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08040092CITY OF CUPERTINOI PERAUT a - s cONTI2AC.TUI2.�I 'C 1 "IA'�It;)N'PERMIT BUILDINC; DIVISION BmLg2i1'�9LR NO. COLUMBUS AVE ATLAS—TRILLO HVAC 08040092 OWNERS NAME: PERMIT ISSUE DATE BRUCE FUJIKAWA 1965 KYLE PARK CT 04/14/2008 NE: SANITARY NO. CONTROL NO. (408)286-8931 ARCHI ECffENGINEE0.: BUILDING PERMIT INFO BLDG ELECT PLUMS MECH LICENSED CONTRACTOR'S DECLARATION Job Description I affirm all am licensed under provisions onChapWr 9 (commencing i with Scotion7OX1)mf Divialonlof the Business and Professions Code,end my lice= is ion? R/R FURNACE UNIT W full forte and e Lkense Lld. N i Dale Contractor A CHITECI-S DECLARATION 1 undefuand my plane shall W need as public rcoords Licensed Professional OWNER-BUILDER DECLARATION 1 Wrohy effrts that 1 Me exempt from the Commodes License Law far the, following mason. (Section 7031.7. Business and Professions Cade: Any city or county which acquires a Permit to construct, altar. improve, demolish. or repair any structure prior to I% Issuance. also requires the applicant for such permit to file asigned stsmmcot that W is licensed purmnt to the pmvisiou of Ble Conlrecmri LWcrtsc Law (Chapter 9 Sq. Ft. Floor AreaValuation (commencing with Section 7000) of Division 3 of NBusiness and Professions Code) or $3000e that he Is attempt themfmm and me basis for the alleged exemption. Any vlol Wan of Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty ofNumber Oeeu anC e .t seam than fin hundred dollar, ISM 35 618056.q P Y�'P 0 I. u awrof of Ilia pmpelty, m my wploym with xga u their mle compenudon, will do thework and thasaumme is notion n im mediemd formic (See. 7094, Busircss end Pmfeaemes Cade: The Commuters License Law am oat apply W me owner of Required Inspections property who builds to improv thereon, andwhodacesuchwok hima lforenough his - own employees. Provided that such imptovemenu art notinuended mediated forsme If, however, the building or improvement is sold within an year of completion, the man". builder will ban the burden of proving that W did not Wild or improve for purpose of ole.), ❑ 1, as owner of the property, an exclusively conbaNng with licensed commocam to construct the Projm (Sec. 7094. Sassiness aha Professiaw Code:) The Conuutats Li- cram law does not apply W M owm of property who Wilds or improves Merton, and who contracts for such pmjems with a corm smor(s) licensed purawnt W the Counselors License Taw. 0 lam mompt under See ,B k P C for this mason Owner Data WORKER'S COMPENSATION DECLARATION 1 hareby affirm under penalty of perjury mm of the fallowing declar,Wns: have and will maintain a CeWRwm ofConsenl W self.lasum fm Wariness Campos. - n, u provided for by Section 1700 of the Labor Cade, for me performance of me, for which this permit is issued. ZIf[ Ave and will maintain Workers Compensation Immense, as required by Secaan 00 of the Labor Cade, for the performance of tW wart for which this permit is issued. My Workers Com ensedon Inn nee cortico and Paltry number are: Cartier: PoliryNo.: t�in.�lQ(n-L2 CE FICATE P EXEMPfIONFROM WORKERS' COMPENSATION INSURANCE Crhtssemion coed nat4completed I(the permit is Throne hundred dollars ($100) or least) 1 certify Nat In me performance of the wants for which this permit is issued, I Nall nm employ any person in my matter m as W become subject to the Workers'Compensation ' Laws of California. Dale Appliesal - - NOTICE TO APPLICANT: If, after makAng mis Certificate of Exemption, you should become subject W me Worker's Compensation previsions of the Lainr Code, you must - forthwith comply with such