08020041 (2) CITY OF CUPERTINO
BUILDING DIVISION PEPNHr COA_ITRACTOR1ATQ1V
BUI IN4ADORE95: PERMIT NO.
�0�313 TONITA WAY WATER HEATERS ONLY 08020041
ER'S NAME: PERMIT ISSUE DATE
AORUNKUNAR, BALLARAN 970 E MAIN ST 02/07/2008
PHONE: SANITARY NO. - CONTROL NO.
ARCHMECrfENGINEER: BUILDING PERMIT INFO
REPLC 40 GAL GAS WTR HTR BLDG ELECT
PLUMB MECH O
3a ij LICENSED CONTRACTOR'S DECLARATION Job Description
rd FFhereby affirm Nn 1 am licensed muter provisions of Chapter 9(commencing P
Alwith Secdon 7W0)ofDivblon 3 of the Business and Professions Code,uW my license is
neo khan roma and arc _ ( 7
?n? Lt.. Ue.N
0 Conuxmr
ARCHIECI'S DECLAIIATION
I understand my plans"I W hand as public records
56
{std Licensed Professional
y OWNER-caumpt RDtho Contractors
E I heresy.(Sue Nm I pm,umpt from roc Canvato/s Lkenxi Law for the
p o roll.wwhich re mason.Permit
1 IIammm Business and sue. a moll Code:Any city or county
which m9vus Issuance.aim m coma the plus improve,demolish.t m Nash any structuhatemcm
iy
prior miu ensedtlromgolthe the o far such permit Ueeeslanedwumcm
�<
that be is licensed pScene-7000) Division
of Ne Canuacmrl LumrseLaw
ons Code)or Sq.FI.Floor Area Valuation
(corre9 'atM incingwithhcmf land onbasisan,of theegBusiness
arempdon.Myovi Code)of
Nn ho u aemDt M'•frmn and Ne bait for tin aIIryW eacmption My WOlauon a(
Section 703"by arty applicant For a permit subjeca the applicant to a civil penally of APN Number Occupancy Type
Inst come Nut It.hundred dallam(3300.).
❑1,u owner of the pmpeny,army employees with wage u ock mkcompensatian,
will do thework,and the suucmre is notintended or offered for We(Sec.IDN,Business Required Inspections
and Professions Code:TW Communities License Law dao ret apply m an armor of Q ns p
property who build,orimpmvu the con,andwho doessuch workhimselfor through his
ownemployem,provided Nu such improvements tie not intended maimed fmsale.If.
however,the Wilding m Improvement 4 said within on you of completion,the mamr-
W ilder wlil bave the Wrdrn of proving Nat ho did ham build or improve for purpose of
nle.l.
0 I,as owmvr W tis property am exclusively contracting with licensed conuurton on
canswct the project(Sen.7014,Business and Profcsdons Cod^:)The Conwenr's U,
cc=law docs not apply on an owner of property who Wilds or improves demon,and, .
who canes for such projects with a mnhmkr(s)licensed pursuant to the COmfoo Cat's
Lkeusa Law.
❑lamaemptundm Set ,B&PCforthismuon
40 m Dau
W ORKERI COMPENSATION DECLARATION
1 hereby aRHm under penalty of perjury,arc of the following daivaumrc -
❑I haw and will maintain a Cmtifmakof Consent to self-Insure farWOrkera Compere
radon,as provided for by$Cedar,37M of the IJbm Cade,Ire the performNC of the
work for which this permit is Issued.
nave and will maintain Came,
performance
Compensation Insurance,h required by Schon
370.0ofthe cesco Code,far theperfomranm of the work for which this pctmirs issued. '
My Workeh Com ewuop huu� canis.end Polley number art:
Cartier,�V�/��PoIIN No.: �O,ER ' l��S
IFlCAOEOE COMPENSATION
EXEMPTION MOM WORKERS'
COMPENSATION INSURANCE
Illus satire hand rust ho cmnpleud lithe permit lsforen a hundred damsefica)
or less.)
