08040046 CITY OF CUPE$TINO r ,.«. �' •*��+ r'
BUILDIt,lc DG VI50T PERMIT C� RA T(1ItJ FOIWAkTC01
BUILDING ADDRESS: PERMIT NO.
19960 PEAR TREE LN ACE PLUMBING 08040046
OWNER'S NAME: PERMIT ISSUE DATE
STROHECKER ROBERT E AND L J 565 N CENTRAL AVE 04/08/2008
HONE SANITARY NO. CONTROL NO.
(408) 226-2243'
CHIIEC rENGINEER: - BUILDING PERMITINFo
BLDG EIEC? PLUMB MECH
l� 0 0 0
r�oo LICENSED CONTRACnOR'SDECLARATION lob Descrl tion
1 on 7 affirm dam 1 am limned under ditf previsions of Chapter 9(commencing P
c I f11fuan]ll(IU)ofDivision3aflheBuuneasandProfessiavCode. dmylicenseu GAS PIPNG FOR COOK—TOP FM GAS MTR APX 1$ LNR FT
I full(men and effect t
jrat Licm.Cl Lm.g
e qqqq Da¢ Contractor
;qa AEC15 DECLARATION
I understand my plans mail _
be used as,public records
n
ga(; Limned Pmfeaional
3 OWNER-BUILDER mDECLARATION
<E I Wrehy.(Item that 11. exempts a the Canlns Co License Law for the
eO following mason.encthon 7031.5,Business and Profecsiov Cafe:Any city or county
m which mquimu a permit to cnnsuue alar.improv,do Permit
t ar mash any sweture
prior uiulauanpursunt1.the lW applicant far suchsmuractt Limoralgnedstsmmem
ppmm< that he(commencinnandpuruanemthepmvivisiono of oBuiness ndPoneaw(Chapmr9 Sq.Ft. Floor Area [ Valuation
y F$ that he bi
(commencing pt Section]0nd of Division 3 of al eged Business and on.Any
Code)or J$0 0
— Natio u exempt therefrom and the beer for the alleged exemption.to Any l platoon of
Out. than by any applicant for a permit subjects the applicant m•civil penalty of Number Occupancy Type
Out man than fiw hundred dollars(1500)• 316 310 0 4!l7 Cly
❑1,asawvr of the property,or my employm with wagm u Neirmlecompensadon,
will do the work,and the mucture lsnothmended uroffded forsam(Sec.7044,Business Required Inspections
and Professions Code The Correctors Limme Law dm net apply m e ns an owner of q p
pmpeny who build.or impmwa themon,and who domsuch work himselforthrough his
novo employ.,provided thea such improvements meet imended oreffmal far said.if.
however,Ne building or imprownmt is sold within one year of completion,the owner-
builder will haw the burden of pmMng that he did Out Mid or improve for purpose of
sale.).
❑I,as Owner of the property.am exclusively contracting with licensed uncommon,to
construct the project(Sec.7044,Business and Profmsiav Cade)The Conraneur's U-
cove law dm not apply w an Owner of property who Wilds or improves daemon,and
who camels for such project with a contractor(s)licensed immune m the Contractor's
License Law.
❑Iameampimmer See ,B&PCfm Lhismxdmr
owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby.Bbm under penalty o(penjury,one of this fallowing declarations:
ham and will maintain a cmdrextea Convent in alf-imam for Workers Campen-
n,as provided for by Scene.3700 of the Labor Cade,for m,prolmmance of IW
rk for which this permit is issued.
❑I haw and will maintain Warker's Compensation Insurance,as required by Section
3700 of the LaWr Code,for thO performance of the work forwhich this permit is Issued r
My War es,Ca--m__pevauoalnsunncecartimand Politynumberart:��
Grier�yj�LQ Policy No.:g/
•• CElIRID IFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu semlat ad Out Wcompleted if the permh Is for one hundred dollars(SIM)
or less)
1 certify Nee in the performance of the.,it for which this anch is issued,I shell nal
employ any person in any monomer an as m become subject to the Workers''Compennaan
Laws of Califamia.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation previsions of the labor Cade,you meet
Q O forthwith comply with such provisions or this permit shall W deemed mwked.
