08010105 CITY OF CUPERTINO '�" "++� "v a' r``"T' t` ° "TION,�`
BUILDING DIVISION PERMIT RCQNTRA " l?RI
BUIIIiiG DRESS
LDI : PERMITNO.
2U�c11 SUISUN DR ABC COOLING & HEATING 08010105
OWNER'S NAME: FESUMET ISSUE DATE
RANGWALA JUMANA Z AND ZOAIB 31845 HAYMAN ST 01/16/2008
ONE: (510) 471-8181 SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
app LICENSED CONTRACTOR'S DECLARATION lob Description
I hmby.firm Net 1 am lkm under pmv cion.of Chapw 9(commencing p
Nsatiom 7IXIU)ur0iriaonsordm ewinemane noka.mn.Com..nd my license I. REPLACE..FURNACE 80. K BTU 93% EFF ADD AC NEW
iv full forteand off
uanrodm -Z10 Lic.g 3 3b'3 ELECTRIC CIRCUIT FROM PANEL TO DISCONNECT
c ppp Dab ContrrYo
3 ARCHrrhC SDECLARATION
Q I understand my plans limitW wed o public retard,
D U1.
�p LICCwed PN(wtieMl
5
OWNER-BUILDER fr DECLARATION
qy I hereby.(Sero o n I am susin from Nc Comms Co License Law for IW
i O O following won.(Section 703 1.5.Business and Nabmkm h,Or Any city or county
ISE which mquiru.permit to construct alcor.ImPmw,dcmalWt ar mash any,tructum
_ prlwblts;m=d ales tquima Ne applicant for such permit bfileasiCoed statement
gggg�$FF< Nnn<knmnsca pmrroantNthe pmvitions of the Gnmicbr,Ideeese law(Chapter9 Sq.Ft.Floor Area $7900 Valuation
d$ (commencing with section 7000)nf Division Sof On Business and N.ren(on+Code)or
a that M I.enempt Nmeftcm and the bums for the litleged exemption.Any violatfon of
section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofNumber Occupancy Type
not mom Nan five hundred dollars(5500). 3 6 9 2 8 015 A
❑1,u owner of ttie property,or my employes with couples their role compensstion,
will do the work and the "ChuM Bmm intended oroneml fomak(S.C.7014.Butiness Required Inspections
and Pmmuiou Code:The Committer'.Ucrose Law don Out apply b SO Owner of q p
property who builds or improvesthumn.and whodessuch west hitttselforthrough his
awn employes,provided that such improvements are not Intended oro0'eted forma IC
however,the building or improvement is sold within one year of completion.the Owner-
' Wildm wipe have the Wrdcn of proving that W did not Wild or improve for puts=of
ask.).
❑L.3 menu of On property,m uclu.ively contracting with themed cmntrvnoss an
comtmct the project(Sec.7044,B omm and Prefuslos Code:)The Contrutor's LI-
tome Law dos not apply In an owns of pmpertY who W(Id+ur impmw diete rm,and,
who conmicta to,such projects with acontrcmrp)licensed pursmint to the Gnuactafs
License law.
❑Iameaemptwder Set ,B&PCfaf Nismuon
OwnerDam
WORKERS COMPENSATION DECLARATION
1 hereby&Bina under Mwty of perjury one of Ne folbwing dslmuom:
Mas and will for by eCe n 3700 of G,LAb"Code.for fm performance
Campers- '
on, r pmvidhi for mi sceuam 3]Oo of the tabor Code,far tha performut¢of tiro
went far which Nu permit is issued.
have
sold will maintain Workefa CompemNon banrance,u required by Section
10TOM he labor Cade,For the performance of Ne work for which this permit is Earned.
