08040120 CITY OF CUPERTINO n •i:�+ a s„.;., C �' ^;� +1
BUILDING DIV14ZON PERMIT . CONTRAGTUR II f?RMATIf11��`�
s TaF” :M s'fi. ....•'+ ". ,ca 3.'vrt"ztd,-i+`34Y 3.
BUILDING ADDRESS: PERMITNO.
7918 OCTOBER WAY ACE PLUMBING 08040120
OWNER'S NAME: PERMIT ISSUE DATE
SHAWN CHEN 565 N CENTRAL AVE 04/16/2008
NE: (406) 226-2243 SANITARY NO. CONTROL NO.
ARCHITEC YENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 (� C= t�
3 •� LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I w liana d under pmvinaiaw of Chapter 9(commencing Job Description
with Section 7011))of Dirlalon 3 of NO B. and PraradomCodd, mylicenseU (-`TTY CLEAN-OUT
n th NftRfinee,Me1 s/B6o�
ueenm caw 56 1s:.1
Dam Comrom ��,va
7
ARCHITECTS DECLARATION —p
I morvand my plants Nall he used as public secome
yG Licensed Pmfeuianal
OWNER-BUILDER DECLARATION
i 1 hereby•berm that I am attempt farm the Contractor's Lkcnm Law for the
02 renaming renwn.(Snedun 7031.5.Business and Profession Cox:Any city or county
$ which mquios a permit to construct.alter,hnpmve,demo)that,or mpdt any s m m.
prior at its inwnm.also rcqufms the applianlfar such permit to file a signed summa,
that he is licensed pursuant to the pmvislom of the Comrmmea Liarense Law(Chapter9 Sq.Ft. Floor Area Valuation
9 (commencing with SeNon7")ofDivision 3ofthe nations and PmfeuiamCode)or _ $1800
3
than,W is evmpt therefrom and the bads far the alleged momptlon,My violation of
Section 70315 by my applicant for a permit subjects the applicant to a civil Family of
son m 3 6 213 03 5 :6�1 Number Occupancy e
am Nm flus hundred dollars ISMp yTyp
❑1.u owns of Na PcoP'ntY,a my wploym with wage a drew sole compensstio,
will do the wak and she s neons Is act mended or offered formic(Sec.7044,Business
and Pfafeedam CML'The Chrommr'i License Law does net apply an m owner of Required Inspections
property who Wildaaimpmvves thenxn.md who does suNwerl himaelfathntuN his
own employers,provided that such Improvements are not immdW reoffered!fassle.IL
however,the Wilding or Improvement is sold within am year of eamPlemes.the owner-
builder will have the Woman of proving that Ise did an,build or improv for purpose of
mm.]
0 I,as owner of Ne property,w exclusively contracting with flawed anumtan m
,amuse Nees a., (See 7044,Business and Py.1ho m Code:)The Cwuacmis and
come onus alas not apply m as ons of retorts who builds car impmm Centro,andwho conuacuforawh Dmjecu Nthaconvmmr(s)Ilamed purewntm Ne Conummfs1 \ TARY
License,Law. U _
❑Tun aentpl under Ser ,BdPC fa 9da moon
Owner Data
WORK0s5 COMPENSATION DECLARATION
I hereby arm under penalty of perjury,aro of tin following dematWou
Mm aM will mandate•Certificate of Cament to coif-imus ra Worker's Cmnpen-
,,an,as provided for by Section 3700 of dm Isba Code,fa the perf ernmen of the
wort for which this permit is issued.
0 1 have and will maintain Worker's Compensation Insurance,as required by Section
3700of No Iaba Cox,for that performance of the work far which this permit la lewd.
My Worko' mmpcmWan lmenme artier and Policy number
C SPolley No.: mil `
ERTiFlCATE OF EREMPTION FROM WORI:ER5
COMPENSATION INSURANCE
(Thu sects need an,N completed If dW permit Is forme,hundred dollars(5100)
or las)
I CenifY Nat in Ne performance of Use work for which this permit is issued,1 dWl,set
employ any person in my manner so as m became subject to the Workers'Compensation
Isws of California.Data
Applicant
NOTICE TO APPLICANE If.after making this ContOam of Eacteption,you Could
become subject to the wmaer'a Compensation pmvidmu of Ne Isba Cade,you a=
.J O forthwith comply with such p nvidnns or Nu permit mail be danced reveked.