1 comfy that in the performance of the worlr fm which this Permit s issued,I shall not
employ any person in my manner an is ut Woman subject to the Workers'Compensation "
Laws of California.Dau '
Applient
NOTICE TO APPUCAN..If,after making this Cenificak of Exemption.you should
become subject k tha Woh z Comp ssmion provisions of the labor Code,you man
.J O forthwith comply with inch provisions m Nu Ronit 0,11 W dmmcd revoked.
y CONSTRUCTION LENDING AGENCY
I--r 1 hereby aRnn that them isa construction lending agenry,for tic performance of
C the work for which this Permit Is issued(Sec.3M,Civ.C.)
WM A Lendcfs Nauru
Z Lessees Address
U 0 1 comfy that 1 have road Wa application and suss that the W.information la
{iv cortin 1 agree to comply with all city and county ordlmrcns and Nu laws nelating in
.0 Wilding construction,and hereby suNodrz representative of this city to enter upon roc
{il show-meadoed pmmny for inspection purposes.
gy
(WO)agree to save,indemnify and trap harmless tic City of Cupertino against
r.r y Iiabilide,judgments,cosy and incomes which may In my way amus against mid City
U',z in consequenm Of the limndng of Nis Permit.
APPL CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dated-
SOU Z# EGULATIONS. `�
/�riiA.. ( J !/
a 7- t7
Signuurcof ApplicanVCm r d qts Re-roofs
HAZARDOUS MA AIS OSURE Type of Roof
Will Ne a Cumo t m future Wilting emupant 349.1 m handle Mazda
Safety
deRhad by tic Cupertino Municipal Cade.Chapter 9.11 and the Huslth and Safety
pYa 255324)7 All roofs shall be inspected prior to any roofing material being installed.
Will the nppImml Of future Wilding Occupant van equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hmakous air cmuminma as dc0ned by the Bay Area Air Quality Management all new materials for inspection.
District?
C]Yen
I have,mad the hvardos mandate requirements under Chapter 6.95 of the Califon
nu Heal"Safety Cade,Socias 2550.5.25533 and 25534.1 oMcnund that ifthe Wilding
Jura of curmmly hew a unary out It s mY mponsinililY u mtifY tie aeupanl of Ne 1 }� X-YNN�/J
ma which aarmancn etearaehpnry. Signature Of Applicant Date
L All roof coverings to be Class"B"or better
Owner or awhorse agenl Dau'
OPCS boy
CITY OF CUPERTINO
WATER HEATER
CITA
ON
�CUPERTINO PERMIT APPLICATION FORM
APN # 35-91409 , Dater
Building Address:
/03/ 3 / v✓li t4' �ay
Owner's Name: Phone#:
Artly) r a y09- 873— O9SCo
Contractor: / Phone#: J—(23-27Y-300/
Fax#: 530 2 -7Y- 30GS
Cupertino Business License#: Contractor State License #:
Contact: Phone#:
Fax#:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb Mech ❑
Job Description: /
l \ 19c � (/0 C94�
Residential Commercial ❑
Strapped )I On Platform BondedX New Location ❑ Replacement
Valuation: ;�D
Green Building Check must be completed and attached to this application.
