08010093 CITY OF CUPERTINO4rm4
BUILDING DIVISION PERNIIT ,kaCON12AC�T.QRNFORMATIO�
BUILDI G qqO ESS: PERMIT NO.
1Wff RAMPART AVE ALTON AIR CONDITIONING & HT 08010093
OW NER'S NAME: PEReM ISSUEDATE
OWYANG—LEE 45300 INDUSTRIAL DR 01/15/2008
ONE: SANITARY NO. CONTROL NO.
ARCHITECDENGINEER: BUILDING PERMIT INFO
REPLACE FURNACE, 100K BTU eB e� PO 0
uoo LICENSED CONTRACTOR'S DECLARATION Job Description
OF� I hcmby affirm thea 1 am Ime ead under Provisions or Chapter 9(enmmcmbtg p
with Section 70(10)of Div Won 3 of the Buurw and Pra(nsiaro Cade,aW�li.c.re
^�$-, to
(arts and eB 11
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^p Dam at car
7W ARCHITECTS DECLARATI
6
U 1 undmxand my plane shall W head u public rtc
g0Liconcd Plainest anal
S 5 OWNER-exampt frDECLARATION
C 9 I hereby.(sero that 11. exempt from Na fessi�mre :Any c law far Ne
O O following reason.(Sc=ion 71mam Business and Improve,
de iudi Code:Any city or county
3 3
which mgulrte•issuance.also re conuhe aper.Improve,d=muhah,or repair my amtmem
�Z}
prior tolmenseprsu m9ot he pro.pions of for such Permit mBl=ae Lam(emmmrrll
x52 Nn ixulicewith Snuam totheof Diriom of of ft Buenessan¢velsiw(aapmr9 Sq.Ft. Floor Area Valuation
i-$ 'at
with Section 70n d th o alis n,err Ne Business and on.My vi Code)or
^ Nm ha re samnpt thcmlram and de bore for the allotted assumption.My vio1Won of
Section 7031.5 by any applicant for a permit mbjecu the Applicant to a civil penalty of APN Number Occupancy Type
Out came dun five hundred dollars(5500).
❑1,u owner of de property,or my employee with cages u tisir mm enmpewtimn.
will do Newark,and thmre
eucture notlnended maltreated forsale(Sm.70a t.Bushes,
and Profession Caec T1s Contractors Licetue law does mm apply to an owner of Required Inspections
property who bunds or Ion prows thereon,and who does such wart himselr orthrough his
own employma,provided thatsuch Improvenuum arc not lamented ororteted for We.if.
however.the building or Improvement resold within an year of completion,the owner-
bullder will low W burden of proving that ha did not build Or improve for purpose of
ark.).
❑1.u Owner or than pmpeny mos escl Wvely contracting with licensed=ontlectun m
construct site project(Sm.7014.Businere and profession Code)The Contractors U.
cone Law does not apply to an owner of pmpeny who builds or improves themon,and,
who conu ens for surd projects with a eonumtor(s)licensed pumuunt to the Contractors
Lleene law.
[:] I am nemptunder Sac .B A,P C For thus moron
Owner Date
WORKERS COMPENSATIONDECLARATION
I herby aBhm under Family of perjury,am of the fallowing declandions:
I haw and will manuin t CeNOnmaf Caneanno self-Imurt far Worker=Comp=n-
an,u provided for by Section 3700 of Iha labor Code,for dna performance of that
work fm which this permit is issued '
❑1 have and will maintain Workers Compenatian Insurance,u requard by Section
3700.1'the labor Code,fm the perfarm ucemrthe wont far which this Permit le Iset
My WCpmpemdae Ltvuanq ca nim W Polity numbv up;W� /r1' m (�f7Llt Z tie-.
ry,.V. e01rs. FPolley W �--�-1
CERTIFICATE.OFEXEMPTION
XEM NFROM WORA
COMPENSATION INSURANCE
(Thiemedon need sotbecompl=teti If tie permit is froom hundred dollars($100)
or loss)
I comfy that in the performance of thO work for which this permit Is issued,l their not -
emplay any penan In my mannerso as to become subject o the Worker'ComF=nation
Laws or California.Dae
Applicant
NOTICE TO APPUCANC IL trier making this Cenincae of Examptian,you should
become subject to the Warders Compensation provision of the labor Cade,you am
0 forthwith comply with such provision or or this permit mall he dmmcd mated.
y CONSTRUCTION LENDING AGENCY
[r I Manby ailuro thea then Is.construction ending agency far the performance at .
