08030150 (2) CITY 06 CUPERTINO err * • � E r?<:;a.ls. *' " +�' a '
BUILDING D IvIsioN PERMIT
"CO, NTRACTOR INF,.OR�'VIATI N
P 2�rt*.t2_ `°. "-aZt
BU PERMIT
PERMIT NO.
fff�IATHANSON AVE CUPERTINO PLUMBING 08030150
ER'S NAME: PERMIT ISSUE DATE
NG WILLIAM S AND MAY D 1300 DELL AVE STE C 03/26/2008
PHONE: (408) 253-0618 SANITARY NO. CONTROL NO.
ARCHI]EC iENGINEER: BUILDING PERMI T tWO
BLOO ELECT PLUMB MECH
�a p LICENSED CONTRACTOR'S DECLARATION Job Description
rd F I knotty )of Nn 1 am of
Bulconstol under and
Ptudom of Chapter 9 my license
T�1 . r flf ]0011)o(DlWeionlof the Business sed Profcuiom Code,And mylicenso is COPPER RE-PIPE,WATER MAIN,WATER HEATER
" in full forte and IT x
Z Dammc u. — cLl 1
over '�y90S
r Dam contractor Af,= �
e ARCHITECTS DECLARAT ON
y IundemnJ myplus shall Mused As public rtmrJs
J U
kQ� Licensed Professional
5 OWNER-BUILDER DECLARATION
COO 1 Mrthy.Diem Nat I 1 eseropt from the Contram000 License city
a for the
COO following ui mn.ommitt ]fDIS,Badness and Pmfesdom Cook:Any citymmunry
3$let which requites n lesmit to connrocL alter,nt rmw,de such Permit
t.fie I: d atwetum
_ o mal he iuuensed ulwnt wore lM applicant for Conarmtit mftlea Law(Cawmcnt
thatMtscamc0lmmtwtmute of Division
of the Canusines alJmn¢IAon,Code)or
Sq.FI. Floor Area $5000 Valuation
3 that he
(commencing with Sectimminent
t and am basis for the
Al eg Business on.PreAnyavi Cade)or
Nat M u 31.5 b thmefmm and Ue bobs far the u the emmpdom Any violNnn of
SAM. 7031.!five
airy red don,for a Permit wbjttu the appllam to a dull penalty a( 3 2 6 4 3 0 6 9 ? Number Occupancy Type
AM mora man fiw hundred dalton(5300).
❑1,m.war of N"pmpmty,or my moploym with wwges m their mle compensadm.
will An the werk.And uasu,Mueis oat inmnded or offered foraala(Sm.7014,Business Required Inspections
and Profeadom Cade:The Con rmsor's Licvuee Law does not apply W An owner of 9 P
property who buildsorimpron,themen,and whodoessuch work himselforNmugh his
awn employees,provided that web impmwmenu are not intended oroReem for sale.IL
Mwever,Ne building or improwmert Is sold within one year of completion,Ute owner-
Mllmn will have the bounce of proving thea he did oat build or improv for purpose of
saleJ.
C)L as owner of the property am exclusively contracting with licensed contncmn in
compact IW pmlcm Ise e.]OCA,Business and Profession Cade:)The Commocu ei Li.
came Law docs col apply in w owner of propeny who Wilds or Improver thereon,and
who contracts for such projects with a canuanar(s)licensed purwam to the Cont uWs
License Law.
❑Ism uam"mAm See .B&PC for this remora
40— Dan
WORKERS COMPENSA7]ONDECLARATION _
1 Wrtby a1Rrm under pemiry of perjury aro a(de following declendam:
0 1 hue and will maintains Cerdlesm of convent to self-imine forworlmrscompew
sa,ion.As provided for by Section 3700 of the labor Cade,for the performance of the
work for which this permit is issued.
