10050141I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 11912 PLACER SPRING CT
OWNER'S NAME: SUSMITA SINGH
NER'S PHONE: 4086151293
❑ LICENSED CONTRACTOR'S DECLARATION
License Class(( C" I I Lic. # 9 _-i 0 ` 5 (O
Contractor (. G j ,ll0 S �00_W" % Date 5
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date J — `--7't o
LJ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
1 have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
unify and keep harmless the City of Cupertino against liabilities, judgments,
, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Date J (% – ID
COT` TRACTOR: CASTILLO'S ROOFING PERMIT NO: 10050141
1703 CATHAY DR DATE ISSUED: 05/17/2010
SAN JOSE, CA 95122 PHONE NO: (408)251-3565
BUILDING PERMIT INFO: BLDG F ELECT PLUMB F
MECH F RESIDENTIAL F COMMERCIAL f—
JOB DESCRIPTION: RE -ROOF TEAR OF EXISTING COMP INSTALL #30LB FLET
INST ALL GAF GRAND CANYON COMP CLASS A 18SQ
Sq. F t Floor Area:
APN Number: 36655009.00
Valuation: $8000
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
`JVITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: �— Date:,--P.,2
ld'
RE -ROOFS:
All rcofs shall be inspected prior to any roofing material being installed. If a roof is
instal ed without first obtaining an inspection, I agree to remove all new materials for
inspertion.
Signature of Applicant: %�, (_� Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
comp iance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safet;, Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Healt i & Safety Code, Sections 25505, 25533, and 25534.
Owner of-autk rized9g ent: i
(.�_ Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for wl ich this permit is issued (Sec. 3097, Civ C.)
Lend(r's Name
Lend(r's
ARCHITECT'S DECLARATION
I unde-standmy plans shall be used as public records.
Licen:.ed Professional
3 ITEMS OF 3
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36655C09.00
DATE ISSUED.......: 05/17/2010
RECEIPT #......... BSOOOC10428
REFERENCE ID # ...: 10050341
SITE ADDRESS 11912 PLACER SPRING CT
SUBDIVISION ......
CITY CUPER-INO
IMPACT AREA ......
OPERATOR: patg
COPY # : 1
OWNER SUSMI"A SINGH
ADDRESS 11912 PLACER SPRING CT
CITY/STATE/ZIP CUPER"INO CA, CA 95014-5102
RECEIVED FROM CASTI:_jLO'S ROOFING
CONTRACTOR JOSE CASTILLO LIC # 25850
COMPANY CAS='iLO'S ROOFING
ADDRESS 1703 '_ATHAY DR
CITY/STATE/ZIP ...: SAN JOSE, CA 95122
TELEPHONE (408)251-3565
FEE ID UNIT
QUANTITY
AMOUNT
PD -TO -DT
---------
THIS REC
NEW BAL
-----------------------
1BCBSC VALUATION
----------
8,000.00
----------
1.00
0.00
1.00
0.00
0.00
1BSEISMICR VALUATION
8,000.00
0.80
0.00
0.80
234.00
0_00
1REROOFRES SQ FEET
18.00
234.00
0.00-
------ ---
- - -
TOTAL PERMIT
----------
235.80
0.00
235.80
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
235.80
---------------
235.80
VOICE ID DESCRIPTION
-------- ----------------------------
601 ROOF TEAR OFF
REFERENCE NUMBER
--------------------
� 16366
VOICE ID DESCRIPTION
-------- ----------------------------
602 ROOF PLYWOOD NAIL
604 ROOF IN -PROGRESS 605 FINAL REROOF
CITY OF
CUPERTINO
CITY OF CL PERTINO
REROOF
PERMIT APPLICATION
APN # , _C1
rD
Date: r
`
Building Address:
MID 7C-14.