N CONSTRUCTION LENDING AGENCY
[••� I hereby,affirm that there u a consuascom lendmgagency fm the performaramof
z > Bat
.,it ser which thus permit is limed(Sa.3097,Civ.C.)
t27� O
Undoes Name
D Z Lcmxr's Address
U Q 1 comfy that I have rad this application and sum Nu to above iaournmen N
tL ^ cormn I agta m comply with all city and county ordinances and sum lam relating to
Wilding construction.and hereby authorize representatives of Nu city to ester upon the j�
W above-menuanedproperty forimpani ,Purposes. V�"!'J AJiW
L1e (We)agree to ave,indemnify and kap harmless the City of Cupertino against
VCA) liabilities Judgmentsecordand of this pamiL hmay In arty wyamus agaimtsald City
7 A PLICA T of Ne[senting of this permit.
a APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE ULATIONS.
Re-roofs �^
Sign re of AppliantaConumbr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII tier applicant or run=WildeC occupantatore or handle haurdaw material
as xEnnd by 0m Commune Municipal Code.Chapter 9.12,and the Health and Safety
Code.semiea 25532p>7
❑Yea All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection,I agree to remove
WIII tise applicant or fu re Id asupant ute egmpmml car xvics which g
hmauous air caumWn x0wd=Bay Bay Area AiMimlly Management all new materials for inspection. -
m7
0Ya No
I have mod the ha=unts materials requirements under Chapter 6.95 ofthe Califor.
nia Health&SafetyCcde.Seen=75505.25533 atm 25534.1 undmaund tins iflhc Wilding
does set ca entry haw•mmol that I,u my mapomimiity m ncury the occupant of the
mquirt 'chmost bemelpiarmi `ar,cetdrN.maraw Signature of Applicant Date
Own rat authamrda cm Data ---All roof coverings to be Class'W'0[better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36213035 . 00
DATE ISSUED. . . . . . . : 04/16/2008
RECEIPT # . . . . . . . . . : BS000004499
REFERENCE ID # . . . : 08040120
SITE ADDRESS . . . . . : 7918 -OCTOBER WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHAWN CHEN
ADDRESS . . . . . . . . . . : 7918 OCTOBER WAY
CITY/STATE/ZIP . . . : CUPERTINO, 95014-4145
RECEIVED FROM . . . . : BRIAN H KIM
CONTRACTOR . . . . . . . : TAEK SONG LIC # 24542
COMPANY . . . . . . . . . . : ACE PLUMBING
ADDRESS . . . . . . . . . . : 565 N CENTRAL AVE
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 226-2243
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--------- ----------- ---- ---------- -=-------- ---------- --------
1BSEISMICR VALUATION 1, 800 . 00 0. 50 0. 00 0 .50 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 102 .48 ' 0 . 00 102 .48 0. 00
.METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 102 .48 MC .
---------------
TOTAL RECEIPT 102 .48
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301 ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
CITY OF CUPERTINO
ais REPIPE/SEWER/MAIN SERVICE
CUPEKT-INO PERMIT APPLICATION FORM
APN# o 3 S Date: /4 1(3,
Building Address:
w
Owner's Name: Phone#:
ilAPJN 6L<Ijg S—q-- -) s�
Contractor: Phone#:
(/<*) 91��
Cl eL ./713/Aj Fax #:
Contact: Phone#:
Fax #:
Contractor License #:
Cupertino Business License#:
Job Description:
41
+y
Residential Commercial ❑
Valuation: a
/ D
Green Buildi g 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 11CPSS
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/sanit sewer
00 CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
IPRREPIPE 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 OtherPlumbing/gas Insp. P
/ 1TRAVDOC Travel &Documentation Fee B
1BUSLIC Business License B
s
SirigleFamilyGreenPointChecklist dam: �/-�� n� BuildltGreed
The GreenPoint Checklist is based on the various green features Incorporated into the home and is the Smart Solutions from The Ground Up
_...basis for the GreenPoint Rated program.A home ran be considered green h it fulfills the prarequlshas, T Hams at Ieas15o rtes(and meets the minimum points par category Energy st of Intloor Air Quality/Health(5),Resources(6),and Water(B).Please corwd Build II Green for a list d qualifietl GrenPoint
Raters if you are interested In pursuing third-parry,Varifil -
• The green building practices listed below are described In the New Home Construction Green Building
Guidelines,available at www 6uiltlimreen.om.
