08090012 CITY OF CUPERTINO �r �o-�.�s�, xr;;e� �-�`<•:' �-�=�« .
BUILDING DrvlsyDN PERiVIIT
BUILDINGDI) ESS:.. PERMIT NO.
zOS/2 P,I.NNTAGE PY FIRST AIR HEATING AND A/C 08090012
OWNER'S NAME: PERMIT ISSUE DATE
IRAFEAL 4510 FELTON RD 09/03/2008
lipNE: (408) 422-3729 SANITARY NO. CONTROL NO.
ARCHI ECVENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
�oij LICENSED CONntACfOWS DECLARATION
1 hereby mr..that 1 am licamed under provisions of Chapter 9(commencing Job Description
wins Secuon7p )of0ivision3afthe Butt and Profeuiam CodeaM mYli—is ADD A/C TO EXTNG FURNACE, ELCTRCL BOX EXISTING
at m full Ions and e0
p 2 Lt. Lkc.a
�FQ Dao: ContMnr
aARCHITECTS DECLARATION 01
a 1 understand my plans Nall be used at public records
6
5 Licensed Professional -
y 1 OWNER-BUILDER DECLARATION
a� F I hereby&Rm that I am exempt from the Contnctaes License law for the
20 (allowing mann-(Section 71131.5,Business and Profusion Cade:MY city or county
S_ which requires a permit to comvmt.Wer,hnprove,demolish.Or arum any mnmtum
primus itscsuable.also mquims me applicant for such permit as rile a sigmas statement
<
that misli¢n¢dpursuant tothe provision offCon=lm's Uccome Law(Chapter 9 Sq.Ft.Floor Area Valuation
x� (commencing with Section 7000)of Division 3 of the Business and Profession Cock)as $2800
Y R$E that he is exempt therefrom and the basis for the alleged exemption.My violation of
Section 7031.5 by my applicant for a permit subjects the applicant to A civil penalty of Number
rum mre One live hundred dollars(SM. 3 6 9 4 7 0 2 9 .•V( Occupancy Type
Lo the we of the pmaemyomy wpleym with ngua their mk compeonuses
will do thewon and the he Co a.1 intended I Imedn Law
Cls far
not apply to at,Busiest
and property
wh ons Cade The Cmmnaes t:.-e Uw dao not apply lf an awns is Required ITSPECLIODs
propentwho s,Wsaimproteachimpr and who am asuintwokhi ermaumugh his
Own employes,lding or i prat such imps mid within am
not ear ded ofema@ret the salm.own r,
f.
however,the Wilding or impmvemant u std within arm Lear of comove for the owner- _
Wilder will have tae burden of proving that k did not build or improve for puq.e of
ale.).
❑1,as owner of the property am acluiively contracting with Hammed c...to
contract the project(Sec.7004,Business and Praftmeas Cade:)M Conuaeter's Li.
came Law does not apply as an n mer of property who builds or improves,dement.and
who comets fur such projects with aconbxmr(O licensed pursuam as the Cantrano's
Lkense law.
Iamuemptumm Sec. ,B&PCfeethbresson
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby slims under penalty of perjory ane or the fallowing deckrstiom:
and will maintain a Cmdfiam ofCnnsent m self-inmm fa Wortcfs Compcn-
on,as provided for by Section 3700 of the Ub.Code,fm the perferean¢of the
wort for which this permit is issued.
1 have and will maintain Wokee,Compemauon Insurance,as napdred by Suction
3700 of the Lather Cade,fm the performance a(tae work fa which this permit u iamd. '
My Worwsc remotion lmumnca artier and Poliry number tae:
Corti Pal No.:
O ) ON FROM WORKERS'
C IPI ON INSURANCE
(rhis mcdoe teed Out pktedifthe permit is rar enc hundred doral(5100)
arless.)
I cuuifv that in me perimm. wok for whh this sued.I shall tan
Lawsoanypoxoo inany mmrrierdau�RmwCf�ij a Y Oop
Laws of Califon a n y O
Applicant I � T
NOTICE TO APPLICANT.If,aver making tt��s Ce991I'I m of Fs.nniu n,you dmuld
became subjcm m me Worker's Compcnution�iom of use Labs Cade,you mint
.J O forthwith comply with such provisions or this permit shall be domed revoked,
'�� CONSTRUCTION ravDING AGENCY
[ti... I hembY a1Rrm taw Jere is.consuncilm knding agmay for tae pamo er.of
C'> um wart for which this permit Is booed(So.3097,Civ,C.)
