08030158 CITY OF CUPERTINO " "
BUILDING DIv1510N PERMIT " CONT&A6TQR'iINF®RMAtT ON.
n�� dti .«uSrcr s% .'Z I. .�.aY^S.t-'@T ile .a ir�+4�
BUILDIUO,ADORESS,--ITE FIR CT GENMOR PLUMBING 08U.i U158
EER1SINAN`EE- Wtl PERMIT ISSUE DATE
HSU WAN—YEN ET AL 2552 SEABOARD AVE 03/27/2008
PHONE SANITARY NO. CONTROL NO.
(408) 855-8348
ARCHIIEC(ENGINEER: BUILDING PERMIT INFO
BLDO ELECT' PLUMB MECH
0 0 0 0
�OZ, LICENSED CONTRACTOR'S DECLARATION Job Description
rd I Wmby affirm Nu 1 am licensed under provisions of Chapter 9(commencing P
.1NSmdon7")of Division3afthe Burinmu d 3nm Code.and nq Beense is COPPER REPIPE & 40 GAL WATER HEATER
in full force and o I
i0Z we,
Cl
9 full
tg us AulI use D public
ATION
I underwnJ my plana shall he used v pruMfe mcnrm
SS� Licensed Professional
^ OWNER-BUILDER DECLARATION
S�9 1 hereby air.that I em exempt from we Conaacum's License Law for me
C 0 O fallowing reason.(Section 70 15,Business and Professions Code:My city or county
S$PLI which ventures a Permit to co zoncL atm,improve,demolish.or repair any structure
_ZLrt Prior an its issuance.also requires du:applimnt for such permit to rile a signed statement -
p � that he Lr licensed pursuant mweprmviuomofthe CumracWtsUcenseLaw(Cou.9 Sq.Ft. Floor Area $5000 Valuation
Y (commencing with Section 7000)of Division 3 of the Business and professions Crawl or
ERF thu he is eaempt therefrom and the btu fm the alleged eaempdoo.Any vwoladon of
Seeman 7031.5 by any applicant for a permit subjects we applicant to a civil penalty ofNumber Occupancy
act...th500).an Bve hundred doll.1535905088 .ETYPe
0 I,a owner of Om pmperry,m my wployeu with wgm u Neo sole mmpe=Om,
wlll&the work.and wo.n.mre is notimended oraRered for ask(Sec.7044,Bum. Required Inspections
and Preferments code: cm
The Commencer Lionro
waters Law mom t apply m an owrcs of e q P
property wbe Wild,mint m us therme.and who dodauchwarthim elf ar tNeugb his
awn employ=.provided that such Improvements art m,intended oroRered fm sale IL
however,the building or impovemmt is veld within arc wv of mmpletian,
monomer.
builder will Mw rose burdrn of proving Nat be did rot build m impovefar purpose of
talc.).
0 1,as owner of Ne property am exclusively contracting with IlceruW mmacrors In
couuuct the project(Sec.7044.Business and Pmfessiou Coda)The Cmmmus'.U.
cema Law does not apply in an owner of property who builds or improve thereon,ad.
who contracts far such projects with a eons acmr(s)licensed pursuant N the Communaute.
License law.
0 larnmereptumWSea ,B&PCforNumuan
Dam
WORKER'S COMPENSATION DECLARATION
1 hereby ahlren under penalty of perjury one of toe following trslun lone:
01hawandwillmsinwna Certiriawofcouentio¢If-luunfmwa esComNn-
umm,u provided fm by Section 3700 of tic Labor Code,for tM PeAarmenae of the
work,for which this permit is isued. -
0 1 have and will maintain Worker's Compensation In umnce,u squired by Section _ -
3700of the Labor Cade,far the Performac of the work far which this permit is wound. "
MyWerher.Cempenumm lnannc artier and Paltry number
Carrier. �-Oa'L! Policy No.: T� '�p�
CEl" 1�CATE OF EXEMPTION FROM ORKERB'
COMPENSATION INSURANCE
rMissemwm need not be completed'Jmx Permit Is Intone hundred dollars($100)
orkra)
I codify wet in the performance of Itr work for which this Permit is bound.I"I not
employ any person in any manner an at;he become subject he the Workeri Cmtpenudon
Laws of Caifemla Dam
APPRcmt
NOTICE TD APPLICANT:If,other making this CertiOcats of Exemption,you should
become subject to the Work o's Compensation provisions of tho Labor Code you mux
0 foMwith comply with such provisions or this permit shall be dcemedmockedmocked.„Zy y CONSTRUCTION LENDING AGENCY
[—i•+ 1law,y ofllm f.there era construction lending agency for the Performa col
lYi> the work for which this Permit Is issued(Sec.3091,Civ.C.)
