08030169 (2) CITY OF CUPERTINO a ?t .ea°�^A✓aw 'dsf-e6'`"'?""�++''�--YI 'a' .�
BUILDINIS DIVISION PERNIITCONTRk0T,0VINFORMA'
s t F.a�+17
BUIL Igr�pTTR ANNISPORT DR AFFORDABLE WATER HEATERS & PV25U�G0169
R'S NAME: PERMIT ISSUE DATE
SUMEI LEE 24707 SAN FERNANDO RD 03/28/2008
PHONE SANITARY NO. CONTROL NO.
(661) 259-7131
ARCHITECOENGINEER: - BUILDING PERMIT INFO
'BLDO ELECT PLUMB MECH
0 0 0 0
3rp ZpF LICENSED CONTRACTOR'S DECLARATION Job Description
�6F Ibemt)(11by 3 e that Divisilunlicensed MeBud atedPeiovofCMplcr9(romi,,.I. WATER HEATER REPLACEMENT p
z with Sodium Division 3.f Me Bualnw.M Profualov Cotle.ub mylicca¢is
n< in full faux end eHm
License❑w Counselor
ur
TSDECL
ARCHITECTS DECLARATION
1� 1 urbenennJ my plain shall be wed u public records
6
k G Licensed Professional -
H OWNER-ceempt Fr mDECLARATION
a5 1 hereby aRrm o n I am uempt from the Gonion,Cc :Any c Lew for Me
i p O followingI=occur.(Sedan coram Business and Pe.de Profession,Cale:Any city or county
$ which rtquiw Issuance,permit re cores Me alter,impose,do ermit t fire a sig any awcture
i^n tvior hat hoitsensedpalwntin Meth applicant for such Commmitmrtinw Law statement
that hcenllTnaJ punuantatim previsions of the Cantratara[.lecna Law(Chaplcr9 Sq.Ft.Floor Area $1175 Valuation
51 (commencing with Section 7000)of Division]of the Busineaeand Professions Cods)or
that he is exempt therefrom and de basis for the alleged emmptim Any violation of
Section 7031.5 by M'applicant fora permit subjects the applicant to a civil penalty ofNumber Occu ane e
int more Jun five Imodred doling(5500). 3 5 6110 2 2 RbI P y�'P
lo
evoot.Je papeny,amywplayw withwagoauthevee. Business
and danmwnt and the int curto is CommeatinLiamnded La ch ad fertile WL apply 7o a,Boalrof Required Inspections
and Pnoproperty
wh builds
r:The Camrcunt, fid who Law does res apply lf an owner of q P
property who builds i improve discount,and improvements ts areacuhwrkhimalf ser f o gists his
awn emr,M euiproWdetl Nat such t are not Intended ooRrred Me cancer.however.Neave Mae or uimprovemvnt4anldodid one year of camPlNon.theownof
Wilder vele Nve Je Wrdan of proving than he did on,build or Improve for purpose of
I.
I, a area of project
(Sec.prope
,Businessa. si nd! eatinC d:) oeC mesa uses .
resat Jin es em (Sec.IMC, .. fmp rtywoProfessions Cade:) pro Con ... fid
cove onw does not apply m an owner of progeny who Wada or improve Nemaa and.
who contracts far such pmjeN with.contracmrte)IiTvca pursuant to the Convacress
License Law.
❑lam oaempt untiieeywBee B At P C for Chia n
u />•1 Dam
s a
'WORK 'S COMPENSATION DECLARATION
I hereby aMme under Family of perjury ono of Jae following declaratiorms
I haw and will malma n a CertiOnamof Consenuo alf-Wum far ,Wmke"Camper
setlon.u pmvided far by Section 1700 of the Labor Cade,for the KdonmanT of Ne
work far which Nis permit I.issue:
❑T have and will malnWn Workese Compensation InaranT,as required by Section
3700.f the labor Code.for the performance of Jin wok for which this permit is lssrea.
My Weakest Compenaarloo lnso.carrier and Policy number art:
Canler, Policy No.: - --
CERTIFICATE OF EXEMPTION FROM WORKERS' ..