CL the work fm which Ims pemuit U Wised(Sec.3097,Ch.Q
QLanders Name
z Lenders Address
U eF I calcify that I haw mW this application and sum that the show information is
12, U .arre=L I agree to comply with all city and county ordinances and tum laws misting to
_O building construction,and hemby indication mpmeanutives or this city to murupnn the
L57 shove-memdonW Property for inspection purposes.
LL
(WO)ati m to eve,iM=mnity and keep heatless the City of Cupertino lips.
SOURCE
yr,A liabilities.jWgmonu,cru and expe•ast which may in my way section against said City
1'J 7 in cmtemmom Of the granting of thp permit.
r'� APPLICANT U DERSfANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
Re-roofs
Signume licca ontrsctor Dam -
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
the applicant or fuutm building accumot Rom or handle havemon materia
as defined by site Cupertino Municipal Co .Chapmr 9AZ and the Heath and safety
cWe.Scotian 25532(a)7
❑Yrs All roofs shall be inspected prior to any roofing material being installed.
Will the appricmt or rumor Wit! cups I area equipment or devices which If a roof is installed without first obtaining an inspection,.I agree to remove
't havamnn air cmWelam of u& by the Bay Arta Air Quality Mem2notant all new materials for inspection.
uicq
prat PXa
I hone rtW the hrzWms materirleroquimm=nuumkrChapter6.95aftheGlifor-
nreHulthA Samy Code.Sections 25505,25533 mil 25334.1 underhand thatifth,building
does an,cuready haw a moanl We it is my mmoniMlity to notify the occupant or thc
rcyulm .new on 'artoissuartec of
Crnilvam orOccupue>-j Signature of Applicant Date
GUS
owners rota. ,edas=nt Dam' All roof coverings to be Class"B"or better
W1 D D�j3
aiRF CITY OF CUPERTINOFURNACE/AC
CUPINO PERMIT APPLICATION FORM
APN# Date:
_O O
06 S^
Building Address:
'S C3
Owner's Name: Phone #:
6c�yy=aKc�` LE 0
yC>£3—.f7 r7'7—cog a
Contractor: Phone #:
Fax #:
Contractor License#: Cupertino Business License #:
Contact: ,/,_ �L'�ly Phone#: " ( — 2'l lU
Fax #:
Building Permit Info:
Elect Plumb Mech [�
Residential Commercial El
Job Description: FWF—"HC6� C-o 1pi,tCxj� Z'(l
For Residential Installations:
Attic ❑ Is` floor 2nd floor ❑
Adhere to minimum setback requirement ❑
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural talcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Projects 2 Type of Construction (Usage Class):
y�aclU. cx7
Strapped On Platform Bonded El New Location Replacement
Valuation:_( 3 a�Q
Green Building: Must attach Green Building Check list to this application
CITY OF CUPERTINO
I���" FURNACE/AC
. CITY OF
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
IMCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,ihcl
installation of controls regulated by
this code.
IMRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
IMRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install & not incl in an appl permit.
at-m-
CITY
CITY OF CUPERTINO
FURNACE/ACCURTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
IPGASRES -Residential-for ea-gas of--P-
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
IBSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
famace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1 MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
/ IMPERMITFEE Mechanical Permit Fee M
IPPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
IBUSLIC Business License B
•
CITY OF CUPERTINO
Sm;1-' FURNACE/AC
CITY OF
• CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
_ CONDITIONING
1BCAIRHAN Commercial A/C Units <=—1 Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P _
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAIRHAN Residential A/C units <= lOk CFM B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
IMPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
ITRAVDOC Travel Documentation B
IBUSLIC Business License B
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CITY OF CUPERTINO
• 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36925009 . 00
DATE ISSUED. . . . . . . : 01/15/2008
RECEIPT # . . . . . . . . . : BS000003702
REFERENCE ID # . . . : 08010093
SITE ADDRESS . . . . . : 10502 RAMPART AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : OWYANG-LEE""
ADDRESS . . . . . . . . . . : 10502 RAMPART AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4525
RECEIVED FROM . . . . : ALTON AIR CONDITION
CONTRACTOR . . . . . . . : ALTON, MICHAEL LIC # 21326 -
COMPANY . . . . . . . . . . : ALTON AIR CONDITIONING & HTG
ADDRESS . . . . . . . . . . : 45300 INDUSTRIAL DR
CITY/STATE/ZIP . . . : FREMONT, CA 94538
TELEPHONE . . . . . . . . : (510) 490-5655
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------ ---------- ---------- ---------- --------- ----------
1BSEISMICR VALUATION 3, 290. 00 0.50 0. 00 0 .50 0. 00
1BUSLIC FLAT RATE 1 . 00 110.00 0. 00 110 . 00 0. 00
1EPERMITFE FLAT RATE 1. 00 40.79 0. 00 40 .79, 0. 00
1MFR=<100 UNITS 1. 00 122 .38 0. 00 122 .38 0. 00
1MPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 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 396 . 04 0. 00 396 . 04 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------------
CHECK 396 . 04 #6300
---------------
TOTAL RECEIPT 396. 04
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
.1 Single Family GreenPoint Checklist date, Build ItGreeri
The GreenPoint Checklist Is based on the various green features incorporated into the home and is the Smart 5inuthons From The Grwrd Up
basis for the GreenPoirn Rated program.A home can be considered green if It fulfils the prerequisites, F—I
earns at least 50 points,and mean the minimum come par category.Energy list
of Indoor Air Onualkyl I I
Health(B),Resources(fi),and Water(g).Please contact Build It Groan for a list of quallfietl GreenPoint I JI
Raters If you are Interandeb In pursuing third-party verification. L
• The green building pramicas listed below are described in the New Home Construction Green Building
Guidelines,available at www.builditoraen oro.
