08020056 CITY OF CU
Yy 7a,g* t ,.B^'�g}f y�t7 }'/wry '�
BUILDINCZVISION PERMIT •t�A+A:rt'kT" % q*1N�' I'M
UI1UqTT'3O1`1ANSON AVE PRO ROOTER E0600056
41WER3NAME: PERNUT ISSUE DATE
HE CAL 2306 AMERICA AVE #7 02/11/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTfENGINEER: BUILDING PERMIT INFO
PROP-LINE CLEANOUT BLDG ELECT
PLUMB MECH
le o LICENSED CONTRACTOR'S DECLARATION 0 O O O
rd I hereby&farm Net 1 am licensed under Provisions of Chapter 9(commencing —^ Job Description
Z wiNSecdon]g10)ofDiWslan3afdm BusinmudProfeuam Code.andmy license is
^<� in full force and effect.
� Z Lianm Clots Lic.B
F Da¢ Contractor
A CHITECTSDECLA ION
Cg` I understand my plans shall be used as public recut&
ioL'
9 ted Licensed Professional
^
OWNER-BUILDER DECLARATION
4<i 1 hereby affirm that I am exempt from the Contractor's License Law for the
D O following mason.(Section 703 1.5,Buninem and Pmfcssims Code:Any city or county
$ which requires a permit to construct,mer,hnpmw,demnlLah,or repair my structure
zy imor 0 its issuance,also requima the applicant forsuch permit to file aslgnel summene
]�ssC
that he is licensed pursuant to the provision of Ne Centimeters Liscve Law(Chapter 9 Sq.Ft. Floor Area Valuation
yFs (commenting with Section 7000)of Division 3 of the Business and Pmfetsiom Code)or
r3—
the,he u exempt Nesefmm and the basis for the alleged exemption.Any violation of
Section 7031.5 by arty applicant for a permit subject,Ne applicanua a civil penalty of APN Number Occupancy• p e
not mon Nan rim hundred dollars(MMPne Y 'gy)P
I,n Owner of she property,or my employees with wages as their sok eomperuedon,
will do the work and timans clure is not intended manered foraaN(Sec.7014,Business
and Profenions Code:The Comtxmrt License Law does not apply to an owner of Required Inspections
property,who Wilds m ire proves Neuron,and who does such work himself car trough bit
awn employees.pmNded Onmmeh impmwmsm art not intended moffmad fmaele.If.
however.the Wilding or imprommem is sold within one year f completion.the morin,
Wilder will have Ne burden of proving Nal he did nos Wild or imprm for purpose of -
❑Las owoer or the
such
Property,am exclusively contracting with Lamsono Commerc to SAN17ARY
u`,b1 I I�'+t�constmet the pmjen(Sec.7044,Business and Professions Code:)M Contractor,Li- \\+\+\\\U\ II'PfJII{Is\\Je\U)J'' \�\U'(/came law does not apply in an Owner of property who builds car improves daemon.and
.
who cnnuacLLfor such pmKcts wiNaconmcmr(s)Ilavetl pmsuanlm Ne ConuacmYs
Lice•en Law.
❑I am exempt under See ,B B P C for Nis mine
net Data
WORKER'S COMPENSATION DECLARATION
I hereby afftm under penalty of Perjury ane of the following declandons:
❑iWaw onowilllfor byaCertifinm of COnsemrsede.for fmWorkersCompen-
wran,r which
i this
for mi Secuon 3]00 of One labor Cade.(car Ns perfarmenco Of the
wont for which Nis permit is issued
❑I have and will mairrom Worker's Compensation Insulin,as required by Section
3700 of dm Labor Cade,fm Ne perfarmentt of the work for which this permit is Wood
My WorkM1 Compensation Insurance carter and Policy number am:
Carrier, Iry �C �MON ROO
ORK R
S'
COMPENSATION INSURANCE
,
,
(rho notion need wt W composed if tle permit is foram hundreddellars($100)
or less)
1 sent lost in the performance of dao work for which Nis permh is issued.Isbell not
employ any person in any memorm m N becomes subject to Ne Workers'Compensation - ..