Q I mcces Name
] z Lender's Address
V 0 I caNfy that 1 have mud it .applieuim and mate that we above itummolun is
Iy correct.I agree or comply with all city and cowry ordinances and sum Iowa relaung in
0 building conswction,and hereby amhorien representatives or this city in now upon the
LU above-mendamd property for Wpemion purymes
(We)ago to taw,indemnify and keep harmless,the City of Cupertino aganst _ ^
VI 0abilimes,judgments.cord and expenses which may In my way smrm.gaim,said City
V in consequence of the granting of this Permit. /e
^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REG LAMONS.
� z L d Re-roofs
sue tamrcomncmr Dow �_-
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
mI the applicant or future Wilding aeupantsm s or handle Nuatdou materia41
'
defined by the Cupertino MumcipW Code.Chapter 9.12.and Ne Health and Safety
co
Stian xss3x(a)7❑Yes /L>TNo All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining'an inspection,I agree to remove
emit havardom air contsminacts as defined by the Bay Area Air Quality Management all new materials for inspection.
Dimict7 �(
0Yew Iyd No
I haw mW ides haramtm materials requirements under Chapter 6.95 of tite Glifor.
nu HUIN&Safety Cade,Sariom25505.25533u 25534.1maoxeudlhuiflMWilding
durarott, n have.0"•"s that it is my me,onsmility w nctiry the occupao of the
requimmcnu"hmuxbeemsprimmiuvanmafa Cenilica Signature of Applicant Date
Owner amhoriecdage., I 1 DamAll roof coverings to be Class'%?.!'or better
• CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35905088 . 00
DATE ISSUED. . . . . . . : 03/27/2008
RECEIPT #. . . . . . . . . : BS000004290
REFERENCE ID # . . . : 08030158
SITE ADDRESS . . . . . : 21100 WHITE FIR CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HSU WAN-YEN ET AL
ADDRESS . . . . . . . . . . : 21100 WHITE FIR CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4037
RECEIVED FROM . . . . : GENMOR PLUMBING CO
CONTRACTOR . . . . . . . : GENARO MORALS LIC # 27101
COMPANY . . . . . . . . . . : GENMOR PLUMBING
ADDRESS . . . . . . . . . . : 2552 SEABOARD AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95131
• TELEPHONE . . . . . . . . : (408) 855-8348
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- --'-------- ---------- ---------- ----------
1BPWATER UNIT 1. 00 40:-79. ' 0. 00 40.79 0. 00
1BSEISMICR VALUATION 5, 000. 00 •0 :50 0. 00 0. 50 0. 00
1PLMBINSP HOURS 1 . 00 122 .38 0. 00 122 .38 0. 00
1PPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40 .79 0. 00
1PRWHEATR UNITS 1 . 00 24 .48 0. 00 24 .48 0. 00
1TRAVDOC FLAT RATE 1. 00 40.79 0. 00 40 .79 . 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 269 .73 0. 00 269 .73 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 269 .73 #6287
---------------
TOTAL RECEIPT 269 . 73
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
106 SEWER & WATER 301 ROUGH PLUMBING
507 FINAL PLUMBING
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: patg
