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CITY OF CUPERTINO
BUFLDING DIVISION PERMIT
s lJ�l\`11�LiV�QA jEl1Y�IQ."'
BuaTgcMDT6'RKSHIRE DR
A-1 ELECTRIC
PERMR NO.
08070205
OWNER'S NAME:
PERMIT ISSUE DATE
ROBERT WHITTEN
421 E HEDDING ST
07/29/2008
NE
SANITARY NO, CONTROL NO.
(408)975-9171
ARCHITECf1ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONfRACIVR'S DECLARATION
Chapter 9
lb Description
y affirm I am licensed under previsions of (commencing
1 borebffirm N
with Section 70f ) of0hision 3 afore Business and Professions Code. and my license is
UPGRD SVC FRM 100 TO 200AMP
in full force and efre[h L J
License Class C
Dam "7-29—oV Contractor —1 aft
ARCHrfECfS DECLARATION
1 understand my plans shall he used as public accords
Licensed Professional
OWNER -BUILDER DECLARATION
I hereby alTime Not 1 am exempt from the Convectors License Lew for the
following reahan. (Section 7031.5, Busircss and Professions Calc: My city or county
which rtquimn a Permit to consmct, alta, improve, demolish, or repair any muttum
! prior at its issuance. also requires the applicant for such permit w file a signed atsemem
to the of Ne Committers Liana<Law (chapter 9
Sq. Ft. Floor Area
Valuation
that In, is licensed pursuant proviskns
Section 7000) Division 3ofth, Business and Profession&Codi) or
$2600
1 (commencing wild Of
thal W in attempt thed. and tbo basis for the alleged crampoon. Any violation of
36207014 Number
Occas
Occupancy T'Pe
Section 7071.5 by arty applicant fore pewit subjects the applicant m a civil penalty of
oat ream Nan livelivehundred dollars (seem.
❑ I. as owner oflbe Property Ormy cmployas with wages u their role compensation,
Required Inspections
will , License aw faro n0a4,Businm
Ncwens andan-
do
TW O omesta Law does rot apply lf rt owner
prop Pr cede TW apply
ve beemrs and is
property who improves Nmeonandwho doermmass himueedououghhie
propertywW
awn res, provided that such imps in not inmnded for role If.
,pmol
ver. da id within m leered
builder. Ne Wilding mimprowmantahalt withinoneyear of wmplefa, theowe
of
builder will have the When of proving out W did not bNld or improv far Puryou o!
serest.
❑ 1, as Owner of the property, am exclusively conoaming with licensed contractors to
cmutrocl the project (see. 7044. Business and Professions Cedc) The Coomarwrs U.
ave Law docs nut apply in an owner of property who Wilds or irepmves demon, add.
who commuss for such projects with a constituents) licensed pmseent m the ConlranoYs
License Law.
❑ I and esemps under See , B B P C to, this acason
Owner Dau
WORKERS COMPENSATION DECLAPU 1ON
I hereby affirm under penalty of perjury one of the following decimations:
10
I harm and will maintain a CenRioro of Cement to %If -Wore far Workers Corpse.
sation, as provided for by Section 3700 of the labor Code. for the peRornmend of ted
work for which this permit is issued
have and will maintain Wortrfs Compamadon Insurance, as acquired by Section
'
]BO of oe Labor Coon. for the pcnteran. fNe wort forwhich NU Permit u issued
'
My Wmkay[s COmpemN
xtion sur.. earn .1 and Policy number ad:
Cartier: ` � CraRs�Policy No.L wl to
C ACATEE E. IMON FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W campleted VOW Pewit is foram hundred dollen ($100)
carless)
1 certify Nut in the performance of the work for which this permit is issued. I shall tort
employ anypermn In my mmterse as On becente subject to ft Worsen' L'ompersamen
'
Laws of California. Dau
Applicant
NOME TO APPLICANT: If, after making this Certificate of Exemption, you should
became subject in the Warde3 Compensation previsions of the Labor Cade you most
' foMwidt comply with such provisions of this Permit shall W deemed revoked.
