08090069 CITY OFCUPERTINO +�mt �t� t"r' *T' ' " '-. " '�'•
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DIVISION PERMIT -kCUNTR'A.CTQR I �O ,M�ATION, `
BUILq�r #.��REsF'ARALLONE DR PRINCIPLE ROOFING & PERMIT08090069
OWNER'S NAME: PERMIT LSSUEDATE
RAJA & KATRINE BHADURY 10160 STERN AVE 09/12/2008
PHONE: SANITARY NO. CONTROL NO.
ARCH=/ENGINEER: BUILDING PERMIT RE—RF RMV EXT WDSHK INSTL 'BLDG ELECT PLUMB MECH
300 LICENSED COND(ACIDR'S DECLARATION
in ffim N
IWreby aat l am licensed under provisions of Chapter 9(commeneing ------ ,._ .. _ ......,. Job Description
witb Section 10(10)of Division 5 of Nc Business and Profession;Code,and my license is
e m in full forea and
Lice,sense Clam Contractor gti�
n ARCNTfECI-S DECLARAT�
?i U 1 understand my plans shml he u,ed—.—Public mcoms
g C Licensed Prefecsi...I
3 OWNER-BUILDER DECLARATION
I I hereby alfm
that I am exempt from Ne Contractor,License law for the
t pe O following reason.(Section 703 1.5,Business and Prorrssums Cods:My city or county
_ which requires a permit to crmsuun,alter,improve,dcm.lish,or repair any awmum
_zy Prior in its iaswnee.aEu mquirts the applicant for such prrmitto file a signed suument
< 'man he is licensed pursuant to the pmvudons of the Conuactur'a License Lao,(Chapter 9 Sq.FC Floor Area Valuation
x�$ (commeming with Section IOW)of Division S of the Business and Pro2ss(mu Code)to `
vitt he Is exempt therefrom and the bola for the alleged exe4nption Any violation of
Section 1051.5 by any applicant for a permit subjects Ne applicant to a civil penalty of APN Number
ml sumo Nan foe hmrdmd dml,m(6500). Occupancy Type
01,Mownerofthe PMPCM.mmYwploymwithwag=uthebwlemmpe UM,
will do the work,and she structure is notimmeded oroffemd for,ale(Sec.7066,Business
and Profession,Code:The Contractors Lt..Law does Out apply to an owner of Required Inspections
property who indicts or improver demon.and who does such work himmlr or through his
own employees,provided that such improvements are not intended oroffered for tal&if.
however,the building or impeovemrnt i,sold within one yw of completion.the owmr-
Wilder will have Out bards.of proving that he did Out Mid or impmw for imr an,of
LIe.L
❑1.as owner of the property,am=elusively conamting with Ikerued cnnonamm s Or
cooawct the project(Sec.1014.Business and Professions Code:)The Coememrs U.
cease law does not apply in an owner of property who Wilda or improves thereon.and
who mmuacts for such projects with a rnntracwr(,)licensed pursuant to the Conuannrs
License law.
❑I am eaunpt undor See ,a&P C for Nis reason
Owner Dau
WORKERS COMPENSATION DECLARATION
1 hereby affirm under pe ra ty of perjury arc a Ne following dedications:
❑1 hew ono provided
maintain•Cion 3M of Consent r Coca.
Wmc the
Workers Comp em
moan,r provided for mi Section IIID of the Vher Cede.for the performance e(w
wort far which oda pcmituiaucd.
I have and will maintain Workers Compensation Insurance,as required by Section
5100 of Ne labor Codi for rhe performance of the wort for which this permir u issued.
My Wortrfs C�oam..pAenamoi..Ir�uv�rance Gamer and Policy n rndxc mime:
Carrie. QLA sr Ym`R9 Policy No.:C-�eVQ— r t.
CERTIFl8OF EXENPrtON FROM WORKERS'
COMPENSATION INSURANCE
(IhisseNm need ran x completed ifthe Permit is fm.ne hundred donan(SIM)
or lean)
I Unify that in the performane,of Ne work for which this Permit is issued,l shall not
employ any person in any manner so as to become subject to the WorkeK Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Ccnifiene of Exemption,you should
become mbjeer th the Worlers Compensation provisions N the labor Cede,you muse
.JO forthwith comply with such provisions m this w
pemit knoll k deemed rekcd.
