08070015 CITY OF
,NO ' ;:=«a.�cewtks r m-sr
BUILDING DIVISION PERNIIT „COl!IT,RACTQR INFORMATION ,
PERMIT NO.
BuaT'rdTRE98:CENVIEW AVE TBD - TO BE DETERMINED 08070015
OWNER'S NAME: PERMIT ISSUE DATE
D1NISH KUMAR 07/01/2008
.ONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
0
uija LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby affirm tat I am liconsed under Provisions or Chaper me oCSCII 9 rmmr p
zz with section May,of Divides 3ofdoes Businrax dPrommiamCnde.andmyfconsais NON-STRUCT IN BDRMS, LVNG RM, FAM RM TITLE24
=N in fullrortemdeff _7 O/-7
,qz License Clns- - LIc.L COMPLIANT 33 FIXTURES 6 SWTCHES, RECESSED LIGHTS
Date— ARCHITECTS D�ECLAaAnoN W/SWITCHES ONLY
1 understand my plans shall be meds Public records
k iso t; Licensed Profcssm.1
5 OWNER-BUILDER DECLARATION
I 1 hereby affirm Nat I am exempt from the Contractors Liccnm Law for the
O O following mason.(section 71131.5.Business and Pmfessiov Cade:Any city or county
429 which mquira a permit to ennsuueL alas,improve,demolish,or expoir my someone
U un prior an itswuancc.alw requires the applicant for such permit to file a signed suumcm
< wt a is licensedp=art to to Provisions of the Conaacmra Uanm law(Chapter9 Sq.Ft. Floor Area Valuation
i $ (eearmcncing with Section 7000)of Division 3 of the Business and Professions Calc)or $1000
Nat a is exempt dumfwm and the Luis for the alleged esempuon.My viohuon of
Secaon 7031.5 by any Appliwtt for a pemsit subjects the applicant m a civil penalty of Number .Occupancy Type
trot more than five hundred dollars(S500). 3 6 9110 5 6 .�
I,vawms of Ne pmpmy,or my moploycns with wagau Neirwle campewuan,
will Phlawork,ands:The
Licoseorawdo fmxale(sec.to an,Business
and ere, Wilds.Coe .p mons .a wW L,w rens mart applyMunn tr an Owner or Required Inspections
property who pmAdcdpmveach improvements
andwho som=1 chvamk Mmulfar Uuoughh.
boweer.Oce Wilding
Nvtitchimpmsemauin not ear ofdmoDerW fmrthe mea,
Wilder,Ne ave the m impmmnent la sold within am yearw compkuon,the owes-
builder ,will have to burden of goring tat lis did not btild w improve roc purpose of
saes.l.
1,as owner of she property,am exclusively contracting with]I...d co mustma In
comonex the project(Sec.1056.Business and Profession Code:)The Comuanors U.
conn law dna not apply to sm owner of Property who Wilds or improves thereon,and
who contracts for such projects with a eomnamr(s)licensed pursuant b ttr Contractors
License Raw.
El I am exempt under See .B&P C for this reason
caner Dau
WORKER'S COMPENSATION DECLARATION
l lonely affirm meer penally.(perjury rn of the following declanu Kron
❑1 have and will ma dada a Canifiauar Covent to ulf-m urs for Workers Compere
sauon,as pmvlded fm by S .n 3700 of the Labor Code,fm the p d.rmaoe of de
work for which this Permit is issued
❑1 have and will maintain Workers Compensation Insurance,a mquimd by section
3700 of the labor Code.for the pmformance of dm work forwhich his permit is issued.
My Workers.Cro'm�p{e�v.nim;n+lvu�rwce command Policy nugb�ry
Cartier. '2W_ ;
Puliry No.: II��JJ
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thissection need no,be completed if the Permit is forome hundmAdoltan($10D)
or leu)
1 certify Nat in the perfomnnce,of me work for which this Permit is iuued.1 shall not
employ any person in my manncrm u to became subject to Use Wmrk<ra'Compewuon
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:IL after making this Ccrtifcau of Exemption,you should
heome subject m the Workers Campmemon provisions of the labor Cedc,you mute
.J z fortbwithcomply with such provision or this permit shall W deemed mucked
Z Vy CONSTRUCTION LENDING AGENCY
'I hereby affirm that them is a construction lending agency for the Performance of
fl. the work fur which Uses Permit u Wood(Sec.31A1,Civ.C.)
SLenders Name .
z fonder.Address
V C) I caufy that l have read On applicaian sM suis that the above inrmem.is
LT.E cornu.l ague to comply with all city and county ordinances and sum Ian relating to
0 Wilding consuuctian,and WrOyamhodm mprvenuuvesof thiscityte c.w,.,a Ute
W above-mentioned property for inspection purposes
Ly,gy (We)agree m save,indemnify and keep harmless the City of Cupertino against
rg IimiliUajudgmenu,costs and expenses which may in anyway accrue agaivt said City
f,z in consequence of Ne granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCERE ONS.