pmvisinw or this permit shall W deemed Ievaked. CONSTRUCTION LENDING AGENCY 1 hereby Afton titre them is a construction lending agemy far the perfmmance of the work fm which this Permit Is issued (Sec. 3097, Civ. C.) Lenders Name ' Landers Addie•" 1 ceNfy that 1 have read this application and stem met the aWn Information u coma I agras W comply with all City Nd county ordinances and Alam lawn Riating m Wilding conaouction, and hereby aasthor m reptwere avis of this city W calm upon the above-memoned property for inspection putpoxst (We) rte W ssn, 'Me-pefy and keep harmlessagainstthe City of Cupertino against liabilitimild coNaMeswu whichmaymenyway amucagaiwlsaid City in eonseq a. floating of this permit. APPLICA AN WILL COMPLY WITH ALL NON-P01 Issued by: Date°— SOURCE Re-roofs Type of Roof Signature o(AppliwM HAZIEARDOARDO US MATERIALS DISCLOSURE Will thioe or rehandle ased Cupuntmforumhulldingoccupantstare Ha ithmmamrial me Cupertino M icipd Code. Chapmr 9.11. and des Health and Smely de,Section io Code, o on 1ss3z(a)7 Yu o All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I to Will me applicul, Lute building occupant um equipment m dcvim which agree remove IsulMarine. Cif eomamin u 1de0ncd by the Bry Amo Air Quality Managcmcm all new materials for inspection. 0I Nu I hen mad the haw smaeriaIs reqummeenu under CWpW6.93 ofthe Califor. ssaalrcade.s ansss30S.25533andZS334.1understandthuiffWilding / D d not ly hen e L thm it 4 my responsibility W noufy the occupant of the m— i h must W mat. tlafto issuance of Carofiwe of npanry r9/�/f —' Signature of Applicant Date - All roof coverings to be Class'W' or better Owner or aumorimd agent dDoW' -• 6 ITEMS OF 6 • 0 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35618056.00 DATE ISSUED.......: 04/14/2008 RECEIPT #.........: BS000004466 REFERENCE ID # ...: 08040092 SITE ADDRESS .....: 21572 COLUMBUS AVE SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 224.85 --------------- 224.85 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- #9403 VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING OWNER ............: BRUCE FUJIKAWA ADDRESS ..........: 21572 COLUMBUS AVE CITY/STATE/ZIP : CUPERTINO CA, 95014-4711 RECEIVED FROM ....: ATLAS-TRILLO CONTRACTOR .......: TRILLO, STEVE LIC # 4269 COMPANY ..........: ATLAS-TRILLO HVAC ADDRESS ..........: 1965 KYLE PARK CT CITY/STATE/ZIP ...: SAN JOSE, CA 95125 TELEPHONE ........: (408)286-8931 FEE ID ---------- UNIT QUANTITY ------------- AMOUNT PD -TO -DT THIS REC NEW BAL 1BSEISMICR ---------- VALUATION 3,000.00 ---------- ---------- 0.50 0.00 ---------- 0.50 ---------- 0.00 1EPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 IMPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MRRAA UNITS 1.00 61.19 0.00 61.19 0.00 1PPERMITFE 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 ---------- ---------- 224.85 0.00 ---------- 224.85 ---------- 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 224.85 --------------- 224.85 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- #9403 VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING vl .CUPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM 0Folfooq� APN# CO b� Date: Building Address: 5 Yn leu Owner's Name: Phone #: Con�tr�a t/or: Phone #: 3 y-f o OL/ Fax #: Contractor License #: Cupertino Business License #: Contact: Phone #: ta ' `� Fax #: Building Permit Info: Elect ❑ Plumb ❑ Mech ❑ Residential Commercial ❑ Job DescriptionA,K. For Residential Installations: Attic E-1151 floor 2"d floor El Adhere to minimum setback re uirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural cales) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Re uired ❑ Cost of Project: Type of Construction (Usage Class): V�obv Strapped On Platform El Bonded New Location Replacement Valuation: Green Building: Must attach Green Building Check list to this application r l` . 