Z CONSTRUCTION LENDING AGENCY
.�
F Iher by which mthas Nem iaa Issued
lending aBenry for the perfumamx of
C the work for which Nis permit u issued(Sm.3091,Civ.C)
Qnder's Name
Le
Z) z
Lender's Add
U O 1 certify Wt 1 low mad W,applicatim aM sort this ore aWw information I'
gL E correct.I agree w comply with All city and county oNiwuxs and soon laws nelafng to
'0 Wilding construction,arW hereby auhorim mpresentarives of this city to enter upon the
how-menwmd property for inspection puryoeu
H a a (We)agree to saw,indemnify and keep hermleo the City of Cupertino against -
tun inconitl=,jume of the Swung
and=Rnseswhich may in any wYacrneagainst mid City
U'z in consegmmc.f the Bmnunt of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE EGULAT10N5. _.
� OqIlLte Re-roofs
Sngnuum Appli=HAZA HAZARDOUS
Dass
xnza lot= MATERIALS tsiaosuRE Type of Roof
WIII the applicant m future Wilding e.Chapter
seam mheMk hai anmaerial
u deOned the Cupertino Municipal Code.Chapter 9.13,and Ne x=Ith and Safety
Code.Section n532(a)± Na All roofs shall be inspected prior to any roofing material being installed.
Will the, licamorfuture Wilding Occupant use equipment If a roof is installed without first obtaining an inspection,I agree to remove
PP G P ea Panna m devices which g
emit ha'ramnus air cmtaminanu m d ncd by the Bay Arca Air Quality Management all new materials for inspection.
Dau n7
❑Y= Nu
I have mW w hoamnu muensio- hemeras under Chapter6.95ofthe Califon
nu x=Ith&SafetyCode,Sections 25505.25555 and 255th.l undersuM wtifde Wilding
dans set currently have a tenant.Nu it a my r=ponsihility re ratify w occupant of use
mquincmen which muss b,met prior toismame of a Certifcau of a
6- f�C Signature of Applicant Date
ownefmwthmi.cdagcm' 11 DkteI All roof coverings to be Class'n"or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . 1 : 36931016 . 00
DATE ISSUED. . . . . . . : 09/12/2008
RECEIPT #. . . . . . . . . : ES000006066
REFERENCE ID # . . . : 08090069
SITE ADDRESS . . . . . : 10355 FARALLONE DR
SUBDIVISION
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RAJA & KATRINE BHADURY
ADDRESS . . . . . . . . . . : 10355 FARALLONE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3104
RECEIVED FROM . . . . : DERECK LOI
CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564
COMPANY . . . . . . . . . . : PRINCIPLE ROOFING &
ADDRESS . . . . . . . . . . : 10160 STERN AVE -
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 898-7298
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1REROOFRES SQ FEET 22 . 00 286 . 00 0 . 00 286 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 287 . 00 0 . 00 287 . 00 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 639.20 MC
---------------
TOTAL RECEIPT 639 . 20
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
00409
CITY OF CUPERTINO
Cel' REROOF
• CUPEkTINO PERMIT APPLICATION
APN # Date:
/Z— cle
Building Address:
10353 f—A 4AGGOn/E AE-
Owner's Name: Phone #:
>ea72t-r 6" 6ga;1JS6 q_ ? zcq
Contractor:oo' /, Phone #: L! ) �g
Fax #:
Cupertino Business License #: Contractor License #:
� 163�r
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ilt-Up roof
❑ alt Shingles e( Asphalt Shingles
�(Wood Shakes ❑ Wood Shakes
• ❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfg. Installation Specs.
Job Description:
�ermnvc C-A_W `r. Woav Asa}ate .-dry �i as i3 S�Cea � vGs>
Gv»��UFii?� i .Ship �/�'S �+ 2 2
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: .y
/ d� rJOd '
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOFC 11 atto F
`
CUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1RER00FRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
113SEISMICRE Seismic Residential B •
1BUSLIC Business License B
Revised 6/16/08
Community Development Departrnent
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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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 Raid 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: "6t+(-t!!?�
Job Site Address: /a3SS -4AA 0,AIF �
Roofing Company Name: cf�37fc"rte_
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 07/30/08
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
3:30 p.m. to request a next-day inspection.
• 2. When the roof is torn off, the nails have been removed or driven in,
and all of the dry-rotted wood has been replaced, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this service: from 7:30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from
7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear-off inspection and the job is not ready, you will
be charged a re-inspection fee of$176.18. The re-inspection fee must
be Raid before another inspection can be scheduled
• Greg Casteel
Building Official
Revised 8/13/04.
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
x
v
B. Site 9. Install H.E. Irrigation, (details/spec)• L-1 72pointss nts
11. Permeable Paving, Note L-1 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 nts
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 poin
5. Use Truss with heels, (detail) S-2
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 oints
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. Ener Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 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.
