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08030125CITY OF CUPERTINO�l,�Yr'a) ' `"7��"��`'{`Q-�11 BUILDING DIVISION PERMIT *+x��i\?lid['���,3'1kaTM� i'^$•�a^ �*� �� +1'' BUTTON g HN DR d DRESS:JO DRAIN DOCTOR PERMIT NO. 08030125 R'S NAME: PERA4I ISSUE DATE SESSOMS JOHN G ET AL 1775 WINCHESTER BLVD 03/24/2008 PHONE: SANITARY NO. CONTROL NO. (408)370-3082 ARCHITECfrENGINEER: BUILDING PERMIT INFO BLDGEIPCf PLUMB MECH I� I� I� LICENSED CONTRACTOR'S DECLARATION lob Description P 1 Mosby anrm Our 1 son mcesed under provisions of Chapter 9 (commencing with Sac"ora 701111) oraiNaon3ord. Businmand mfmiglf)oye�d Bmomla INSTL CITY CLEAN—OUT TO CITY USE in fore fo.m ad efcQ. S 71'`• Liceose conn Date - contractor ARCHIIECrS DECLARATION I undcmhand my pluu shall ed used a WElic mord! Licensed professional OW NER-BUILDER DECLARATION I Icreby alum that 1 am uempl from the Canuane'i License Law for the following moon. (Section 7031.5, Business and professions Cade: My city or county which dOoru • Permit to cmcmuct. abet. improve, dere led, or.pair any structure prior m its issuance, Wm mqulres the applicant far such permitan file signed atsremenl- he is thement to the of that Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that pursuant provisiona $2700 (commando{ with Section 7000) of Division 3 of the Business and profession! Code) or that he is amoursmQarrom and the bull for the alleged exemption. Any violation of Aff Number 36923003 Occupancy Type fo 1.5 by M' applicant forpermit anbjm:Qa "re applicant m •civil penalty of Sectionthan act nnl come than Ow hundred dollars O 1, a owms or"ie property, a my wployeu with wa{u u their rola eompmua"an. Required Inspections aowdu CdtheshNmurecmn's 11 hotm- weer Or and Profession"Code: The Canvamars I,iml. law don rd stet and apply q P or f is aropenywd bulprovid mprawchvmprove ets aosesuchwmk himulfm Woo{h his property, who dual such improvements am not ln¢ndd moRemd for sale B. owe employees.providedor ' however. Nebo, arimpmlewoil cold meyersir completion. mhLCwm of sadQ MO Nw, tis hddea of posting this K did vel WIC a improve for puryose of ft did iso as concocting with Icenud conowmon u ❑ L u ower N papery. .B umm Y and the pmjeQ (Sec. 7110x, Businm and RafelaoN Cede:) The Contractors V- cons. a TAR, ceuo [sive doe! not apply b an owner of propenY who Wilds or improve thCRan. and, e who contracts far such projects wins aconuaveds) licensed purvunt m the Comamm's SAN m Law. ❑l.meempl undo See ,BkPCfor this mown [3 1 nsr Damn WORKER'S COMPENSATION DECLARATION 1 Mmby aflm under penally of perjury ane or the following declarations: ❑ 1 bow and will malnWn • CQtificareaf Cotmnt m aelf•INu. forWarkeYl Compo- utinn. u provided fm by Section 37011 of the Labor Code, for use performance of the work for which this permit is issued ❑ 1 haw and urill maintain Worker! Compensation Insurance, as mqu'ued by Session 3700ofthe Labor Ca .fathepeaaman ofthewmkfm wblchthcpremki.1-t d. My WarkQ's Campudan lwrannumbQ a.: �� f.'a111Cf'. �. No.: ) CERMET TE OFEXEMPTION FROM WO E0. COMPENSATION INSURANCE CThts section most wtbecmnphand Bmhe permit l! faanc hundred dollars ($1011) or less.) ' 1 modify the, In the performance or the work for which this panels Is issued. l