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08030004 CITY OF CUPERTINO IA.rF BUILDvINGDIVISIONPERMIT �UCUNTRAC�,TOR'INFORNIATION' cdi '.ser BUILEP8 ADDRESS: PERMIT NO. 1(1421 E ESTATES DR - CUPERTINO PLUMBING 08030004 OWNER'S NAME: PERMIT ISSUE DATE SMITHSON ROBERT C AND SUSAN D 1300 DELL AVE STE C 03/03/2008 NE: SANITARY NO. CONTROL N0, ARCHITECT/ENGINEER: BUILDING PERMIT INFO COPPER REPIPE BLDG ELECT PLUMB MECH 0 0 0 0 ;OQ LICENSED CONTRACTOR'S DECLARATION IOI)D05CrIpC100 i U 1 hereby affirm Nal I am lic,ued under provisions of CNpur 9(gammercing aiN Secugn]Olrll)of Diviaien Sof Ne Business aM Prafmsians Code.vnd mylicerrse I. in full forte and eff ;?14 10 Zqq Licanac CI Lt.N Ear it: Dam TECTSD CLA�TRAB 0 ££7 ARCNfTELTS DECLARATION i k< I understand my plana shall he used as public records sec 'aG Licensed Pmfcssian.l H 3 OWNER-BUILDER DECLARATION ' f I hmhy affirm Nal 1 am exempt from the Contacur's License Law for the g m o following mason.(Section]1131.5,Business and Pmfeasiom Code:Any city or county SZi which requirew s a permit construct,alalts,, improve,demolish,or mpoir any stmeture pnor to its issuance.also requires tcapplicent for such Perming rile asigncd statement ss� Not W is licensed pursuant to to provisions of to Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation OR[l-0 00)(eamormeng with section of Division 3 or Ne Business and Professions Cude)or _ our he is exempt tecmfrom and to baso for to alleged exemption.Any violation of Section 70313 by any applicant far a permit subjects to applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(ML ❑1,as owner of the propenty,or my employes worth wages as Heir sole compensation, will do tc work and the structure is not intended or offered for sale(Sec.7044.Business Required Inspections and Pmfessimu Cad.The Committees License Law does teat apply u a e owner of 9 p property who build,or improvsstereon,and who doessuchwmk himself or tonight his own employers,provided Nat such improvements are not inmldW proffered(orale.B. however,the Wilding or improvement is mid wiNin one year of eompletion,Ne oarren builder will have the WNen of proving Nat he did not Wild or imprmc far purpose of sale.l. 1,a awns,of to propcny,am exclusively contract art licensed conmaemu m consumer to project(Sec.7814,Business and Profmsiom Code:)The Costumes U. cave law dors not apply to in owner of propsny who builds or improves thereon,and who Cartago for such projects with acomnctoNa)licensed pursuant to to Contracter's LIcense Law. ❑lam exempt under Sec .B k PC fa this naggers rc Dau WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following decoutlom: ❑1 have and will maintain a Cenificeu of Cement in self-inau far WmIsce.Compen- sation,as provided for by Section 3700 of Ne labor Code.for Ne performance of Ne work for which this permit is issued. 1 have and will maintain Warker's Compensation Insurance,as required by Sectors 3700.17m,Lum,Code,for Ne performance of em work for which Ni,permit is issued ' My Worker's CconNor a im lln�surance canna,and Policy Monte,ang: Carer. t<-s.