❑I ban and will maintain Wwkce3 Compensation Insurance,As required by Section
3700 of the Labor Code.for the performance of the work for which this permit is issued. '
My Workee!Si tn,penswon Insurance carrier and Policy number am:
Canicr.Afl'_ATG FU,,J� Poliry N".:may=
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thumedm teed not Mcomplmed ff Na permit is forone hundmddollan($1017)
or lest)
1 certify Not in the performance of do,work for which this Permit is limed.I shall am
employ sny person In my roamer so at m Mceme subject in the Woft f Compenow n
I.Am of Califanno,Disc
Applicant
NOTICE TO APPLICANT`.IL after making this Cer ificam of Exemption.you should
become subject At the Worker's ComNmkdan provisions of the IerMr Code,you must
OZ forthwith comply with each prvvism.or this permit shall he domed revoked.
Z O
CONSTRUCTION LENDING AGENCY
1lumhyafiifm that Nen la a construction landing agency far Uw Performance of
Cli the wort for which Wer permit ts Wood(SM.3097,Civ.C.)
[L1 0 Lender's Name
jz Lender's Add.
U 0 1 certify Uta,I haw read this application and show that the above Intoxication Is
Ly P correct.I agree to comply with all city and county oniinmces and show lava nla,in&to
DU building conswNon,and hereby autbarim minamnutin,of this city to enter upon the
W above-menumted PMPeery for Inspection Purpowt
6, (WA)agree to an,indemnify and keep harmless the City of Cupertino aga est
h liabilities,judgmcnho,costs and expenses which may in my my amu,against aid City
V in mnsagmnee of the Sooting of this permit
APPLIC S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date C_
E REGULAMO
j-zF-T Re-roofs
T&n
pplt NAZARDOUSMATERIALS DISCLOSURE Dow Type of Roof
Wit the applicant or future Wilding atcupmtnom or handle harsNom material
defined by the Cupertino Municipal Cade.Chapter 9.12.and de Health and Safety
Section W32(07❑Yes eBw-� All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building aamp2m uso equipment or devises which If a roof is installed without first obtaining an inspection,I agree to remove
..It ha/afdoes air contaminmu as Jclned by the Bay Arta Air Quality Management all new materials for inspection.
DiwicR
❑Yes Q
1 have nW the hvand...wrialsrequircmcnu umb,CMPwr6.95 of the Cslifan
rale &Safety CC riRt5.2UPw4W34.IuMcddwiiftpw Wilding
not c Wer, y my ThIII, oufy Ne occupant of the
menuhjch
wm w t Eva armies it, of Occupancy. O Signature of Applicant Date
All roof coverings to be Class%!r'or better
norm mt�ied agent Dow
• CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . .. 32643069 . 00
DATE ISSUED. . . . . . . : 03/26/2008
RECEIPT #. . . . . . . . . : BS000004271
REFERENCE ID # . . . : 08030150
SITE ADDRESS . . . . . : 10678 NATHANSON AVE
SUBDIVISION . . . .
CITY . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NG WILLIAM S AND MAY D
ADDRESS . . . . . . . . . . : 10678 NATHANSON AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1332
RECEIVED FROM . . . . : ROSALYN 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
---------- ------------- ---------- ---------- ---------- ------=--- ----------
IBPWSVCS WATER SERVICE 1 . 00 20 .40 0. 00 20 .40 0. 00
1BSEISMICR VALUATION 5, 000. 00 0 .50 0. 00 0.50 0. 00
1PPERMITFE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
1PRREPIPE NO OF FIXTURE 10 . 00 102 . 00 0. 00 ' 102 .00 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 228 . 96 0. 00 228. 96 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 228. 96 VISA
