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08030003 CIOUOONopv Rtel o ILIPERMIT CONTRACT T®R IN�'ORMATI0,1Y Pxwv,.K:afi,g«,,...MrYv*ra�- +s.,� ry.'tt,"+itne-,x'nan PERMIT N0. BUILD(n19TsWOODBURY DR CUPERTINO PLUMBING 08030003 NER'S NAME: PERMIT ISSUE DATE ARNOLD CROSS 1300 DELL AVE STE C 03/03/2008 NE: SANITARY NO, CONTROL NO. ARCHITEC fENGINEER: BUILDING PERMIT INFO WATER MAIN ONLY - BLDG EO PLO MO Op LICENSED CONTRACTOR'S DECLARATION Job Description SZFF 1 Inmby affirm that 1 am licensed under provisions of Chapter 9(commencing y with Section 0M)ofDivision3might,Business and PrOffmiun.Coda.and mylicense is j Zin full fame and effect,,.3/ G�1 `/S� Liccnm clear CC�- (o Lic.N Dale '�� —Contractor `­_ ontractor "IONQ ARCHITECTS DECLARAT i�� i uledersmnJ mY plana shall be used u public rtenrN )yU C License)Professional 5 OWNER-BUILDER DECLARATION no I hmaso affirm,on 1 am cmmpl from he C ssions c License Low for Ne .❑O following mama.Permit t ]071.5•Business and sae.d aiona Coda:Any city S munty one �$� which requires a Permit m cnnstrucL alms,improve,demnli.N,or repair any mudum PAar m its issuance.also mquiru lbe applicant for Such Comma tors U l nz Law(atammem .S< NelheislicensedpursuanttotheprovisionsofNcCanlracwrilJsmnselaw(CNplm9 Sq.Ft. Floor Area Valuation e l'•� (commencing with Section 70D0)of Division 3 of Ne Businessand Professions Code)Our that he is samept therefrom and the bub for the alleged eaemptiaL Any violation of Section 7031.5 by any applicant for a peemil Subjects the applkaft m a Civil penahy Of APN Number Occupancy Type not mom than five hundred dollars(33170). 0 1.u owner of Ne property,or my employees with wages as their sole compensation• will do thework.and lheswcture is notimmndedor offered rental.(See ID ,Business Required Inspections lan and Prefssss Cade:The Contractor's License Law does not apply m an Owner of q P property who builds or im proves thereon•and wbo does such work himself or tiuo ngh his own employees,providad that Such improvements art not intended oronered for tale If, however.the building orimprovement is Sold within one year of compladm.the owner. Wilder will have the burden of proving Nal he did rot Wild Or improve for purpose of vele.). 0 I..,owner of tins properly.am exclusively compacting with licensed mnhaerma m construct Ne project(Sec.7014,Business and Professions Code:)The C°ntnmafa U. ' cents law docs not apply In an owner of property who Wilds or impmsms thereon,and who contracts for such projects with acontmctor(a)Iimved pursuant to IW Consommes LRense Law, ❑1 em exempt under See .B&P C for this roaon nes Dam WORKER'S COMPENSATION DECLARATION ' 1 hereby&Mm under penalty of perjury mm of the fallowing decluatia� (hart and willmelnminaCertifiem o(COnsemmself-InsumfarWartersCampm- sation,as Provided(of by Section 3700 of the Labor Cade,fm die performance of tic work for which this permit is issued. 0 1 have and will maintain Workers Compensation Insurance,as required by Section 37M of the labor Cade.for the Performance fir Ne work for which this permit is issued. My Worker Compensation Insurance carrier and Policy number am: CartSf am- Carrier _k V-InOAP A Policy No.: ��'� gZ 4Z-07 CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed if ths,Permit Is foronc hundmddoWs($100) or less.) 1 sonify that in the performance Of the work for which this permit is issued-I shell not employ any Person in any manners as to became Subject to the Workers'C°mpw".•tion Laws of California.Dole Applicant NOTICE TO APPLICANT:IL alter making this Certificate of Exemption,you should become subject Or the Workers Compensation provisions of Ne labor Code,you muss 0z forthwith comply with such provisions Or this Permit shall be doomed n+vted. Z '--' CONSTRUCTION LENDING AGENCY F.