08050043 CITY OF CUPERTINO ??' r
BUILDING • PERMIT .,CONTRACTO,R3I�IFQRMATION
qQQ $. PERMIT NO.
BUILTr4A3VR�l.HAR SAN LN CALVIN & BROS CONSTRUCTION, 08050043
OWNER'S NAME: TNe PERMIT L6UE DATE
GONG XIN HE 1194 FARGATE CIR 05/02/2008
.NE: SANITARY NO. CONTROL NO,
ARCHITELTIENGINEEK: BUILDING PERMIT INFO
POOL DEMO BLDG ELECT PLUMB MECH
O O O O
o p LICENSED CONTRACTOR'S DECLARATION
F 1 honey affirm that 1 w li¢mW under provisions of Chapter 9(comm a ting Job Description
¢¢`uj with
iScforces.
LmcmaaClaxs 111U)ofDiviuon Jof dm BIucs.ir•lru end PDro
fessioru Code,antl mylicenrc is
'I
-FO Dam N� CSDECr f�
ARCNTIELTS DECLARATI
$a 1 understand ery plans shall be used es public rccnrda
sboto L iccnscd P,ofcsonmil
OWNER-BUILDER DECLARATION
i<i I hereby afa m that 1 am exempt from Ne CnmtrSlafs License Law for the _
p O following won.(Section 71D 1.5,Business and Profcssiuu Cade:My city or county
3$ which requites a Icrnnu,o comtmcs alter.impur e.demultsh,or.,an any strecrum
Prior vat us issuance.aster requires ft applicant for such permit to file a signed statement
ss<
lead an,is licensed pursuant to thepreAsions of the,Cmdmctoex License LOW(chapter 9 Sq.Ft. Floor Area Valuation
sF� (commencing with Section 701 of Division 3 of the Sminess and professions Code)or
-
that be ta exempt Locanfinam and the basis for the akgw cwnphom.My Nola,ion of
Section 7031.5 by any applicant for a permit subjects thc applicant to a civil penalty of APN Number Occupancy e
.or moan Nan five hundred dollars(5x00), P y •T]y p
0 I,u owner of the pmpmty,Or my employees with wage as their sum compensadon,
will ate the work.arta the structure,Is act intended or offered for sok(Sec.7014,Busimu
and Profession,Coe:The Caahacmfs License Law duce not apply to an owns of _ Required Inspections
mapenywWbuilstor ins ioaeschunpoanerents enotim, k himselfmthmuehh.
own vee,u r uiss.davmed t improvement
i memenu can an intended m leeretl for ale B,
builder the Wildingmtmpmwnantismid withinarc your ofcprovefrthe owe of
e le.). will Mw tis Wrdce of pmHng Nit W did Out Wild or improve for purpose of
alt.).
❑1.u owner of than prepeay w exclusively contracting with licensed contractors to
constrtmt flan project(Sec.7044.Business and Professions Coda,)The Coneaebfs U. _
cense Law does not apply b an owner of property who Wilds or improvm dsmun,and
who contracts far such projects with a eamacbRs)licensed por tom tithe Co mmotes
Licence law.
❑lammemp,undea See ,B&PCforthismamn -
Owner Das
WORKER'S COMPENSATIONDECL RA71014
I hcmby affirm under penalty of perjury arc of the following declarations:
1 ham and will maintain a Cartiftme of Cement b self-imam fm WortefsCampen-
salon,as Provided for by Section 3700 of use Labor Code,for the Md...of the
work for which Nts permit is issued.
❑1 have and will maintain WmItefa Compensation insurance,as marched by Section
3700 of the labor Code.fm the performance of site wart for which this permit u issmA.
My Worker,Compensat�ion�Insa/anm carrier and Policy number art:
Carrm".5dr Policy No.: Ov?'
