08030101 CITY OF CUPERTINO # v.i^+
BUIcDIN'G OIVI6ION PERMIT ,COO NTRACTCIR IIV'FORMATION
PERMIT NO.
"`Hl 5`4T4.E%CENIC CT - TBD - TO BE DETERMINED 08030101
OW NER'S NAME: PERMIT ISSUE DATE.
PING LAN LEE 03/19/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB - MECH
0 0 0 0
o c LICENSED CONTRACTOR'S DECLARATION Job DOSCrIpLIOn
!std❑ Ikrtby affirm that l am limnudunder,pmvisionsof Clmmm
pmr 9(eaennng
wiNSecuon7")of Division7ofd,a BusincesaM Profession Cande,andmylicense4 BKFILL POOL IN BACKYARD
s in full fora and.N.I.
�j in
License Class L'c.M
q Data Commerar
q�q W ARCHITECTS DECLARATION
Z 1 understand my plans shall k med as public.,ends
!8U
:8 G Licensed Pro '
OWNER-BUILDER DECLARATION
1 krchy atrrm Nm I am exempt from the Currummorlicence Lia,licenLaw(or the
:mO following mum.(Sadao Rn 1.5,Business and Prefessimis Code:Any city or=only
121 whish neutrons a Permit so continua,alcor,W prove,demnllah,or repair any ssrtclum
.Z< Priarmiaissuad pursantto the prevision of
f favuch Pnrmi'micese Law sutammt
b,rheiscingwitPSectimu.dk ru Disiov ofdre ellmemrt License Law(Chapta9 Sq.F[. Floor Area $5000
�p Valuation
$ (cot M is romancing it t isccuon 70nd th Division 3.f she Businm and n.fAny vi Cade)m Q J O 0 0
Stet es 4 31.5 b therefrou and me beer for the alleged exemption.atto Any vio4don of
Saddest 7031.5 headed
forapermis subjects Ste applianrso•cavil pevhy of pp�Number Occupancy Type
oat marc man five huMrcd eaR&m(s5m). 3 5 7 0 7 016 .'V V'
❑Lu owncrof Ne pmpemy,ormycmploycu with verges, vale c.mpenssdoa,
will dothewoh,Code, he Comlanoes Luceederaw does ru4(Sey to ad..of Required Inspections
and Pr wh oN Calc The Connacmh License Law Sar ms apply lf an.wv<.f q p
pw. play .proviimproseach improvements
who dnenotinZxuach hhimuifmshtvagh hL
awn employees,provided that such nt is mid
in not intaMW car Offered fm Bale B,
bwevcr,mebuildingsimprovement4midodid arcyear ofcnmoms,fa,the.wQs-
ask.).r wiB have the burden of posting that k did not Wild err impnwe(or puryose of
tale.),
i1.u owner of the property,am exclusively conducting wish licensed cmm m
aaan
nuts the project(Sec.704E Businm and Protestant Code:)Th,Donaaemrs U.
course law dace oat apply in in owner of peapany who Wilds or Improves detem.hand.
.be,...=for such project an i cordri U ficased purnum as me Cmnrsrefh
Licence Law.
❑Ina exempt under/Se�c. 1 .B&PC(oqr dtia n
Owner /f/_ a .1 ,c W 3/T's
WgCI KER'S COMPENSATION DECL.SRATION
k1 thereby& an under pevhy of perjury arc of me following dalsratn
os:
a,nebaa and will maintain a Certificate of Co.n,m air-imam for WarkefsCompen-
son,u provided far by Section 3700 of the Labor Code,far the pecramranx of dk
work for which this permit is issued.
i]1 have and will maintain Warkee.Compensation Ivmhna,as requited by Scene.
3700.1'me labor Code,fm the perfamtana of the,work for which mr naft is-s-vvi
My Wmi use.C.mpemadon run.arrim and Policy,number ant
Cartier. Policy No.:
CERTIFICATE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
mus maim nerd nock complecd!fine Permit is froom hundred dollars($100)
err lrsc)
1 certify that in thd performance of the were fm which this Permit 4 Wood.l shag not
emPloyany pe=a in any manncrmu tab�o 7bl,an 11Warken'Condition,.. .