� Ihereby affirm Nat there isa<anspuctinn lending agency for She Performance of p: 7 on..,it fur which this permit is issued(Sec.3097,Civ.C.) QLender's Name .7 z Lenders Address U 1 certify that 1 have read this application and sum that the above information is U, cmmen.I agree m comply with all city and county onlinames and sum laws mlating In OU building construction.and hereby authorme mpmunmtives of this city to enter upon the � above-mentioned property for insPmtion purposes. 0., (We)agree to sale,indcmni If and keep homeless the City of Cupertino again,, wV] liabilities,judgmcnu,core,and expenses which may in any wayaccruc agelns,said City U z in consequence of line tm Issued by: '• Q '-' AP ICANT UNDLY WITH ALL NON-POINT Date sOg�AC'SA6GVtAT _/ Re-roofs Signature of Apple poem Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof will applicant or forum Wilding°ccupan,store Or handle breardos,mamind ha daRned by f Cupertino Municipal Code.Chapter 9.11•and f Health and!Safety Simon.15531(x)7All roofs shall be inspected prior to any roofing material being installed. 0 Ye O Wits the applicant or future building Occupant use equipment or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove troll hvardnus air eonmminane,as defined by the Bay Amu Air Quality MoaagWomt all new materials for inspection. District? / oyes �Au I have mad dm hvardmss matermismquimmcm undarChapmr6.95OfticCalifm- nia Hcslth&Safcty Cock,Scc6au15505.15533 Soul n314.I understand thuif do Wilding Jets not cu mnlly he L tits responsibility to mtir the ant of the "l ' "lents no 'aro °r " " Signature of Applicant Date All roof coverings to be Class"B"or better Owner dtofuda Dam' _ • CITY OF CUPERTINO 4 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 - Sec: Twp: Rng: Sub: B1k: Lot: APN . . . . . . . . : 32639020. 00 DATE ISSUED. . . . . . . : 03/03/2008 RECEIPT #. . . . . . . . . : BS000004062 REFERENCE ID # . . . : 08030003 SITE ADDRESS . . . . . : 21962 WOODBURY DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ARNOLD CROSS ADDRESS . . . . . . . . . . : 21962 WOODBURY DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : FRANK L CARDIA CONTRACTOR . . . . . . . : CARDIA, FRANK L LIC # 612 COMPANY . . . . . . . . . . : CUPERTINO PLUMBING ADDRESS . . . . . . . . . . : 1300 DELL AVE STE C CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408)253-0618 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC . NEW BAL ---------- ------------- ---------- ---------- - --- ---------- ---------- 1BPWSVCS WATER SERVICE 1. 00 20.40 0. 00 20 .40 0. 00 1BSEISMICR VALUATION 1, 000. 00 0. 50 0. 00 0. 50 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 102 .48 0. 00 102 .48 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 301 ROUGH PLUMBING 507 FINAL PLUMBING CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPEkTINO PERMIT APPLICATION FORM APN# (OZO o DO Date: 3--5 -cs8 Building Address: ::,— 19 (P ;), VIC)o0 bCs Owner's Name: Phone#: 2S 7 C)(, U ArAot,(-- Cf C-, 55 Contractor: Phone#: Fax #: Contact: Phone Fax #: Contractor License#: a y 10 5 bo I Cupertino Business License#: Job Description: Irl - Nf 0r) Residential © Commercial ❑ Valuation: // o U U Green Building Check list must be completed and attached to this application. Green Building Points: Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary sewer IBPREPIPE Commercial re-pipe per fixture P 1CPRP 1PGASCOM Commercial Gas Piping System P 1-4 Outlets 1BSEISMICOM Seismic Commercial P IBSEISMICR Seismic Residential P 1PRSEWER Residential