Re-roofs
signuurc afApplianUCon Dau .
ous TERIALS DISCLOSURE Type of Roof
Will scant or(Ulm dl ng occupant slam or handle hrrardom material
u defnN Ik Cupertino INpal Code.Chapter 9.13,and to Health and Safety
code' pyo ,O All roofs shall be inspected prior to any roofing material being installed.
Wit]Ne,applicant or rULUm Wilding occupant am If a roof is installed without first obtaining an inspection,I agree to remove
np B e ca Air
or Mann which g P
emit ha'rardous air contaminants u Wood by Nc Bay Area Air Quality Management all new materials for inspection.
D'suicO
❑Ya �No
I have vial the a ndwsn dalsmquimmenuumb Capmr6.95ofthecalifer-
nuHa1N&SafctyCmdc,Sa.m 505,25533"25534.1umtnur ifdc building
doss Incl currently have a IananL Nat it is my rexpensibaity m notary the meupant or the
mquimmrns wNcb mum Wm at pd or anesmance. mr,aroccepromy. Signature of Applicant Date
7-1-0)s
owner or:mnmixed Dam All roof coverings to be Class';}”or better
CITY OF CUPERTINO
• 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36911056 . 00
DATE ISSUED. . . . . . . : 07/01/2008
RECEIPT # . . . . . . . . . : BS000005320
REFERENCE ID # . . . : 08070015
SITE ADDRESS . . . . . : 10441 GLENVIEW AVE
SUBDIVISION . . . . . . :
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : DINISH KUMAR
ADDRESS . . . . . . . . . . 10441 GLENVIEW AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4512
RECEIVED FROM . . . . : ANDREW CRAIG
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS. . . . . . . . . . . :
CITY/STATE/ZIP . . . .
TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BREMFIXT NO. FIXTURES 33 . 00 100 . 97 0 . 00 100. 97 0 . 00
IBREMRECEP NO. OUTLETS 6 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1BSEISMICR VALUATION 11000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1EPERMITFE FLAT RATE 1. 00 40 . 79 0 . 00 40 . 79 0. 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
------ ---------- ---------- ----------
TOTAL PERMIT 223 . 84 0 . 00 223 . 84 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 223 . 84
---------------
TOTAL RECEIPT 223 . 84
Oo7 O0 /S
CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
iP 77,t
Building Address:
Mailing Address (if different from building address):
Owner's Name: PhoneHol#:
t l.( ln 32K- 69o5
Contractor: Phone: /jo& 374 -t w �?
"boLt-, Ceotrib GLwcst2 W owb Fax:
Contractor License#: Z w I�
Cupertino Business License #: Q()JO N 0121
Contact: Phone:
• Fax
Residential ommercial
Job Description: Wo rle 47-7?kc-ma dt l,7d 1317 Vtl S, LI V I NCs RM. ) F-/an i L-'t Z
T tr 2`f CoMkAa47-, 33 ��c�urr��l 6svrT
Lt r21W 1Te- H l�L
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction (Usage C ass): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B [l/ 15114(t r F
U c7 U
V luation:
Square Footage:
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 help, contact Build it Green at www.buildit reen.or
Revised 6/16/08
rQ CITY OF CUPERTIN0
ITYF
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
1BTEMPPER Temporary Building Permit (good for B
30 days)
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)
IBBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
IBBOILER3 histallation/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
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH 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.
lELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour)
IPLMBINSP Other Plumbing & Gas Inspections P •
(per hour)
IMEETINGIHR Application Meeting B
aclioF
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
CUPERTINO
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
ICHIMNEYR Chimney Repair B
FENCES
IFENCE>6FT Non-masonry, over 6 ft in height B
I 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
IMODUSTRU Modular Structures B
FOUNDATIONS
IFOUNDREP Foundation Repair B
I PILECAST Pile Foundation Cast in place concrete B
1 PILEDRIV Pile Foundation Driven (steel,pre- B
stressed concrete
3of5
CC CITY OF CUPERTINO
OF GENERAL BUILDING APPLICATION
CUPEkTINO
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY)
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
IRETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft)
SIDING
1SIDESTBK Siding, Stone & Brick Veneer B •
(interior/exterior)
1 SIDEOTHER Siding all other B
SKYLIGHTS
1SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l 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
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
•
4of5
(D- CITY OF CUPERTINO
Cff'OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1GENCOM
1 WIlVREP Replacement windows/sliding glass B
door ea 8 windows)
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
/ 1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pin Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1PLMBLNCK Stand Alone Plumbing Pln Ck(hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no-E/Tv") B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
lBSEISMICO Seismic Commercial B
1TRAVDOC Travel &Documentation B
1BUSLIC Business License B
• 33 - L���/f l=x�u �-cf
5of5
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
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 paints
D. Structural 3. Uses Wood IJoist, (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 Sidin (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 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. Ene Star Refrigerator, Note/S ec. AJ 1 oint
P. Other 1. List Green Features on 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.
A.Site
1.Recycle lob Site Construction&Demolition Waste �!