�'� TIwr�1p�, Policy No.: C��Z-TZ' o CERTIFICATE OF EKEMPTION FROM(WORKERS COMPENSATION INSURANCE (Thu section rued rust hcamplctd if its,permit Is feronc hundreddalun(SIOG) or 1.1 1 .mfy Nat in to perfammna of Ne.,it for which this pemrit Is issued.)shall rim employ any person in any manner an as to became subject to the Warkcn'Cmnpenation . Laws of California.Date Applicant NOTICE TO APPLICANT:IL after making this Cenifrcat of Exemption.you should become subject tg the Workees Compensation provisions of Oe Labor Code,you am .J. O faMwit comply wit such provisions or this Permit shall h dcemed revoked. + Z'—' CONSTRUCTION LENDING AGENCY F"^ Ihemhyaffirm tat Nnre Is.construction lending agency for rhe Perpormanaof ai ti to work for which Nis permit is Earned(Sec.3097,Civ.C.) W Q Lcndcr's Name , .7 z Lender's Address V Q 1 certify Nat 1 have mad this application and sate Nat on,above mfomame is LL F-' Coro¢.Loren to comply wit all city and Emery ordinances and sou laws relating m OI- Wilding e0naveetlon,and hereby sutodae representatives of Nis city to enter upon Ne LU shove-mcmiunN propcny for inspection purposes. (We)ague to ave,indemri Ty and keep harmless tc City of Cupertino against (~fA liabilities.judgments,ensu and expenses which may in any way game against said City U Z in consequence of the granting of this perm it. ^' A PLIC�ANT UNDERSTA WILL COMPLY WITH ALL NON-POINT Issued by: Date s — /�� 3—US Re-roofs Signuure li o tosDat p s FI�AZAADOUg MATERIALS DISCLOSURE Type Of Roof Will dm applicant or future Wilding eempantsmre or handle honrdom material 1on0-stric" 'e0ned by Ne Cupertino Municipal Code.Chapter 9.12,and Ne Hurt and Saint,de,Stenon 25532(,)? All roofs shall be inspected prior to any roofing material being installed. Win the applicant or future building oeaupamt useequipment or device,which If a roof IS installed without firs[obtaining an inspection,I agree t0 remove it hvardnm air canuminanu a defined by dmBay Arca Air Quality Management all new materials for inspection. 1 have marl Nehannitu s materials requirements undcrchapterb.95 ofNeCalifn. HeaW&SafetyCade Sections 25505,25533 and 25534.1 undcmwnd tot if&Wilding a not curmn0 u' rosponsibility to nodlY Nc aaupant of tits 1111gw mh most yr -aor OcaPmey. Signature of Applicant Date ownerer ariveasg / �_.3^ o All roof coverings to be Class "B"or better • CITY OF CUPERTINO 5 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36913046 . 00 DATE ISSUED. . . . . . . : 03/03/2008 _ RECEIPT #. . . . . . . . . : BS000004062 REFERENCE ID # . . . : 08030004 SITE ADDRESS . . . . . : 10421 E ESTATES DR SUBDIVISION . . . . . . . CITY • CUPERTINO ' IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SMITHSON ROBERT C AND SUSAN D ADDRESS . . . . . . . . . . : 10421 EAST ESTATES DR CITY/STATE/ZIP . . . : CUPERTINO, 95014-4505 RECEIVED FROM . . . . : FRANK L CARDIA CONTRACTOR . . . . . . . : CARDIA, FRANK L ' LIC # 612 COMPANY . . . . . . . . . . : CUPERTINO PLUMBING ADDRESS . . . . . . . . . . : 1300 DELL AVE STE C CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 • TELEPHONE . . . . . . . . : (408) 253-0618 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- --------- ---------- ---------- ---------- 1BPWSVCS WATER SERVICE 1 . 00 20 .40 0. 00 20 .40 0. 