shall not employ any person In any manner an as m become subject te the Worked Compensation Laws of California. Dam Applicant NOTICE TO APPLICANC If, after making this Cerinere of Exemption, you should become subject to mho Wo, r s Campemtion provisions of the Labor Code you most • forthwith comply with .eh provisiom or this permit shall be dcencd nevoked ) CONSTRUCTION LENDING AOBNCY I hemby afrm"ft. is a coubmtinn coding agency far the poor.. of ' doe wh for which this prlmit is Wood (Sec. 3097, Clw. C.) ' Lender's fandn':Address 1 modify that I have read this .yplie"on and share than the above Information c ' Corset I gnat m comply with all city and county adimmess, and same laws mixing to building cunauuctlon, and hereby women. representatives of this city as an One "c 1 abom-men"omrcd property for inspection purposes (We) agree la Lw, Indemnify .d kQp harralm mC City of Cortaro. MmNl j Ilabllitie,IodgmenW casts and expenses which may in any way accrue Maim, mid city • in con. vence sir the dwllln Wia r ' APPLICANT R D '>LND ILL COMPLY WITH ALL NON -POINT Issued by: Date �_4� SOURC GUL N +' ��� Re -roofs Type -of Roof �c �� _/L--' Si{m A IIca HAZARDOO US MATERIALS DISCLOSURE HAZARDOUS WIII the applicant m(Mouebuilding a. sometimesmaterial Chapter 9Amand dennd by the Cupertino Modules) Coda. Chapter 9.12, and "c Hearth and Safety .Section.532(.)7 �N^ ❑ Yca All roofs shall be inspected prior to any roofing material being installed. /`^ If a roof is installed without firs[ obtaining an inspection, I agree to remove Will the applicant m fumm building occupant um equipment or devices which mail huardow air comaminanma as dcfioc l by Uha Bay Ama Air Quality MmMmOnl all new materials for inspection. District? .L,.��� ❑ Ye C I have mal the hnndms material requirements under Chapter 6.95 of the Caifar- ail Health St Safety Code, Sac" 25505,25533 and 25534.1 oodcmtsnd that lflhc building Imdfy mmurn of me dais of cumntly ha4r.6,tW t II is my respomiNiny m the a req"I. to iuuanmo ora Cenift 55 Signature of Applicant Date a All roof coverings to be Class'" or better owner r or a"me t(///�'C—. • CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36923003.00 DATE ISSUED.......: 03/24/2008 RECEIPT #.........: BS000004237 REFERENCE ID # ...: 08030125 SITE ADDRESS .....: 6756 JOHN DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: SESSOMS-JOHN G ET AL ADDRESS ..........: 6756 JOHN DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 METHOD OF PAYMENT AMOUNT ----------------- --------------- CHECK 212.48 TOTAL RECEIPT : 212.48 VOICE ID DESCRIPTION -------- ---------------------------- 106 SEWER & WATER 301 ROUGH PLUMBING 507 FINAL PLUMBING • REFERENCE NUMBER -------------------- #16669 VOICE ID DESCRIPTION -------- ---------------------------- 202 UNDERFLOOR PLUMBING 400 SEWER/LATERAL RECEIVED FROM ....: DRAIN DOCTOR CONTRACTOR .......: JOHN H. LIM LIC # 24784 COMPANY ..........: DRAIN DOCTOR ADDRESS ..........: 1775 WINCHESTER BLVD CITY/STATE/ZIP ...: CAMPBELL, CA 95008 TELEPHONE ........: (408)370-3082 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BSEISMICR ------------- ---------- VALUATION 2,700.00 -------------------- 0.50 ---------- 0.00 0.50 ---------- 0.00 1BUSLIC FLAT RATE 1.00 