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35905088.00
INVOICE DATE. . . . . . : 03/27/2008
REFERENCE ID # . . . : 08030158
SITE ADDRESS . . . . . : 21100 WHITE FIR CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HSU WAN-YEN ET AL
ADDRESS . . . . . . . . . . : 21100 WHITE FIR CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4037
CONTRACTOR . . . . . . . : GENARO MORALS LIC # 27101
COMPANY . . . . . . . . . . : GENMOR PLUMBING
ADDRESS . . . . . . . . . . : 2552 SEABOARD AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95131
TELEPHONE . . . . . . . . : (408) 855-8348
'I • FEE DESCRIPTION - -- - DUE FOR AMOUNT DUE --- PAID BALANCE
--------------- ---------------- ---------- ---------
INSTALL/ALTER WATERPIP PRINTING PERMIT 40.79 0 . 00 40.79
SEISMIC RESIDENTIAL PRINTING PERMIT 0.50 0. 00 0. 50
OTHER PLUMBING INSPECTIONS PRINTING PERMIT 122 . 38 0. 00 122 .38
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40.79 0 . 00 40 .79
RESIDENTIAL WATER HEATER/VE PRINTING PERMIT 24 .48 0. 00
TRAVEL & DOCUMENTATION FEE PRINTING PERMIT -_---40_79 ------0_00 ----40_79
269 .73 0. 00 269 .73
VOICE ID DESCRIPTION VOICE ID DESCRIPT
-------- ---------------------------- -------- ----------------------- ---
106 SEWER & WATER 301 ROUGH PLUMBING
507 FINAL PLUMBING
•
Single Family GreenPoint Checklist date: Lam Build It Gareed
The GreenPmnt Checklist Is basad on the various green features Incorporated into the home and is the SmanSolutions From The Ground Up
• basis lot the Gmar lyd Rated program.A home can be consldlired green 11 11 Millis the prerequisItes, _ -
same at least 50 Poll and meals the minlmum points per Category:Energy(30),Indoor AIr Quality/
Health(5),Resources(6),and Water(9).Please cordal Build It Green for a list of qualified GmanPoim
Ratere it you are interested in pursuing third-parry verification.
The green building practices listed below are described In the New Home Construction Green Building
Guidelines,available at www.builditoreen.oro. - — — — - -
ENTER PROJECT NAME as
A 6ITE Front Available Per Met a
1.Probst T psoll en Inimirn Divupbon L Evicting Plants 6 Trees
❑ a Protect Topsoil hem Erosion and Reuse after Construction p 1 1
❑ b.Uri and Delineate Construction Pool for Maximum Praectien 0 T 1
El 2 Desenstrum Instead of Demolishing Existing Buildings On Site 0 3
3.Rarycle Job Sha Construction Were,(including Green Wena)
❑ a.Murinven 50%Wane Dhtmeon by Weigh(Recyclarg Or Reuse)-Required 0 R
❑ b.Minimum 65%DNerskm by Weight(Recycling a Reuse) 2
❑ c.Minimum BO%Diversion by Weight(Recycling or Reuse)
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a Walkway and Driveway A. 0
❑ b.Roadeay Base i(Rq r 0 1
Taal Points Avallable In .1 '-
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled I'll or Slag } 'I T'V/ -},
❑
al Minimum 20%Flyash a Slag 0.> 0 _ _
❑ b.Minimum 25%Ryser,or Slag /10 I r 1
2.Use Frost-Protected Shallow Foundation in Cold Aron(C.F C.Climate Zone 16) -0 r 3 1
3.Use Radon Resistent Conduction(In At-Rick Landers Only) D 1 I