00 1BSEISMICR VALUATION 4, 000. 00 0 .50 0 . 00 0 .50 0. 00 1PPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00 1PRREPIPE NO OF FIXTURE 8 . 00 81 . 60 0. 00 81 . 60 0. 00 1TRAVDOC FLAT RATE 1 . 00 40.79 0 . 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 184 .08 0. 00 184 . 08 0. 00 METHOD OF PAYMENT AMOUNT - REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 286 .56 VISA --------------- TOTAL RECEIPT 286.56 VOICE IO DESCRIPTION VOICE ID DESCRIPTION -------- --------------------- -------- ---------------------------- 106 SEWER & WATER 301 ROUGH PLUMBING 507 FINAL PLUMBING • ogn3 o � c�� CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPERTINO PERMIT APPLICATION FORM APN# 2 3 Date: 3 - 3 3 - 00 O 0 Building Address: 10 q2- 1 Owner's Name: Phone#: 25-7 _ 3(,P? PJ41,' + SM 1+� \ 5-o,-) Contractor: Phone #: Fax #: Contact: Phone#: �r-� I, �� "� — Fax #: Contractor License#: a y 9 CJ 5 Cupertino Business License#: lD l Z Job Description: Residential [�� Commercial ❑ Valuation: Z/, U U.�-- Green Building Check list must be completed and attached to this application. Green Building Points: Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer IBPREPIPE Commercial re-pipe per fixture P 1CPRP 1PGASCOM Commercial Gas Piping System P 1-4 Outlets 1BSEISMICOM Seismic Commercial P 1BSEISMICR Seismic Residential P IPRSEWER Residential building P 1RPSS sewer/sanitary sewer CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group 1PRREPIPE Residential re-pipe per fixture P 1RPRP 1BPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P / 1BPWATER Install/alter Water Pipe P 1BPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets 1BPGAS Gas Piping System 5+ Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P • 1PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P / 1TRAVDOC Travel & Documentation Fee B 1BUSLIC Business License B Singie Family GreenPoint Checklist date: Oro Build It Greed The GreenPoint Cheddist is based on the various green features Incorporated into the home and Is the SmaeSolutions From The 6mund Up basis for Na GreenPoint Rated program.A home can be considered green 11 it fulfills the preraquilums, same at lead 5D points,and meets the minimum points per category Energy(30),indoor Air Oueiltyl • Health(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint Raters It you are interested in pursuing third-parry verification. The green building practical listed below are described In the New Home Construction Green Building _ n Guidelines,available al www.bulldnoreen oro. 5 ENTER PROJECT • , s cs 5 ¢ PointsAvailable Par Mee! a 1.Proll Topsoil and Minimize Disruption o1 Existing Plants d Trees ❑ a ProtectTopsol from Emslon and Reuse after Construction D , , ❑ b.Limit and DaTMBM Construction Footprint Its Maximum Protection 0 , 2.Dery ct instead of Demolishing Bel Buildings On site D 3 d.Reyde Job S'a Construction Was,(Including Green Waste) ❑ aMaurmm 50%Waste Diversion by Wery#(Recycling orReui-Requiretl ❑ to.Minimum 65%Diversion by Weight(Recycling or Rause) p 2 ❑ c.Minimum BD%Diversion by Weight(Recycling or Rause) 0 1' 2 4.Use Recycled Content Aggregate(Minimum 25%) ❑ e Walkway and Driveway p ) ❑ b.Roadway Base 0– Total Points AvallaNe in Site 12 –TotalPointsAvallaoleinSlie=12 0 B.FOUNDATION Points Available Per Measure 1.Replace Portland Cement in Concrete with Recycled Flyesh or Slag ❑ e Minimum 20%Flyash or Slag D , ❑ b.Minimum 25%Ryash or Slagp , _2UN Frost-Protectetl Shallow Foundation in Cold Arses(C.EC.Climate Zone 16) 0 3 e.Use Radon Resistant Construction On At-Rick Locations Only) D ! 