Laws afcslifi ice.Dam_,a,�5 A
Applicam /J as-
NOTICE TO APP�f.after making this CcnircMe of Exemption.you should
become subject in da Wonat Compensation Provision;of the Labor Codd you mass
.J O foMwish comply with such provisions err flus rm
Peit shall W doemed rovokad.
Z CONSTRUCTION LENDING AGENCY '
t-y� IkrcbyafOrm that mem is a consort leading agency far the Pa,fur ..f
tai me work for which this permit is issued(Sec.W.Civ.C)
Q Lenders Name
z Lcnders Address
J O 1 certify that i have meed this application art staid that the above let..a.Or
U, coke I agree to comply with all city and county ordinances and said laws slating in CU building consum
ucridn,and hereby autherim rtpmscmtives of this city to enter upon e
W oho -mdmiuned property for inspection ptOpMax
CL (We)agree to save,indemnify and kaep harmless the City of Cupertino against
rA liabilida,judgments,costs and cinemas which may in any My at against sed Cho
in consm,unce,drum gramiting of
J Z
s Permit.
APPLICANT UNDERSTANDS AnND WILL COMPLY WITH ALL NON-POINr Issued by: Date
SOURCE REGU TIONS.
V) baa 31 jg/o$ Re-roofs
Si,Astim of APpliamiConuector Ir&a
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tic appliam or(arum Wilding accepant store Or handl.handou material
ss deavd by she Cupertino Municipal Code.Chapter 9.12,and this Health and Safety
Cade.Section 255324)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yds
If a roof is installed without first obtaining an inspection,I agree to remove
Will than applimator future building occupant use equipment ordcvias which
haxatne,air contamivnts u defined by the Bay Arca Air Quality Management all new materials for inspection.
eta
(]Yu in No
1 have mail the Wasrdom materials requircircna umber Chapter 6.95 afthe Califor-
nisHealth&Saki,Cade,Sectov 255115,25533 and 25534,1.&mind that irSc Wilding
does not currently have a meant that it is my spans hility a entry me aeupant of that
sgtimmcnaty�tch7the edpriarciem.a .CatGemcdo, ig Signature of Applicant Date
J- d o�n e. 3/l
owners mimed after Data All roof coverings to be Class "B"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35707016 . 00
DATE ISSUED. . . . . . . : 03/19/2008
RECEIPT #. . . . . . . . . : BS090004197
REFERENCE ID # . . . : 08030101
SITE ADDRESS . . . . . : 10474 SCENIC CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : PING LAN LEE
ADDRESS . . . . . . . . . . : 10474 SCENIC CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2765
RECEIVED FROM . . . . : PING-LAN LEE
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 5, 000. 00 0.50 0. 00 0. 50 0. 00
1DEMORES SQ FEET 0. 00 490. 00 , 0. 00 490. 00 0. 00
r. -------- ---------- ---------- ----------
TOTAL PERMIT 490. 50 0. 00 490. 50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 490. 50 PING-LAN LEE
---------------
TOTAL RECEIPT 490. 50
VOICE ID DESCRIPTION VOICE ID . DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
003 010
CITY OF CUPERTINO
�d DEMO
•CUPEkTINO PERMIT APPLICATION FORM
APN# � D e:
25 -7 -7 60 /� Zoog
Building Address: q
)04-44 Sc e n i c Cottri Cts per { ; n o CA
Mailing Address (if different from building address):
Owner's Name: Phone:
PIIJC-7 Lail SEE ( 408 ) 3 / 6 4Sl,02
Contractor: Phone
Fax:
Contractor License #:
Cupertino Business License #:
Contact: . Phone:
T in1C1 LAiJ LEE ( 41 3 16 2,
Fax:
41kesidential ® Sq Footage Commercial ❑ Sq Footage
Job Description: to b ACK fill -the 9 o o l ,Ii bie 6a ck y oA r p�
Valuation: J p
Attach Green Building Checklist to demo plans.