Laws of California.Dada
Applicants
NOTICE TO APPLICA147:IL after making this CetRate of Exemption,you Mould
become subject to the Worker,Compensation previsions of the Labor Code,you must
.J O forthwith comply with such provision or this permit shall be deemed revoked.
z y CONSTRUCOON LENDING AGENCY
[••t 1 mushy alio Nn Nen it,comtrucdnn lending agency far One Performance of
!X> the work for which this Permit is loved(Sec.3097,Civ.C.)
dQ Iandcr's Name
n7. z Lender's Address
V Q 1 emtify that I have road Its application and new Nm Out,above Informed.is
ly F correct.1 agree in comply with all city and county^finances and slim laws miming in
Q V buildingconsuucran,and hereby authorise representativesofthia city to enmr upon the
Liz above-mentioned property for inspection purposes.
t�,vt a. (We)agree to sant,indemnify and keep barmiest the City of Cupatno gains,
is rA liabilities,judgment,,costs and expenses which may in any way accrue against midCity
OZ in consequence of the granting of this permit.
^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2— rr-f�
SOURC/ERJ�ULA NS.
Ssgnmurt or� dCOn aV'bea
s Dau Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will One applicmt or future building oecupantmme car handle hummi caudal
defired by the Cupertino Municipal Code.Chapter 9.12 and the Health ands!Safety
Section 25532(.)]❑Yes ❑No All roofs shall be inspected prior to any-roofing material being installed.
If a roof is installed without first obtaining an ins ection,I agree to remove
Will the applicant or futon building&&Paco use equipment Of devices which g P g
emit hantnus air conuminanu M defined by the Be,Arca Air Quality Management all new materials for inspection.
District]
❑Yee ON.
I have set the harm materials mquimmuits underChapmr6.95 of the Cables,
nu Health&SafmyCadc,Sections 25505,25533 and 25534.1 understand that if dm Wilding
does not currently haw a wort.that It 4 MY respectability to oOdIY One oecupmt Of Ne
mquimmenu�met poor to issmaceo acctificemuf Orcupm Signature of Applicant Date
Owner ter awhariacd agent a
®2"D.
g
All roof coverings to be Class"B"or better
m
CITY OF CUPERTINO (V 5
REPIPE/SEWER/MAIN SERVICE
CUPEkTiNO PERMIT APPLICATION FORM
APN#,3 (259 ,
5 ' l Date: /
Building Address: V
Yf O /
Owner's Name: Phone#:
Contract
Ph #:
eX Fax #:
ontact: Phone#•
Contractor License#:
Cupertino Business License#: (D
Job Description:
B
Residential Commercial ❑
Valuation:
�_
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
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial--P
/
IBSEIS MICR Seismic Residential P
1PRSEWER 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
1PPRSEWG Private Sewage Disposal System p 1RPWS
1PCESS Cesspool p
IBPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
IPGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets p
1PPERMITFEE Plumbing Permit Fee Issuance P
J 1PLMBLNCK Plumbing Plan Check P
/ 1PLMBINSP Other Plumbing gas Insp. P
i 1TRAVDOC Travel &Documentation Fee B
1BUSLIC Business License B
• CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37537052 . 00
DATE ISSUED. . . . . . . : 02/11/2008
RECEIPT # . . . . . . . . . : BS000003901
REFERENCE ID # . . . : 08G20056
SITE ADDRESS . . . . . : 10585 JOHANSON AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . . .
OWNER HENRY CAL
ADDRESS . . . . . . . . . . : 10585 JOHANSEN DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : PRO ROOTER INC.
CONTRACTOR . . . . . . . : JIN OH DBA PRO ROOTER INC LIC # 24097
COMPANY . . . . . . . . . . : PRO ROOTER
ADDRESS . . . . . . . . . . : 2306 AMERICA AVE #7
CITY/STATE/ZIP . . . : HAYWARD, CA . 94541
• TELEPHONE . . . . . . . . : (510) 670-1115
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
1BUSLIC FLAT RATE 1. 00 110.00 0. 00 110 . 00 0. 00
1PLMBLNCK HOUR 1. 00 122:38_ 0. 00 122 .38 0. 00
1PRSEWER UNITS 1. 00 20.40 0. 00 20.40 0. 00
1TRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ----------• ----------
TOTAL PERMIT 294 .07 0. 00 294 . 07 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------ --------------- -------------------
CHECK 294 . 07 #9394
---------------
TOTAL RECEIPT 294. 07
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ---------------------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
- "4iii as Family GreenPoint Checklist date 1 5 Build It Gmti
The GreenPoint Checklist is based on the various green features Incorporated Into the home and is N Strait Solutions from The Ground Up
lass for the GreenPoinl Rated program.A home ran be considered green 01t fulfills the prerequisflea, -�
eams at least 50 points,and meek the minimum points per category.Energy(30),Indoor Air Quality/
• Ha (5),Resources and Water(g).Please comas Build It Green for a list of qualified GreenPoint I_. _I�_ _ I i_ IF)
Ratemrsos It you are interested in pursuing third-party verification. - '
The green building practices listed below are described in the New Home Construction Green Building
Guidelines,available at waw lulidllorean.omas.