COMPENSATION INSURANCE
(Tds acdon need not Is,completed)(the permit is for one hundred dollar(5110)
nrina)
1 Tnifv that in the performance of Me.,it for which this permit Is issued,I thall not
employ any person in anysoambeeameaen'Com
bjctat eve penation
Laws of califomia.Use,
Applicant mann� s Q
NOTICE TO APPLICANT.qr.after maks this Certificate of Exemption,you should
become Subject m Ne Worteei Compensation provisions of the:xbre Cada,you man
.^J z forthwith comply with such provisions or this permit shall W doomed molted.
z Q CONSTRUCTION LENDING AGENCY
[+� I homey afRm ort then iso covwNon lending agency fon Ne perfmm.nT of
fY. thr wrk for which this permit Is issued(Sec,1041,Civ.CJ
aA Lenin"Name
.`7 Z Lenders Address
U Q 1 certify that I haw road this application and sum Nat the above information is
W emmct.l agree to comply with all city and county ordinances and sena lave relating to
building convection,and hereby authodre mpruenuJw of this city to cnar upon J¢
LIJ above-mentioned property for Inspection purposes.
gy (We)agree to ave,indemnify and keep harmless de City of Cupertino against
(q Iiabilitin,judgments,cots and eapeow,which may 1.amy way amus agalna,said City
V 7 In cement S of Me .art of this permit ,r"7
a7 APPLICANT UNDERSTAND555555S_4���ND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATONS&,��Ls 3b00 c
Q G Re-roofs
Signature of App:iunuContralor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof ��-
WN the applicant or future Wilding occu tam nom orGMle hesardow m.¢rial ,
deEnrA by the Cupertino Municipal Code,Chapter 9,11 and the Hcalth and Safety
Section 25532(a)? KN.
All roofs shall be inspected prior to any roofing material being installed.
❑Yu DI
Will the applicant or future building occupant use equipment or dcvlm which If a roof is installed without first obtaining an inspection,I agree to remove
emit havardoue air contaminants as deflned by the Bay Area Air Quality Management all new materials for inspection.
District?
01b
I hoe mW the chromiu/m/marerAlt requirements under Chapter 6,95 of are Califor-
nia Head"Seely Code,Sccdrts 25505,2551]and 25574.1 turnaround Mn ift a holding
does int curmnJy •taint.ort it Is my responsibility to notify the occupant of the
requiremen ohm WMetpda mgaeoaf.cenireateafOccupancy, Signature of Applicant Date
?/��/ d�
Owren or authorisd ager All roof coverings to be Class'%W'or better
Dam'
• CITY OF CUPERTINO
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35611022 . 00
DATE ISSUED. . . . . . . : 03/28/2008
RECEIPT # . . . . . . . . . : BS000004295
REFERENCE ID # . . . : 08030169
SITE ADDRESS . . . . . : 8175 HYANNISPORT DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SUMEI LEE
ADDRESS . . . . . . . . . . : 8175 HYANNISPORT DR
CITY/STATE/ZIP . . CUPERTINO, CA 95014-4063
RECEIVED FROM . . . . : JAR-LON LEE
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 1, 175 . 00 0 .50 0. 00 0. 50 0. 00
1PPERMITFE 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
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 106.56 #5493
---------------
TOTAL RECEIPT 106.56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
518 WATER HEATER
•
oP o/(-o 9
CITY OF CUPERTINO
"CIL WATER HEATER
CUPEkTINO PERMIT APPLICATION FORM
APN # 3 �`v a a+ D Q Date:
Building Address:
15
Owner's Name: Phone #:
Su-Me' L 40�,-
Contractor: 1 u Phone #: �_�� 11_4 A f} v,dQ & Iv dP✓ TIPti��yS
Fax #:
Cupertino Business License #: Contractor State License #:
CA 36 9-
Contact: Phone #:
Fax #:
Building Permit Info: ceQwonJ�-
Bid ❑ Elect ❑ Plumb ❑ Mech ❑
Residential Commercial ❑
Job Description:
Strapped [n'� On Platform Bonded 0! New Location ❑ Replacement
Valuation: -7 S — GU
Green Building Check must be completed and attached to this application.
Green Building Points achieved: .
CITY OF CUPERTINO
' WATER HEATER
CUPEI,TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
1BSEISMICOM Seismic Commercial B
1PRWHEATR Residential Water B PRWHEATR
HeaterNent
( 1BSEISMICRE Seismic Residential B
1PPERMITTEE Plumbing Permit P
I 1 TRAVDOC Travel & B
Documentation
1BUSLIC Business License B
Single Family GreenPoint Checklist. date: Build ltGreed
The GreenPoint Checklist Is based on the various green features Incorporated into the home and is the Smart Solutions From The Ground Up
basis for the GreaOPolnt Rated program.A home can be considered green if it fulfills the prerequisites,
• Hams of lease 50 pointe,and d Wet the minimum points per category Energy list
of Indoor Air reemPOualli FI
Henith(5),Resources(6),end Water(S).Please tooted Build It Green for a Ilsl of qualified GreenPoint
Raters H you are interested In pursuing third-parry verification.
