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08090167 CITY OF CUPERTINO BulcmNc DnesloN PERMITC,ONTRACTCTR INF,QILMATIQN BUILDING ADDRESS: PERMIT NO. 22476 LINDA ANN CT E G ELECTRICAL SERVICES 08090167 OWNER'S NAME: PERMrT ISSUE OATS GONTANG ALLAN R AND CAROL R 1170 BISMARCK DR 09/25/2008 NE: SANITARY NO. CONTROL NO. (408) 370-2222 ARCH=ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 X00 LICENSED CONTRACTOR'S DECLARATION Job Description uC I hereby&RNDSCTIpam at 1 am licensed under provisions of Chapter 9(commencing ZW withSccdon70(MBofDividom3oftheBusinessandProfcseiumCoulmylicenseis SUB PANEL CHANGE ^<<�N in son rnr¢he errS— D0Z Licrnse❑ L'c.g '131 & Date Contractor 't' ARCHITECTS DECLARATION a V I u rid my plans shall W used L public records Ma G Licensed Professional OWNER-BUILDER DECLARATION I Wmhy a?rot that I am exempt from the ConuactoeA License Law for the a O O following mann.(Section 703 1.5.Business and Professions Cod::Any city Or county which,equina n permit m eormntcL alun.impm c.demolish,or repair any structure Zy prim to its issuance,also require tW applicant rorsueh permit b Bk a signed nsumcm Fss< that he is Hounded pursuant to the provisions of Ne Conlsoctor's Liam,Law(Chapter 9 Sq.Ft.Floor AreaValuation y�FO (commencing with Section 700M of Division 3 of tW Business and prof nm Code)or $1100 y $ that W is c unapt Ocrcfmm and de buts for the Olegnd eumption.Any violadon of Section 7031.5 by any applicant fora permit subjcN the applicant an a civil penalty ofNumber O Out mom than five hundred dollars ISM 32613 07 2 .(V Occupancy P Y Type 0 I'm own"of the pmpersy,or my employees with wages an their sale compettsadon, will do tiro work,and the swctuu is Out intended or offered forsal.(Sec.7(x4,Business and Proressimas Code The Contractors I act,Law,dunes Out apply an u awn"or Required Inspections property who build,or i m proves thereon,and who dues such work himself or through his own employees•provided that such improvements are not intended ureffeud forsele.U, however.the Wilding or Wprownent is sold within arc year of completion.the ownm- builder will love tW WNen of proving Nat be did not build or improve nor purpose of sal..). 0 1,an owner or she prop:ny,am esclu nively contracting with Handed contranors to construct the project(Sec.7(04.Busineu and Professions Cade:)The Caouaoor's Li. mese Law does not apply ro in owna of property who Wilds or improves theme,and, who contracts for such projects with a eontracton.)resmsed pussunm ad de Convenor, License Law. O lasteaemptunder See .B&PCrarffiis. Own" Data WORKER'S COMPENSATION DECORATION 1 bemby afar¢under Malty of Priory,arc of the roliawing alalentiom,: have and will mountain a Certificate of Cement to self-insum for Workers Compem- anium,an provided for by Section 3700 of de Labor Cade,fa the part. a of th< work for which this permit is issued. 0 1 have and will maintain Worker]Compenadon Insoru¢,as acquired by Section 3700 of tho la�!Wrrr CCeoda,for the performance offt work for 91which this Permit u ivW u . My due I nrian and Policy No.: Carders x s P IONN IOM WORKERS' COMPENSATION INSURANCE (Thttsmim ner4 rot be camplcted Van pmmit is fmonc handed dollen(1100) or less) 1 century that in the performanu of f work far which this permit is Wood.l seal trot employ any person in any manner¢as to Weame subject to the Works,Compemetion . fawn of California.Date Applicant NOTICE TO APPLICANT:IL after making this Ccr ifomc of Exoneration,you should become,abject as f Workces Compccaidon provisions of the Laton Code,you muss .,O forthwith comply with such provisions or this permit shall W decred mveked. 'z CONmucnON LENDING AGENCY (-v Ihereby hill.that them is a construction lending agency for the periarroana ter a the work for which this permit is invA(Sec.3(197,Civ.C) lenders None Z Lenders Addm.. U O 1 certify that I haw notal this application and,este that the shove inrmmauon is . L, P contact I agree to comply with 01 city and county ordinances and sum laws minting to OU building convection,and hereby mtbodmmprexnutives ofthlf city to enter upon the r fZl aW.-mentioned property for inpesdon parpn¢a Ey p, (WO agree toss indemnify and kxp harmless tW City or Cupenine against ti fA lmbilides,)udgmenu, d saptanses which may in any way acne agarol said City U Z in consequence of the g 'ng or this permit. �T ^ APPLICANT UND ANDS AND WILL COMPLY WITH AL NON INT Issued by: Date SOURCE RE GU NS. F Re-roofs Signuum of App nVCo qts HAZARDOUSMATERIAISDISCLOSURE Type of Roof Will th appllon ca paun Wilding oauputsmm or bandk bvallon maurial as domed by f W Cupertino M-mitiPal Coale,Chapter 9.12,and the Health ad Safety Coda.Scott..Yes iA on 25532(.)