110.00 0.00 110.00 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 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 ---------- ---------- 212.48 ---------- 0.00 212.48 ---------- 0.00 METHOD OF PAYMENT AMOUNT ----------------- --------------- CHECK 212.48 TOTAL RECEIPT : 212.48 VOICE ID DESCRIPTION -------- ---------------------------- 106 SEWER & WATER 301 ROUGH PLUMBING 507 FINAL PLUMBING • REFERENCE NUMBER -------------------- #16669 VOICE ID DESCRIPTION -------- ---------------------------- 202 UNDERFLOOR PLUMBING 400 SEWER/LATERAL 42 CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE OF • CUPERTINO PERMIT APPLICATION FORM 4 APN #,2 ( 9a 3 © 03 v 6 Date: Building Address: Fee Group V//Ir! -,Tokh by Owner's Name: I r S -e SS ° M S Phone #: > )-0/ Contractor: D r� I h n rL� Y Y Phone #: a 7� / o n o 03 Fax #: 7'b ,7 Contact:/ Cb ah C�jM Phone #: P 7ol1-835 1CPRP Fax#: Contractor License #: /� 3 4-�- � Commercial Gas Piping System 1-4 Outlets Cupertino Business License #: I Job Description: c74� C1 vj 6' L4 C us-� Seismic Commercial P Residential Commercial ❑ Valuation: 1BSEISMICR Green Building Check list must be completed and attached to this application. Green Building Points: Quantity Fee ID Fee Description Fee Group Permit Type 1PCSEWER Commercial building sewer/sanitary sewer P 1CPSS 1BPREPIPE Commercial re -pipe per fixture P 1CPRP 1PGASCOM Commercial Gas Piping System 1-4 Outlets P 1BSEISMICOM Seismic Commercial P 1BSEISMICR Seismic Residential P / IPRSEWER Residential building sewer/sanitary sewer P 1RPSS CUPEkTINO CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type IPRREPIPE Residential re -pipe per fixture P 1RPRP 1BPWSVCS Water Service P 1CPWS or IRPWS 1PPRSEWG Private Sewage Disposal System P IPCESS Cesspool P IBPWATER Install/alter Water Pipe P 1BPFIXTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System 1-4 Outlets P IBPGAS Gas Piping System 5+ Outlets P IPPERMITFEE Plumbing Permit Fee Issuance P 1PLMBLNCK Plumbing Plan Check P IPLMBINSP Other Plumbing/gas Insp. P ITRAVDOC Travel & Documentation Fee B IBUSLIC Business License B s • 0 Single Family GreenPoint Checklist date: �-2 Build It Greed The GreenPoint Chaddist is based on the various green features incorporated Into the home and Is the Smart Solutions From The Ground Up deals for the GreanPolm Rated program. A home can be considered green It it fulfills the prerequisites, • Hams at least SD pointe antl meets the ). Please points Per category: Energy list of Indoor Air rDemPyF � Hsegh (BI, Resources (6), Hntl Water (B). Please tooted Build It Green for a list of qualified GreenPoint Retire If you are Interested In pursuing third -party verification. The green building prances listed below are described in the New Homs Construction Green Building Guidelines, available at wwwbuilditimi an.Oro. • • B. FOUNDATION // Points Available Per Measure ❑ ❑ 1. Replan Portland Cement in Concrete with Recycled Flynn or Stag a Minimum 20% Flynn or Slag b. Minimum 25% Flynt or Slag ❑ ❑ Elc. 1. Construct Resource -Efficient Landscapes a No IMESNe Species Listed by Cel -IPC Are Plamatl b. No Pam Species Will Require Hedging 75% of Plains Am Drought -mint m California Natives, Mediterranean, a Other App iodats Species p 0 3 ! 