ENTER PROJECT
• • t
A.5118" Points Available Per Measure
1.Protect Topsoil and Minimize Disruption of Existing Plant 6 Tree
❑ a.Protect Topsoil from Erosion and Reuse after Construct= 0 ] 1
❑—tiLimd endDelineale Cmat=-6m Foo¢uinifa MaxPFoteCtian - 0 ]
2 Deconseruct Instead of Demolishing Existing Buildings On Site 0 3
3.Recycle Job Site Construction Waste(Including Green Waste)
❑ a.Minimum 50%Waste Diversion try Waight(Ru)))ing or Rouse-Required 0 R
❑ d.Minimum 85%Diversion by Weight(Recycing or Reuse) 0 2
El c.Minimum BD%Diversion by Weight(Re cycling or Reuse) 0 -- -- 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a Walkway and Driveway
El b.Roadway Base 0 ___ ]
Total Points Avallable In Site 12 0
B.FOUNDATION - - Points Available Per Measure
1.Replace Portland Cement in Concrete with Resydad Flyash or Slag
O e.Minimum 20W Fly1tcr Slag
❑ b.Minimum 25%F ash or Slag 0 1 !
2.Use Frost-Protected Shallow Foundation in Cold Areas(C.E.C.Climate Zone 1B) 0 3
El 9.Use Radon Resistant Construction In At-Risk Locations Only) 0 11
4.Design and Buiid Structural Pest Controls
❑ a.Install Temille Shields A Separate All Exterior WDDd-to-CDncrete ConnectionsMetal a Plastic FasumersOMdars p ] !
b.All New Plains Have Trunk,Base,or Stem Located At Least 35 Inches from Foundation 0 1
Total Points Available in Fountlatlon=8 0
C.LANDSCAPING Points Available Per Measure
1.Construct Resource-Eficiem Landscapes
❑ a.No Invasive Species Listed by Cel-IPC Are Planted
0
❑ b.No Plain Species Will Require Hedging _0
. ❑ c.75%of Plants Are Drought-tolerunt California Nantes,Mediterranean,or Other Appropriate Spsctes p 3
2.Use Fire-Safe Landscap n Techniques u 1
3.Minimize Turf Areas in Landscape Installed by Builder
❑ a.All Turf Will Have a Water Requirement Less than or Equal to Tag Fescue(SD.3 plain factoq D ! 2
❑ b.Tud Shall Not Be Installed on Slopes Exceeding 1D%or In Area Less than 8 Feet Wide 0 �_ 2
❑ C.Tud Is 513%of Landscaped Area(fetal 2 points) D _ 2
❑ J.Tud is S10%of Landscaped Area(total 4 points) 0
/.Plant Shatle Trees 0 3
❑
S.Group Planta by Water Needs(Hydrozonin ) 0 2
S.Install High-Efficiency Irrigation Systems
❑ a System Uses Only LowFloM Dnp,Bubblers,or Law-low Sprinklers 0 I ! ! ! 2
❑ b.System Has Strait Controllers 0 3
7.Inco orate Two Inches of Compost In the Top B to 12 Inches of Soil D ! 3
El e,Mulch All Placing Beds to the Greater of 2lnches or Local Water Ordinance Requirement 0 ! ! 2
9.Use 50%Selvaged or Racycled-Content Materials for 50%of Non-Plant Landscape Elements 0 1
10.Ratluee Li htpllutiDnb Shielding Rxturet andfDr Directing Light Downward 0 1 ! !