Quantity Fee ID Fee Description Fee Group Permit Type
1DEMORES Demo-Residential B 1SFDWL-DEM
/ iBSEISMICRE Seismic Residential B
1DEMOCOM Demo-Commercial B 1COMML-DEM
1BSEISMICOM Seismic Commercial B
1BUSLIC Business License B
Single Family GreenPoint Checklist date:S/I I / Z 04 Build It Greed
The GreenPoint Checklist is based on the various green features incorporated Into the home and is the Sman Solutions From The Ground Up
basis lot the GreenPoint Rated program.A home can be considered green If It Iutfills the prerequisites, Tnn
Hams at least 50 points,and meets the minimum points per category:Energy st of Intloot Alr ree icy/Health(5),Resources(6),and Water(9).Please contact Bulltl II Green for a list 01 qualifietl GreenPoint
• Raters If you are Interested in pursuing third-party veriflcatlon.
the green building practices listed below are described in the New Home Construction Green duildinq L p { ((
Guidelines,available at www.builtlitoreertom. p!A)CT ZEE /o[/7�- SCes'tic C'[ l.:u ef�l"2 C4 %-017
ENTER PROJECT
• , 4
U ¢ 3
A.SITE Points Avallaole Per Measure
1,Protect Topsoll and Minimize Disruption of Existing Plants 6 Trees
❑ e.Pm1am Topsoil from Erosion and Reuse after Construction 0 1
❑ b.Limit and Delineate Construction Footprint for Maximum Protector 0 i
2.D.Ponstruct Instead of Demolishing Existing Buildings On Site 0 I 1 3 1
3.Recycle Job Site Construction Waste(including Green Waste)
❑ A.Minimum 50%Waste Diversion by Weight(Recycling or Reuse-Required 0 R
❑ b.Minimum 55%Diversion M Weight(Recycling or Rause) 0 1 2
❑ c.Minimum 60%Diversion by Weight(Recycling or Reuse) 0 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0 r 1
❑ o Roadway Bou 0 I I 1
Total Points Available in Site=12 0
H.FOUNDATION Points Available Per Measure
1.Replace Portland Cement In Concrete with Recycled Flyesh or Slag
❑ a.Minimum 20%Nash or Slag 0 I 1
❑ b.Minimum 25%Nash or Slag 0 I 1
❑ 2.Use Frosl-Protected Shallow Foundation in Cold Areas(C.E.C.Climate Zone 16) 0 3 1
El J.Use Radon Resistant Construction In At-Risk Locations Only 0 I 1
4.Design and Build Structural Pest Controls
❑ a.Install Termite Shields 6 Separate All Exletior Wo0d.toConmete Connectors by Metal or Plastic FastanervOividers .0 (I 1
to.All New Plants Have Trunk,Base,or Stam Located At Least 36 Inches from Foundation 0 1 1
Total Points Available in Foundation=B 0
C.LANDSCAPING Points Available Per Measure
1.Construct Resource-Efficient Landscapes
❑ a.No Invasive Spades Listed by Cel-IPC Are Planted 0 I _J 1
❑ b.No Plant Species Will Require Hedging 0 1
• ❑ C.75%of Plan6 Are Drought-tolarant California Natbes,Meditemanean,or Omer Appropriate Species 0 I I 3
77 2.Use Flr&Sak Landscaping Techniques 0 1 I
3.Minimize Turf Areas in Landscape Installed by Builder
❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(550.6 plant factor) 0 I 2
❑ b.Tud Shall Not Be Installed on Slopes Exceeding 10%or In ken Less than 6 Feet Wide 0 I I 2
❑ c.Turf is 5n%of Landscaped Area betel2Points) 0 I 2
❑ d.Turf is 510%of Landscaped Area(total4 points) 0 1 I 1 1 2
4.Plant Shade Trees 0 I 3
S.Group Plants by Writer Needs(Hdrozoning) D I 1 2
S.Install High-Efficiency Irrigation Systems
❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers 0 2
❑ b.System Has Smart Controllers 0 3
7.Ineor orete,Two Inches of Compost In Lha Top 6 to 121nches of Sall 0 i 3
Ej 6,Mulch All Planning Beds bthe Crestar o12 Inches or Local Water Ordinance Requirement 0 1 2
LJ 9.Use 50%Salvaged or Recycled-Content Materials for 5M of Non-Plant Landscape Elements 0 I 1 1 1