CERn CATEOF EXEMPTION FROM WO ERS' -
COMPENSATION INSURANCE
(Ibi,rection need not uncompleted if the permit is forarm hundred dollars(5100)
or kis)
1 certify Nat in Na,performance of the work Im which this Permit is issued.I shad.not
employ any person in any manxrm as to become subject to the Workers'Compensation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Car iftcate of Exemption,you should
become Subject b the Worteh Compensation provisions of the Labor Code,you mus
.,O forthwith comply with such pmvisions or this permit shall be deemed molted.
z '•' C°NsrstucnON LENDING AGENCY
(-a•y- Ihereby affirm that More is a construction lending agency for to performance of
C' dm worst for which this permit Is issued(Sec.3099,Civ.C.)
6Wi Q Lcndce,Name
Lender's AM.
U p 1 certify Ma'1 have read Wa application W shote dead ted aw,c information is
IT. ^ corms 1 agrnx b comply with all city and county ominarces and sumo laws relating un
.� Wilding construction.and hereby mthorier repremmadres of Mu city m come upon Me
W aWw-mentioneepmpcny for inspection purposes
tiany (Wc)agree to save.indemnify and keep hamiess the City of Cupertino against
to liabilitiesunde of thecoffiandexpeveswhtch may in any wyacerue against said City
V z A APPLICANT
ofdangrantingof this permit.
�••' APPLICANT UNDERSTANDS AND WI COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. v f
!/ ` S -7_09 Re-roofs
Signaum of ApplicamMo turnew, Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof j
Will the applicant or future Wilding occupant cmc ar handle havmdam material
a dcfimcd by the CUPeahb Mumgpal Code,Chapter 9.11 and the Health and Safety
Code, Elk.25532(,)7 - All roofs shall be inspected prior to any roofing material being installed.
El Y. �Np
Will Mc, recent or mbm Wilding m am nae If a roof is installed without first obtainingan inspection,I agree to remove
pP e p ea Air
of M...which pe
ad.,hammmm air contamimnts a defined by Mc Bay Am Air Quality Managcmem all new materials for inspection.
District]
Dyne ANO
I have,read the hvardmts materialsrequimmenu under Cluptcr6.95 ofthe,Califor-
nia Health&Sx1 fly Code.Sections 25Xel.25533 md25534.I undersand dmif dm Wilding
does out currently have a ounces.that It if my maptumbility to notify the occupant of the
rcquiremcnts whicn mus met pier b issuance of a Crnifum of
Signature of Applicant Date
Owner Or aathn ,.d,g cat Dam All roof coverings to be Class'W'or better
i
CITY OF CUPERTINO
DEMO
9CUPEkTINO PERMIT APPLICATION FORM
5 D�-I3
APN# �n IS-0� Date: D ,
Ul7 0 �a
Building Address: p
11160 C&r5a,,, Zrutlq.
Mailing Address (if different from building address):
4 �s
40 Ile
Owner's Name: Phone:
m He
Contractor: CLVI'qCc"& .4f n yi,IC Phone :
". r� Dc27 i'oS `�-u V
I ,' AA 11 . XV Fax:
Contractor License #: �Oct 72Y
Cupertino Business License #: 7j
Contact:// Phone: ��
( G (,V;;1 X( C Fax: /o
Residential ❑ Sq Footage ' X Commercial ❑ Sq Footage
Job Description:
oC �ef,,Lz
Valuation: I
,�Cc�
Please complete relevant portions of the Green Building Checklist & attach it to the application
or if applicable, include on the plan set & the sheet index.
Quantity Fee ID Fee Description Fee Group Permit Type
1DEMORES Demo-Residential B 1SFDWL-DEM
IBSEISMICRE Seismic Residential B
1DEMOCOM Demo-Commercial B 1COMML-DEM
1BSEISMICOM Seismic Commercial B
1BUSLIC Business License B
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 S�e!!
B. Site 9. Install H.E. Irrigation, (details/spec)" L-1 2 points .e
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 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
0
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Plan Review Process Work Book Page-12-Revised 3/25/08
1
Single Family GreenPoint Checklist dens: Build ItGr"6
:..
The GreenPoim Checklist is based on the various green features incorporated into the tame and Is the on:V:zwu- - 4V
basis for the GreenPoint Rated program.A home can be considered green it It highs Ile prerequisiles,
• same at least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Duality/
Health(5),Resources(6),and Water(9).Please banned Build it Green(or a list of qualified GreenPoint
Refers if you are interested in pursuing third-party verification.
