08030025 F CUPERTICITYIONNO yl..
PERTBULDG DIVISION r "f x*aTr+RxA-C=`4n°TNORs'tuIxA7OR'��
mil aT'..t -5?.: 4`¢?h .rel a,t#27"--`sz...w,"�s•=ik s:
BUILD�ur� TsSUNRISE SPRING CT AFFORDABLE WATER HEATERS & PERMfT N0.08030025
OWNER'S NAME: PERMIT ISSUE DATE.
FERGUSON CATHY 24707 SAN FERNANDO RD 03/06/2008
NE: SANITARY NO. CONTROL NO.
ARCHr1ECT/ENGINEER: BUILDING PERMIT INFO
REPLACE WATER HEATER BLDG ELECT PLUMB MECH
0 0 0 0
Op LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing
,Z with Section 70(kl)of Division 3 of NC Business and Professions Code,and my homes is
<< n full force and cifn
License Cl¢, s Lm.X—�027.3L _
F Dam Co. ribs
ARCHITECTS DECLARATION
W I understand my phos shall he used ss Public recort
U
o Licensed Profcoicnal -
OWNER-BUILDER DECLARATION
to
1 hereby afford that I am exempt from the Contractors Liecnu Law for the
mCC following resume.(Section 7031.5,Business and Professions Code:Any city or county
which require a permit In construct.alter,improve,demolish,or repair any structure
'.z prior In its issuance.also requires use applicant for such permilw rite a signed statement
that hehlicensedforetenuotheprovisionsoftheContractureLicenseLaw(Chpw9 Sq.Ft.Floor Area Valuation
(commencing with Section 7000)of Division 3 of the Business aM Profmions Coale)or
$ that he u esempl thctafmm and am boo for the alleged cocupd.n.Any violation of
Section 7011-5by airy applicantfor a permit subjects the applicant to a civil pvtalty of APN Number Occupancy Type
not...than Ow touched cutlass(5500}
❑
1,as owrmrof tis Property,or caycmployw wit wager v dmbmk compensation,
will do thewons codec he curt tenors Liceedw dew Oca1'w W apply ttMn,Bosirm Required Inspections
and property
who
Coale:The Comecon,License law aces tet apply to an owuer of q P
pme enywhos.iprolds orid thiam himprovements
mprandwhe aloessuchwork him,mfedtrough his
howe however.
the
ori improvement
Improv sold
wit in not lery ofc w.B¢mtl forole lL
however,Oe bve the orimprovementg midwithinoneyorofcompletionthe owner.
builder will have the burtlen of proving cal he tlitl net build or improv for pugmse of
role.).
0 I,es mvuer a the property,am exclusively contracting wide Im mud contractors be
construct dee pmjm(Sec.7061.Business add Professions Code:)The Contractors U.
genu Law doer not apply to in owner of property who Wilds at improvn thereon,and
who contracts for such projeckr with a conuxcmr(s)licensed persuade to the Contractors
License law.
❑I am exempt under Sec ,B k PC for this reaoe
woes Dau
WORKERS COMPENSATION DECLARATION
I hereby allure under perulty of perjury arc of the following declaradome
I ham and will maintain a Cmifinsm of Comm m self-h udre fur WollessCompen-
nation.as provided for by Section 3700 of the labor Code,for the Perforans of dee
work for which this permit is issued.
0 I have and will maintain Workers Compensation Instant =.as required by Section
3700.1'the Labor Coale,for the performance of the work for which this permit is issued.
My Worker's C.mperuatio s Insurance Cartier and Policy numbm am:
Cmrvr,Zr I�� Policy Nn.:�1067BS97i
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(lh section need not Wcomplemd if tis permit Is(orae hunaed dogma(SIM)
or less)
1 anif-y that in dee Performance of dee work for which this Permit Is issued.)shall raw
employ any person in any mannerse as to bcame subject to dee Worker'Compensation
Law,of California.Dom
Applicant
NOTICE TO APPLICANT:If,after making els Cenificale of Eumpti.n,you should
become subject to the Worker's Compensation provisions of dee labor Code.you most
.JO forthwith comply with such provisions or this Permit shall be dammed sensed.
z CONSTRUCTION LENDING AGENCY
I hereby apron oat acrt is a Conmvction lending agency,for the performance of
a ,1
use work for which this permit is issued(Sec.1097,Civ.C.)