0 CUPERTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MCREPALT Commercial for the repair of alt/add to M ea beating appliance,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absorption,or evaporative cooling sys, incl install of controls regulated by this code. 1MCSUSHTR Commercial Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & not incl in an appliance permit. 1BSEISMICO Commercial Seismic B 1MRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, r cooling unit,absorption unit,or ea / heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. INnWPVNT Residential for the install/relocate/ or M replacement of ea appliance vent install & not incl in an app] permit. • 11 CITY OF CUPERTINO FURNACE/AC OCUPQTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1PGASRES Residential for ea gas piping system of P 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst <=100k BTU install or M relocate ea forced-air/gravity type furnace/bumer, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h 1MFRN>100 Furnace Syst > 100k BTU install or M relocate ea Forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance over 100,000 Btu/h n lEPERMITFEE Electric Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B coo CUPERTINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Grou Permit Type AIR CONDITIONING FURN/AC 1BCAIRHAN Commercial A/C Units <= l0k CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ea gas piping System 1-4 outlets P 1PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS. For each gas piping system of 5 or more per outlet. Comm/Resid P 1BRENLkRHAN Residential A/C units <= l0k CFM B IMRRAA Residential Mech Repair/alt/add M 1BSEISMICR Seismic Residential B 1EPERMITFEE Electric Permit E IMPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B • 0 Single Famiiy GreenPoint Checklist date: `t- l c rr The GrumPoim Checklist is based on the various green features Incorporated into the home and is the basis for the GreenPoint Rated program. A home can be considered green If it fulfills the prerequisites, j earns at least SD points, and meets the minimum points per category: Energy (3D), Indoor Air Ouellty/ Health (5), Resources (6), and Water (g). Plasse contact Build It Green for a list of qualified GreenPoint Raters h you am interested In pursuing third -party verification. The green building practices listed below are described in the New Home Construction Green Building Guidelines, available at Www.bullditgMgn oro. E • Build ItGreeri Smarr Solutions From The Ground Up 8. FOUNDATION ) Points Available Per Measure —❑L 1. Replace Portland Cemant in Concrete with Recycled Ftyesh or Slag 1. Construct Resource -Efficient LeLandscapes'P_antg:Available a No Invasive Species Listed by Call Are Planted b. No Plant Species NIDI Require Hedging c. 75% of Plants Are Drought -tolerant Celifomia Natives, Meddenan an, or Other Appropriate Species 2. Use Fil Landscaping Techniques • PROJECT NAME A- SITE- c u $ E e U p 0 a i Points Available Per Measure ❑ ❑ 1. Protect 1 once and Mimmim Disrupfion of s ng P nb 6 Tmes a. ProeclTopsollfrom Erosion and Reuse after ConsWction b. Limo and Delineate Construction Footprint for Maximum Protection 2. Use Frost -Protected Shallow Foundation to Cold Areas (O.E.C. Climate Zone 16) D 3 1 0 1 i .1 _ 0 1 El 2 Deconstruct Instead of Demolishing Existing