1 ❑ 2. Use Frost -Protected Shallow Foundation in Cold Auras (FEC. Climate Zona 16) 0 I I 3 ❑ D. Use Radon Rmisbnt Construction Pn At -Risk Locations Only) 0 0 ❑ a, Design end Build Swctuml Pest Controls a. Install Tamm Shields & Separate All Estador Wood -to -Concrete Connectors by Metal or Plastic Faslsnwsumdars ❑ El ❑ ❑ d. Minimize Turf Aram in Landscape Installed by Builder a, All Tud will Have a Water Requirement Less than or Equal 10 Tell Fescue (SCe Alam factor) b. Tud She Not Be Installed on Slopes Exceeding 10% or in Areas Less than a Feel Wada C. Tud is 533% M Landscaped Area (Mml 2 points) d. Turf is SIC% of landscaped Ams Proal 4 poims) 0 0 0 0 —0 �_ __' ! _ b. All New Plants Have Trunk, Bass, or Stem Located Al Least 35 Inches from Foundation ❑ 4. Plant Shade Trees D. STRUCTURAL FRAME & BUDDING ENVELOPE // Points Available Per Measure ❑ ❑ Elc. 1. Construct Resource -Efficient Landscapes a No IMESNe Species Listed by Cel -IPC Are Plamatl b. No Pam Species Will Require Hedging 75% of Plains Am Drought -mint m California Natives, Mediterranean, a Other App iodats Species /p i ❑ 0 _ _ J lip �, j 1 ❑ 2 Use gteSefe Landscaping Techniques e(± ❑ b. Size Door and Window Headers for Load ❑ El ❑ ❑ d. Minimize Turf Aram in Landscape Installed by Builder a, All Tud will Have a Water Requirement Less than or Equal 10 Tell Fescue (SCe Alam factor) b. Tud She Not Be Installed on Slopes Exceeding 10% or in Areas Less than a Feel Wada C. Tud is 533% M Landscaped Area (Mml 2 points) d. Turf is SIC% of landscaped Ams Proal 4 poims) - -- 0 0 0 —0 �_ __' ! _ 2 2 p 2 ❑ 4. Plant Shade Trees - 0 }y j� 3 ❑ 5. Group Plants by Water Needs drozonin) 0 _ 2 ❑ ❑ ❑ B. Install High -Efficiency Imigation Systems a. System Uses Only Low -Flow Drip, Bubblers, or Low -bow Sprinklers b. System Has Smad Controllers 7. Incur orb Two Inches of Compost In the Top 6 to 12 Inches of Soil - ❑ 0- �,� _ L 2 0 0 %� 3 ❑ B. Mulch All Planting Bells to the Greeter of 2Inches or Local Water Ordinance Requirement 0 I I I 2 9. Use 5D% Salvaged or cledContant Materials for 50% of Non -Plant Lantlscepe Elements 0 I 1 ❑ ❑ 10. Reduce Light Pollution W Shieldin FlYWrcs antl/or Oirectln Li hl0mmward o 1 I ❑ D. STRUCTURAL FRAME & BUDDING ENVELOPE Points Available Per Measure 1. Apply Optimal Value Engineering /p ❑ a. Place Rafters and Studs at 24 -Inch On Center Framing ❑ b. Size Door and Window Headers for Load ❑ c. Use Only Jack and C Ppe Studs Required for Load—_ - 2. Use Engineered Lumber ❑ a Seems and Headers ❑ b. InsulWood btl EnsorWeb HBatlws ❑ ❑ ❑ C. Wood -JOISb WWei1Trusses fix Fgpm d. Wood I -Joists for Fact Rafters e. Engineered or Finger -Jointed Studs for Vertical Applications 0 D -- 1 ❑ I. Oriented Strand Board for Sublim 0 -- ___ ❑ g. Crandall Strand Board for Wall and Root Sheathing 0 3. Use FSCCeNfied Wood ❑ a Dimensional Lumber, Studs and Timber. Minimum 40% 0 2 ❑ b. Dimensional Lumber, Studs and Timber. Minimum 70% p ---- 2 ❑ c. Panel Products: Minimum 40% I ] E]._o d. Penal Products, Minimum 7096 - 02D07 Build It Green Single Family GreanPolm Checklist 2007 Version Page 1 of 4 H. HITATING VENTU ATION R AIR CONDITIONING Points Available Per Measure 1. Design and Install HVAC System to ACCA Manuel J, D. and