08040096 CITY OF CUPr+.RTINO /�1 X3°4°.cu xugs,{ cyv
BUIL bINC DTVI§ION PERMIT £ ,�L\;"1CVL�.1NY�A�AV"',yam
PERM T ND.
BuaT�IlgSd,q�naPP9�PPY WAY BJURMAN CORP 08040096
OWNER'S NAME: FERMrf TSSUEDATS
ANAND PAI 1250 HIGHWY 101 04/14/2008
g; SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
POOL REMO (AL/ FILL BLDG ELECT PLUMB MECH
O O O O
�Ocs LICENSED CONTRACTOR'S DECLARATION
uZ 1 meet arLirm thOt 1 am licensed umkr povieons o(CMper 9(=mans tin{ Job Description
< with Sondes 7M)ofDirWon 3 ofde Budnsss aW Professions Code,and my license is
^�N in full face and ding.
j �Z Linenm Cl LJc.{
Date Co.usmar Q s 6.0.)
U ARCHITECTS DECLARATIO
I !
1 uadnsund my Fl•.-than he Used as While records,
y
a O Licensed Professional
` m
OWNER-BUILDER DE CLARATION
C0 i I herthy a(Rrm Nu I a1.eBusin from Me Cusion, o License Law for Me
O O following myon.(exit]mmub Business and Pmfnseons Code:Any city or county
S$ which its Ess a.leash ie rnnaruc4 Optic,improve,demoLM,m rtpdr any eamen,
ZT Pnwmi4 lensed p OBuatus On
thoviiUmcmt for such permute Neadghe(Coup.t -
< Mm hmenli=nwtpSemant to Oe of Dillons of the eBusi ren Lilremlaw(ChOO)or Sq.Ft.FI00[A[ea Valuation
O—t he In
waccepth Semina and of Divisions of Me eg a caterpil arefMy vi Cada)or
3 that M ts exmnPl therefrom and On b..s fm the alleged eumptiw.MY Nal Wan of
Scene.7031.7 by any applicant far a permit subjects the applicant m a civil Penalty of APN Number Occupancy Type
am more Ileo five hundred da1Wa(5700).
❑I.ummofthpropwy,amyrmploymwiNmp3uMelrmleeompemdon,
will da Ihework,and W smetum U nal mmWed oroaertd far We(Sa.TON.Budnsas
and Pasfasdou Cade:The CwOmmr's LicenseLaw than ant apply In an owns of Required Inspections
property who builds or impmaea thereon,and who does such work himself er through his
own employer,provided that weft improvements art not Intended aroRarcd ferule If.
however,the bolding or improvement is mid Morin am year of completion,the Owner.
builder will have the burden of passing Nn has did ret hold or Improve for porpm of
ale.).
❑I.an owns,of the property am exclusively commol ng wine licensed canVactws In
=me=the project(Sec 7044,Business and Prafmlom Cada:)The Contractor's U
=m law it.not apply an an Or W Property who,builds or improves Nems,sun
who converts for such project,with a contra ears,licensed p mune in de Conuaeear's
Licerm Law.
❑I ren tempt under See ,B k PC for this reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Penalty of perjury,em of the fallowing declarstiout
1 ham and will maintain a Cenlbcem of Comms an mlf-Inaum far Wo lose.Camps..
Mum,as provided far by Section 37M of the Labor Cade,for W performance of On
work for which thin permit is issued.
❑I have and will munuin WorkeYs CompamWon Insurance,u mi Bred by section
3700 of the Labor Code,for the per(ormanm of Me work far which Nis permit a issued.
My WorkelO Continuation Insurance carrier and Policy number art:
Carrier. FJR1.0 41JCE Policy No.:�
CERTIFICATE OF EKEMMON FROM WORKERS'
COMPENSATION INSURANCE
(nus mNon heed mt he completed If the permit Is frown hundmdde0an($100)
or re)
1 mNfy Mat In the perfow.n=of the work for which Nis Permit Is issucd.I Mall am
employ any person in my mmherm an m human subject an the Wortrri Compemdon
Laws of CeifaML Data -
Applicant
NOTICE TO APPUCANT.If,after mW ng his Ccnificem of Fxcmpdm.you Mould
become subject in the Worker's Compensadw provisions of Me Latin Code,you mud
O forthwith comply wait such Forstmann or this permit Mall he nominal ed.