---------------
TOTAL RECEIPT 228. 96
VOICE ID DESCRIPTION - VOICE ID DESCRIPTION
---- -------------------------- --- -------------------------
301 ROUGH PLUMBING 507 FINAL PLUMBING
r
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: patg
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32643069 . 00
INVOICE DATE. . . . . . : 03/26/2008
REFERENCE ID # . . . : 08030150
SITE ADDRESS . . . . . : 10678 NATHANSON AVE
SUBDIVISION
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : NG WILLIAM S AND MAY D
ADDRESS . . . . . . . . . . : 10678 NATHANSON AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1332
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 DESCRIPTION- ------- DUE FOR--------- AMOUNT DUE --PAID BALANCE
---------- ---------- ----------
MAIN WATER SERVICE PRINTING PERMIT 20 .40 0. 00 20 .40
SEISMIC RESIDENTIAL PRINTING PERMIT - 0 .50 0. 00 0 .50
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40.79 0. 00 40 .79
RES REPIPE OF FIXTURES PRINTING PERMIT 102 . 00 0. 00 102 . 00
RESIDENTIAL WATER HEATER/VE PRINTING PERMIT 24 .48 0. 00 24 .48
TRAVEL & DOCUMENTATION FEE PRINTING PERMIT 40.79 0. 00 40.79
---------- ---------- ----------
228 .96 0. 00 228. 96
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
301 ROUGH PLUMBING _ 507 FINAL PLUMBING
CITY OF CUPERTINO o �3
• � � REPIPE/SEWER/MAIN SERVICE
CUPERTINO PERMIT APPLICATION FORM
APN# 3 2-eP/ Date:
�
� Building Address:
/(Xio7o
Owner's Name: Phone#:
73U - i64�. 8
!E�'I-eve N
Contractor: Phone#:
f Z53 - U� 1 �
Cil f{nJ �lt� ��ti
Fax #:
Contact: Phone#: 5,
3U � —3V/ I
'Fran Le Fax #:
Contractor License#: (o a 4 S v 5
Cu ertino Business License#:
Job Description:
CoPp� � �
Residential Commercial ❑
Valuation: e :-
5, vvU
Green Building Check list must be completed and attached to this application.
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Grou
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
IBPREPIPE Commercial re-pipe per fixture P 1CPRP
IPGASCOM Commercial Gas Piping System P
1-4 Outlets
tIBSEISMICOM Seismic Commercial p
/ 1BSEISMICR Seismic Residential p
/ IPRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
�p 1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
IPPRSEWG Private Sewage Disposal System P
IPCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
IBPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P
1PLMBINSP Other Plumbing/gas Insp. P
ITRAVDOC Travel &Documentation Fee B
rIBUSLIC I Business License B
Single Family GreenPoint Checklist dare: Build It Greed
The GreenPoint Checklist Is based on the various green features Incorporated Into the home and is the SmanSolutions From The Gmund Up
basis for the GreenPoint Rated program.A home can be considered green It It tultlls the prerequisites,
® Hams at least SD points,and meets the minimum points per category:Energy list
of Indoor d rasnPol
Health(5),Resources(6),and Water(9).Please contact Build It Green for a IIsi of qualified GreenPoint
Raters g you are interested In pursuing third-party voi fication.
The green building practices listed below are described in the New Home Construction Green Building
Guidelines,available at www.hultliforeen.ory. w
ENTER PROJECT
R, 1 c E S e
A.SITE -Points Avaliable Per Measure
,1.Protect Topsoil and Minimize Disruption of Existing Plants 6 Traes
❑ a.Protect Topsoil from Erosion and Reuse after Construction
❑ b.Lima and Delineate Construction Footprint for Maximum Protection 0 1