ENTER PROJECT NAME 0 E w i
o _
U a-
A 61TE2 Points Available Per Measure
1.Protect Topsoil and Minimin Disnrp5on o/Existing Plants h4rrevsjy
❑ a ProtectTgnoll from Erosion and Reuse after Construction _p t 7
❑ b.Limit and Delineate Construction Foo¢dnt for Maximum Protection 0 I 3
2.Deconabuct Instead of Demolishing Elating Buildings On Site 0 3
a.Recycle Job Silo Construction Words(Including Green Waste)
❑ aMinimum 50%Waste Diversion by Weight(Recycling or Reuse-Required 0
❑ b.Minimum 65%Diversion by Weight(Recycling or Rouse) p
❑ c.Minimum so%Divehi by Weight(Recycling or Reuse) p Z
4.Use Recycled Content Aggregate(Minimum 25%)_...-_ ---
❑_-
-- - a We" DMeway .. - _- _ p J
❑ b.Roadway Base - — 0 — 1-'--
Tot Point AvailableinSite=12 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cemem in Concreb with Recycled Flyesh or Slag
❑ aMinimum 20%Fiyash or Slag p J I
b.Minimum 25%FI ash or Slag p 1
2.Use Frost-Protected Shallow Foundation in Cold Areae(C.E.C.Climate Zone 16) 0 3
El 3.Use Ration Resistant construction(In At-Risk Locations Only) 0 1
4.Design and Build Structural Peet Controls
❑ a.Install Tenth Shields 6 Separate All E minor WoDd-ID Connections MSW a Plastic FastenerarDNMers _ 0 _ _ _ '__
Id.All New Flan%Have Trunk,Base,a Stem Located Al Least 36 Inches from Foundation 0-I 1
Total Pains Available In Fountlation e e 0
C.LANDSCAPING Points Available Per Measure
1,Construct Resource-EfOcknt Landscapes -
• ❑ a.No Invasive Species Listed by Cel-IPC Are Rented
❑ D.No Plant 5pB0196 Will Require Hedging p I I
❑ c.75%of Plans Are Drought-tolerant California Natives,Mediterranean,or Other Appropriate Species p,
2.Use Flr"afe Landscaping Techniques p 1
3,Minimize Tud Areas in Landscape Installed by Builder
❑ a AH Tud Will Have a Water Requirement Less than or Equal to Tell Famous(50.8 plamfactor) 0 _ r- 3
❑ b.Tud ShallNol Se installed on Slopes Exceeding 1D%a in Auras Leu than 6 Feet Wds p 7
❑ c.Tud is!M%of Landscaped Area(tonal2 points) --_0
❑ d.Tud is 51 D%of Landscaped Area botal4 point) p ------>
❑ 4.Plant Shade Tree p 3
77 5.Group Plant by Water Nods Hydrozoning) 2
6,Install High-Efficiency litigation Systeme
❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low4low Sprinklers 2
❑ b.System Has Smart Controllingroo 3
7.Incorporate Two Inches of compost in the Top 6 to 12 Inches of Soft _ 1 g
Lj 8.Mulch All Planing Bede to the Greeter of 2lnches or Local Water Ordinance Requirement 10 2
g.Use 50%Salvaged or Re Bled-Content Materials for 5D%of Non-Plant Landscape Elements 1
10.Reduce Light Pollution by Shielding FlsWrea motor Directing Light Downward 101 1LLI
Tonal Point Available in Landscaping=31 0
D.STRUCTURAL FRAME R BUILDING ENVELOPE Poing Available Per Measure
1.Apply Optimal Value Engineering
❑ a Place Rafters and Studs at 244ncn On Center Framing
❑ b.Size Door and Wmtlow Headers for Load
❑ c.Use Only Jack and Cripple Studs Required for Load_ - -1 -?