My woftesCompem tion lnsua orris an d5wcy number m:
t}N :?tnlzi3L
Grtier 4`eTI Poli o
ERTiFl CO OF COMPENSATION
I N FROM WORKERS'
COMPENSATION INSURANCfi '
(This section need Out he comPlemd Ude permit Is forom hundred dollars(3100)
or tut)
1 certify that in the performance of the work for which Oil permit Is fumed,I then not
employ any9�ap In any m crro bb mch pt an the Workers'Compensation
taw.ar GlPketf�Dwo —
NOTICE 70 APPLICANT:r'after making this prevision,
ncab o ab rtio c you should
bsowith comp y it WoherS Coma a this permit
of On Labor Code.you rotes
Oforthwith comply with such prvralou w this permit,hall W domed rewketl.
� zt.y�.i CONSTRUCTION LENDING AGENCY
i.r I hereby affirm Nat Nem ts a comtructirm lending agency for the performance of
{Y,> On work for which titin permit Is issued(Sec.7097,Civ.C.)
W0 Lendce.Name '
0.. Z Undoes Address
V 0 1 unify that 1 have read this application and some Nu the above information Is
con I agree in comply with all city and county ordinances and.tam laws misting m
.� Wilding construction.and Wmby authorise rtprsemadve+of Nu city on enter upon the
Gil above-mendmmd Property for Inspection purposes.
y (We)agree to save,indemnify and keep h&rmkss the City of Cupertino against
E liabilidet.judgmenta.eom and expects which may in any my accrue against said City
U in consequence of the swung of this permit.
^7 d by: Date
APPL ANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issue
50 REGULATON . t ,,::,2
-C Z� lel()_",
el b-d i Re-roofs
Sigmuun of ppll nest Dab of Roof v
H MATERIAISDISCLOSURE Type
Willytkapplictuat Cupertino
futm building ChaptHortmand hamdommamti&1
u dcOned by de Cupertino Municiwl Code.Chapter 9.11,.tW the Health and safety
Code,Section2553100T All roofs shall be inspected prior to any roofing material being installed.
❑Yen
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future Wilding aupant cquipmcni or devices which
¢ use
hEFA air contaminants u defined by the Bay Am.All Quality Management all new materials for inspection.
nT _
❑Ys CTInIG '
I have mad the hnarGmamaLdslsmqu;cmenaunder Ch&pmr6.95 of Ne Califor.
nia mkolth k S.fctyCadc.Sceuom 25305.25533 and25534.I understand theirtab Wilding
dataai currently haw•i-.....t Nat It u my mapom hility b mdty tiro meupant of t e
tawhkhmuabemet mmuarezaf.comficabafocctmway. Signature of Applicant Date
Owner or ,A' cors Dao All roof coverings to be Class "B"or better
J _ CITY OF CUPERTINO
«. FURNACE/AC
•CUPEkT iNO . PERMIT APPLICATION FORM
APN # Date: /` /`� - 7 GtU
(�q p) S, �
Building Address:
Owner's Name: Phone#:
2OQiLyae-
Conttor, I1 11 I / I -T Phone#:'n�J _ c��j
Fax #: SLD - Y7/ F-36Y
Contractor License#: Cupertino Business License#:
3 �?23F?3 G - �� &
Contact:
Phone#:aeD- 117/- P/ ()"/
Fax #:
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Job Description:
Residential Commercial LJ
For Residential Installations:
Attic ❑ 151 floor 2"d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: y Type of Construction (Usage Class):
79 c/
Strapped On Platform El Bonded New Location Replacement
Valuation:
Green Building: Must attach Green Building Check list to this application ��
s
CITY OF CUPERTINO
FURNACE/AC
a(c,
CUPERTINO FEE SCHEDULE
FURNACE:
Qty. if
Applicable Fee ID Fee Description Fee Group Permit Type
MCRAA Furnace M FURN/AC
MCREPALT Commercial Mech Repair/alt/add M
MCSUSHTR Commercial Suspend Wall/floor M
Heater
PGASCOM New Gas Piping System 1-4 Outlets P
Commercial
BSEISMICO Seismic Commercial B
/ MRRAA Residential Mech Repair/alt/add M
MRSUSHTR Residential Suspend Wall/floor M
Heater
BSEISMICRE Seismic Residential B •
MFLRFURN Install/relocate Floor Furnace M
MECPLNCK Mechanical Plan Check M
MFR=<100 Furnace Syst<100k BTU M
MFRN>100 Furnace Syst> 100k BTU M
MRAIRHAN Comm/Res < 100k BTU M
EPERMITFEE Electric Permit Fee E
MPERMITFEE Mechanical Permit Fee M
BREMRECEPT Electric Receptacles E