2 Deconstruct instead of Demolishing Existing Buildings On Site D 3
3.Recycle Job She Construction Wass including Green Waste)
❑ aMinimum 50%Waste Dlvesion by Weight(Recycling or Rause)-Required 0 _ _ R
❑ h.Minimum 65%Diversion by Weight(Racy ting or Rause) p 1 2
❑ c.Minimum BO%Diversion by Weight(Recycling or Reuse) 0 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0 I __
❑ b.Roadway Base 0 '� 1
Total Pointe Available in Site=12 0
B.FOUNDATION .Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash or Slag
❑ e.Minimum 20%Flyash or Slag 0
❑ b.Minimum 25%Finish or Slag 0 1
❑ 2,Use Frost-Proseted Shallow Foundation in Cold Areas(GE.C.Climate Zone 16) D 3
❑ 3.Use Radon Resistant Construction On At-Risk Locations Only) 0 1
4.Design and Build Structural Pest Controls
❑ a.Install Termly Shields a Separate All Exterior Wood4o.Concrete Corrections by Metal or Plastic Faslanas/Dviders 0
b.All New Plants Have Trunk,Base,or Stem Located At Least 36 Inches from Foundafion 0 1
Total Palms Available in Foundation=8 0
C.LANDSCAPING Points Available Per.Measure
• L a No imitativeub.Resourc Efficient Landscapes
❑ e.NO — --- _ — _---- -- —
Specieas Listed by Cel-IPC Are Planted p j ]
❑ b.No Plant Speciate Will Require Hedging p 3 )
❑ C.75%of Plants Are Drought-tolerant California Nabves,Mediterranean,or Other Appropriate Spades p 1
❑ 2.Use Rwitafe Landscaping Techniques 0 1
3,Minimize Turf Areas in Landscape Installed by Builder
❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.8 plant labor) 0
❑ b.Turf Shall Not Be Installed on Slopes Excil 10%or in Areas Less than 8 Feet Wide 0 _ i 2
❑ c.Tud is 533%of Landscaped Area(toiel 2 points) p 2
❑ d.Turf is<_t0%of Landscaped Area(total 4 points) 0 r
❑ 4.Plant Shade Those 0 3
❑ 5.Group Pians by Water Needs Hlydrozordi D i i I 1 2
S.install Hight-Efficiency IM eton Systems
❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinkler _ p _� I _ j 2
❑_ to,System Has Smart Controllers 0 3
❑ 7.Incorporate Two Inches of Compost in the Top 6 to 12 Inches of Soil 0 3
❑ e.Mulch All Planting Beds to the Greater 0f2 Inches or Local Water Ordinance Requirement D 2
LJ 9.Use 50%Salvaged or Recycled-Content Materials for 60%of Non-Plant Landscape Elements D 1
❑ 10.Reduce Light Pollution by Shielding Fixtures andfor Directing Light Downward p 1
Total Points Available In Landscaping=31 0
D. STRUCTURAL FRAME A B1111MING ENVEIAPR - Points Available Per Measure
1.Apply Optimal Venue Engineering
❑ a.Place Reflex and Settle at 24-Inch On Center Framing 0 I 1
❑ b.Size Door and Window Headers for Load +p _r__
❑ c.Use Only Jack and Cripps Studs Required for Load 0 1 T
2.Use Engineered Lumber
❑ a.Beams and Heatley
❑ b.Insulated Engineered Header --
❑ C.Wood Walsh;or Web Trusses for Floo s
❑ tl.Wood pJoiste for Roof Ratters
o --�--- --- I
❑ e.Engineered or Finger-Jointed Studs for Vertical Applications p I �'
❑ L Oriented Shand Board for Suhgoor D
❑
it Oriented Strand Board for Wall and Roof Sheathing D 1
® 3.Use F n Wood _ —
❑. e.Dimensioerasionall Lumber,Studs and Timber.Minimum 40% p ( 2 j
❑ b.Dimensional Lumbar,Studs and Timber.Minimum 70% D j 2
❑ o.Panel Products:Minimum 4D% _p - ---- --- T----�- —�'--
❑ d.Panel Products:Minimum 70% 1 D t T I
02D07 Build It Green Single Family GreenPoint Checklist 2DD7 Version Page 1 of 4
wy
GK �i
ENTER PROJECT NAMEmen
4.Use Solid Well Systems(Includes SIPS,ICFs,6 Any Non-Stick Frame Assembly)
❑
11.Room
0 2 _ ! 2
❑ b.Wells 0 _ 2 _ 2
❑ c.Roofs 0 2 2