2.Use Engineered Lumber LJ'
❑ a Beams and Headers p 1
❑ In.Insulated Engineered Haddam -�� -FT—
c.
c.Wood IJol or Web Trusses for Floors
❑ d.Wood l-Joints fa RDol Rafters _ 0 _ __
❑
D.Engineered or Finger-Jdmled Surds for Vertical Applications .D r
❑ f.Oriented Strand Board fa Subflocr 0
❑ g.Oriented Strand Board for War and Roof Sheathing 0 1
• ].Lee FSFColWood
❑ e..Dimensional Lumber,SNds and Timber.Minimum 40% 0 2
❑ d.Dimensional Lumber,Studs and Timber:Minimum 70%
❑ c.Panel Products:Minimum 40% --p---- -- _ -'
❑ d.Panel Produces:Minimum 70% 0
1
02Do7 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
ENTER PBOJECT NAME R 0
Hui
ti
4.UN Solid Wall Systems(includes SIPS,ICF4 6 Amy Man•6tick Frame Assembly)
❑ s Floors D 2 2
El b.Wane o z _
El c,Roofs D 2 _
S.Reduce Pollution Entering the Home from the Garage
❑ B.Tilmy Seal the Air Basler between Garage and Living Area _ D _ ]
❑ b.Insall Gare a Exhaust Fan OR Build a Doli Geroge D ]
Lj 8.Design Energy Heels on Trunnion,(75%of Adie Insulation Height st Outside Ede of Egador Wall) 0 1
7.
Design Roof Trueness to Accommodate Ductwork ' D 1
Is,Use RerycletlLon and Steel Studs for 90%of Interior Wall Forming 0 1
9.n..w Mau Willis:SAI-Inch Drywall on All Interior Wells or Wells Weighing mora than 4D lb/i D 1
10,Install Overhangs and Gutters
❑ a Minimum 164nsh Overhangs and Butlers _ g _ 7
❑ b.Minimum 24-Inch Overhangs and Gutters g 1
Total Points Available In Structural Building Frame and Envelope.36 D
E.EXTERIOR FINISH Points Available Per Measure
1.Use Recycled-Content No Virgin Ploi or FSC-CeNgod Wood Docking 0 2
t Install a Rein Sereen Well System 0 2
—dui Durable and Noncombustible Sid!n Materials 0 1
LSelaer Durable end Noneombuctihls Roofing Materials D 2
Taal Points Avalli in Exton Finish.7 D
F.INSULATION Points Available Per Measure
1,Install Insulation with 75%Reryded Content
❑ a Walls endo,Flows 0 7
❑ b.Collins
2,install Insulation that Is Low-Emitting(Certlflad Section D1350)
❑ e,Walls angor Floor; 0
❑ b.Cantu -a
o i
9.Inspect Duality of Insulation Installation before AFpti Drywall 0 1
Total Points Avaclable In Insulation.5 0
O.PLUMBING Points Available Pat Measure
1.Dami Do=bc Hot Water Efficiently(Maximum 7 Points)
❑ a Insulate Hot Water Pipes from Water Heater to Kitchen 0 7 ]
❑ b,insulate All Hot Water Pipes _]
❑
C.Use Engineered Parallel Piping _ 0
❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0 7
❑ e,Use Structured Plumbing with Demand Controlled Circulation Loop 0 _ 1 _ _ _ 2
Elf.Use Central Core Plumbln 0 ] 1 2
El 2.Install Only High Efficiency Tollate DuaFFlush or 5138 D 4
Tote)Points Available in Plummin .TOW 12 0
H.HEATING VENTILATION&AIR CONDITIONING Points Avalhdtia Per Measure
1.Design and Install HVAC System to ADCA Manuel J,D,and S Recommendations 0 4
2 Install Soled Combustion Units
❑ aFumres D _ _ _ _ 2
❑ b,Water HBaran 0 2 '
9.Install Zoned,Hydronlc Radiant Heading with Slab Edge insulation D 1 1
4.Install High Efficiency Air Conditioning with Envlmnmentetly Responsible Refrigerants D 1
S.Design and Install Effective Ductwork
❑ a.Install HVAC Unit and Ductwork within Conddionad Space _ 0 _ 3 _ _ _ '
❑ b,Use Dud Magic on All Dud Joints and Seems 0 _ - 1
❑ c.losing Ductwork under Ago Insulation(Buried Duds) 0 _] _
❑ d,Pressure Balance the Overwork System _ g _ 7 _
❑ a.Putted Ducts during Construction and Clean Al Ducts before Occupancy, 0 1
