08050045 (2) •
CITY OF CUPERT[NO • y'� " ` �" x3 '4 �
BUILDING DIVISION' PERMIT CNTRaCTl �INEQTIV rO4t
MIT
O.
BUILDILStAD(yR LA RODA DR TBD - TO BE DETERMINED P 08050045
OWNERS NAME: •
PERMTI ISSUE DATE
SANDEEP GUPTA 05/02/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: DEMO BACK FILL POOL BLDG B ELEECTO PERMPLu BO • MECH
O lni C lni
100 LICENSED CONTRACTOR'S DECLARATION Job Description
r6 C "'lathy
affirm that I am licensed under provisions of Chapter 9(commencing
is with gation 7 T5)of Division 3 of the Business and Professions Code,and my license u
n o.s In full fora end effca
j�z License Clan Lica •
E Dale Contractor
`i1 ARCHIECI'S DECLARATION
i I undemand my Plans shall be used as public records
G Licensed Professional
`o3 OWNER-BUILDER DECLARATION
E I hereby alrirm that I am exempt from the Contractors License Law for the
i 0 o following reason.(Section 7031.5,Business and Professions Code:Any city or county
li 2 M which requires a permit to ennuauct,alter.improve.demolish,or repair any ssnmturc
—y prior to its issuance,also requires the applicant for such permit to file a signed statement
< that he is licensed pursuant to the provision of site Contractors License Law(Chapter 9 Sq.Ft. Floor Area Valuation
sIe (commencing with Section 1000)of Division 3 of the Business and Professions Code)or
e 5-.• that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of APN Number • Occupancy y e
not more than five hundred dollars(555001 P y Tr`J p
❑Las owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044.Business
and Professions Code:The Contractors License Law does not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If.
however,the building or improvement is sold within one year of completion.the owner.
builder will have the burden of proving that he did not build or improve far purpose of
ale).
a1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044.Business seed Professions Code:)The Contractor's Li-
cense Law dote not apply to an owner of pmpeny who builds or improves thereon,and
who contracts for such projects with a conuacmr(s)licensed pursuant 10 the Contractors
License Law.
❑I am exempt under See ,BBPsC for thhis reason
. Owner TION _
WORKER'S &PEA'S ON DECLARATION 1—�—
I hereby aPmn under penalty of perjury one of the following declarations:
have and will maintain a Certificate of Consent to self-insure for WorkersCompen-
ation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued. .
0 I have end will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Cade,for the performance of the wort for which this permit is Issued.
My Workers Compensation Insurance carrier and Policy number are: •
Cartier. Policy No.: ,
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollen($100)
or lase)
I certify that in the performance of the work for which this permit is issued,I shall not
employ any person in any manrmr robe me subject to the Workers'Compensation
Laws of Califomig Os¢ 0��
Applicant rni
NOTICE TO APPLICANT:If,after making this Cenifcate of Exemption,you should
become subject to the Workers Compensation provisions of he Labor Code,you must • . .
0 z forthwith comply with such provisions or this permit shall be deemed revoked. •
,
•
z y CONSTRUCTION LENDING AGENCY
[-v I herebyafrm that there is a construction lending agency for the performance of
a, > the work for which this permit is issued(Sec.3097.Civ.C.)
G6 Landers Name
z Landers Address •
IJ O I certify that I have read this application and state dist the above information is
LL. ^ correcs I agree 10 comply with all city and county ordinances and state laws relating to
.Q SV" building conswnion,and hereby authorise representatives of this city to enter upon the
•
above-mentioned property for inspection purposes.
F y (We)agree to save,indemnify and keep harmless the City of Cupertino Spiral
01) liabilities,judgments,costs and expenses which may in any way acme against said City 7111,1
0 Z in consequence of the granting of this permit /
^' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: N. I Aftj Date 2 rG ih
SOURCE REGULATIONS.
