08020038 (2) CITY OF CUPERTINO �d ��,�! .yg+;q .�i( �y��7 �ll�,s�♦ "
BNtiDING DWlSION PERMIT COM l ACTl'. RI FO�kYlk1T
BUILINCA WESS: PERMIT NO.
TOSLU PINEVILLE AVE CUPERTINO PLUMBING 08020038
IWERNJ AME: PERMrf LSSUEDATE
OHN A. O'CONNOR 1300 DELL AVE STE C 02/06/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHREC IENOINEE'R: BUILDING PERMIT INFO
COPPER REPIPE BLDG elEcr PLUMB MECH
300 LICENSED CONTRACTOR S DECLARAT ON IOb Description
eZ I Micby arm dial I em bossed under provisioncom
s of Chapter 9( mencing
< with Section TOM)of Division 3ofde Burnam and Profeuioru Cade.md my licam is
in full forte a I arils
�aZ Ueenve Clue_
— Dam Canuamar a— F
ARCHfTECrS DECLARATION
1 understood my plans Nall o used u public mcards
'8t;
U
y sed 3 Licensed Proof caalanaI
^ OWNER-BUILDER DECLARATION
iI times,.,I,.that I em exempt fare de Comracmra License Lsw for the
cog following moon.(Sudan
703 1.5,Businces and Profeuiou Code:Any city or county
S$ which equina a Permit in construct,eller,improve,demolish,or repair my structure
prior to its hs"=.atm requires the applinnl far such permit to fileasigned artement
that k is licensed potential to de,Provisional of the Contarectur's Licase Law(Chapter 9 Sq.Ft.Floor Area Valuation
$ (commencing with Section 7000)of Division 3 of the Business and Professions Codc)or
— that he is emmpl therefrom and the basis for the alleged t ssmpdon.Any vlobUan of
Sudan 70315 by my eppnetm for a Permit mbjeots the 4Ppremt a e civil penalty of APN Number Occupancy Type
oat mart Nm fw hundred dolHrs($5001
❑1,u owner of the property,m my employees with wages u their min compensation,
will do the work and the structure H not intended or offered for sale(Sec.70x4.Dams
and ProfCaloN CadC:The Caaaacmra U.Law dm cot apply to m awn of Required Inspections
property who builds a improves duncon,and who dm such work himself o through his
awn employe.provided that such improvements am notinended araRemd for sale.If,
however.the building or improvement is mid within aro year of comple0on.the owner-
builder will hew W burden of proving deal he did no,Wild or impure for purpose of .
ute.l.
1,ea mar of the property,as esclwively contracting with licensed contractors m
construct the proket(Sec.7014,Business and Professions Code:)Ilan Communes U.
um Law dm sot apply to an Owner of property who Wilds or improves thereon.m l
who...acts formula projects with a con4tcar(s)licensed p rmant in she Cenlrartors
License Law.
❑I ore uempt under See ,B e P C f"is moon
Oner Dan
WORKER'S COMPENSATION DECL RATION
I hereby affirm umkr penalty of perjury as of tin following declandom: w
❑I ham and will main Wn a Certifiarte of Consent in self-boort for Warkers Compen-
nWon,u provided for by Sedan 3700 of the labor Code.fm the performaae of do
wort for which this permit is issued
❑I have and will maintain Workers Compensation Insumce,u required by Schon
3700 of the labor Code.for the performance of the mark for which this Permit is issued
My Workers Compensation Insuranar,l5.pmiv and Polk,numbs art:
Cartier. tv�.oC._ Policy No.
CER77Fl. ATE Op E%E.PITON FRO WORKER
COMPENSATION INSURANCE
r this mode anted at W completed If the Permit Is forum hundred doRas($100)
or less)
I certify Not in the performance of the work for which this perrd,is land.I shell not
employ eery pervert to my mmrcrve as to become mbjtet in IW Wi rtes'Compenwion
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,oiler making this Certificate of Exemption.you should
Indent subject to the Workers Compensation provisions of the Labor Cade,you muse
QO forthwith comply with such pmu visiaor this permit shall W deemed revoked.