QLender's Name
.D z Landers Address
U O 1 certify Oat I have mad this application and sum that the abou information is
Ty correct,I agree 10 comply with all city and county ordinances and slam laws relating to
0U building Conswction,and heby aurhorim mpresenutiver nfthi,city to enter uponthe
0. shuvn-mentioned proleny for inspection purposes-
(We)agme to save,immmmfy and keep handless the City of Cupertino against
liabiliticsjudgmenu,costs and carenscs which may in any way acesse,against said City
U z in eanrguenec of the&mddu&of this Permit. J_ G�
�-' APPLICANT Uy yyggAND O WILL COMPLY WITll ALLf'ON-POINT Issued by: Date
souRCEcus Re-roofs
Signature of ApplicanUConuacar / Dam
HAZARDOUS MATERIALS DISCLOSURE Type Of Roof
Will lac applicant er future building occupant stere or handle hwardons manorial
as defined by the Cupertino Municipal Code.Chapter 9.13,and the HealO and Safety
code,Section 355134)7 All roofs shall be inspected prior to any roofing material being installed.
0 Yu
Win ec a lieam or future building occupant use If a roof is installed without first obtaining an inspection,I agree to remove
Pp B P equipment Qm der Manotr which
emit nus air conumirunts o defined by the Ray Area Air Quality Management all new materials for inspection.
District?
❑Yes PKu .
I harc mad the havNous mamruisrequiremenu un"rChapter 6.95 ofthe Cdifor.
nia Heal"SafetyCo ,Secdom355U5,35511mJ}-SSyktodersundthatifaebtilding
dors raw eunemlyharc a ant,tar it u my respo tfility ro nouly the occupant of dee
mqulmmemswhi ult4o a non Tamm, ,cenirmem of Occupancy. Signature of Applicant Date
ownw.r,— ,d,gent / D,m All roof coverings to be Class "B"or better
• CITY OF CUPERTINO
4 ITEMS OF 32 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36652006 .00
DATE ISSUED. . . . . . . : 03/06/2008
RECEIPT #. . . . . . . . . : BS000004096
REFERENCE ID # . . . : 08030025
SITE ADDRESS . . . . . : 11501 SUNRISE SPRING CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : FERGUSON CATHY
ADDRESS . . . . . . . . . . : 11501 SUNRISE SPRING CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5133
RECEIVED FROM . . . . : EDDIE D NALLEY
CONTRACTOR . . . . . . . : LEONCE ROUX LIC # 26850
COMPANY . . . . . . . . . . : AFFORDABLE WATER HEATERS &
ADDRESS . . . . . . . . . . : 24707 SAN FERNANDO RD
CITY/STATE/ZIP . . . : NEWHALL, CA 91321
• TELEPHONE . . . . . . . . : (661) 259-7131
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 2, 000. 00 0 .50 0. 00 0. 50 0. 00
IPPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
1PRWHEATR UNITS 1. 00 24 .48 0. 00 24 .48 0. 00
1TRAVDOC FLAT RATE 1. 00 40 .79 0 . 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 .56 0. 00 106 . 56 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-- ---------------------------- -------- ----------------------------
518 WATER HEATER
•
off03 O (�, ZS
CITY OF CUPERTINO
WATER HEATER
C or
•CUPERTINO PERMIT APPLICATION FORM
APN# / G �j n� / 0 Date:
(,p '7j0' �1Lp 340 g,
Building Address:
I S� S N N f ( f e S P f .vyy C ►'
Owner's Name: Phone #:
CA41,1 �Fe-r8`�or" y0� - 2s2 _ I► ► 7
Contractor: Phone #: &(,/.- zj--5 - 7/3i
Fax #: (o(ol - ZS9 - 551-1
Cupertino Business License #: Contractor State License #:
z6 � 5D & E -) 346
Contact: Phone #:(,6/ - zs5- GS"-
5uA� l ( � �1cI�i� 11
Fax #: 6 6 / z-0 - 9ffb
Building Permit Info:
Bldg ❑ Elect E�r Plumb F Mech
Residential [ Commercial ❑
Job Description:
Strapped Eg`� On Platform ❑ Bonded [J] New Location ❑ Replacement
Valuation: 2000
Green Building Check must be completed and attached to this application.