building P 1RPSS sewer/sanitary sewer CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPER,TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group IPRREPIPE Residential re-pipe per fixture P 1RPRP 1BPWSVCS Water Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1BPWATER Install/alter Water Pipe P 1BPFDCTURE Plumbing Fixture P 1PGASRES Residential Gas Piping System P 1-4 Outlets 1BPGAS Gas Piping System 5+ Outlets P 1PPERMITFEE Plumbing Permit Fee Issuance P / 1PLMBLNCK Plumbing Plan Check P IPLMBINSP Other Plumbing/gas Insp. P / 1TRAVDOC Travel & Documentation Fee B 1BUSLIC Business License B e � Sinjle Family GreenPoint Checklist rias=: Build It Greed The Grear lnt Checklist is based on the various green features Incorporated into the home and is the Sman Solutions From The Ground Up basis for the GreenPoint Rated program.A home can be Considered green It It fulfills the premquishes, same at leas)50 points,antl masts the minimum paints per category:Energy(30),Indoor Alt Quality/ I Health(5),Resources(6),and Water(B).Please comaol Build It Green for a list of qualified GreenPoint Ratars If you are interested In pursuing thlyd-party,verification. —) L- The green building practices listed below are described in the New Home Construction Green Building Guidelines,available at www.builditgrean.oro. — -- ENTER PROJECT NAME MMURG: A 61TE I, Points Avellable Per Measure- 1.Itnaci and Minimize Disruption of Existing Plants 6 Trees 11 ❑ a.Protect Topsoil from Boston and Reuse aide Construction ❑ b.Limit and Celli Construction FODgrint for Maximum Protection 0 ❑ 2.De=nstruct Instead of Demolishing Existing Buildings On Site 0 3 2.Recycle Job Site Construction Warm(including Green Waste) ❑ a.Minimum 50%Wade Diversion by Weight(Recycling or Rouse)-Required 0_ _ __ _ - R ❑ b.Minimum 65%Diversion by Weight(Recycling or Rause) _7 E] c.Minimum BO%DMersion by Weight(Recycling or Reuse) p 2� 4.Use Recycled Content Aggregate(Minimum 257.) ❑ a Walkway and Ddvoway 0 - ] ❑ b.Roadway Base 0 Total Points Available in Site 12 0 B.FOUNDATION Points Available Per Measure 1.Replace Portland Cement in Console with Recycled Reach or Slag ❑ a.Minimum 20%Flyash or Slag 0 _ 1 _ ❑ b.Minimum 25%FI ash or Slag 0 T1 ❑ 2 Use Frost-Promctetl Shallow Foundation in Cold Arae(C.E.C.Climate Zone 16) 0 3 ❑ 3.Use Radon Resistant Construction On At-Risk Locations Only) 0 1 1 1 4.Deign and Build Structural Pet Controls ❑ a.Install Termite Shields 8 Separate All Exterior Wood-to-Concrete Connections by Math or Plastic Fastonarr✓DNiders 0 to.All New Plants Have Trunk,Bese,or Stem Located At Least 36 Inches from Foundation 0 1 Total Points Available in Foundation=8 0 C.LANDSCAPING Points Available Per Measure 1.Construct ReeouraFEfil l Landscapes ❑ a No Irweslve Species Listed by Cal-IPC Are Planted' 0 _— ❑ b.No Plant Species Wit Require Hedging 0 -❑ c.75%of Plants Ara Drought-tolerant _California Nerves,Mediterranean,or Other Appropriate Species 0 ❑ 2 Use Fire-Safe Landscaping Techniques 0 1 3.Minimize Turf Areas in Landscape Installed by Builds ❑ a All Tud WIII Have a Water Requirement Less than or Equal to Tall Fescue(50.8 plain factor] - p ❑ b.Turf Shall Not Be Installed on Slopes Exceeding 10%or in Areas Less than 8 Fest Wide 0 _ _ _ ___ .2 _- ❑ c.Tud Is 533%of Landscaped Area(total 2 points) p _ 2 ❑ tl.Turf Is 510%of Landscaped Area(total 4 points) 0 7 ❑ 4.Plant Shade Tree D I 1 3 Ej S.Group Plants by Water Netla Hydroeoning) 0 2 S.instell High-Efficiency Irrigation Systems ,) ❑ a.System Uses Only Low-Flow Dnp,Bubblers,or Low-flow Sprinklers _ ❑ b.System Hes Boom Controllers 0 1 1 3 ❑ 7.Ineorporete Two Inches of Compost in the Top 