Total Points Available in Landsca In =31 0
D.STRUCTURAL FRAME&BUILDING ENVELOPE Points Available Per Measura
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 24-Inch On Cerner Framing 0 1
❑ b,Size Door and Window Headars for Load
0 _! 1
❑ c.Use Only Jack and Cripple Studs Required for Load 0 1
2.Use Engineered Lumbar
❑ a.Beams and Headers 0
❑ to.Insulated Engineered Headars 0
E3c.Wood bJokk or Web Trusses for Floors
❑ d.Wood 1-Joists for Roof Raters 0 __
❑ 0.Engineered a Finger.,mi ted Studs for Vertical Applications _0 ! 1
❑
I.Oriented Strand Board fa Subloor 0 -- ; —
❑ g.Oriented Strand Board for Wall and Roos Sheathing 0 ! 1
3.Use FSC.Certlfietl Wood
❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% p !
E] b.Dimensional Lumber,Studs antl Timber:Minimum 70% _ 0
® ❑ c.Panel Products:Minimum 40%
❑ d.Panel Products;Minimum 70% 0 1 I
02007 Build It Green Single Family GreenPoint Checklist 2D07 Version Page t of 4
IEWEA . .O
V
4.Use 50 o Well Systems(Includes SIPS,ll&Any Non-Stick Frame Assembly)
❑ a Floors - p 1 2
❑ dWalls 0 —Z i _
• Elc.Roots 0 _—.— 2.——_j 2 —
5,Reduce Pollution Entering the Home from the Garage
Ela.Tghtly Seel the Air Barrer between Gal and Living Area 0
El In.Install GalExhaust Fan OR Build a Detached Garage 0- 1
77 S.Design Energy Heals on Trusses(75%of Attic Insulation Height at Outside Edge of Exterior Wall) 0 1
❑ 7.Design Root Trusses to Accommodate Ductwork 0 1
77 Is Use Rerycied-COment Steal Saudis for 9r%M Interior Well Framing 0 1
L LJ B.Thermal Mass Walls:SIB-Inch Drywall on All interior Wells or Wells Weighing more than 401blcu.111. p 1
10.Install Overhangs and Gullers
---- �- - --e:Minimum 16-Inch Overhangs and Gutters -- - -- - -- - -- ---- - o - i-
❑ b.Minimum 24-Inch Overhangs and Gutlars 0 1
Total Points Available In Structural Building Frame and Envelops 36 0
E.EXTERIOR FINISH - - Points Available Per Measure
1.Use flerycied-Comenl(No Virgin Plitatic)or FSC-CaNfied Wood Decking p Z
2.Install a Rein Scheer Well System D 2 1
3.Use Durable and Noncombustible Siding Mmariais 0 1
❑ C Select Durable and Noncombustible Roofing Materials - 0 2
Total Points Avallable in Exterior Finish=7 D
F.INSTILATION" _ ' � '- Points Available Per Measure
1.install Insulation with 75%Recycled Content
❑ a.Walls andor Floors 0 ]
—E]—b.-Callings 0
2.Install Insulation that Is Low-Emitting(Certified Section 01950)
❑ .a.Walls anWor Floors 0 1
❑ d.Ceilings 0 1
❑ 9.Inspect Duality of Insulation Installation before Applying Drywall 0 1
Total Points Avallable In Insulation=5 0
G:PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
❑ a.Insulate Hot Water Pipes from Water Heater l0 Khchen 0
❑ b.Insulate All Hot Water Pipes p ]
❑ c.Use Engineered Fe l Piping 0 — 1
❑ d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop _D —_1- _ 2
❑
I.Use Central Core Plumbing0 11 ! 2
❑ 2.Install Only High Efficiency Toilets(Dual-Flush or 5126 gpf) D 4
Total Points Available in Plumbing=Total 12 D
H:HEATING,VENTILATION&AIR CONDITIONING Points Available Per Measure
❑ 1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendations 0 4
1 Install Sealed Combustion Units
❑ a.Furnaces 0 �_�
0
E] b.Water Hasse; 0
ters 2
77 3.Install ZoneZoned,Nytlronic Radiant Heating with Slab Edge Insulation 1 1
4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1
5.Design and Install Effective Ductwork
❑ e.Install HVAC Unit and Ductwork within Conditioned Space 0— 3
E] Jo.Use Duct MasSc on All Dud Joints and Seams p ------I-�
❑ c.Install Ductwork antler Attic Insulation(Burietl Duch) p --- —