a� e W i3 3
ENTER PROJECT NAME
s
A BITE Points Available Per Measure
1.Protect Topsoil and Minimize Disruption of Esisfing Plants 6 Trees
❑ a.Protect TopaD11 from Erosion and Reuse attar Construction
❑ b.Limit and Dentine Construction F 0 } ]
. oo�rimhr Madmum Protection
2 Deconstruct Instead of Demolishing Edstbg Buildings On Sib 0 3
S.Recycle Job Site Construction Wtab(including Grain Wash)
❑ a Mlnimun 50%Waste 0h emon oy WaigM(Rw yffmg wReuse)-Reca and '
o R
❑ b.Minimum 65%Diversion by Weight(Recycling or Rause) - p - - --- —'---_2 ----
❑ c.Minimum 60%DNersion try Weight(Recycling w House) Q' -' ---"-
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a Walkway and DMeway 0 ]
❑ b.Roadway Bake
0 }
Total Points Available in Site=12 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash of Sieg
❑ e.Minimum 20%Flyash w Slag 0 ]
❑ b.Minimum 25% ash or Slag 0 1
2.Use Frost-Probclad Shallow Foundation In Cold Areas(C.E.C.Climate Zone 16) 0 3
I.Use Radon Resistant Construction tin AI-Risk Locations Only) 0 - 1
4.Design antl Bulltl SWctum Pest Convols
❑ a Install Termhe Shields a Separate All Exterior Wooddo-Concrete Connectons by Metal or Plas11c Easbner ividem 'erf
0 _ _ ' 1
b.All New Plants Have Trunk,Base,a Stem Located N Least 36 Inches Iron Foundation 0 1
To rote Available in Foundabon=S 0
C.LANDSCAPING Points Available Per Measure
1.Construct ResourceEfficientLantlscapn
E] a.No Invasive Species Listed by CaHPC Are Planed \ 0
• E] b.No Pan!Species Will Require Hedging _0
❑ c.75%of Plants Am Drought-tolerant California Natives,Mediterranean,a Other Appropriate Species p 3
❑ 2 Use FlrsSefe Landiscaplop Techniques 0 1
a.Minimize Turf Areas in Landscape installed by Builder
❑ a.All Tud Will Have a Water Requirement Lees than or Equal to Tall Fescue(50.6 plant rector) ..ell .r 0 j 2 _
❑ h.Tud Shall Not Be Installed on Slopes Exceeding 10%a In Areas Less than 6 Feel Wde ,.....�� p _� -T 2
❑ c.Turd is SM of Landscaped Area(total 2 points) fi ----- ----
❑ d.Tud is510%of Landscaped Area(ana 4 pants)
❑ 4.Plant Shade Trees
3
❑ S.Group Plants by Water Nestle Vdrozonin 0 2
G.Install High-Efficiency Irrigation Systems
❑ a System Uses Only Low+low Drip,Bubblers,or Low-flow Springers - r
❑ b.System Has Sman Controllers
❑ 7.Inco rate Two Inches of Compact In the Top 6 b 12 inches of Soil 0 3
❑ S.Mulch All Painting Beds to the Greater of 2Inches or Local Water Ordinance Re uirement2
LJ 9.Use 50%Salvaged or SMded-Contont Materiels for 511%of Non-Plant Landscape Elements '0 1
❑ 10.Reduce Light Pollution by Shielding FMures andior Direping Light Downward 0 1 r
Total Points Available In Landscapin =37
D.STRUCTURAL FRAME R BUILDING ENVELOPE Points.4vallable Per Measure
1.Apply Optimal Value Engineering
❑ a Place Falun and Studs of 24-Inch On Center Framing 0 1
❑ b.Size Door and Window Headers fes Load
❑ c.Use Only Jack and Cripple Studs Racil lar Load
2 Use Engineered Lumber
❑ a.Been and Headers 0
❑ b.Insulated Engineered Headers 0
❑ c.Wood Woists or Web Trusses for Floors �'----"
❑ d.Wood l•Jotsh for Pool Rafters D1'"--