Green Building Points achieved:
Qty, if
Applicable Fee ID Fee Description Fee Group Permit Type
PCWHEATR Commercial Water B PCWHEATR
HeaterNent
BSEISMICOM Seismic Commercial B
PRWHEATR Residential Water B PRWHEATR
HeaterNent
BSEISMICRE Seismic Residential B
PPERMITFEE . Plumbing Permit P
TRAVDOC Travel & Documentation B
BUSLIC Business License B
• CITY OF CUPERTINO
4 ITEMS OF 6 .PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35914001 . 00
DATE ISSUED. . . . . . . : 02/07/2008
RECEIPT # . . . . . . . . . : BS000003877
REFERENCE ID # . . . : 08020041
SITE ADDRESS . . . . . : 10313 TONITA WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : AORUNKUNAR, BALLARAN
ADDRESS . . . . . . . . . . : 10313 TONITA WY
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2931
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : MCGEE, PAT LIC # 18986
COMPANY . . . . . . . . . . : WATER HEATERS ONLY
ADDRESS . . . . . . . . . . : 970 E MAIN ST
CITY/STATE/ZIP . . . : GRASS VALLEY, CA 95945
• TELEPHONE . . . . . . . . : (800) 835-5946
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 950. 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
----------------- --------------- --------------------
CREDIT CARD 474 . 06 VISA
---------------
TOTAL RECEIPT 474 . 06
VOICE ID DESCRIPTION - VOICE ID DESCRIPTION
-------- ---------------------------- ----=---- ----------------------------
518 WATER HEATER
•
Single Family GreenPoint Checklist data: a— 7- )JJ li' Build It Greeri
The GreenPoint Checklist is based on the various green features incorporated into the home and is the Smart Sollabbr6 hum 7h°um:d Up
basis for the GreenPoint Rated program.A home can be considered green R k tuft the prerequisites,
Wat least 50 points,and meets the minimum points per category:Energy(30),Indoor Air Quality/ I
ems alth(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint
Raters gym are Interested in pursuing third-party verification.
The green building irmcbces listed below are described in the New Home Construction Green Building 1 _f
Guidelines,avail able atwww.build'doreen.om. '- - - -
MV,111AIaelfiltil,
ENTER • • E
A.SI'CE : /3 1 +: ure
1.Protect Topsoil and Minimize Disruption of Existing Planta&Trees
❑ a Protect TopscO from Erosion and Reuse after Construction 0 _ 1
❑ b.Uma and Dolmans Construction Footprint for Maalmum Prosstion 0
2 Deconstruct Instead of Demolishing Existing Buildings On Site0 3 11
3.Recycle Job Site Construction Waste(Including Green Waste)
❑ a Minimum 50%Waste Diversion by Weight(Racyr9ng or Rem)-Required R 1
❑ b.Minimum 65%Diversion by Weight(Recycling or Reuse) 0 2
❑ a Minimum 80%Diversion by Weight(Recycling or Rause) -0- - -
4.Use Recycled Cement Aggregate(Minimum 25%)
❑ a.Walkway and Odveway 0 I 1
❑ b.Roadway Base 0
Total Points Available N Site=1 0
B.FOUNDATION - Points Available Per Measure
1.Replace Portland Cement in Concrete wlth Recycled Finish orSlag
❑ a.Minimum 2D%Flyash or Slag MAvaftla
i❑ b.Minimum 25%Fyash or Slag11 r"--
2 UseFrost-Protectad Shallow Foundation In Cold Areas IC.EC.Climate Zone 1A 33.Use Radon Resistant Construction n AbRlek Locations Onl 4.Design and Build SWctural Past Controls
a.Install Tannker Shields a Separate All F_xterior Wood-to-Concrete Connections by Metal or Plastic FastenervDNiders 1b.All New Plants Have Trunk,Baseor Stem Located At Least 36 Inches from Foundation1+LANDSCAPING Total Points Avallable m Foundation= asure -
1.Construct Resource-Ef dent Landscapes
Cla.No Invasive Species Listed by Cal-IPC Are Planted 0 I
❑ b.No Rants __ 1
Species Will Require Hedging _ U.
Lj
El c 75%of Rants Am Omught-tdemm California Nerves, na
ives,Medttanean,or Other Appropriate Spades 0 -`r 3
2 Use Flre-Safe Landscaping Techniques 0 1 j
3.Minimize Turf Areae In Landscape Installed by Builder
❑ e.AO Turf Will Have a Water Requirement Less than or Equal to Tail Fescue(9.3 plant fai p
❑ b.Tud Shall Not Be Installed on Slopes Exceeding 10%orin Areas Less than B Feet Wide p
❑ c Turf¢93%o/Landscaped Area(total 2 points) 0 _ -
Z-
❑ d.Turf is A 0%of Landscaped Area(total4 points) -g - " _i'r--T_=.��- i Z
Lj /.Plant Shade Tress
0 ll 3
S.Group Plants by Water Needs(Hydroxoning) 0 - 2
S.Instill High-Efficiency Irrigation Systems .