6,Reduce Pollution Entering the Home from the Damps
❑ A.Tightly Seal the Air Bamer between Garage and Livinp Area 0
❑ In.Instep Garage Exhaust Fen OR Build a Detached Europe 0 1
B.Design Energy Heels on Trueaa(76%of Attic Insulation Haight an Outside Edge of Exterior Well 0 1
❑ 7.Deallet RooiTmwe•ad Accommodate Ductwork ' 0 1
6.Use Racycled-Contam Sleal Studs for DD%of Interior Well Fronting o - 1
D.Thermal Mea Wells:WIneh Drywall on All Interior Walls or Walls Weighing more than 4D Iblcu.R 0 1
10.Install Overhangs and Gutlem
❑ a.Minimum 16-Inch Overhangs and Gutters 0 _ ]
❑ b.Minimum 24-Inch nch Overhangs and Guee0 1
Total Points Available In Simdulal Building Frame and Envelops':3B 0
E.EXTERIOR FINISH Points Available Per Measure
1.Ua Retyded-0onte it(No Vlr In Rated)or FSC•Cor ified Wood Docking 0 2
2latell a Rain Screen Well System 0 2
3,Use Durable and Noncombustible Siding Materials 0 1
4,Select Durable and Nonmmbustibie Roofing Materiels 0 2
Tool Pal"Avallable In Exterior Finish.7 D
F.INSULATION Points Available Per Measure
1,Install Insulation with 75%Recycled Comment
❑ A.Walls anther Floors
❑ b.Collins 0 1
2.Install insulation that is Low•Emitling(Certified Section D1350)
❑ a,Wails andfor Floors 0 1 t
❑ b,Collings
3.Inspect Quality of insulation installation before Applying Drywall 0 1
Total Points Available in insulation=5 D
G.PLUMBING Points Available Par Measure
1.Distribute Donnnea Hol Water Eff Diently(Maximum 7 Points)
❑ a.Insulate HM Water Pipes from Water Hater to Kitchen
❑ b.Insulate All Hot Water Pipes _ 0 _ _;_ 1
❑ c.Use Engineered Parellal Piping _ 0
❑ d.Use Engineered Parallel Piping with Demand Controlled Clmulacon Loop --0
❑ e.Use Shudured Plumbing with Demand Controlled Circulation Loop 0 _ _ 1 2
Elf.Use Central Coro Plumbing 0 1 _ t 1 2
❑ 2.Install Only High Efficiency Toilet(Dual-Rush or 51.26 ppQ 0 - 4
Total Points Available In Plumbing.Tatal 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 D i 4 I
2.Install Sealed Combustion Units
❑ e.Furnaces 0 _ _2 I__
❑ h.Water Heaters 0 2 T
3.Install Zoned,Hydmnic Radiant Hating with Slab Edge insulation 0 1 1 I
4.Install High Efficlency Air Conditioning with Environmentally Responsible Ratrigemnts 0 1
S.Design and Install Effective Durnvork
❑ a,Install HVAC Unit and Ductwork within Condlooned Space 0 _ _ 3
❑ h.Use Duct Mastic on All Dud Joints and Seams 0
❑ c.Install Duchvork under Aft Insulation(Buried Ducts) 0
❑
it.Pressure Balance the Ductwork System _ 0__ 1 _
❑ e.Protect Ducts during ConsWcsM and Clean All Ducts before Occupancy0 1
LJ S.Install High EMcieecy,HVAC Filter(MERV&) 0 1
❑ 7.Dont Install Fimplaee or Install Sealed Ga Fireplaces with Ef fancy Rating Not Lae Than 6D% 0 1
using CSA Standards
S.Install Effective Exhaust Systems in Bathrooms and Kitchens
❑ a Install ENERGY STAR Bathroom Fens Vented to the Outside 0 ]
T�___
❑ b.All Bathroom Fang Are on Timer or Humidistat 0 _ _ �1
❑ c,Install Kltcha Range Hood Vented to the Outside 0 1
e.Install Mechanical Ventilation Symant for Cooling(Maximum 4 Points)
❑ e.Install ENERGY STAR Calling Fens S Light Kits In LNing Area S Bedrooms 0 _j_
❑ h,Install Whole House Fan with Variablepeeds S0 ] t
❑ c.Automatically Controlled IntegratedSystem _ 0 _ 2
❑ d.Automatically Controlled integrated System with Variable Speed Conhol 0 _
3
10,Install Mechanical Fresh Alr Ventliation System(MMimum 3 Points)
❑ a.Any Whole House Veri latlon System That Mosts ASHRAE 822 _ 0_ _ _I 2
❑ D.