LJ 6.Install ISgh Emcian HVAC Fllter(MERV 6� 0 1
❑ 7.Don't Ineteli Flreplap or netell Sealed Gac Flnplaees with EMreienry Rating Not Lesa Than 60% 0 1
using CSA Standards
B.Install Effective Exhaust Systems In Bathrooms and Kllchens
❑ a.Install ENERGY STAR Bathroom Fans Vented to the Outside _ _0
❑ b.All Bathroom Fans Are on Timer or Humidistat _ 0
❑ C.Install Kitchen Range Hood Vented to the Outside D ]
Q.Insall Mechanical Ventilation System for Coonng(Maximum 4 Points)
❑ a.lnstes ENERGY STAR Calling Fans a Light Ku in Living Ana S Bedroom D
❑ b.Inches Whole House Fan with Variable Speeds D ]
❑ c.Automatically ComWad Integrated System - U- Z -
❑ d.Automatically Connected Integrated System vdth Variable Speed Control 0 3
1 D.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ e.Any Whole House VenIDatlon System That Meats ASHRAE 82.2 0 2
❑ b.install Air-io-Alr Heal Exchanger that meets ASHRAE 622 0 7 2
11.Install Carbon Monoxide Alarms) 0 1
Total Points Available In Hot Ventllatlon and AV Conditioning.30 0
0 2007 Build It Groan Single Family GreenPolnt Chi 2007 Version Pago 2 of 4
ENTER PROJECT NAME c
• I.RENEWABLE ENERGY Points Available Pat Measure
i.Pre-Ptumb in,Soler Hot Water Heading 0 ( 4
2.Install Solar Water Heading System71 0 10
9.Install Waring Conduit for Future Photovoltaic Installation A Provide 200 iP of South-Facing Root p 2
4.install PhotowNeic(PV)Panels
❑ a.30%of electric needs OR 12 kW(totals points) 0 F
❑ b.So%of electric needs OR 24kW(total 12 points) -p -
_
❑ C.90%a eledno Deed OR 3.6 kW(htal 16 points) 0 6
Total Available Points In Renewable Energy=2B 0
J.BUILDING PERFORMANCE Points Available Per Measure
1,Diagnostic EVelsetion¢
❑ a House Paves Blower Door Test 0 1
b.House Pen Combustion Salary BackdraATest p
2 Design and Build High Pedormanoe Homes-%above The 24-minimum 15%Required 0 >_30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Cenification-Pliot Measure(Total 45 pointy,reed rommen) 0 5 2
Total Available Points in Bulldin Pedormanca=39 0
H.P—1.DidfiiPoints Available Per Measure
1.Desgn Fslryweyeto`ReduesTracketl in`Conisminenta—- -- - - p - - 1 - -
2 Use Low-VOC or Zero-VOC Point(Maximum 3 Points)
❑ a Low-VOC Imeda Waditwin Paine
g (60 gDl VDCs(Flap and 450 gpl VOCs(Non-Flat)) --- - p
❑ b.Zero-VOO Interior Wall/Celfin Paints(<5 0 VOCs(Flat)) 0 3
❑ 3.UN Low VOC,Water-Besed Wood Finishes O o I VOCs) 0 2
4.Uce Low-VOC Caulk and Construction Adhesives(Oil got VOCs)for All Adhadve, 0 2
❑ 5.Use Rerycled-Content Paint
0 1
S.Use Environmentald Profitable Machinists for Interior Finish:AJ FSC-Certlfietl Wood,8)Redefined,C)Rapidly Renewebl4 D)RerydetlLontent
or E)Finger-Jointed
❑ a.Cabinets(50%Minimum) 0 1
❑ b.Interior Tnm(50%Minimum) --0 --
❑,' c.ShelAng(50%Minimum)
-�
❑ d.Doors(SD%Minimum)
❑ 1 e.Counten 50%Minimum � _0D 7
• ].Reduce Formaldehyde
mads Interior Finish(CA Section 01350) ---- -
❑ aSubtoorABialr Treads(50%Minimum)
❑ b.Cabinets 6 Countamps(50%Minimum) n- f
❑ c.Interior Trim(50%Minimum) -- �—
❑ d.SheNin 50%Minimum) 0 - - ---- ----
A.Alter InM¢IIeH 0 1
❑ on Minimum)
Test of Indoor Air Show¢Formaldehyde Level Q7 b
0 3 ,
Total Available Points in Finishes=21 0
L.FLOORDMO ppinls.4vailable Per Iddazure
1.Use Environmentally Preferable Flooring:A)FSC-CerMied Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Reryded-C mm�t,E)
Exposed Concrete Flooring Adhesives Most Nava c50gpi VOCs.