Green Building Points achieved:
CITY OF CUPERTINO
WATER HEATER
CUPER,TINO PERMIT APPLICATION FORM •
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
1BSEISMICOM Seismic Commercial B
1 1PRWHEATR Residential Water B PRWHEATR
I HeaterNent
/ 1BSEISMICRE Seismic Residential B
r/ 1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel & B
Documentation
1BUSLIC Business License B
Single Family GreenPoint Checklist date: 3- �'� 0-1 Build It Greed
The rnsil oirn Checklist is based on the various green features incorporated Into the home and is the Small Solutions From Trip Smund Up
basis for the GreenPoint Rated progam.A home can be considered green d It fulfills the prerequisites,
Hams at least 50 points,and moats the minimum points per mtagore Energy list
of Indoor Air merrPoi
• Health(5),Resources ste and Water gfl Please meted Build It Green for a list of qualified GreenPoint
Raters H you are Imaasletl in pursuing third-parry verification.
The green building precdces listed below are described in the New Home Construction Green Building
Guidelines,avallable at www.builditareeaoro52.
ENTER PROJECT
• , 1
d i
U �
A BI'PE I A IK f 4�••- i Points Available Per(Measure
1.Protest! opsoll and Minimize Dimuption of Ezi ng Ptente 6 Tree&
❑ e.Protect Topscfi from Erosion and Reuse after Construction g 3 3
❑ b.limit and Delineate Conmmction Footprint for Mmdmum Protection p- -----
2 Deconstruct instead of DeenDlianning Existing Buildings On She. 0 3
J.Recycle Job Sib Construction Waste(Including Goren Wants)
❑ aAfrismet50%Waste Dherslcn by Weight(Racychng crReusal Required D - R
❑ b.Minimum 65%Diversion by Weigle(Recycling or Reuse) p -- —--- —"—
❑
c.Minimum 60%Diversion by Wagon(Recycling or Reuse) 0 — --- 2--
4.Use Recycled Content Aggregates(Minimum 25%)
❑ a.Walkway and Driveway
❑ b.Roadway Base _� g
__ .. � � _-
0 3-
Treat Points Available in Site=12 0
B.FOUNDATION. Points Available Per Measure
1.Replace Portland Cement In Concrete with Recycled Flyash or Slag
❑ a.Minimum 20%Flyash or Slag p 1
❑ b.Minimum 25%Flyash or Slag 0 7
2.Uce Frost-Protected Shallow Foundation In Cold Areas(C.E.C.Climate Zone 16) 0 1 3
6.Use Radon Resistant Cormor on on AI-Risk Locations Only) 0
1 I
1.Design and Build SWebrel Pest Controls
❑ a Install Tormi a Shields A Separate All Exterior Wood-to�Concrom Connections by Mated or Plastic FastanerMONlders 0
It.All Now Plane Have Trunk,Base,is Stem Located At Least 36 Inches from Fountlation 0 1
TOW Points Available In Foundation 0
C.LANDSCAPING Points Available Per Measure
1.Construct Resource-Etectant Landsropes
• ❑
H.No Invasive Species listed by Cal-IPC Are Planted 0❑ _ — t
❑ b.No Plant Species Will Require Hedging g- ---f---'---
r� _-1__._c.75%WPlants Are Drought-tolerant Califomle Natives,Mediterranean, Other Appropriate Species __ I �—._
71 ,.D i i 3
2.Use Fire-Side Landscaping Techniques - 1
2.Minimize Tud Areas in Landscape Installed by Builder
❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.6 plant factx)
C] b.
2
b.Tud nes Shall Not Be installed on Slopes Exceeding 10%w In ALess than a Feet Wide 2
- g - T--- '-
❑ c.Tud is Sit%of Landscaped Area(total 2 points) T'',�,� —rte=_
J
❑ tl.Tutl is 510%A Landscaped Area(IoW 4 points) t 2
A.Plant Shade These I 3
S.Group Planta by Water Needs(Hydmzoning) OJ I I 2
6.Install High-Effictency Irrigation Systems
Ela.System Uses Only Loll-Flaw lBubblers,a Low-flow Solutions g [ r
[Ib.System Has Smarr Controllers _ l 2_
D r I 1 1 3
7.Inrorpareb Two lichee of Connector in the Top Eric 121nehea of Soil i0� 3
❑ 6.Mulch All Planting Bade to the Greater of 2Inches or Local Water Ordinance Requirement 0 L 2
