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08020165 FORMATIO Ik BUILDING DIVISION NT. "CITY OF CUPERTINO ` Epy�T - ; BUILDING ADDRESS: PERMIT NO. 10741 RANDY LN TBD - TO BE DETERMINED 08020165 OWNER'S NAME: PERMIT ISSUE DATE MATSUNAMI GARY 02/26/2008 ONE: SANITARY NO, CONTROL NO. ARCHITEC MNGINEER: BUILDING PERMIT INFO BLDG E� PLUMB 0 0 0 LICENSED CONTRACTOR'S DECLARATION I Job Description 1 Wooley affirm that 1 sur licensed under Provisions of Chapter 9(commencing p with Section 7M)ofDiviaion 3 allies Business and Profeuiuu Code,and my license is INSTL PROP LINE CLEANOUT. IBEE PLUMBING PD FOR n rl in full to.and effort. Nagy �2 License Lm.M RBS-I90 BSL Dau `C jWgt f�Contractor Ylk�tjZy„v rr.w.� B W C l t AR�CHr1ECI'S DECLARATION 2/28/8 U 1 undenunJ my Plane shall W usetl u puhlie mrnrJa yo Licensed Pmfcssianal OWNER-BUILDER DECLARATION S 1 Worthy aRrm on I em exempt Bum the CanvactCo License Law for the C 20 following moon.(Section 703 LS,Business end improve. dem li Calc:Any rily at county which its is a a permit ro co oo the alar.improv,demolish.or repair ed structure �Z�w priarmits issuance,also requires the inion O for such permiuofilew anwJauumem g that he is licensed purusenuo to Provisions of the Conuacmrk License law(Chapter Sq.Ft.Floor Area 1600 Valuation 9^$ (commencing with Section 7")of Division 3 of the Business and Professions Cm)at 3 that M Is exempt theofmm and the bub for the alleged eumplian.Any violation of Secdon 7031.5 by any applicant for a permit ubjects the applicants On a civil penalty of. Number Occupancy Type nor come than It.hundred dallua($500). 31602 040 .W ❑1,u awusa of the pmperty,army employed with wagesu thew ole compensation, will do the work,and theasbacmm is notimended muQeed foreale(Sec.7044,Business Required Inspections and Professions Cade:The Conscience,Liaise Law Cads Out apply m e ns an owner of q p property who builds or improves themon,and who does such work himself or thmugb his however.the ildingdedthalauch(mpmvemdtsaene intended arofcmo@rcd fm Wk.mem- [7 however.the Wilding Orden of p memtg sold within one year of amplWan,the over TAR builder will haw ties leaches of povmg Nat K did ust build cur improve far puryose ofComes. ❑f.ea tarter of the S c.70,1 ,B escualwlY convecting with )Ton C canvam's - Construct a the p of Use (Sec.7614,Business and PmRatloru Cade:)the Con ntrusu s U- U(//r c��'\� cense Taw does not apply to an owner of poor(who Wilda or improves theean,and, whence Lace for such projects contractcontractor(s)with contractor(s)Ilansetl pumm m We wContractor's License ❑Lem demPt antler See ,B&PC fa Nis mason Owner Date WORKERS COMPENSATION DECLARATION 40 I herby affirm under penalty of perjury one,of the following dacle rations: ❑I haw 4nd will mainuin aCer Timm of Consent a self-insum for WorkeJ4Compen- ution,as provided for by Sodium 3700 of the Inbar Cade,fm the perform.¢of the work for which this permit is bound. ❑1 have and will maintain Wafer's Compensation Insurance,an required by Schon 3700 of the Latour Cade,for the performance of de work for which this permit is issued. My Work e,Compensation Inaunnce caries and Policy number ore: Cartier.b "Pal �^a5r Petry No.0011oSy'ZooI CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sedan used nothecompleted if the Permit is(wont hundred doBass($100) or Iris) 1 anify Net in the performe ea of the work for which this permit is issued,I shell not employ any person in my muner an as to become subject to the Workdri Compensation Lawn of California.Dam Applicant NOTICE TO APPUCANP.If.after making this Cenificate of Exemption,you