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08020097 CITY OF CUPERTINOxy BUILDING DIVISION PERMIT a ual21'�51Es9KRZICH PLPERMITNO. PLUMBERS ON CALL 08020097 NER'S NAME: PERNITIESUEDATE SUBASH & SHANTHA 520 E MCGLINCY LN #12 02/14/2008 PHO (408) 879-0483 SANITARY NO. CONTROL NO. ARCH117=13NGiNEER: BUILDING PERMIT INFO BLOC EfECI' PLUMB - MECH atop LICENSED CONTRACT'OR'S DECLARATION IOb Description rd 1 hereby Affirm that 1 am licensed under pmviaians of Chapter 9(com mencing p with Section 90010)dDivision 3 ARM Business and Professions Code,and my license is REPIPE FRESH WATER n in full fame and effem. Q O u.mac Clsss Lic.A r Dam �. 141—/v�Comrumr M 4 ARCHmicrs DECLA A ION 1 understand my plum shall be used As public recoMa ay0 o Licensed Professional OWNER—BUILDER DECLARATION I hereby mea .mein Thal 1Exempt from the Conhaemos License Law for the Aida D o fallowing n.(Section 7031.1.m 3,Business and am,dm ons Cute:Any city at county $ which mquimu n peals l ac construct,aline impress,h permit tar repair ed structure z in' prior m its issuance,also acquires dm applicant far such menti'm 01.w L w(aakmmt (fluit he commencing with pSeamtmthe provisions of the Canunessa dPanfLaw(Chapter9 Sq.Ft. Floor Area Valuation $ (commendsgwiEaSoctioort,ad MDivislon3 of theBusinessandon.Any violation or $8357 mu he u Exempt tbcmfrem and the Cud for the alleged euntant to Any violation of 004Jon 9031.5 by a,applicant fora permit abjttts the Applicant m a civil penalty of na mart Nan five hundred dollars($300). 36205037?ftlNumber Occupancy Type ❑1,u owner o!Eae preperty,army employees with weW u Neo sole ttmpenuuan, will do thnwaek,and Re muuure Is rmtimanded araRered formas(San.' .Business and Profossions Cade:The Croman tar,Lion Law does not apply m An awxr of Required Inspections prepemY who buildsorimpmvedhemon,and whodaeasuch work himselforthmugh his Own employees,provided Eaauuch improvements arc not intended aroBered finale If. however,the building tar improvement uaold within ane y<v of completion,the owmr- builder will have Eae buNm of proving East he did at build or improve far purpose of dk.). ❑1,d owner of the property.em Exclusively contracting with licensed contractors as aonstmct Ne pmjem(Sac.9044,Business and Professions Code:)The ConmaaoeS u- came Law does not apply m an ownp of property who builds or Improves thereon,and, who mnmmts fm Such projects with aExa mumr(s)licensed pursuant m the Communaute. License Law. O l Am eaempl under See ,B@PC for Nis moon 40 mer Data WORKER'S COMPENSATION DECLARATION I hemby a0)rm under penalty of Perjury ane of the fallowing decimated: 0 I ham and will maintain a CertiOesm of Consent It selFWum far Worker's Compen. Sudan,As provided far by Section 3700 of the labor Code,for the perfmmame of the work for which this permit is issued. 0 I ban end will Easimain Wmkees Campensnlon Insurance.As required by Sccdan 37W of tate Labor Code,fm dm perfa cr mes of the work for which this permit is issued. My Workees Compensation Inamnce carricr ad Polley number are: Grtier.�` INSsyrareP Polley No.: uh�too 3!00101 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This Aceflan need not be completed if[be permit is fm aro hundred dollar($100) or Irv.) I certify mal in the performance of the work for which this permit is Weed.I shall not employ any permn in my mmner so As in become abient in the Worken'Coniumsmon laws of Califomia.Date Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become subject he,the Worker's Campen.allom previsions of Nu Labor Code,you must ,J 0 (aMwith comply with such Provisions or this permit shell he daunted revalued. tiCONSTRUCTION LENDING AGENCY E+ l hereby aRrm that them is a construction lending agency far the perfammm of a arm work far which this .it is issued(Sec.3097,Civ.C.) W� A Lender's Nun. - —' Q z Lenders Address U Q I coldly that 1 have rend this application and sum out the above inforeman is Ik.