The green building practices listed below are described in the New Home Construction Green Building
Guidelines,available at wvnv.huiltlimraen om
n_ P R_
ENTER PROJECT
U �
A 6ITE - Points Avallahle Per(Measure
1.Proom opwil end Minimize Disru on of Existing Plants Trees
❑ a Pmted Tapsell from Erosion and Reuse altar Construction 0 1 1
❑ to Limit and Di fneate Construction Footprint for Msximum Protection p
2 Decensbud instead of Demolishing Existing Buildings On Site 0 3
3.Recycle Job Site Construction Waste(Including Green Waste)
❑ aHimnsum 50%Waste Diversion by Waigm(RaryTJing or Reuse;-Required D R
❑ b.Minimum 65%Diversion by Weighl(RscydNg a Reuse) p 2
❑ c.Minimum 80%DNemion by Weight(Recycling or Reuse) 0 —-- _2 —
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0
❑ b.Roadway Base ._-o_ ,_—_ 1
1
Total Points Available in Site 12 0
B.FOUNDA11ON Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Fly%h or Slog
❑ e.Minimum 20%Ryash or Slag 0 _ 1___
❑ b.Minimum 25%Flyesh or Slag 0 i 1
2 Use Fros4Protacted Shallow Foundation in Cold Areas(C.EC.Climate Zone 16) D I 3
9.Use Ration Resistant Commotion on At-Risk Lenders Only) - 0 1
4.Design and Build Structural Pest Controls
❑ a Install Tanntle Shields 6 Separate All Exterior Wood-lo-Concrete Connections by Metal or Rated Fasteners/Dividers 0
17 b.All Now Plants Have Trunk,Base,or Stem Located At Least 36 Inches him Foundation 0 1 4
Total Points Avallada In Foundation=8 0
C.LANDSCAPING Poinankieflal Measure
• 1.Construct Resource-E@ielent Landscapes - —
❑ a.No InvasIve Species Listed by Call Are Flamed 0 1
❑ b.No Plan Spacias Will Require Hedging 0 ]
❑ c.75%of Plante Are Drought-miaranl California Nadves,Medimmuneen,or Other Appropriate Spades 0 n 1 3
2 Usenwsaie Landscepin Techniques 0 i(
3.Minimize Turf Areas in Landscape Installed by Buildar _
❑ a.All Tug Wlll Have a Water Requirement Lass than or Equal to Tell Fescue(S0.8 planttecto(t 0
❑ b.Tug Shall Not Be Installed on Slopes Exceeding 10%or in Areas Less than 8 Feet Wide
❑ c.Tug Is 93%of Landscaped Area(total 2 points) moi,0 T
❑
J.Tug Is 510%of Landscaped Area(toddl 4 points) "o -�- —�--�--�2
El 1.Plant Shade Trees 3
6.Group Pienb by Water
Needs(H dmzoning) 2
S.Install High-Efficiency Irrigation Systems
❑ a.System Uses Only Low-Flow Ddp,Bubblers,or Low-flaw Sprinklers o _
❑ b.System Has Smart Controllers 'y' 0 -T 3
7.Incorporate Two Inches of Compost in the Top 6 to 12 Inches of Soil 0 ( 3
❑ B.Mulch All Planting
is to the Greater bill Inches or Lowl Water Ordinance Req remanl '�� 0 ( 2
H.Use 50%Salva ad or Recycled-Content Materials for 50%of Non-Plant Landscape menta0 - 1
10.Retluce Ll ht Pollution by Shielding Fixtures and/or Directing Light Downward ,`:y 0 1
�Totel PdWs able In Landscaping=31 0
D.STRUCTURAL FRAME&BUD,DDNO ENVRLOPE v Poems Available Per Measure
1.Apply Optimal Value Engineering
❑ a Placa Rafters and Studs at 24-Inch On Center Framing
E] p.Size Door and Wit Headers for Load
E] c.Use Only Jack and Cripple Studs Required for Load 0
L Use Engineered Lumber
❑ a Beams and Headers
❑ b.Insulated Engineered Handers di_
c.Wootl hJolsts or Web Trusses for Floors Eld.Wootl l-Josts for Rosi Rafters _____❑ e.Engineered or Finger-Jointed Studs for VeNwl Applications f.Orientetl Strand Board Ica Bubfloorg.Oriented Strand Board for Wall antl Roof Sheathing 1 1
3.Use FSC-Cortllmd Wood
• ❑ a Dimensional Lumber,Studs and Timber:Minimum 40%
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% 0 7
❑ c.Panel Pmdudr Minimum 40% - -"
❑ d Panel Products:Minimum 70% U
D I l i
02007 Build It Green Single Family GreenPoint Checklist 2DD7 Version Page 1 of 4
ENTER PROJECT NAME
/.Uu Solitl Well System(includes Slics,ICFs,6 Arry NomStick Frame Assembly) mall
❑ A Flan _ a- 2—
El
__❑ b.Weill 0 _ 2 z
❑ c.Rooth 0 2 2
S.Reduce Pollution Entering the Home from the Garcia
❑ L Tightly Seal the Air Banter between Garage and Living Aru _ 0
❑ b.Install Gere s Exhaust Fan OR BWd a Detached Gems 0 1
Lj S.Design Energy Huls on Trustees 175%of Attic Insulation Height at Outside Edge of Exactor Wall 0 1
7.