should become subject to the Went Compensation provisions of the LnWr Codd,you must .,7. foMwith comply with such provisions"i,parmitshaii W Counted rewked. ,Z.,O CONSTRUCTION LENDING AGENCY Iherob,.M.Own these isacoutroudnn lending agency for the peopmoutead !Yi> to work for which this permit is issued(Sea 3091,Civ.C.) WQ Lender's Name � ad 2 lenders Address V Q L certify that I have dad this application and sum that the above information is IT,!'T Comm 1 agree m comply wit all city and county orcho ncea and sum laws elating to QSV^ building commosetion.and hereby authorim representatives of this city to door upon thc 4i] above-mcndoned property for Inspection purposes 6. (We)slime to now,indemnify and kap hvmless the City of Cupertino agalnsl Cj liabilities.judgments,coats and expense which may in Coy way accrue egaind acid City V Z in consequence of the grandng of this permit, ^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date CL��•( SOURCE REGULATIONS. o Re-roofs Ifeut/Canvacmr Da HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tee applicant or future Wilding Oceupnrt nae arhandle haurtlons material as defined by Bre Cupertino Municipal Code,Chapter 9.13,and the Health and Safety Cade,Saction 25532(m)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yea Pin— Will esu applicant ur fume building Ompant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hadrdou air cemarrinsom u de0usd by the Bay Area Air Quality Management all new materials for inspection. District? �� ❑yes L4Y I have sad the huudoes materials requirements under Chapter 6.95 of the Califor. nia Health&Safety Code,Sections 25505.M533 and 25534.1 undersand esu if the Wilding does not currently ham a tenant,that it b my maponsibility On rmdfy the occupant of the requiremmut wh4 mnO,1P mel prior so ssuanm of u Cotifteam of Occupancy. Signature of Applicant Date a All roof coverings to be Class"B"or better se nfr 94u Livollices 1,6n ate' • CITY OF. CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31602040 . 00 DATE ISSUED. . . . . . . : 02/26/2008 RECEIPT #. . . . . . . . . : BS000004030 REFERENCE ID # . . . : 08020165 SITE ADDRESS . . . . . : 10741 RANDY LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER MATSUNAMI GARY ADDRESS . . . . . . . . . . : 10741 RANDY IN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM BRC DRAIN CLNG INC CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD -. TO.'BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -------=-- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 1, 600. 00 0. 50 0. 00 0 .50 0. 00 IPPERMITFE FLAT RATE 1.00 40.79 0. 00 40 .79 0. 00 1PRSEWER UNITS 1. 00 20.40 0. 00 , 20 .40 0. 00 ITRAVDOC 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 ----------------- --------------- -------------------- CHECK 102 .48 #1319 --------------- 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 • -� 010 ( (-D5> CITY OF CUPERTINO -' REPIPE/SEWER/MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM APN# ( lPe� p2OLf0 C)C� Date: Oa bks o Building Address: �I 10 '7L11A of P, L ri Owner's Name: Phone#: 2� Al Svo Aw, yog 61st 5p'lLI -I Contractor: Phone#: clog - old _ t o r G 6-G Fax #: Contact: Phone#: L10S . gL19-3-1-1-1 Fax #: Contractor License#: " g Q 1 9 p Cupertino Business License#: G` 9 Job Description: Z a s w 11 L Residential Commercial Valuation: I & o o 00 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 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 IPGASRES Residential Gas Piping System P 1-4 Outlets IBPGAS Gas Piping System 5+ Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P iPLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P 1 TRAVDOC Travel &Documentation Fee B 1BUSLIC Business License B • Single Family GreenPoint Checklist date: tea a6 °a Build It Green Smart Solutions From the Ground Up The GreenPoint Checklist is based on the various green features Incorporated into the home and is the basis for the GreenPoint Rated program.A home can be considered green if It fulfills the prerequisites, - • Hams at least 50 paints,and meets the minimum points per category:Energy( Indoor Air Quality/ Health(5),Resources(6),and Water(9).Please contact Build It Green for a listt of of qualified GreereenPoint L JI L JI 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 bunditoree i.ora. $ c § & qFqis ENTER PROJECT 1 t E w d 3 n Q V 6 6 A. SITE IE0 v So Points Available Per Measure 1.Protect Toped and Minimize Disruption of Existing Plano 6 Trees ❑ a.Protect Topsoil from Erosion and Reuse after Construction - 0 ❑ b.Limit and Delineate Construction Foo¢rim for Maximum Protection 0 1 ❑ 2 Deconstruct Instead of Demolishing ExfstinA Buildings On Bio 0 I 3 3.Recycle Job Sim Construction Waste(Including Green Wane) ❑ a.Minimum 50%Waste Diversion by Weighl(Recycling or Reuse)-Required _ 0— b. _b.Minimum 65%Diversion by Weight(Recycling or Reuse) 0 ❑ c.Minimum 80%Diversion by Weight(Recycling or Rouse) 0 I 2 I 4.Use Recycled Content Aggregate(Minimum 25%) ❑ a.Walkway and Driveway 0 _� 1 ❑ b.Roadway Base 0 1 Total Points Available in Site=12 0 B.FOUNDATION Points Available Par Measure 1.Replan Portland Cement in Concrete with Recycled Ri ash or Slog ❑ a.Minimum 20%Flynn or Slag 0 1 ❑ b.Minimum 25%Flash or Slag ❑ 2.Use Frost-Protecled Shallow Foundation in Cold Areas(C.E.C.Climate Zone 16) 0 ! 3 ❑ 3.Use Radon Resistant Construction(In At-Risk Locations Only) 0 1 4.Design and Build Structural Past Controls ❑ a.Install Termite Shields 6 Separate All Fxtenor Wood.loConmete Connections by Metal or Plead,FastanorslDividers 0 Id.All New Plants Have Trunk,Base,or Stem Located At Least 36 Inches Rom Foundation 0 1 Total Points Available in Foundation=8 0 C.LANDSCAPING Points Available Per Measure 1.Construct Resourn-ENicisnt Landscapes • ❑ a.No Invasive Species Listed by edgin Are Planted H ❑ b.No Plant Species Will Require Hedging 0 1 I ❑ c.75%at Plants Are Drought-mlemm California Native$,Mer itenan ion,or Other Appropriate Species 0 1 3 ❑ 2.Use FireBam Landscaping Techniques 3,Minimize Told Arne In Landscape Installed by Builder ❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.11 plant factor) 0 2 ❑ b.Turf Shall Not Be Installed on Slopes Exceeding 10%or in Areas Less Man B Feet Wide _ 0 _ 2 ❑ c.Turf Is 513%of Landscaped Arse(total 2 points) 0 _ 2 ❑ J.Turf Is 510%of Landscaped Area goml4 points) 0 1 1 1 2 ❑ 4,Plant shade Tran 0 ! 1 3 ❑ 5.Group Plants by Water Needs Hydrozoning) 0 2 6.Install High-Efficiency Irrigation Systema ❑ e.System Uses Only Low-Flow Dnp,Bubblers,or Low-flow Sprinklers 0."4 L_ 1 2 ❑ b.System Has Small Controllers - - 1 3 ❑ 7.Incorporate Two Inches of Compost in the Top 6 to 12 Inches of Soil i f 3 ❑ B.Mulch All Plontin Is to the Greater of 2Inches or LDMI Water Ordinance Requirement 2 9.Use 50%Selvaged or Recycled-Content Materials for 50%of Non-Ptant Landscape Elements UI 1 ❑ 10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 1 I I Total Points Available in Landsc 'n _31_. D.STRUCTURAL FRAME&BUU.DING ENVELOPE Points Available Per Measure 1.Apply Optimal Value Engineering Lf, ❑ e.Placa Rafters and Studs at 24-Inch On Center Framing D i ❑ b.Size Door andWindow HeadeB for Load _ ❑ c.Use