T!•,,green hueJmn pra;'.lice,s;wird below are described in the NewHome Consirclion Green Building
C,,,m,rne.s ayNable;i"whudMareen or
PROJECT f s
V S
A.SITE i... .. h: - -
.., ,- ... ..• c a :'•,rS.* ..+,: r\:!„F':Points Available Per.Measums '
ronecl Topsoil and almlmiar Disruption of Existing Plants 6 Trees
■ a.Panned Topsdl from Erosion and Rause after ConsWdbn 0 1 t
---f—'— i
■ b.Lural end oMkaane Construction Footprint M Maximum Preledion -_—
■ 2 Demvtruct Instead of Demollshin0 Exuting Buildings On SW 0 3 r
3.Recycle Job site Construction Waste(Including Green Waste)
■ e.Minimum 60%WaVe Dehanlon by Wei fgecyft or Reuse)-Reaand p R r
b.Minimum 65%Diverabnbr WeiRe �— — (—
■ apl( rydugarRevee)
r ■ c.k4nkaxn 60%oNenion by WeghllReryr5rp or Rauea)
a.Use Recycled Content Aggregate(Mlnimum 25%)
■ a,Walkway she Driveway
■ b.RmtlwaY peso
Trial Pdnis Aiababne in So=1 0
B:FOUNDATION`_- ointsAvatabie Per Measure's%6'`
1.Ross.PaHfand Cement In concrete wan Recyded FI oha51,
■ e.Minimum 20%Fithian or Slag 0
■ b.Minimum 25%Flyasn or Slag 0
■ Z Use Frosi-PmtecUd Shallow Foundation in Cold Areas(C.E.c.Climate Zone 16) 0 j 3 j
■ 3.Use Radon gaslstent Con."cron(In A14Usk Locklibe.any) 0 r l I r
• a.DeMgn and Build SWaural Past Controls
■ e.Imtell Tams,ShMMsIS."ofte Al TutelarWoabbCmcnte Connecti by Metal or Puede FeflanaraNNden 0 { ) 1 !
b.All Naw Manta Have Tmnk,pass,or Slam Located At Lear 36Inches from Foundation
TdM Points Avallade b Fouaelbe=6 0
C.LANDSCAPING,'
e -
<.�. . ,.r...x•,..,, �i;. ..�.k. x}. Polats AveilahlaPer Measure
1.Communal Resource-ERiclent"nod caps.
■ e.No Invasive Spades Llslad by CMJPC M Punned 0 ( I 1
■ b.No Rant Spedes Wd1 Requim Hadglrq p
■ p.TsxdPnerd Ano
%pMmnl Uldomfa NaMs,M.ditemneen,orONer Appmpmes Species ---.)
■ Z Use Fim5ala Landscaping Tachnlpuea p 1
3.MInki Turf Mas In Urniscipe troubled by Bonds,
■ a.Ad Tuff WYI Have a Water Requirement Less Ian a Equi b Tell FaseuktB 6 purl facts) 0 r r I 2
■ D.Tied Snag Not Be Insisted on Sbpas Excesdrry 1er M Arees Lass Dnn 6 Feel Wide p i
2-
■ c.mil 33%of landscaped Ana di 2 pomsl
■ d.Turlifl0%of Labscaped Mafmuleed rb)
—.�-- ..�-.
D i i 2
■ d.bond Sao Trans 0 1 ! ) 3
■ S.Group Planta by Water Needs(Hydroaoning) 0
6.Imtell XIONEIDdency Irtipetlon 5ys1ema
■ e.Sysnem lhes pity lorFMDrip,Bubbbu,alax-MvSpnnklers
0 i �
■ b.5yanem Han$maX Cvnbdan
■ i.lncoryorete Two Inches of Compost In Me Top 6 W 12 Inches of sell
p 3
■ 6.Mulch All Pibbonp Boob to Ne Greener of 2lnchn or Local Water Chambers Requirement 0 ) ( 1 2
■ 9.Use 50%SeNaped er Reryde6Content Mel.rals for 50%0 Non-PlantUndampe Elements p I ( 1
■ 1p.getluca LlBM Pollution by SM1leltlinp Fixtures andlur Olmang Light DovmW.N
Toad Poles A seed a In 1-aaecayirq=31 0
D.STRUCTURAL FRAME&BUILDING ENVELOPE p. .Je7s
'Point-
s Available Per,Measurec,,,-'
1.Apply Bourret VSIue Englund,
■ e.N.Rehm Vol Sluds at 24lhch On Canter Framing
■ b.Sia.over and,Whiten Horden ler Load
• c.Use
■ Only ab CdDga ShMs RMYJFetl W load � 1
2.Use Engineered Umber
■ a,Beams and Headers 0
■ b.Insulated Engineered Hod. 0 l 1 ......
