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08080084
CTTY OF CUPERTINO a -+agA.r ` rax' BUH..IINO DIVIZION` PERMIT BUILDING ADDRESS: PERMIT NO. 20608 SHELLY DR JS MILLER 08080084 OWNER'S NAME: PERMIT ISSUE OATS ANNY CI1IU 87 WESTMONT DR 08/12/2008 NE (408) 674-2306 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG EIEC, PLUMB MECH 30 j LICENSED CONTRACTOR'S DECLARATION I Job Description I hereby".that I wo licensed under provision of Camp cr 9(commencln{ P wlNSeedon 70t1U)of Ivision3oftic Businevand"Of 10 k Code And Reese is STUCCO 'EXTERIOR (APPX 800SQFT) in rWl free and eR� .. 3 License Class Conm 5 DamC.nLIC.arxemr - e ARCHITECTS DECLARATION u I understand my plans shall W used As public mcor0 S0 Licensed Pmfnesi.nal - an OWNER-BUILDER DECLARATION f I Wmby a?,m Nat I Am exempt(cent dA,Comr cus'a License Law for the N o Wl.vomg revon.(Secim.111!1.3,Business and professions Code:Any city or county $ which¢quires A perntt to co mme4 Alcon improve,demoll h.or repel,Any =I.. Z� prior mics issuance.Alto requires the applicant far such permit to file a signed comment < wt he is licensed punwnt to Use provision,of to Conuacmr,Il¢aase Law(Chapter 9 Sq.Ft.Floor Area Valuation �s (commencing with Section T000)w Division 3 of Also Business And Profesm.ns Code)or 8000 Nn he 1.Attempt tMmbmn And the buts for the ellryed exemption.Any violation of Section 7031.5 by any eppllun,for a permit subjects shA applicant to a civil penalty of trot more NuOve hundred dollars( 0). 35915010 Number Occupancy Type ❑L he work, Uig pmputy,a my empleneed wish wgp u ale4mk campenstmemm who dotheweh,ende,The cuum Is net Commercksendnsorow ed does of apply 1014,Owner or Required Inspections - um Ponfinsaiertywhe, u Cade:The Canmemen,Liceand Amo Lew doh not apply m an awrcr is q P Own cvr who Wild,mMmnva Numn,end wW dotsach work oraffe edNmugh his ownom.Us,buildingm dust such Improvements are not intended oraRued for vale.It. however,the and the h Impmwmant ti gold a within m old W i m ovefo,the owm- builder .will haw Ut buNm of poHry that k did ret build or improve for Purpose of sok.). ❑I.As Owner of And property.am exclusively conuActin{wish licensed cenea=to mnstmct Ne project(See.7014,Businm and Profhtions Codon)The Contranm's M- cense law does net apply in an.ues or property wW Wilda or tmpmwa Lt....and. who comment for such Projects with a contractor(s)licensed purauam to the Cummer'. Licence Law. ❑lameacminvocirSee ,Bd PCfUthisreaan Owner Dam WORKERS COMPENSATION DECLARATION 1 hereby wRmunder porosity of perjury am of the following declANionc' 1 haw And will real"We A CeNncemaf Consent m calf-Insure for Worker,Compe, sWm,u provided for by Section 37W of the Labor Code,for mA performance of Use Ao for which Nis Permit is ivucd. - ❑I haw taw will maintain Worker,Compensation Insurance,As acquired by Section 3100 of the LaborCade,for she performance allies work for which this permit is Issued. ' My Worker,CompemNlR and cssn'cr and Poliry number1� O Zo 7 Cartier. Policy O Fl COMPENSATION I N FROM ORKERS COMPENSATION INSURANCE (This most.need ret W completed IfUse permit Isformm hundred cloOAn(SIM) ' or least) I century Nat In the Mr..N tit work for which Nie permit Is Issued,l shall am employ anypermn in any manceru As to become subject to the Workers'Compensation . Laws of Csli(amia.Data Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should became subjAct m the Wofkel Compensation provitimu.f the labs Code,you mus .,O foohwish comply with sh such provisions,or this permit all W rimmed revoked. 'Z'y CONSTRUCTION LENDING AGENCY r. Thereby AM.that Nem iso comnethm kndin{ARnry per the performance of Qi > Use work for which this Permit is issued(Sec.3D97,Civ,C.) W�Q Lander,Name Z)z Lenders Add= U Q 1 rectify shat I have mad this Application And sum that the Above information Is coven 1 agree In comply Add,all city And county aminanes and 0k laws relating to Wilding construction.and Wmby authorise mpmenWIM of Nu city to mterupnn use [Il Above-mendmcdl Property for inspection purposes (%)Agree to ave,indemnify And keep harmless tie City of Cartoon.Aeeivt ,.y IA Imbiliticsjudgments,cosm andexpemu which may In Any way seems aAlmtaid City in f V APPL CANT UND FSTANDS AaNQ WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC EGUL F lgtga Re-roofs sienuure w an or Dat ZA DGUS MATERIALS DISCLOSURE Type of Roof WIII pian future Wllding.ccuplulose orhandle Ivalloes metrial u defined by tis Cupenln,Municipal Code.Chapter 9.13,and the Helm And Safe,, Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yr, NO Will th applicant or future Ilding accupanl=equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it Imardnh ver conumirunts as dcfircd by she Bay Ams Air Quality M...:mcnt all new materials for inspection. District? ❑Yr, fV Mu ' I hew mad the hasWaus`ma crisis requirements under Chapter 6.95 of Ne Califor- .is Hcalsh A SafmyCnde,Sections 25305.25533 uW 25534.Imberund Use if Ne Wildi.1 dors ret currently have•rars,Use It u my reaPommility An Ann( t of tie mmdmucm mctlnio ' uvecofeCtTifca Signature of Applicant Date Ower.r..mnriead ttnlINDnm' All roof coverings to be Class'W'or better CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35915010 . 