':',a(';llA'rb,'Air Heal Ex a h a n a that meati ASHRAE 62.2 0 T ] Z_
i t. arbon Monoxide Alarms) 0 1
Total Points Available In Hashing,Vangle6on and Air Conditioning=3D 0
0 2007 Bu lid It Gratin Single Family GmenPoinl Checklist 2007 Veralon Page 2 of 4
lei
ENTER
y
• I.REN WARLE ENERGY Prints Available Per Manure
LJ t.PwPlumb for SOW Hot Water Howling 0 4
LJ 2 lneta!l Solar Water Heading System 0 10
9.Install Wiring Conduit for Future Photovoltaic Installation It Provide 2DD te of South-Facing Root 0 2
4.Install Photovoltaic(PV)Panels
❑ a.30%d electric needs OR 12 kN hotel 6 points) 0 6 _
❑ b.SD%Of 1I111 needs OR 24kW(total 12 points) 0
El ___
c.90%of eiectik need OR 3.6 kN(cast 16 points) 0_ 6
Total Available Punts in Renewable Ene =26 0
J.BUnMIRG PERP'OR1l&"CE Punts Available Per Measure
1.Diagnostic Evaluations
❑ a.House Passes Blower Door Teel 0
to House Posses Combustion Saffely BackdreitTesl 0
12.design and Build High Performance Homes-%above Title 24-minimum 15%Required 0 >_30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package CeNBcation-Phat Manure(Total 45 points;read comment) 0 5 2
Tual Available Points in Building Performance=39 0
E.FINISHES Points Available Per Measure
Ef 1.Design Enayways 0 Reduce Tracked in Contaminants 0 ]
2 Use Low-VOC or Zino-VOC Paint(Ifosineum 3 Point)
❑ e Lew-VDC Interior WaIVCellng Pain(d0 gpl VOCs(Ra(I and x150 g7l VOCs(Non-Fli
❑ b.Zwo-VOC:Interim WelllCellin Points(d go VOCs Flat) 0
❑ 3.Use Low VOC,Water-Based Wood Finishes(Q50 gpi VOCs) 0 2
❑ 4,Use Lcw-VOC Caulk and Construction Adhesives(c7D OPI VOCs for All Adhesives 0 2
❑ S.Use Retyded-Content Palm 0 1
6.Un Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,e)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-loinbetl
❑ a Cabinets(5D%Minimum) 0
❑ d.Interim Tom(50%Minimum) p 1
❑ C.Shelving(50%Minimum) _ D
❑ d.Doors(50%Minimum) _0
❑ a.Countertops 50%Minimum 0 I ]
• 7.Reduce Formaldehyde
Treads
in Interior Finish(CA Section 019$0)
❑ e.Subgom Is Stir Treatls(SD%Minimum) 0
❑ b.Cabinets a Countenops(50%Minimum)
❑ c.unarm Trot(5D%Minimum) 0 ___ 1
El d.Shol in 50%Minimum) __
0 1 1
❑ 6.After Inetallatlon of Finishes,Teri of Indoor AD Shows Formaldehyde Level a71ppb D I 3
Total Available Points In Finishes=21 0 '
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Cerdfied Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Content,E)
Exposed Concrete Flooring Adhesives Most Hever 00gpi VOCs.