,z.t^" CONsrRucnON LENDING AGENCY
.�., Iara affirm this dart is a connotation leading agency
F r g for the partamaaac of
C> da wort for wMan thin panni,In load(Sec.3041.sty.e)
f33 0 Lenders Name
=Z landeh Addrta
V Q I certify Na I have read this application and nun thal the move information Is
L. commk I agree to comply with all City and county ordinances and arts Iso minting to
.Q building convection,and hereby mthaim representatives alibis city to anteaters tit
W cove-mentioned property for inspection purpOmL
13. (-1 agree m aw,indemmfy and keep harmlm the City of Canada against
cAA limilidu.judgmento,com and capenw which may in anyway accrue agaiutaid City
V Z in consequence of the laeua of this perms. —
ti APPLICANT UtjDER WILL COMP WITH ALL NON-POINT Issued by: Date —�
$-QURG&RL'Cl1LAT10
�� G-o6
sigma Appli n ?- Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tin applicant or future Wilding ocumnatherear Mndle anomalous material
defined by the Cupertino Municipal Code par 9.13,ad due Hulth and Safety
Section us33.17 All roofs shall be inspected prior to any roofing material being installed. .
❑Yrs a
Will the applicam or future building Occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit handout air conuammu at defined by the Bay Area Air Quality Management all new materials for inspection.
District?
DYa Nu
1 hew and the huudas museriW requirements under Chmmr6.95Of that Califm-
ma Hui"Safaty Code.Seeticvts 35505.35533 and 25534.1 understand thaifda building
dots cot eormadyy a.a tenant.that bis my rmponsailky to notify dC a ctra m,of the
mqulmments which must W met pd.,to issuatec of a Certificate of Occupancy. Signature Of Applicant Date
Owner or mthorimd agent Date All roof coverings to be Class°B"or better
'11,
D�oaDo�
CITY OF CUPERTINO
C REPIPE/SEWER/MAIN SERVICE
CUPEIZTINO PERMIT APPLICATION FORM
APN# Date:
v8
Building Address:
- Zo 5.;?-(-) Pi Atm .
Owner's Name: Phone#: 2:T- _Oy 57
Contractor: Phone#:
(/ Fax #:
Contact: Phone#:
Fax #:
Contractor License#:
G:ay s`o5
Cupertino Business License#:
Job Description:
Residential Commercial ❑
Valuation: / )rU v�—
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
1BPREPIPE Commercial re-pipe per fixture P 1CPRP
1PGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
1BSEISMICR Seismic Residential P
1PRSEWER 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
1PRREPIPE Residential re-pipe per fixture P 1RPRP
IBPWSVCS Water Service P 1CPWS or
1RPWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
IPGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
/ 1 PPERMITFEE Plumbing Permit Fee Issuance P •
/ IPLMBLNCK Plumbing Plan Check P
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel & Documentation Fee B
r 1BUSLIC Business License B
IT F
• CITY CUPERTINO
0 CU 0
5 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot: .
APN . . . . . . . . : 36913030. 00
DATE ISSUED. . . . . . . : 02/06/2008
RECEIPT #. . . . . . . . . : BS000003872
REFERENCE ID # . . . : 08020038
SITE ADDRESS . . . . . : 10520 PINEVILLE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOHN A. O'CONNOR
ADDRESS . . . . . . . . . . : 10520 PINEVILLE AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4529
RECEIVED FROM . . . . : FRANK 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
---------- ------------- ---------- ---------= ---------- ---------- ----------
1BPWATER UNIT 1 . 00 40 .79 0. 00 40 .79 0. 00
1BSEISMICR VALUATION 4, 500. 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 8 . 00 81.60 0 . 00 81. 60 0. 00•