4.Design and Build Smuctursl Pest Controls
❑ a.Instep Termite Shields a Separate All EOoda Wootl-1o�CBmcmle Connections by Metal a Plastic Faneners/DNidxrs 0
It.AO New Plants Hews Trunk,Boo,or Stem Locateal At Least 36 Inches from Foundation p 1
Total Pant Avallable In Foundation 0
C.LANDSCAPING Points Available Per Measure
• 1.Construct Resource-Efficient Lsndscapee
❑ a.No]mash's Sol Lisled by CaHPC Are flamed 0
❑ b.No Plant Species W01 Require Hedging p
-❑ c.75%of Plants Are Drought-tolerant Ca ifomla Nantes,Madt9na man,a Other Appropriate Species
2 Use Flnei Landscaping Techniques - 0 1 'I
3.Minanee Turf Areas in Landscape Installed by Builder
❑ a Ali Tud Will Have a Wates Requirement Less than or Equal to Tell Fescue(50.6 Plant factipp _ ( j i 2
F_] d.Tud Shall Na Be Installed on Slopes Exceeding 10%a in Areas Less than 8 Feet Wide cc 7,p/ j ( 1 0-
❑ c.Tud is 533%at Landscaped Area(tmal 2 points) L1 -_ '_ ( --___ __1 2 _
E] d.Tud Is 510%of Landscaped Area"14 points) �OJ r D
4.Plant Shade Tree ;r0 I 3
LJ 5.Group Plants by Weler Needs dmeonin ) u 1 i I 2
6.Install High-Efficiency Irrigation Systems t
❑ s.System Uses Only Low-flow DIP,Bubblers,or Low-flow Spdnklem 0
❑ 2
b.System Has$man Controlters I 0
3
Lj T.Inver orate Two Inaba of Compost in the Top 6 to 12 Inches of Soil 0 I I I 3
It Mulch All Painting Beds to the Greater of 2 Inches or Local Water Ordinance Requirement17—
e.Use 50%Selvaged or Recycled—Content Material,for SD%of Non-Plant Landsope Elements
10.Reduce U ht Pollution by Shielding Flxmres andix Directing Light Downward 0 I)1
Total Pointe Available in Lentls In =3
D. 6TRUCTURAL FRAME @ BUILDING ENVEIAPE Pointe Avallable Pei Measure
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Suds at 24-Inch On Center Framing
❑ b.Size Dom and Window Headers 1a Lead
❑ c.Use Only Jack and Cripple Studs Rsqulbd for Load
2.Use Entimeened Lumber - -
❑ a Beams and Headers 0
El __b.Insulated Engineered Hall _ 0 —L j 1_
El C.Wood Wolsts or Web Trusses for Floors --
❑ d.Wood 4Joiste for ROD[Rafters p
❑ e.Engineered or Finger.Jointed Studs for Vertical Applications p
❑
f.Oriented Strand Board fa Subfloa U -
❑ g.Oriamed$pendBcard foWail and RoaSheathing 0 T 11
• 0.Use FSGCarti9ad Wood
❑ a Dimensional Lumber,Studs and Timber.Minimum 40% 0 - 2
❑ b.Dimensional Lumber,Suds and Pal Minimum 70% ____T_2— r---
❑
C.Panel Products:Minimum 40% _0 _ _______ 1 1 I _
El d.Panel Products:Minimum 70% _ _0 T-1
02DD7 Build It Green Single Family GreanPoin(Checklist 2DD7 Version Page 1 of 4
ENTER PROJECT NAME
u5 a P. i
5 n
4.Use Solid Well Systems(Includes SIPS,ICFs,A Any Nall Forms Assembly)
❑ s Floore 0_ 2 _ 2
❑ b.Wella _0 2 _ _ 2
❑ C.Rohe 0— -- 2 2
5.Reduce Pollution Entering the Home from the Oe7ege
❑ a Tightly Sed the Air Bell betworm Garega and Utng Area 0 ]
❑ to.Install Garage Exhaust Fen OR Build a Detached Garage D ]
El 6.Del Energy Huls on Truces 75%of Attie Insulation Height m Outside Ede of Exterior Well D 1
7.