PGASRES New Gas Piping System 1-4 Outlets P
Residential
BPGAS Gas Piping System 5+ Per Outlet P
TRAVDOC Travel Documentation B
BUSLIC Business License B
jW
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE
AIR CONDITIONER:
Qty. if
Applicable Fee ID Fee Description Fee Group Permit Type
BCAIRHAN Commercial A/C Units <= I Ok CFM B FURN/AC
MCRAA Commercial Mech Repair/alt/add M
SEISMICOM Seismic Commercial B
/ BREMAIRHAN Residential A/C units<= lOk CFM B
MRRAA Residential Mech Repair/alt/add M
J BSEISMICRE Seismic Residential B
/ EPERMITFEE Electric Permit E
MPERMITFEE Mechanical Permit M
PPERMITFEE Plumbing Permit P
BREMRECEPT Electric Receptacles E
PGASCOM New Gas Piping System Commercial P
1-4 Outlets
PGASRES New Gas Piping System Residential P
1-4 Outlets
BPGAS Gas Piping System 5+ Per Outlet P
TRAVDOC Travel Documentation B
BUSLIC Business License B
CITY OF CUPERTINO
• 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36928015 . 00
DATE ISSUED. . . . . . . : 01/16/2008
RECEIPT #. . . . . . . . . : BS000003716
REFERENCE ID # . . . : 08010105
SITE ADDRESS . . . . . : 20211 SUISUN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA
OWNER . . . . . . . . . . . . : RANGWALA JUMANA Z AND ZOAIB
ADDRESS . . . . . . . . . . : 20211 SUISAN RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4427
RECEIVED FROM . . . . : RICHARD GREGORY
CONTRACTOR . . . . . . . : GERALD UNRUH LIC # 24643
COMPANY . . . . . . . . . . : ABC COOLING & HEATING
ADDRESS . . . . . . . . . . : 31845 HAYMAN ST
CITY/STATE/ZIP . . . : HAYWARD, CA 94544
TELEPHONE . . . . . . . . : (510) 471-8181
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-
--------- ------------- ---------- ---------- ---------- ---------- ----------
1BREMAIRHA NO.UNITS 1. 00 61 . 19 0. 00 61 .19 0 . 00
1BSEISMICR VALUATION 7, 900. 00 0 . 80 0. 00 0 .80 0. 00
1EPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40 .79 0.00
1MPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40 .79 0. 00
1MRRAA UNITS 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 286.34 0 . 00 286 .34 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 286.34 MASTER CARD
---------------
TOTAL RECEIPT 286 .34
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
Single Family GreenPoint Checklist data: �cra� Build It Greeri
The GreenPoint Checklist is based on the various green features incorporated into the home and is the '= Smart 5oludom from fi^Ground U;
2 basis for the GreenPoint Rated program.A home can be considered green NR fulfills the prerequisites, �1
.eams at least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Ouarityl n
��(i
Health(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint f f ) ! 'Raters Ifyou are interested in pursuing third-party verification. p{f If`
e green building practices listed below are described in the New Home Construction Green Building
uidelines,available at www.builditoreen.om. -
PROJECT
t c% 6 In FF B 8
a s
A.SITE ^'•r' < - " Points Available Per Measure
1.Protect Topsoil and Minimize Disruption of Existing Plants I Trees
❑ a Protect TOMB from Erosion and Rouse afar Consbuctbn 0 1 I
❑ h.Limit and Delineate Construction Footprint for Minimum Protection
2 Deconstruct Instead of Demolishing Existing Buildings On Site 0 3 I
3.Recycle Job Site Construction Waste Dncluding Green Wass)
❑ a.Minimum 50%Waste 9wroon by Welghl(Rec)d'rg or Reuse)-Required __0 _ R
El b.Minimum 65%Diversion by Weight(Rang or Reuse) --
❑ c.Minimum 80%Dverslon by Weight(Recycling or Reuse) 0 _ I 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0 j
❑ b.Roadway Base D
Total Points Available in Site e 1 p
B.FOUNDATION - - Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash or Slag
❑ a.Minimum 20%Flyash or Slag __0
❑ b.Minimum 25%Flyash or Slag p..... . _1_i_.�- - -
2.Use Frost-Protected Shallow Foundation In Cold Amu!GEC.Climate Zone 16 0 3 !