Z CONSTRUCTION LENDING AGENCY
Thereby affrm that there I.a construction lending agency fen the performance of
(Y,> the work for which this permit is issued(Sec,3097,Civ.Q
W Q Lenders Name
Q z Lenders Address
V Q 1 certify that 1 haw read this application and sum that the show information is
[s. F .Treed agree to comply with all city and county On inanees and sum laws mladng to
0 U Wilding construction,and hereby authoda mpresentsIM ofdH3 city to murupnn the
[Il above-mentioned property for impaction purposes
LL (We)agree to saw,indemnify and keep harmuss the City of Caperton against
r.s y liabilithv,judgmcou.coats and expenses which may in any way accrue agsinr aid City
(„)Z in consequence of the gmnrng of this Permit. -
Fr APPLIC NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR REGUL S. e
z yA n f �/B� Re-roofs'
sig man of Appliaen✓Cantractor / Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant orfuture Wilding cempanlstoe orhandlc has rdov material -
a defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code.Scrim 255320)7
❑Yon aIYJ Ne All roofs shall be inspected prior to any roofing material being installed.
WIII the applicant or future building Occupant use equipment or devl.which If a roof is installed without first obtaining an inspection,I agree to remove
It hmardous air conWninanu u defined by the Bay Area Air Quality Management all new materials for inspection.
rict7
❑Yca �Tu
I haw reef the harmdrnes materials refuimmenu under Chapmr6.95oftheCalifor-
nia Health&SafciyCaia Seeumr 25505,25533 aod25534.I understood Nati(the building
dm not currently how a mnanda
4 m it u my nequM hility to noccupant Of the occupOf the
rtyuirtmenuw hcard,W mel oruissuanm tar.ccrircam of Occupancy. Signature Of Applicant Date
VCE
wneronulhamedpent Dam
All roof coverings to be Class'%¢."or better
Of '
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31631004 .00
DATE ISSUED. . . . . . . : 04/08/2008
RECEIPT #. . . . . . . . . : BS000004395
REFERENCE ID # . . . : 08040046
SITE ADDRESS . . . . . : 19960 PEAR TREE LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : STROHECKER ROBERT E AND L J
ADDRESS. . . . . . . . . . . : 19960 PEAR TREE LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : TAEK YIM SONG
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 800. 00 0 .50 0. 00 0.50 0. 00
1PGASRES OUTLETS 1 . 00 61. 19 0. 00 61 .19 0. 00
1PPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40 .79 0. 00
1TRAVDOC FLAT RATE 1 . 00 40.79 0. 00 40 .79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 143 .27 0. 00 143 .27 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 143 .27 MC
---------------
TOTAL RECEIPT 143 .27 - "
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----- ----------------------
106 SEWER & WATER 301 ROUGH PLUMBING
507 FINAL PLUMBING
Olay 00
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPERwO PERMIT APPLICATION FORM
APN# / 00
Date: /$10,P
Building Address: 7
/ L71Z6 eai- ree L/l1 _
Owner's Name: Phone#:
Robt,rt 6to) 906
Contractor: Phone#:
�eL f "m6-,e,44
, Fax #: qDk) 0
Contact: Phone#: e fop) 6 — �f
Tae*, S crvt Fax #:
Contractor License#: Sj P 6 6
Cupertino Business License#:
Job Description:
a aSP,1p,�,., �oY- e onlc—dap from � a.s w►e�er
P ' �—
Residential ® Commercial ❑
Valuation:
� U'D
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
IBSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEtZTINO FEE SCHEDULE 4
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
IBPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1 BPGAS Gas Piping System 5+ Outlets P
/ IPPERMITFEE Plumbing Permit Fee Issuance P
I lPLMBLNCK Plumbing Plan Check P
IPLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
1BUSLIC Business License B
\I _
'Single'Family GreenPoint Checklist date: Build ItGreeri
The GreenPoint Checklist is based on the various green features incorporated Into the home and is the Smart5o)udom from the Ground Up
basis for the GreenPoint Rated program.A home can be considered green If It fulfills the prerequisites,
earns at least 50 points,no meets the minimum points per category:Energy(30),Indoor Air Quality/
Health(5),Resources antl Water(g).Please conlei Build It Green for a list of qualified GreenPoint n n
Raters If you are Interested in pursuing thlrtl-party verification. L I L
• The green building practices listed below are described In the New Home Construction Green Building
Guidelines,available at MmLjg ilditmee0.oro.