?ea)+ J NO All roofs shall be inspected prior to any roofing material being installed. Will the applicant of banding occupant au equipment Or saedwmen If a roof is installed without first obtaining an inspection,I agree to remove harardmu,air ennuminuu as defined by tW Bay Area Air Quality Management etT all new materials for inspection. ❑Ya No Ihnomedde ,Sadoousnuudals 533 rul=nder Chapter6.9595 of de Calding does not Secemanmhat It i my reapmebil.1 muncy understandf ft Wilding docs mat c y have a emus that el u my aespo,ahiliry m redly die�uput of the an,do men ich¢tut be met pia,to iesuvuc or a Color..of cup Signature of Applicant Date Ow ta4,atn agent I I Dale All roof coverings to be Class'%¢"or better CITY OF CUPERTINO • 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32613072 . 00 DATE ISSUED. . . . . . . : 09/25/2008 RECEIPT # . . . . . . . . . : BS000006182 REFERENCE ID # . . . : 08090167 SITE ADDRESS . . . . . : 22476 LINDA ANN CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GONTANG ALLAN R AND CAROL R ADDRESS . . . . . . . . . . : 22476 LINDA ANN CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1026 RECEIVED FROM . . . . : EG ELECTRICAL SERV CONTRACTOR . . . . . . . : EDWARD GORGINIAN LIC # 24831 COMPANY . . . . . . . . . . : E G ELECTRICAL SERVICES ADDRESS . . . . . . . . . . : 1170 BISMARCK DR CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 370-2222 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 1, 100 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1EPERMITFE FLAT RATE 1. 00 40 . 79 0 . 00 40 .79 0 . 00 1ERT<200 UNITS 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 82 . 08 0 . 00 82 . 08 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 82 . 08 #368 --------------- TOTAL RECEIPT 82 . 08 • Oso of vi CITY OF CUPERTINO • CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # I .3 C, Date: Building Address: Mailing Address (if different from building address): Owner's.Name: Phone#: CAIL(OL LOKEP43G Contractor: Phone: /, ()K ZZ • 1 L Fax: �1 Contractor License#: -k6,p s 0S Cupertino Business License#: Contact: �w A O Cl t N If�1 Phone: 2222 3 0- • Fax: ResidentialZ Commercial Job Description: (Su6 )6tNcL- C,w ,16F, Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, I-B ❑ II WIN-A ❑ II/III B, N-HT, V-B Valuation: Square Footage: Project Size: Express a 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.builditgreen.org Revised 7/01/08 l aCITY0 CITY OF CUPERTINO CUPEkTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1 BBOILERI 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 1 BBOILER2 Installation/relocation of ea M boiler/compressor over 3 horsepower to & incl 15 horsepower, or ea absorptions s over 100,000 Btu/h 1BBOILER3 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 1 BBOILER4 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 Installation/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 ELECINSP 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 • �. . CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM ACOUSTICAL REVIEW. IACOUSFDW SFDWL/Duplex New B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B IACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1CHIMNEY 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 IFIREPLMAS Fireplace Masonry B 1 FIREPLFAB 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 IPILECAST Pile Foundation Cast in place concrete B IPI LEDRIV Pile Foundation Driven (steel, pre- B stressed concrete 3 of 5 r.., , va CITY OF CUPERTINO CATV OF GENERAL BUILDING APPLICATION } CUPERTINO FEE SCHEDULE • ' 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 1RETSP310 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 R 1RETCRB> Gravity/Crib Wall over 10' high (up to B 50 ft SHED-(EACH) Shed Over 120 sq ft B • SIDING 1SIDEST/BK 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) • •4of5 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 1 WINREP Replacement windows/sliding glass B door (ea 8 windows 1 WINMEWSTR New Window-structural shear B wall/masonry includes plan ck'fee IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M IPPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E I MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M IPLMBLNCK 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 / 113SEISMICR Seismic Residential B 1BSEISMIC0 Seismic Commercial B 1TRAVDOC Travel & Documentation B 1BUSLIC Business License g 5 of 5 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 MMM 2 paints 11. Permeable Pavin , Note L-1 2 oints C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 paints D. Structural 3. Uses Woad kJoist, (See Spec.) S-2 2 points 5: Use Truss with heels, (detail) 5-2 2 points 6. B. OSB Sheathing, detail S-2 2 oints E. Ext. Finish 1. Composite Decking, (Note/Spec.) AJ 2 points 4. B. Fiber Cement Siding, Note/S ec. A-4 ­12L_ ts F. Plumbing 1. Insulate all H.W.pipes, (Note/Spec.) P•1 2 points 5. Tankless WA. (Note/Spec.) A-2 2 points 11.A 2500 Gal.Tank, Note/S ec L-1 1b oints G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 __Lpoints H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A3 1 point 3. Energy Star Refrigerator, (Note/Spec. A-3 1 point P. Other 1. List Green Features on Plans A-1 1 point TOTAL POINTS 40 points • I Plan Review Process Work Book Page-12-Revised 325/08 Tr r 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 