08050084 CITY OF CUPERTINOa:t,--gyp
BUILDING DIVISIGN PERAUT kcoINT�RAFC, T.ORINFXORRMAT,I01V
PERMITNO.
POWNEWS
'Yff 'F AXLEY CT STEVENSON' S ROOFING 08050084
NAMES: PERMIT ISSUE DATE
ABA SATHYA 1594 MAIN STREET 05/09/2008
Nr. -
(650) 969-5134 SANITARY NO, CONTROL NO.
ARCHTIECT/ENGINEEA:
BUILDING PERMIT INFO
' BLDG ELECT PLUMB MECH
0 � � 0
moZ, LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby sffism this 1 we 1'rtenad under provisions of Chapter 9(commencing
with Smtion70 )of Division3oflMBusinw Mdprofeuimns Codc,andmyl&cnscis RE-ROOF FINAL; ORIG PERMIT EXPIRED - STEVENSON' S
n full for¢and efrnt
'q_ Lic..Clua Lk.0 ROOFING VALID AT TIME WORK DONE
r p Dem Conuaemr
7th
ARCHITECT'S DECLARATION
m u 1 u okossa d my plans shall W used a re
public cords
Ld
ywt; Licensed Pmfuasionel
OWNER-BUILDER DECLARATION
f I hereby afnmm Net 1 am exempt from the Contactors License Law for Ne
p O following mason.(Seedon ss 7031.5.Business;and Prolusions Code:Any city or Monty
i$�i which mquiru a Permit In construct,slm..ice crow.xmNLth,or repair any mecum
to ph.,to its issuame.slats mgdres Wespplicant for such permit to file asigrcm
d statement
££ss� that lit is licensed purowd to the provisions of the Contractors license Law(Chapter 9 Sq.Ft.Floor Area Valuation
YFe� (eommencingwith Section 70110)of Division 3 ofthe Bummusand Professions Codc)or $100
_ thd he is counam therefrom and the basis for the alleged!assumption.My violation of
Section 7031.5 by any applicant for a permit wbjc=the aPplkauo a civil penalty OfNUmbei Occupancy Type
at momthan Anhundred dalhra(SIMI 35606022 P y yp
0 I,u owns of the pmpcny,err mr cmployca with ego u theuwle campenudm,
send Pr the wart,and the he Cont armes Livens err a w does
t o1a,Business
and en,wh ons Cade:The Cantrumn.License who Law dohs rot apply lf an owns err Required Inspections
manprocnYwho Weradwel Chat
at such
uthirnpransursts .at inducuch ed for
his
sen cmr.me W.pmWxd W ove rent is sold
wthin not eat!of c m iwor.me Owner.
wsad.if.
however.me Wilding or duce a pmMtuhat withinmusWild of compleuaa,drop.of
Wilder will have the Wrxn of pmvug Wert K did trot Wild m improve fm pogo¢of .
7. -
n Owner of the property,am exclusively contracting with flamed Mnmaetan to
construct the project(Sec.70aa,Business and Professions Cade:)The Commuch rs L,
Mere law does al appy to M owner of propenr who builds or impmw Woman.and.
who contracts for such projects with•comesmor(s)licensed purswnt In the Contractors
Liar:Law.
0 lammem t Intim See. — .B&PCfor thus n
Owner Dam OS O
WORKERS OMPEN9 ECLARATION
01
1 hereby aRnd
ren uer penalty of perjury oro of the following declarsuons:
have nd awill mainifio
maintain a Cem of Consent to sell-insom fawor4YM
scomp -
ation.u provided for by Section 37M of time Labor Code,for the Performance of use
work for which this Permit is Caused
0 1 have and will maintain Wmkees Compensation Insurance.u hummed by Section
3700 ofthe Lunn Cade.for We performance of the wok for which this Permit is issued '
My Workers Compassed.I....urkr and Policy number am: -
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(lhuaccuon reed at be completed if the permit is fmane humdsedxllars(SIM)
mkaa)
1«pity that in the perrormavce of dos work for which this Permit is laded.l shill and
Implayanyperwninanymarom m Leo c 'u time Workers'Compenauon
laws of Califomu.Dam
ApplicarnNOTICE
� h $.