1 4.Design and Build Structural Peat Controls ❑ a.Install Tel Shields A Separate All Exterior Wood-tDConoreta Connections by Motel or Plastic FastenerslDiuidere 0 _ 1 _ b.All New Plates Have Trunk Base,Or Stem Located At Least 36 Inches from Foundation 0 t 1 Total Points Avaiable In Foundation=B 0 C.LANDSCAPING Points Available Per Measure 1.Construct Resourc-Ethcient Landscapes • ❑ a.No Invasive Species Listed by Call Are Planted p In. _ __ 0 ❑ .No Plant Species Will Require Hedging _p ❑ c.75%N Planta Are Drought-tolerant California Nerves,Meditananean,or Other Appropriate Species D i 3 L Use RmSah landscaping Techniques 0 1 J.Minimal Tud Areas In Landscape Installed by Builder ❑ &AUTurAftl Have a Watar Requirement Less than or Equal to Tal Fescue ISM plant t ll _ � 2 ❑ o Tud Shag Not Be Installed onSlopes Exceeding 10%orin Areas Less man B Feet Wida 0 2 ❑ c.Tud Is SM of Landscaped Area gmv 2 pull 0 _--- I 2 Eld.Turfis 510%M Landscaped Area(total 4 polms) D > ❑ 4.Plant Shade Trees 0 3 5.Group PlenLL by Water Needs tlroxonin 0 i 2 6.Ideal High-Efficiency Irrigation Systema ❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers ❑ b.System Has Smart Controllers 0 7.Incorporate Two Inches of Compost In the Top 6 to 12 Inches of SDU 0 ( 1 3 B.Mulch All Planing Beds to the Greater of 2 inches or Local Water Ordinance Requirement 0 \Y 1 2 g,Uce 5o%Selveged or Re eletl-Content Materieb for 50%01 Non-Plant Landscape Elements 0I 4\LI 1 I til.Reduce Light Pollution by Shielding FixWma andror Directing Light Downward 0 1 ToW Points Available In Landscaping=31 0 D.STRUCTURAL FRAME @ BUILDING ENVELOPE ie--A 'Hole Per Measure 1.Apply Optimal Value Engineering 7 ❑ e.Place Rafters and Studs at 24-Inch On Center Framing _0 ❑ b.Ste Door and Window Headers for Load ❑ c.Use Only Jack and Cripple Studs Required for Load 0 I h 1 L Use Engineered Lumber ❑ a.Beams and Headers ❑ b.Insulated Engineered Headers -f^ I 0 ❑ 0.Wood WDIM or Web Tnlsum fir Floors Fs�� ❑ d.Wood I-Joists for Roos Rafters ❑ 9.Engineered orFlnger-Jointed Studs for Vertical Applications MAR 0 31088 D ; — ❑ f.Grunted Strand Board for Subfloor p ❑ g.Oriented Strand Board for Wan and Roof SheathingD —T j 1 D.Use FSC-Lert fled Wood • E) a Dimensional Lumber,Studs and Timber.Minimum 40% p -- ❑ D.Dimensional Lumber,Studs and Timber.Minimum 70% 0 2 ❑ c.Panel Products:Minimum 4096 0 ❑ d.Panel Protiums:Minimum 7D% 0 1 0 2007 Build It Green Single Family GreenPoint Checklist 2DO7 Version Page 1 of 4 ENTER5: 4.Un Solid Well Systenq(Includes SIPS,ICFs,a Any Non-SOck Peee Anembiy) ❑ L Moore D 7 _ 2 ❑ b.Walls 0 2 2 ❑ C.Roots 0 2 5.Reduce Pollution Entering the Home hom the Garage ❑ a.Tightly Seal the Air Bender between temps and LMnp Area 0 ❑ b.Insall Gere a Exhaust FoORBuRdeDochudGaralls 0 1 Lj e.Desi n En