3.Use Radon Resistant Construction an At-Risk Locations Only) 0 I I
4.Design and Build Structural Pest Controls
❑ a.Install Termite Shields a Separate All Exterior Wood-to-Concrete Connections by Metal or Plastic Fasteners0viders - D
b.AO New Plants Have Trunk,Base,or Stem Located At Least 36 Inches from Foundation 0 1 1
Total Points Available in Foundation=11 0
C.LANDSCAPING - Points Available Per Measure -
1.Construct Resource-Efficient Landscapes _
❑ a.No Invasive Species Listed by CaHPC Are Planted I 1
❑ b.No Plant Species Will Require Hedging cam. . ._--- - ---T—
❑ c.75%of Plants Are Drought-tolerant Callfomla Natives,Mediterranean,or OtherAppropdets Species CT —f 3
Lj 2 Use Flrs-Safs Landscaping Techniques .g Ij ]
3.Minimize Turf Areas In Landscape Installed by Builder q
U L
❑ a.All Turf Will Have a Water Requirement Less than or Equal to Tall Feswe(&.B plant factor) —i 2
c Turf is 93%ofntlema ad Area(total Intl (--_` ...L..._ _�--
❑ b.Tun Shall Not Be Installed on Slopes Exceeding
eeding 10%orin Areas Less than B Feet Wide 2
❑ d.Turf is!111%of Landszod Area lotel4 ?
Pe ! points) -- ---"r-'--i"'—'I 2 .
4.Plant Shade Trees
Lj S.Group Plantsby Water Needs(Hydrozoning) ,g. 32
6.Install Hlgh•Ef6clancy Inlgabon Systema
❑ a.System Uses Only LowSaw Drip,Bubblers,or Low-lbw Sprinklers i _ 2
❑ b.System Has Smart Controllers (�0 -.. ;- ._ ...._ . _.;.______3.._
7.Incorporate Two Inches of Compost In the Top 6 to 12 Inches of Soil -0—-3 3
Lj B.Mulch All Planting Beds N the Greater of 2Inches or Local Water Ordinance Requirement o L J - r 2
9.Use 50%Salvaged or Recycled-Content Materials for 50%of Non-Plant Landscape Element 0i 1
10,Reduce Light Palluttan by Shielding Fixtures andfor Directing Light Downward `0 �l
Total Points Available in Landscaping=31-_0
D.STRUCTURAL FRAME&BUILDING ENVELOPE - Pointe Available Per Measure
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 24-Inch On Center Framing 0
❑ b.Size Door and Window Headers for Load —- --
_..
❑ a Use Only Jack and Cripple Studs Required for Lead
2.Use Engineered Lumber r f
❑ a.Beams and Headers D I r
❑ b.Insulated Engineered Headers —p
✓q� ]
❑ cWaod l-Joists or Web Trusses for Floors 0
� ' -- "- -
LL ]
E] d.Wood West;for Rin/Rafters ilk
❑ e.Engineered or Finger-Jointed Studs for Verbol Applications �B 0
❑
I.Oriented Strand Board for Subfbor 0
1
❑ g.Oriented Strand Board to,Wal and Roof Sheathing � 0 I
low 3.Usa FSC-CoNfied Wood
❑ a.Dimensional Lumber,Studs and Timber Minimum % D 2
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% p
40 2
❑ c.Panel Products:Minimum 40% 0 1
❑ d.Panel Products:Minimum 70% - --
....._._.-------- 0 . . . I
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
\a
ENTER PROJECT NAME
4.Use 6alid Well By .S Oncludes SIPS,ICFs,&Any Nonstick Frame AssemblyBye... 6 a�
❑ Z 2 e.Floors . ._ ,
❑ b.Wells
❑ 0 2
c.Rosh 2
5.Reduce Pollution Entering the Home from the Garage
❑ a.Tightly Seal the A4 Banter between Geroge and LMng Area
❑ h.