00 DATE ISSUED. . . . . . . : 08/12/2008 RECEIPT # . . . . . . . . . : BS000005767 REFERENCE ID # . . . : 08080084 SITE ADDRESS . . . . . : 20608 SHELLY DR t SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ANNY CHIU ADDRESS . . . . . . . . . . : 20608 SHELLY DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2924 RECEIVED FROM . . . . : JASON MILLER CONTRACTOR . . . . . . . : JASON MILLER LIC # 30014 COMPANY . . . . . . . . . . : JS MILLER ADDRESS . . . . . . . . . . : 87 WESTMONT DR CITY/STATE/ZIP . . . : DALY CITY, CA 94015 TELEPHONE . . . . . . . . : (408) 674-2306 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -- -- ----- ---------- ---------- ---------- ---------- ---------- IBSEISMICR VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00 1STUCOAPP SQ FEET 800 . 00 459 . 00 0 . 00 459 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 459 . 80 0 . 00 459 . 80 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 459 . 80 VISA -------------— TOTAL RECEIPT 459 . 80 • aaPoCITY OF CUPERTINO • CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # ate:D 5 � ,_ c� � Building Address: Mailing Address (if different from building address): Owner's Name: f�N NJ C.. 1� v Phone#: .0 —34S-1 Contractor: 5 ^,\ r 1 Phone: 1 Fax: Contractor License#: Gl,-L'�7 Cupertino Business License#: �7 I Contact: s—S CWC^Jl Phone: • Residential Commercial Fax: Job Description: S�v L(,0 Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: ©� Square Foot O Project Size: Express ❑ Standard 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: For hel , contact Build it Green at www.buflditgreen.org Revised 7/01/08 la "A CITY OF CUPERTINO , CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1BBOILERI 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 1 BBOILER5 Install ation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h 1 BAPPLOTH 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 ELECfNSP Other Electrical Inspections (per hour) E 1MECHINSP Other Mechanical Inspections (per M hour) 1 PLMBINSP Other Plumbing& Gas Inspections P (per hour 1MEETINGIHR Application Meeting B • 1 CITY OF CUPERTINO CUPEf� r GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1 GENCOM ACOUSTICAL REVIEW IACOUSFDW SFDWL/Duplex New B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B IACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1 CHIMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES 1FENCE>6FT Non-masonry, over 6 ft in height B 1 FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1 FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1FOUNDREP Foundation Repair B 1PILECAST Pile Foundation Cast in place concrete B I PILEDRIV Pile Foundation Driven (steel,pre- B stressed concrete 3of5 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPER,TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM RETAINING WALL(CONCRETE OR MASONRLID 1RETSTN Standard (up to 50 R) B 1 RETSP310 Special Design, 3-10' high (up to 50 `) B 1 RETSPI O Special Design, over 10' high (up to B 50' 1 RETCRB< 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 1SIDEOTHER Siding all other B SKYLIGHTS IS KYL<10 SF Skylight less than 10 sf B 1 SKYL>1 OSF Skylight greater than 10 sf or B structural 1STAIRS Stairs-first flight/ea addt'I 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 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPERTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM goo o 1STUCOAP Stucco Applications (up to 400 sf) B o additional stucco application 1 WINREP Replacement windows/sliding glass B door ea 8 windows 1WINMEWSTR New Window-structural shear B wall/masonry includes plan ck fee IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P VIF IELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK 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 1TRAVDOC Travel & Documentation B 1BUSLIC Business License B 5of5 Green Building Plan Check Index of Green Building Points/Categories 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 S. Use Truss with heels, (detail) 3-2 2 points 6. B. OSB Sheathing, detail S-2 2 Dints 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 point P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS 40 points • Play 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. rte 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 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 8 Trees 1 Resource pt y=yes 0 S.