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials J 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/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 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 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 wth 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 Eneroy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts yeses 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
J,Wall 3 Energy pts y=yes � p
3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
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.
Use0S8
a.Subfloors t 1 Resource pt Y--yes p
• b.Sheathing
thin thin_ _ _ 1 Resource pt y=yes 0
1 1 f
D.Exterior Finish
�1.Use Sustainable backing Materials •
a.Recycled content 3 Resource pts y=yes 0
t
J.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
13,Install House Wrap under Siding 1 IAQMealth pt y=yas D
14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
1 f 1
E.Plumbing .
L1.Install Water Heater Jacket
_ --- -i----- - -- - -- -' 1 Energy pt Y=Yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y--yes 0
3.RetroM all Faucets and Showerheads with Row Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
J.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toiled with Ultra-Low Flush Toilets t
(1 point each,up to 3 points) _ _ J Up to 3 Resource pts. 0
5,Install Chlorine Filter on Showerhead 1 IAQ/Health pt y--yes 0
5.Convert Gas to Tankless Water Heater 4 Enargy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAC/Health pts. D
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 f 1
t-.tiectncar
1.Install Compact Fluorescent Light Bulbs(CFLs) I
(6 bulbs=2 points,t o bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. 0 •
2.Install IC-AT Recessed Fxtures with CRs(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. D
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. D
{ { 1
G.Appliances
1.Install Enr Di
ergy Stashwasher 1 1 Energy pt y=yesTo
0
2.Install Washing Machine with Water and Energy - 1
[3.lnstall
onservation features 1 Energy pt y=yesD
Energy Star Refrigerator 1 Energy pt y=yes0
Install Built-In Recycling Center 3 Resource pts y=yes
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
IS.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 31AQ/Health pts y=yes D
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.t;eilings 4 Resource pts y=yes 0
1 1 i
INPUT Resnurces Energy
I.Windows !
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt Y--yes 0
I b.Low-Emissivity(Low-E) 2 Energy pts Y--yes0
c.Low.Conductivity Frames _ _ 2 Energy pts Y--yes0
2.Install Low Heat Transmission Glazing _ 1 Energy pt y=yes 0
1 1 t
J.Heating Ventilation and Air Conditioning
fi.Use Duct Mastic on All—Duct Joint's j 2 Energy pts y--yes 0
2.Intallw rk within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 21AQ/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 Eneroy pts y=yes p
S.Install Sealed Combustion Units -
a.Furnaces 3 IAQ/Health pts y--yes
0
b.Water Heaters 3 IAQ/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 stoveslinserts 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 p
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes p
17.Install Separate Garage Exhaust Fan 31AQ/Health pts y=yes p .
K.Renewable Energy and Roofing 1 I 1
1.Pre-Plumb for Solar Water Heating 4 Energy pis y=yas 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=16 points)_ _ Up to IS Eneroy pts 0
I6.Selai Safe and Dureble Roofing Materials _ ____ 1 Resource pt y=yes p
7.Install Radiant BardeIr -- 3 Energy pts y=yes p
1
L.Natural Heating and Cooling I 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 pts y=yes p
• 1 1 1
M.Indoor Air Quality and Finishes
'1.Use LowiNo-VOC Paim 1 M/Health pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Fnishes 2 IAQ/Health pts y=yes 0
i3.Use Low/No VOC Adhesives _ 3 IAQ/Health pts y=yes D
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 D
S.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
L7,Seal all Exposed Particleboard or MDF _ 4 IAQ/Healthpts y=yas D
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes D -
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes D
10.Install Whole House Vacuum System 31AQI Health pts y=yes 0
f i 1
N.Flooring
1,Select FSC Certified Wood Flooring 8 Resource pts y=yes D
F2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes D
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yas 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
S.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points A 1 1401 1301 57 •
Total Points Project Received: 0 0 0
Gaaarpmas'greenSoildnp3uidelimslramotlelersrgreeap�imsf nal2t 2.04pr�te,7ed.zls
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY Of Fax(408)777-3333
6EUPEkTINO
Building Department
JOB ADDRESS: PERMIT#
1/4c c 6 , -2d C)/-
OWNER'S NAME: 0 5 g PHONE # I.�U8 3-7L(-I X19`7
GENERAL CONTRACTOR: 4 FAX # bt 0 .9 2(�•�l0 7�
I am not using any subcontractors: �7-1 -0 B
Signa Date
Please check applicable subcontractors e the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
aLinoleum/ 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/Contr r Si ture Date