Design Poor Trustees to Accommodate Ductwork D - 1
0.Use P detl-Content Smal Studs for BO%of Interior Well Fermin 0 1
B.Thermal Men Walls:Wrl Drywall on All Interior Waite or Wells Weighing more OW 40lbicu.tL 0 1
10,Install Onrhangs and GUMM
❑ A.Minimum 1&Inch Overhangs and Outten D
❑ b.MWmum 244nch Overhangs and Butlers D 1
Taal Points Available in SWctuial Building Forms and Envelope=36 D
E.EXTERIOR FINISH Points Available Pm Measure
(.Use Re clad-Ccntsm(ND Virgin Plastic or FSC-0erlifietl Wood Decking 0 2
2Install a Rest Screen Well System 0 2
3.Use Durable and Noncombustible Siding Materials 0 1
1.Seams Durable and Noncombustible Hoofing Materials 0 2
Total Party Available in Extedu Finish.7 0
F.INSULATION Points Available Per Measure
1.Install Invulefion with 75%Recycled Carol
❑ a Wells andlor Floors 0
❑ b.CeRcip
L Install Insulation that is Low-Emitting(Certified Section of 350)
❑ e.Wells andmr Flame 0
❑ b.Collin a 0 ]
9.Inspect Ouelity of Insulation Installation before Applying Drywall 0 1
Total PONb AValubb In tradition=5 0
O.PLUMBING Points Available Pet Measure
1.Distribute Domestic Hot Wetm Efficiently(Maximum 7 Points),
❑ a insulate Hol Water Pipes from Water Header to Kitchen _0_
C1b.Insulate All HN Water Pipes _D
❑ c.Use Engineered Parallel Piping _ 0 —
❑ d.Use Engineered Pal Piping with Demand Combated Circulation Loop _ 0
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop _ 0 7 __ 2
❑ f.Use Cental Core Plumbing 0 ] I 2
❑ 2.Install Only High EfficienToilets(Dual-Flush or 5120 qpj 0 4
Total Puma Avanable in Plumbing.Total 12 0
H.HEATING,VENTII ATION k AIR CONDITIONING Pants Available Par Model
1.Design and Install HVAC System to RCCA Manual J,D,and S Recommendations 0 4
2.Insall Samed Combustion Units
❑ e.Furnaces D ___ __ 2
❑ b.Water Holm 0 2
3.Insmsl Zoned,Hydronic Radiant Heading with Slab Edge lnsaladDn D 1 1
4.favors-High Efficiency Air Conditioning with Environmentally Responsible Refrigerants D 1
S.Design and Insall Effective Duchvork
❑ s Imtm HVAC Unit and Ductwork wl0un Conditioned Spars _0_ _ 3
❑ b.Use Duct Mal on M Duct Jame and Seams 0
❑ c.Install Ductwork under Adc Insulation(Buriod Duals) 0
❑ d.Pressure Balance the Ductwork System
❑ e.Protect Ducts during Construction and Clean 9 Ducts before Occupancy 0 1
El B.Install High Efficiency HVAC Firm(MERV S+) 0 1
❑ 7.Dont Inca=Fireplace or Install Stated Gas Fireplaces with Efficiency Phil Not Len Then 60% 0 1
using CSA Standards
B.Install Effective Exhaust Systeme in Bathrooms and Kitchens
❑ a Install ENERGY STAR Bathroom Fans Vented to the Outsida 0
❑ b.At Bathroom Fans Are on Timm or Humidisml 0
❑ c.Instal Kitchen Range Hood Vented to the Outsitls D 7
a.Install Mechanical Ventilation System for Cooling(Maximum 4 Pointe)
❑ e.Install ENERGY STAR Ceiling Fens A Light Kits In Living Area A Bedrooms
❑ 6.Inmal Whole House Fan with Variable Speeds
❑ c.Automatically Control Integrated System _ 0
❑
J.Automatically Controlled Integrated System with Variable Speed Con" 0 3
10.Instal-Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventilation System That Meets ASHRAE 622 0 _ 1 2 _
[:1b.Install kmo•Ar Heat Exchanger that meats ASHRAE 622 D -] 2
11.Insomll Carbon Monoxide Alarmist 0 1
Total Points Available In Heading,VerMadon and Air Cordia tin .Gel 0
0 2DO7 Build It Green Single Family GreenPolnt Cil 2007 Version Page 2 of 4
ENTER PROJECT
• C
• I.RENEWABLE ENERGY Points Available Per Measure
LJ L Pre-Plumb for Soler Hol Wear Hoofing 0 , 4
LJ 2 Iestsll Soler Water treating Siloam 0 -110
sWan Conduh for Fuare Photovoltaic Installation&Provide 20D fe of Scull Roof 0 2
C Insall Photovolaic(PV)Panels -
❑ A.3D%d electric needs OR 12 kW(tole 6 points) 0 6 !