❑ a System Uses Only Low-Flaw Drip,Bubblers,or iax-flow Sprinklers 0 1 __ I 2_
❑ b.System Has Smart Conboliers 0- -- - ..I- --_I i 3 ..
L Incorpon4te Two Inches of Compost In the Top 5 to 12 Inches of Sell 0 3
Lj B.Mulch All Planting Beds to the Greater of 2Inches or Local Water Ordinance Requirement 0 2
9.Use 50%Selvaged or Recycled-Contant Materials for 50%at Non-Plant Landscape Element
Lj 10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0
Total Points Available In Landsceping-31 0
D.STRUCTURAL FRAME&BUILDING ENVELOPE ' Poi T1vallabl Per Measure
1.Apply Optimal Value EngineeringrM
❑ a.Place Rapers and Saads at 24-Inch On Canter Framing _ 0_ _-
❑ b.Size Door and Window Headers for Load
❑ c Use Only Jack and Cripple Studs Required for Load 1 '"-
2.Use Engineered Lumber
❑ a Boams and Headers
0 _
❑ h.Insulated Engineered Headers � � ""'
❑ c Wood Wolsts or Web"Noes far Floors 0 1 1
0
❑ d.Wood Wichita for Roof Rafters ._g -
❑ e.Engineered or Finger-Jointed Studs for Vertical Applications
❑ 1.Oriented Strand Board for Subfloor 0 1
❑ g.Oriented Strand Board for Well and Roof Sheathing__ 0 1
3.Use FSC-Certified Wood
❑ a.Dimenslonal Lumber,Studs and Timber.Wnhum 40% 0 2
❑ b.Omensional Lumber,Sands and Tartar.Minimum 7D% p - - -
❑ a Parwl Products:Minimum 40% - 0- - 1
❑ d.Panel Pmducts:Minanum 70% .. ... _.. . .-
0 2007 Build It Green Single Family GreenPoint Checklist 2007 Version Pace 1 of 4
ENTER PROJECT
'
Munfl.Ti
1.Use Solid Wall Systams Qndutlos SIPS,ICFs,B Airy Nonstick Frame Assembty)
❑
8.FIOo0 2 2 n _..
...0
❑ b.welts _ .. ..
❑ z
c.Roots 0 2
5.Reduce Pollution Entering the Home from the Garage
❑ a.Tlghuy Seal Na As Banner between Garage and Living Area _ 0
❑
It.Instill Garage Exhaust Fen OR BuIM a Detached Garage 0 1 _I
B.Deal n Eno Heels on Trusses(75%of AWc Insulation Height at Outside Edge of Exterior Well) 0 1 .i
T.Design Roof Trusses to Accommodate Ductwork 0 1 i
B.Uu
RacyclaclZoment Steel Studs for 90%of Interior Wall Framing 0 1 t
9.Thermal Most Wells:5194nch Drywall on All Interior Walls or Wella Weighing mon than w Ihlcu.R 0 1
10.Install Overhangs and tauten
❑ a.Minimum 16-Inch Overhangs and tauten 0
❑
It.Mtn mum 21-Inch Overhanga and Gutters
Total Points Avallahle in Sbuctural Bulxog Frame and Envelope=38 0
E.EXTERIOR FINISH - - Points Available Par Measure
1.Use Recycled-Content o Virgin Plastic)or FSC-CaAfled Wood Decking 0 1 2
2lnatall s Rain Screen Well System 0 i 2 1
3.Use Dunhlo and Noncombustible going Mstedals 0
1.Select Wnhle inti Nancomhwtlble Roafln Materials 0 i i 2 i
Total Points Available M Exaubr Finish 0
F.INSULATION "" Points Available Per Measure
1.Install Insulation with 75%Recycled Content
Swain and/or Floors
b.Camra s
L Install Inaulabon Natls low-Emlttlng(Certified Section 01350)
❑ e Walls lu lm Floors
❑ h.Cemn a
3.Ins actO all of lnsuladon Installation baton Applying Dall 0 1
Total Points Available NInsulation=5 0
G:PLUMBING - - Polnts Available Per Measure .