CONSTRUCTION LENDING AGENCY
1Wr
Nermitut Iae(Se.3 Reding.) for Ne PCffOwamCof
haRw
mac work for which Nu pewit u issued (Sm. 307, Civ. C.)
Isndefs Awe
'
LendeYS Address
1 1 enify that I haw read this sppliestion sed sou that ted above information u
ceweL I agree to comply with all city and county ordinalm and amen laws relating m
Wilding conmoction. and hereby auNense representatives of Nu city m enter upon sec
aWw-mamiened properly for impaction purposes
(We) agree u arm, indemnify and trap harmless the City of Cepcnino a[mad,
j ealenseseaft. mryin anY war acrneagaimt said Cry
inconsesjedeOfthecoauand
in consequence of the granting of this pewit
i AP (CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
U GU�JSIONS�-
Issued by: Date. Ira -
Re -roofs
or Oeu
Signmurt of Applinn�ARRDOUS
MATERIALS DISCLOSURE
Type of Roof
will Ne or er handle material
Code. Chaptnam
CupertinoMunicipalReanlean
as defined by see Cupertino Munici WI Coder. Chapter 9.11, and the HuiN and Safely
Code. Section 25532(.)7All
❑tam
roofs shall be inspected prior to any roofing material being installed.
Will mac applicant or future holding occupant tau al
Ire [ Pan equipment w devices whim
If a roof is installed without first obtaining an inspection, I agree to remove
g P
itores air conmminanm m dcOncd by mac Bay Ama Air Quality Manegcmcnt
all new materials for inspection.
Daniel?
❑tam
1 berm read mac ha andom mmerisls requncomm under Chaser 6.95 of the Calif.,.
nia Hcalth k Safety Cade, Sections 25505, 25533 and 25574.1 understand that if Ne Wilding
des el a Wrtndy have a.4 the it Y my nCapenelhility to Miry the IXLupNI of Ne
iremcnts whkn eL Prior u usvmee of a CerefWae of Gaup.nay.
Signature of Applicant Date
�
All roof coverings to be Class'W'
g or better
Owner or auNerisd agent Date
am
• 3 ITEMS OF 3
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36207014.00
DATE ISSUED.......: 07/29/2008
RECEIPT #.........: BS000005619
REFERENCE ID # ...: 08070205
SITE ADDRESS .....: 1117 YORKSHIRE DR
SUBDIVISION ......:
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
METHOD OF PAYMENT
------------------
CREDIT CARD
TOTAL RECEIPT :
0
AMOUNT REFERENCE NUMBER
------ --------------------
82.08 VISA
---------------
82.08
OWNER............. •
ROBERT WHITTEN
ADDRESS ..........:
1117 YORKSHIRE DR
CITY/STATE/ZIP ...:
CUPERTINO CA, 95014-4916
RECEIVED FROM ....:
BOB LAMANTIA
CONTRACTOR .......:
ROBERT LAMANTA LIC # 27061
COMPANY ..........:
A-1 ELECTRIC
ADDRESS ..........:
421 E HEDDING ST
CITY/STATE/ZIP ...:
SAN JOSE, CA 95112
TELEPHONE ........:
(408)975-9171
•
FEE ID
- ---
UNIT QUANTITY.