^^ Ganott 1 gree m camplY with til city and county mtlinmces and sate laws relating m .Q SV^ building convection.and hereby auaotlre representatives of this city to enter upon the fA shove-mentioned property for inspection purpose's. (We)agree to ave,indemnify and keep harmless the City of Cupertino against ,.y H incomptudgmcnhecdtsand expenses which may in any my seem against And City t„)7 A APPLICANT of me granting of this mentis t r7 APPLICANr UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date _\�c IS, SOUZULATIONS. Re-roofs Silinhuldidof Applicadc traror Data H RDOUS MATERIALS DISCLOSURE Type Of Roof WIII the Appliance m future builtling orcupmismm or handle huadou material ilaed by the Cupen m Municipal Code,Chapter 9.12.and the Health and Safety section 25 532u)' III��.o All roofs shall be inspected prior to any roofing material being installed. ❑Yes N If a roof is installed without first obtaining an inspection,I Will the Applicant or future building Occupant ata equipment or Devices which g agree to remove P emit hammusi air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection. District? OYp Sjtu. I have mad Che.Sec tnamrlala5533mdo55M.1er Chapterd.93ifute Glding na HplN&Safetyhe.A ueuunshat it i mynmmobil.I undnNmde.,.P.,.Pat the Jma not currently haw a tenmt.that It a my rcsmmihility m nosily the aceupmt of Jrt requlremm hkh most bent 'tar to mumce ah Ccdr..m of Occupancy. Signature Of Applicant Dale 2 0� 0 er autharncd age g All roof coverings to be Class"B"or better am- - co osotq ® o � CITY OF CUPERTINO • aryor REPIPE/SEWER/MAIN SERVICE CUPkTINO PERMIT APPLICATION FORM APN# O 5 03-7, O Date ` O Building Address: 01-1101 -- V,rz-tCh [c, Ce Owner's Name: r Phone#: u ba -I rn [ Y c4 9 2s- o0— Contractor: Phone#: l d°`1 A rS h C)"It Fax #: Contact: Phone#: d w 5 Fax #: Contractor License#: Cj&oq& 0/ Cupertino Business License#: Job Description: L 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 lei / 1BSEISMICR Seismic Residential P 1PRSEWER Residential building P 1RPSS sewer/sanitary sewer CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPERTINO FEE SCHEDULE • Quantity Fee ID Fee Description Fee Permit Type Group 1PRREPIPE Residential re-pipe per fixture P 1RPRP J 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 IPLMBINSP Other Plumbing/gas Insp. P / 1TRAVDOC Travel &Documentation Fee B 1BUSLIC Business License B • tCITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: - APN . . . . . . . . : 36205037 . 00 DATE ISSUED. . . . . . . : 02/14/2008 RECEIPT #. . . . . . . . . : BS000003952 REFERENCE ID # . . . : 08020097 SITE ADDRESS . . . . . : 21397 KRZICH PL SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . : OWNER SUBASH & SHANTHA GOPALKRISHNAN ADDRESS . . . . . . . . . . : 21397 KIRZICH PL , CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4942 - RECEIVED FROM . . . . : PLUMBERS ON CALL CONTRACTOR . . . . . . . : ROBIE DOBKINS LIC # 27158 COMPANY . . . . . . . . . . : PLUMBERS ON CALL ADDRESS . . . . . . . . . . : 520 E MCGLINCY LN #12 CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 • TELEPHONE . . . . . . . . : (408) 879-0483 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 8, 357 . 00 0 .90 0. 00 . 0.90 0. 00 1PLMBLNCK HOUR 1. 00122.38 0. 00 122 .38 0. 00 1TRAVDOC FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 184 .47 0. 