2 Re-roofs Or
Simmtuurt c`
of Appli mf d�
DOUS MATERIALS DISCLOSURE Type of Roof !�
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupenino Municipal Code,Chapter 9.12.and the Health and Safety
Code,Section 25531p71
❑Yu All roofs shall be inspected prior to any roofing material being installed.
l.7Na
will the applicant or future buildingoccupant taxIf a roof is installed without first obtainingan inspection,I agree to remove
PP W equipment or devices which
1wico A hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
❑Yes E-yNo
I have read the hazardous materialsrequirements under Chapter 6.95 of he Califon
Ma Ileal h h Safety Cede,Sections 25505,15533 and 25534.1 understand Nair dor building
does not currently ham a tenant.dor it is my responsibility m notify he occupant of he
requirements which must be mel or to issuance of a Certificate of Occupancy,
5, ,,a,ol, ,-u� ��, /� Signature of Applicant Date
Owner orauthorizedaagent/ "" DAte' • All roof coverings to be Class 73"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # : 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN • 36933025 . 00
DATE ISSUED • 05/02/2008
RECEIPT # • BS000004659
REFERENCE ID # . . . : 08050045
SITE ADDRESS • 10577 LA RODA DR
SUBDIVISION
CITY • CUPERTINO
IMPACT AREA
OWNER • SANDEEP GUPTA
ADDRESS • 10577 LA RODA DR .
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4430
RECEIVED FROM • SANDEEP GUPTA
CONTRACTOR • TBD .. TO BE DETERMINED LIC # 00096
COMPANY • TBD - TO BE DETERMINED
ADDRESS
CITY/STATE/ZIP ,
TELEPHONE
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
1BSEISMICR VALUATION 100 . 00 0 . 50 0 . 00 0 . 50 0. 00
1DEMORES SQ FEET 0 . 00 490 . 00 0 . 00 490 . 00 0 . 00
TOTAL PERMIT : 490 . 50 0 . 00 490 . 50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CREDIT CARD 490 . 50 MASTER CARD
TOTAL RECEIPT : 490 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
704 DEMO
•
CITY OF CUPERTINO
«CGS, DEMO
•cukkf iNO PERMIT APPLICATION FORM
ORDSDD`-.S
APN# 310q 33 025.00 Date: p51 .g.
Building Address:
10577 LA 6ZojA pRI vE cu_PffRTINo, c.a
Mailing Address (if different from building address):
922-6 REAG/tnA RoAb It217 , CAN DIE-4101 e1\ 012_,210,
Owner's Name: Phone:
J>-1=P
SArc,uP SS8 -3/417H-`1 -96
Contractor: Phone :
QWtdE& 13L4LDEQ
Fax:
Contractor License #:
Cupertino Business License #:
Contact: Phone:
Fax:
•Residential ® Sq Footage 2-2 Commercial ❑ Sq Footage
Job Description: SOW- QoWN AND FALL 11-1E POOL •
Valuation:
/2)o
Please complete relevant portions of the Green Building Checklist & attach it to the application
or if applicable, include on the plan set & the sheet index.
Quantity Fee ID Fee Description Fee Group Permit Type
IDEMORES Demo-Residential B 1SFDWL-DEM
1BSEISMICRE Seismic Residential B
IDEMOCOM Demo-Commercial B 1COMML-DEM
1BSEISMICOM Seismic Commercial B
• 1BUSLIC Business License B
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent, spouse or child) will perform:
• A. x All the work authorized by this permit
B. _ A portion of the work
C. None of the work •
If B or C is checked, complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. _ All of the work
B. _ A portion of the work (complete section below)
Contractor Address/City Phone # State License # Type of work to
be performed
3. I will utilize unlicensed person(s) other than my immediate family to perform all or
• portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office. •
Person/Firm Address/City Phone Number Type of work to be
performed
•
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information(reverse side).
Property Owner's Signature: SO 911C-
Date: 0w/o /lam
Job Address: I°477 IA 4Z09n 671<1 VC / Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
Department.
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i City of Cupertino Building Department
CITY04 •
Torre Avenue.