D ]
❑ e.Engineered w FngerJanted Studs for Verfical Applications 0 - ---
❑
I.Oriented Strand Board for SubOoor 0
❑ g.Oriented Strand Board for Wall and Roof Sheathing 0
J.Use FSC-Cerbfied Wood
❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 � 2
• b.Dimensional Lumber,Studs and Timber.Minimum 70% p -'_i
❑ c.Panel Products:Minimum 40%
❑ J.Panel Products:Minimum 70% ---
D I T 1 1
C 2007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
ENTER PROJECT NAME manual
/.We Solid Well Systems oncludee SIPS,ICFs,6 Arry Non-Stick Frans Assembly)
El Floor _ 0 2 2
❑ b.Walt 0 --T 2
❑ c.ROIs D 2 2
5.Reduce Pollution Entering the Home from the Gal
❑ is Tightly Seal the Air Banter between Garage and Living Area
❑ b.Install Georgia Exhaust Fan OR Build a Descnad George 0 1
6.Desi n Eneryy Heels on Thomas ttic 5%of AInsulation Height M GUMdteri
e E69D of Ethanol Well 0 1
7.Da0 n Roof Truon to Accommodate Ductwork D 1
A.Use RKYCiOd{entad Steel Studs for 10%of Inferior Wali Freming 0 1
Lj a.Thmmel Man Wells:Kinch Dryvmll on All Interior Walls m Wells Weighing more than 4D Iblcu.A 0 1
10.Install Ovedungs and GUMAl
❑ L Minimum 1BAnch Overhangs and Dulles _ 1
❑ b.Minimum 24-Inch Overhangs and Guars 0 1
TOW Poon Available In Sbuctuial Building Frame and Fmeeye•36 0
E.EXTEFLIOR FINISH Points Available Pat Measure
1.Use Re cls-0ontam Mo Virgin Pool or FSCtsrlified Wood Decking D 2
Lj 2Install a Rain Screen Well System D 2
3.Use Durable and NoncombusOble Siding Mal 0 1
I.Ssiem Durable and Noncombustible Roofing M MMAIS 0 2
Total Points;Available in Extoller Finish D
P.INSULATION Points Available Per Measure
1.Install lnsui wino 75%Recycled Content
❑ a.Walls Bndror Moore 0
❑ b.Collins 0 f 1
2.Insall Insulation that is Low-EMding(Certified Section D1350)
❑ a.Wells anNor Floors \ —U — -
❑
to,Ceilings0 1
❑ 3.inspect Quality of Insulation InlaIIMlon before Applying Drywall 0 1
Total Points Available In Insulation.5 0
G.PLUMBING Points Available Par Measure
1.Distribute DDMAatie Hot Water Efficiently(Maximum 7 Pointe)
❑ s.Insulate Hot Water Pipes from Water Heater to total U _ _ -
❑ to.Insulate All HM Water Pipes
❑ c.Use Engineered Parallel Piping _ 0_
❑ I.Use Engineered Pareeul Piping with Demand Controlled Carol Loop
❑ e.Use Simmered Plumbing Wth Demand Controlled Clrculmlon Loop
❑ 1.Use Central Cos Plumbing 0 1 1
❑ 2.Install Only High Efficiency Toll(Dual-Flush or 51.25 l 0 4
Told Points Available N Plumbin =Total 12 0
H.IDEATING VENTILATION R AGI CONDITIONING Points Avaltebla Per Measure
1.Design end Install HVAC System b RCCA Manuel J,D,end S Recommendations 0 4
2.Install t
Sealed Combustion Uni
❑ L Furnaces o _ ._ _ , 2 _
❑ b.Water Headers 0
3.Install Zoned,Hydronlc Radian Hewing with Slab Edge Insulation 0 1 1
4.Install High Efidency Air Conditioning with Environmentally Responsible Refrigerant 0 1
S.Design and Instal Effective Mimi
❑ e Intal HVAC Unit and Dumwork vdthin Conditioned Space _ 0 _ 3
❑ It.Use Dud Mastic an All Dual Joints and Seems -
❑ c.Install Ductwork under Attic Insulation(Buried Ducts) ...