Owner's Name:sm $ ry i -� cJ i y��
Phone #:
V
HOA: Yes ❑ No [� If Yes, provide letter from HOA
Contractor:
Phone #:
Fax #:
Cupertino Business License #:
Contractor License #:
V�
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑,,Built -Up roof
❑ Asphalt ShinglesAsphalt Shingles
V Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.C.E.S. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: -Tec,,- Off el f !� fi n� M tic p .:Zr)
T-11 cbV a P (inp n4 oonx on nue
cJ $ c
Residential Y 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, Understand and Will Comply with Cufertino's Tear -Off Policy:
Revised 02/05/09
CITY OF
CITY OF CUP ERTINO
REROCIF
CUPERTINO FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BCBSC
Cal'Bldg Standards
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICO
Seismic Com=-cial
B
1RER00FRES
Re -roof Residen-Jal
B
1SFDWLR00F
1BCBSC
Cal Bldg Standa-ds
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Residential
B
1REROOFMRES
Re -roof Multi-F�unily
B
1MFDWLROOF
1BCBSC
Cal Bldg Standa:-ds
Commission Fee
B
ALL PERMIT TYPES
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business License;
B
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 CBC Standards
and manufacturers specifications on re-roo:.ing. 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:
Pre -inspection and/or tear off approval.
a) AT TEAR OFF PULL OUT ALL ROOF FASTENERS.
2) In -progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail ins-:)ection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new materiel down to the sheathing,
so a proper City inspection can be perfor-med.
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 5126.00. The re -inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " PE r 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: n
Job Site Address: _J
h
Roofing Company Name:
Applicant's
Albert Salvador
Building Official
Revised ;3/09/10
Date: 01 / —/ U
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 fir the tear off the day before
you wish the inspection to be mad 2. The procedure is to call the
Building Division (408) 777-3228 b E!tween the hours of 7:30 a.m. and
3:30 p.m. to request a next -day ins:Dection.
2. When the roof is torn off, the nails/fasteners have been removed,
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., Mondav through Thursday and from
7:30 a.m. to 10:30 a.m. and 1:00 p.;a. 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 $126.00. The re -inspection fee must
be paid before another inspectioi can be scheduled.
Albert Salvador
Building Official
Revised 3/09/10
1. Use Low/No-VOC Paint
1 IAO/I-ealth pts
y=yes
2. Use Low VOC, Water -Based Wood Finishes
21A0/1-ealth pts
y=yes,
3. Use Low/No VOC Adhesives
3 IAQ/1-ealth pts
y=yes
4. Use Salvaged Materials for Interior Finishes
3 Reso irce pts
y=yes
5. Use Engineered Sheet Goods with no added Urea
4 ReSOI rce pts
y=yes
Formaldehyde
6 IAQ/I- ealth pts
y=yes
6. Use Exterior Grade Plywood for Interior Uses
1 IAQ/F ealth pts
y=yes
7. Seal all Exposed Particleboard or MDF
4 IAQ/F.ealth pts
y=yes
S. Use FSC Certified Materials for Interior Finish
4 Resojrce pts
y=yes
9. Use Finger -Jointed or Recycled -Content Trim
1 Resojrce pts
y=yes
10. Install Whole House Vacuum System
3 IAQ/Iealth pts
y=yes
N. Flooring
1. Select FSC Certified Wood Flooring
B ResDLrce pts
y=yes
2. Use Rapidly Renewable Flooring Materials
4 Resolrce pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Resor. rce pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQ/l- ealth pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 ReSOI rce pts
y=yes
6. Install Recycled Content Carpet with Low VOCs
4 Resol rce pts
yges
Total Points Available:
Total Points Project Received:
1 1401 1301 57
01 0 0
G:data1progs/greenbuilcfinojuideline remodelers/greenpointsfinal212.04protected.xls
0
0
0
1 1401 1301 57
01 0 0
G:data1progs/greenbuilcfinojuideline remodelers/greenpointsfinal212.04protected.xls
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: C1 136 P � 0.C' lr
OWNER'S NAME: ', i
PERMIT
PHONE # 4WJ I -3JCOS
GENERAL CONTRACTOR: pS
BUSINESS LICENSE # 4 30L�5(a
ADDRESS: (' ,A► h ftN4
CITY/ZIPCODE: p CA .95--19.-;L
*Our municipal code requires all businesses working in the city to have a city of uupertnno nusmess license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRAC'FORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontracto
Signat ire Date
Please check applicable subcontractors and complete the following information:
Owner / Contractor Signature
Date
SUBCONTRACTOR
BUSINESS PdAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date
CITY OF CUPERTINO BILILDING PERMIT
BUILDING ADDRESS: 10431 PLUM TREE LN CONTFACTOR: GENMOR PLUMBING
OWNER'S NAME: MURUGANANTHAM ZIYUE 2552 SEABOARD AVE
NER'S PHONE: 4087189569
cense Clas Lic. 4
UY
o.