PROJECTENTER
Moon
c"
A SITE - Points Avellable Pel ldeasure
1.Protect Top¢oll end Minimice Disruption of Existing Plenb 8ees
Tr
Ela Protocl Topsoil from Erosion and Rause alter Construction
❑ b.Limit and Carnotite CanSimi Footprint for Miudmum Protection p---- - --- I'
2 Decenstruct Instead of Demolishing Existing Buildings On site 0 3
3.Recycle Job She Construction Waste(Including Green Waste)
❑ aMmimuer50%Wabffi Direw'ruby WeigM(RocyrJingorReuse)-Required 0 R
❑ b.Minimum 65%Diversion by Weigh(Recycling a Reuse) -p-"' --'—'—j 2 - "-
❑ c.Minimum 80%Diversion by Weight(Recyding or Reuse) U --" '--'---'i"z---
4.Use Retycled Content Aggregate(Minimum 25%)
❑ B.Walkway and Driveway
❑ b.Roadway Base D 1
Total Points Avalabe in Site=12 0
B:FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled FIYash or Slag
❑ a Minimum 20%Flyash or Slag 0
❑
It.Minimum 25%Flyash or Sialf
❑ 2.Use FrDbt-Protacted Shallow Foundation in Cold Areas(C.E.C.Climate Zone 16) D 3
3.Use Radon Resistant Construelion(In At-Risk Locations Only) 0 1
4.Design and Build Structural Pest Controls
❑ B.Install Tmmlto Shields B Separate All EdDria Wood-*Comets Connections by Moral or Plastic FastenerivOlvi 0 _ 1
b.All Now Plants Have Trunk,Base,or Stem Located Al Least 3fi Inches from Foundation 0 i 1
Total Paces Avalabb In Foundation=B D
C.LANDSCAPING Points Available Per Measure
1.Construct Resourc Efficient Landscapes
❑ e.No Invasive Species Listed by Cal-lPC Are Planted p
❑ b.No Place Species Will Require Hedging '-
• ❑ c.75%a Plants Are Drought-tolerant California Nalli Mediterranean,or Other Appropriate Scoot
2 Use Fhi0
r afe Landscaping Techniques 0 1
3.Minimim Turf Area In Landscape Installed by Builder -
❑ a Al Tud Wll Have a Water Requirement Less than a Equal to Tal Fescue(50.8 plant factor) 0 2
❑ b.Tud Shell Not Be Insisted on Slopes Exceeding t0%a in Areas Less than B Feel Wide 0 I I 2
❑ c.Tud Is 533%of Landscaped Area(total 2 points) 0_ _ _ —T 2
❑ d.Tud Is 510%M Landscaped Area(total 4 points) - T —'---- --'
0
4.Plant Shade Trees 0 3
5.Group Plants by Water Needs(Hydroeontn ) 0 2
5,Install High-Efficiency Irrigation Systems
❑ a.System Uses Only Low,lox Drip,Bubblers,or Lux-row SpdnMers 0 _ 2
E] b.System Has Sman Conbolan; D 1 3
❑ 7.Incorporate Two Inches of Comp2mIn the Top 6 to 12 Inches of Sol 0 I 1 r 3
❑ B.Mulch All Plarding Beds to the Greater of 2lnches or Local Water Ordinance Requirement 0 I I 2
9.Ube so%Salvaged orfl aed-Conlanl Matedate for 50%of Non-Plant Landscape Elements 0 1
❑ 10.RetluceLl hi Pollution byShialdin Flxtisraantl/orDiracling Light Downward 0 1
Tobi Points Available in Landsc lir =31 D
D.STRUCTURAL FRAME 8 B[TD.DPIG ENgEIpPE � Points Available Per Measure
1.Apply Optimal Value Engineering
❑ a.Place Rafbb and Surds W 24-Inch On Center Framing 0 I I
❑ b.Size Doo'and Window Headers for Load 0 ( 1
❑ t Use Only Jack and Cripple Studs Required fa Load
—0
2.Use Engineered Lumber
❑ a.Beams and Headors
❑
It.Insulated Engineered Headers
❑ c.Wood I-Joists or Web Trusses for Floors
❑ d.Wood Wools for Roy Ratters7—
❑ e.Enginemed or FingerJoined Sr for Vertical Applications 0 -� 1
❑ f.Oriented Stand Board fa Subfioa ---- —' —'
U r 1