Design Pool Trusses to Accommodate Ductwork 0 1
0.Use Re clad•Content Stell Studs for Bo%of Interior Well Fnming 0 1
LJ B.Themul Mau Waits:ars-Inch Drywall on All Interior Wells or Wells Weighing more than 40lb/cOl. 0 1
10,Install Overhangs and Gumrs
❑ a.Minimum 16lnch Overhangs and Gubes 0
❑
Is Minimum 241nch Overhangs and Gutters 0 7
Total Points Avollable In Structural Building Frame and Emelope=3a 0
E.EXTERIOR FINISH Points Available Per Measure
T3-1.Use R cted-0onWd o Virgin Plage or FSCH]arfifietl Wood Docking 0 2
2lnstall a Rain Screen Wall System 0 2
3.Use Durable and Noneombutlble Siding Materials 0 1
a,Select Durable and Noncombustible Roofing Materiels 0 2
Total Polnte Available In Ekholor Finish=7 0
F.INSULATION Points Anflable Per Measure
1.Instep Insulation with 75%Recycled Content
❑ e.Walls and'or Floor 0 h ]
th.Callings
2.Install insulation that is Low-Emlmng(Decided Section D1350)
❑ .a.Waite anclol Floor 0 1 1
❑ b.Ceffings
].Inspect Quality o/Insulation Installation before Applying Drywall D 1
Total Points Available in Insulation 5 0
O.PLtTM13ING Palms Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points).
❑ a.Insulate Hot Water Pipes tram Water Heater to Kitchen 0 _ _ ' 1 1_ ]
❑ b.Insulate Al Hot Water Pipes 0
❑ c.Use Engineered Parallel Piping
❑ d.Use Engineered Parallel Piping win Demand Controlled Circulation Loop
❑ e.Use Structured Plumbing with Demand Connoted Circulation Loop -0
❑ I.Use Cenral Core Plumbing 0 - -- — _- 1 2
—2.Install Only High Efficiency Tolleu Gual-Flush or 51.28 t) 0 4
Total Points Avalabte In Plumping Total 12 0
H.HEATING VENTILATION R AIR CONDITIONING - Points Available Per Measure
1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendations 0 1 4
2 Install Settled Combustion Units
❑ L Fumaces 0 _ _ _ _ _ 2 1
❑
in.Water Henan 0 2
9.Install Zoned,Hydronic Patient Heating with Slab Edge Insulation 0 1 1
Lj (.Install High Efficiency Air Conditioning with Environmentally Responsible Retrigarenta 0 1 I
S.Design and Install Effective Ductwork
❑ e.Install HVAC Unit and Ductwork within ConGtianed Space _ 0_ _ h 3 _
❑ b.Use Dun Masgc on All Duct Joins and Seems
❑ c.Install DUctWDrk untie Alto Insulation(Buded Ducts) D
❑
J.Pressure Balance the Ductwork System
❑ e.Protect Ducts during Construction and Gun All Ducts before Occupancy p ]
Lj S.Install Man Efficiency HVAC FlIW(MERV&) 0 1
❑ 7.Don't Install Fireplace or Intel Soled Gas Fireplaces with Efficiency Rating Not Leu Than 60% 0
using CSA Standards h
B.Install Effective Exhaust Systems In Bathrooms and Kitchens
❑ a.Install ENERGY STAR Bathroom Fans Vented to the Outside 0
❑ b.All Bathroen Fans Am on Timer or Humitlistel
❑ c.Install Kitchen Range Hood Vented to the Outelde 0 1
9.Install Mechanical Ventilation System for Cooling(Maximum 1 Points)
❑ a.Install ENERGY STAR Ceiling Fane 6 Ught Kin In Uving Areas 6 Bedrooms
❑
In.Install Whole House Fan wish Verlable Speeds
❑ c.Automatkaly Controlled Integrated System _ 0 _ 2 _
❑ d.Automatically Controlled Integrated System wish Variable Speed Control p _ 3 y
1 D.Install Mechanical Fresh Air Ventilation System(Maximum a Pointe)