ontractor
hereby affirm that I am licensed under the provisions oChapter 9f
:ommencing with Section 7000) of Division 3 of the Business & Professions
'ode and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
have and will maintain a certificate of consent to self -insure for Worker's
,ompensation, as provided for by Section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
have and will maintain Worker's Compensation Insurance, as provided for by
lection 3700 of the Labor Code, for the performance of the work for which this
)ermit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above information is
,orrect. I agree to comply with all city and county ordinances and state laws relating
.o building construction, and hereby authorize representatives of this city to enter
1pon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date D
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
SAN JOSE, CA 95131
PERMIT NO: 10050066
DATE ISSUED: 05/06/2010
PHONE NO: (408)855-8348
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB F
MECH F RESIDENTIAL F COMMERCIAL
JOB E ESCRIPTION: RUN NEW 3/4" GAS SUPPLY LINE FROM METER TO
KITCHI ;N
STOVE APPX 40-45FT THRU THE CRAWL SPACE
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indP.mnify and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which may accrue against said City in consequence of the
g. ..mg of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18. -[�
4'n� I�
c: ....o Date
Sq. Ft Floor Area:
APN P umber: 31633117.00
Valuation: $850
Occupancy Type:
P ERMIT EXPIRES IF WORK IS NOT STARTED
`VITHIN 180 DAYS OF PERMIT ISSUANCE OR
130 DAYS FROM LAST CALLED INSPECTION.
Issue I b
Datea `
—
RE -ROOFS:
All ro ifs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspei.tion.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I ha -,a read the hazardous materials requirements under Chapter 6.95 of the
Calilornia Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safely Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
cont ►minants as defined by the Bay Area Air Quality Management District I will
mail tain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owl ((y f
Date:
CONSTRUCTION LENDING AGENCY
I hei eby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Lic :nsed Professional,
5 ITEMS OF 5
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Loft:
APN ........: 31633117.00
DATE ISSUED.......: 05/06/:2010
RECEIPT #.........: BSOOOOL0341
REFERENCE ID # ...: 100500-6
SITE ADDRESS .....: 10431 ?LUM TREE LN
SUBDIVISION ......
CITY CUPERTINO
IMPACT AREA ......
OWNER MURUGAAANTHAM ZIYUE
ADDRESS 10431 ?LUM TREE LN
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM ....: GENMOR PLUMBING
CONTRACTOR GENARO MORALS LIC # 27101
COMPANY GENMOR PLUMBING
ADDRESS 2552 SEABOARD AVE
CITY/STATE/ZIP ...: SAN JOSE, CA 95131
TELEPHONE ........: (408)855-8348
FEE ID
UNIT
QUANTITY
AMOU\TT
PD -TO -DT
THIS REC
----------
NEW BAL
----------
----------
1BCBSC
-------------
VALUATION
----------
850.00
----------
1.00
----------
0.00
1.00
0.00
1BSEISMICR
VALUATION
850.00
0.50
0.00
0.50
0.00
1PGASRES
OUTLETS
1.00
63.00
0.00
63.00
0.00
1PPERMITFE
FLAT RATE
1.00
42.00
0.00
42.00
0.00
1TRAVDOC
FLAT RATE
1.00
42.00
0.00
42.00
----------
0.00
----------
TOTAL PERMIT
----------
148.50
----------
0.00
148.50
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
AMOUNT
---------------
148.50
---------------
148.50
VOICE ID DESCRIPTION
-------- ----------------------------
106 SEWER & WATER
301 ROUGH PLUMBING
507 FINAL PLUMBING
REFERENCE NUMBER
--------------------
#6004
VOICE ID DESCRIPTION
-------- ----------------------------
202 UNDERFLOOR PLUMBING
400 SEWER/LATERAL
CITY OF
CUPEkTINO
CITY OF CUPERTINO ��� o oo U
REPIPE/SEWE]Z/MAIN SERVICE
PERMIT APPLICATION FORM
Building Address: —
ro
Owner's Name:
U I i4, of clff l
Contractor: n n
Contact:
Contractor License #:
Cu 3ertino Business License #:
x-7101
Job Description:�,�
'Ttise - G t -r U -1- f'�- U -
Residential
Valuation:
i 1 -1,
Project Size: Express
Standard ❑ Large
Commercial ❑
Major
Green building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the :Iheet index.