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 Matedals/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 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 D 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesFI p 1 1 1 C.Structural Frame t.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 pis 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 Ener is 9Y P Y=Yes 0 b.Wall 3 Energy pts y_yYes 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 0SB — a.Subfloors 1 Resource pt y=yes 0 • b.Sheathing _ 1 Resource pt y=yes 0 INPUT Rp�nulces Energy iALINeilth xter or n s 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 ChromiumlArsenic 1 IAQ/Health pt y=yes 0 3.Install House Wrap under Siding 1 IAQ/Health pt y--yes 0 4.Use Fiber-Cemani 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 Showarheads 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 ,(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--yes 0 r•.eiecmcai 1.Install Compact Fluorescent Light Bulbs(CFLs) (6 bulbs=2 points, 10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy 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. D 1 1 ! G.Appliances '1.Install Energy Star Dishwasher 1 Energy pt Y--yes 0 2.Install Washing Machine with Water and Energy Conservation Features 1 Energy pt Y_—Yes 0 3.Install Energy Star Refrigerator 1 Energy pt Y--yes 0 4.Install Built-In Recycling Center 3 Resource pts y--yes 0 I H.Insulation 1.Upgrade Insulation to Exceed Title 24 Requirements a.Walls 2 Energy pts yryes 0 b.Ceilings 2 Energy pts Y--yes 0 2.Install Floor Insulation over Crawl Space 4 Energy pis Y_—Yes 0 3,Install Recycled-Content,Fiberglass Insulation with No Added 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 pis y--yes 0 b.Ceilings 4 Resource pts y=yes 0 . 6.Alternative Insulation Products(Cobon,spray-foam) a.Walls 4 Resource pts y=yes 0 D.uemngs 4 Resource pts y--yes 0 1 1 n ows 11.Install Energy-EffckaWlndows • i 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 pis Y--yes 0 2.I stall Low Heal Transmission Glazing 1 Energy pt y=yes 0 1 1 f J.Heating Ventilation and Air Conditioning 1.Use Ducl Mastic on AIII DuctJoints _ _ j 2 Energy pts y=yes 0 2.Install Ductwork within Conditioned Space 3 Energy pts y=yes D 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 D 7.Install Whole House Fan 4 Energy pts y--yes 0 B.Install Sealed Combustion Units a.Furnaces 3 IAQ/Health pts y--yes 0 b.Water Heaters 31AQ/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 D 15.Install High Efficiency Filler 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 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 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 8.SeledSate and Durable Roofing Matenals 1 Resource pt y=yes 0 7.Install Radiant Barrier 3 Energy pts y=yes 0 1 1 1 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 D 1 1 1 • M.Indoor Air Quality and HnISheS 1.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 IAO/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 7 Formaldehyde 61A0/Health pts y--yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pis y=yes 0 7.Seal all Exposed Particleboard or MDF 4 IAO/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 D 10.Install Whole House Vacuum System 3 IAO/Health pts y=yes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y--yes 0 2.Use Rapidly Renewable Floo ng Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAOMealth 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 o ntsvela e: 1 1401 1301 57 Total Points Project Received: 01 51 0 • G:damlprogsrgmmbuildngguidelines4emodelerOgmppoinfsfnalZ72e4prWecfeduds • Community Development 10300 Torre Avenue S Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 *UPE�TINO Building De artment JOB ADDRESS: 2 / Z1 �W) v PERMIT # OCU OO OWNER'S NAME: 1.) b C %J I PHONE # LjdT -0 — L GENERAL CONTRACTOR S VV\ FAX # I am not using any subcontractors: a/f oo �S)gr�a-ttUe Date Please check applicable subcontractors and co Tete the following information: 60 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 er/4tractkNnature Date