CUPEKTIN® Phone: (408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself, you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract,you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is$200 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer, you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes,workers' compensation insurance,disability insurance costs, and unemployment compensation•
contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your
obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor,only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street,Sacramento,California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department,
City of Cupertino •
Printed on Recycled Paper
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
• Building Points Categories that must be
shown and referenced on the Project
Plans (See below)
yA ,Vaiga14- hMS. • ra'72 Wi� , sV�cry
f}"{f $+ 4,4 r-•1114`,N'.`"r
B. Site 9. Install H.E. Irrigation, (details/spec)* L-1 2 points
11. Permeable Paving, (Note) L-1 2 points
C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
• 5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, (detail) S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec) L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec.) A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
5.101#32MMI4 TOTAL POINTS ' 40 points
rees
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Plan Review Process Work Book Page-12-Revised 3/25/08
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Single Family GreenPoint Checklist date: ( Build ItGreen
I`
The GreenPoint Checklist is based on the various green features incorporated into the home and is the ""'AD frotrn tv:fp:: lip
basis for the GreenPoint Rated program.A home can be considered green if it fulfills the prerequisites, v— —. '
• earns at least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Quality/
Health(5),Resources(6),and Water(9).Please contact Buld 1t Green for a list of qualified GreenPoint
Raters if you are interested in pursuing third-party verification.
Ice green building practices Malec below are described in the New Home Construction Green Building
Guidelines available atyvm buildiloreen orq . -.- .-•- -.- -•- -•-
ENTER PROJECT NAME 8 < i . 5 p ti
•
A.SITE ...
r +''p: ? ' .. . ..:'i..>- '7.. f ;9 f. . .- .r?.. ',n.fS.11'.. ' i.c.;,...iii P.alnq Aveilahle Per Meaeure':': `
I.Protect Topsoil and Minimize Disruption of Existing Plants&Trees
• a.Protect Topsoil from Erosion and Reuse after Construction 0 1 I i I
-
'._._.__..f_.-__.�..._-.-.U__1..
▪ b.Limit and Delineate Conslroction Footprint for Maximum Protection 0
• 2.Deconstruct Instead of Demolishing Existing Buildings On Site 0 I I I 3 i
3.Recycle Job Site Construction Waste(Including Green Waste)
• e,Redrew)50%Waste Diversion by Weigh!(Recycling or Reuse)-Regrind 0 I I j R r
• b.MNlnum65%DNersbn by Weight(Recydkg or Reuse) 0 .-`{1 1
4
II c.Minimum 80%Diversion by Weight(Recycling or Reuse) - 0 _ ---- ` - —L-?-
i
I.Use Recycled Content Aggregate(MlnImum 25%) I I I 2 ,_
• a.Wenwey and Driveway i 1 I
■ b.Roadway Base -�-- 1
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Total Points Avabable in Site=1
eco FOUNDATION '. ` . ..'•:, i:"-i.'Ii!-‘ii - ^--_n. --,- , -.c;:Points Available Per Measure:i:'.'.
1.Replace Portland Cement In Concrete with Recycled Flyash or Slag
• e.Minimum 10%Fyesh or Slag I t I 1
• b.Msmum lS%Flesh or Slag I___.I 1
• 2Use Frost-Protected Shallow Foundation in Cold Areas NEC.Climate Zone 16) I 3
I3.Use Radon Resistant Construction lin Al-Risk Locations Only) I r 1 j
• 6.Design and Build Structural Pest Controls
• a.Install Termite Shields a Separate Al Ededor WoobiConcrele Connections by hell or Plastic FeseneravMders r I
b All New Plane Have Trank,Base,or Slam Located Al Least 36 inches from Foundation
Total Points Available in Foundation=a
C.LANDSCAPING, • r; v.,, w..n r +,;` r al xl 'iFr'ii "1: k<i..?.c',a '.:.; '>•.;.
.. �... ! .r-r,.':;i , t„ �, ;:Poirits'Adeilable Per Measure T:(; '
1.Construct Reeouru-Hfcient Landscape.
• a.No invasive Species Listed by Ca-IPC Are Planta t 1 1
• b.No Plant Species Wit Require Hedging '�-- ._ _'.1-'I-"---
• c.75%of Plants Are Drougv-lolerant California Nates,Mednamnean,or Other Appropriate Species
I I I i 3
. 1u..Firws.ta Landscaping Techniques 1 r I I
3.Minimize Turf Areas In Landscape Installed by Builder
• a.NI Turf WE Have a Water Requirement Less than or Egrd to Tag Feswepi.e plant factor)
•_4.____L_-1-----L
I�.—_ 3_.