- ------
AMOUNT.. PD -TO -DT THIS
REC
NEW BAL
1BSEISMICR
----------
VALUATION 2,600.00
------- -----------------------
0.50 0.00
0.50
----------
0.00
lEPERMITFE
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
--------- -------------------
82.08 0.00
82.08
--------
0.00
METHOD OF PAYMENT
------------------
CREDIT CARD
TOTAL RECEIPT :
0
AMOUNT REFERENCE NUMBER
------ --------------------
82.08 VISA
---------------
82.08
•
0
•
CITY OF CUPERTINO
CITY of
CUPEI�TINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # / o'2 c) L/. U
Date:
Building Address:
Mailing Address (if different from building address):
Ow((/4eyr'�sName:
Phone #:
Contractor:
Phone:
T7L�
Fax:d—
Contractor License #: (!�72�OI
Cupertino Business License #: c� 7 0 / � /
Contact:
Phone:
Fax:
Residential Commercial
Job Description:
. h c_F
Building Permit Info:
Bldg ❑ Elect Ef-- Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV -HT, V -B EEJ—
Valuation: Square Footage:
Project Size: Express ❑L—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: g�
For help, contact Build it Green at www.builditgreen.org
Revised 7/01/08
�o
CUPER,TINO
CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf
Fee ID
Fee Description
Fee
Permit Type
Group
1GENRES or
1GENCOM
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
1BBOILER2
Installation /relocation of ea
M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1 BBOILER3
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
1BBOILER4
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
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
11
•
U
a ax
CITY OF
CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW
SFDWL/Duplex New
B
IACOUSRESAD
SFDWL/Duplex-Addition/Alteration
B
1ACOUSCOM
Multi-Family/Commercial
B
CHIMNEY'S
1CHIMNEY
Chimney
B
1CHIMNEYR
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
1FIREPLMAS
Fireplace Masonry
B
1FIREPLFAB
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
1PILECAST
Pile Foundation Cast in place concrete
B
1PILEDRIV
Pile Foundation Driven (steel, pre-
stressed concrete
B
3 of 5
Sm -
CITY Or
CUPERTINO
CITY OF CUPERTINO.
GENERAL BUILDING APPLICATION
FEESCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
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
1RETSPI0
Special Design, over 10' high (up to
50')
B
1RETCRB<
Gravity/Crib Wall, 0-1O'high (up to
50 ft
B
1RETCRB>
Gravity/Crib Wall over 10' high (up to
50 ft
B
SHED -(EACH)
Shed Over 120 sq ft
B
SIDING
ISIDEST/BK
Siding, Stone & Brick Veneer
interior/exterior
B
1 SIDEOTHER
Siding all other
B.
SKYLIGHTS
1 SKYL<l0 SF
Skylight less than 10 sf
B
1 SKYL>1 OSF
Skylight greater than 10 sf or
structural
B
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
st)
B
4 of 5
Is
•
•
t
ary of
CUPEkTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEESCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
]GENRES or
1GENCOM
1STUCOAP
Stucco Applications (up to 400 sf)
additional stucco application
B
1 WINREP
Replacement windows/sliding glass
door (ea 8 windows)
B
1WINMEWSTR
New Window -structural shear
wall/masonry (includes plan ck fee
B
/
1 EPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
1PPERMITFEE
Plumbing Permit Fee
P
1 ELCPLNCK
Stand Alone Electric Pln Ck (hourly)
E
1MECPLNCK
Stand Alone Mechanical Pln Ck (hrly)
M
1PLMBLNCK
Stand Alone Plumbing Pln Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no EAW)
hourly -stand alone
B
1BSEISMICR
Seismic Residential
B
1BSEISMICO
Seismic Commercial
B
1TRAVD0C
Travel & Documentation
B
1BUSLIC
Business License
B
5of5
•
Plan Review Process Work Book Page -12-Revised 3/25/08
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
Q
Y:
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 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.
Energy Star Refrigerator, (Note/Spec.