❑
d.Pressure Balance the Ductwork System 0J--
❑ e.Protect Duds during Construction and Clean All Dugs before Occupancy 0 1
S.Install High Efficiency HVAC FIItar(MERV Sa) D 1
❑ 7.Don't Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Less Than 60% 1
using CSA Standards 0
B.Install Effective Exhaust Systems In Bathrooms and YJtchans
❑ a,Install ENERGY STAR Bathroom Fans Vented to the Outside 0 _ 1
❑ le.All Bathroom Fans Are on Timer or Humidistet
❑ c.Install t0tchan Range Hood Vented to the Outside 0
9,Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ e.Install ENERGY STAR Ceiling Fans&Light Kits in Living Areas&Bedrooms _D
❑ b.Install Whole House Fan with Variable Speeds 0
❑ c.Automatically Controlled Integrated System _ 0 2 � __
—
❑ d.Automatically Controlletl Integrated System with Variable Speed Control 0 —'-- 3 i
10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ - a.Any Whole House Ventilation System That Meets ASHRAE 622 p 2
❑ b.install Air-to-Air Heat Exchanger that meets ASHRAE 62.2
LJ 11.Install Carbon Monoxide Alarms) p 1
® Total Points Available In Hearing,Ventilation and Air Conditioning 30 0
0 2007 Build It Green Single Family GraerrPDlnl Checklist 2D07 Version Page 2 o14
PROJECT NAME
1.RENEWABLE ENERGY' Points Available Per Measure
LJ 1.Pre-Plumb for Solar Hot Water Heading 0 4
2.Install Solar Water Heading System 0 1 To
. LJ 3.Install Virifing Conduit for Future Photovoltaic Installation 6 Provide 200 he of South-Facmgl Roof D 2 i
4.Install Photovol adc(PV)Panels
❑ a 30%of elechic needs OR 12 kW(atal6 Pat=) 0
❑ , b.50%of electric needs OR 2.41kN(total 12 poims) _0
❑ c.9D%of electric need DR 3.6 kW(local 18 points) 0 6
Total Available Points In Renewable Energy=2B 0
J.BDILDING PERFORMANCE- Palms Available Per Measure
1.Diagnostic Evaluations
❑ a.House Passes Blower Door Test 0 }
----- - b:House Passes Commodon Safery Backdrell Test -- --- --
2 Design and Build High Performance Homes-%above Titie 24-minimum 15%Requred 0 >30
❑ 3.House Obtains ENERGY STAR with Indoor An Package Certification-Pilot Measure(Total 45 points;read comment) 0 5 2
Total Available Points in Builtlin Performance=39 0
R.FINISHES Points Available Per Measure
1.Design Entryways to Reduce Tracked in Contaminants 0 }
2.Use Low-VOC or Zwo-VOC Paint(Maximum 3 Points)
❑ e.Low-VOC Interim Waltili Pain(6D gpl VOCs(Flat)and 450 fit,I VOCs(NonFlat))
❑ b.ZSro-VllC:Interior WelllCeilln Paints b gol VOCs(Flap) 0 3
❑ 3.Use Low VDC,Wider-Based Wood Finishes;(450 got VOCs) 0 1 1 2
—Q-4.Use Caulk and Construction Adhesives(OO gpI.VOCS)forAliAdhesive 0
❑ 5.Use Recycled-Content Paint 0 1
G.Use Environmentally Preferable Materials for Interior Finish:A)FISC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,0)Recycled-Content
or E)FlngerJoinced
❑ a.Cabinets(50.4 Minimum) 0
❑ b.Interior Trim(50%Minimum) p -----} --
❑
C.Shelving(50%IAinimum) 0 1 -
❑
J.Doors(5D%Minimum) 0
❑ e.Countanwas 50%Minimum) 0 1
7.Reduce Formaldehyde In Interior Finish(CA Section 0135D)
❑ a.Sub600r B Sta4 Triads(50%Minimum) 0 f }
❑ b.Cabinets s Countedops(50%Minimum) 0 1
® ❑ C.Interior Trim(50%Minimum) p -- —
❑ d.Shelling(50%Minimum) 0 1
❑ B.After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Level<I 0 1 3
Total Available Points in Finishes=21 0
L.FLOORING IPoints Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Cardfied Wood,B)Reclaimed or Refinished, C)Rapidly Renewable,D)Recycled-Content,E)
Exposed Concrete.Flooring Adhesives Must Have<50 lit VDC9.