00 184 .47 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 184 . 47 #15860 --------------- TOTAL RECEIPT 184 .47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 301 ROUGH PLUMBING 507 FINAL PLUMBING S ingle Family GreenPoint Checklist date: l�"��(-6� Build It Green The GreenPoint Checklist Is based on the various green features incorporated Into the home and is the Smart Solutions From The Ground Up same at the GreenPoint and mated atsthprogram..moueA home cans per catconsideredcategory. Erg l(30),is the door A prerequisites, cams at least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Quality/ IL I I JI Health(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint Raters if 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 www.builditoreen ore. 'ENTER PROJECT NAME 9 F bis In Q A.6ITE � Points Available Per Measure 1.Protect Topsoll and Minimimirruption of Existing Plants&T ❑ a.Protect Topsoil from Erosion and Reuse after Construction 0 1 ❑ b.Limit and Delineate Construction Footprint for Maximum Protection 0 I l ❑ 2.Deconstruct Instead of Demolishing Existing Buildings On Site 0 1 3 1 3.Recycle Job Site Construction Waste(Including Green Waste) ❑ a.Minimum 5o%waste onma on by Weight(Recycling or Reuse)-Required DR ___ ❑ b.Minimum 65%Diversion by Weight(Recycling or Reuse) D_ ❑ c.Minimum 80%Diversion by Weight(Recycling or Reuse) 0 2 4.Use Recycled Content Aggregate(Minimum 25%) ❑ a.Walkway and Driveway 0 ❑ to.Roadway Base 0 Total Points Available in Site=12 0 H.FOUNDATION Points Available Per Measure 1.Replace Portland Cement in Concrete with Recycled Flyash or Slog ❑ a.Minimum 20%Flynn or Slag 0 ❑ In.Minimum 25%Flynn or Slag 0 ) 1 I ❑ 2.Use Frost-Protecled Shallow Foundation in Cold Areas(O.E.C.Climate Zona te) 0 I 1 3 ❑ 3.Use Radon Resistant Construction(In At-Rick Locations Only) 0 1 4.Design and Build Structural Peat Controls ❑ a.Install Teonite Shields&Saarate All Exterior Wood-fo-Concrete Connections by Metal or Plastic Fasteners/Dividers b.All New Plants Heys Trunk,Base,or Stem Located At Least 36 Inches from Foundation 0 ` �— TotalPointsAvailableinFoundation=a 0 C.LANDSCAPING Points Available Per Measure 1.Construct Resource-Edicant Landscapes ❑ a.No Invasive Species Rby Cal-IPC Are Placed 0 FT h.No Plant SDecies Willl Requite Hedging _0 1 ❑ c.75%of Planta Are Droughl-tolerant California Natives,Mediterranean,or Other Appropriate Species 0 3 ❑ 2.Use Fine-Safe Landscaping Techniques 0 1 ) 3.Minimize Tud Area in Landscape Installed by Builder ❑ e.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.13 plats tactor) 0 2 ❑ b.Tud Shall Not Be Installed on Slopes Exceeding 10%or in Areas Less than B Feet Wide 0 _ 2 E] c.Tud Is 533%of Landscaped Area(total 2 points) 0 2 ❑ d.Tud Is 510%of Landscaped Area(total4 points) 0 I 2 ❑ 4,Plant Shade Three 0 3 El 5.Group Plants by Water Needs(Hydrozoning) 0 2 S.Install High-Ef6cienry Irrigation Systeme ❑ a.System Uses Only Low-Flow Dnp,Bubblers,or Low-How Sprinklers 0 2 ❑ b.System Has Smart Controllers 0 3 ❑ 7.Incorporate Two Inches of Compost in the Top&to 12 Inches of Soil 0 3 ❑ P.Mulch All Planting Beds to the Greater of 2 Inches or Local Water Ordinance Requirement D 2 9.Use 50%Selvaged or Recycled-Content Materials for 50%of Non-Plant Landscape Elements 0 1 1 ❑ 10.Reduce Light Pollution by Shielding Fhoureeand/ur Directing Light Downward 0 1 Total Points Available in Landscaping=31 0 D.STRUCTURAL.FRAME&HUDADVG ENVELOPE Mm"vefp1a Per Measure 1.Apply Optimal Value Engineering ❑ a Place Rafters and Studs at 24-Inch On Center Framing 0 _ l_ l_ 1 ❑ b.Size Door and Widow Headers for Load 0 1 ❑ c.Use Only Jack