In
Gane Exhaust Fan OR Build a Detached G e 0 1
S.Desi nEno Hoels on Trusses(7b%of Attic sulatien Height at Outside Edge of Exterior Wall 0
7.tied n Roof Trusses to Accommodate Ductwork 0 1
9.We Reryclad•Content Stool Studs for 90%
of Interior Wall Framing 0 1
B.Thermal Mass Wells:SMI-Inch Drywall on All Interior Wells or Walls Weighing mon Nen w Ihlcu.R 0 1 t
10.Install Overhangs and Outten
❑ e.Minimum 16-Inch Overhangs and GuOon
0
❑ b.Minimum 24-Inch Overhangs and Outten 0 I
Tani Points Available In Structural BUMkg Frame and Envelops•78 0
E.EICTERIOR FINISH Points Available Per Measure
1.Ila.Rocyclod•Content(No Virgin Plastic)or FBC•Curilfied Wood Docking 0 I 2
2lnmll S lseln Screen Wall System 0 2 1
7.Uu Durable and Noncombustible Siding Materials D ( I l 1
4.Select Durable and Noncombustible Roofing Materials 0 2
Total Points Available In ExterlDr Finish=7 0
P.INSULATION - Points Available Per Measure
1.Install Insulation with 75%Recycled Content
❑ � " ! I
0.Walla endPor FloOre
❑ b.Collings
2 Install Insulation that is Low-Emitting(Certified Section 01350)
❑ a.Watts and/or Fbom 0_. .
❑ h.Callings
0 1
3.in Quality
of Insulation Installation before Applying Drywall 0 1 j
Total Points Available In Insulation=5 0
G:PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
❑ a.Insulate Hot Water Pipes fmm Water Healer to Kitchen
❑ b.Insulin AD Hot Water Pipes
❑ a Use Engineered Parallel Piping 0-
d.
_d.Use Engineered Parallel Piping with Demand Controlled Clmulaean Loop
❑ a.Use Strucnratl Plumbing with Demand Controlled Circulation Laop --
0 1 1 �_2
❑ I.Use Central Can Plumbing -.O _ .___T-i.i._. -.�2_
2.Install High 9.18 0 4
Total Points Available In Plumbing=Total 12 D
H.HEATING VENTILATION&AIR CONDITIONING Points Available Per Measure:-
1.Oulgn end Inmll HVAC System to RCCA Nenuat J.D,and B Recommendations 0 4 1I
2.install Sealed Combustion Units
a.Fumaces 2
b.Water Healers
3.Install Zoned,Hydnnic Radiant Heating with Slab Edge Insulation 0 1 1
4.Inatell Hlgh Efficiency Air Conowthung with EnvinnmanWly RosponslElo ReMgersnte 0
S.Design and Install Effective Ductwork
❑ a.Install HVAC Unit and Ducavork within Conditioned Space 3. 1
❑ b.Use Duct Mastic on AD Duct Joints and Seams 0 '
❑ c.Install Ductwork under Ads:Insulation(Burled Duch)
d.Frustum Balance the Ductwork System 0_ �
_❑ a.PmW Duch during Construction and Clean All Ducts before Occupancy
6.Inmll High Efficiency HVAC Filter(MERV 6+) 0 '1
❑ 7.Dont Install Fireplace or InmII Sealed Gas Fireplaces with Efficiency Rating Not Len Than 60% 0 1
using CSA Standards
9.Install Effective Exhaust Symms In Bathrooms and Kitchens
❑ a.Install ENERGY STAR Bathroom Fens Venn l to the Outside U
❑ b.All Bothmom Fans Am an Timor or Humldlsnt 0
❑ c.Install Kitchen Range Hood Vented to the Outside 0 I
9.Install Mechanical Ventilation System for Gosling(Maximum 4 Points)
❑ e.Install ENERGY STAR Calling Fans a Light Kits In Living Amax&Bedrooms 0 1 _