Buildings 0n Site 0 0 3 ❑ ❑ E3 3. Recycle Job Site CensiNetion Waste (Including Green Waste) a. Minimum 50% Waste Diversion by WaiW Recycling or Recast - Requiretl to. Minimum 86% Diversion by Weigh (Recycling or Reuse) a. Minimum BO% Divembn by Weight (Recycling or Reuse) 1 0 0 b. All New Plants Have Trunk, Base, or Stem Located At Lang 36 Inches from Foundation 0 0 __ R i 2 I 0 _ 2 ❑ ❑ 4. Use Recycled Contend Aggregate (Minimum 25%) - a. Walkway and Driveway b. Roadway Base 0 D D ^al✓3 3 - 2 _ D 1 z I D 0 1 1 _ 1 8. FOUNDATION ) Points Available Per Measure —❑L 1. Replace Portland Cemant in Concrete with Recycled Ftyesh or Slag 1. Construct Resource -Efficient LeLandscapes'P_antg:Available a No Invasive Species Listed by Call Are Planted b. No Plant Species NIDI Require Hedging c. 75% of Plants Are Drought -tolerant Celifomia Natives, Meddenan an, or Other Appropriate Species 2. Use Fil Landscaping Techniques /: �4 Minimum 20%-Flyasly orrSlap D ❑ b. Minimum 25%Flash or Slag „`0 7 3 1 s" ❑ 2. Use Frost -Protected Shallow Foundation to Cold Areas (O.E.C. Climate Zone 16) D 3 1 ❑ 3. Use Radon Resistant Construction (In Al -Risk Locations Only) 0 D � T Z 4. Design and Build Structural Put Controls - — I 2 0 ❑ a. Install Tennhs Shields 5 Separate All Exterior Wood-toConcreb Connections tI Metal or Plasto FesbnerslDividers D 1 0 0 b. All New Plants Have Trunk, Base, or Stem Located At Lang 36 Inches from Foundation 0 1 C. LANDSCAPING ) Per Measure ❑ ❑ ❑ ❑ 1. Construct Resource -Efficient LeLandscapes'P_antg:Available a No Invasive Species Listed by Call Are Planted b. No Plant Species NIDI Require Hedging c. 75% of Plants Are Drought -tolerant Celifomia Natives, Meddenan an, or Other Appropriate Species 2. Use Fil Landscaping Techniques /: �4 - D D 0 0 7 3 1 s" ❑ ❑ ❑ ❑ 3. Minimize Tud Ames In Landscape Installed by Builder a All Turf Will Have a water Requirement Less than or Equal to Tall Fescue SI03 plain factor) b. Tud Shall Not Be Installed on Slopes Exceeding 10% or in Areas Less than 6 Foci c. Tud is 533% of Landscaped Area (total 2 points) d. Turf is 510% M Landscaped Ana (total 4 points) iD B 0 2 D � T Z D - — I 2 0 _� 2 ❑ 4. Plant Shade Trees - —5GIDue Plants by Water Needs f c rozoning) —" 0 0 0 If V/ 3 11-5111 2 ❑ ❑ ❑ ❑ 6. Install High -Efficiency Irrigation Systems a. System Uses Only Low -Flow Drip, Bubblers, or Low-floW Sprinklersi� b. System Hes Smarr Controllers 7. Incorporate TWO Inches of Compost in the Top 6 W 12 Inches of Soil B. Mulch All Planting Beds to the Greater of 2Inches or Local Water Ordinance Requirement ❑ ❑ ❑ ` ❑ a. Dimensional Lumber, Studs and Tni Minimum 40% L. Dimensional Lumbar, Studs and Timber. Minimum 70% c. Panel Products: Minimum 40% d. Panel Pmducts: Minimum 70% 0 D D ^al✓3 3 - 2 ❑ 9. USa50%Belvaged or RecydedComent Materials for So%of Non -Plant Lenience Elements 11Reduce Light PohWon by Shielding Flxturee andior Directing Light Downward z I D 0 1 1 D- STRUCTURAL FRAME $ EULLDING ENVELOPE\ ) Points Available Per Measure ❑ ❑ ❑ 1. Apply Optimal Volus Engineering a. Place Rafter; and Studs at 24 -Inch On Canter Framing b. Size Door and Window Headers for Load c. Use Only Jack and Cripple Studs Required for Load /: �4 - 1 ❑ ❑ ❑0 ❑ ❑ ❑ ❑ 2. Use Engineered Lumber a. Beams and Headers b. Insulated Engineered Headers— c. Wood l -Joists or WebTmsses for Floors d. Wood I-JoisB for Roof Rafters e. Engineered or Finger -Jointed Studs for Vertical Applications L Oriented Strand Board for Sabfieor g. Oriented Strand Board for Well and Roof Shutting iD B 1 1 —" 0 � 1 3. Use FSC-CeNfiad Wood ❑ ❑ ❑ ` ❑ a. Dimensional Lumber, Studs and Tni