6 to 12 Inches of Soll 0 3 ❑ B.Mulch All Planting Bede to the Greeter of 2Inches or Loral Weser Ordinance Requirement 0 _ 2 9.Use 50%Salvaged or Recycled-Content Materials for 50%of Non-Plant Landscape Memanm 0 1 ! ❑ 10.Reduce Light pollution by Shielding f9ro es anNor Directing Light Downward 0 r, 1 Total Points Avallabe in Landscaping=31 0 D. STRUCTURAL FRAME 8EBUDAING ENVELOPE Pot ta'A ifl ebeRer Measure 1.Apply Optimal Value Engineering ❑ a Place Ratters and Studs at 24-Inch On Center Framing _0 ❑ b.Size Dos and Window Headers for Load ❑ c.Use Only Jack and Cripple Studs Required for Load D 1 2.Use Engineered Lumber �1 ❑ a.Beams and Headers 0 ❑ b.Insulated Engineered Headers /Jn p ❑ c.Wood Writs or Wab Trusses for Floors ❑ d.Wood I-Joists for Roof Palters /�.� ❑ e.Engineered or Finger-Joand Studs for Vertical Applications 11 //L/i,a �ery n —+ 1 ❑ L Oriented Strand Board fa SubflDs �-f��/1(t 0 T--I 1 1 L.___ ❑ g.Oriented Strand Board for Wall and Root Sheathing D r I i 3.Use FSO-Certified Wood • ❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% D ' _—': 2 ❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% 0 ❑ c.Panel products:Minimum 40% ❑ d.Panel Products:Minimum 70% 0 T 1 02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4 v 3 ENTER PROJECT NAME 4,Use Solid We11 Sysama(Includes Glee,ICFs,6 Any Non-Stick Frame Assembly) ❑ a Floors 0 2 2 ❑ b.Wells D --_ -2 - - — 2 El C.Roofs 0 2 2 5.Reduce Pollution Email the Home hom the Ganga ❑ a.Tightly Sea]the Air Bardar between Gams and LNing Area _D C] b.Inetall Gare a Exhaust Fen OR Build a Detached George D 1 Lj 6.Design Energy Heels on Trusses(75%of Aide Insulation Height at Outside Edge of Exterlor Well 0 - 1 ❑ 7.Design Roof Truax to Accommodate Ductwork 0 - 1 9.Use Rexrycled-Conam Sti al Studs for 00%of Interior Well Framing 0 1 B.Themsel Mesa Wells:9&Ineh Drywall on All Interior Walls or Wells Weighing mora than 401byco.A - 0 1 50:Install Overhangs end Gutare . ❑ e.Minimum 1Noon Overhangs and Gutters 0 ❑ It.Minimum 24-Inch Overhangs and Gutters D 1 Total Points Available in Structural Building Frame and Envelope=36 D E.]EXTERIOR FINISH Points Available Per Measure LJ 1.Use Recyelod-CDm M(No Virgin Plastic)or FSC-Certified Wood Decking 0 2 —2.Ineall a Rain Screen Well System D 2 3.Uss Dumble and Noncombustible Siding Materials 0 1 El 4.Select Durable and Nonccmbuetibie Roofing Materials 0 2 Totse Pointe Available In Exterior Finish=7 0 F.INSULATION Points Available Per Measure 1.Install Insulation whin 75%Recycled Content ❑ aWalls til Floors D ❑ b.Callings 0 1 2 Insall Insulation that is Low•Emlrting(Certified Section 01350) ❑ .a Walls anchor Floors - _0 1 _ ❑ b.Callings 0 1 ET-3 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) ❑ e.Insulate Hot Water Pipes horn Water Heater to Rnon 0 ❑ b.Insulate All HM Water Pipes ❑ c.Use Engineered Parallel Piping _ 0 ❑ d.Use Engineered Parallel Piping Wth Demand Controlled Circulator Loop ❑ e.Use Entered Plumbing with Damentl Contmllatl Circulation Loop 2 ❑ 1.Use Central Core Plumbing 0 ] 1 2 ❑ 2.Insall Only High Efficiency Touea(Dua4Bush or S1.213 pf) 0 4 Total Points Available In Plumbing=TOW 12 0 H.HEATING VENTILATION R AIR CONDITIONING Points Available Per Measure 1.Design and Install HVAC System to ACCA Manuel J,D,and 9 RecammandatlOns D 4 P.Install Sealed Combustion Unite ❑ a.Furnaces _ 0 �_ 2 ❑ b.Water Heaters 0 2 1 - Install Zoned,Hydropic Radiant Heeling with Slab Edge Insulation 0 1 1 4.Instell High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1 S.