❑ a.Any Whole House Ventiatlon System That Moate ASHRAE 62.2 _ 0_ _i 2
❑ b.install Mr.*Alr Heat Exchanger that mots ASHRAE S22 0 7 2
11.Install Carbon Monoxide Alarm(o) 0 1
Total Palmer Available In Hoeing,Variation and Air Conditioning=3DI__2
0 2007 Build It Green Single Family GresnPolnt Chocidist 2007 Version Page 2 of 4
ENTER
•ROJECT
NAME
c< v 5
!•
LEENERGY I Points Available Pel Measure
. 1.Prt-Plumb for Solar Hot Water Heating 0 q
LJ 2.Install Solar Water Hearing stem 0 10
9.Install Vill Conduct tor Future Photovoltaic lnstelllion&Provide 200M of Sourdi-Fating Roof 0 2
4.Install Photovoltaic(PV)Panel
❑ a.3D%of electric needs OR 12 kW(total 6 pains) 0 F
❑ b.SD%at electric needs 08 2.4kW poll 12 paints)
❑ c.90%m electric bead OR 3.6 kW proal 16 points) — - — 6 —'—
Total Available Points in Renewable Energy=26 0
J.StM DING PERFORMANCE Paints Available Per Measure
1.Diagnostic EvaJULlol
❑ a.House Passes Blower Dow Test p 1
b.House Passes Combustion Safety Bacal Test p
2.Deaignand Build High Performance Homes-%above Title 24.minimum 15%Required 0 >_3O
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Pilm Measure(Telt 45 points,read comment) 0 5 2
Total Avaiehle Points in BuildingPerformance 39 0
asure
H. —1.DINISE5 Points Avdllable Per Me
1.Dmign EntryweyHo Reduce Treeketl In Conteminenl D
2 Use Low-VDC or Zero-VOC Paint(Maximum s Points)
❑ a-w VOC Interim Well Palm(<50 90 VOCs(Flap and a50 Nd VOCs(Nail 0
---C3b.ZernVOC:Interim WaIIIC911in Paints(6go VOCs(Flag) 0
❑ 3.Use Low VOC,Water-Based Wood Finishes((450 opt VOCs) 0 2
❑ 4,Us,Low-VOCCeulk and Construction Adhesives(O0 got VOCs)for All Adhealves p 2
❑
S.Use RMCIMI-Content Peine - -
0 1
6.Use Environmentally Preferable Materiels for Interior Finish:A)FSCCart fled Wood,B)Reclaimed,C)Rapidly Renewable,D)Rerydedtontanl
or E)Finger-Jointed
❑ a.Cabinets(50%Minimum)
El b.Interim Trim(50%Minimum) o
❑
C.Shaving(50%minimum) p-
❑ d.Debts(50%Minimum) -- -- —�
❑ e.Coume 50%Minimum 0 ! 1
7.Reduce Formaldehyde in Interior Finish(CA Section 01350)
• ❑ e.Subiloor&Stair Treads(5D%Minimum) 0
❑
It.Cabinets&Coumamps(50%Minimum) 0
❑ c.Intoner Tom(50%Minimum) 0 —T-- '---
❑ d.SheMn (5D%Minimum)
❑ 6.Alter Installation of Finishes.Test of Indoor Air Shows Formaldehyde Level 47ppb• D 3
Total Available Points in Finishes 21 0
L.FLOORING Points Angelis Per Measure
1.Use Environmental Preferable Flooring:A)FSC-Ceiti6od Wood,B)Reclaimed or Refinished, C)Rapidly Renewable,D)ReryGed-Coril E
Exposed Comms Flooring Adhesives Must Have 609(1 VOCs
❑ a.Minimum 15%of Flow Area - 0 I
❑ b.Minimum 30%of Floor Area p —'�—i___r_"T T_--
❑ c.Minimum 50%of Flow Area 0 _ I� I
❑ J.Minimum 75%of Flow Area' 0 —7 1
❑ 2 Thermco Maw Floora:Floor Covering Other than Carpet on 5D%or Moro of Concrete Real 0 1
❑ 3.Fluorin Meal Section 01350 all Green Label Plus Requiramenl 50%Minimum 0 2
Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Pet Measure
1.Instal Wets and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total 1 poll 0
❑ to.Dishwasher Uses No More than 6.5 GallonsC le total2points) p 1
2lnstall ENERGY STAR Clothes Washing Machine with Water Fedor of 6 or Lew
❑ s Meets Energy Star and DEE Tier 2 requirements(momfied energy factor 2.0,Water Fader 6.0)(tohl 3 points) 0