1.Distribute Domestic Hot Water Efficiently(Msxmum 7 Pairs)
❑ p.Insultersir uters Hol WePipes fiom Wafer Heeler to _ 0 _
❑ b.Insulate Al Hot Water Pipes
❑ c Use Engineered Parallel Piping
❑ d.Use Engineered Parallel PlpN with Demand Controlled Circula0on Loop
❑ e.Use Structured Plumbing wIN Demand Controlled Gtwration loop _ ___1--_
❑
I.Use Cantral Care Plumbing 0 ? 1_T 1 ! 2
L Install Dnl HI h Efficiency Tallon Pual-Flush or Sig 0 I 4
Total Points Available In Plumbing=Total 12 0
H.}IEATING VENTILATION&AIR CONDITIONING " Points AvaNable Per Measure
1.Onign and Install HVAC System to ACCA Manual J,D,end S Recommendations 0 4
L Install Sealed Combustlon Unita
❑ a,Fumacea _0. _. � 2 l
❑ b.Water Hastert -0 — 2
3.Install2anad,Hydropic Radiant Heading with Slah Edge Insulation 0 ! 1 I 1
Lj 1.recall High Ef0clncy our Cortlltlamne with Environmentally Responsible Refrigerants 0 1 I
5.Design and Install ESecd"Ductwork
❑ a.Install HVAC Unit and Ductwork within Conditioned Specs 0 i 3 I I
❑ It.Use Duct Mastic on All Duct Joints and Seams 0 1
❑ c.Install Ducriork undarAtgc Insulation(Boded Oucts)
❑ d.Pressure Balance the Overwork system 0 1
❑ e.Pretsq Dur during Construction and Clean All Ducts before Occupancy
5.Inxall High Efficiency HVAC FlIter(MERV N)
❑ 7.Don't Install Fireplace or Install Sexed Gas Fireplaces with Efflcincy Rating Not Len Than 60% 0 1
using CSA Standards
B.Install Eentive Exhaust Systems In Sa hmarm;and IOtahens
❑ a.Install ENERGY STAR Bathroom Fane Ventsd b the Outside 0
❑ b.All Bathroom Fns Am an Ther or HumMtstal -
❑ c.Insist mchan Range Head Vented to the Outside 0 ( -1
9.Inetell Mechanical Vendiallon System for Cooling(Maximum/Palm)
❑ a.Install ENERGY STAR Calling Fens B Light Klts In LMng Areas a Bedroom$ 0 1 _
❑ b.Install Whole Hour Fan with Variable Spends 9 1
❑ c.AUlomadl COnroOed Integrated System 0 2 ; .. . ..
C3 d.Automagrah Corralled Integrated System with Variable Speed Control -.0 3
10.Install Mechanical Fresh AlrVentication System(Mnlmum 3 Palms)
❑ a.Any Whole House Ventilation System That Meets ASHRAE 1122 0 Z .
