08090139 CITY OF CUPERTINOxa', .
BUILDING'DIVISION PERMIT CO,6"T"W' 'ORMATION�
BUILDING ADDRESS: PERMIT NO.
20671 RODRIGUES AVE TNT ROOFING CO 08090139
OWNER'S NAME: PERMIT!ISSUE DATE
OSBORNE WILLIAM T AND CAROLINE 1610 BLOSSOM HILL RD STE 6C 09/22/2008
NE: SANITARY NO. CONTROL NO.
ARCHr1EC71ENGINEER: BUILDING PERMIT INFO
RE—RF RMV SHK INSTL 1/2"OSB BLDG ELECT PLUMB MECH
0 0 LICENSED CONTRACTORS DECLARATION O O O O
1 herchY.fir mat 1 atm licensed under provision of Clasher 9(commencing ^----^- ^•^^ Job Description
with section 7MIy.fDivisiam3af NC Bushes and Proteasium CadO.md my licensein
in full Tand ercect Lu.g
p i License Class
r Dao: Caru i y
VVMFIIIECrs DECLARATION
< 1 understand my plans shall he used as public records
3�U
g Q�
Licensed Prolossmal
3OWNER-BUIIDER DECLARATION
I hereby mfOr that 1 am exempt from Ne Conuache's License Law for the
00 following wan.(section 7031.5.Business and Rofestivas Code:Any city or county
$ which requires a permit he conswct.atom,improve,demolish.Or mpair any struaum
prior th its issuance.also squites the applicant for such Permit to file a signed stanmcnt
tic that he is licensed purseant to the provisions of the Convactor'a Uixtmac Law(Chapter 9 Sq.Ft. Floor Area Valuation
4 2 (commencing with suction 7000)or Division 3 of the Business;and Professions Code)at
Nat he is exempt therefrom and the but,for IW alleged exemption,Any violation of
second 7031.5 by any applicant for a permit mbjccu me applleant to a civil penalty of APNumber Occupancy N NumbType
on,marc usd fiva hundred dollars($5M P Y YP
0 1,a caner of the property m my mopnyca with wags u dmh sole compensadon,
will do Ihewmis.and thctwctum u not eendCd a oRercd tarsale($ec.]016,Budnm
sent ProtestinN Calc:The Comma pr's License Law does net apply in an coma a Required Inspections
property who bui Ids or im prom thereon.aM who does such work himsel f or through hu
own employee,provided that such irephoemenu art not in¢ndcd maRcred forsale IL
however,the building or improvement Is sold within one year of compkileo.We wnm
builder will have the burden of proving that he did not Wild or improve for purpose of
sale.).
El 1,u water of the property em ancrie ivelY command.,with ilansed conB.mas to
co"slmct the project(Set 7W6,Business and mofadans Codc:)TW Contractos's U.
ceoe law does not apply m an owner of proWny who builds or improve macer,and
who convects for such projects with s cumranas(s)licensed pursuant b the Coroacmts
License law.
O lamuempsundm See ,BAPCfarmismason
Owner Date
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of penjur,oro of the fallowing decimation:
1 have and will maintain a Certificate orCmus m in teff-insure far WorkdsCompea-
sadom,as pmvkkcd for by Section 3700 of the labor Code,for the perfarana of the
work for which this permit is issued.
0 1 have aM will maintain Worker's Compensation Insurance,as Inquired by Section
3700 oftm labor Code, a Ne pchforance of the wart for which this permit is issued.
My
CarriWeor.rker's /� ra and Policynmber rt:Policy No.: 0 e'?✓wO
CERTIFICATE
OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
rlhu section need out be completed Ilt&permit is imone hundred dollen(SI00)
of teal)
I codify that in the paforume of use,work for which this perms is issued;l shall ata
employ any person in any ma umisa as In become subject on the Workerd Compensator
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Ceni0can of Exemption,you should
become subject In the Woftes Compensation provisions of the tabor Cade,you most
.,O foMwith comply with such provicans a r
this peil mallW Gamel
Gamed reveled.
.zi "" CONsrRucnoN LENDING AGENCY
F-hr IhembYaRr that there it.conairoctien lending agency for to perfwmena of
thr wart fur which tons permit Is issued(Sec.3097,Civ,C.)
W�Q Undoes Name .
Z)z t<nd es Address
U Q 1 curtify that I have mW this application and run that the above information is
17. correct 1 agree in comply with all city cord county ohNnatmef and some laws rcu umg in
Wilding coniWttidn,an0 hereby suthorire reprommad ve of Nu city to ems upon the
W .1owe-mentioned property for impcaion purposes
(We)agree n sane,indemnify add k=P harmless Oe City of Cupcnino against
(ZI Iiab"himjudgmene,Coss and espenues which may n any way aura apinsl said Cry
U Z in earmommen of Lou graining of this permit. c
APPLICANT' DERS7AND5 AND WILL COMPLY WITH ALL NON POINT Issued by: Date /
SOURCE U2ONS. I
Re-roofs
or. h_HAZARDOUS MATERIALS DISCLOSURE Dan Type of Roof
Will ton appliam or future building acupanlstoro or hand to
material
u dcfmM by the Cupertino Municipal Code.Chapter 9.11,and IW Health and Safe,,
Cade,section 25532(.)7
❑Yon p All roofs shall be inspected prior to any roofing material being installed.
Will me amliant ter r building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
t i�ha menus air conorrommu an de0red by the Bay Area Air Quality Management all new materials for inspection.