1TRAVDOC FLAT RATE 1. 00 40 .79 0 . 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 204 .47 0. 00 204 .47 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
301 ROUGH PLUMBING 502 FINAL PLUMBING ENERGY
507 FINAL PLUMBING
Singlo-Family GreenPoint Checklist date,_2--(�— 9) Build ItGvmd
The GreenPoint Checldist is based on the various green features Inprporatad into the home and is the Smart Solutions kom The Ground Up
basis for the GreenPoint Rated program.A home can be considered green 6lt fulfills the prerequisites,
cams at least 5D poins,and meets the donlmum points per category:Energy(30),Indoor Air Duality/
Health(5),Resources(6),and Water(9).Please contact Build It Green for a Had of qualified GreenPoint I _ FI
Raters It 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 atwww.builditoreen.oro. — n —ENTER PROJECT NAME p
U s �
A.s { PpiniS Available Per IAeasure
1.Protect I open and Minimise Disruption of Existing Planta A Trees
❑ a Protect Topsoil fmm Erosion and Reuse after Construction D } ]
❑ b.Limit and Degnoate Construction Footprint fix Maximum Promotion. p -
2.Deconstruct Immand of Demolishing Existing Buildings On Site 0 3
d.Recycle Job Site Conswetion Webb(Including Green Wane)
❑ e.Minimum 50%Waste Diversion by Waigid(Recycling or Reuse)-Requiretl 0 R
❑ d.Minimum 65%DWemion M Weigh(Recycling a Reuse) p —
❑ C.Minimum 80%Diversion by Weight(Recycling or Reuse) 0 - '--"'--`---- -2-- '--
_ _ 4.Use@ecyoed Content Aggregate(Minimum 25%)"
❑ a Walkway and Driveway 0
❑ b.Roadway Base _. _o_
Toto Points Available in Site 12 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyesh or Slag
❑ aMinimum 20%Flyaah a Slag 0
1
❑
to.Minimum 25%Firash or Slag -p -- --------" ] _—"
2.Use Fron-Protacted Shallow Foundation in Cold Areas(C.E.C.Climate Zone 15) 0 3
d.Use Radon Resistant Construction On At-Risk London&Only) 0 1
4.Design and Build Structural pest Controls
❑
H.Install Termite Shieltl5 A Separate All Exterior WoodiConcrete Connections by Metal or Plastic FeStanerslDWidere0
It.All New Plants Have Trunk _
Base,or Stem Located At Lent 36Inches from Foundation 0 1
Total Points Available In Foundation=8 0
C.LANDSCAPING Points Available Per IAeesure
• 1.Construct Resource-Effcient landscapes
❑ a No Imagine Species Listed by Cel-IPC Are Planted
❑ b.No Plant Species Will Require Hedging 0 ]
❑ G. of Plants Are Draught-tolerant Callhornia Natives,Mediterranean,or Other Appropriate Spades 0-
2.Use
2Use Rroi Landscaping Techniques 0 1
a.Minimise Tod Arms in Landscape Installed by Builder
❑ a.All Tud Nil Have a Water Requirement Less than or Equal to Tell Fescue(50.8 plant factor) 0 i 2 _
❑ b.Turf Shell No Be Insured on Slopes Exceeding 10%or In Arent Less than 6 Feet Wide p 2
❑ c.Tud Is S33%of Landscaped Area(total 2 points) -- 0 T--'i 2
❑ it.Tod Is 510%of Landscaped Area(taal4 points( 0 �—--- F--
E]
—❑ 4.Real Shade Tram
0 3
5,Grote Plants by Wetw Needs tlrmonin ) D i I 2
6,Install High-Efficiency irrigation Systeme
❑ a System Uses Only Low-How Drip,Bubblers,a Laivhow Spinders p _ Z
❑ b.System Has Smart Controlled; 0 (� ( _7 3
7.Incorporate Two Inches of Compost In no Top 6 to 12 Inches of Soil 0 I 3
9.Mutat All Plantln Dada to the Greater of 2Inches or Local Water Ordinance Re uirement 0 i 2
9,Use 50%Selvegad or Re tied-Content Materials for 50%of Non-Plant landscape Elements 0 1 i
❑ 10.Retluce Li ht Pollution by Shioding
down and/or Dbacting Light downward 0 1
Total Points Avalleble In Landscaping=31 0