❑ 10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0 1 1 1 1 1
Total Points Available in Landscaping=31 0
D.STRUCTURAL.FRAME R BUILDING ENVELOPE Points Available Per Measure
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 24-Inch On Center Flaming D 1
❑ b.Size Door and Window Headers for Load 0 �— 1
❑ c.Use Only Jack and Cripple Studs Required for Load 0 I I 1 1 1
2.Use Engineered Lumber
❑ e.Beams and Headers 0 1
❑ b.Insulated Engineered Headers 0 1 1
❑ c.Wood 6Joists or Web Trusses for Floors 0 1
❑
it.Wood I-Joists lar Roof Rafters 0 I
❑ e.Engineered w Fingar-Jointed Studs for Vertical Applications 0 1
❑ f.Oriented Strand Board for Suificor 0 _ 1
❑ g.Oriented Strand Board far Wall and Roof Sheathing - 0 1
3.Use FSC-Certffied Wood
E] a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 2
❑ o Dimensional Lumber,Studs and Timber,Minimum 70% 0 I— 2
❑ c.Panel Products:Minimum 40% 0 1 t
Eld.Panel Products:Minimum 70% 0 I 1 I
I,
02007 Build It Green Single Family GreenPoint Checklist 2DD7 Version Page 1 of 4
ENTER
4.Use or Well Systems(Includes SIP&,ICFs,8 Any Norl Fame Assembly)
❑ a.Floors
❑ b.Walls 0 2
❑ c.Rools 0 2 2
5.Reduce Pollution EntainA the Home from me Garage
❑ a.Tightly Seal the Air Bamor between Garage and LNing Area 0--
0
_
❑ b.Insall Gere a&nut Fan 09 Build a Detached Garage
0 1
6.Dad n Ene Heels an Trusses(75%of Aide In&uletidn Height at Outil Ede of Erhardt Well 0 1
❑ 7.Design Roof Truuea td Accommodate Duchwork 0 1
B.Use R cled-Conhenr Steel Studs for BD%of Interior Wall Framing0 1
Tmal Mau Wella,51&lnch Drywall on All Interior Walls or Wells Weighing mora Than 401b/cuA 0 1
10.Install Overhangs end Curtis&
❑ a.Minimum 1&Inch Overhangs and Gardens 0
❑ h.Minimum 24-inch Overhangs and Guests D 1
Total Points Available in Structural Building Frame and Envolope.3B 0
E.EXTERIOR FINISH Paints Available Per Measure
Cr 1.Ua Re pied-Content(No Virgin Plasoc or FSCCoMfied Wood Dodking 0 - 2
21nets11 a Reln Screen Well System 0 2
3.Use Dureble and Noncombustible Siding Materiels 0 - 1 1
Ll 1.Select Durable and Noncombustible Roofing Materials 0 2
Total Points Available In Extsria Flesh 7 0
F.INSULATION Points Available Per Measure
1.Insist Inaulatan with 75%Recycled Content
❑ e.Walls ands Floors
b.Collins —0— f 1 --
2.Install Insulation that Is Low-Emimng identified Section 0135D)
❑ a.Walls andor Floors
❑
It.Callings 0 1
❑ 3.Impact Quality of insulation Installation before Applying Drywall 0 - 1
Total Pants Avallable In Insulation=5 0
0.PLUMBING Points Available Par Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
❑ e.Insulate Ha Water Plpee from Water Heater to Kocher _0
❑ b.Insulate All Hot Water Pipes
❑ c.Use Engineered Parallel Piping
❑ J.Use Engineered Parallel Piping with Demand Controlled Circulation Loop
❑ e.Use Stracared Plumbing wee Demand Controlled Circulation Loop _ g_
❑ 1.Use Central Core Plumbing 0 1 1 2
❑ 2.Install Only High Efficiency Toilets(Dual-Flush or 5135 qpQ D - 4
Tots Points Available In Plumbing=Total 12 0
H.HEATING VENTILATION R AIR CONDITIONING Points Available Per Measure
❑ 1.Dasign and Install HVAC System to ACCA Manuel J,0,and S Recommendseons 0 4
2.Install Sealed Combustion Units
❑ e.Furnaces u _ . 2
❑ b.Weer Hamm 0 2
3.thmil Zoned,Hydronic Radiant Heading with Slab Edge Insulation 0 1 1
L Insall High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1
5.Doo lgn and Insall Effective Ductwork
❑ a.Install HVAC Unit and Ductwork within Conditioned Spare 0 t_ 3
❑ b.Use Duct Morbid on All Dud JMnts and SeamsD _ _ 1