❑ le.SD%d electric needs OR 24kW(foal 12 points) 0 p
El c.90%of electric need OR 3.6 kW"11e poires) 0 7 6
Total Avallable Points In Renewable Energy2B 0
J.BUILDING PERFORMANCE Points Available Par Measure
1,Diagnostic Evaluations
❑ a.House Passes Blower Dow Test 0
❑ It House Passes Combustion Safety Backdraft Test 0 1 r
20esign entl Build High PeHarmaoe Homes-%above This 24-minimum 15%Required 0 >_30
❑ J.House Obalna ENERGY STAR with Indoor Air Pneope Certification-Pflot Measure(rotal 45 points;reed comment) 0 5 2
Tbal AnHable Points in Exiling Pedom rice=39 0
E.FINISHES - Points Available Per Measure
1.Design Entryways to Reduce Tracked In Contaminants 0 1.
2 Use Low-VOC or Zero-VOC Paint(Maximum 3 Points)
❑ &Lox-VOC Interior WaNCeMng Paints(d0 gpl VOCs(Flap and<t50 gp VOCs(Non+lat) 0 _ I 1
Elb.Zero-VOC:Intedur WaNCellin Palmed [VOCs(Flap) p _ 3
❑ S.Use Low VOC,Weal-Based Wood Finishes(d50 pit VDCs) D1 2 I
❑ 4,Use Low-VOC Caulk and Construction Adhesives(<n giel VOCs)for All Adhesives 0 2
❑ 5.Use Recycled-Content Paint 0 1
6.Use Environmentally Preferable Materna for Interior Finish:A)FSC-Cerdfied Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Conant
or E)Finger-Jolnad
❑ L Cabinets(5D%Minimum) 0
❑ b.Interior Tdm(50%Minimum) pEl c.c.Shi(50%Minimum) -p — — -- - _j---- -
❑ d.Doors(50%Minimum) - 0 t ]
❑ e.Coume 50%Minimum)
• Z Reduce Formaldehyde In Interior Finish(CA Section 01350) - f
❑ a.Subfioer&Stair Treads(50%Minimum) p ]
❑ b.Cabinet&Comadops(50%Mommum) ---'--
❑ C.Interior Trim(50%Minimum) 0 1
❑ d.Shofvin (50%Minimum) 0 1
❑ &.Atter Installation of Finishes,Tat of Indoor Air Showa Formaldehyde Level 4!7ppb 0 3
Total Available Pants In Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Envlronmanally,Preferable Flooring:A)FSC-CeNfied Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-0ontant,E)
Exposed Concrete.Flooring Adhesion Must have<50 pet VDC&
❑ a.Minimum 15%of Floor Area ' 0
❑ b.Minimum 30%of Floor Area 0
❑ C.Minimum 50%of Floor Area 0
❑ d.Minimum 75%a Floor Area 0 I 7
❑ 2 Thermal Mop Floors:Floor Covering Other than Carpet on 5D%or More of Concrete Floors 0
❑ 3.Flooring Meets Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 - 2
Toal Available Pants in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per IJeasure
1.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total 1 point 0
❑ b,Dishwasher Uses No More than 6.5 Gallon le nal 2 points 0
2 Insall ENERGY STAR Clothes Washing Machine with WOW Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier requirements(modified energy factor 20,Water Fedor ED)(total3 points) 0
E] b.Meets Energy Star and GEE Tier requirements(modified energy lector 22,Water Fedor 4.5 or less) 0 I 2
(total 5 onal1
3.Install ENERGY STAR Refrigerator
❑ A.ENERGY STAR Oualfied&c25 Cubic Feet Capacity 0 _ 1
❑ b.ENERGY STAR OuafiOad&<20 Cubic Feet Capacity 0 1 I
4.Install BullHif Recycling Carter 0
❑ a Bufd-In Recycling Center
❑ b.Built-In Composting Center 0 1
Total Available Points in Appliances and U 'ng=12 0
N.OTHER Points Available Per Measure
❑ 1.emporium GreenFoint Rated Checklist in Blueprints-Required 0 ( R
❑ 2 DevelopHomeownar Manual of Green FesareslBanefi s 0 I 1 1 1
3.Community Design Messuree&Local Priorities:See the Community Planning&Design section In Chapter 4 a the New Home Guidelines for
measures.Maximum of 20 pants for suggested measures.Local requirements may also be fisted here.