D.STRUCTURAL FRAME R BUILDING ENVELOPS Poin S yMfable er Measure
1.Apply Optimal Value Engineering
❑ a Place Rafters and Suds at 24-Inch On Center Framing 0 ]
El b.Size Dow and Window Headed for Load — —'
❑ c.Use Only Jack antl Cripple Studs Required for Load 0 1
I Use Engineered Lumber
❑ a.Beams antl Headers 0
❑ b.Insulated Enginmmd Headers --— }--
❑
C.Wood Winds or Web Trusses for Floors
❑ _--__LJ. 1 __
J.Woad IJoisls to Rood Rafters 0
0
❑ e.Engineered or FhgervJoMtetl Studs to Verflcal Appllcetlons 0
❑
I.Ounad Smand Board fa Subfloor 0
Elg.Oriented Strand Board fix Wail and Roof Sheathing 0 �' 1
• a.Use FSGCaWood
[3T_
' e.Dimensional
l Lu Lumbar,BNtlS and Timber.Minimum 40% 0 i 2
❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% --
❑ c.Panel Products:Minimum 40% —
❑ J.Panel Produces:Minimum 70%
0 2007 Build It Green Single Family GreanPoint Cl isI 2007 Version Page 1 of 4
ENTER PROJECT NAME9
4.Use Solid Well Systems(Include,BIPa ICFs,6 Any NontSilek Fria Anembly)
❑ a Floors 0 2 _ 2
❑ b.Walt D 2
❑ C.RDA
__p_ 2 2
S.Reduce Pollution Entering the Home from the Damage
❑ e.Tightly Seel the Alt Berner between Garage and LMng Area D -, 1
❑ It.Itself Garen Exhaust Fen OR Build a Detached Garage D 1
6.Desi n En Heala on Truese,(76%of Aftic Insulation Height a Outside Edge of Exterior WWI 0 1
7.Dell n Rool Tnue,to Aecommotlala Duework 0 1
IL Use Re Died-CD te Stell SWM for 90%of Interior Wall F=Ing 0 1
9.Thermal Mew Wells:W-Inch Drywall on All Interior Walls or Wella Weighing mon than 4D WOOL 0 1
10.Install Overhangs and Gutman
❑ a.Minimum l6-Inch Overhangs and Guhere 0 ]
❑ b.Minimum 24-Inch Overhangs and Goners D 1
Trial Points Avellable In Structural Building Frame and Envelops 30 D
E.EXTERIOR FINISH Points Available Per Measure
1.Use R sled-Contest Mo Virgin Plnu or FSC-CONDed Wood DeckingD 2
2lwtell a Ln sonars Wall"M 0 2
3.Use Durable and Noncombustible Sidtn 11 D 1
/.Select Durable and Noncombustible RD MeteMla 0 1 2
Total Prime Available In Exterior Finish.7 0
F.INSTILATION Points Available Per Measure
1.Install Insulation with 75%Recycled Content
❑ a Wells antics Floors 0
El b.Collings .� _ 1
2.Install Insulation thst is Low.Emitting(Cenlfled SectiDn D1350)
❑ a Walls andtor Flocs _ 0
❑
In.Collins o 1
❑ 3.Inspect Ouallly of lnsulatlon lnsiellaron before Applying Drywall 0 1
Total Point Available In Insulation 5, 0
O.PLITIM331 G Points Available Pat Measure
1.Distribute DomnOc Hot Water Efficiently(Maximum 7 Points),
❑ a Insulate Hot Water P'pesfrom Water Heater to Kitchen D 1 r 1
❑ b.insulate All Hot Water Pipes
❑ c.Use Englneand Pamllel Piping
❑ d Use Engineered Parallel Piping with Demand Controlled Chcula0on Loop D 7
❑ a.Use Structured Plumbing with Demand Controlled Circulation Loop
❑ 1.Use Gemrel Core Floating 0 ] 1 2
❑ 2.Install Only High EfficienToilets Dual-Flush or 51.28 0 4
Total Per=Avallab'e In Pluftin .Told 12 0
H.HEATING VENTILATION Sc AIR CONDITIONING Points Avallable Per Meal
ET i.Deaign and Install HVAC System to ACOA Manual J.D,and S Recommod;tDns 0 4 1
2.Install Sealed Combustion Units
❑ a Furnaces 0
❑
D.Water Healers 0 2
3.Intal Zoned,Hydronic Radiant Heating with Slab Edge Insulation 0 1 1
4,Install Hlgh Efficiency Air Conditioning with Environmentally Responsible Refrigerant 0 1
S.Design and Install Effective Ductwork
❑ a.Imted HVAC Unit and Duclwwk within Conditioned Space 0 3
❑ b.Use Dud Masni:on All Duct JuIn4 and Seams _0
❑ c.leaned Ductwork under Attic Insulation(Bustled Duct) 0