Minimum 40% L. Dimensional Lumbar, Studs and Timber. Minimum 70% c. Panel Products: Minimum 40% d. Panel Pmducts: Minimum 70% 0 I I I 2 D ---' -- I______ z I D —_�__ _ 1 _ 0 J I _ ] ® 2007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4 1. Install Insulation with ❑ a. Wells action Floon 2. Install Intimation that ❑ a. Wells andfa Floon ❑ a. Insulate Hot Water Pipes from Water Heater to Kitchen ❑ In. Insulate All HM Water Pilose ❑ c. Use Engineered Parallel Piping ❑ d. Use Engineered Parallel Piping with Demand Controlled Circulation Loop ❑ e. Use Structured Plumbing with Demand Controlled Cinulatlon Loop ❑ f. Use Cantel Care Plumbing Taal A. HEATING V&NTM ATION R AIR CONDITIONING Points Available Per Measure D ' 4 ENTER ..O Install Sealed Combustion Unita e. Furnaces a E:1a. El ❑ 1, Uu Solte Well Systeme Qneludss SIPa, ICf0. 8 Arry Non•Stick Frame Assembly) Floon h. Welke c. Roots 0 2 ❑ ❑ S. Reduce Pollution Entering the Home holm the Garage e. TgMly Seal the Air Senior between Garage and Living Area b. Install Garage Exhaust Fan OR Build a Detected Gana b. Water Heaters 1 3. herself Zoned, Hydfonic Redlant Healing with Slab Edge Insulation 0 B. Deal nEn y=on Trusua(75% of Attic Insulation Hef ht at Outside Edgeo/Exterior Wall 0 1 i 1 7. Desi n Rool Truuss to Aceommodete Ductwork 0 1 0 B. Use Rerycled-Content Steel Bluds for 110% Of Interior Weil Framing 0 e. Install HVAC Unit and Ductwork within Conditioned Space3 ! 1 _ Termal Man Wallin Ws4nch Drywall on All Interior Walls or Wella Weighing more than 401Wcu.tL 0 1 1 EC ❑ 10. Inrfal' Overhangs Bntl Quitters a. lJmimum 16•Inch Dvemuge and Gutters h. Minimum 24•Inch Ovarhan s and Gunn U -,. 1 - 4 �T ❑ — --1=- - 0 1 1. Install Insulation with ❑ a. Wells action Floon 2. Install Intimation that ❑ a. Wells andfa Floon ❑ a. Insulate Hot Water Pipes from Water Heater to Kitchen ❑ In. Insulate All HM Water Pilose ❑ c. Use Engineered Parallel Piping ❑ d. Use Engineered Parallel Piping with Demand Controlled Circulation Loop ❑ e. Use Structured Plumbing with Demand Controlled Cinulatlon Loop ❑ f. Use Cantel Care Plumbing Taal A. HEATING V&NTM ATION R AIR CONDITIONING Points Available Per Measure D ' 4 1. Design and Install HVAC System M ACOA Manual J, 0, and B Recommendations Install Sealed Combustion Unita e. Furnaces 0 ❑ b. Water Heaters 1 3. herself Zoned, Hydfonic Redlant Healing with Slab Edge Insulation 0 1 1 Lj I. Install High EMciency Air Conditioning with Environmentally Responslble Refrlgerente 0 1 S. Design and Install Elective Ductwork 0 �_ I I ❑ e. Install HVAC Unit and Ductwork within Conditioned Space3 _ ❑ b. Use Duct Mastic on All Duel Joints and Seams 0 1 ❑ c. Install Ductwork under Attic Insulation (Buried Ducts)- U -,. 1 - 4 �T ❑ / d. Pressure Balance fine Ductwork System -�- -- �- 1 1-7 e. Protect Ducts during Construction and Clean All Ducts before Occupancy 0- 6. Install High Efficiency HVAC Filter MERV St 0 1 1 ❑ 7. Don't Insured Fireplace or Install Sealed Gas Fireplaces with Efficiency Hating Not Less Than 60% D I 1 using CSA Standards B. Install Effective Exhaust Systeme in Bathrooms and Kitchens D 0 —1 —}�-- - - - -- ❑ a. Install ENERGY STAR Bathroom Fane Vented to the Outside ❑ h. Ail Bathroom Fans Are on Timer a Humidista ❑ c.lnstell KAchon Range Hood Vented to the Ounitla D 1 1 k g. Install Mechanical Vantlletlon System for Cooling (Meximum 4 Points) 0 ❑ a Install ENERGY STAR CelOng Fens & Light Kits In Living Areas & Bedrooms, ❑ ❑ b, Install Whole House Fan with Val Speeds Automatically Controlled Integrated System 0 0 1 ❑ C. d. Automatically Controlled Integrated System with Val