■ c.Wood L sts or Web Tmsses W Fbas ...U ._..�_..._J�..... _(......
02007 Build It Green Single Family GreenPoint Chaddist 2007 Version Page 1 of 7
i ENTER PROJECT r
s
d.Wwd VJols6 ror Rool Faders 0
e.EiglmertEor FingerJ.mW Saks br Viii appa:alame
I.Drienmd Strand Boal u SWAoor ��-
g.Grimed!Stow Board brWdail Roof SnaWrg
d.Uw FSGLerdfed Wood
a.Dlmmabral Lumber,Stuns and Timber Minimum 40% 0
—
tr.Olmerebnal lumbi,$A108 erd Tmber.Mnlmum 70%
C.Parol Pmdugs:Mmmnum 40%
d.Penal Pmddui MWmsm 70%
l •
02007 Build It Green Single Family GreenPoint Chi 2007 Version Page 2 of
ENTER PROJECT NAME = a
V S
• 6.Use Solid Wall Systems gndudas SIP,,ICF,,6 Any N.r SUdd Fnme Asumbly)
■ a.Floors 0 1 2
■ b.walla
■ aPhony 0 +..-_.
I 2 1 _ � 2 f
S Rell Pollution Enuring Uw H.from Has Garage
■ a.Tightly Sul Un Air Bamer mMaen Carpe and UMW Me
■ b.smand!Garage E[mesal Fan OR Butld a Dsladwd Gamin
■ 6.design Enmrgy Heals on Trusses(75%of auto Insulation Wight at Outside Edge of Estedor Wall) 0
■ 7,design Roof Trunes to Accommodate Ductwork 0 1
■ S.Us.RxW,cI Contsnt SWI SWM for 90%of lntedor Wall Framing 0
■ 9.Themul Mm Wails:W..h Drywall on All Interior Was.or Was.Weighing mon than W Rhoo.M1 0 1 j
10.Install N.mangs and GaW n
■ a.Mnknum IFIner Ovamigs am Guyin
■ b.M:nlmvm 24-Inch Ovemangaantl Gvmn 0
Taxi Pons Avakeblo In StrucWml Buldp Trans and Envelope=J 0
E.EXTERIOR FINISH .. .... , ., . . . . . . . . , .. . .. "._
PInL{Avvlabe PeFMeesuie',.:r
■ I.Use RaryWd-0ontant(No Virgin P1uM)or F5CCaNMd Wood Decking p 2
■ ZWall.plain&.aWall syslam 0 2
■ J.Use Durable and NoncombuWblo Siding Would). 0 I 1 i
■ CS.IWDunbk and Nonconbustibla Roofing Mal•Ms 0 2
Toll Pounds AuiuWb In EMM Fnksh= 0
F.INSULATION t ,. . y„,Y,(:i, ` ^,t s„,� �,H.�.; 11'.o,t bY'r;'J.��r,`„FU A ?tirS�"». eJ3 ...;�,.:_:s.. '•h .�Polnts Ave11501e Per Measu're'Y.49 ;`
1.humid Insulation Mar 75%Wgcted Content
■ a.Walls a:dVor Floors
.4...__..___• ' r
■ Ixxgs 0 1
Z Install Insulation that Is tx, E JDing(Cedlllad Sacbon 01350)
■ e.lads endbr Fbpn p � ! J
_■ b.calkgs
U_ ._..._p.__.�._.i..._�_i:..,...