'Z^ CONSTRUCTION LENDING AGENCY
[-� Ihemhy M.Our Mem is a comwmlw tending agency for the inrformuae of
a> Oe work fou which def Permit Is issued(Sec 3097.Civ.C)
GQ Inndeh Name
.7 z Leaden Address
U O I mount that 1 have mad this application and sue Out the above information is
Fcorreca I a{rom as=reply with dI city and cowry ordinances;and atate Isco relating In
U Wilding construction.and hemby•uliodre rtprtxnudves or Mu city m=ler upon the
W alcove-mendoncd property for inspemion Purposes.
0. (We)agree to save,indemnify and kecp harmless the City of Cupertino against
l'A liabilities,judgments.emu and expenses which may In my way acme a{alnst sed City
L)z in cemgucme of {ranting of Nis permit. y J�
^+ APPLICA RSTANOS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date l
SOUR U ONS. 'J f,I n
Re-roofs
Si{mu pp' ontmor Data
HAZARDOUS MATERIALS DISCLOSURE type of Roof
Will appl=or future building uc=pmtuae orhanoc hamdeu materia
as deRnsd by Me Cupertino Munici al Cada.Chapter 9.12,and the HaIM and safety
Cade,section 27732(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes Nu
Will the applicant or futum building Occupant use equipment or dcvim which If a roof is installed without first obtaining an inspection,I agree to remove
cmlt hvardom air cmiuminanu as da0md by the Bay Aura Air Quality Managcmcnt all new materials for inspection.
District?
❑Ye. QNu
"a-mad amiandabmqulremcnu underCMpmri93 often Calfar.
rGnM.Huldt& 25733 wo27734.1undcrumd Muirdm Wilding
it.ret c n a •tiney t I a my res o aihility m nosily the mcuP•^r of Mc
mqulremic�Iuyu�mbkPd ...misPo acenilk.te Ora�r Signature of Applicant Date
owmr a%mnti�r<d� `+�` vel Dow All roof coverings to be Class'n"or better
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . 36615023 . 00
DATE ISSUED. .. . . . . : 04/14/2008
RECEIPT # . . . . . . . . . : BS000004472
REFERENCE ID # . . . : 08040096
SITE ADDRESS . . . . . : 1455 POPPY WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ANAND PAI
ADDRESS . . . . . . . : . . : 1455 POOPY WAY
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5316
RECEIVED FROM . . . . : BJURMAN
CONTRACTOR . . . . . . . : PHILLIP 0 BJURMAN LIC # 23653
COMPANY . . . . . . . . . . : BJURMAN CORP
ADDRESS . . . . . . : . . . : 1250 HIGHWY 101
CITY/STATE/ZIP AROMAS, CA 95004
TELEPHONE . . . . . . . . : (831)726-9907
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ----------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 8, 500. 00 0. 90 0. 00 0. 90 0 . 00
1DEMORES SQ FEET 0 . 00 490. 00 0. 00 490 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 490.90 0. 00 490.90 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 490. 90 1090
---------------
TOTAL RECEIPT 490. 90
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
CITY OF CUPERTINO
DEMO
�UPEfi;TINO PERMIT APPLICATION FORM
APN# Date: l'-1
Building Address:
ILASS 1PoP4p95o 114
Mailing Address (if different from building address):
Owner's Name: Phone:
AN�Mo £ IuatIL� IT �a tio8 �iq � Z09
Contractor: �3
Phone : 83l - -12-6 - `k 4 o
Fax: S11 - -72L - `l9 0 g
Contractor License #: 971o2_50 A
Cupertino Business License #: ?)m 3
Contact: Z „k� (�o N ; 11 �, Phone:H o b q OS— L (o 1c�
Fax:
Residential O' Sq Footage --Z4=CXD Commercial ❑ Sq Footage
Job Description:
Valuation:
Attach Green Building Checklist to demo plans.
Quantity Fee ID Fee Description Fee Group Permit Type
1DEMORES Demo-Residential B 1SFDWL-DEM
iBSEISMICRE Seismic Residential B
1DEMOCOM Demo-Commercial B 1COMML-DEM
IBSEISMICOM Seismic Commercial B
1BUSLIC Business License B
Single Family GreenPoint Checklist date: Build It Greed
The GreenPoint Checklist is based on the various green features Incorporelad into the home and Is the SmarlSolutions From The Ground Up
basis for the GreenPoint Rated program.A home can be considered green If It fulfills the prerequisites,
Hams at least 50 points,and meats the minimum contact
per category:Energy list
of Indoor Air Oualityl
Health(5),Resources(6),and Water(9).Please contact Bulitl It Green for a list of qualified GreenPoint
Rafters if you are interested in pursuing third-parry verification.