❑ LMinimum 15%d Floor Area
❑ oMinimum 30%d Floor Area
El
c.Minimum 50%of Flom Area
❑ d.Mlnlmum 75%d Floor Area
❑ 2 Thermal Man Flows:Floor Covering Other than Carpet on 50%or More of Concrete Floors
Li 3.Flooring Meets Section DI 35D or CRI Gran Label Plus Requirements 50%Mmimum I 2 ' I
Total Available Palms In Floxin =7,10
M,APPL[ANCE9 AND LIGHTINGPolnis Available Per Measure
1.Install Water and Energy Effluent Dishwasher
❑ a.ENERGY STAR(Iota!t poinq 0
El to Dishwasher Uses No More than 6.5 Gellony cls total2points) 0 1
2,Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CFE Tier2 requirements(modrfed energy factor 2A,Water Factor 6.0)(total 3 points) 0 ] 2
❑ to Meets Energy Star and CEE Tier 3 requirements(Modified energy factor 22,Water Fervor 4.5 or less) 0
fotal5 points) r 1
3,Install ENERGY STAR Ref igaretor
❑ a ENERGY STAR Guallfied It c 25 Cubic Feet Capacity D
❑ b.ENERGY STAR Duetted 6<20 Cubic Feet Capacity 0 1 1
L Install Bulh-In R.crycllng Center 0
❑ aBuilt-in Recyceng Center 0 7
❑ b.Burg-!n composting center o
Total Available Points in Appliances and Li htin =12 D
N.OTHER Points Available Per Measure
❑ 1.IncorporateGreenPDlntRatedChecklistinBlueprints-Required D R
• ❑ 2 Develop Homeowner Manua!of Green FvawreslBerrcflh 0 1 1 1
3.Community Design Meesures 6 Local Pforifies:See the Community Planning 6 Design strum in Chapter 4 of the New Horne Guidelines for
measures.Maximum of 20 points for suggested measures.Local regtmements may also be listed here.
0 2007 Build It Green Single Family GreenPoinl Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAME
MUR
❑ Elder tlneriplin hole,end onter polos avallable In menus in rypnglele cse901in to the dgr4. 0 0 D D 0 0
Enter description here,not order points avalsWe Iv menus In eppraprss uleporin to the 19p. 0 0 D 0 D D
40
Enver descriptionhere,and anter points entraps to measure In appsopdale ceregnns to the dpnt. 0 0 0 0 D
Enter description hare,and enter points evasable Its measure in appropriate canppr 0 to the dpht. _D 0 0 0 _0 0
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Bulltl It Green Checklists shed
ma4mum combined total 0120 pts.See Innovation Checklist for suggested measures,using the link to the right. Guidelines
LJ Imwatim In Communl .Enter description hen,aromas points evosese is measures appoprisse cera to the d 0_ 0 0 0 0 0
Innwaticn in En .Ener deampron hen,and rental points available Is menus In apposite categorles s W ogre. 0 . 0 D 0 D D
Inwaaon In IAOe1W Ih:Enver de hare,and ems points vessels Is memm in ui to Ida d a 0 0 o D D
InwaDon In R=earm.Enter ion hare,and ever s wastes for mnt re in ale ul 'n to the 0 0 D 0 D D
Inn ral_in In W_eler,_Enter doecdp6n hare,and enter points veilante Is manus in apprgeste caspass nlhe dUK _ D _ 0 0 D 0 0
Total Available Points in Other.41 D
Total Available Points In Specific Categodes• 4+ 96+ 42+ 66+ 43+
Minimum Pointe Required In Specific Categodes 0 30 6 8 9
T(Dtal Pcontss s e e e e
Prepect has not yet mat the fotilmving recommended minimum requirements:
-Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-72:15%above Title 24
-Ni:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points In specific cateoorles:
-Energy(30 points)
-IAQ/Health (5 points)
-Resources(6 points)
-iNater(9 points)
02007 Build It Green Single Family GreenPoint Checklist 2DD7 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
1qk' InCITY OF
Ckj'N0 Fax(408) 777-3333
IJrC ISI Building De artment
JOB ADDRESS: PERMIT #
067 ez*l4mso , Aye- 02-030ls' 0
OWNER'S NAME: v e N PHONE # 7230 — /p&
GENERAL CONTRACTOR: CR4
c� FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date