❑
It.Instal Air-"Ir Heat Exchanger that meee ASHRAE 62.2 0 1 2
11.Install Grboo Monmlds Alerm(s) 0 1
Total Points Available in Heeffig,Vent hdo anti At CondllbnIng 30 0
...�...,.. ,...____ cinnt•F=mtN r. .nPnint rhrrkact 7nn7 V=reinn 0—1 M A
LF $rte
PROJECTENTER ' ME
6 < 9 W C7 s
U Q 6
,def
RENEWABLE ENERGY Points Available Per Measure
1.Pre-Plumb for Solar Hot Water Heading p 4
21nsta11 Solar Water Meeting System 0 : 10
LJ 3.Install Wring Conduit for Future Photovoltaic Installation d Provide 200 K of South-Facing Roof p 2
4.Install Photovoltaic(PV)Panels
❑ e.30%of electric needs OR 1.2 kW(btal6 points) 0 6
❑ lb.60%ofelectric needs OR 24kW(total 12 points) —p
C] c90%of electric need OR 3.6 kW(tatal lB points) --_O 6_ .. . ._
Total Available Poims In Renevrdble Energy=26 0
J.BUILDING PERFORMANCE Points Available Per Measure
1.Diagnostic Evaluations
❑ a.House Passes Blower Door Test 0 1
El It.House Paces Combustion Safety Backdralt Test .—O_ _ ._ _ ..._._..1,:
2 Daslgn and Build High Pedormance Homes•%above Titre 24-minimum 15%Required 0 210 1 i
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification•Pliat Unsure(Total 45 points;mad comment) 0 5 2
I
Total Available Points in Building Performance=39 0
K FINISHES Points Available Per Measure
Lj 1.Design Entryway,to Reduce Tracked In Contaminants 0
1
2 Use Low•VOC or 2nro-VOC Paint(Maximum]points)
❑ a LorVOC Intoner WaI0Ce0,g Paints(G50 gpl VOCs(Ftet)and<150 go VOCs(Non-Fiat)) - 0 3
❑ It.7sio-VOC:Interior WeIOCel0rtg Paints(c5 BPI VOCs(Flat)) p
El 7.Use Low VOC,Water-Basad Wood Finishes(<250 gpl VOCs) p 2
EJ 4.Use Low•VOC Caulk and Construction Adhesives <70 gpl VOCs)for All Adhesives D2
S.Use Recycled-Content Paint 0 1
S.Use Envlmnmentally Preferable Materials for Interior Finish:A)FSC-Cerdfled Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled.
Content or E)Flngar-JoinNtl
❑ a.Consent(50%Mmenum) 0 0
❑ It.IntedorTdm(50%Minimum)
❑ c Snelling(50%Minimum) �' • '
❑ d.Doors(50%Minimum)
I
❑ e.Counedops(5 %m
p
__.....^_... ._._., ..1... ... ._
T.Reduce Formaldehyde In Interior Finish(CA Section 01350)
❑ a.Subbor It StairTmais(50%Minimum) 0 1
' ❑ h.Gannets 6 Couneriops(517%Minimum) D I 1
❑ c Interior Trial(511%Minimum) 1—t-""�----
.._F._._.._.__(._ ....
❑ d.Shelving(50%MlnMum) 0 I 1 ---
6.Agar Installation of Finlshea,Test of Indoor Alr Shows Formaldehyde Leval c27pp1b 0 3
Total Available Points in Finishes=21 0
C.FLOORING Points Available Per Measure':
1.Use Environmentally Preferable Flooring:A)FSC-Certified Wood,BI Reclaimed or Refinished, C)Rapidly Renewable,D)Recycled-Contont,
E)Exposed Concrete.Flooring Adheshnes Must Nave Gyp got VOCs.
a.Mhurnum 15%of Floor Area 0 1 ;
It.Minimum 30%of FeorArea _. --—_._ ----.._
El Minimum SD%of Floor Area --0--
0 _._ .__.. .._.__ .._i.. 1 ... ..
❑ d.Minimum 75%of Floor Area _.0_.