S Recommendations 0 4 1 L Install Sealed Combustion Unit ' U 0 _ _ _ _ — _ 2 2 11 ❑ a. Furnaces ❑ b. water Haxtt Y Install Zoned, Hydronic Radian Heading with Slab Edge lnsuletion 0 1 1 /. Install High Efficiency Air Conditioning with Envlronm atolly Responsible Refrigerant 0 1 S. Design and Install Effective Ductwork _ -0- _0 _ 1 3 _ ❑ e. Install HVAC Unit and Ductwork within Conditioned Space _ ❑ b. Use Dud Mastic on All Dud Joint and Seams ❑ ❑ ❑ c. Install Ducwrk under Attic Insulation (Burled Duct) d. Pressure Balance the Ductwork System e. Protect Dude during Construction and Clean All Duda before OMUPoncy U 0 1 El 6. Install High Efficiency HVAC Filter MERV 6a 0 1 i ❑ 7. Don't Install Fireplace or install Sealed Gas Fireplaces with EBidency Rating Not Less Than 60% using CSA Standards 0 1 B. Install Effective Exhaust Systems In Bathrooms and IOtchens ❑ a. Insist ENERGY STAR Bathroom Fans Veined to the Outside ❑ b. All Bathroom Faro Are on TimM or Humidstat - _ r — ❑ c. Irrotll Kitchen Range Hood Varied to the Outitle 0 I s. install Mechanical Vandlstion System for Cooling (Maximum a Point) ❑ a. Install ENERGY STAR Ceiling Fans a Light Kits In LNing Ates S Bedrooms ❑ It. Install Whole House Fan with Variable Space ❑ c. Automatically Controlled Integrated System ❑ d. Autocratically Controlled integrated System with Variable Speed Control 0 3 10. Install Mechanical Fresh Air Ventilation System (Medmum J Point) _0 _ 2 ❑ a. Any whale House Ventilation System That Meets ASHRAE 622 ❑ b. install AIMPA4 Heal Exchanger that meets ASHRAE 82.2 0 1 2 11. Install Carbon Monoxide Alermle 0 1 Total Points Avelloble In Heurng Ventilation no Mr Gonomoning .3D 1 0 1 02D07 Build It Green Single Family Greor Polnl Checklist 2007 Version Page 2 of 4 • Total Available Points In Renewable Enemv=28I 0 1 J. BUILDING PERFORMANCE Points Available Pel Measure Points Available Par Measure 1. Diagnostic Evaluation& ' 1. Design Entryways to Reduce Tracked in Conteminents ❑ a. House Passes Blower Door Test _ 0 _ I ❑ b. Hoose Faces Combustion Solely BackdmftTest 0 ] ❑ LMinimum l5%0 Floor Area PROJECT NAME L Low-VOC ImedOr WeIVCeifng Paints (d0 0 VDCs (Flat) and c1 5D gpI VOCs (Non -Flat)) 2. Design and Build High Performance Homes -%above Title 24 -minimum 15% Required 2t30 _ 0 ,ENTER 6 2 E]3. House Obtains ENERGY STAR with Indoor Air Package Certification - Pilot Meastiure t 45 poin% read comment) 0 ❑ I. RENEWABLE ENERGY 0 - 2 Points Available Pet Measure LJ 7. Pre -Plumb tot Solar Hot Water Heating 0 2 4 ❑ S. Use Rerycled-Contend Paint 2, Install Solar Water Hoofing stem 110 1 S. Use Environmentally Prefineble Materials for Interior Finish: A) FSC -Certified Wood, B) Reclaimed, C) Rapidly Renewable, D) Rerycletl-Content 77 9. Install Wiring Conduit for FUWre Photovoltaic instillelion & Provide 200 f i of South -Facing Roof 0 2 0 4. install Photovoltaic (PV) Panels ❑ a. Cabineb(50%Minimum) 0 ❑ ❑ a. 30% 01 electric needs OR 12 kW (total 6 points) 0 0 ❑ b. 80% W Mod 1, needs OR 2.4kW (total 12 points) 0_ 6 ❑ E] c, 90% of electric need OR 3.6 kW (total 1B pointe) 0 6 e. CounleRms (50% Minimum) Total Available Points In Renewable Enemv=28I 0 1 J. BUILDING PERFORMANCE Points Available Pel Measure Points Available Par