Only Jack and Cripple Studs Required for Load 1 2.Use Engineered Lumber �p ❑ a.Beams and Headers ❑ b.Insulated Engineered Headers /� 0 1 - ❑ c.Wood]Joists or Web Trusses for FIDOM ❑ d.Wood].Joists for Root Rafters __ 1 ❑ e.Engineered or Finger.Jointed Sods for Vertical Applications sz 1; 1 ❑ I.Oriented Strand Board far Subgoor \ _ E] g.Oriented Strand Board for Wall and Roof Sheathing ac=0 �- 3.Use FSCCemfied Wood l • ❑ a.Dimensional Lumbar,Studs and Timber.Minimum 4D% 0 �_ 2 — ❑ b.Dimensional Lumber,Sods and Timber:Minimum 70% 0 2 ❑ c.Panel Products:Minimum 40% - 0 _ 1 ❑ d.Panel Products:Minimum 7D% o 1 1 02007 Build It Green Single Family GreenPoint Checklist 5007 Version Page 1 of 4 $ ' 8 . .O----------------- ; /.Use Solid Well Systams(Includes SIP&,ICFs,6 Any Non-Stick Rome Assembly) ❑ a.Floors 0- --- -y --_+-2 ❑ b.Walls 0 —__}_ 2 ,—I 2 El c.Rode S.Reduce Pollution Entering the Home from the Drmge ❑ e.Tightly Seal the Air Baffler between Garage and Livinp Area ❑ b.Install Garage Exhaust Fan OR Build a Detached Garage 0 1 B.Design Energy Harris on Trustees,(75%of Attic Insulation Height el Unnuu a Edge of Exterior Well) 0 1 I Dost n Roof Trusses As Accommodate Ductwork 0 1 a.USA Rerycled-Conront Ebel Sunn for a0%of Interior Well Framing 0 I 1 LJ a.Thermal Men Wells:511141 Drywall on All interior Well&at Walls Weighing more than 401hleu.a. 0 1 10.Install Dvarhengs and GUMM ❑ a.Minimum l6-Inch Overhangs and Guders 0 __ __� ] _ __- ❑ b.Minimum 24-Inch Overhangs and Gutters 0 Total Points Available in Btroctuiel Bulldin Frame an Envoi =36 0 E.EXTERIOR FINISH Points Available Per Measure 1.Use Re clad-Content(No Virgin Parallel or FSC-Certl0ed Wood Deciding D 1 2 2. fall a Rein Screen Well system 0 I 2 LJ O.Use Durable an Nonwmbustlbls Sidin Metarials 0 1 4.Select Durable and Noncombustible Floating Materiels 0 2 Total Points Available in Extedor Finish=7 0 F.INSULATION Pointe Available Per Measure 1.Install Insulation with 75%Recycled Content ❑ a.Walls anryor Floors ❑ b.Collins 2.Install Insulation that is Low-Emitting(CeNSed Section 0135D) ❑ a.Walls andlor Flows 0-------- --�-- ❑ b.Collins ] ❑ 0 O.Inspect of Insulation installation before Applying Drywall 1 Total Points Available In Insulation=5 D G.PLIIMH[NO Points Available PEMeasure 1.Distribute Domestic Hol Water Efficiently(Maximum 7 Points) ❑ a.Insulate HM Water Pipes from Water Heater to Kitchen Db.Insulate All Hot Water Papas oc.Use Engineerad Pa allel Pipingd.Use Engineered Parallel Piping with Demand Controlled Circulation Loop _❑ e.Use Shuauretl Plumbing wits Dementl Controlled Circulation loop —0- — -1--. 2❑ f.Use Central Cas Plumbin 0 . ] — ❑ 2.Install Only High Efficiency Toilets Dual-Flush or 51.28 p 0 I I 4 Total Points Available In Plumbing=Total 12 0 H.HEATING VENTDATION Sc AIR CONDITIONING Points AvellahlB Per Measure ❑ 1.Design and Install HVAC System to ACCA Manual J.D,and 6 Recommendations D 1 1 4 I 2.Install Sealed Combustion units ❑ a.Fumaces 0 2 ❑ b.Water Healers O.Install Zoned,Rydronic Radiant Heating with Slab Edge Insulation 0 1 1 Lj I.Install High Efficiency Air Conditioning with Environmenlelly,Responsible Refrigerants 0 1 S.Design and Install Effective Duehvork ❑ a.Install HVAC Ung and Duchvork Whin Coral Space 0 __ 3 ❑ b.Use Duct Mastic on All Dud Joints and Sons 0 ❑ c.Install Ductwork under Attic Insulation(Boded Ducts) 0 ❑ d.Pressure Balance the Ductwork System 0 --(-- ❑ e.Protect Ducts doing Conslmdion and Clean All Duds before Occupancy _ 0 , 1 9.Install High Efficiency HVAC Filter(MERV M 0 i 1 ❑ 7.Don't Install Fireplace or Install Sealed Gee Fireplaces