IAD/Heafth 1.Recycle Job Site Construction&Demolition Waste 1 65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0 i2.Salvage Reusable Building Matedals 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 8,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 I B.Foundation 1.Incorporate Recycled Flyash in Concrete - • 25%Recycled Flyash=2 points;Add 1 point for every 10% increase of fiyash,up to 5 points up to 5 Resource pts 0 2.Use Recycled Content Aggregate 2 Resource pts y=yes0 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesF 0 1 I ! C.Structural Frame fL Substitute Solid Sawn Lumber*6 Engineered Cumber— 3 Resource pts y--yesp 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 Vertical Applications 2 Resource pts y=yes 0 7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0 6.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0 9.Use Structural Insulated Panels(SIPs) ' a.Floors b.Wall 3 Energy pts y=yes 0 3 Energy pts y=yes 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 oSB - - a.Siubfloors 1 Resource pt y=yes 0 • b.Sheathing' 1 Resource pt Y--yes p 1 1 D.Exterior Finish 1.Use Sustairiable 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 Chromium/Arsenic 1 IAQ/Health pty=yes 0 3.Install House Wrap under Siding 1 IAQ/Health of y=yes 0 II4.Use Fiber-Cement Siding Materials 1•Resource of y=yes 0 E.Plumbing 1 Install Water Heater Jacket L- -— - - — 1 Energy P1 Y=Yes 0 2.Insulate Hol and Cold Water Pipes 2 Energy pts y=yes 0 13.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 pts. 0 14.Replace Toilest with Ultra-Low Flush Toilets Ill 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 8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 1 1 1 r.tiecmcai It.Install Compact Fluorescent Light Bulbs(CFLs) 1(6bulbs=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 i 1 1 G.Appliances 1.Install Energy Star Dishwasher 1 Eneroy pt y=yes 0 i I2.Install Washing Machine with Water and Energy ,Conservation Features 1 Energy pt y=yes 0 3.install Energy Star Refrigerator Energy pt y=yes 0 14.Install Built-Io-Recycling Center 3 Resource pts y=yes 0 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 13.Instill Recycled-Oontent,Fiberglass Insulation with IND 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 pts y=yes 0 b.Ceilings 4 Resource pts y=yes 0 • 6.Alternative Insulation Products(Cotton,spray-ioam) a.Walls 1 4 Resource pts y=yes 0 o.Uemngs 4 Resource pts y=yes 0 1 1 1 INPUT Resources Energy IAQ/Heafth I.Windows 1.Install Energy-Efficient Windows . 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 pts Y--yes0 2.Install Low Heat Transmission Glazing - 1 Energy pt y=yes D 1 1 1 J.Heating Ventilation and Air Conditioning i-1.Use buct Mastic on All Dunt Joinis- _ _ 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 of 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 S.Install Attic Ventilation Systems 1 Energy pt Y7—yes 0 7.Install Whole House Fan 4 Energy pts y=yes 0 B.Install Sealed Combustion Units a.Furnaces 31AQIHealth pts y--yes 0 b.Water Healers 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_yYes 0 13.Retrofit Wood Burning Fireplaces • a.Install EPA certified wood stoveslnserts 1 IAQ/Haalth 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 ptsy=yes 0 5.Install High Efficiency Filter 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 p 1 1 1 K.Renewable Energy and Roofing 1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes0 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=18 points) Up to 18 Energy pts 0 _ 6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes p 7.Install Radiant Bamer - 3 Energy pis y=yes p 1 L.Natural Heating and Cooling 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 pts y=yes 0 1 1 1 • M.Indoor Air Quality and FlnlsMs 1.Use LowAJo-VOC Paint 1 IAQ/Health pts y=yes 0 2.Use-Low-V66,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 • �3.Use LowMo VOC Adliesives 31A0/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 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 17._Seat all Exposed Particleboard or MDF _ 4 IAQ/Health pts y=yes 0 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 IQ.Install Whole House Vacuum System 31AQ/Health pts y--yes 0 1 1 1 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 D 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.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 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 Total Points Available: 1 1401 1301 57 Total Points Project Received: 0 0 0 • ZS -off Gaa:a/progslgreenbuilding idelineslremodelerslgreenpoinlsUnal2.12.04prolecled.xls • Community Development 4 10300 Torre Avenue It '/' Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 4FUPEI,TINO Building De artment 2B ADDRESS:W+6 LIND 6 4w ( PERMIT#' U n, OWNER'S NAME: t_ PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: 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 Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile lyn• a er/Contractor Signature Date