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 Seams 0 __ 1 ❑ c.Install Ductwork under AOic Ishulahm(Budod Ducts) U 1 El _d.Pressure Balance the Ductwork System _ D _ t 1 7 ❑ e.Protect Duds during Construction and Clean All Ducts dome Occupancy 0 1 LJ IL Install High Efficiency HVAC Filar MERV Bt - 0 1 ❑ 7,Donn Install Fireplace or Install Sealed Gas Fireplaces with Efficiency Rating Not Lees Than 60% 0 - 1 using CSA Standards e.Install Elf@ctive Exhaust Systems In Bathrooms and Kitchens ❑ it,Install ENERGY STAR Bathroom Fans Vented to the Outside ❑ h.All Bathroom Fans Are on Timer or Humidistal ❑ 0.Install Kllchen Range Hood Vented to the Outside 0 1 T 0.unroll Mechanical Ventilation System for Cooling(Maximum 4 Points) ❑ 9.Install ENERGY STAR Calling Fane a Light Kos In Living Areas a Bedrooms _0 ❑ b.Install Whale House Fen with Variable Speeds _ 0 ❑ C.Automatically Controlled Integrated System _ 0 ❑ c.Automatically Controlled Integrated System with Variable Speed Control 0 3 10.Insall Moehanical Fresh Air Ventilation System(Maximum 3 Points) ❑ e.Any Whole House Ventilation System That Meats ASHRAE 622 _ 2 ❑ b.Insall Alo-toAh Heat Exchanger that meats ASHRAE 62.2 0 r ] 2 LJ 11.Insall Carbon Monoxide Almm(e) 0 1 Total Points Available In Haft Ventilation antl Air Coneieonln =30 0 02007 But Id It Green Single Family GreenPMnt Checklist 2007 Vicaion Page 2 of 4 ENTER PROJECT ym s I.RENEWABLE ENERGY Points Available Par Measure • M 1,Pre-Plumb for Soler Hot Wemr Hadfing 0 4 Lj 2.traded Soler Waste Heading slum 0 10 77 S Insist Wiring Conduit for Future Phdovoloric Installation 6 Provide 2D0le of SoultrFachug Roof 0 2 I.Install Photovollalc(PV)Panels ❑ a3D%of electric heads OR 12 kW(tobl 6 pone) D 6 ❑ 660%d electric needs OR 24kW lead 12 points) D .-67 ❑ c.90%d elected treed OR 3.6 kW(lots 1e points) D 6 Tod Available Pointe In Renewable Energy=2B 0 J.BUILDING FRIUrORMANCE Points AvalleMe Per Measure 1.Diagnoa0e Evaluation ❑ a House Passes Blower Door Test 0 h.House Passes Combustion Safety Backdreft Test 0 3 2Dnign end Bulltl High Pedormence Homes-X above This 24-minimum 15%Required 0 ' >_30 ❑ 3.House Obtains ENERGY STAR felon Indoor Air Package Cor0ficatlon-Pilot Measure Rots 45 points;read comment 0 5 2 Total Available Points In Building Performance=39 0 E.FINISHES Points Available Pel Measure 1.Design Entryways to Reduce Tacked In Contaminants 0 3 2.Use Low-VDC or Zen-VOC Point(Maximum 3 Points) ❑ a Lov-VOC Interim W81110e10ng Paints(60 got VOCs(Flat and<150 girl VOCs(Non-Flea) 0 _ _ 1 ❑ h.Zato-VDC:Instate Wallri Paints(d girl VOCs(Flat)) 0 _ 3 ❑ 3.Use Low VOC,WMer4Besed WGcd Finishn(¢SD gpi VOCsI 0 2 I ❑ 4.Use Low-VDC Caulk and Construction Adhesives(A0 gpI VOCs)for All Adhesives 0 - 2 ❑ 5.Use Rerysed-Content Point 0 1 6.Use Envimnmentaty Preamble Mavials for Interior Finish;A)FSPCertifiad Wood,B)Reclaimed,C)Rapidly Renewable,D)Reryded-Coment or E)Finger-Jointed! ❑ a.Cabinets(50%Minimum( 0 ❑ b.Inlado Ttim(50%Minimum) 0 ❑ c.Shelling(50%Minimum) _ 0 ❑ d.Doom(50%Minimum( ❑ a.Counter a 50%Minimum) 0 ] 7.Reduce Formaldehyde in Interior Finish(CA Section 0135D) • ❑ a.Subfiox a Stair Than(50%Minimum) 0 ❑ h.Cabinets 6 Coun mrops(50%Minimum) 0 ❑ c,Interim Trim(50%Minimum) 0 7 ❑ 6.Shelving(50%Minimum) 0 1 ❑ 6,After Installation of Finishes,Tea of indoor Air Shows Formaldehyde Level Q7ppb 0 3 Total Available Poims In Finishes=21 0 L.FLOORING Points Avallable Per Measure 1.Use Environmentally Preferable Flooring:N FSC-Certified Wood,B)Reclaimed or ReFlnished,C)Rapidly Renewable,D)Recycled-Content,E) Expond Comets FlooringAdheshn Must He"60 gpl VOCs ❑ a.Minimum 15%of Floor Area ❑ b.Minimum 30%d Floor Area 0 El c.Minimum 50X of Flux Nes 0 ❑ d.Minimum 75%d Floor Area ❑ 2 Thermal Man Floors:Floor Covering Other than Carpet on 5D%or Mora of