A-3
1 22int
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
I1. Recycle Job Site Construction & Demolition Waste
65%=1 point; 75%= 2 points; 60%= 4 points up to 4 Resource pts 0
2. 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 0
4. Protect Native Soil 2 Resource pts y=yes D
5, Minimize Disruption of Existing Plants & Trees 1 Resource pt y=yes 0
6. Implement Construction Site Stonnwater 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 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 D
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
2. Use Recycled Content Aggregate
3. Insulate Foundation/Slab before backfill
C. Structural Frame
i1. SSubstitute Solid Sawn Lumber with Engineered Lumber
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10)
3. Use Wood I -Joists for Floors and Ceilings
4. Use Web Floor Trusses
5. Design Energy Heels on Trusses 6" or more
6. Use Finger -Jointed Studs for Vertical Applications
7. Use Engineered Studs for Vertical Applications
6. Use Recycled Content Steel Studs for Interior Framing
9. Use Structural Insulated Panels (SIPs)
a. Floors
b. Wall
c. Roof
10. Apply Advanced Framing Techniques
11. Use Reclaimed Lumber for Non Structural Applications
12. Use 0SB
a. Subfloors
b. Sheathing
up to 5 Resource
2 Resource pts y=
3 Energy pts y=
3 Resource pts y=ye
up to 10 Resource pts
2 Resource pts
y --ye
2 Resource pts
y=ye
2 Energy pts
y=ye
2 Resource pts
y=ye
2 Resource pts
y=ye
2 Resource pts
y --ye,
3 Energy pts
y=ye!
3 Energy pts
y=ye:
3 Energy pts
y=ye!
4 Resource pts
y=yes
3 Resource pts
y=yes
1 Resource pt y=yes
1 Resource pt y=yes
6
J
0
i
0
0
0
0
0
0
0
0;
It 0.
l_
_-
1. Use Sustainable Decking Materials
a. Recycled content
b. FSC Certified Wood
,2. Use Treated Wood That Does Not Contain Chromium/Arsenic
,3. Install House Wrap under Siding
14. Use Fiber -Cement Siding Materials
E. Plumbing
�1. Install Water Heater Jacket
2. Insulate Hot and Cold Water Pipes
13. Retrofit all. Faucets. and Showerheads with Flow Reducers
a. Faucets (1 point each, up to 2 points)
b. Showerheads (1 point each, up to 2 points)
I4. Replace Toilest with Ultra -Low Flush Toilets
1(1 point each, up to 3 points)
5. Install Chlo ne Filter on—Shower-head-
6.
nShowerhead6. Convert Gas to Tankless Water Heater
7. Install Water Filtration Units at Faucets
(2 points each, up to 4 points)
6. Install On -Demand Hot Water Circulation Pump
3 Resource pts
y=y
3 Resource pts
yryi
1 IAQ/Health pt
y--yi
1 IAQ/Health pt
y=yi
1 Resource pt
y=yes
J 1 Energy pt y=yes
2 Energy pts y=ye<-
r. oecmcal
I1. Install Compact Fluorescent Light Bulbs (CFLs)
,(6 bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points)
2. Install IC -AT Recessed Fixtures with CFLs (1 point each, up to
5 points)
3. Install Lighting Controls (1 point per fixture, up to 4 points)
4. Install High Efficiency Ceiling Fans with CFLs
(1 point each, up to 4 points)
Up to 2 Resource pts
Up to 2 Resource pts
Up to 3 Resource pts.
1 IADMealth pt y=yes
4 Energy pts y=yes
Up to 4 IAQ/Health pts.
4 Resource pts y=yes
Up to 4 Energy pts.
Up to 5 Energy pts.