4 Q Undue,Name '
z Lendefs ss
Addre
*O 1 annuity that 1 have mad Ws application andante that the above information is
py coma I agmca m comply with all city and county aNinamer and state Ian mlaung in
Wilding camwction,and hereby•mbadse mpresentatives of this city to enmrupon the
shave-menuorrcd property,for impaction which
/`'^�J IJC./1/
y (We)agree m ave,indemnify and kap hamlem the City of Luper ins apimt
VZ ii conccmx Of theeosuandOf On nes peeariL may in anynyaectuc agsimt said City
Z A cPLICANca of the granting of this D WILL
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
EGULATIONS. — S �
Q Re-roofs
sighaturea pCo RDO Dem
HAZARDOUS MATERIM Dam o handl Type of Roof
Will the Cuproorouteipal Cooccupant marcor and havaNeusmaterial
u dentes io tae Cupertino Municipal Code.Chapter 9.11,and tae Heals and Safety
Code.seerron ns3u.)7 7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or fume building Occupant me equipment or devices which P
01 b-tl-mmm air conaminams a dcOmd by tae Bay Area Air Quality Man gnmcm all new materials for inspection.
mctT
❑Yen
I have read theh umnau materials Occ do menu uodm CN'ao('95 afore Calif.-
32�
te2da5s50it5b.2m55y33 anAmMi53's,1 uMmcroau fanCEkcuutnpainfryine.
buoilfditaneg
Signature of Applicant Date �
DamI All roof coverings to be Class'V*or better
CITY OF CUPERTINO
•6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36947029 . 00
DATE ISSUED. . . . . . . : 09/03/2008
RECEIPT #. . . . . . . . . : BS000005980
REFERENCE ID # ... . : 08090012
SITE ADDRESS . . . . . : 20272 PINNTAGE PY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RAFEAL
ADDRESS . . . . . . . . . . : 20272 PINNTAGE PKWY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2133
RECEIVED FROM . . . . : FIRST AIR HEATING &
CONTRACTOR . . . . . . . : SAM PHONG LIC # 29220
COMPANY . . . . . . . . . . : FIRST AIR HEATING AND A/C
ADDRESS 4510 FELTON RD
CITY/STATE/ZIP . . . : MILPITAS, CA 95035
TELEPHONE . . . . . . . . : (408) 422-3729
eFEE IO UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --- ---- -------- ------- --- - -- -------
1.BSEISMICR VALUATION 2, 800 . 00 0 . 50 0 . 00 0 . 50 0 . 00
I.EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
.I.MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 1 . 00 61 . 19 0 . 00 61 . 19 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
7TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
'DOTAL PERMIT 224 . 85 0 . 00 224 . 85 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK
------------------
CHECK 224 . 85 #1334
---------------
TOTAL RECEIPT 224 . 85
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- --------------------------- --- ------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
e
o o9ovia
CITY OF CUPERTINO
FURNACE/AC
C1 OF
�•CUPERTINO PERMIT APPLICATION FORM
APN # J t ' 0 Ln . 00 Date: .T— o p
Building Address: -2-( •Z 7 L I %1\1 A) TPeA-5 2, k_W 0
Owner's Name: Phone#:
Contractor: S54 vv\ Phone #:
Fax #:
Contractor License#: 6 20 Cupertino Business License#:
Contact: S}1Vv\ Phone #:
Fax #: Z6 Z 63 ZbT 7
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Residential Commercial
ob Description: iVLJ A-10-. to ,
For Residential Installations:
Attic ❑ 1s` floor �/ 2"a floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑ _
New installation Planning Approval Required ❑
Cost of Project: - z 9�Q a,� Type of Con'tructi*on (Usage Class):
1 0 L/Y
Strapped On Platform Bonded New Location Replacement
Project Size: Express ❑ Standard Lar e ❑ Major❑
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index. tq�
Revised 6/16/08
CITY OF CUPERTINO
FURNACE/AC
CITYOF
CUPEI,TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system;incl
installation of controls regulated by this
code.
IMCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or •
floor mounted unit heater.
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
113PGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
permit.
IBSEISMICO Commercial Seismic B
IMRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
--7
1MRAPPVNT Residential for the install/relocate/ or M •
replacement of ea appliance vent
install ¬ incl in an a 1 permit.