❑ g.Oriented Strand Board fa Wel and Roof Sheathing
3.Use FSC-CeNrad Wood
❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 2
❑ b.Dimensional Lumbar,Studs and Timber.Minimum 70%
• ❑ c.Panal Products:Minimum 40% - 0_
El d.Panel Products:Minimum 70% _0 1
02D07 Build It Green Single Famlly GreenPoint Checklis12007 Version Page 1 of 4
ENTER PROJECT GURU:
4.Use Solid Well Syanms(Includes SIP&,ICFs,5 Any Non-Sdick Flame Assembly)
❑ a.Floor _0___ Z _ Z_
❑ b.Walls D _. 2
❑ c.Rook D 2 2
5.Reduce Pollution Entering the Home from the Gandoe
❑ e.Tightly Sen the Air Banner between Garage and LMng Area 0
❑ b.Install Gane Exhaust Fen OR Build a Declared Garage 0 1
6.Design Energy Heals on Trustees(75%of Attic Insulation Height at Outside Ede of Exnrlor Wall) D - 1
7.Design Root Trusses,to Accommodate Ductwork 0 1
B.Use Rs clod-Conant Steel Studs for 90%of Interior Wall Framing 0 1
s.Thermal Mau Wella:5@-Inch Drywall on All Interior Walls or Wells Weighing mon then 401bIcu.LL 0 - 1
10.Install Overhangs and Gutnn
❑ B.Minimum 16-rch Overhangs and Gunen D_ _ I
❑ b.Ma imum 244roh Overhangs ad Guaer 0 1
TOMI Points Available In Souchdal Bulichng Frame and Erwalope.36 0
E.EXTERIOR FIMSH Points Awllable Per Measure
1.Use Re clod-Contend(No Yir in Plastic)or FSC-Gnified Wood Docking0 2
21nste11 a Relit Screen Well System D 2
Lj D.Use Durable and Noncombustible Siding Marshals 0 1
Lj 4.Saint Durable and Noncombustible Roofing Materiels 0 2
Total Polos Available in Exterior Finish.7 0
F.INSULATION Points Avallahle Per Measure
1.Install Insulation with 75%Recycled Convent
❑ a.Wells andror Floor D_ 1
❑ It.Cenin s 0 1
2 Install Insulation Net is Low-EmiNng(Cuddled Section D135D)
❑ a.Wella andlor Floors 0
❑ b.Collings D I
9.Inspect Quality of Insulation Installation before Applying Drywall 0 1
Tow Points Available in Inulatim.5 0
O PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Palms).
❑
A.Insulate Hot Water Pipes from Water Holter to Kitchen _0
❑ b.Insulate All HM Water Pipes
❑ c.Use Engineered Parallel Piping _ 0
❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop 0 1 __ __ _ _2
❑ 1.Use Central Core Plumbing O 1 1
❑ 2.Install Only High Efficiency Toilets(Dual-Flush or 5120 ppj 0
Total Points Available in Plumbing=Total 12 0
H.HEATING VENTILATION R AIR CONDITIONING Points Available Par Maasure
1.Dealgn and Install HVAC System 10 ACCA Manuel J,D,and S Reeommendadions 0 4
L Install Seated Combustion Unit
❑ a.Furnaces o -- _ _ 2
❑ b.Water Heaters 0 2 1I f
3.Install Zoned,Hydronic Radiant Heeding with Slab Edge Insulation 0 1 1
(.(retell High EMdency Air Conditioning with Environmentally Responsible Refrigerants 0 1
5.Design and Install ENecdive Ductwork
❑ a.Instag HVAC Unit and Ducnwrk within ContlMmed Space _0 3
r - -
❑ b.Use Duct Mew:on AP Duct Joints and Seems
❑ c.Install Duchworx under Attic insulation(Burled Ducts)
❑ d.Pressure BalBnoe the Ductwork System -
❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0 1
e.Imtall HI h Effielen HVAC Fluter(MERV 6v) 0 1
❑ 7.Don't Ireland Fireplace or Insall Sealed Gas Fireplaces with Efficiency Rating Not Less Than 60% 0 1
using CSA Standards
9.Install EOectM Exhaust Systems in Bathrooms and IGMhma .