A.Site INPUT Resources Energy 1ADIHeafth
FIRocycle Job Site Construction&Demolition Was=1 point;75%= 2 points;80%=4 points � � up to 4 Resource pts 0
v. lvage 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 of 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-Effident Landscapes and Gardens _ _ f 4 Resource pts Y--yes 0
9.Reuse Matenals/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-Sile Water Catchment/Retention 2 Resource pts y=yes 0
1 i 1
B.Foundation
1.Incorporate Recycled Ryash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every 0%
increase of flyash,up to 5 points up to 5 Resource pts p
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 Sawe Lumber with Engineered Lumber j 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 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 Vartical 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 Ener is
c.Roof gyp Y--yes 0
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.Use0SB -- — - -- --
a.Subfloors
b.Sheathing 1 Resource pt y=yes p
L
• _ —_
__ _ 1 Resource of y=yes 0
1 1 1
D.Exteriorrmsh
11.Use Sustainable Decking Materials _
a.Recycled content 3.Resource pts Y--yes 0 •
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
r
3.Install House Wrap under Siding 1 IAQ/Health pt y=yes o
�4.Use Fiber-Cement 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 Hol 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. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pis. 0
4.Replace Toilest with Ultra-Low Flush Toilets I
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showsrhead 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 IAO/Health pts. o
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts Y--yes 0
1 1
r.rrecvrcar
1.Install Compact Fluorescent Light Bulbs(CFLs) '
l
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) 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
1.Install Energy Star Dishwasher i 1 Energy pi y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features j . t Energy pt y=yes 0
3.Install Energy Star Refrigerator 4 1 Energy pt y=yes 0
4.Install Built-In Recycling Center i 3 Resource pts y=yes 0
1 =11111
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
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde i 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
D.t;eninos 4 Resource pts y=yes 0
1 1 1
i 1ADIflealth
I.windows
I1.lnnall Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes p
b.Low-Emissivity(Low-E) 2 Energy pts yryes p
c.Low.Conductivity Frames _ 2 Energy pts y=yes p
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes p
1 1 1
J.Heating Ventilation and Air Conditioning
(1.�Use Duct Mastic on All DLa Joimts _ 2 Energy pts Y--yes p
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 p
4.Clean all Ducts Before Occupancy 2 IAO/Health pts y=yes 7
p
5.Install Solar Attic Fan 2 Energy pts Y_—Yes 0
S.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes p
8.Install Sealed Combustion Units
a.Furnaces 3 IAO/Health pts y=yes p
J.Water Heaters 3 IAQ/Health pts y=yes p
9.Replace Wall-Mounted Electric and Gas Heelers with
Through-the-Wall Heat Pumps 3 Energy pts Mas p
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes p
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 p
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stoveslnseds 1 IAQ/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt Y--yes p
c.Install Airtight Doors 1 Energy pt y=yes p
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes p
15.Install High Efficiency Filter 41A0/Health pts y=yes p
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes p
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes
D
1
K.Renewable Energy and Roofing 1 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
2.Install Solar Water Heating System 10 Energy pts y=yesp
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yesF7 p
4. Install Photovoltaic(PV)System
(1.2 kw=6 points,2A kw=12 points,3.6 kw=18 points)_ ___ Up to 1 B Energy pts p
6.Select Safe and Durable Abofing Matenals - _ _ _ 1 Resource pt y=yes p
7.Install Radiant Barder - , 3 Energy pts y=yesi
p
L.Natural Heating and Cooling 1 1 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pis y=yes p
1 1
•
INPUT Resources Energy 1ADIlreafth
M, ndoor Av Quality and Finishes
�1.OseL6w/NaVOQPant J_ 1IAQ/Health is es 0
_ y=Y
P
-2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
i3.Use Low/No VOC Adhesives �- _y__ 31AO/Health is es 0 •
_._ _ _ P y=Y
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AO/Health pts y--yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes D
'Seal all Exposed Padicleboard or MDF __ �; 4 IAQ/Health pts y=yes D
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 0
10.Install Whole House Vacuum System 31AQ/Health pts y=yes 0
1 1 1
N.Flooring
Select FSC Certified Wood Flooring 8 Resource pts y=yes0
gUse
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 IAQ/Health 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 i t
Total Points Available: 1 1401 1301 57
Total Points Project Received: 0 0 0 •
Gdatarpropslgreenbuildngguidelineshemodelerslgmenpointsfinal2.12 04protecledxis
N Community Development
AIr 10300 Torre Avenue
`l Cupertino CA 95014
Telephone(408)777-3228
CITY Of Fax(408)777-3333
,+ CUPEkTINO
Building Department
JOB ADDRESS: PERMIT #
is 3r;;r F,4-iza LGGNc- o,,� 't 6 069
OWNER'S NAME: 4 -?aXZvX r(,a.p PHONE # P
C-FIrl/3) 9 8 — ;ZL9b
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors: OL OY
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
iGlass / 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