Green Building Points
Quantity Fee ID
1 PCSEWER
1 BPREPIPE
1PGASCOM
1BCBSC
1BSEISMICOM
Fee Description
Fee
Permit Type
Grou
Commercial building;
P
1CPSS
sewer/sanitary sewer
Commercial re -pipe per fixture
P
1CPRP
Commercial Gas Piping System
P
1-4 Outlets
Cal Bldg Standards Commission
Fee
B
ALL PERMIT
Seismic Commercial
P
TYPES
Revised 01/07/09
�t1
CITY Of
CUPEfZT1NO
Quantity I Fee ID
CITY OF CUPIATINO
REPIPE/SEWER/1V JN SERVICE
FEE SCHEDULE
1BCBSC
1 BSEISMICR
1 PRSEWER
1PRREPIPE
1BPWSVCS
1PPRSEWG
1PCESS
1BPWATER
1BPFIXTURE
1PGASRES
I 1 BPGAS
1PPERMITFEE
1 PLMBLNCK
1PLMBINSP
r 1TRAVDOC
1 BUSLIC
Fee Description
Cal Bldg Standards Con
Fee
Seismic Residential
Residential building
sewer/sanitary sewer
Residential re -pipe per
Water Service
Private Sewage Dispos
Cesspool
Install/alter Water Pip(
Plumbing Fixture
Residential Gas Piping
1-4 Outlets
Gas Piping System 5+
Plumbing Permit Fee
Plumbing Plan Check
Other Plumbing/gas I
Travel & Documenta
Business License
N. Flooring
1. SelectCertified Wood Flooring---- -- - - ---
I IAQIHEalth Pts
y=ye
I. we lO►Mo-VOC Pint
2 IAQ/HE alth pts
y=yes
2. Use Low VOC, Water -Based Wood Finishes
3 IAQ/HE:alth pts
y=yes
3. Use LovrMo YOG Adhesives
3 Resou -ce pts
y=yes
4. Use Salvaged Materials for Interior Finishes
4 Resoirce pts
y=yes
5. Use Engineered Sheet Goods with no added Urea
6 IAQ/H :alth pts
y=yes
Formaldehyde
6. Use Exterior Grade Plywood for Interior Uses
1 IAQ/H:alth pts
y=yes
7. Seal alIEXposed, ebWd.Or MDF
4 IAQ/F aalth. pts
y=yes
FSC Certified Materials for Interior Finish
i
4 Resorce pts
y=yes
8. Use
9. Use Finger -Jointed or Recycled -Content Trim
1 Reso rce is
y=yes
10. Install Whole House Vacuum System
3 IAQ/ health pts
��--
y=yes
N. Flooring
1. SelectCertified Wood Flooring---- -- - - ---
- ---- 8-Resof rce pts-
-=yes
_FSC
2. Use Rapidly Renewable Flooring Materials
4 Resource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Reso irce pts
y=yes
Install Natural Linoleum in Place of Vinyl
5 IAQ/I iealth pts
y=yes
4.
5. Use Exposed Concrete as Finished Floor
4 Resoirce pts
y=yes
6. Install Recycled Content Carpet with Low VOCs_
4■=urce pts
y=yes
Total Points Available:
Total Points Pro'ect Received:
11.
J 13057
GAatalprogs/greenbuilc ingguidelines/remodelerslgreenpc intsfina12.12.D4protected.xls
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LI11- ST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS:
SUBCONTRACTOR
BUSINESS NAME
PERMIT #
OWNER'S NAME: U 1 1
PHONE #
GENERAL CONTRACTOR:( i2�
BUSINESS LICENSE # �]
ADDRESS: ,264 QW
CITY/ZIPCODE: 3 1
*Our municipal code requires all businesses working in the :ity to have a City of Cupertino usiness license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND A N C7'ORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors.
� 0
Signatu re Date
Please check applicable subcontractors and complete the following information:
/ Contractor Signature
ate
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
/ Contractor Signature
ate