Concrete Floor@ 0 1 ! ❑ 3.Flooring Moots Section 01350 or CRI Green labs Plus Requirements(5D%Minimum) 0 1 2 Trial Available Points In Flooring=7 0 M.APPLIANCES AND LIGHTING Point;Available Per Measure 1.Instal Were and Energy ERclea Dishwasher ❑ a.ENERGY STAR(las 1 pdna 0 ] ) ❑ b.Dishwasher Uses No More than 6.5 Gall le(totaf 2 rots) 0 1 Z Install ENERGY STAR Clothes Washing Machine with Wets Factor of 6 or Len ❑ a.Most Energy Star and CEE Tia 2 requirements(modified energy factor 2.0,Water Factor 6.0)hold 3 points) 0 1 _ _2 ❑ b.Meets Energy Star and CEE Tier 3 requirements(modfiad energy factor 22,Water Factor 4.5 or Ian) 2 totalsPoints) 0 3.Install ENERGY STAR Refrigerator ❑ a ENERGY STAR OuallAed 6<25 Cubic Fes Capacity ❑ h.ENERGY STAR Qualified a<20 Cubic Feet Capacity0 1 4.Install Built-In Recycling Center 0 ❑ a Built-in Recycling Canter - 0 2 ❑ h.Built-In Composting Center 0 1 Taal Available Points In Appliances and Li htin =12 0 N.OTHER Points Available Per Measure ❑ 1.Incorporate GraenPolnt Rated Cheeklia in Blueprints Required 0 ( R • ❑ 2.Develop Homeowner Manuel of Green FeaturesrBehadia 0 I 1 1 1 3.Community Design Manures 6 Loral Priorities:Seethe Community Planning B Design section in Chapter 4 of the New Home Guidelines for measures.Maximum of 20 points for suggested measures.Local requirements may also be listed hem. 0 2007 Build It Green - Single Family GreenPoint Checkfst 2007 Version Page 3 of 4 ENTER PROJECT NAME 1 Enterd.-10-be-,eed mar pons wa0sae fa measure U appropriate categories to the right 0 0 0 0 D 0 Enter daCdpliw hen,aM emm pd=9ueleme for mesas a 9lxagxiall wapsin Id h1 69M. 0 0 0 0 0 D Enter description hme,and ems points within is manure In appropriate wlepsln a he dphL 0 0 0 0 0 Emu description hen,era m pas ave9eba Io meson in eppropaU cale901es U he 69M 0 0 0 0 0 D 4.Innovation:List Innovative measures that meet the Breen bullding objectives of the Guidelines.Enter up to a Build it Green Checklists end maximum combined total of 20 pts.See Innovation Checklist for suggested measures,usingthe link to the right fl _ linwalion In Commum .Enter description hen,and ends points avande far meadows M c to IM d 0 D D D 0 0 ImiweOon M En@W.Enter O lion hem,and sols Points available Is manure M e es a he d D D 0 D D D Imwallon M IAOMntm:Enter attenuation hon,and enter ws m 'ellien to measure cat s to the D 0 0 D 0 0 ImwT2o In B__rees'.Eatondaarghon hen,an enter wa0eble for immature in ale cats to the right. 0 0 0 0 0 D Irmovafoo a l r_:Enter dncApnon here,and mm points wellatde is manure In gp m compares to to rtift _ _0 0 0 0 0 0 TOUT Available Poi=In other 43 0 Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+ Minimum Points Required in Specific Categories 0 3D 5 6 B 1 1 1 1 1 e Project hits not yet mot the following recommended minimum requirements: G(� -Total Project Score o(At Least 50 Points -Repulred measures: -A3a:50% haste diversion by weight -J2: 15%above Title 24 -N1:Incorporate GreenPolnt Rated Checklist Into blueprints -14inimum points In speciric categories: -Energy(30 points) -LAQ/Health(5 points) -Resources(6 points) -(Nater(9 points) • 02007 Build It Green Single Family GreenPolnt Checklla12D07 Version Papa 4 ol4 Community Development " 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 0 nCITY OF C�'�O Fax(408) 777-3333 rC Building Department JOB ADDRESS: PERMIT # 9L 1d(-0C(-JJ 0• 06C, 3 O D OWNER'S NAME: -na« C. s PHONE # P:57— DCGG O GENERAL CONTRACTOR: FAX # 1 am not using any subcontractors: Signature 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 Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock ie Tile Owner/Contractor Signature Date