Quantity Fee ID Fee Description Fee Permit Type
m
CITY OF CUPERTINO
FURNACE/AC
`•CUPEkTiNO FEE SCHEDULE
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
IBPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
IMECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst > 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
IEPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit --P-
ITRAVDOC Travel Documentation B
1BUSLIC Business License B
•
uantity Fee ID Fee Description Fee Permit Ty e
CITY OF CUPERTINO
'JUMN FURNACE/AC
CUPERTINO FEE SCHEDULE •'
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= l Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
IBPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAH; HAN Residential A/C units<= l0k CFM B
p 1MRRAA Residential Mech Repair/alt/add M
/ 1BSEISMICR Seismic Residential B •
1EPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
I 1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
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 an the Project
Plans See below,
MOM
B. Site 9. Install H.E. Irrigation, (details/spec)' L•t 2 points
11. Permeable Paving, Nate L-1 2 tints
C. Foundation I. Use 15 % Flyash Concrete, (note) S-1 5 paints
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 oints
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 aints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 paints
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. EnergyStar Refrigerator, Note/S ec. A3 1 -int
P. Other 1. List Green Features an Plans A-1 1 point
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 IAWHealth
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point,75%= 2 points;80%=4 points
up to 4 Resource pts D
i2.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 D
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes D
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes D
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
�B.Design Resource-Efficient Landscapes and Gardens 4 Resource pis y--yes D
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 p
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
S 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 p
1 1 1
C.Structural Frame
(1.Substitute Solid Sawn Lumber with Engineered Lumber . - 3 Resource pts y=yes p
2.Use FSC Car ffied 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 pis y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes p
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes p
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pis y=yes p
9.Use Structural Insulated Panels(SIPs)
a.Floors 3 Ener is
Energy P Y=Yes 0
b.Wall
3 Energy pts y=yes p
c.Roof 3 Energy pts y=yes p
10.Apply Advanced Framing Techniques 4 Resource pts y--yes p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes p
12.Use OSB
a.Subfloors 1 Resource pt y=yes p
• b.Sheathing 1 Resource pt y=yes p
f 1 1
INPUT Resources Energy ]AD/Health
D.Exterior Frmsh
1.Use Sustainable Decldng 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 ContainChromium/Arsenic 1 IAQ/Health pt y--yes 0
i3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
l4.Use Fiber-Cement Siding Materials 1 Resource of y=yes 0
E.Plumbing
1.Install Water Heater Jacket J 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. D
1b.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 Chlor6a Filter on Showerhead J 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 41AQ/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes D
1 1
r.necmcai
11.Install Compact Fluorescent Light Bulbs(CFLs)
i(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) a Up to 4 Energy pts. 0 •
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
jt.Install Energy Star Dishwasher 1 1 Eneray pt y=yes 0
12.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
_ .- . - - - 1 1 1
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
i3.Install Recycled-Content,Fiberglass Insulation witfi
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
o.ceilings 4 Resource pts y=yes 0
1 1
V
INPUT Resources Energy r
I.Windows
. 1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pis y=yas 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
se Duct Mastic on All Duct Joints - , 2 Energy pts y=yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7
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
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
J.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 pis y=yes 0
11.Install AC vnth Non-HCFC Refrigerants 2 Resource pis 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(nserts 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy of y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydropic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/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 0
I 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yas p
2.Install Solar Water Heating System 10 Energy pts y=yes p
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=18 points) Up to 18 Energy pts 0
6:Select Safe and Durable Roofing materials - _ 1 Resource pt y=yes 0
7 Install Radiant Barrier 3 Energy pts y=yes p
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 0
1 1 1
INPUT Resources Energy MOfflealth
M.incloor Aur Quality and Finishes '.
r1.Use Low%No-VOC Paint - - - 1 IAQ/Health pts y=yes 0 '
2.Use Low VOC,1Naler-Based Wood Finishes 2 IAQMeslth pts y=yes 0 •
3.Use LowRJo VOC Adhesives 31AQMealth 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 IAQMealth pts y--yes
0
'7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yesD
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D
10.Install Whole House Vacuum System 3 IAQMealth pts y=yes 0
1 1 I
N.Flooring
1.Select FSC Certified Wood Flooring 8 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
a, Install Natural Linoleum in Place of Vinyl . 51AQ/Health pts y--yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
B.Install Recycled Content Carpel with Low VOCs 4 Resource pts y=yes 0
1
Total Points A 1 1401 130 57
Total Points Project Received: 0 0 0 •
G:datarprogslgreenbuildingguidellneshemodelerslgreenpointsfinal2.12.04protecled.xls
•
Community Development
t 10300 Torre Avenue
e Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
,6UPEkTINO
Building De artment
JOB ADDRESS: 2b Z 7Z !ti/v Tiles PERMIT # (�
OWNER'S NAME: rzz PHONE # ' 2— T 7Z-
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:
Signator 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
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Conor ct Signature Date