08010133 CITY OF CUPERTINO
BUILDING DIVISI-ON PERMIT " C(11RATCaYRTN. JMAtTIf7rN -
BUILDIN A DRESS: PERMIT NO.
74 � TIPTOE LN AAA FURNACE & AIR 08010133
OWNER'S NAME: C UNDT I I UN 117, PERMIT LIUE DAIS
ROY LORD 1712 STONE AVE 01/22/2008
ONE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
REPLACE FURNACE,DUCTS IN ,LOG ELECT PLUMB MECH
d10 0 LICENSED CONTRACTOR'S DECLARATION O O O O
dr�+FF I lo:eby affirm dost 1 am licensed under provisions of Chapter 9(commixing Job Description
with Suction 70(10)ofDivislon 3 of the Business and Professions Cola, sal my license is
r in Trot cera an�9f LS'LG
Z_ Lieenu Clue Lt..I
Contucmr /'r�
9 A HIIECTS DEC _
de , ~
I unmm�d my plana shall he used u public records
e
yo Licensed professional
OWNER-BUILDER DECLARATION
I hereby alarm that I em exempt from the Combat License Law for the
COO following mason.(Section 7031.5,Business and Professions Code:Any city or county
13lri. which"unem a Permit to construct.a@r.improve,d,moliah,or mpair any structure
Zy prior m its issuance.alm requires the applicant for such permit to file a signed statement
Rgq< that he is licensed pursuant m the provisions of the Consumer's License Law(Chapler 9 Sq.Ft.Floor Area Valuation
D (commencing with Section 7000)of Division 3 of the Business and Proportion Cook)or
that he u eumpt therefrom and the hula for the alleged exemption.Any vlolNon of
Section 7031.5 by any applicant for a permit subjects the applicant m a civil penally or APN Number Occupancy Type
not mom this love hundred dollen(5500).
❑I,as owner ofthe property,w my employees with leges as their sole compemdon,
wflld thew rk,mdtheswetumisnotimmndedoroQemdforsam(San.7 .Butims
anRequired Inspections
d Pmressions de:CoThe Conmcmm m t's License law dnot apply an owner of q P
property who builds orfmproves thereaeand whodmasuch workhimselforthrough his -
Own employees,provided Nu such improvements son rat Intended oraRend for ale 11.
however,Ne Wilding or improvement is mid within one your of,nmphalon.the Owner.
builder will have the burden of Navin,dust the did not Wild or improve for Purpose of
ale.).
❑1,as ower of the Property,am exclusively connecting with licensed conuumn In
ennstroct the pmjem(Sec.7044.Business and Pronasions Code:)The Coaaacmr's Li,
come Law dens not apply to an owner of property who Wilds or improve,thenen,and
who contracts for such projects with a conuactor(s)licensed pursuant to the Contractors
License Law.
❑Iamexempturnim See ,B&PCforthisnuon
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby afrlrm under penalty of perjury on:of the following declamations:
1 have and will maintain a Costliest:of Command m self-ilium for Workaes Comment.
on,as provided for by Section 37W of the Labor Code,for the Performance of the
wark for which this permit is WOOL
❑I hive and will maintain Workers Compensadon Insurance,u required by Section
3700 of doe Labor Coda,for the performance of the work for which this permit u Issued.
My Workers Compensation Insurance artier and Policy number am:
Cartier. Policy 1YKAnsfftFEM INNFRDZW
F
COMPENSATION
INSURANCE
(Ihissection need wt ho completed If the permit is forum,hundred dollars($100)
Or leu)
I mnify dust In Ne performance of to work for which this permit is issued.l shall amt
employ any perm.in any manner to u to become subject o the Warkcn'Canpemtion
Is vs of California.Dam
Applicant
NOTICE TO APPLICANT:If,aMr making this Certjficem of Exemption,you should
become subject to the Worker's Compemtion previsions of the labor Code.you most
,J 0 forthwith comply with such provisions or this permit shall he deemed revoked.
z^" CONSTRUCTION LENDING AGENCY
[r mN—d I henbyalRrm Nat then isacarntrctinn lending agency for the porfamamouf
CG D the work for which this permit It Iauol(Sec.3097,Civ.C.)
aQ Lender's Name ,
5 z Lenders Add.