❑ 9.IAINmum 15%of Floor Area - 0
❑ b.Minimum 37%at Floor Area 0 j 1 1
❑ c.Minimum 50%of Floor Area D 1 __
❑ d.Minimum 75%of Floor Area 0 T 1
❑ 2.Thermal Man Floors:Floor Covering Other then Car et on So%or More of Concrete Floors 0 1 f
❑ 3.Flooring Meets Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 2
Total Available Points in Floomill=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
1.Install Water and Energy Efficient Dishwasher
❑ a ENERGY STAR(latal l point) 0 i 1 1
❑ b.Dishwasher Uses No More than 6.5 Gallon de lotal2 pol 0 ij 1
2.Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier 2 requirements(Modified energy factor 2.0,Water Factor SO)(total 3 points) 0 1 _ _2
E] A Meets Energy Star and CEE Tier 3 requirements(modified energy fa:tor 22 Water Factor 45 or less) 0 .T 2
totals lots f
3.install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Oualified a e 25 Cubic Feet Capacity a
❑ b.ENERGY STAR Ouaiified B e 20 Cubic FeetCapacity0 1 —�
4.Install Buill-In Recydtng Center 0
❑ a.Bulll Recycling Center 0
E] b.Bull Composting Center 0 1
Tidal Available Points in Appliances and Lighting=12 0
N.OTHER Points Available Per Measure
❑ 1.Incorpoba Omani Rated Checklist in Blueprints-Required 0 R
❑ 2.Develop Homeowner Manual of Green FeaturesrBenefits 0 1 1 r 1
3.Community Design Measures 6 Local Priorities:See the Community Planning a Design section In Chapter 4 of the New Home Guidelines for
measures.Maximum of 20 points for suggested measures.Local requirements may also be fisted here.
02007 Build It Green Single Family GreanPoint Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAME
n a v a
❑ Enter tleuription here,end ever ms avmtaid for msasure L ale care ones to Men t 0 0 _ _0 0 _0_ _0-----
and - - e�roprl--"p-----�'—
❑ Enter tleurlption hare,end enter pants wallaae to measure In epmomme mnliP nes to Me nghL_ - ____ D 0 __0__ _ 0 0 __
❑ _Einar deuription here,and anter pains ava0safe for measure In am atsRpri s to Me fight 0_ _0_ 0 _
• ❑ Ener tlescriplbn here,end enter points avmlable for measure in appropriate tate ones to Me right D__0_ _0_ _0 0 _ 0 _
4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up to a B IId It Gr en Checkl'sts and-
maximum
dmaximum combined total of 20 pts.Sea Innovation Checklist for suggested measures,using the link to then ht Guidelin
Li Innovmton In Community:Enter desurdam here,and enter aims avalwe ter-measure in approphme categories to Men t _ 0 0 0 __0_Eloo__
0
❑ Innovator in Energy:Enter desmrition here,and enter pains avallaae for measure in mpnate categories to the right. 0 0 _ 0_'_ _D 0__❑ Innwetion In IAOIHaelth:Enter deunplion here,antl enter Dins avalleble fa measure in cpnas tate odes to the night 0 D 0 0D _Innwetioningmources:Enter description here,antl enter oink uallable to measure in ep nate categories to the n ht 0 0 0 0 0 _❑ Innovedon in WeerEiner tleuription hereand enter ains avmlablfor min appropriate categories to Me right D D D0 0
Tosl Available Points in Other=43, 0 -
Summary
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories 0 30 5 6 9
Total Points Achieved r e I e t 1
Project has not yet met the following recommended minimum requlrements:
-Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% rmaste diversion by weight
Jd�IS%-above-Title-24 _
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific cdtepories:
-Energy(30 points)
-I40/Health(5 points)
-Resources(6 points)
-Mater(9 points)
•
•
02007 Build It Green Single Family GreenPoint Chndsl 2007 Version. Page 4 of 4
Community Development
OCIF
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
CUPEkTINO
Building De artment
JOB ADDRESS: I QST fl1 � E PERMIT # 0&
r O` (,Dog
OWNER'S NAME:p 4-E�£ PHONE # ag- p a
GENERAL CONTRACTOR FAX #
I am not using any subcontractors: V-�- a
Signature Date
Please check applicable subcontractors d 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