2 Thermal Mass Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floors 0 1 I
3.Flooring Meats Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 2
Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Avalable Per Measure
1.Install Water and Energy Efficient Dishwasher
Cl a ENERGY STAR(Intel 1 pon0 0 1
It.Dishwasher Uses No More than 6.5 GaOoimrCyde(total 2 points) O
L Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier 2 requirements(Modified energy factor 20.Water Factor 6.0)(total3 penal) 0 , . . 7 _.. _ ! 2
❑ b.Meets Energy Star and GEE Tier 3 requirements)modifled energy factor 22,Water Factor 4.5 oress) 2'-
(se15
3.Install ENERGY STAR Refrigerator
❑ a ENERGY STAR Qualified d<25 Cube Feet Capacity 0 1
It.ENERGY STAR Qualified It 20 Cubic Feel Capacity p 3
4.Install Bunt-In Recycling Center
a.Built-In Recycling Center _---- 0 2_
b.Buldin Composting Center 0 3
Total Available Points i;APPRan= LJghting=1 0N.'OTHER _ Points Available Per Measure1.Incorporate GreenPaint Ratl ChecMlct In Bluepdnb-Required _ _ 0 - R
Lj L Develop Homeowner Manual of Green FeetureeyBenefits 0 1 1 1
1 Community Design Measures It Local Priorities:See the Commmity Planning 8 Design section in Chapter 4 0l the New Home Guidermes for
measures.Maximum of 20 Points for suggested measums.Local requirements may also be aced hare.
02007 Build It Green Singie Family GreartPDlnt Checklist 2007 Version Pane 3 of 4
e
ENTER PROJECT NAME a i
6 � � W ,
5 z
!..t;"- =daplion hem,and soler poins,eveitebte ter moasum in appropdes cem0odas te Ne right _ ._ .,. _0 0 0 0 0 0
Enter desoiption hem,and enter points available for measum In appropriate categories to the right ..._ 0 0 0 0 0 0
Enter description hem,end enter points avallaote for manum In appropriate categories to the Not _ _ _ 0 0 0 0 0
.
Enter desoipWn hem,and enter points avatiable for measum in appropdas rasgadn m Ne right . .. .. .. .._.._.. . Q Q.. .�_ 0 0
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Bulh Il Green Checklists and
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,usin the Ilnk to the right Guidelines
Innovation In community,Enter dowdption hem,and enmr points s redable for measum In appropriate caro odes be Na ditht. 0 0 0 0 0 0
Innovation in Energy:Enter decd n hem,and enter Ino anflable for messum Inappropriate ce odes to the ht _ _o_ _ 0 g _ o_ ll _o
Innovation In IAalliedth:Enter dowel tion here,and enter points evaeabte for m asum In appropriate ram cries to the right. 1 0 0 0 0 0 0
Innovation In Renounces:Enter description hem,and enter points ovasabte for m asure In apirmoato ces0odes to the right 0 0 0 0 0 0
Inmvadon h Water.Ener descdpion here,end ansr points mLible for measum N appmpdes®mporms m the 4lilt. ._....___.._._._. .0__ _..0 .a. _ _.0 . ...0 0
Total Aratiabte Poss h ONer•4 0 _
Summary
Total Available Points In Speciflc Categories' 4+ 96+ 1 42+ 66+ 43+
Minimum Points Required In Spec Categories 0 30 5 6 9
Total Points Achieved 1 1 1 I I 1 1 1 1
Proloct has not yet mot tho following recommended minimum roquirementas O
- Total Project Score of At Least 50 Points
-Reauired measures:
-A3a: 50% waste diversion by weight
-J2: 15%above Title 24
-Nl: Incorporate GreenPo/nt Rated Checklist Into blueprints
-Minimum points In specitic categories:
-Energy(30 points)
-IAO/Health (5 points)
-Resources (6 points)
-Water(9 points)
•
o vnm MOW It r_...,. Straits family Grear Point Check1rsl2007 Vemlon Pare 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
MRTINO
Building De artment
JOB ADDRESS: � PERMIT#
10313 i0 .1) ,4� way 0 o co
OWNER'S NAME: PHONE # Yp - 73 —CO9 —ry
GENERAL CONTRACTOR W. e4He We,-s o f FAX# 530- 2Z
I am not using any subcontractors: ` rpty:vt of `(� 2 -7- OZ
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
X Plumbing we- rt It,s
oK—
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Con actor gnature Date