()Q 1 atufy that I haw rad this application and sou that Ne short information is
LI, H cotrem.1 agree to amply with all city and county onlinancea and sun laws misting m
Q V building construction.and hembyauthodu minommutives of this city to enter upon the
W above-mentioned property for inspection purposes
d (Wc)agree to sew,indemnify and kap hun lea the City of Cupertino against
,.y lyj liabilides,judgments,costs and expenses which may in my way acme against said City
V Z in consequence of the gaming of this Permit. `I -ejL-
�+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date !�
SOURq REGULATIONS. 2ci�_k_
—�� J . + 4 Re-roofs
sig ata o fApppcmNConueCmr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WIII Ne applicant or fumm Wal C..aupant son or haMlc Halloud Safer l
ns d.flnedSOc by the Cupertino Municipal Codc.Chapter 9.13.and the Health and Safety
Cale,Sention 35532(x)?
❑Yes All roofs shall be inspected prior to any roofing material being installed.
o
Will the applicant or utter building Occupant use equipment Or device which If a roof is installed without first obtaining an inspection,,l agree to remove
+hazardous air comaminanu as defined by the Bay Area Air Quality Management all new materials for inspection.
ct7
❑Yes u
I haw mad ear
the hado ma 13 requirements under Chapter 6.95ofthe Califor-
nullealth&SafciyCae,Sadaw25505.25533md255M.lu mdOmirdce Wilding
dm not cue curly haw a mnmt,that it u my map notolity m notify oho=now,of the
osmiz which mot he met prior m iaama or a Cer4,cateof Occupang S ignature Of Applicant Date
zpzf
owner mthodvedagent D All roof coverings to be Class"B" or better
CITY OF CUPERTINO
® 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35932060 . 00
DATE ISSUED. . . . . . . : 01/22/2008
RECEIPT #. . . . . . . . . : BS000003755
REFERENCE ID # . . . : 08010133
SITE ADDRESS . . . . . : 7414 TIPTOE LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ROY LORD
ADDRESS . . . . . . . . . . : 7414 TIPTOE LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5819
RECEIVED FROM . . . . : JIM RANDO
CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050
COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING
ADDRESS . . . . . . . . . . : 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 293-4717
® FEE ID UNIT ---- QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 16, 650. 00 1 .70 0 . 00 1 .70 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
IMRRAA UNITS 1. 00 61 .19 0. 00 61 . 19 0. 00
IPPERMITFE FLAT RATE 1. 00 40 .79 0 . 00 40.79 . 0. 00
ITRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 226.05 0. 00 226 . 05 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- ------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
001 D 13"'�
CITY OF CUPERTINO
FURNACE/AC
®CUPERTINO PERMIT APPLICATION FORM
IN# � O/ O Y �� Date:
Building Address:
Owner's Name: Phone#:
Contractor: Phone#:n?"_ Y ,71 7
1AI'VZ20 A0,4 // C c Fax #:
Contractor License#: ' Cupertino Business License #:
Contact: Phone #: .5/ dr--W Y ;71
Fax ft:
Building Permit Info:
Elect Plumb ❑ Mech
Residential Commercial ❑
Job Description:
lee/,O c c �v/n d c c � ale, C -/,r /A Sai{c /0 c—,r X"-,v oof of 2 X'r, f/,�C
For Residential Installations:
Attic ❑ 152 floor 2nd 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: Type of Construction (Usage Class):
Strapped On Platform ❑ Bonded New Location 0 Replacement [t_�
Valuation:
Green Building: Must attach Green Building Check list to this application _��
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Cormnercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
_ installation of controls.regulated by this
code.
1MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the instalI/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential InstalI/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install ¬ incl in an appl permit.