❑ a.Minimum 15%of Flom Area 0
❑ b.Minimum 30%DI Floor Area —"� ----"'_"—''- -'--
.❑ c.Minimum 50%a Floor Area 0 '— -"— --
_1
El d.Minimum 75%aFloor Area0' ---- - ---
0
❑ 2 Thermal Mev Floors:Floor Covering Other than Ca Mon 50%or Mon of Concreteg Floors p � 1
17-3 Feeling Meats Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 z
Taal Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Pants Available Per Measure
1,Insist Weser and Energy Efficient Dishwasher
❑ a.ENERGY STAR potal l poinp 0
❑ d Dishwasher Uses No More than 6.5 Gellonsr cle total 2 points) 0 �- 1
,2.Install ENERGY STAR Clothe Washing Machine with Wets Factor of 6 or Less
❑ a Meets Energy Star and CEE Tier requirements(modffad energy factor 20,Water Factor ED)(total3 pants) 0 g 2
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 22,Water Factor U a lace) ---�- — 2 -"
Irial5 dints 0
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Duellist!A<25 Cubic Feet Capacity p 1
❑ b.ENERGY STAR Oualifietl A<20 Cubic Feat Caped -p --"—T-'-
4.Install
Bd114n Recycling Canter 0
❑ a.Built-In Recycling Center
❑ b.Built-In Composting Center 0 ----- --
0
Total Avallaole Points in Appliances and Lihtn =12 0
N.OTHER Pants Available Per Ivleasur2
❑ 1,Inroryonte CreenPoint Rated Checklist in Blueprints-Aequired 0 R -
• ❑ 2 Develop Homeowner Manuel of Green FeaturesrBenefb 0 1 1 1
3.Community Design Measures A Local Priorities:See the Community Planning A Design section in Chapter 4 of the New Home Guldelines for
measures,Maximum of 20 points for suggested measures.Local requirements may also be listed here.
❑
02DO7 Build It Green Single Family GmenPoint Checklist 2p07 Version Page 3 of 4
PROJECT
• mum-
ENTER
s
Emn dasiondbon hen,and mass pointe"ante to meson in elprapriae caeporin to the dgk 0 0 0 0 D D
Enter desorption hear,andcan pomp ovatahanes m
e la moppropmes caftoda,to the righ. 0 0 0 0 D 041
Enter dacriplim ham,and snare points na0eble IN meawre In appropriate caagoriei to the right. D 0 0 0 D
❑ Enter dontiptirn hen,and anter points avellsole far measure in appropriate categories to he right 0 0 0 0 0 0
4.Innovation:List innovative measures that meet the preen building objectives of the Guidelines.Enter up to a Build it Green Checklists and
maximum combined total of 20 one.See Innovation Checklist for suggested measures,using the link to the right, Guidelines
Innovation In Cominumbir.Erne da 'on hon,and aare points evanhe to museum In appropriate Categories to she rigid. 0 0 0 D 0 0
Innovation In Enor .Enter deet tion hem,ad enter points evaluable In measure In Ian catB Blas to the rl h. 0 0 0 0 0 D
Imovalim IME IAOMaIM:Enter deo Ion here,and Near points ava0eoe in menun in appropriate categories to tie tl t. D 0 0 0 0 0
Innovation In Resources:Einer aberration tion here,and ends walahe la menun m 'ate cats rise ID the 0 0 0 0 0 D
Innovation in Weer.Entre dicta prim hen,ea arses pdra avaiehe lu menun a appropriate categories a the right. 0 0 0 D 0 D
Thal Available Points in Other 43 0
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories O SO S 8 9
o e e e e e
71—t
use not yet met the following recommended minimum rastalrements: -
- Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-32: 15%above Title 24
-MS:Incorporate GreenPoint Rated Checklist Into blueprints
•Minimum points In specific wregories:
-Energy(30 points)
-IAQ/Health (5 points)
-Resources(6 points)
-14rater(9 points)
•
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 4 04
e Community Development
10300 Torre Avenue
tI Cupertino CA 95014
Telephone(408)777-3228
4tCITY OF Fax(408)777-3333
UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: W VPHONE d
GENERAL CONTR CTO . ems, F # j2 m (3o -
(9) 670"��
I am not using any subcontractors: \c4vo
Signature Date
Please check applicable subcontractors and complete the following information:
60 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
®2 i o
Owner/Contractor Signature Date