j ii;t: 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.
INPUT Resources Energy IAO/Health
.Site
Ii.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points • up to 4 Resource pts . 0
1,2.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 Stomrwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
I8.Design Resource-Efficient Landscapes and Gardens _ il 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
U 0 0
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
C.Structural Frame •
0 0 0
r1.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 10Resourcepts. 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 0
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Energypts
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 pt y=yes 0
a 0: 1
INPUT Resources Energy IAD/Health •
B. Amor Finis
'1.Use Sustainable Decking Materials
, a.Recycled content 3 Resource pts y=yes- 0
le
' b.FSC Certified Wood 3 Resource pts y=yes- 0
12.Use Treated Wood That Does Not Contain Chromium/Arsenic - 1 IAQ/Health pt y=yes • 0
13.Install House Wrap under Siding 1 !AO/Health pt y=yes_ 0
14..._Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
0 0 0
E.Plumbing
D.Install Water Heater Jacket '
_ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 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 .
1(1 point each,up to 3 points) _ Up to 3 Resource pts. 0
5:Install Chlorine Filter on Showerhead 1 IAO/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
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
o 0 0
r.electrical ' - - - -
'1.Install Compact Fluorescent Light Bulbs(CFLs)
t(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) 1 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 Eriergy pts. 0
0 0 0
G.Appliances •
1.Install Energy Star Dishwasher ' ; 1 Energy pt y=yes_ 0
2.Install Washing Machine with Water and Energy
Conservation Features1 Energy pt y=yes- 0
i3.Install Energy Star Refrigerator - 1 Energy pt y=yes- 0
1
4.Install Built-1n Recycling Center - 3 Resource pts y=yes_ 0
o 0 0
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 with
INo 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_ 0 .
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes_ 0
b.uenings 4 Resource pts y=yes- 0
•
INPUT Resources Energy 7AQ/Heatth
.Windows
. ' 1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
' b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames _ _ ___ 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing ^ . 1 Energy pt y=yes 0 '
0 • 0 0
J.Heating Ventilation and Air Conditioning
1.Use Dud 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/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 IAQ/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)Fumace 2 Energy pts y=yes 0
. 13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoves/Inserts 1 IAQMealth pt y=yes 0
b. Insta VReplace 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 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAO/Health pts y=yes 0
o 0 0,
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
(1.2 kw=6 points,2.41(w=12 points,3.6 kw=18 points) Up to 18 Energy pts 0
6.Select Safe and burable Roofing Materials_ — _ ' 1 Resource pt y=yes 0
7.Install Radiant Barrier " - 3 Energy pts y=yes 0
_. .O . . U_ . _ 0
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 pts . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
o, o. 0
•
INPUT Resources Energy lenielealth
.In.oorArQua ityan. Inis es
1.Use Low/No-VOC Paint 1 IAQMealth pts y=yes 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 6IAQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQMealth pts y=yes D
f7.Seal allExposed 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 IAQMealth pts y=yes 0
0 0 0
N.Flooring •
1.Select FSC Certified Wood Flooring B Resource pts y=yes 0
[2.Use Rapidly Renewable Flooring 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 IAQMealth 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 D
0 0 0
Total Points Available: 1401 1301 57
Total Points Project Received: DI 01 0 •
•
Gdatarprogstgreenbuildingguidelineshemodelersrgreenpoimsfna12.I2.D4proleded.xls
•
•
OWNER-BUILDER VERIFICATION
• 1. (Check one) I or my immediate family (parent,spouse or child) will perform:
A. .r All the work authorized by this permit
B. _ A portion of the work
C. None of the work
If B or C is checked, complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. _ All of the work
B. _ A portion of the work (complete section below) •
Contractor Address/City Phone # State License # Type of work to
be performed
• 3. ar I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number - Type of work to be
performed
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature: Tw. Date: 7 /3 J•
Job Address: 2-4,44/1i 6 ih 3 rs rz Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
• Department.
`t' City of Cupertino Building Department
CITY OF
10300 Torre Avenue
CU P E TIN 0 Phone: (408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself,you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county: They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family,and the work
(including materials and other costs) is$200 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer, you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes,workers' compensation insurance, disability insurance costs, and unemployment compensation•
contributions.
There may be financial risks for you if you do not carry out these obligations,and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and,if you wish,the U.S. Small Business Administration). For more specific information about your
obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor,only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department,
City of Cupertino •
Printed on Recycled Paper
Community Development
10300 Torre Avenue
„tam, :. Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
Ili UPEI�JINO
Building Department
JOB ADDRESS: PERMIT #
'Zoe gLj7gb )c.sra Cr ��D'7bZ f
OWNER'S NAME: IPeu c C So%a rt.,s r PHONE # C/Gv tS y -L60 s
GENERAL CONTRACTOR: s,,,g FAX #
I am not using any subcontractors: ,0_--0 -71 ,/c,e
Signature Date
Please check applicable subcontractors and complete the following information:
El 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
• C c .__ 7/30)o a
Owner/Contractor Signature Date