Measure 1. Diagnostic Evaluation& ' 1. Design Entryways to Reduce Tracked in Conteminents ❑ a. House Passes Blower Door Test _ 0 _ I ❑ b. Hoose Faces Combustion Solely BackdmftTest 0 ] ❑ LMinimum l5%0 Floor Area 0 L Low-VOC ImedOr WeIVCeifng Paints (d0 0 VDCs (Flat) and c1 5D gpI VOCs (Non -Flat)) 2. Design and Build High Performance Homes -%above Title 24 -minimum 15% Required 2t30 _ 0 ❑ 6 2 E]3. House Obtains ENERGY STAR with Indoor Air Package Certification - Pilot Meastiure t 45 poin% read comment) 0 Total Available Points in Building Pelormance=3a 0 K. FINISHES - - Points Available Par Measure 1. Design Entryways to Reduce Tracked in Conteminents 0 1 ❑ Ecposed Concrete. Floodog Adhesives Must Have c50 Sol VOCs. 2 Use Low-VOC or Zero-VOC Paint (Unimum 3 Points) ❑ LMinimum l5%0 Floor Area ❑ L Low-VOC ImedOr WeIVCeifng Paints (d0 0 VDCs (Flat) and c1 5D gpI VOCs (Non -Flat)) ❑ b. Minimum 30% of Floor Area _ 0 ❑ b. Zaro-VDC: Interior WaIIICaIIb Palmed gpi VOCs (FIO) 0 3 _ I 1_ ❑ 3. Use Low VOC, Water -Based Wood Finishes (260 gpl VOCs) 0 - 2 ❑ ❑ 4. Use Low-VOC Caulk and Construction Adhesives (OO pl VOCs for All Adhesives 0 2 3. RDovInp Meets Section 01350 or CRI Green Label Plus Requirements (5o%Mnimum) ❑ S. Use Rerycled-Contend Paint 0 a. ENERGY STAR Qualified & <25 Cubic Feet Capacity 1 S. Use Environmentally Prefineble Materials for Interior Finish: A) FSC -Certified Wood, B) Reclaimed, C) Rapidly Renewable, D) Rerycletl-Content ENERGY STAR Ouel'Mad & <20 Cubic Feet Ca aci 0 I or E) Anger -Jointed 0 ❑ ❑ a. Cabineb(50%Minimum) 0 ❑ h Built -In Composting Cantor ❑ In. IntahorTrim (50% Minimum) 0 ❑ c. Shelving (50% Minimum) 0 ❑ d. Doors (50% Minimum) __ 0 ❑ e. CounleRms (50% Minimum) 0 ! ] 7. Reduce Formaldehyde In Interior Finish (CA Section 0135D) ❑ a. Subfioor It Stair Treads (5D% Minimum) 0 _ ___ ❑ b. Cabinets & Countertops (50% Minimum) _ _ 0 ❑ c. Interior Trim(50%Minimum) ❑ d. SheNin (50%Minimum) 0 1 ❑ 5. After Installation of Finishes, Test of Indoor Air Showa Formaldehyde Level Q7ppb 0 ! 3 Total Available Points In Finishes =211 0 L. FLOORING - Points Available Per Measure 1. Use Environmentally Preferable Flooring: A) FSC -Certified Wood, B) Reclaimed or Refinished, C) Rapidly Renewable, D) Rerycled-Contanq E) ❑ Ecposed Concrete. Floodog Adhesives Must Have c50 Sol VOCs. 0 ❑ LMinimum l5%0 Floor Area 0 I 1 ❑ b. Minimum 30% of Floor Area _ 0 ❑ c. Minimum 50% cd Floor Area 0 _ I 1_ ❑ d. Minimum 75% of Floor Area 0 1 ❑ 2. Thermal Mass Floors: Floor Covering Other than Carpel on 50% or More of Concrete Floors 0 1 ❑ 3. RDovInp Meets Section 01350 or CRI Green Label Plus Requirements (5o%Mnimum) 0 Z 1 Total Available Points in Flooring =7 D M. APPLIANCES AND LIGHTPNG Points Available Par Measure 1. Install Water and Energy Efficient Dishwasher ❑ a. ENERGY STAR (total 1 poin 0 ❑ b. Dishwasher Uses No More than 6.5 Gelbns/ le (total2points) 0 I 1 2. Install ENERGY STAR Clothes Washing Machine with Water Factor of 5 or Less ❑ a. Moats Energy She and GEE Tier 2 requirements (modi5ed energy factor 2.0, Water Factor 6.0) (Vola[ 3 points) 0 1 1 11 2 ❑ b. Meats Energy Star and CEE Tier requirements (modified energy lector 22, Water Factor 4.5 or less) 0 2 (total s oints 3. Install ENERGY STAR