❑ a.Install ENERGY STAR Bathroom Fane Voted to the Outside D
❑ b.Al Belhmom Fere Are on Tom or Humidrtal _0 -
❑ c.install Kitchen Range Hmd Varied to the Outside 0 I
g.Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ a.Install ENERGY STAR Ceiling Feng a Light(lts In Living Areas a BedrDDms _0
❑ b,Install Whole House Fen with Variable Speeds
❑ c.Automatically DminOed Integrated System
❑ d.Automatically CmboOed Integrated System With Variable Speed Central 0 3
10.Install Mechanical Fresh Air Votiiedion System(Maximum J Points)
❑ a.Any Whole House Ventilation System That Meets ASHRAE 622 0 _ _ 2 _
❑ b.Install Alr4coAk Hem Exchanger that meets ASHP,AE 62.2 D 1 2
71.Install Carbon Monoxide Admirals) 0 I
TOMl Points Available In Hoofing,Ven111ation and Air Condioningi 301 0
0 2007 Build It Groan Single Family Groar Point Checklist 2007 Version Page 2 of 4
MEW
a s
ENTER PRO JECT NAME
I.RENEWABLE ENERGY Prints Available Per Measure
1.Pro-Plumb tot Soler Hot Water Hoofing 4
LJ 2lnstall Solar Water holding System D 1 10
• 3.Install WrIng Conduit for Future Photovoltaic Installation 6 Provide 200 fe of South-Facing Root 0 2
4.Install Photovoltaic(PV)Panels
❑ a.3D%of electric needs OR 12 kW W 6 points) 0 6
❑ h 6D%d electric needs OR 241AN(sW 12 palms) D 6
❑ c.90%of elecrric need OR 3.6 kW(total 16 points) 0 6
Total Available Points In Renewable Energy=2B 0
J.BDGAWG PERFORMANCE - Prints Available Per Measure
1.Diagnostic Evaluations
❑ s.House Passes Blower Door Test _0
b.Hausa Passes Combustion Safety BackdraitTest 0 1 r
2 Design and Bulla High Performance Homes•%above Title 24•minimum 15%Required 0 >_30
❑ 3.House Obtalna ENERGY STAR wdh Indoor Air Package Certification-Prim Measure(Total 45 points;need comment) 0 5 2
Total Available Points in Building Performance 39 0
E.FINISHES Points Available Per Measure
1.Design En M to Reduce Tracked in Conteminanb 0 7
2.Use Low'VOC or Zmo-VDC Paint(Metlmum 3 Palms)
❑ a Lo VOC Interior WaIVCeRng Paints(d0 gpi VOCs(Flat)and=150 gp1 VOCs(Non+le4) 0
❑ b.Zam-VOD:Intend,WeIOCellin Pains d gpi VOCs(FTeq) 0 3
❑ S.Use Low VOC,Watm-Saeed Wood Finishes(450 qu,1 VOCs) 0 ! 2
❑ 4.Use Low-VDD Caulk and Construction Adhesives(C70 Sol VOCs)for All Adhesives 0 2
❑ 5.Use R cded-Conlem Paint 0 1
B.Use Envirommenslly Preferable Materials for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Rmeueble,D)Recycled-Content
or E)FlngerJohmed
❑ a.Cabinets(50%Minimum)
❑ b.Interim Trial(50%Minimum) 0 1
❑ c.Shelving(5D%Minimum) 0 _-
❑ d Doors(50%Mnimum) —0
❑ a.Couma a(50%Minimum) 0 ]
7.Reduce Formaldehyde In Interior Finish(CA Section 0135D)
❑ a SubfiDm is Stair Treads(50%Minimum) 0 1
❑ b.Cabinets fl Cmnsri _
ops(50%Minimum) 0
• ❑ c.Interior Tom(50%Minimum) _0 __. —7
❑ d.Slh 50%Minimum) 0 1 1
❑ B.AMr lnttmledon of Finishes,Test of Indoor Air Shows Formaldehyde Level 47ppld 0 3
Total Available Points In Finishes=21 0
L.FLOORING Poinis.Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Certified Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Coment E
Exposed Concrete.Flooring Adhashea Must Nava degpt VOCs.