NOTICE TO APPLICANT: f.Caeomalting this sm th ^ tun,on,you sham
.J.Obcemne abjcel m the Waiters('mnawuan ermiit imus of the reed Code,you muss
faMwithcomply with such pmviaions m Nis permit shall be domed revoked.
Z M cONsmucnON LENDING AGENCY _
I hereby affirm that thea u a cotmuucunn lending agency far the pmfmmana of
C r�.t the work for which this ward,is issued(Ser.3097,Civ.C.)
0 Lemmen Name
z Leaders Addhaa
U O 1 certify that 1 bare mad this application and sem ala the salve iu femme is
I%, P cmreea 1 agile to comply with all city and county o dindmes and state laws relating a .
p building construction,and hereby mthotim rcprownamns of this city m enter upon the
r W
above-menuamm t property,for inspection purpowhich may
,
t„t gy (We)agree to ave.indemnify and kap h.rmma Ile City of Cupertino against
fI1 IiabilitieyjudgmenW corm and expenses which may th any way act7ue yainsl Cid City
U z APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �
SOURcE REGULATIONS. /_
05109 Re-roofs
Smgoatuse of Appliun omnwwr ' Daie
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will the applicdm or I.,.Wilding ottmpent stere Or handle haardou rismrial
u @Rned by the Cupertino Municipal Cade.Chapter 9.13.and the Health and Safety
cox,sextan s532(a)+
❑Ins g4
0 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
Will the aalinnt or future Wining by the Bl taw equipment or xviaa which P g
v ht? air contaminants u x0ned by U¢Bay Arta Air Qumily Mansgcmcnt all new materials for inspection.
wtr ct7
❑ler 0<1
I have read the huand.mamriaumquirc!ems unxrch imer6.95Ofthe Califor-
M.Hulth&SafetYCax.Sections V5505,25533 and 755M.1 understand thdlf the Wilding
Own not curcntly bow s meant.this it is my eaponubitity to notify mite uecupmt of me
reyuyemPnu�a'It mtm tpdor
iastonaaf.CerdnMf, Signature of Applicant Date�o �., All roof coverings to be Class'%W'or be
tterOwner mwOlunagcm Dam
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 35606022 . 00
DATE ISSUED. . . . . . . : 05/09/2008
RECEIPT # . . . . . . . . . : BS000004717
REFERENCE ID # . . . : 08050084
SITE ADDRESS . . . . . : 22023 BAXLEY CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : SABA'SATHYA
ADDRESS . . . . . . . . . . : 22023 BAXLEY CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4744
RECEIVED FROM . . . . : SABA CHOCKALINGAN S
CONTRACTOR . . . . . . . : MICHAEL STEVENSON LIC # 22847
COMPANY . . . . . . . . . . : STEVENSON' S ROOFING
ADDRESS . . . . . . . . . . : 1594 MAIN STREET
CITY/STATE/ZIP . . . : SANTA CLARA, CA 95050
TELEPHONE . . . . . . . . : (650) 969-5134
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------ - ---------- ---------- ------ -- - ----------
1BSEISMICR VALUATION 100 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1REROOFRES SQ FEET 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 390 . 50 0 . 00 390 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 390 . 50 .DISCOVER
---------------
TOTAL RECEIPT 390'. 50 , -
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
/ CITY OF CUPERTINO
REROOF
OF
•CUPERTINO PERMIT APPLICATION
APN # 3 5 , 0 6 0 22 . D D Date: D 5/0 ? /Dg-
Building
D8'Building Address: 2Zo23 13Ax Lsy GOVT-T CUPE-r--r it,10 C& 95;011--
Owner's Name: Phone #:
34& A SATHYA 4-08-- 34-3 — 1299
Contractor: 0169Phone #:
Fax #:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
�k Wood Shakes ❑ Wood Shakes
II ❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify) T 1 L E
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: IC E P D o p _,a7 c_
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in plan
set & the sheet index.