❑ b.Install Whole House Fan with Variable Speeds
❑
C.Automatically Controlled Integrated System _Q 2
❑ d,Automatically Controlled Integrated System with Variable Speed Consul _ 0 3
10.Install Mechanical Fresh Air Vonglation System(Maximum 3 Points)
❑ a.Any Whole House Vemdiation System That Meets ASHRAE 622 0 2
❑ b.Insall Air-toAlr Heat Exchanger that meats ASHRAE 622 0 3 2
Lj 11.Install Canon Monoxide Narm(s) 0 1
Total Points Available In Haatng,Ventilation and AO Conddunng=3D 0
0 2D07 Build It Green Single Family GreenPoint Checklist 2007 Version Page 2 of 4
ENTER
11�
V I:RENEWABLE PROJECT A - S�LO
W g
NERGY Pm
Available Per Measure
1.PraPlumb for Solar Hot Water Heating 0 4
LJ Z Install Soler Water Hoofing System 0 ]0 3AMI U .Instal Wiring Conduit for Future Photon,
oltalc Installation Is Provide 20D ft of South-Facing Rood 0 2
4.Install Photovoltaic(PVI Panels
❑ a.30%of electric needs OR 1.2 kW(total 6 points) 0 6
❑
It.60%of electric needs OR❑ 24kW(total 12 points) — U - -- --,--6
c.90%of electric need OR 3.6 kW(total 1 B points) 0 6 '
Total Available Points In Renewable Energy=28 0
J.BUILDING PERFORMANCE - - Points Available Per Measure
1.Diagnostic Evaluations
❑ e.House Passes Blower Door Test 0 1
h.House Passes Combustion Safety Backdraft Test 0 I
2 Design and Build High Performance Homes•%above Title 24.minimum 15%Required p ! �30 !
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification Pilot Measure(Total 45 points;read comment) p 6 2
Total Available Points in Building Performance 39 0
IC.FINISHES _ Points Available Par Measure
1,Design Entryways to Reduce Tracked in Contaminants 0 1
2.Use Law•VDC or ZemoVOC Paint(Maximum 3 Paints)
❑ e.Low-VOC Interior WalllCeling Paints(c50 go VOCs(Flat)and<150 go VOCs(Non-Flap), p I
❑ b,Zem.VOC:Interior Wall/Colling Paints 6 gpl VOCs Flat ------
3.Use Low VOC,Water-Based Wood Finishes(<250 gpl VOCs) 0 2
71 4.Use Low•VOC Caulk and Construction Adhesive[(<70 got VOCs)for All Adhesives - 0 I 2 1
5.Use Recycled-Content Paint 0 j I
6.Use Environmentally Preferable Materials for Interior Flnish:A)FSC•Cergfled Wood,B)Reclaimed,C)Rapidly Renewable,DI Recycled.
Content or E)Finger-Jointed
❑ a.Cabinets(50%Minimum) 0 I
❑ to Interior Tdm(50%Minimum)
❑ c.Shelving(50%Minimum) _—o._ ._. ..;...—._.._ _._... ...;.._...._
1
❑ d.Doors(50%Minimum)
❑ e.Counteracts(50%Minimum) _._o —_..._.__...
—_ 1
7.Reduce Formaldehyde in Interior Finish(CA Section 01350) '
LOour&SrairTmads(50%Minimum) 0inets&Counterfeits(50%Minimum) . _._.__rhrTdm(50X Minimum)ving(50%Minimum) Onstallation of Finishes,Test of Index Air Showa Formaldehyde Level<Z7ppb 0 ( 3
Total Available Points in Finishes=21 0
L.FLOORING '. „ L - Points Available Per Measure;,
1.Use Environmentally Preferable Flooding:A)FSC-Certiflad Wood,B)Reclaimed or Rallnished, C)Rapidly Renewable,D)Recycled-Content
E)Exposed Concrete.Flowing Adhesives Mus!Have<50 gpl VOCs.