and Cripple Studs Required for Load 0 1 2.Use Engineered Lumber \ ❑ a.Beams and Headers 0 1 ❑ b.Insulated Engineered Headers 0 ❑ c.Wood l-Joists or Web Trusses for Floors 0 _ 1 ❑ o.Wood IJoists for Roof Rafters 0 1 __ ❑ e.Engineered or FingerJointed Studs for Vertical Applications w.,0 1 ❑ I.Oriented Stand Board for SIl lour ^�0 _ 1 ❑ g.Oriented Stand Board for Wall and Roof Sheathing 0 �— 1 ® 3.Use FSC-Cerdged Wood ❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 _ f 2 ❑ In.Dimensional Lumber,Studs and Timber.Minimum 70% 0I_ 2 F-1 - c.Panel Products:Minimum 4D% _ 0 _ -I} 1— ❑ d.Penal Protluds:Minimum 70% 0 1 02007 Build It Green Single Family GreanPoint Checklist 2007 Version Page 1 014 r 5 ENTERLIM PROJECT s W s 3 4.Uw Solitl Wall Systems Ilncludw$IPa,ICFs,6 Any Non-Stick Fra es Aawmhly) 333 ❑ a.Floom '"� 2rt_J- --�-- - ❑ b.Wella —0 2 —I 2- -- ❑ c.Roots S.ROK08 Pollution Entering the Home trom the Garage ❑ a.Tightly SSBI the Air Banter between Garage and Living Area 0 --H—+--- ❑ b.Install Gere a Exhaust Fan OR Build a Detained Gera a 0 i 1 0.Daci n Energy Heals on 7rusws(75%of AWc Insulation Height at Outside Ede of EMHer Welg D 1 ❑ w 7.Dw{ n Roof Trustee-Accommodate Ductwork 0 1 9.Uw R•ryole H;cmusnt Steel Studs for 00%of Interior Well Fmmtng 0 1 El O.Thermal Mass Wells:51ll Drywall on All interior were or Welts weighing more than 401b1cu.tt 0 1 10.Install Overhaul one Gutten ❑ 0 a.Minimum 16-inch Overhangs and Gutters - - - - -'----1=�— ❑ 0 b.Minimum 24-Inch Overhangs and Gutters ] TMBI Paints Available in Structural Butting Frame and Envelops=38 0 Points Avalleble Per Measure E.EXTERIOR FINISH 0 2 7.Uae Recycled-Contanl(No Virgin Platlie or FEC-CeNfiad Woad Docking 0 1 2 1 2.Inwell a Rein Scrwn Well S stemp I 1 1 9.Use Durable and Nonwmb1.61161e Slain 1 Materials Lj /.Select Durable and Noncombustlhle Feeling Materiels 0 1 2 Total Pointe Avalleble In Exredm Finish=7 0 Points Avallable Per Measure F.INSULATION 1.Install Insulation with 75%Recycled Content ❑ 0 Walls anNor Floon; D ] r ❑ 6.Collin s 2.Install Insulation that Is Low-Emitting(Certlfed Swoon 01350) ❑ 0.Walls andror ROOM -i -- 0 1 1 1 ❑ b.Collin a 0 1 1 ❑ 3.Inspect Ouellry of Insulation Installation(mere Applying Drywall Total Pointe Available In insulation=5 0 Points Available Per Measure O.PLUMBING 1,Distribute Domestic Hot Water Efficiently(Maximum 7 Points). ❑ a.Insulate Hot Water Pipes from Water Hearer to Kitchen ❑ b.Insulate All HM Water Pipes ❑ c.Use Engineered Parallel Piping ❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop _ i ❑ e.Use Structured Plumbing with Demand Controlled Circulation LOOP - 0 --- -ti 1 -- 2 2 El I.Use Central Core Plumbin [j2.Inatel1 Only High EfficienToilets(Duel-Flush or 51.28 0 I I I 4 Total Pointe Available in Plumbin =Total l2 0 H.HEATING VENTILATION R AIR CONDITIONING Points Avallable Per Measure ❑ 1.Design and Install MVAC System te At Manuel J,V.entl S Recommendations 0 4 2.Install Sealed Combustion Units t -I}— ❑ 9.Furnaces 0 1 ❑ b.Water Heelers 0 1 1 1 1 1 1 I J.Install Zoned,Hydronic Radiant Heatlnp with Sleb Etlga Ineulallon 4.Install High llrc,,nry Air ContlWoning with Environmentally Responsible Refrlgarante 0 1 I S.Design and Install tractive Ductwork _0 _ _3 ❑ e.Install HVAC Unit and Ductwork within Conditioned Space - ❑ In.Use Duct Mastic on All Duct Joints and Seems ❑ c.Install Ductwork under Aft Insulation(Buried Ducts) _0 ❑ J.Pressure Balance the Ductwork System ❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0 —�-- —Install High Efficiency HVAC FlIter(MERV Oa) 0 ! 