❑ c.Install Duct _work under Affic Insulation(Bused Ducts) U _ 1--L
❑ d.Pressure Balance the Ducavork System 0- _ 1
❑ e.Protect Ducts during Com uction and Clean All Ducts betas Occupancy 0 1
El 6.Insall High EfficienHVAC Filter IMERV(N) 0 1
❑ 7.Don't Indeed Fireplace or Insall Sealed Gas Fireplaces with Effidancy Reeng Not Leu Than 60% 0 1
using CSA Standards
S.Install Effective Exhaust Systema In Bathrooms and Kitchens
❑ e.Install ENERGY STAR Bathroom Fere Vented to the Dual D
❑ w_
h.All Bathroom Fens Are on Timer or Humidstet _0
❑ a.Install Kitchen Range Hoorn Vented to the Outside 0 I 1
a.Install Mechanics]Ventilation System for Cooling(Maximum 4 Points)
❑ e.Install ENERGY STAR Calling Fan s Light Kits In Wing Areas 5 Someone _0 __ _�
❑ b.Install Whole House Fan with Variable Speeds _07
1
❑ c.Automatically Controlled Integrated System __0
❑
I.Automatically Controlled Integrated Syetam with Vatable Speed Dontrd 0 3
10.Install Mechanical Fresh Air Ventilation System(Medmum 3 Points)
❑ e.Any Whole Hausa Ventilation System That Meets ASHRAE 622 ro
[I h.install Alrto-Air Haat Exchan er that mors ASHRAE 62.2 177 11Iutall Carbon Monoxide Alarms 1
Tonal Points Avallatue In Heading,VenIDation and Ak Candrouning 301 0
02007 Build It Green Single Fatally GreenPolnl Checidist 2DD7 Version Page 2 of 4
L 5
PROJECTENTER NAME
W
I.RENEWABLE ANERGY Points Available Per Measure
LJ 1.Pre-Plumb for Solar Hot Water Heating 0 1 4 1 1 1
t Immill Solar Water Heading System 0 1 10 I
• 3.Install Winds Conduit for FuWre Photovoltaic Installation 6 Provide 200 tP of South-Facing Roof 0 1 2 I
4.Install Photovoltaic(PV)Panels
❑ e.30%of electric needs OR 1.2 kW(tole)6 points) - 0 1 6 1 I
❑ b.60%of eledre needs OR 2.4kW(total 12 points) 0 i 6 1
❑ c,90%of electric need OR 3.6 kW(total 13 points) 0 I 6 t
Total Available Points in Renewable Energy=26 0
J.BUILDING PERFORMANCE Points Available Per Measure
1,Diagnostic Evaluations
❑ e.House Passes Blower Door Test 0
It.House Passes Combustion Safety Backdrefl Test 0 1
2.Design and Build High Performance Homes-%above Title 24-minimum 15%Required 0 l >_30 i
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Pilo Measure(Total 45 points;reed comment) 0 5 2
1
Total Available Points in Building Ferranti 3 0
R.FINISHES Points Available Per Measure
❑ 1.Design Entryways to Reduce Tracked in Conmminanm 0 1 I
2 Use Low-VOC or Zonal Paint(Maximum 3 Points)
❑ a.Low-VOC Interior WeIDCeiling Paints(40 got VOCs(Flat)and<150 gpI VOCs(Non-Flaq) 0 I 1 1
❑ b.Zercl Interior WeIUCelling Paints(6 gpi VOCs(Fla ) 0 ) 1 3
❑ 3.Use Low VOC,Wate,13ased Wood Finishes(Q50 gpi VOCs) 0 I 1 2 1
❑ 4.Use Lml Caulk and Construction Adhesives(OD gpl VOCs for All Adhesives 0 1 2 1 1
❑ 5.Use Recycled-Cornent Paint 0 I 1 1
6.Use Environmentally Preferable Materials for Interior Finish:A)FSCLerdfied Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed
❑ e.Cabinets(50%Minimum) 0 1
❑ b.Interim Trim(5D%Minimum) 0 1
❑ c.Shelving(50%Minimum) 0 1 j
❑ d.Doors(50%Minimum) 0 1 1 1
❑ e.Canlartops(50%Minimum) 0 1 ! 1
7.Reduce Formaldehyde in Interior Finish(CA Section 01350)
❑ a.Subfloor B Stair Treads(50%Minimum) 0
❑ b.Cabinets B Counteracts;(50%Minimum) 0 F
• ❑ c.Interior Trim(50%Minimum) 0 1 1 1
❑ d.Shelving(50%Minimum) 0 I 1
❑
all After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Level d7ppb 0 3 1
Total Available Prints in Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Certigod Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Content,E)
Exposed Criticisms.Flooring Adhesives Must Have 60 Spit VOCs.