9.Use 50%Salvaged or Recycled-Content Materials for 50%of Non-Plant Landscape Elements
Lj 10.Reduce Light Pollution by Shielding Fixtures windier Directing Light Downwardk`0—iy 1
Total Points Avallable in Landsca in =31 0--i'1
D.STRUCTURAL FRAME&BUILDING ENVEIAPE Points Available Per Measure
1.Apply Optimal Value Engineering iJ
❑ s.Place Raters and Studs at 24-Inch On Canter Framing —0 -1
❑
It.Size Dox and Window Headam for Load _ 0
E] c.Use Only Jack and Cripple Studs Required fix Load 0 I -1
2 Use Engineered Lumber
❑ a Beams and Headem
❑ b.Insulated Engineered Headers
❑ c.Wood West or WeIcTrumes to Florae
❑ d.Wood Wolds for Rool Rafters1-
❑ e.Engineered or Finger-Jointed Studs for Vertical Applications --- L___• 3�_ _
E] t.Oriented Strand Board for Subteen MAH 6 700 0 E---
❑ g.Oriented Brand Board for Well and Root Sheathing '_o ---- `--i_"7-
3.Use FSC-Conified Wood SPY
• ❑ e.Dimensional Lumber,Studs and Timber Minimum 40% n ^
❑ _ g_ -_
b.Dimensional Lumbar,Studs and limbar.Minimum 70% 0 r
❑
C.Panel Products:Minimum 40% 2 g'
❑ d.Panel Products:Minimum 70% 0 I 1
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
ENTER
PROJECT NAME
H $
4.Use Solid Well Systems(Includes SIPS,ICFs,A Any Neal Frame Aeeembly)
❑ al Film _ D 2_ _ 2
❑
to,Walla D 2 2
❑ c.Hoofs
5,Reduce Pollution Entering the Home from the Gal
❑ A Tighay Seal the Air Samar between Barrel and LIl Nee _re e D
❑ b.Install Geroge Exhaust Fan OR Build a Detached Ga6_
Lj � 1
B.Design Energy Holes;on Trustee 75%of Attic Insulation Height at Outeide Edge of Exterior Well 0 1
7.
Design Roof Trusses to Accommodate Ductwork 0 1
B.Use Re cledCDmism Steel Studs for Do%of Interior Well Framing 0 1
A.Thermal Men Walir.Sladnch Drywall on All Interior Walls or Wells Weighing more than 4D I1:1c01. 0 1
10.Insall Overhangs and Guars
❑ a.Minimum 16-Inch Overhangs and Gunn _ 0
❑ b.Minimum 24-Inch Overmings and Gunn 0 ]
Toted Points Available In SwcW're!Building Frame no Envelope•36 0
E.EXTERIOR FINISH Points Available Par Measure
1.Use Recycled-Content(No Virgin Plaul or FSCC11l Wood Deciding 0 2
r7-2.Install a Rain Screen Wall System 0 - 2
d.Use Durable and Noncombustible Siding Materials 0 1
A.Select Durable and Noncombustible Roofing Materials 0 - 2
Total Points Available in Exerim Finish.7 0
F.INSULATION Poinla Avallable Per Measure
1.hall Insulation with 75%Recycled Content
❑ a.Wails andlol Floors _ 0 ]
❑ b.Callings 0 ]
2.Install Insulation that is Low-EmiNng(Certified Section 0135D)
❑ .a.Walls andlor Floors 0
❑ b.Ceilings
_o
❑ O.Inspect Quality of Insulation Installation before Applying Drywall 0 1
Total Points Available in Insulation 5 0
O.PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points).
❑ al Insulate HM Water Pipes ham Water Heater to Kitchen 0 1 1_ 1
❑ b.Insulate All Hot Water Pipes _ 0
❑ c.Use Engineered Pareilal Piping 0 _ _ _7
E:1 d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop
❑ e.Use Strul Plumbing with Demand Controlled Clmulahon Loop _0 _
❑ I.Use Carrel Core Plumbing0 1 1 1 2
❑ 2.Install Only High ElDeincy,Tolists(Duni-Flush or 51.26 B 0 1 4
Total Points Available in Plumbing=Treat 12 0
H.HEATING VENTILATION 3 AIR CONDITIONING Points Available Per Measure
Lj 1.Design and Install HVAC System to ACCA Manual J,0,and S Recommendations 0 4
2lnstall Sol Combustion Unita
❑ a.Furnaces _ 0 _ _ L 2 1
❑ b.Water Hann 0 2 I
Lj O.Install Zoned,Hydrunic Radiant Hearing with Slab Edge lnnlatlon 0 1 1
e.install High Efficiency Air Conditioning with Environmentally Respouible ReMgerante 0 1
S.Design and Install Effective puehvers