Refrigerator ❑ a. ENERGY STAR Qualified & <25 Cubic Feet Capacity 0 ❑b. ENERGY STAR Ouel'Mad & <20 Cubic Feet Ca aci 0 I 4. In stall Built -In Rerydin p Cmtar 0 ❑ a. Built-in Recycling Center 0 j 2 ❑ h Built -In Composting Cantor 0 _ ( 1 Total Available Points In Appliances and Lighng = 121 0 N. OTHER Points Available Per Measure ❑ 1. Incorporate Groanpoint Rated Checklist in Blueprints - Required 0 1 ( R ❑ 2. Develop Homeowner Manuel of Green FestureslBensfits 0 1 1 1 3, Community Design Meesures & Local Priorities: See the Community Planning s Design section in Chapter 4 of the New Home Guidelines for maesures. Mullmum of20 points for suggested measures. Local requirements may also be listed has 0 2007 Build It Green Single Family GreenPDIM Checklist 2007 Version Page 3 of 4 E • 02007 Build It Green Single Family GmenPDlnt Checklist 2007 Version Page of 4 .9 r$ Enter descriptor hen, and enter points avallaWb for menan In appropriate categories to the right. D_ D 0 0 o 0 Enter d9banpllon here, and enter points avaIIBWB for mBBauR In appnpdate catagortai them right 0 o D D 0 0 El Elver descr odw hen, and enter points wallaWe for pressure In appropriate catBpaAei to the right. _ DD 0 _ 0 0 _ _ L1 Erri do"iPr hare, and "or pWm6 wallahle In measure In appropriate,cetegIXlas to the right, 0 _ D 0 0_ 0 0 4. Innovation: List innovative measures that meet the green bullding objectives of the Guidelines. Enter up to a Build It Green Checklists Guidelines and maximum combined total of 20 tots. See Innovation Checklist for suggested measures, using the link to the night. D _ _ D D _ 0 D D 0 0 D D o0__ 0 0 D D 0 D 0 0_ 0 _ 0 D D D 0 0 0 0 0 0_ Innovallm In Cammunl : Enter deo on hare, and enter points availahle for manus In Mn ale cats to the right ❑ Innuial in Energy: Enter description hen, rod ante IIIc al for mansara i0 ase can orlBe to the right. Innwnion In IAGNaalth: Enter dimall hen, and ental points nalleble Its Ensure in ate cele odes to IM right IreMaaan in Resources: Enter despdplim hare, and error points nailaWa for measure In sla Cale m; to the right. ❑ _ Innodalion in Mater: Enter daecripdon hore, and anew points a_vallab_le for menus In apprwIlits catspodes b she dpht Total Avallaoie Points In Dther.4 _ _ 0 _ Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43 Minimum Points Required In Specific Categories 0 3D 6 6 B 01 t B e e 1 Project has not yet met the following recommended minimum requirements: - Total Project Score ofAt Least 50 Points - Required measures: -A3a: 500/a waste diversion by weight -12: 15% above Title 24 -NI: Incorporate GreenPoint Rated Checklist Into blueprints - Minimum points in speclfc categories: -Energy (30 points) -IAQ/Health (5 points) -Resources (6 points) -141ater (9 points) E • 02007 Build It Green Single Family GmenPDlnt Checklist 2007 Version Page of 4 r. k, - t ��✓ CITY OF IkUPEPTINO Fj C JOB ADDRESS: GENERAL CONTRACTOR: Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department . , PERMIT # J ° pr- 0-g-10 :3 V1 PHONE # s v FAX # I am not using any subcontractors: Signature Please check annlicable subcontractors and complete the followinLy information: 3/2-/C' Da Owner/ Contractor Signature Dat 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 Dat