▪ b.Turf Shale Not Be instated on Sbpes Exceeding l0%or n Meas less than a Fool Wde j 2
• c.Turf 033%of Landscaped Area petal 2 oohs) --'---.i 1_2
• Mald.Turf SI0%of Area al a pants) .i._---... J—._/.._._
i
I. 4.Plant shade Tree
I I 3
I. 5.Group Plants by Water Needs IHydmionhpl i I I 1 2
6.Install High-Efficiency irrigation Systems
• e.System Uses Only Low.Fbw Ode,Bubblers,crLow.fcw Sprnker
12
▪ b.System Nos SmartConaalers .__�_.___ __I,- i.__._.
•
a 7,Incorporate Two Inches of Compost in the Top 6 to 11 Inches of Soli
III
3
• e.Mulch All Planting Beds to the Greeter of 2 Inches or Local Water Ordinance Requirement 1 I i I 2
• a.Use 50%Salvaged or Recycled-Content Materials for 50%of Non-PientLandscape Elements I 1 I
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• 10.Reduce Light Pollution by Shielding Fixtures endfe Directing Light Downward g 31, 1 i I I I
Total Points Available Lands®p
D:STRUCTURAL:1.Apply FRAME o BUDDING ENVELOPE}`-',f d>° "r;r.,rr ,Jwxw,yt,(fv a .;I -,.
t}J �,, .. P - Points Available Per Me6tii.e ;"
Optimal
Value
• a.Place Rade and Stud el 24een On Center Framing 0 r n
II b.SWLoad Door and Window Headers for j_ '_ _.
• • c.Use OnlyJack and Cripple Studs Rppkedlor Load
2.Use "'-- ----- ---s"--'-----,
Engineered Lumber 0 I I l
ill e.Deems and Headers
0
b.Insulated Engineered Headers 0 l I I I .
,
In c.Woad WaistsWaistsor Web Trusses for Floors 0 I -._.t 1
_._I_
a
02007 Build It Green Single Family GreenPoint CheWist 2007 Version Page 1 of 7
ENTER PROJECT NAME TTTT7T1IIII
■ d.Wcal kloists for Roof Ratters •
• ..Engineeredd or ayer.,romWb Studs rorvenw nyPc:ww
Ma
■ I.Oriented Strand Board for SWdaor
■ g.(Mated strand Board far Wall ata Roof Sheathing
3.We FSC-CarlMd Wood _
■ a.Dimensional Lumber,Studs and Tinter Mailroom 40% I 2
■
b.Dimensional Lumber.Studs and Tinter:Mnlmum —
■ c.Panel Products:Minimum 40% — ---. 1
■ F_.
d.Panel Products:Mnlmtm 70% ] i
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02007 Build It Green Single Family GreenPoint Checklist 21007 Version Page 2 of 7
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!ENTER PROJECT NAME 8 2 t z g
. I C V S
• 4.Use Solid Wall Systems(includes SIPs,ICFs,&My Non-Stick Frame Assembly)is e.Fleas , : 2
I
• b.Wail , ...____1 2 ,.-1_. z._I.__....
• c.Rods
i 2 I. E 2 I
S Reduce Pollution Entering the Home from ted Garage
• a.lignty Seal the Air Banter between Garage and Living Area1 I 1 ; 1
• , b.Install Garage Exhaust Fan OR Build a Detached Garage _._-1--__7-71,____1__
• 6.Design Energy Heels on Trusses(75%of Attic Insulation Height at Outside Edge of Exterior Wall) I 1 I i I
• 7.Design Roof Trusses to Accommodate Ductwork I I I {
I. 5.Use Recycled-Content Steel Studs for 90%of Interior Wall Framing { { I
I. 6.Thermal Mass Walls:S/5-Inch Drywall on All Interior Walls or Walls Weighing mon than W Idcu t I I I, •
10,Install Overhangs and Gutters
• a.Minimum 16-Inch Overhangs and Gutters
J__. 1 r•
In b.Minimum 24-Inch Overhangs and Gutters i 1 I —'• `-
Total Points Available In Structural Budding Frame and Envelope=3.
E,EXTERIOR FINISH,:.--1'r-.. '.," '.„11..„2.1,:- ,,';'.1„,-i.:,::--. . n;s'...' r : F, " :" 'i,:PointsAvailable Per Meesure;;`En.