CITY OF CUPERTINO
' FURNACE/AC
®CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance up to and
Ah include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
/ lEPERMITFEE Electric Permit Fee . E
1MPERMITFEE Mechanical Permit Fee M
/ 1PPERMITFEE Plumbing Permit P
/ 1TRAVD0C Travel Documentation B
1BUSLIC Business License B
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= lOk CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
-- -- - — - -
-1PGASRES Residential-for ea gas piping system - P --- -------' —- -
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAIRHAN Residential A/C units <= 1 Ok CFM B
1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: patg
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35932060. 00
INVOICE DATE. . . . . . : 01/22/2008
REFERENCE ID # . . . : 08010133
SITE ADDRESS . . . . . : 7414 TIPTOE LN
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ROY LORD
ADDRESS . . . . . . . . . . : 7414 TIPTOE LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5819
CONTRACTOR . . . . . . ..: RANDO, JIM ' LIC # 8050
COMPANY AAA. FURNACE & AIR CONDITIONING
ADDRESS . . . . . . . . . . : 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408)293-4717
FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE
--------------------------- ---------------- ---------- ---------- ----------
SEISMIC RESIDENTIAL PRINTING PERMIT 1 .70 0. 00 1.70
ELEC PERMIT ISSUANCE PRINTING PERMIT 40 .79 0. 00 40.79
MECH PERMIT ISSUANCE PRINTING PERMIT 40 .79 0. 00 40.79
RES MECH REPAIR/ALT/ADD PRINTING PERMIT 61 .19 0. 00 61.19
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40.79 0. 00 j4l-07.7�9,,,�TRAVEL & DOCUMENTATION
FEE PRINTING PERMIT - 40.79 0. 00---------- ---------- ----226 . 05 0. 0 VOICE ID DESCRIPTION VOICE ID DESCRIP ON-------- ---------------------------- -------- ---------------- ----505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
Single Family GreenPoint Checklist date: Build It Green
The GreenPoint Checklist is based on the various green features Incorporated Into the home and is the Smarr Solutions From The Ground Up
basis for the GreenPoint Rated program.A home can be considered green 11 It fulfills the prerequisites,
Hams at least 50 poen(,and meets the minimum points per category Energy list
of Indoor Air rQualftyl
eimPol
Health(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint
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.builditmeen.orD.
P 5
ENTER PROJECT NAME
U Q
A BITE Points Availehla Per Measure
1.Protect Topsoil and Minimize Disruption of Existing Plants 8 Trees
❑ e.Protect Topsoil from Erosion and Reuse after Construction 0 1 1
❑ b.Nmh and Delineate Ccnsbuction Foomrint for Maximum Protection 0 I i
2.Deconstruct Instead of Demolishing Existing Buildings On Site 0 I 3
9.Recycle Job Site Construction Waste(including Green Waste)
❑ a.Minimum 50%Waste Diversion by Weight(Racycl or Reusef-Required 0 R
❑ b.Minimum 65%Creation by Weight(Recycling or Reuse) 0 2
❑ C.Minimum 8D%Diversion by Weight(Recycling N Reuse) 0 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway D —{I— 1
❑ b.Roadway Base 0 1
Total Points Available in She=12 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash or Slog
—❑ a.Minimum2KI'linhwSlag '- 0 I 1
❑ b.Minimum 25%Flyash or Slag0 1
Ll 2.Use Frost-Protemed Shallow Foundation in Cold Areas(C.E.C.Climate Zone 16) 0 i 3
3.Use Radon Resistant Construction(In At-Risk Locations Only) 0 1
4.Design and Build Structural Pest Controls
❑ a.Install Termite Shields 8 Separate All Exterior Wood-toConcer,Connections by Matal or Plastic FastenersrDridars 0 I 1
It.All New Plan(Have Trunk,Bass,or Stem Located At Least 36 Inches from Foundation 0 1
Total Points Available in Foundation=- 0
C.LANDSCAPING Points Available Per Measure
1.Construct Re usurce-Ef icant Landscapes
❑ a.No Invil Species Listed by Cil Are Planted 0 I
❑ b.No Plant Species Will Require Hedging 0 1
• ❑
C.75%of Plants Are Drought-tolerant Celliomia Natives,Mediterranean,or Other Appropriate Spades 0 1 3
2.Use RwSeo Landscaping Techniques 0 1 I I I
3,Minimize Turf Anna in Landscape Installed by Builder
❑ a.All Turf Will Have a Water Requirement Less than or Equal to Tall Fescue(50.6 plant factor) 0 2