Speed Contra _ 0 10. Install Mechanical Fresh Air Ventilation System( Maximum S Points) D 2 Ti+T1 _ ❑ a. Any Whole House Ventilation System That Meets ASHRAE 62.20 .E1 h. Install Air-tc-Air Heel Exchanger that made ASHRAE 62.2 11, Install Carbon Monoxide Alarms) 0 1 0 2D07 Build It Green Single Family GreenPoint ChecMlst 20D7 Version Page 2 of 4 E • 7,ael ewnel.le o„ I„m h ae„ew�r,m c„e.m, _ nal n I J. BUMAING PERFORMANCE I k0JE m A a EN T ER CT NAM E c B >= E o 0 LRENBWABLE ENERGY - - ❑ - 'Points Available Pec Measure p G i 2 I 1.Pre-Plumb for Solar Hal WSW Heating D 1 4 2. Install Solar Water Heeling System D 10 3 9. Install Wiring Conduit for Future Photovoltaic Installation & Provide 2DD to of SoullnFacing Roof 0 2 ! ! 2 4. Install Photovoltaic (PV) Panels Use.Low VOC-Caulk and Construction AdheMves(OO gpIVOCs).for-All Adhesives D ❑ a 30% M elects'¢ needs OR 1.2 kW (total 6 points) 0 S ❑ b. 50% of electric needs DR 2.4l (total 12 points) 0 6 ❑ c. 90% of electric need OR 3.6 kW (total 16 points) 0 ! �- 7,ael ewnel.le o„ I„m h ae„ew�r,m c„e.m, _ nal n I J. BUMAING PERFORMANCE Points Available Per Measure ❑ EDb. 1. Diagnostic Evaluations a. House Paues Blower Door Test House Passes Combustion Safety Seckdmlt Test 0 1 _ D ! 1 0 2Design and Build High Performance Homes •%above Title 21 -minimum 15% Required 0 >30 ❑ 9. House Obtains ENERGY STAR with Indoor Air Package Certification- POot Measure (Tire 45 points; reed comment) p G i 2 I E. FINISH" Points Available Per Manure 1. Design Entrywayato Reduce Tracked in Contaminants 0 1 ❑ Exposed Concrete. Flooring Adhesives Must Have <50 gpI VOCs. 2. Use Law-VOC or Zero -i Paint (Maximum 3 Points) ❑ ❑ e. Minimum 15% of Flom Area b. Minimum 30% Floor Area ❑ e. Low-VOC Interior Wali Calling Paints (c D gpI VOCs (Flet) and <150 gpI VOCs (Non -Flat)) 0 of ❑ b. Zero-VDC: Interior WeIOCellin Palms (<5 gpI VOCs (Flat))0 g 3 c. Minimum 50% of Floor Area tl. Minimum 75% of Floor Area ❑ 3. Use Low VOC, Water -Based Wood Finishes (,250 ppi VOCs) - 0 ! 2 —❑-4. Use.Low VOC-Caulk and Construction AdheMves(OO gpIVOCs).for-All Adhesives D Z — 3. Flooring Meets Section 01350 or CPI Green Label Plus Requirements (50% Minimum) ❑ 5. Use RecycledContent Paint D 1 3. Install ENERGY STAR Refrigerator 6. Use Environmentally Preferable Materials for Interior Finish: A) FSC -Certified Wood, S) Reclaimed, C) Rapidly Renewable, D) Recycled -Content ❑ e. ENERGY STAR Oualmed & c 25 Cubic Feet Capacity or E) Flnger�.lointed ❑ b. ENERGY STAR Qualified &<20 Cubic Feet Capeciry ❑ a. Cabinets (50% Minimum) - 0 4.Install Built -In Recycling Center ❑ b. Interior Trim(50%Minimum) 0 ❑ a. Built -In Recycling Center El a Shelving (50%Minimum) D --- ❑ d. Doom (50% Minimum) _ 0 0 ❑ e. Countedops50°A Minimum) 0 7. Reduce Formaldehyde in Interior Finish (CA Section 01350) ❑ a. SubfiDor&Stair Treace (5D%Minimum) 0 ❑ to. Cabinets & Countadops (50% Minimum) 0 — 7 1 ❑ C. Interior Trim (SD% Minimum) 0 ❑ it. Shelving (50% Minimum) 0 r— T 1 ❑ e. After installation of Finishes, Test of Indoor Air Shewa Formaldehyde Level <27ppb 0 1 3 L. FLOORING - Points Available Per Measure 1. Use Environmentally Preferable Flooring: A) FSC -Certified Wood, B) Reclaimed or Asti C) Rapidly Renewable, D) Reryclad-Conant, E) ❑ Exposed Concrete. Flooring Adhesives Must Have <50 gpI VOCs. 0 ❑ ❑ e. Minimum 15% of Flom Area b. Minimum 30% Floor Area 0 -II --TI — 1 of 0 g ❑ ❑ c. Minimum 50% of Floor Area tl. Minimum 75% of Floor Area 0 p 1 ! 