❑ a.earth HVAC Ung and Ductwork within Conditioned Space _ 0 1 3
❑ b.Use Duct Mastic on All Duct Joints and Seams
❑ c.Install Duahvorx under Attic Insulation(Burled Ducts)
❑ d.Pressure Balance the Ductwork System 0
❑ a.Protect Ducts during Construction and Clean All Duma before Occupancy, 0 H 1 r +
Lj e.Install High Efficiency HVAC Filter(MERV 6w) 0 1
❑ 7.Don't Install Fireplace or Install Satetl Gas Fireplaces with Efficiency Rating Not Las Then 50% 0 1
using CSA Standards
,
6.Install Eflecdve Exhaust Systems In Bathrooms and Mothers
❑ a.instep ENERGY STAR Bathroom Fans Vented to the Outside _0
❑ 0.An Bathroom Fant Are on Tomer or Humidified _0_
❑ c.Inra0 Must Range Hood Vented to the Outside 0 g
0.install Machenical VnNation System for Cooling(Maximum 4 Points)
❑ a.Install ENERGY STAR Calling Fans 6 Light Kits in Living Areas A Sadmoms
❑ b.used Whole House Fan with Variable Spaces _0 ] _
❑ c.Automatically Controlled Integrated System _ 0 2
❑ d.Au ernaticaly Controlled Integrated System with Variable Speed Control 0 3 T
10.Install Mahnical Fresh Air Ventilation System(Maximum J Points)
❑ e Any Whole House Vengla0on System That Meets ASHRAE 622 - 0_ ! 2
❑ b.Install Air-to-Air Heat Exchanger that more ASHRAE 62.2 0 1 2
11,Install Carbon Monoxide Alarms 0 1
Total Points Available In Henn,Ventilation and Air Conditioning 0
0 2D07 Build It Green Single Fell GreenPoinl Checklist 2007 Version Page 2 of 4
ENTER PROJECT
a rs
I.RENHWA LE ENERGY Points Available Par Measure
1.PwPlumb for Solar Hot Water Healing 0 q
• LJ 2.Install Solar Water Heating System 0 10
LJ ].Install Whiny Conduit for Futuro Photovoltaic Installation&Provide 2DO te of South-Facing Roof 0 2
4.install Phot rmitza(PV)Parri
❑ e.30%of olei needs OR 12 kW(Iobl6 points) 0 5
❑ D.50%of electric needs OR 2.411W(total 12 pants) 0 ---g--- ' ----- —
❑ c.90%of electric need OR 3.6 kW(total lB pants) 0 ---- 6 -- -- - —
--
Total Available Points in Renewable Energy=28 0
J.BUILDING PERFORMANCE Points Available Per Measure
1,Diagnostic Evelusboru
❑ a.House Pages Blower Door Test D 3
b.House Process Combustion Salmy Backdrafl Test 0
2.Design end Build High Performance Homes-%above Tlde24.minimum 15%Requfied 0 2!30
❑ 3.House Obtain ENERGY STAR with Indoor Air PackageCertification-Pilot Measure(Total 45 poinia,read comment) 0 5 2
Total Available Polns In Building Performance=39 0
E.FHgISEM - Points Available Per Measure
❑ 1.Design Entryways It Reduce Tracked in Contaminants 0 1
2.Use Low40C or Zero-VOC Fakir(Maximum 3 Points)
❑ A.Low-VOC Interim WalliCeiling Palms(<SD 0 VOCs(Flat end<150 gel VOCs(NonFlai 0 ]
❑ b.ZwpVOC:Interior WatkCel3n Pease(d 0 VOCs(Fla)) 0 --'---g_
❑ 3.Use Low VOC,Water-Based Wood Finishes(450 gpI VO(s) D - 2
❑ 4.Use Lew-VDD Caulk and Construction Adhesives <71t gpI VOCs)for All Adhesives D 2
❑
S.Use Re Bled-Content Palm 0 1
6.Use Environmentally Preferable Materiels for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed
❑ a Cabinets(SD%Minimum) 0 3
❑ b.Interim Tdm(SD%Minimum) p
❑
C.SheMng(50%Minimum) p --j ------- —
❑ d.Doors(50%Minimum) 0
❑ e.Counters (50%Minimum) 0 1
7.Reduce Formaldehyde In Interior Finish(CA Section 0135D)
❑ e.Suldoor&Stair Treads(50%Minimum) 0 3
• ❑ b.Cabinets&Counterrom(50%Minimum) -
❑ C.Interim Tina(50%Minimum) 0 ,
❑ d.SheMin (50%Minimum) 0 1
❑ B.After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Lent d,7 pb 0 3 1
Tobi Amiable Points In Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Certified Wood,B)Reclaimed or Refinished, C)Rapidly Renewable,D)Recycled-Content,E)
Exposed Commits Flooring AdhWvea Must Have<50 gpI VOCs.