0 7 T
❑ d.Pressure Balance the Ductwork System
❑ a.Protect Ducts during Construction and Gaon Al Ducts before Ooloi y 0 1
S.Install High Efficiency HVAC Filter MERV 5.1 0 1
❑ 7.Don't Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Raring Not Len Than 60% D 1
using CSA Standards
B.Install ENedlvs Exhaust Systema in Bathrooms and Kitchens
❑ a.Insall ENERGY STAR Balmotn Fens Vented to the Outside _ 0
❑ b.M Bedroom Faro Are on Timer or Humidislal
❑ c.Install Kitchen Range Hood Vented t0 the Outside 0 7 r
6.Install Mechanical Ventilation System for Cooling(MAXIMUM 4 Point)
❑ a.Instal ENERGY STAR Call Fans 6 Light Kd,In living Areas 8 BadMDMe _0_ 1
❑ It.Install Whole House Fan with Variable Speeds --o
❑ c.Automatically Controlled Integrated System _ U 2 _ _
❑ d.Automatically COnbollad Integrated System with Variable Sped Control 0 3
10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Pointe)
❑ a Any Whole House Ventlalion System That Moos ASHRAE 62-2 0 2
❑ b.install Alr-toAk Heat Exchanger that Meem ASHRAE 622 0 ] 2
11,Install Carbon Monoxide Alarms) 0 1
Total Points Available In Healing,Ventilation and Air Condlonln 301 0
0207 Build 11 Green Single Family GreenPoint Checklist 2007 Version Pago 2 of 4
ENTER PROJECT
� NAME
t.RENEWABLE ENERGY - Points Available Par Idaasure
1.Pre-Plumb for Solar HM Wale Hating 0 4
2.Install Solar Water Heating System 0O
LJ 3,Install Wiring Conduit for Future Pholovoliaic installation 6 Provide 200 M N South-Facing Roof 0 2
4.Install Photovoltaic(PV)Panels
❑ a.30%of electric needs OR 12 kW(total 6 points) p 6
❑ h.60%of electric needs OR 2.4kW(total 12 points) - p
❑ c.90%of electric heed OR 3.6 kW(total 16 points) p - 6 — ----
Total Available Points in Renewable Energy=28 0
J.BUILDING PERFORMANCE .Paints Available Per Measure
1.Diagnostic Eveluadiona
❑ a House Passes Blower Door Test 0 1
❑ b.House Passes Combustion Safety Backdrafl Test p - � --�--
2Designand Build High Performance Homes.%above Titie 24-minimum 15%Required 0 ?30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package CWfication-Pilot Measure(Total 45 points;read comment) 0 0 2
Total Available Points in Building Performance=39 0
R.FINISHES - Points Available Per Measure
1.Design Entryways to Reduce Tracked in Conteminems p 1
2 Use LMAYNOC or Zeo-VOC Paint(Maximum 3 Points)
❑ a.Law-VDC Interior Walnelling Paints(6l Sol VOLS(Flat)and 050 lint VOCs(Non-Flat)) p 1
❑ b.Zero-VOC:Interior WaIMCalling Paints(6 I VOCs(Fla)) p - 3
❑ 3.Use Low VO2,Water-Based Wood Finishes(Q50la l VOCs) p 2
❑ 4.Use Low-VOC Caulk and Construction Adhesives(<70 gpl VOCs)for All Adhesives p 2
❑ S.Uss Recycled-Content Paint 0
1
6.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed
❑ a.Cabinets(50%Minimum) 0 1
❑ b.Interior Trio(50%Minimum)
❑ u Shelving(50%Minimum)
❑ d.Doors(50%Minimum) p
❑ e.Countetlops(50%Minimum � p ---- —" -'-"—"'- 1 --"—'--
7.Reduce Formaldehyde in Interior Finish(CA Section 01 35D)
❑ a.Subfloor&Stair Trends(50%Minimum) 0 1
• ❑ b.Cabinets i Countertops Minimum)
❑ c.Imedor Trim(50%Minimum) p �
❑ d.Shelving(50%Minimum) 0 1
❑ 9.After Installation of Finishes,Test of indoor Air Shows Formaldehyde Level a7ppb 0 3
Total Available Points in Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Certified Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Rocycled-Conienq E)
Exposed Concrete.Flooring Adhesives Must Have 6ogpl VOCs.