J.Inspect duality of insulation Installation Whom Applying Drywall 0
• ToW Points Awllade int Suiamn= 0 ,
G.PLUMBING rr==": `:i v a r Pomts AVa9aWe Per Me05Ufe..l
1.Distribute Domestic Hol WMr E10clently(Maximum 7 Points)
■
I.ImWats Hat Wwar Pupas from Water Haler to plum, 0 1
...__..... ._..__�._.__..:..__...� 1....�__.
■ b.lnaulee 9 Hot Wafer Pipe p
■ o UseE smsered Panld Piping
■ dUU Engimemd Parallel Piping wM Dam•m Condoled Cicussm torp .O_ .
■ a.Use Sime rxdl Mapping with Damani Wnlrollad CirNallon Loop 0•-"'-"--^'-'-�---'-,---.
■ I.Use Genal Con Ffumdnp --O -..�_i_�___.�._...f__Z_
Z Instal Only High EM,I.r,Whom(Dve4Fluah or51.29 gpQ 0 I f 4
Talc'Points Available In Pomona•Total 1 0
H.IIEATING,VENTILATION&AIR CONDITIONING r`✓ .%?T.rd rr;'�h�}Y,'V ;ori ;'n-�15>;..'<4.3x ?�4 h;: "':s.. f'...`Poink AvegaDle Per McRauie}`;j,.;',
■ 1.Desitin and Imull HVAC Syssm b ACOA INnual J,0,and S Recommendetions 0 1 4
2.Install Sealed C Ipusrtion Units
■ a,Furnaces 0
■ b.Watsr Weten 0 i 2
■ J.Install Zoned,Hydronlc Ra04nt Healing with Slab Ban Insulation 0
■ 6.Install High Effidemry Air Conditioning with Environmental,Responsible Rhdgemns 0
5.Deign and Inmml EH.dM.Dactwok
■ ¢.Install HVAC Unit am Dwmerk within Cobllbrnd Spm 0 1 3 )
■ oUUIM.t Masucon Al Dud Jolnsam Sums __O.._
■ clnalall DudworkumerAWClmWmn(Bumd putts) O + 1 )
■ d.PneAln BBamW Ih0 WdMOA SYstam p 1 J ) i•.. .T. .
■ ..Pmts¢Ogee dung coum¢em am('.laxm AaWrn mwn aawpnry p J
■ 6.Imbill High Effidency HVAC Filter(MERV 6.) 0
{ 1
■
T.Dont Insult Fireplace as Insult SeMd Gu Dnpl.cas with El0ciency Rating Not taus Than 60% I 1
uMgCSASlanderM 0 )
0.Inalsll EflecUn Exhaust System.In B.0raans and IUkhmm
■ a.
Install ENERGY STAR B.Orom Fans Venal 0 tie Outdom 0 1
• ■ b.All Bathroom Fans An on Timer or Humksul
'
■ c.ImuO Npchmn Range Noatl Venlod 0 H Wyke -
9.Imtell Medenlul VanUbuon System I.Cosiing(M.kmum A Polris)
■ e.lnslall ENERGY STAR CeRIp Fans BL'Oht His In Living Anax6Bedmons _0
■
b.noddy WUde Nouse Fen War Venose Speeds 0 .._J
as -
02007 Build 11 Green Single Family GmenPoint Cheddist 2007 Version Page 3 of 7
ENTER PROJECT NAME
i 5 mill'
N C.AudmaOuly rAnlmlae lnuguue syaam •
.Aubr WWIY CMI,dlee In _ 0
e --' 2 —L----
tagretaO Syabm with VeeeOb Spee ConOd
10.Install Maotunlul Fresh Air Vsntlation Spurn(WxImum 6 Points)
e.Any Whole Hb Venuairen Sp%m Thal Muu ASHRAE 621 0
O.Install Ak-bAlr Heel Emla
rypr mel meals A6HHAE 6x.2 0 1 ! 2 I
11.Insult Caton Monoxide AMrm(s)
Total Pons Available In Heabrg Venlltation one Air CoWiommn,•00 0
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02007 Build It Green Single Family GmenPolnt Cheodist 2007 Version Page 4 of 7
,ENTER PROJECT NAME
-Moll
•1 1.RENEWABLE ENERGYq'.,.