❑
to Masts Energy Star and DEE The 3 requirements(motllfied energy factor 22,Water Fester 4S or less) 0 2
(total 5 nis
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Oualiflad&e 25 Cubic Feet Capacity 0
Elb.ENERGY STAR Oualifiod 6<20 Cubic Feel Capacity 0 1
L meal Built-in Recycling Cerner 0
❑ a.Built-in Recycling Center 0 .p
❑ It.Buie-In Composting Center 0 1
Total Available Points in Appliances and Lighting=12 0
N.OTHER Points Available Per Measure
❑ 1.Incorpomta GreenPoinl Rated Checklist in Blueprints•Required 0 I .R
• ❑ 2 Develop Homeowner Manual of Green FsetureaBenefil D 1 1 1
3.Community Design Measures&Local Priorities:Sea the Community Planning&Design section in Chapter 4 of the Now Home Guidelines fm
measures.Maximum of 20 points for suggested measures.Local requirements may also be listed here.
02007 Build It Green Single Family GraenPoint Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAME
..
Me:
Einer tlnolpllm hue,and Omer Wane wdlede to messun In AOPapdau ceteponn to the right. 0 0 0 0 0 0
Enter daepiplmn hen,and emu points W81108 for mina de in Appropriate categories 10 the rind. 0 0 0 0 0 0
Enter deeulptlon hare,and enter pours Available for manure In Appropriate categodos to the did, _ 0 0 0 0 0
Enter dawrlpllon hen,and enter points avallablo for meeaure In a pto;*Ata casporse to the right. 0 0 0 0 _0 0
4.Innovation:List innovative measures that meet the green building objectives of the Guidellnes.Enter up to a Build it Green Checklists and
maximum combined total of 20 ple.See Innovation Checklist for suggested measures,using the link to Ned ht. _ Guld es
Li Innovation In Community:Enteranthiplion hen,and onto points evaOeMe to manure In aloorposlacatatiorift to in right. 0 0b 0 0 0
Ej Innovation in Energy:Enter description hen,and onto mine mailable formeasure In appropriate cats odn to the right, 0 0 0 0 0 0
Imaion In IAGMptth:Enter daw tion here,antl mars anllese for measure in ate Magnin to the right, 0 0 0 0 0 0
allon a Rmurees:Einar da ham,and enter s valiant low mono re in te cote d es to aro 0 0 0 0 0 0
Innwetloo s Water.61er. easel hero,and oma polos eveAaWe he meson m enpraPleb catepadw to the right _ 0 0 0_ _ 0 0 0_
Tots Available Points In Other 43 0
Summary
Total Available Points In Specific Categorles' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories 0 30 6 6 9
I util Points Achieved e e e e e e
Project has not yet met the following recommended minimum requirements:
- Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-32: 15%above Title 24
-NZ:Incorporate GreenPoint Rated Checklist Into blueprints
-Minimum points in specific categories:
-Energy(30 points)
-IAQ/Health (5 points)
-Resources(6 points)
-(Vater(9 points)
02007 Build It Green Single Family GrearrPolnt ChecdI42007 Version Page 4 of 4
Community Development
' '.,, 10300 Torre Avenue
J, Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
4LPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
.T- ae53aC 9
OWNER'S NAME: PHONE 6/
GENERAL CONTRACTOR: 44ffikAAt, FAX#
C. CAV-r- h—,,z�,r
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