❑ b.Turf Shall Not Be Ins(Iled on Slopes Exceeding 10%or in Areas Less than 6 Feet Wide 0 2
❑ c.Turf Is 43%of Landscaped Area(total2 Points) 0 2
❑ c.Turf is 510%of Landscaped Area(I114 points) 0 2
I,Plant Shade Train 0 3
5.Grou Plen(by Wekr Needs(Hydrozoning) 0 2
6.Install High-Efficiency Irrigation Systems
❑ e.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers 0 2
❑ b.System Has Small Controllers 0 3
].Incor orate Two Inches of Compost in the Top 6 to 12 Inches of Soil 0 3
-Mulch All Planting Beds to the Greater of 2Inches or Local Water Ordinance Requirement .0 I 2
9.Use 5D%Salvaged or Recycled-Content Materials for 5D%of Non-Plant Landscape Elements 0 1 I I 1 1
10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0 1
Total Points Available in Landscaping=31 0;.;.J
D.STRUCTURAL FRAME @ BUILDING ENVELOPE V.,, Points Available Per Measure
1.Apply Optimal Value Engineering L C�
❑ a.Piece Rafters and Studs at 24-Inch On Center Framing
❑ b.Size Door and Window Heatlers for Load I
❑ c.Use Only Jack and Cripple Studs Required for Load D1
2.Use Engineered Lumber
❑ a.Beams and Headers 0 1
❑ It.Insulated Engineered Heatlers 0 y
❑ c.Wood Woes or Web Trusses for Flows :10-2
0 1
El J.Wood I-Joists for Roof Rapers 0 1
❑ e.Engineered or Finger-Jointed Studs IN Vertical Applications 0 1
❑
I.Oriented Board Board for Subfloor 0 __ 1
❑ g.Oriented Strand Board for Wall and Roof Sheathing 0 1
3.Use FSGCertified Wood
'❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 2 1
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% 0
❑ c.Panel Products:Minimum 40% 0 � I
❑ tl.Penal Products:Minimum 70% 0 1
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
ENTER NAME
e
4.Use Solid Well Systeme(Includes SIP&,ICFs,5 Any Non-Stick Frame Assembly)
❑ e.Floraer� 22
❑ b.Wells / (� / L 0 _ --�-- 2
El C.RODIS I u 0 2 i 2
S.Reduce Pollution Entering the Home from the Glarege
❑ a.Tlghtry Seat the Air Bernier between Garage and Living Area _ _
D 1 _
❑ b.Install Garage Exhaust Fan OR Build a Detached Garage 0 1
B.Dui n Energy Heels an Trusses(75%of Attic Insulation Height at Canada Ede of Exterior Well 0 1
7.Desi n Roof iruuea a Aaommoden Dus:Mork 0
e.Uee Recydetltonnnl Steel Sntls for BO%of Interior Wall
Frarrang D 1
9.Thermal Mw Wells:518-Inch Drywall on All Insider Wells or Walls Weighing more than 40laIcuAL 0 1
10.Install Overhangs and Guttas
❑ a.Minimum 16-Inch Overhangs and Guinn 0 1
❑ b.Minimum 24-Inch Overhangs and Duties 0 r 1
Total Points Available In Seuchmal Building Frame and Envelope•36 0
E.EXTERIOR FINISH Points Available Per Measure
1.Uee Rs 0 ed-0omenl(No Vir in Plastic) rtiFiu c)or FSC-CeWood Backing0 2 I
21n&tall a Rein Screen Well System 0 I i 2
J.Uee Dumbleand Noncombustible SidingMaterials 0 1
4.Sal em Dumb le and Nonmmbustibls Roofing Materials 0 2
Total P inn AvaOade In EgBda Finish•7 0
P.INSULATtON Pointe Avallable Per Measure
1.Install Insulation with 75%Recycled Content
❑ a.Walls and/or Floors
-- ❑ - b.CeOm -- -- ' -- - --- - --- - o - -- - -- -i-- -
2.Install Insulation Net Is Low-Emitting(Certified Section 01350)
❑ a.Walls anNar FIDDrs 0 _ 1
❑ b.Collings 0 1
-- J.inspect Cuailty 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 Paints)
❑ a.Insulate Hot Water Pipes ham Water Heater to Kitchen 0
❑ b.Insulate All HM Water Pipes 0
❑ c,Use Engineered Parallel Piping 0
❑ d.Use Engineered Parallel Piping with Demand Controlled Clrooleti0n Loop 0
❑ e.Use Sbuchired Plumbing vAth Demand Controlled Clrculaeon Loop —0
❑
I.Use Central Core Plumbing 0 1 1 2
Ej 2.Inslell Only High Efficiency Toilets Dual-Flush or 51.28 9PQ D
Total Pans Avallable In Plumbing=Total 12 0
H.HEATING VENTILATION R AIR CONDITIONING Points Available Per Measure
1.Deagn and Install HVAC System to ACCA Manual J,0,and S Recommendations 0 4
2.Install Stated Combustion Units
a.Furnaces 0 _ 2
It.Water Heaters 0 2
Lj J.Install Zoned,Hydronic Radiant Heating with Slab Edge Insulation 0 1 1
L indell Hiph Effieienry Air Conditioning with Environmentally Responsible Refrigerants 0 1 r �'
5.Design and Install Effective Ductwork
a.Install HVAC Unit and Ductwork within Conditioned Space 0 3
❑ b.Use Duct Mastic on All Duct Joints and Balms 0
❑ c.Install Ductwork under Attic Insulation(Buried Duca) —0 _ 1
t
❑ tl.Pressure Balance the DactwDlB System _D 11.
❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0 1
e.Install High EfficienHVAC Fiber MERV 6s) 0 1 /
❑ 7.Don't Install Fireplace or Install Salad Gu Fireplaces with Efficiency Rating Not Las Than 6D% 0 I 1
using CSA Standards r
S.Install Effective Exhaust Systems in Bathrooms and Kitchens
❑ a.install ENERGY STAR Bathroom Fans Vented to the Outside 0
❑ b.All Bathroom Fans Are an Timer a Humidertat D 1
❑ c.Install Kitchen Range Hood Vented to the Outside 0 1
g.Install Mechanical VanWetion System for Cooling(Maximum 4 Pointy)
❑ a.Insall ENERGY STAR Ceiling Fans It Light Kris In Living Arent B Bedrooms 0 1
❑ b.Install While House Fan vAlh Variable Speeds 0
❑ c.ANomadca%Controlled Integrated System
❑ d.AutornaticOy.ContrWled Integrated System with Variable Speed Control 0 3
10.Install Mechanical Fresh Air Ventilation System(Maximum J Points)
E] a.Any Wholetiouse Ventilation System That Meats ASHRAE 622 It _ 2 _
❑ b.install AMo-AIr Heat Exchanger that mems ASHRAE 622 D
it.Install Carbon Monoxide AIBrm s 0 l 1
Total Pollan Available In Heating,Ventilation and Air Conadorning•30D
02007 Build It Green Single Family GmenPoint Checklist 2007 Version Page 2 of 4
1 PROJECT
• c & S
rs`
I.RENEWABLE ENERGY Paints Available Per Measure
Lj 1.Pre-Plumb for Soiar Hot Water Heading 0 l a
LJ 2.Install Soler Water Heading System 0 10
• U 3.Install Wiring Conduit for Future Photevollsic Installation 6 Provide 200 K of South-Facing Roof 0 2 1
4.Install Photovoltaic(PV)Panels
❑ a.30%of electric needs OR 12 kW(total6 points) 0 6 1 1
❑ b.SD%0 sle,mric needs OR 2.41W(total 12 points) 0 6
❑ C.90%of electric need OR 3.6 kW(total 18 points) 0 1 6
Total Available Points in Renewable Ener =28 0
J.BUILDING PERFORMANCE Points Available Per Measure,
1.Diagnostic Evalustions
❑ a.House Penes Blower Door Test 0
❑ It.House Passes Combustion Solely Backdraft Test 0 1
2.Dasign end Build High Performance Homes-%above Tide 24-minimum 15%Required 0 >30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Pilot Measure(Total 45 points;read comment) 0 I 5 2
Total Available Points in Building Performance=39 0
E.FINISHES Points Available Per Measure
❑ 1.Design Entryways to Reduce Tracked in Contaminants 0 1 1 I I
2.Use Low-VOC or Zero-VOC Paint(Maximum 3 Points)
❑ a.Low-VOC Interior WaIVCaffing Paints(<50 gpI VOCs(Flat)and 0500 VOCs(Non-Flat)) 0 1 t
❑ b.ZeraVOC:Interior WaKelBn Paints(6 GotVOCs(Fial)) 0
❑ 3.Use Low VOC,Water-Based Wood Finishes(Q50 gpI VOCs) 0 2
—❑-4.Use Loi Caulk and Construction Adhesives(<70 p)VDI for All Adhesives 0 —1—f _2-1 —1—
EF-5.