❑ a.Minimum 15%of Flom Area 0
❑ b.Minimum 30%d Floor Area D
❑ c.Minimum 50%or Floor Area 0 1 __
❑ Q Minimum 75%of Floc Area 0 ! ]
❑ L Thermal Mass Floors:Floor Covering Other than Carpet on 5D%or More of Concrete Floors 0 1 i.
3.Flooring Macs Section 01350 or Did Green Label Plus Requirements(50%Minimum) 0 1 1 2 1 1
Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
1.Install Water and Energy EMcient Dishsahm
❑ a ENERGY STAR gosl 1 polnU D
❑ b.Dishwasher Uses No More Nen 6.5 GellonslC Ie(Val2points) 0 1
2,Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a Meets Energy Ser and DEE Tier requirements(modified energy factor 2.0,Water Factor 6.0)imall3 Points) 0 1 2
❑ b.Meets Energy Star and DEE Ter 3 requirements(modified energy factor 22,Water Factor 4S s less) 2
totals Intl D
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified fl=25 Cubic Feet Capacity 0
❑ b.ENERGY STAR Qualified 6 c 20 Cubic Feet Capacity 0 1 T
4.Install Suiltbn Recycling Carrier 0
❑ a Suit"'Recycling Center p
❑ b.Suil4n Composing Center p 1
Total Available Points In Appliances and Lighting=12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporate GremPoint Rated Cheoldist in Blueprints•Required 0 - R
❑ 2.Develop Homeowna Manual of Green FeaturesrBmefis 0
3.Community Design Measures a Local Priorities:See the Community Planning 6 Design sectlon In Chapter 4 of the New Home Guidelines for
• measures.Maximum of20 points fm suggested measures.Local requirements may also be filed here.
02007 Build It Green Single Family GreenPoim Checklist 2007 Version Page 3 of 4
.1
PROJECTENTER
Enter dawriaron hen,and emer pons veteran In measure in flem oo Wagon W the right. 0 0 D D D D
Enter dncnp6on here,and amo pours available la menum In Appmpnela cnegodn to the rot 0 D D a D 0
Enter dewrlpllon here,and onto pals variable her meaun In appmpdale mergodn to the right. 0 D 0 0 0
Eller deacrlpdon ham,and euro polls available In measure in appropriate cM Drn 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 Build It Green Checklists and
maximum combined total of 20 ptal.See Innovation Checklist for suggested measures us Ing the link to the right. _ Guidelines
Innwalion In Commoner.Enter decor Ion hen,and amnr pointa avalloble to headline In appropriate Carillons to the right. 0 D 1 0 1 0 D D
Innwallon In Energy,Enter description here,and enter dna available he measure In late cog oln to the right. 0 0 0 0 0 0
InnovallooIn IAaHatlh:Enter Mac on here,and anter points milable to mseoa in le wle odes ID the 0 0 0 0 0 0
Imiwaeon m aaouroea:Euro Memblmn hoe.and emer Palms walebla fu meeeun in appropriate rat es to the d _ 0 0 D 0 0 0
Innweean in We wm.Enter decr an hare,and emw pblrM wellable to measure in epPopdau oenpodn to the d9l6 0 0 D o 0 0
Teel Available Poll in Other•4 D
Surnmary
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required In Speclflc Cete9odes 0 30 6 6 9
Total Points Achieved Ot e e0 e e
Project has not yot met the following recommended minimum royulromentsr
- Total Project Score of At Least 50 Points
-Required measures:
43a:50% waste diversion by weight
-J2: 15%above Title 24
-NI:Incorporate GreenPoint Rated Checklist Into blueprints
-Wrilmum points in specific categories:
-Energy(30 points)
-IAQ/Health (5 points)
-Resources(6 points)
-Ilrater(9 points)
0 2007 Build It Green Single Family GresnPoint Checklist 2007 Version Page 4 of
Community Development
1030 Torre Avenue
sa
Cupertino CA 9014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
CUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
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080 dU �o
OWNER'S NAME: HONE # p " -
GENERAL CONTRACTOR: Cr— p/� FAX
I am not using any subcontractors: zspz
ibnature 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
Owner/Contractor Signature Date