• 1.Use Recycled-Content(No Virgin Plastic)or ESC-Certified Wood Decking I 2 i
• 2.Install a Rain Screen Well System 2 j
• 3.Use Durable and Noncombustible Siding Retaliate j I i 1
• 4.Select Durable and Noncombustible Roofing Materials 11 I 2
ii
Tota Points Available in Exterior Finish=
F.INSUI'ATION rf, ,',•3i., . . t.-�y..;eh -,eras *: J ,C.C1 .M.ui a�'':h' -'. fv..C,,pu,',f1Vyx,nyn?eri'?!r2=!4:#_,tas% "1„Poinis Available Per Meesurej:EFEi:{
1.Install Insulation with 75%Recycled Content
• a.WalFloors ,ors i { 1 I
_.
▪ 2.Install Insulation that Is Low-Emitting(Certified Section 01350) .
IN a.Wade and/or Floors 0 I i
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• b.CeWgs o 1 ,
• 3.Inspect Duality of Insulation Installation before Applying Drywall 0 1 j I
• Total Points Available in Insulation= 0
C.PLUMBING . i' K°'- '- I Poin.ts Available Per Measurrec!=r$
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
• e.Insulate Hct Water Pipes from Water Heater to Hitchen 0 __ i 1 _{ I 1
• b.Innate All Hot Water Pipes -0.- __ __._J _-y._ .._
• C.Use Engineered Parallel Piping -` J...�.-• i "1-"
d.Use Engineered Parties Piping with Demand Command Circulation LoopI .-I-.___ r._._.. ..._
• e.Use Strecesed Plumbing with Demand Controlled Circulation Loop p----_-I iIi- 2
• !Use Central Core Fumbing _O._ --"II 112
• 2.Install OnlyHigh Efficiency Toilets(Dual-Flush 0%1.23 grill {
0 { 4
Trial Points Amiable in PMmbing a Total 1. 0
H.HEATING,VENTILATION&AIR CONDITIONING;; r. p „"l,Rl:,e k'yt Vit:d lid x3w "h G. .j:; _ )PointsAvagable Per MeasuieA✓.'e)
• 1.Design and Install HVAC System to ACCA Manual J,0,and S Recommendations 0 I 4 I I I
2.Install Sealed Combustion Unite
111a.Furnaces 0 :El
b.Water Heaton ry'
D
▪ 3.Install Zoned,Hydro,*RadiaHeating1 .
nt Heng with Slab Edge Insulation 0 I 1 i I j I
In 4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1 j I 1 I
5.Design and Install Effective Ductwork
• a.Intel HVAC Unit and Ductwork within Conditioned Spam 0 3 I I
b.Use Duct Mastic on M Dud Joints ale Seams 0 1 _ '{
• c.Install Ductwork under Ms Insulation(Burled purist 0
r i
In
d.Pressure Betanin me Ductwork System 0 1 I
a e.Protect Duds during Construction and Clean All Ducts before Occupancy "_""-- -- 1- 1 ----j•------{-.__.....
_ 0 ]
&Install High Efficiency HVAC FIder(MERV 6x) 0 I 1 I { —
. 7.Don't Install Fireplace or Insall Sealed Gas Fireplaces with Efficiency Rating Not lass Than 60%
0 I 1 I
using CSA Standards
1
S.Install Effective Exhaust Systems In Bathrooms nd Kitchens
In a.Install ENERGY STAR Bahoom Fans Vented to the Outside 0 i
411 . dMBeIMmm Fans Are on timer or Numklstal "D ' ? l
▪ c.Instal Kitchen dwn Range Hood Ventedtia Outside 0 ---f—j I 1 � j� '
I.Install Mechanical Ventilation System for Cooling(Maximum 4 Points)
• a.Install ENERGY STAR Ceiling Fans&tight Kits In Living Areae&Bedrooms 0 1
In b.Inst Wide House Fan wVisitable Speeds O— _.l__1.)__. 1_._ _'
02007 Bullet It Green Single Family GreonPoint Checklist 2007 Version Page 3 of 7
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ENTER PROJECT NAME
▪ c.Automatically Connoled integrated System 0 __1.11-2---1—
• d.Aobmaticay Continued Integrated System vin Variable Speed Conti 0 3i `�___ •
I4.1nsMO Mechanical Fresh Air Ventilation System(Maximum 3 Points)
. a.My Whole House Ventiatlon System That Meets ASHRAE 62.2 0 4 2
▪ b.instal Ai-OAir Heat Exchanger that meets ASHRAE 622 0 f 1 I 2 I
In It,Instill Carbon Monoxide AIamris) 0 If 1
Total Points Avaiable In Heating,Ventlabon and Air Conmtaring=30 0
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Page 4 ul7
02007 Build It Green Single Family GreenPoint Checklist 2007 Version
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,ENTER PROJECT NAME e l 111 5
�. Q V $ K
• I.RENEWABLE ENERGY.it . . <. Y tz F r ..v ...... .. '.CF
,.s.t ,. "'a.:?,�.r.+. �:� • ;? - t: 1Poinls AJa6abk Pei Measure;+'-,.'�.