❑ L Minimum 15%of Floor Area D
❑ b.Minimum 30%of Floor Area D
❑ c.Minimum 50%at Floor Area �--
❑
J.Minimum 75%of Floor Area
❑ 2.Thermal Map Floors:Floor Covering Other than Carpet on 50%or Moro of Concrete Floors 0 ( 1
❑ 3.Flooring Mets Section or 35D or CRI Green Label Plus Requirement 50%Minimum) 0 i 1 2 1 1
Total Available Points In Floorin =7 0
M..APPLLANCES AND LIGHTING Points Available Per Measure
1.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(tore]1 point 0
❑ b.Dishwasher Uses No More than IS Gallon DIB(total2 oints) 0
Z Instill ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Len
❑ e.Mesta Energy Star and CEE Ter 2 requirements(modified energy factor 2.0,Water Factor 6.0)flood 3 points) 0
❑ b.Meets Energy Star and CEE Ther 3 requirements(modified energy factor 22,Water Factor 45 _or less) 0 Z
lotal5 points)
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified&<25 Cubic Feet Capacity 01 I
❑ b
_0___.i__... -
.ENERGY STAR Qualified&<20 Cubic Feet Capacity _i—I'
_
4.Install Built4n Reryctin9 Center 0
❑ a BULB-In Recycling Center D 7
❑ b.BUIWnCompostingCenter D 1
Taal Available Points in Appliances and Lighting=12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporate GmenPoinl Rated Checklist in Blueprints-Required 0 1 1 R
❑ 2,Devaiop Homeowner Manual of Green FeatureslBenefits 0 1 1 1
• 3.Community Design Measure&Local Priorities:Sea the Community Planning 8 Design section In Chapter 4 of the New Home Gulmlines for
measures.Mexlmum of 20 points for suggested messures.Local requirements may also be fisted here.
02007 Build It Green Single Family GreimPOint Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAME MUGHUR
❑ _Enter dowrimun hoe,and enter points nvellabts for manure In appropriate chieftain to the right. 0 0 0 0 0 0
Ej Enter d oulmon here,and ental pointsovellabts for measure In appropriate ateporlac to the right. 0 0 0 0 0 0
Enter dncriplion hes,and enter points evade s for measure In ft"the e atepofin m the Tight. 0 0 0 0
Enter doculpllon hue,and enter points available IN measure In appropriate Cartagena;to the right 0 0 0 0 0 0
4.Innovel on:List Innovative measures that most the green building objectives of the Guidelines.Enter up to a Build h Green Checklists and
maximum combined total of 20 pts.See innovation Checklist for suggested measures,using the link to the right Guldellnes
Innovation M Common ;Enter Th ion hen,and ems points Vehicle Inr manure in sonaprall calagodes to the righL 0 00 0 q o
Innovation In Eno an:Enter cannon hen,and enter points avallMle for manure In tae cat Mas to the Tight. 0 0 0 0 0 0
Inch vallan In IAOMaltht Enter duml ion here,and enter points available for manure in ate categories to the right, 0 0 0 0 0 0
Innamga In Pesouraa:Enter causal hoe,and enter points anleds he measure In 2proprlsla cats adn to the right. 0 0 0 0 0 0
intimation in Water.Enter daaw"on here,and ants points available for manure in appopflee atepMn to In right_ _ 0 _ 0_ 0 0 0 _0_
Tobi Available Pointe N Other= 0
Summary
Total Available Points In Specific Catepodes' 4+ 96+ 42+ 66+ 43+
Minimum Pointe Required In SpeclFlc Categodea G 30 5 6 9
I DUll Points Achieved
1 1 1 1 I 1
Project has;not yet met the following recommended minimum mcpalroments:
-Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-12: 15%above Title 24
-NI:Incorporate Green Point Rated Checklist Into blueprints
-Minimum points In specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(5 points)
-(Nater(9 points)
•
02007 Build It Green Single Family GreartPolnt Checklist 2007 Version Pape 4 of 4
Community Development
10300 Torre Avenue
('Ell Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
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Building De artment
JOB ADDRESS: PERMIT #
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OWNER'S NAME: CA-{4 X e t a ✓ PHONE # 'lo t- ZS2—
GENERAL CONTRACTOR: K rvae1� ua4� 6a.-I- — 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
•
Owner/Contractor Signature Date