Valuation:
• I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
- � REROOF
CITY•CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1 REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
d 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
•
Community Development Department
Building Division
City of Cupertino
10300 Torre 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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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: g A AT H IA-
job Site Address: 'L2o L 3 l3A-2c L_c `/ Cz>y 2T
Roofing Company Name:
Applicants Signature: `Y Date: o > o 7/0 Q�
• Greg Casteel
Building Official
Revised 11/2/04
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
a . 72points B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 11. Permeable Pavin 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 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. Enerqy Star Refrigerator, (No te/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
FM
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.
Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points f up to 4 Resource pts 0
2.Salvage Reusable Building Materials _ _ 1 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 Quality with Landscape Design 2 Resource pts y=yes 0
design Resource-Efficient Landscapes and Gardens_—} 4 Resource pts y=yes 0
9.Reuse Materials/Uss Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes , 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes D
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 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Lumber _� 3 Resource pts y=yes p
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
B.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 p
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
r12.Use O9B -- --�^_'— - --
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource
— � Pl Y=Yes 0
04 1 0
INPUT resources Fnergy IAO[Health
.Extenor Finish
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y=yes D •
I
b.FSC Certified Wood ( 3 Resource pts y--yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenio i 1 IAQ/H"th pt y--yes 0
3.Install House Wrap under Siding ! 1 IAQ/Health pt y=yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
1 ! 1
E.Plumbing
�1`Install Water Heater _^� _ 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. D
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. D
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 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
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--
r.
D
1 1 1
r.tiecvicar
f1.Install Compact Fluorescent Light Bulbs(CFCs)
16 bulbs-2 points,10 bulbs=3 points,12 bulbs=4 points) _ f U to 4 Ener
-- �_ p0_.__. �_. _.� P � J P 9Y Pts. D
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
1.Install Energy Star Dishwasher's 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt Y--yes D
3.lnstall Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center ! 3 Resource pts y=yes 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 D
3.Instal(Recycled-Contant,Fiberglass Insulation w th
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 D .
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
U.cewngs 4 Resource pts y=yes 0
TNTindDWS
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
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use DuctMastic on All Ducl Joints 2 Energy pts y=yes D
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 D
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes D
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 D
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes D
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 stovesrinserts 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 41AQ/Health pts y=yes 0
16.Install Heal Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes D
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 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 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 D
i6.Select Safe snd Durable Roofing Materials 1 Resource pt y--yes D
7 Install Radlanl f3arner' - - - 3 Energy pts yryes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes D
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 p
1 1 1
•
INPUT ResDurces Energy IADNealth
.Indoor Air Qua ity and Finis es • • -
it.Use{ow/No-VOC Paint 1 IAO/Health 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- v 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
7 Seal all Exposed Particleboard or MDF 4 IAQ/Health.pts y=yes 01
8.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 D
10.Install Whole House Vacuum System 3 IAQ/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring a Resource pts y=yes 0
[2.Use Rapidly,Rdneweble Rooring Mate als _ __ _` 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 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
B.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1 1
Total Points Available: 1 1401 130 57
Total Points Project Received: 1 01 0 0 •
G:daiarprooslgreenbuildingguidelineslremodelerslgreenpointsf ne12.12.04pmleoied.xls
•
n Community Development
� 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPEf�TINO
Building De artment
JOB ADDRESS: PERMIT #
22o2-3 gAxL� CoVa?T �PERTIN� .� 005 Doi
OWNER'S NAME: S q PHONE #
GENERAL CONTRACTOR: p 1„ifVE-2 L FAX #
I am not using any subcontractors: 05 b p
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 p o / n/L--R—
Septic Tank
Sheet Metal
Sheet Rock
Tile
05
Owner/Centraete�Signature Date