. 1.Pre-Plumb for Solar Hot Water Heating i 4 I i E
. 2.Install Soler Water Heeling System I 10
• 3.Install Wiring Conduit for Future Photovoltaic Instillation 6 Provide 20011 of South-Facing Roof I 2 I I I .
4.Install Photovoltaic(PV)Panels
111 e.30%of electric needs OR 12 kW(btal6 paints)
▪ b.60%ofelectric oases OR 24kW hotel 12 points)
11--61—_._._ 1
' • c.BO%of electric need OR 3,6 kW(total 18 points) .._—_I--_6...I- .1___..'_.__._.
Total Available Points in Renewable Energy•28
ir.'BUILDINGPERFORMANCE„ ?
ENTER PROJECT NAME 8 L 5 W •
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• b.BuiFln Composting Center 0 1 1_ . •
TotiAvailable Poils in Appkanoss and Llghtng•12 0
N.OTHER '.e § „; w , ,q�' '....” � `<}i"f ' C..., e..l. -:!`.,, i:r'P6irits Available Per Measure„'•:
• 1.Incorporate GreenPoinl Rated Checklist In Blueprints•Required 0 j R
• 2.Develop Homeowner Manual of Green FeaturesIBenMb 0 i 1 1 i 1
3.Community Design Measures 8 Local Priorities:See the Community Planning&Design section In Chapter 4 of the New Horne Guidelhies for measures.
Maximize of 20 points for suggested measures.Local requ'eemene may also be listed Mn.
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0 2007 Build It Green Single Family GreenPoint Checddist 2007 Version Page 6 of 7
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4.Innovation:List innovative measures that meet the green building objectives of the Guidelines.Enter up toe
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maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right. ____
Innovation In Community.Enter description here,end enter pointsevalteblo for measure In appropriate categorisbthe ght 0 '0 ". 0 0 0 0
• Imosoton b Energy:Enter desciplen here,and enter pants available fa measure In appropriate categories to ba right. r 0 0 • 0 0 0 0
Innovation In KO/Health:Enter description here,and enter pointe avertable for measure In appeopiete mlegmnes to the right • - 0 0 0 0 0 0
• Innovation In Resources:Enter description here,end enter points'sa0able for measure In appropriate categories to the right. 0 0 • 0 0 I 0 0
Innovation In Water:Enter description here,'rd enter points available for measure In appropriate mleporesbtlro right. . -• 0 0 p '0- 0" p
Total Am
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Summary
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+
• Minimum Points Required in Specific Categories 0 30 5 6
. ' Total Points Achieved 0 0 0 0 0 1 0
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
-12: 15%above Title 24
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific categories: •
-Energy(30 points)
-IAQ/Health(5 points)
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{ -Resources(6 points)
-Water(9 points)
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02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 7 of 7
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Community Development
10300 Tone Avenue
ief_ Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
•UPEICrINO
Building Department
JOB ADDRESS: 10 '77 j 6?oDA bp RI VF= PERMIT #
KS
OWNER'S NAME: S AN0 (P (f U PHONE it v 4' - 72/740
GENERAL CONTRACTOR: ' 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
SGlass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
• Sikv,etekepc/coayc�
Owner/Cotract" or Signature (Date