Available Per Mfia
1.Proo4riumb for Scriar Not Water Heading n p 4
2.Insured enter Water Heading System 0 i I.
3.Install Wiring Conduit for Future Pholovoltmic InstalWon&Pronce 20011 of Soutl4acing Root 0 j 2
A.Install Phourvoltale(Post Panels
a.30%WebWrnc needs OR 12 kW(WWI 6 same) p 6
b,60%a eloolme,heads OR 2.4rW(teal 12 points) 0
It.90%of slecure mand!OR 3E kW Hostal 18 anni 0 I 6
Tpal Avoided Points in R.*E.W M 0
J.BUILDING PERFORMANCE
1,Dismoubc Eno alums;
e.House Pwaomm Sumner Door Test t
b House Peanuts Combat.Sane,Eadecraft That 0
12.Design and Build High Performance Homes-%spirit Ties 21•minimum 1SWepired 0 230
5 2
3.House Obtains ENERGY STAR With Indoor Air Package Cerifficathon-Pilo,Measum(Tortal 45 Points mad coarearrint) 0
Tend Aniftead Porms in Buddere Persomeres, 3 0
K FINISHES '4 A,
i+PoihE Avallbhle Per Measliie
En",to Rod.Instead!In Cortwormares 0
I use VOC or UroAOC Point(Marcum
3 Pounds)
e.-o VOC Interior WaInCelirg Palms(< go VOCs(Full and<150 fel VOCs(Non-Rat))
0
3.Use Line VOC,WwtunBrmodl Wood Parishes(Q%gel VOCs) 0 2
I.Use Low-VOC Caulk and Considurucudon Adhesion(<70 gpi VOCs)for All Aillosiver; 0 j i 2
S.Ime R.oYound-Coment Point 0
Us.Emelre...talt,Preferable external.her lidefflor Finish:A)FSCL RjfiWj Wood,B) C)Rapidly Remained.,D)RooYntio"antiont or E)
Fing.W.I.thel
• a,Cablinsto(W%Minimum) 0
■ b.Insurer Y.(50%Monlre.)
c.Shintoist,(W%Minimum)
d Coon(W%Minimum)
e.Coundeftes(50%Minimum)
7.Radom Formaldehyde In Interior Finish(CA Section 1113511)
■ a,Subloor&Slur Trends(!50%Minimum) 0
th.Cabodit&Convene,(5014 Minimum)
c.Inivior Tom(!50%Minimum) D
_JM I.SW,(50%Minimum) 0
6.Aft,installation 0 Finishes,T.1 of molocir 0 Shove F.Thisidadrindo Lnel Q7pb 0 i i 3
Test Angeles,Puerto In trimmed 2 0
L FLOORING
........... .........
1.Us.Eindrommentill,Preferable Flood.:A)FSPG .d Wood B)R..Iol..d or Raffolholood,C)Rapidly Itcommoble,D)RecyeledContend,E)Esposito!
Concrete.Returning Androshms Must Han<50 Sol=a.
■ a.Minimum 15%of I`axo Areas 0
b.Minimum 30%6 of 11pr Anne
c.simirmen 50%of Four Area
d.Minimum 75%of Poor A.