1 7.Don't Install Flreplaw or Install Sealed Gas Fireplace with Emciency Rating Not Lew Than w% 0 1 E] wing OSASten5 e.Install Ell dAltlExhaust Systems In Bathrooms one Kitehena 0 ❑ e.Install ENERGY STAR Bathroom Fens Vented to the Outside - - ❑ b.All Bathroom Fans Are on Timer or Humldistet - ❑ c.Install Kltchen Ranga Hootl Vented''"'Outside 0 1 1 9.Install Mecwniwl Vemiladon System for Cooling(Maximum 4 Palms) l ❑ a.Ionil ENERGY STAR Calling Fans 8 Light Kits in Living Areas 5 B9dmi ms - ❑ b.Install Whole House Fan with Variable Speeds — ❑ c.Automatically Controlled Integrated System - ❑ tl.Automatically Controlled Integrated System with Variable Speed Control 0 ?-- 3 r '0.1 0.lnsteech ll Manical Fresh Air Ventilation System(Maximum 3 Formal 71e.Any Whole House Ventilation System That Movie ASHRAE 82.2 - 0 T -4--+ ❑ b.install Al-to-Air Heat Exchan let that meets ASHRAE 52.2 0 1 11.Install Cerban Monozitle Almm(s) Total Points Available in Hewn,Ventilation and Air Conditioning 30 0 0 2007 Build It Green Single Family GreenPolnl Checklist 2007 Version Page 2 0l 4 ENTER PROJECT • • I.RENEWABLE ENERGY Points Availahle Pet Measure 1.Pre-Plumb for Solar Hot Water Heating 0 ! 4 1 1 1 2,Install Solar Water Heading System 0 1 10 1 1 I 3.Install Wuin Contluit for Future Pholovoltaic Installation&Provide 200 fe of South-FacingRoof 0 ) 2 ! ! 4.Install Photovoltaic(PV)Panels ❑ a.30%of electric needs OR 1.2 kW(total6 points) 0 6 ❑ 6.60%of electric needs OR 2.4kW(total 12 points) 0 6 —_ ❑ c.90%of electric need OR 3.6 kW(tope 16 points) 0 6 Total Available Points in Renewable Energy=213 0 J.BUILDING PERFORMANCE Points Available Per Measure 1.Diagnostic Evaluations ❑ a.House Passes Blower Door Test 0 _ ! 1 ❑ b.House Passes Combustion Safe Backdrad Test 0 ! ( 1 T 2.Design and Build High Performance Homes-%above Tide 24-minimum 15%Required 0 no ❑ 3.House Obtain&ENERGY STAR with Indoor Air Package Certification Pilaf Measure(Total 45 points;read comment) 0 5 2 I Thal Available Points in Building Performance 39 0 K.FINISHES Points Available Per Measure 1.Design Entryways to Reduce Tracked In Contaminants 0 1 2.Use Low-VOC or Zero-VOC Paint(Maximum 3 Points) ❑ a.Law-VOC Interior WeIVCaling Paints(60 gpI VOCs(Flat)and d50 gpl VOCs(Non-Flap) _ ❑ b.Zero-VOC:Interior Wal/Colling Paints(c5 gpl VOCs Flat)) 0 � 3 ❑ 3,Use Low VOC,Water-Based Wood Finishes(Q50 gpI VOCs) 0 ! 1 2 1 I ❑ 4.Use Low-y0C Caulk and Construction Adhesives(J0 gpI VOCs)for All Adhesives; 0 1 2 1 1 ❑ S.Use Recycled-Contain Paint 0 ! 1 1 6.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,0)RecyclsdLonlent or E)Finger-Jointed ❑ a.Cabinets iorTri (5%Minimum) 0 ❑ b.Interior Trim(50%Minimum) ❑ c.Shelving(50%Minimum) ❑ J.Doors(50%Minimum) 0 ❑ e.Countall(50%Minimum) 0 ! ! 1 • 7.Reduce Formaldehyde in Interior Finish(CA Section 01350) — ❑ a.Subfloor&Stair Treads(50%Minimum) 0 1 _ ❑ L Cabinets&Counnhops(50%Minimum) 0 ❑ C.Interior Trim(50%Minimum) 0 ❑ d.Shelvin (50%Minimum) 0 ❑ 0.Alar Inetelle4 ri Minimum) Test of Indoor Air Shows Formaldehyde Level Q7ppb 0 1 3 1 I Total Available Points in Finishes=21 0 L.FLOORING Points Available Per Measure 1.Use Environmentally Preferable Flooring:A)FSC-Cerdfied Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Racycled-Content,E) Exposed Concrete.Flooring Adhesives Must He"P50 gel VOCs. ❑ a.Minimum 15%of Floor Area 0 ! 3 ! ❑ b.Minimum 30%of Floor Area _ 0 __ 1 ❑ c.Minimum 50%of Floor Area 0 1 ❑ J.Minimum 75%of Floor Area 0 1 ❑ 2.Thermal Mass Floors:Floor Covering Other than Carpet on SD%or More of Concrete Floors 0 ! 