with Efficiency Rating Not Lase Than 606 g 1 using CSA Standards t S.Install Effective Exhaust Systems in Bathrooms and Kitchens ❑ a.Install ENERGY STAR Bathroom Fans Ventatl to the Outside 0 ❑ to.All Bathroom Fens Are on Timer a Humidlstat 0 —� ] ❑ o.loat 1_1 Kirchen Range Hand Ventod to tha outside 0 , ] a.Install Moehenlnl Ventilation 6y&tam for Cooling(Maximum 1 Pulnta) ❑ a.Install ENERGY STAR Calling Fans a Light Kits in Living Areas 6 Bedrooms ❑ It.Install Whole House Fan with Variable Speeds - ❑ c.Automatically Controlled Integrated System _ 0 ❑ d.AL,2 aaLaOy Dontrollod Imepralsd System with Variable Speed Control 0 3 10.Install Mechenlnl Frith Aar Ventilation System(Minimum a Pomml ❑ a.Any Whole House Ventilation System That Masts ASHRAE 62.2 — — ❑ b.install Air-to-Air Heet Exchanger that meets ASHRAE 62.2 I H.—, stall Carbon Monoxide Alarms) D 1 Total Points Available In Heating Ventilation and Air Condiflonln =30 0 02007 Build It Green Single Family GreamPolnt Checklist 2007 Version Page 2 of 4 ENTER PROJECT NAME mul I.RENEWABLE ENERGY Points Available Per Measure . 1.Pre-Plumb for Soler Hot Water Heemn D 4 1 1 LJ 2.Install So lar Water Heatin Syamm 0 10 1 1 LJ 3.Itself Witing Condullfor Future Photovoltaic Installation 6 Provide 20l ff of South-Facing Roof 0 2 1 1 4.Insmll Photovoltaic(PV)Panels ❑ a.30%of electric needs OR 1.2 kW(total 6 points) 0 - ❑ b.BD%of electric needs OR 2.41W(total 12 poles) 0 ❑ c.90%of electric need OR 3.6 kW(total 18 points) 0 1 6 Total Available Pointy in Renewable Energy=28 0 J.BUILDING PERFORMANCE Points Available Per Measure 1.Diagnostic Evaluations ❑ a.House Passes Blower Door Test _ 0 __ 1 ❑ b.House Passes Combustion Safety Backdrefl Test 0 T— L 2.Design and Build High Performance Homes-%above Ti0e24-minimum 15%Required 0 a30 ❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Pilot Meeaurc(Total 45 points;road comment) D S 2 Total Available Points In Building Performance=39 0 H.FINISHES Points Available Per Measure ❑ 1,Design Entryways to Reduce Tracked in Contaminants D i 1 2.Use Low-VOC or Zero-VOC Paint(Maximum 3 Points) ❑ a.Low-VOC Interior WaIVCafling Paints(<50 gpI VOCs(Flat)and<150 gpl VOCs(Non-Flat)) 0 ——— 1 _ ❑' b.Zoro-VOC:Interior WayGelln Paints(<5 l VOCs(Rat)) 0 1 3 1 ❑ 3.Use Low VOC,Wetar-Based Wood Finishes 1Q50 Upt VOCs) 0 1 2 1 ( ❑ 4.Use Low-VOC Caulk and Construction Adhesives(OO gpI VOCs)for All Adhesives 0 1 2 ❑ I.Use Recycled-Content Print 0 1 1 1 1 S.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Ce mfied Wood.B)Reclaimed,C)Rapidly Renewable,0)Recycled-Content or E)Finger-Jointed ❑ a.Cabinets(50%Minimum) 0 _ 1 ❑ b.lmannor Thin(5n Minimum) _ 0 1 __ ❑ c.Shoving(50%Minimum) 0 ❑ d.Doors(50%Minimum) 0 NEIEl �1 e.Counted ops(50%Minimum) 0 r 1 ) 7.Reduce Formaldehyde in Interior Finish(CA Section 01350) • ❑ a.Suafloor B Stair Treads(50%Minimum) 0 1 +_ ❑ b.Cabinets 6 Countertops(50%Minimum) 0 1 _ ❑ c.Interior Trim(50%Minimum) 0 1 ❑ d.Irh (sD%Minimum) 0 1 1 1 1 ❑ B.ANelnsellation of Finishes,Test of Indoor Air Shows Formaldehyde Level Q7ppb 0 1 1 3 1 1 Total Available Points in Finishes=21 0 L.FLOORING Points Available Per Measure 1.Use Environmentally Preferable Flooring:A)FSC-Cemifod Wood,B)Reclaimed or Refinished, C)Rapidly Renewable,D)Recycled-Content,E) Exposed Concrete.Flooring Adhesives Must Have<50gpl VOCs. . ❑ a.Minimum 15%M Floor Area 0 1 ❑ b.Minimum 30%01 Floor Area 0 ❑ c.Minimum SD%of Floor Area 0 ❑ d.Minimum 75%of Floor Area 0 1 ❑ 2.Thermal Mass Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floors 0 1 f ❑ 3.Flooring Meets Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 1 1 2 1 1 Total Available Points In Flooring=7 D M.APPLIANCES AND LIGHTING Points Available Per Measure 1.Install Water and Energy Efficient Dishwasher ❑ a.ENERGY STAR(total 1 point) 0 ❑ b.Dishwasher Uses No More than 6.5 Gallons/Cycle(total2 amts) 0 1 2.Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less ❑ a.Meets Energy Star and CEE Tior 2 requirements(modified energy factor 2.0,Water Factor 6.0)Dotal 3 pofms) 0 1 2 ❑ b.Meets Energy Star and GEE Ter 3 requirements(modified energy factor 22,Water Factor 4.5 or less) 0 I 2 totals ints 3.Install ENERGY STAR Refrigerator ❑ a.ENERGY STAR Qualified 8<25 Cubic Feet Capacity 0 1 ) ❑ b.ENERGY STAR Qualified&<20 Cubic Feat Capacity 0 1 4.Install Built-In Recycling Center 0 ❑ e.BuilFln RecliCentar 0 2 ❑ b.BufO-In Compycostingng Canter 0 i 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 R 1 ❑ 2.Develop Homeowner Manuel of Green Featuresl9enefi s 0 1 ) 1 1 • 3.Community Design Measures 6 Local Priorities:See the Community Planning 8 Design section in Chapter 4 at the New Home Guidelines for measures.Maximum of 20 Focus for suggested measures.Local requirements may also be listed hers. 02007 Build It Green Single Family GreenPoinl Checklist 2007 Version Page 3 of 4 ENTER PROJECT NAME 8 4 8 ❑ Enter deecdptim here,and enter upon available for measure In appropriate campories to the right. 0 0 0 D 0 0 Enter description here,and enter points avalleble for measure In appropriate categories to the right D 0 0 0 0 0 Enter description here,and enter points aVBllable for measure In appropriets categorise to the right. _0 0 0 0 0 ❑ EIman de_BCflption here,and Wnr points aVBllable fa measure In appropriate talegoiea to the nghl. 0 0 O 0 O 0 9uiltl It Green Checklists and 4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up to a Gultlelinea maximum combined total of 20 ple.See Innovation Checklist for suggested measures,usin the link to the d ht. Li Innovation In Community'Enter description hers and enter points available to measure in eppropdam Cate ones to rhe ri hl. 0 O 0 0 0 0 Innovation In Energy:Enter dBW IIW here,and enter Points availableI measureRM ER in eglriBle 19AOrie8 iD IhB dAhl I 0 0 0 0 0 Innovation In IADMeaIM:Enter dest ri lion here,and enter points eveliabl0 la measure in approl cats Does to the nham_ 0 0 0 O 0 0 1 LJ nnovatlM In Resources:Enter ruawrignon more,sod emor come oyallable tar measure In appropriate coorpor es to the n ht. _0 _ 0 0 0 0 O ❑ Innovallon IO Watar_Enter descrIPt10n here,and enter points available IM measure In appropriate categories to the right O 0 0 D 0 0 Total Available Points In Other 131 0 Summary Total Available Points In Specific Categories' 4+ 96+ 42+ 66+ 43+ Minimum Points Required In Specific Categodes 0 30 B B 8 TotalI I 1 I 1 1 1 Project hes not yet met the following recommended minimum requirements: - Total Project Score of At Least 50 Points -Required measures: -A3a: 50% waste diversion by weight -71: 15%above Title 14 -Nl:Incorporate GreerrPoint Rated Checklist into blueprints -Minimum points in specific categories: -Energy(30 points) -IAQ/Health(5 points) -Resources(6 points) -Water(9 points) • 0 2007 Build It Green Single family GrearnPOlnt Checklist 2007 VBraIDn Page 4 ol4 Community Development F 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 WUPEkTINO Building Department JOB ADDRESS: PERMIT #o p C) OWNER'S NAME: G pa. vn S a,a , , PHONE <(o8S GENERAL CONTRACTOR: 13e p FAX # I am not using any subcontractors: 1y Oa a 61 og 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 X a 0-AV 0 Owner/ ontractor Signature at