❑ d.Pressure Balance the Ductwork System 0 _ _ I _
❑ a.Protect Duct during Construction and Clean Ad Duct;before Occupancy 0 1
6.Install HTgh Efficiency HVAC Filter(MERV 6.) 0 1
❑ 7.Dont Install Firepleu or Install Sealed Gas Fireplaces with Efficiency Rating Not Las Than 60% D 1
using CS1f Stenderds
B.Install Egec9w Exhaust Systems In Bethrooms and Oceans
❑ a lnstdl ENERGY STAR Bathroom Fes Vested m the Outside D
❑ b.pllpethroo Fane Are on Timer or Humidistet D
❑ c.Intel Klthen Range Hootl Vemad ID Ne Outside D 1
9.Install Mechenicel Ventlletion System for Cooling(Mulmum 4 Points)
❑ a.Install ENERGY STAR Calling Fane 6 Light Klt In Wing Ano 6 Bedrooms _ D
❑ b.Install Whole House Fan with Variable Speeds D 1 y
❑ c.Automatically Controlled Integrated System _ 0 2
❑
J.Aulomellcally Controlled Integrated System with Variable Speed Control D 3
10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House Ventlletion System That Meet ASHRAE 622 D_ 2
❑
D.Intact Alr-16AIr Heat Exchanger that meat ASHRAE 522 0 I 2
LJ 11.Install Carbon Monoxide Alarms D 1
TAW Point Available In Heatln,Vernflation and Ale Contlitionin .30 D
02007 Bu lid It Green Single Family GreDnPolm Checklist 2DO7 Verelon Page 2 of 4
'ENTER PROJECT Is ® s
i s Is
E w 3
U
• I.REIPEWABLE ENEBGT Points, iilablE Par Mansura
1.Pre-Plumb for SolarHM Water Heeling 0 4
2losing Solar Water Heetin System 0 10
J.Install Whiny Condon for Fus re Phand"I'td is Installation 8 Provide 200 fe of Sourth-Facing AD01 0 2
4.Install Photovoll(PV)Panels
❑ a 3D%of electric needs OR 12 kW(total 6 points) 0 6
❑ b.60%of electric needs OR 2.4kW(toll 12 point) 0 _ _ 6
❑ C.90%d ala t hood OR 3.61*(Mal lB pant) 0 6
Total Available Pant In Renewable Energy=23 0
J.BUILDING PERFORMANCE Points Available Par Measure
1.Diagnostic Evaluations
❑ a.House Posses Blower Door Test 0 g
❑ b.House Passes Combus0on Bel Backdreft Test p- --_ _ - --�'-
I2,Design and Build High Performance Homes-%above This 24-minimum 15%Required D >_30
❑ J.House Obtains ENERGY STAR with Indoor Air Packmge Certification-Poor Miami(7oml 45 point;reed comment) 0 5 2
Total Amiable Point In Building Performance=39 0
R.FINIGFSEB Points Available Pel Measure
_ �1`Dmipn Fs ito Retluca Tracked in Contarnirmnra"- — -- - - - 0 - -- - ]
0 Use Lona-VOC or Zmo-VOC Paint(Maximum 3 Point)
❑ a.Low-VOC Intedw wonelling Paint(d0 gpI VOCs(Flat)and<150 gp!VOCs(Non-Flat)) 0 T
❑ b.Zwo-VOC:Interim WaIVC6IIin Paints(d ppl VOCs(Flat) 0 3
❑ J.Use ow.Low VO2,Water-Based Wood Finishes 2'0 gpI VOCs) 0 2
❑ 4.Use LVOC Caulk and Construttion Achieves(<70 gpI VOCs)for All Adhelves 0 2
❑ 5.Use Rerycled-Content Paint 0 1
S.Use Environmentally Preferable Materials for Interior Finish:A)FSC-CeNfied Wood,B)Reeleimed,C)Rapidly Renewable,D)Revf cledLamount
or E)Finger-Jolntetl
❑ nCabinet(50%Minimum) 0 ]
El b.Interior Trim(50%Minimum) -__.O -- -'-- "'--- "-
❑ c.Showing(50%Minimum) �-- -- - -"-' -' _
El Doors(50%Minimum) _ 0
❑ e.CountMps(So%Minimum) -'---
0
• 7.a. use For&Spur Treads
Finish(CA Section 0l JSD) -- - - }
❑ e.Sub0oor65talr Treads(50%Minimum) i
❑ b.Cabinets a.Cour anrys(5D%Minimum) 0 I
❑ C.immix Trim(50%Minimum) -0-
El
—❑ d.5holOn (50%Minimum) 0
1
❑ 6.After Installation of Finishes,Test of Indoor Air Showa Formaldehyde Leval d,7 tab 0 I 3
Total Avallable Palms In Finishes=21 0
L.FLOORING Pants Aveflable Per Measure
1.Use EnwronmenMly Preferable Flooring:A)FSC-Certified Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Content,E)
Exposed Cmdreta Flooring Adhesives Must Ham<50l VOCs.