1 ❑ 3.Flooring Meats Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 1 2 1 1 Total Available Points In Flooring=7 D M.APPLIANCES AND LIGHTING Points Available Per Measure t.Install Water and Energy Efilcienl Dishwasher ❑ a.ENERGY STAR(total 1 point) 0 ❑ b.Dishwasher Uses No More than 6.5 Gallons/Cycle total 2points) 0 1 2.Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less ❑ a.Meets Energy Star and GEE Tier 2 requirements(modified energy factor 2.0,Water Factor 6.0)(land 3 points) 0 ! 1 ! ! 2 ❑ b.Meets Energy Star and CEE Ter 3 requirements(modified energy factor 2.2,Water Factor 4.5 or less) 0 2 (total spoints) 3.Install ENERGY STAR Refrigerator ❑ a.ENERGY STAR Oualifed&<25 Cubic Feet Capacity 0 1 —_ _ El b.ENERGY STAR Qualified&<2D Cubic Feet Capacity 0 ' ! 1 4.Install BullHn Recycling Center 0 ❑ -e.Built-In Recycling Center 0 2 ❑ aBuift-In Composting Center 0 ! 1 Total Available Points in Appliances and Lighting=12 0 N.OTHER Points Available Per Measure ❑ 1.Incorporate GremPoint Rated Checklist In Blueprints-Required 0 1 1 1 R I ❑ 2.Develop Homeowner Manual of Green FeaturearBer efits 0 1 1 1 ! 1 3.Community Design Measures If Local Priorities:Sao the Community Planning&Design section in Chapter 4 of the New Home Guidelines for manures.Maximum of 20 points for suggested measures.Local requirements may also be listed hare. C 2007 Build It Green Single Family GraimPolm Checklist 2007 Version Page 3 of 4 ENTER Enter dasuription here,and enter points a4f ole lor measure in appropriate Categories to Ne right. 0 0 0 0 0 0 Enter deswlp(o-,hare,and enter points available for measure In appropriate CalogwlBa to the Tight Enter descrimion here,and enter points avallable for measure In appropriate Categorles to the right Enter description hare_entl enter prints available for measure in appropriate categories to the right. _ _0 0 0 0 0 0 4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Bulltl It Green Checklists antl maximum combined total of 20 pts.See Innovation Checklist for suggested measures,usin the link to the Tight. _ _ _ _ In Communi :Enter decd tion hare,antl enter ints available la manure In ate categories to the right. 0 0 0 0-.- Innovation e 0 InnDYstIW In Ens :Enter desc' ion hare,and enter Inca available for measure In r late cele ones to then t. 0 0 0 0 0 0 Innovation in IAOMoelth:Enter description here,and enter points available Its measure in nate cel win to the right. _0 0 0 0 0 0 Innovation In aewurces:Enter tlen tion here,antl enter pints ovallettle for manure in approsonate customer to the ilht _0 0 0 0 0 0 Innwallon in Water:Enter description here,and enter points e_vallable itsmeasure In oppmpuats categories to the dgM. _ 0 0_ 0 _0 0_ 0 Total Avallathe Points in Other= 0 Summary Total Available Points In Specific Categorles' 4+ 96+ 42+ 66+ 43+ 01 Minimum Points Required in Specific Categorles 0 30 6 6 9 Total Points Achieved a e i e a a Project has not yet met the following recommended minimum requirements: -Total Project Score of At least 50 Points -Required measures: -A3a: 50% waste diversion by weight -12: 15%above Title 24 -Ni:Incorporate GreenPoint Rated Checklist into blueprints -Minimum points in specific categories: -Energy(30 points) -IAQIHeaith(5 points) -Resources(6 points) -Water(9 points) 02007 Build It Green Slnde Family GreenPoint Checklist 2007 Version Page 4 of 4 Community Development ' 10300 Torre Avenue . Cupertino CA 95014 Telephone(408)777-3228 gCITY OF Fax(408)777-3333 UPERTINO Building Department-7oa v�17 JOBDRESS: PERMIT # D bCV1 (/ O OWNER'S NAME: PHONE # GENERAL CONTRACTOR: FAX# I am not using any subcontractors: Sy tore Date Please check applicable subcontractors and complete the followin 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 h L &0 Owner/Cctractor Signature Dat