❑ a.Minimum 15%of Floor Area 0 I I 1
❑ b.Minimum 30%of Floor Area 0 I 1
❑ c.Minimum 5D%of Floor Area 0
❑ d.Minimum 75%of Flea Area 0 ( 1 I
❑ 2.Thermal Mees Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floods D. 1
❑ 3.Flooring Meats Section D1350 or CRI Green Label Plus Re uirements(50%Minimum) 0 2 I
Total Available Points In Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
1.Install Wates and Energy Efficient Dishwasher
❑ e.ENERGY STAR(total 1 point) 0 _ 1
❑ b.Dishwasher Uses No More than 6.5 Gallons/Cycle total2 paints 0
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 6.0)(total 3 points) 0 I 1 2
❑ b.Moots Energy Star and GEE Tier 3 requirements(modified energy factor 22,Water Factor 4.5 a less) g 1 I 2
(total s 'nts
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified 5 e 25 Cubic Foot Capacity 0
❑ b.ENERGY STAR Calcified&<20 Cubic Forel Capacity 0
4.Install Built-In Recycling Center 0
❑ a.Built-In Recycling Center 0 I 2 1
❑ b.Built-In Composting Center 0 1 T—
TotalAvailablePointsin Appliances and Lighting 12 0
N.OTHER Points Available Per Measure
❑ 1.InoWporete GreenPoini Rated Checklist In Blueprints-Required 0 1 R 1
❑ 2.Develop Homeowner Manual of Green FeaWresSenefib 0 1 1 1
3.Community Design Measures 6 Local Prior tles:See the Community Planning 6 Design section in Chapter 4 of the Naw Home Guidelines for
• measures.Maximum of 20 points for suggested measures.Local requirements may also be listed here.
I El
02007 Build It Green Single Family 3rea0P01nt Checklist 2007 Version Page 3 of 4
-�
Sr ¢ 3
ENTER PROJECT NAME 8
❑ Enter description here,and enter points avallable for nam um in appropriate categories to the right. 0 0 0 D 0 0
Enter deeuption hem,and enter points available for meesom in appropdets coegain to the dint. _0 0 0 0 0 0
Enter dnerpaoo here,and inner pour ev haoto fn meann r in appropriate categories to as ogre. _ 0 0 0 0 0
❑ Enter deeooft here,and enter points available fn measure In appropriate categories to the right. _0 0 0 0 0 D
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Gulid It Green Checklists entl
eline
maximum combined total of 20pig.See Innovation Checklist for suggested measures,usingthe link to the right. -1-6s
LJ Innovation in Community:Enter dost IM hem,and enter pblnts available IR measure in ts categories to the right _ 0 0 0 0 0
Innovation in Emrgy:Enter description hen and enter poop nalleble Im m asum in appropriate categories to the not. _0 0 0 0 0 0
d8555011Innovation in IAQMnlda:Enter d8555011on hand enter points nallme lot measure In appropiem cblegodes to the open. __0 0 0 0 0 0
Innovation In Resource:Enter desoi tion here,and enter pointe available la measure in app�dete celerlpnes to me right. 0 D 0 0 0 0
Imova on In Water:Enter deselicen here,and enter poln%available for measure In approplam categories to the right. 0 _ 0 0 It 0 0
Total Available POlnts In Oher e 4 0
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+all3+
Minimum Points Required in Specific Categories 0 30 5 fi 9
Total Paints s e s e e
Project has not yet mot the following recommended minimum requirements:
- Total Project Score of At Least 50 Points
-Required measures:
-Alia: 50% waste diversion by weight
-J2: 15%above Title 24
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific categories:
-Energy(30 points)
-!AQ/Health(5 points)
-Resources(6 points)
-Water(9 points)
02007 Build It Green Single Family GreenPolnl Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
Y' Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: RR Q-�' PERMIT #
r�
f � J' e
0 1
OWNER'S NAME: Vi N U" ( P til Lj EPHONE # ( 4 316 4z, v 2
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
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
5 / l912oo
Owner/Contractor Signature Date