❑ a.Minimum 15%a Floor Arae 0
❑ b.Minimum 3D%of Floor Area ----'-
❑ c.Minimum 50%of Floor Area 0
❑ d.Minimum 75%a Floor Area 0 1
❑ 2 Thermal Mass Floors:Floor Covering Other than Carpet on 50%or Moro of Concrete Floors 0 I 1
❑ 3.Flooring Meat Section D1350 or CRI Green Label Plus Requirements(50%Minimum) 0 ) 2
Total Available Points in Fluorin =7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure'
1.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total 1 pang 0
❑ b.Dishwasher Uses No More Nen 6.5 Gellan de(total2 point) p ---""-- I
2.install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Len
❑ a.Meet Energy Star and CEE Tier 2 requirement(modified energy fact.20,Wear Factor 6.0)(Iota!3 poli 0 __ j I 2
❑ b.Meet Energy Star and CEE Tier 3 requirement(modified energy factor 22,Water Factor 4.5 or less) —7---"2 "
totals Runi 0
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Oualified 5<25 Cubic Feet Capacity 0 1
❑ b.ENERGY STAR Qualified&<20 Cubic Feet Capacity p ---- 1 --"'
4,Install Built-In Recycling Center 0
❑ a.Built-In Recycling Center D 7 !
❑ h.Bullt-In Gempasting Center '--
0 1
Total Available Pant in Appliances and l i On =12 0
N.OTHER Points Available Per Measure
❑ 1,Incorporate GreenPoint Rated Checklist in Blueprints-Required 0 R
• ❑ 2.Deveii Homeowner Manual of Green Festures/Banefit 0 1 1 1
3.Community Design Measure 6 Local Pdontie:See the Communhy Planning 6 Design auction In Chapter 4 M the New Homo Guidelines for
measums.Maximum of 20 point for suggested measures.Local requirements may also be listed here.
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 3 of 4
ENTER PROJECT
U
Li
EMB,0awriplicn here,and onto,prints avelledt fa moment In a0proprieb ceteyorim to the right. 0 0 0 0 D 0
Enter description here,And onto,point available ler nlaeout In appropriate cotgorlet to the Olin. D 0 0 0 0 D•
Einer dewr¢Glon hen,and order points wanable la maeaut In ep"Ifilla cmpaml to tho,ight. D D 0 0 0
Ensu t etcrpl,al hen,and eta prints wallae fa mucun In eppropriste caepodu to the right. D 0 0 0 0 0
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Build it Green Checklists and
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right Guidelines _
Li Innovation In Cmmunl .Enter un hen,and ante b evaOede la meezun m ® 'et to the i D D D D 0 D
Innovation in E :Enter tl on hem,and enlu ts availaW fa mntut In BIB ane es to the 0 0 0 0 0 0
Innovation in 0OMwIth:Enter den tion here,and enter Ins wallehle la meaem in ate Cala let to the right, D 0 0 0 0 0
Innovation In Nnounam:Einar de ion here,and enter b makable ter measm In 'm pate 'de to the d a 0 0 0 0 D
Iu minin In Water,Enter deaopam here,and enter points avaluble for moetm b ape, ubpait ro iM dplM1. 0 0 D 0 0 0
Total A"11018 Poins in Other 43 0
Total Avallable Points In Specific Categories' + 96+ 42+ 17+77,
6+ 43+
Minimum Pointe Re ulred in Specific Categories 0 3D 6 6 9
Total Points Achieved 01 t t t t e
Project h@s not yet met the foiiowtog recommended minimum
-Total Project Score of At Least 50 Points
-Required measures:
-A32: 50% waste diversion by weight
-J2: 15%above Title 24
-N1:Incorporate GreenPoint Rated Checlaist Into blueprints
-Minimum points In specific categories:
-Energy(30 points)
-IAQIHealth (5 points)
-Resources(6 points)
-14rater(9 points)
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02D07 Bulk!It Green Single Famlly GreenPoint Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
� CITY OF Fax(408)777-3333
UPEI�TINO
Building Department
JOB ADDRESS- PERMIT #
05aGtncvllle_ 0gOZego D � -
OWNER'S NAME: /in U' Con.io r PHONE # 2$3 - U4 5 7
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: G—�/�/ �� z - 6- U`j
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
_ .. •�-I scaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
• Tile
Owner/Contractor Signature Date