2 ❑ 2. Thermal Mau Floors: Floor Covering Other than Carpet on 50% Or More of Concrete Floors 0 1 ❑ 3. Flooring Meets Section 01350 or CPI Green Label Plus Requirements (50% Minimum) 0 2 ! M. APPLIANCES AND LIGMING Points Available Per Measure .1. install Water and Energy Efficient Dishwasher ❑ a. ENERGY STAR (total 1 point) 0 ❑ b. Dishwasher Uses No More than E.5 GallonsC cle (total 2 points) D -II --TI — 1 2. Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less ❑ a. Moats Energy Star and GEE Tler 2 requirements(modified energy factor 2.0, Water Factor 6.0)(total 3 points) 0 1 ! 2 ❑ or Masts Energy Star and GEE Tier 3 requirements (modified energy factor 22, Water Factor 45 or leu) T 2 tole 5 olnts 0 3. Install ENERGY STAR Refrigerator ❑ e. ENERGY STAR Oualmed & c 25 Cubic Feet Capacity 0 ❑ b. ENERGY STAR Qualified &<20 Cubic Feet Capeciry 0 y �- 4.Install Built -In Recycling Center 0 ❑ a. Built -In Recycling Center 0 ( 2 ❑ b. Built -In Composting Center 0 1 N. OTHER - Points Available Per Measure ❑ 1. Incorporate GreenPoint Rated Checklist in Blueprints - Required 0 ! R ❑' 2. Develop Homeowner Manual of Green FamuresrBenefits 0 1 1 ) ! 1 3. Community Design Measures & Local Priorities: See the Community Planning & Design Bastion in Chapter 4 of the New Home Guidelines for measures. Maximum of 20 points forsupgested measures. Local requirements may also be listed here. we 0 2D07 Build It Green Single Family GreenPolnl Checklist 2007 Version Page 3 of 4 Euler dupdpllon hare, and enter points avellable for measure in apgopla4 categories to the right _ Enter deso6phon han and enter points avelail6e fe measure In ajglaprete caepo6u to ea dpht. Enter dem6p0on hen and enter pointe available for measure In appropriate categories to the right. Enter descriptmn hen, and antm grin aveltable it measure In appropriate cam go6u to dro right_ 4, Innovation: List innovative measures that meet the green building objectives of the Guidelines. Enter up to a mazimom combined total of 20 ots. See Innovation Checklist for suggested measures using the link to the rich, pproprtats cae orlee to then D D 0 0 0 0 0 0 0 0 0 D 0 _ 0Q 0 D 0 _0 0 _ o _ 0 0 0 0- o rola calagken to the 621d _ 0 propdnte categories to the right. 0 propriee cetegree to the right. 0 tae entego6u to the rigtn - _ _ _ o Total Available Points In Other 43 0 Total Available Points In Specific Categories' ,Imam Points Renulrad In S adit Cateapriee 4+ 96+ 42+ 66+ 43f O 30 5 8 D_ 0 0 0 o D_ D_ o o_ it 0 0 D_ 0 o _ 0 o _0 o 0 _ 0 pproprtats cae orlee to then D D 0 0 0 0 0 0 0 0 0 D 0 _ 0Q 0 D 0 _0 0 _ o _ 0 0 0 0- o rola calagken to the 621d _ 0 propdnte categories to the right. 0 propriee cetegree to the right. 0 tae entego6u to the rigtn - _ _ _ o Total Available Points In Other 43 0 Total Available Points In Specific Categories' ,Imam Points Renulrad In S adit Cateapriee 4+ 96+ 42+ 66+ 43f O 30 5 8 8 Project hes not yet met the following recommended minimum requirements: - Total Project Score of At Least 50 Points - Required measures: 43a: 50% waste diversion by weight ,1a;-ISS/o-above-Title-24 -NS; Incorporate GnaenPoint Rated Checklist into blueprints - Minimum points in specific categories: -Energy (30 points) -fAQ/Health (5 points) -Resources (6 points) -(Nater (9 points) E C_J 02007 Build It Green Bingle Family GreenPolnt Checklist 2007 Version Page 4 of 4 4 r _ i%. CITY OF UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: v7 /�.ZCq/(tin�o7.�r fjy� PERMIT # �G4oD OWNER'S NAME: tic i Icy PHONE # 2g2 GENERAL CONTRACTOR: - x j/o 1q114r FAX # I am not using any subcontractors: Signature —' Date Please check applicable subcontractors and complete the following information: 21 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/ o�actn a ignature— 6ate