0 2007 Build It Green Single Family GreenPolnt Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAME
Munn .,
3
Enter Ignition here,and enter points available la man n in eplaoprlale categories to the right 0 _ 0 0 0 0 0
Enter dere iplion here,and enter points eva in for m a n In afpropriale categain to the IV. 0 0 0 _ D 0 0®
Enter de¢rlpllon here,and ems pains rvatahU for Man M etpnpriW Wagon"to the 69K 0 0 D 0 D
❑ Ental de erpdon ham,and wig polns available for meaame M appropriate(41800601 to the right. D D 0 0 D D
4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up toe Bulltl It Green Checkllet&and
mardmum combined total of 20 pts.See Innovation Checklist for suggested measures using the link to the right. Guidelines _
Ll Innovation In Commonly:Enter deacdplion ham,and ental nts evoltage tor mervurs In aU ca ea to the riht. 0 o D D 0 0
InnweOon In Em :EMar tln ion here,end solar b rveltsble Is memure M en cele oda to the d D 0 0 0 0 0
Iratwa0on In IAQ Heeah:Enter des: have,ere enter available Is mover in U talo to me 0 0 0 D 0 D
IMwelion In Pnourou:Ems deetagoion hen,and am aveseble for seem M ate cat es to am d D 0 0 0 0 0
❑
Innovation In Water.Enter doscdpllon haze,and enter poiW available Is measure M epploprUte ulapodn to ins right. D D 0 0 D 0
Tost Avelleble PoimalnOMs=U 0
Summary
Total Avallabla Points in Specific Categories' 4+ 96+ 42+ 66+
de43+
Minimum Points Required in Specific Cate os 0 30 5 B 9
I'DIal
Points• a e e a e e
Project has not yet met the following recommended minimum requirements: v
-Total Project Score Of At Least 50 Points
-Required measures:
43a: 50% waste diversion by weight
-72: 15%above Title 24
-Ni:Incorporate Green Point Rated Checklist Into blueprints
-Minimum points In specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(6 points)
-Idrater(9 points)
02007 Build It Green Single Family GreenPoint Checklist 2D07 Version Page 4 of 4
X0 p
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPEkTINO PERMIT APPLICATION FORM
APN# D3���- Low
Building Address: i
a( I0D `1 �� � �'�o C-sIr
Owner's Name: Phone #:
at e 1'i
Co tor: Phone#:/ ��� 2) s7s_ C6
o V( 1 vi rye i I Fax #: '[
Contact: Phone#:���
Coil r Cjb Fax #:
Contractor License #: c8 3-JOS
Cupertino Business License #:
Job Description:
Residential Commercial ❑
Valuation:
Green Building Check list must be completed and attached to this application.
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
1BSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEI�TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
IPRREPIPE Residential re-pipe per fixture P IRPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
IPCESS Cesspool P
/ IBPWATER Install/alter Water Pipe P
IBPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
IPPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P
IPLM13INSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
/ IBUSLIC Business License B
Community Development
10300 Torte Avenue
IIt ! -` �yJ Cupertino CA 95014
a
Telephone(408) 777-3228
� CITY OF T--3333
UPEI�TINO Fax(408)77
Building Department
JOB ADDRESS: PERMIT #
.I) I0b coV �e t 4 0�3o�s
OWNER'S NAME: '%.�G _ _Q SU PHONE # U Oa — 93 ss-831
GENERAL CONTRACTOR FAX # c3 — -4 a —�
I am not using any subcontractors: 1 o
Signature Date
Please check applicable subcontractors d Com Tete the following information:
14 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
Owner/Contractor Signature Date