1❑ S.Use RerycledContent Paint 0
6.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,B)Reclaimed.C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed
❑ a.Cabinets(50%Minimum) - 0 1 _
❑ b.interior Trim(50%Minimum) 0 7
❑ c.Shelving(50%Minimum) 0 _
❑ d.Doors(50%Minimum) D 1
❑ e.Countedops(50%Minimum) 0 1 I
7.Reduce Formaldehyde in Inmrior Finish(CA Section D1350)
❑ a.Subficcr A Stair Treads(50%Minimum) 0 1
❑ o Cabinets a Countedops(50%Minimum) 0
❑
C.Interior Trim(50%Minimum) 0 ]
® ❑ d.Shelving(50%Minimum) 0 1
❑ B.After Installation of Finishes,Test of Indoor AO Shows Formaldehyde Level Q7ppb 0 3
Total Available Points in Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSCCerdfied Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Con ony E)
Exposed Concrete,RooringAdhesives Must Have d0 gpi VOCs
❑ a.Minimum 15%of Flow Area 0 _ 1
❑ b.Minimum 30%of Floor Ahm 0 1
❑ c.Minimum 50%of Floor Area 0 1
❑ d.Minimum 75%of Floor Area 0 1
❑ 2.Thermal Mase Floors:Floor Covering Ot her Man Carpet on50%orMore ofConcrete Room 0 1 1 1
—D-3,Floorin Meets Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 1 2
' Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
t.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(told 1 point) 0 1
❑ b.Dishwasher Uses No More than 6.5 Gallon total 2 ins 0 1
2.Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier 2 requirements(modified energy factor 2.0,Water Factor 6.0)(total 3 points) 0 1 2
❑ In.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 2.2,Water Factor 4.5 or less) 0 2
(total 5points)
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified 8 x 25 Cubic Fast Capacity 0 1 _
❑ b.ENERGY STAR Qualified 6<20 Cubic Feel Capacity 0 1
4.Install Built-In Recycling Center 0
❑ a.Built-In Recycling Center 0 2
❑ b.Built-In Composting Center 0 1
Total Available Points in Appliances and Lighting 1 0
N.OTHER Points Available Per Measure
❑ 1.Incorpmete GreanPoinl Rated Checklist in Blueprints-Required 0 I R I
❑ 2.Develop Homeowner Manual of Green FestureslBenefils 0
3,Community Design Measures B Local Priorities:Sea the Community Planning 6 Design section in Chapter 4 of the New Home Guidelines for
measures,Maximum of 20 points fret suggested measures.Local mquirement5 may also be listed here.
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 3 of 4
5
ENTER PROJECT NAME
CD Enter description here,and enter pointe available for measure In appropriate caleDonal to The right. 0 o D 0 0 0
Enter doeolpoon here,and enter points available Ior measure In appropriate calagaias to the right O 0 D 0 0 0
❑ Enter dewilptim hen,and enter points evdlada fa measure In Appropriate Wegodes to the right 0 0 0 0 0
❑ Enter dereerbadon ham,and enter prism Walloon,for measure in appnpriem ca"Drins to the high._ _ _ _ g o 0 0 o 0 _
4.Innovation:List innovative measures that meat the green building objectives of the Guidelines.Enter up to a Guidelines
D Green Checklists end
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right,
LJ Innovation In Communi :Enter dirmorlidiDn here,and enter points evallable for measure In appromate categories to the right _0 0 0 0 0 0
Innmallon In Energy:Enter description here and enter poll availabe for measure In approphato categories to the right. ____o 0 0 0 0 0
Innwatihe M IAOMasllhl Enter desorption here,and enter nts walleble for ammure In Ian tate es to The right. _0 0 D a 0 0
Innwulon In aasounmbr Enter de on here,and eater prints smashes for measure In toremprefts cal es to rite D_ 0 0 0 0 0
imwvatino In Water,Enter dasogam hen,and enter points Awltade to messme in apprgslere categones to the right _ 0 0 D D o 0
- - -- --' -- '-- — - - - - - Taal Avallade Pdne In Other= ---
Summary
Total Available Points In Specific Calegones' 4+ 96+ 42+ 66+ 43+
Minimum Pointe Required In Spathic Categodes 0 30 t 5 6 9
Total Points Achieved m m m m m m
Project heat not yet mot the following recommended minimum requirements:
- Total Protect Score of At Least 50 Points
-Required measures:
-Aa: —
•A3a: 50% waste diversion by weight Lr/
•J2: 75%above-Title 24 ---- - -- - - - - - - — -- - - --- - --
-NJ:Incorporate Green Point Rated Checklist Into blueprints
-Minimum points in specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(6 points)
-Water(9 points)
02007 Build It Green Single Family GreanPoint Checklist 2007 Version Page 4 of 4
Community Development
' 10300 Torre Avenue
d Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building De artment
JOB ADDRESS: PERMIT #
G4 ORq� ol7 ?
OWNER'S NAME: o PHONE # a ,f—J= 02 ejg O
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors:�bL _ .oQ_
Signatur Date
Please check applicable subcontractors and complete the followinginformation
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating 4AemaAlu wv C = e D f o
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date