❑ a.Minimum 15%of Floor Area 0 1
❑ b.Minimum 30%of Floor Area p --_- ---- - --'-
-._...____
❑ G.Minimum 50%clFloor Area 0
❑ d.Minimum 75%Of Floor Area p- i j 1'----
❑ 2 Thermal Mass Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floors
❑ 3.Flooring Meats Section 01350 or CRI Green Label Plus Requirements(So%Minimum) - 0 2
Total Available Points In Flooring=7 0
M.APPLIANCES AND LIGHTING Paints Available Per Measure
1,Install Water and Energy Efficient Dishwasher
❑ e.ENERGY STAR(total 1 point 0
❑ b.Dishwasher Uses NO More than 6.5 GallonyCycle(lotal2 Dinh) 0 I 1
2 Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meats Energy Star and CEE Tier 2 requirements(modified energy factor 20,Water Factor 6.0)(tolal 3 points) 0 _ i 1 2___
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 22,Water Factor 4.5 m less) .z
totals oim 0
' 3.Install ENERGY STAR Refrigerator '
❑ a.ENERGY STAR Qualified&<25 Cubic Feet Capacity 0 1
❑ to.ENERGY STAR Qualified 8<20 Cubic Feel Capsolty, p 1
4.Install Built-In Recycling Canter 0
❑ a Built-In Recycling Canter 0
❑ h.Built-In Composting Center p ""---- - ---- --
1
Total Available Points in Appliances and Lighting=12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporate GreenPoint Rated Checklist in Blueprints-Required 0 R
❑ 2.Develop Homeowner Manual of Green Featuresasnefits 0 1 1 1
• 3.Community Design Measures 5 Local Priorities:See the Community Planning B Design section in Chapter 4 of the New Home Guidelines for
measures.Maximum of 20 points for suggested measures.Local requirements may also he listed here.
02007 Build It Green Single Family Green Point Checklist 2D07 Version Page 3 of 4
-
. . a r
Enter description here,and enter berft walla ate for measure in appropriate magenta to the right 0 D 0 0 D 0
Enter description hare,and enter points avallode fa manure In alpropriare cologmin to the right. 10 D 0 0 0
Enter dasaripllon hen,and anter points wettable to measure In appropriate categories to the right 0 0 0 0 141
❑ Enter doxriptipn hen,and war points evallahle im measure in appropdah Maintain s the right. _ 0 0 0 0 0 0
4,Innovation:List innovative measures that most the green building objectives of the Guidelines.Enter up to a Bulltl n Green Checklists and
meudmum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right. _ Guidelines __
Innovation In Communl .Enter de list hare,antl ants s evallable to measure In ale categories to Med I. D g D D 0 g
❑ Innovation M Energy:Enter dascri6m ham,and enter points aVallaes la measure M 'ate Ca alai Ip Me right D D 0 D D 0
Innovation In IAOIIIeaIM:Enter dee Im here,antl ender ns available to meecure in 'ate cats sin to then t. 0 0 D 0 0 _ 0
❑ innovation In aaoouroea:Enter dosmplim here,and enter poems mailable la measure In appropriate Wagering to the night, _D_ g D 0 0 0
InoovatiarIn Waten Emer deampdo r hart,and erose pMms available la measure in appmprlere categories to the dght D g_ 0 D 0 0
7sal Avalleble Par Oa in Oth. 43 0
Summary
Total Available Points In Spaclfic Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories 0 30 5 6 9
Total Pcrints Achieved e e o e e
Project has not yet mat 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)
-1AQ1Health (5 points)
-Resources(S points)
-Water(9 points)
•
02007 Build It Green Single Family GreenPoint Checklist 2DD7 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
ryYCITY OF Fax(408)777-3333
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Building De artment
JOB ADDRESS: PERMIT#
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OWNER'S NAME: cL.- PHONE #
GENERAL CONTRACTOR: a bM FAX #
I am not using any subcontractors: a /11 `�— / '6 D'B
Signature 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