Dyes ON
I have road ton lasmadlommamrials requirements under Chshorb.95ofton Caltfor.
nitHahh ASafay Cada.SOeec s25505,M333a a255N.1 urdcmand Natifthc Wilding `1
dao set cum have a sant this itjs my responsibility m notify ton oco ma of the �i
requiremcn hihmaslWmetpri Wino mora OalppfOcCupaney. Signature of Applicant Date
C L �i 1
owner d,,amanzodagent Dan IAll roof coverings to be Class'9 tr'or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35910055 . 00
DATE ISSUED. . . . . . . : 09/22/2008
RECEIPT #. . . . . . . . . : BS000006146
REFERENCE ID # . . . : 08090139
SITE ADDRESS . . . . . : 20671 RODRIGUES AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : OSBORNE WILLIAM T AND CAROLINE
ADDRESS . . . . . . . . . . : 20671 RODRIGUES AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2964
RECEIVED FROM . . . . : MICHAEL D WILLIAMS
CONTRACTOR . . . . . . . : WILLIAM TYLER LIC # 22988
COMPANY . . . . . . . . . . : TNT ROOFING CO
ADDRESS . . . . . . . . . . : 1610 BLOSSOM HILL RD STE 6C
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
TELEPHONE, . . . . . . . . : (408) 277-0800 -
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 338 . 80 0 . 00 338 . 80 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF' 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
%s�Qd`.:, REROOF
OEUPErli°T`INO PERMIT APPLICATION
APN # 591 Date:
v �55 � �� u
Building Address:
O PJ
Owner's Name: Phone #:
Contractor: Phone #: g�7,7— (, Civ
-�7ovT
Fax#: F_6� Zs-63
Cupertino Business License #: Contractor Liceg��e #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ B t=Up roof
❑ phalt Shingles Asphalt Shingles
,ate 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 Mfgr. Installation Specs.
Job Description: Rek�v c C�Ce 12zu r—, 47,- ,S f lyl 6
c_fas f
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:
I Have Read, Underst n and Will Comply with Cupertino's Tear-Off Policy:
S' ature
Revised 6/16/08
�, CITY OF CUPERTINO
I MCREROOF
CUPER,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
2 C 1REROOFRES Re-roof Residential B 1SFDWLROOF
/ IBSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
Community Development Department
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 Paid before another inspection can be scheduled
IMPORTANT:
1. Flat roofs must have a minimum of 1/a "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
y�the above stated policy on re-roofing.
Homeowner's Name: 4�lz w7 JJk4C
Job Site Address: z0g / 'I �vd/7�wej
Roofing Company Name: glel' '�
Applicant's Signature Date:444
• 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 paid 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
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 points
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 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 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. Energy Star Refrigerator, (Note/Spec. A-3 1oint
P. Other 1. List Green Features on Plans A-1 1 point
4_0 IMMAMMMI 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 D _
A.Site
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
�2.Salvage Reusable Building Materials _ 4 Resource pis 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 6 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 p
9. Reuse Matedals/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
• 25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resource pts0
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 Certified Wood for framing
(For every 0%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
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Ener is
9Y P Y=Yes
b.Wall 0
3 Energy pts y--yes 0
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 0
12.Use OSB -- -- "
a.Subfloors - 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes 0
611
1 0 f
INPUT Resources Energy [ADIHealth n
.EXterlof rmsh
1.Use Sustainable 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 ChromiumlArsenic 1 IAQ/Health pt y--yes 0
i3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
�L Install Water Heater Jacket _ 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
F3.Rkrdlt all Faucets and Showerheads with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. D
b.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 Chlorine Filter on Showerhead 1 IAQ/Health pt y=yas 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes D
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 41AQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes D
1 1 1
r.erectncai
11.Install Compact Fluorescent Light Bulbs(CFLs)
'(L6 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. D
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes D
12.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
'3.lnstall Energy Star Refrigerator 1 Energy pt y=yes D
4.Install Built-In Recycling Center 3 Resource pts y--yes 0
I` . - - — -— - —_ _. . .. .
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
3.Install Recycled-Content,Fiberglass Insulation with .
�No Added Formaldehyde 31AQ/Heahh pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes . D
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.uewngs 4 Resource pts y=yes D
1 1
I
I.Windows INPUT Resources Energy 1ADIKealth
0.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes D
b.Low-Emissivity(Low-E) - 2 Energy pts Y--yes D
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y--yes D
1 1 1
J.Heating Ventilation and Air Conditioning
ft.Use buct 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 D
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 7 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
b.Water Heaters 3 IAQ/Health pts y=yes D
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 D
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
Oa.Install EPA certified wood stovesfnserts 1 IAQ/Health pt y=yes p
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 D
15.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 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 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=1 B points) Up to 16 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
i 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts yqy s p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes p
1 1 1
•
INPUT ReMurces Energy ]AD/Health
-W.7r.ODr Atr Quabty and inrshes
5.Use Lo AoA OC Paint' 1 IAQ/Health pts y--yes 0
2.Use Low VOC.Water-Based Wood Finishes 21AQ/Health pts y=yes 0 •
3.Use LowMo VOC Adhesives 3 IAQ/Health 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 61A0/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y--yes 0
.7.Seal all Exposed Padicleboard or MDF 4 IAQ/Health pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pis 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 1 0
t 1 1
N.Flooring
1.Select FSC Certified Wood Flooding B Resource pts y=yes 0
12.Use 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 1
Total Points A 1 1401 130 57
Total Points Project Received: 0 0 0 •
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•
Community Development
t 10300 Torre Avenue
* ✓ Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
IWUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
Z� /Ce6�pgi-013 z
OWNER'S NAME: PHONE # Z
GENERAL CONTRACTOR: U FAX # 2_,(SF_
I am not using any subcontracto s: ll ` �—
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
T
Owner/Contractor Signature Date