L Thermal Mass serum;Floor C..dn Other am.Carre,H on 50%.1 lon.of Connote Fli 0
3.Flooding Murder Sai,tin.B13%or Call Green Uthel Plus Requirements(Sin Minimum) 0
2
Total Antable Points a Fasurfin, 1 0
M.APPLIANCES AND LIGHTING': ':t
j
1.Install Water and Energy Effichard Chronometer
a ENERGY STAR(total I pint) 0
b Dolmadvor Uses No Win then 6.5 GollonsiCycle(Warl 2 pip)
2.Install ENERGY STAR Clothes Washing lontured torth Water Factor a 6 or Les
u Mees Em,,So,and CEE TWI 2 redusnerealts(medfied anegry fiptor 2.0,Water Factor 60)(WWI 3 Who) 2
b,Mants Entire,She and CEE Tiar 3 normimments(modend assay Wi 2.2,Water'par 4 5 or lose) i it
-------
1 2
apil I uses) 0
3.ImMil ENERGY STAR Refrigerator
a.ENERGY STAR Quatifinful It c 25 Curoat Feet Calmest, —0 t
b.ENERGY
ENERGY STAR Due -A<10 C000 Fiat[Cooney
A.Install Rvchd�'n',Center 0
a.Busier Ryh,Center 0
0 2007 Build It Green Single Family GreenPoint Checidist 2007 Version Page 5 of 7
PRO A
b.NOW Cor,Pmbn,Cents, a
TonflAntatels Pokas in Applivicas am tithes; 12 0
:;t,, i_,�-4, 'miA�ail lasers:
i%1,.Po, able Per Me
1.Incorpombe OwnPoint Rated Checklist In Bluapdnb-Roquimd 0 I I R
2.D..Iep Ha....r M.a..l of Grain F.M.&I'Derwiffis
3.Communky Design Measures&Local Notes.:Son,UN Community Plannuh;d Design section in Chapter 4 of ft N.Home Godolne,V measunins.
Mavarrum o120 pal for..gpesloal measmw.Local onainimen4a may anne be Hiced hen,
•
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0 2007 Build It Green Single Family GreemPOint Checklist 2007 Version Page 6 017
PROJECT
MINION
Ereed esapu0nem,are enter points imllaoiefor treses in aplxome catepies te the,ripe. 0 0 0 0 0 0
...___ ____...._.,.._........_.....................__..._......_._._.........,_....__..........._...._.__.......,..........
�._...__...W�.._�._..
Enter tlesPlpOm hes,and sear points ava0ade for mission,NeppOprkte otelpres to pia ryM ' � ','� p _0 01 0 0 0
_..._...__�_.___,_._..._..._.._.___.._.��_..._.__..._.._..___.es_.._._ ... .._..�__....._..__...__.._...__�._.._..__...�:.....�_..__�._.�.._._.�.
EnterdesPgOon sere,ark enter points evad0de for adducin epDmDAate caIBAIXestethe Aphl. 0 p 0, 0 0
EnlIXdesaglbn Mn,uk east prints eva0ede sr mases in epgopriate categories Is the rght � '' 0 '0 OO -, O
Build It Green Checklists and
4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up to a Guideline=
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right.
Innentkn h Community:Enter description hen,and enter ptlnb anhdu for masses h eppepAete categories 0 ge rghL 0 � '0.i. �0 0 0 0�
Innwelenin Energy:Enter dewpten hen,eN enter pains anllabe for measure In eppmprate categories s tireAAhL' - 0� 0, 0 �0 y 0 0
Iswaeim lAfy9eter:Enter desorption Mre,and enter points anMtle M insure In approP6te cetporbe te Ne Ape. 0 D^ 0: 0 a , 0
Innoefon In Resourwc Enter desovion hes,ark enter pdnb aneaee ter assure N appepree,ces xe b the Aghr. �0~ 0 0 0 '0 OY
Im0n ton in Water.Enter deacAplan hen,arE enter points antade for measure 0 appspriate categories b the NhL 0 0 0 0 ,—0 ,_
0�
Toter Anteele Points in Dtw 42 0
suilifirtriiary
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories 0 30 5 6 9
I I
Project has not yet met the following recommended minimum requirements:
- Total Project Score o(At Least 50 Points
-Required measures:
-A3a:50% waste diversion by weight
-32: 15%above Title 24
-NI:Incorporate Green Point Rated Checklist into blueprints
- Minimum points in specific categories:
-Energy(30 points)
• -IAQ/Health(5 points)
-Resources(6 points)
j -Water(9 points)
•
02007 Build It Green Single Family GreenPoint Checklist 20p7 Version Page 7 of 7
- Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building Department
JOB ADDRESS: "f90 C"',11 LCa. PERMIT #
o/ USoo�
OWNER'S NAME: o )(; e PHONE # 4,oy — 4010—
GENERAL CONTRACTO n I 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
Owner/Contractor Signature Date