Up to 4 Energy pts,
UD to 4 Enerov ots
G. Appliances
r
r
0
r
r
0
r
r
1 Energy pt
Y=Yes
2. Install Washing Machine with Water and Energy
2 Energy pts
y=yes
Conservation Features
1 Energy pt
y=yes
13.lnstall Energy Star Refrigerator
G. Appliances
fT. Install Energy Star Dishwasher v
1 Energy pt
Y=Yes
2. Install Washing Machine with Water and Energy
2 Energy pts
y=yes
Conservation Features
1 Energy pt
y=yes
13.lnstall Energy Star Refrigerator
1 Energy pt
y=yes
14. Install Built -In Recycling Center
1. ------------- - -
3 Resource pts
y=yes
H. Insulation
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls
2 Energy pts
y=yes
b. Ceilings
2 Energy pts
y=yes
2. Install Floor Insulation over Crawl Space
4 Energy pts
y=yes
[3. Install Recycled -Content, Fiberglass Insulation with
(No Added Formaldehyde
3 IAQ/Health pts
y=yes
4. Use Advanced Infiltration Reduction Practices
2 Energy pts
y=yes
S. Use Cellulose Insulation
a. Walls
4 Resource pts
y=yes
b. Ceilings
4 Resource pts
y=yes
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls
4 Resource pts
y=yes
D. uemngs
4 Resource pts
y=yes
•
LJ
1. Install Energy -Efficient Windows
a. Double -Paned
b. Low -Emissivity (Low -E)
c. Low. Conductivity Frames
2. Install Low Hest Transmission Glazing
J. Heating Ventilation and Air Conditioning
1. Use Duct Mastic on All Duct Joints
2. Install Ductwork within Conditioned Space
3. Vent Range Hood to the Outside
4. Clean all Ducts Before Occupancy
5. Install Solar Attic Fan
6. Install Attic Ventilation Systems
7. Install Whole House Fan
6. Install Sealed Combustion Units
a. Furnaces
b. Water Heaters
1 Energy of
2 Energy pts
2 Energy pts
1 Energy pt
2 Energy pts
3 Energy pts
1 AC/Health pt
21AQ/Health pts
2 Energy pts
1 Energy pt
4 Eneray pts
31AQ/Health pts
31AQ/Health pts
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps 3 Energy pts
10. Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts
11. Install AC with Non -HCFC Refrigerants 2 Resource pts
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
13. Retrofit Wood Buming Fireplaces
1. Pre -Plumb for Solar Water Heating
• a. Install EPA certified wood stoves/inserts
1 IAQ/Health pt
It. Install/Replace Dampers
1 Energy pt
c. Install Airtight Doors
1 Energy pt
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
15. Install High Efficiency Filter
41AQ/Health pts
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
17. Install Separate Garage Exhaust Fan
3 IAQ/Health ots
K. Renewable Energy and Roofing .
1. Pre -Plumb for Solar Water Heating
4 Energy pts
Y --yes
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy pts
y=yes
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw = 12 points, 3.6 kw = 16 points)
Up to 16 Energy
pts
6. Select Safe and Durable Roofing Materials_
1 Resource pt
y=yes
_ _ _
7. Install Radiant Barrier
3 Energy pts
y=yes
L Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts y --yes
3. Plant Deciduous Trees on the West and South Sides - 3 Energy pts y=yes
E
1. Use Low/No-VOC Paint
2. Use Low VOID, Water -Based Wood Finishes
'3: Use Low/No VOC Adhesives
4. Use Salvaged Materials for Interior Finishes
5. Use Engineered Sheet Goods with no added Urea
Formaldehyde
6. Use Exterior Grade Plywood for Interior Uses
7. Seal all Exposed Particleboard or MDF
B. Use FSC Certified Materials for Interior Finish
9. Use Finger -Jointed or Recycled -Content Trim
10. Install Whole House Vacuum System
N. Flooring
1. Select FSC Certified Wood Flooring
�2. Use Rapidly Renewable Flooring Materials
3. Use Recycled Content Ceramic Tiles
4. Install Natural Linoleum in Place of Vinyl
5. Use Exposed Concrete as Finished Floor
6. Install Recycled Content Carpet with Low VOCs
Total Points Available:
Total Points Project Received:
1 IAQ/Health pts y=yes D
21A0/Health pts y=yes D
31AQMealth pts y=yes 0
3 Resource pts y=yesH D
1 1
61AQMealth pts
1 IAQ/Health pts
41AQ/Health. pts
4 Resource pts
1 Resource pts
3 IAQ/Health pts
6 Resource pts
4 Resource pts
4 Resource pts
5 IAQ/Health pts
4 Resource pts
4 Resource pts
1401 130 57
01 0 0
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CITY OF
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JOB ADDRESS:
OWNER'S NAME:
GENERAL CONTRACTOR:
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (468)`791=33'33
Building Dep cutment
PERMIT # U
l/
l� PHONE #
FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/ Contractor Signature Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
f/
Electrical
- c-
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/ Contractor Signature Date