els Heon Trusses 5%of Attic Insulation Haight at Outside Edge of Ever Well 0 - 1 7.Desi n Root Tmwes ta Aetommodm Ductwork D 1 a.Use ReeyeledtomeM Steel Studs for 60%of Interior Wall Framing 0 1 a.Thermal Mean Wags:Winch Drywall on All Interior Wells or Walls Weighing mora Oen 40 11 0 1 10.Insall Overhangs and Contra; _ ❑ A Minimum 164nch Overhangs and Gutlan _ 0 _ E) h.Methuen 244no Overhangs and Gulden 0 1 Total Paints Available in Sducluml BullicErip From and Envelope+36 D E.EXTERIOR FINISH Poims Avellable Pat Measure EF t.Use RecycledContem(No Virgin Plastic)or FSCCenffied Wood Deciding D 2 21nsW1 s Rain gotten Wall System 0 2 d.Use Ouebia and Noncombustible Siding Meedels 0 1 El A.Select Durable and Noncombustible Hoofing Materiels 0 2 Total Pointer Avdlable In Exterior Finish•7 0 F.INSULATION Points Avellable Par Measure 1.Insall Insulation with 75%Recydsd Content ❑ A Wells andta Rope _0 ❑ b.Cemn s 0 1 Z lnaell Insuefion that is Low•EmiOing(Cerdfled SeNon Dt750) ❑ A Wells andlor Flcots D ❑ It.CallingsD ] a. Inspect Duality of Insulation installation before Applying Drywall D 1 ToW Points Available in Insulation•5 D O.PLUMBING Points Avaliable Per Manum 1,Distribute Coronado Hot Wnwr Efficiently(Maximum 7 Points). ❑ A Insulate Hot Water Plpestrom Water Heelerlc Kitchen —0— _ 1 _ 1 _ ❑ b.Ins01e1e All Hot Water Pipes 0 1 1 ❑ C.Use Engineered Partial Piping _ o El Use Engineaed Parallel Piping with Demand Controlled Circulation Loop / _ D ❑ e.Use Mch ed Plumbing with Demand Controlled Circulation Loop 0 ] ❑ 1.Use Corral Core Plumbing ] __ _ r 1 _ 2 2lnstall Only High Efficiancy Toilsls(Dual-Rush or 51.2119131) 0 4 Total Points Avaeabls In Plumbing a Taal 12 0 H.HEATING VENTILATION R ATR CONDITIONING Poims Available Par Measure 1.Design and Ines HVAC System he ADCA Manuel J.D,and S Racommteda ions 0 d 4 2.Insall Sealed Combustion Unite ❑ a.Furnaces 0 _ _ 2 E] b.Water Heaters 0 1 2 I S.Inotall Zoned,Hydronic Radiant Heading with Slab Edge Insulation 0 1 1 4.InswIl High Efficiency Air Conditioning with Environmentally Responslbla Refrigerant 0 1 S.Design and Invtaii Effeetive Ductwork ❑ a.Install HVAC Unit and Ductwork within Conditioned Space _ 0 3 __ y ❑ It,Use Duct Mastic on All Duct Joins and Seams 0 _ _ 1_T ❑ c.Items Ductwork under Alto Insula6on(Boded Ducts) _D ❑ d.Pressure Balance the Duchvmk System ❑ a.Formal Ducts during Commucl own and Dean As Ducts beldre Occupancy 0 I r S.Install Mph Efficlancy HVAC Flow ERV 6. D 1 ❑ 7.Dont install FOspiaw or Kasten Sealed Gas Fleplem with Ethclenry,Rating Not Lase Than 6D% D 1 using CSA Standards S.Install Effective Exhaust Systems In Bathrooms and Kitchens ❑ A install ENERGY STAR Bathroom Fens Vented to The Outside 0 _ __; 1 ❑ b.All Bathroom Fane Are on Timer or Humidstat ❑ c.Install Khchen Range Hood Vented to the Outside 0 I I a.Install Mechanical Ventilation System for Cooling(Maximum 4 Points) ❑ e.Install ENERGY STAR Calling Fane a Light Kits in Living Areas&Bedrooms ❑ b.Install ladle House Fen with Vendors Speeds 0 ❑ c.Automatically Commlled Integrated System ❑ d.Automatically Controlled Integrated System WIN Venable Speed Control D 3 t 10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Paints) ❑ A Any lade House Venthmon System That Meets ASHRAE 622 0 2 El b.Instal Alr•IflAt Heal Exchanger that meet ASHRAE 622 0 1 2 11.Inse11 Carbon MiAlmon a 0 1 Tool Points A41able In Heading,Ventilation and Ali Conditionin •3D g 0 2007 Build It Green Single Family GreamPolnl Checklist 2007 Version Page 2 of 4 ENTER PROJECT y 5 ¢ 3 L RENEWABLE ENERGY Points Aveilabie Par Measure • 0 1.PrwPlumb for Bole Hol Water Herfing 0 4 LJ 2.Install Bohr Water Heading System 0 10 3.Install Wiring Conduit for Future Photovoltaic Installation 6 Provide 200 if o1 South-FacingRoof 0 I 2 A.Install Photovoltaic(PV)Panels ❑ a 30%N electric needs OR 12 zesty(total 6 points) 0 6 ❑ b.50%of electric needs OR 141 lets!12 paims) p —�—p �—'�—_T-- ❑ c.90%at electric mad OR 3.6IM'(total 16 postal p — g —------ Tote!Available Points in Renewable Energy=211 0 J.Bt7DAING PERFORMANCE Points Available Per Measure 1.Diagnostic Evaluations ❑ a House Panes Blower Door Tem _0 ❑ S House Pewee CornWstion Safety Sackdreb Test 0 20esign and Build High PeHommnce Homes-%above This 24-minimum 15%Requbed 0 >_30 ❑ 3.House Obtains ENERGY STAR with Indoor Air Package CoMficat on-Pilot Measure(Total 45 points;read Comment) 0 6 2 Total Available Points in Building Performance=39 0 E.FINISHES Points Available Per Measure 1.Design Erdrywrys to Reduce Tracked In Contaminants 0 I 7 2 Use Law-VOC or Zero-VOC Paint(Maximum 3 Points) ❑ a Low-VOC Interior WalliCe!ling Palms(<50 go VOCs(Flap and 050 gpl VOCs(Non-Flap) D El Is Zero-VOCi:Interior Wapb AMn Paints(d VOCs(Fl0 3 ❑ 3.Use Low VOC,Watm-Based Wood Finishes(Q50 9pt VOCs) 0 t I 2 ' ❑ 4.Use Low-VOC Caulk end C.man tion Adhesives(OO got VOCs)for All Adhesives 0 2 ❑ S.Use Recycled-Content Paint 0 1 S.Use Environmentally Preferable Metwiels for interior Flnhur A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Contant or E)RngerJDImad ❑ a Cabinaps(50%Minimum) 0 ❑ b.Interior Trim(50%Minimum) 0 _ _ 1 ❑ C Shelving(5D%Minimum) _ 0 ❑ J.Dmis(50%Minimum) —0 ❑ e.Counters s(50%Minimum) 0 I ] 7.Reduce Formaldehyde in Interior Finish(CA Section 013501 • ❑ a Subt 6 Stan Treads(50%Minimum) ❑ b.Cabinets 3 Countedops(50%Minimum) ❑ c.Interior Trim(50%Minimum) 0 —2 ❑ d.Shelving(50%Minimum) 0 1 ❑ e.After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Level Q7ppb 0 3 I Total AvaOEoie Points In Finishes=21 0 L.FLOORING Points Available Per Measure 1.Use Environmentally Preferable Flooring:A)FSC-0ert fiad Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Contan%E) Exposed Concrete Flooring Adhesives Must Hever 60 gip,VOCs ❑ a Minimum 15%of Floor Area 0 ❑ b.Minimum 30%of Floor Area 0 ❑ c.Minimum 5D%of Floor Area 0 ❑ J.Minimum 75%of Floor Area D 1 ❑ 2 Thermal Mess Floors:Floor Covering Other Nen Carpel on SM or Mom of Concrete Floors 0 1 ❑' 3.Flooring Meets Section 01350 or CPI Green label Plus Requirements 50%Minimum 0 I I 2 I Total Available Points in Flooding=7 0 M.APPLIANCES AND LIGHTING Points Available Per Measure 1,Install Water and Energy Effmipnt Dishwasher ❑ e.ENERGY STAR(total 1 pomp 0 1 1 ❑ b.Dishwasher Uses No More than 6.5 Gallons/Cycle 12 points) D S 2 Install ENERGY STAR Clothes Washing Machine with Witter Facer of 6 or Lees ❑ a Meets Energy Star and CEE Tier requirements(modified energy factor 20,Water Factor 6.0)(eta!3 points) 0 ❑ b.Meets Energy Sw and CEE Tier 3 requirements(modified energy factor 22,Water Factor 4.5 or les) —i t 2 0 tura!5 points) 3.Install ENERGY STAR Refrigerator ❑ a.ENERGY STAR Oualihed 6<25 Cubic Feet Capacity 0 ❑ It.ENERGY STAR Quarried a<20 Cubic Feet Capacity a 1 I 4.Install Bui1Hn Recycling Center 0 ❑ aBu01-In RBeycfng Center 0 7 ❑ b.Built-In Composting Center 0 1 Total Av90able Points in Appliances and Lighting=12 0 N.OTHER Points Available Per Measure ❑ 1.Incorporate GremPoint Raped Checklist in Blueprints-Required a i R ❑ 2 Dwalop Homeowner Manuel of Gree,Feamresi9enefitc 0 1 1 1 3.Community Design Measures 8 Lon]Priorities:See the Community Planning A Design section in Chapter 4 of the New Home Guidelines for measures.Maximum 0120 pDlnts for suggested measures.Local requirements may also be listed here. O 2007 Build It 0reen Single Family GrasnPolnt ChecMist 20D7 Vemlon Page 3 of 4 MUGHM ,ENTER PROJECT NAME Enter description hen,real enter pons weasel to measun In g4vopiue taspodas to the right. 0 0 0 0 0 0 Enter deem phon here,nal Mai points evalede to mamma In eppnpdab categorias In the dphL - 0 g D 0 0 0 Enter amm¢Nan hen,and enter points Wettable to measun In appropnme categories to the right. D 0 0 D D 40 Enter deaolption hen,end weer po1Ms avalbble Io measure In alrynoprlals cmepoim to the right. 0 D J_ D g D D 4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Ester up to a Build It Green Checklists and me dmum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the d ht. _ Guidelines _ Irmwation In communal Emer description,hen,real area, b aveltWt to Mumma In oparnpram camintim to the right. D D D D 0 0 Innwnlos in EN I Enter description hater,and euro poirn,rvallaWe Ina mmeun M QPPDphfllf can 0dee b the right. 0 0 0 0 o D Imwahm In In UbMmlth:Enter dascd Ion hen,and enter points avallnble In,measure In es cab misf.lo Me night. _ D 0 0 0 0 0 IrmweOan amommomr.Enter dew' ion hero,and amen pointer Naurne to meuun In appoplat,FampreneS to the rlph. 0 0 0 0 0 0 Innwalim in Water.Ent_o d"an hen,and enter pom wadable to Memme in appaprbte cabgmam b the dyM1 D 0_ „0 0 0 0 TDW AvalaNe Poim In Oth 4 0 mm Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+ Minimum Points Required in Specific Categodes 0 30 5 6 9 -1-Dial Points Achieved e e e e e 13 Project has not yet mot the following recommended minimum requiromentst - -Total Project Score cfAt Least 50 Points -Required measures: -A3a:50% waste diversion by weight -12: 150/s above Title 24 -NJ:Incorporate Green Point Rated Checklist into blueprints -Minimum points in specific catewries: -Energy(30 points) -IAOIHealth(5 points) -Resources(6 points) -Nater(9 points) 0 2007 Build It Green Single Family GreenPolnt Chacdal2007 Version Page 4 of 4 Community Development 10300 Torre Avenue { J. Cupertino CA 95014 Telephone(408) 777-3228 *CUPEI,TINO Fax(408)777-3333 Building De artment JOB ADDRESS: PERMIT # 0 3 D OWNER'S NAME: PHONE # ;L5 7—3C, GENERAL CONTRACTOR: ;V-o 1 FAX # I am not using any subcontractors: 5tg- nature 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