8 a.Minimum 15%of Floor Area ;
h.Minimum 30%of Floor Area —o-
❑ c.Minimum 50%of Floor Area --
-1
❑ d.Minimum 75%of Floor Area p
1
2 Themnal Masa Floors:Floor Covering Other than Carpet on 5e%or Mora of Concrete Floors 0 I 1 I
3.Flooring Meets Section 01350 or CRI Green Label Plus Requirements(5D%Minimum) 0 f 2
Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING - _ Points Available Par Measure
t.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total 1 point) 0 1 -
__
❑
It.Dlshwazher Uses No Mom than 6.5 GalonalCyde(tete)2 points)
Z Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CEE'nor 2 requirements(modified energy factor 20,Water Factor 5.0)(total 3 points) 0 _ _ _ _.. 2
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy faster 22,Water Factor 4.5 or less) Z -
(tol�inis
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified&<25 Cubic Feet Capacity 0 .I
El b.ENERGY STAR Quafdredfl<20 Cubic Feet Capacity
4.Install Bui t•In Rerycling CanNr_ __ 0
❑ e.Built-in Recycling Center 0 2
❑ b.Bulli-In Composting Center p
Total Available Points In Appliances and Lighting=1 0
N.OTHER - _ _ Points Available Per Measure
❑ 1.Incorporate GreanPoint Rated_Checklist in Blueprints-Required_ 0 R
2 Develop Homeowner Manual of Green FeaturesBeneflts 0 I 1 1
3.Community Design Measures&Local Priorities:See the Community Planning It Design section In Chapter of the New Home Guidelines far
measures.Maximum 0120 points for suggested measures.Local requirements may also be listed here.
0 2007 Build II Green Single Family GreenPoint Checklist 2007 Version Page 3 of 4
ENTER PROJECT
AUGHBI
y
Enter description hem,and enter points.available for measure in appopdate catepodas b Na right 76�
0 0Enter descriptimeon ham,and enter points available for asure In appropriate categories m Ne rightEnter desoiprlon hem,and enter points avallabie for measure In appropriate categories to Ne right., 0Enter description hem,and enter points avallabie for maaswa N appropdele catagorbs o IAeright 0 0 0 0 0
4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up to a Build Guidelines Green Checklists and
maximum combined total of 20 is.See Innovation Checklist for suggested measures,usingthe link to the right. uideli- -
Innovation in Community:Enter dawn tion hem,and enter points available for remains in appropriate categories to Ne ht 0 0 __0_ 0 _ 0 0
Innovation in Energy:Enter description hem,and enter points available for measum In appropriate categories to the ht __0 D 0_ _g _0 0 _
Innoval6n h IAOIHealth:Enter description hem,antl enter points available for measum In appropriate rale oche to the ht 0 _g_ 0__ 0_ 0 _ 0
Innovation N Resources:Enter description hem,and enter points avanable for measure N appropriate categories to the ht. 0 0 0 0 0 0
Innovation In Water.Enter description hem,and enter points available for measure In appropriate categories to Na right
- - Total Availebk Points In ONer-4 0
Summary
Total Available Points In SpeciFlc Categories' �aar+miji96+ 14 + 66+ 43+
Minimum Points Required in Spectfic Categories D J 30 5 6 9
Total Points Achieved I I I I 1 1
Project has not yot met the following recommended minimum requirements:
- Total Project Scare of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-J2: 15%above Title 24
-NJ: Incorporate Green Point Rated Checklist into blueprints
-Minimum points in specific catecorles:
-Enerqy(30 points)
-IAO/Health (5 points)
-Resources(6 points)
-Water(9 points)
t
•
0 2007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPERTINO
Building De artment
JOB ADDRESS: 5, v` S n PERMIT #
d
OWNER'S NAME: pw-bs� wQl PHONE # Yv��eae- /Y3P
,
GENERAL CONTRACTOR: 6C r FAX#
I am not using any subcontractors: !,1,6,
Signator Date
Please check applicable subcontractors and comp,Tete theollowin 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