The green building practices dead below are described In the New Home Construction Green Building
Guidelines,available at"w.buiidibmen.om.
• e • , s c � � C
U �
A.SI'CE 4 (v points Available Per Measure
�,/ 1.Probe)Topel antl MlnimW DisrvpO o 'sting Pbnb& -
Ln a.Protect Topsoil from Erasion and Reuse after Construction 0 1 1 1
b.Mmd and Delineate Construction Footpdm for Maximum Protection 0 1
❑ 2 Deconstruct Instead of Demolishing Existing Buildings On Site 0 I I 1 3 1
3.Recycle Job Site Construction West$(including Green Wash)
❑ &Minimum 50%Waste Divrlsson by Wayne(Re}ssrrg orReuse-Required 0 I R
It.Minimum 65%DNerslan by Weight(Recycling or Reuse) 0 2 1
❑ c.Minimum 60%Diversion by Weight(Recycling or Reuse) 0 1 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0
1
❑ b.Roadway Base 0 I 1
Total Points Available in Site_1 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash or Slog
❑ a.Minimum 20%Ryan or Slag 0 I I 1
❑ b.Minimum 25%Flash or Ste 0 1
❑ 2 Uo Frost-Protscksd Shallow Foundation in Cold Ares(FEC.Climate Zone 16) 0 ( 1 3 1
❑ 3.Use Radon Resistant Construction On At-Risk Locations Only) 0 I 1
4,Design and Build Structural Peat Console
❑ a.Install Tends Shields&Separate All Exterior Woad-to-Concrete Connections by Mehl or Plastic FastormrvDMdem 0 I 1 1
b.All Now Plants Have Tmnk Base,a Stem Located At Least 381nches from Foundation 0 1 1 1
Total Points Available N Foundation=E 0
C.LANDSCAPING Points Available Per Measure
1.Construct Heouro-Efficient Landscapes
❑ a.No Inversive Species Listed by CaHPC Am Planted 0 I 1
• ❑ b.No Plant Species WIII Require Hedging - f 0 1 1
❑ c.75%of Plants Are Drought-idemnt California Natives,Mediterranean,or Other Appropriate Speeies 0 1 1 1 1 3
2.Use FIm,SBfs Landscaping Techniques 0 1 1 1 1 1
3.Mullane,Turf Ames In Landscape Installed by Builder
❑ e.All Turf WIII Have a Water Requirement Less than or Equal to Tell Fescue(50.6 plant factor) 0 2
❑ b.Turf Shall Not Be Installed on Slopes Exceeding 10%or In Area Lest than B Feet Wide U_U 0 1 2
❑ c.Turf is SM of Landscaped Area(total2 points) Com,�� 0 —I6-� 2
❑ d.Turf Is 5510%of Landscaped Area pool 4 points) (J (J 0 I 2
4,Pleat Shetle Trees 0 ( I I 3
❑ S.Group Planks by Wetm Needs(Hydrozonin 0 I 2
6.Install High-Efficiency Irrigation Systema
❑ a.System Uses Only Low-Flow Drip,Bubblers,a Low-flow Sprinklers �f'I, 0 - ( 2
❑ b.System Has Snarl CorNollers 0 3
❑ 1.
In.orporrals,Two Inches of Compost in the Top 6 to 12 Inches of Soil 0 1 1 1 1 3
B.Mulch All Planting Beds to the Greater of 2 Inches or Local Water Ordinance Requirement 0 1 1 1 1 2
9.Use 50%SeNo ad or Reryeletl-0ontent Mabriaks for 50%01 Non-Plant Lanc a Elements 0 I I 1
10.Reduce Light Pollution by ShieldingFuturessliver DirectingLight Dowmvartl 0 1 1 1 1 1
Tool' Available in Landscaping=31 0
D.STEUCTUEAL FRAME h BUILDING ENVELOPE L--, r1 Points Available Per Measure
1.Apply Optimal Value Engineering _
❑ a.Place Rafters and Studs at 24-Inch On Center Framing 0 1
❑ In.Size Door and WlndawHeaders for Load 0 1 1
❑ c.Use Only Jack end Cripple Studs Required fa Lod 0 I I 1
2.Use Engineered Lumber
❑ a.Beams and Head9B 0 1 1
❑ b.Insulated Engineered Headers 0 1
❑ C.Wood IJoists a Web Trusses for Floors 0 1
❑ d.Wood I-Joists for Root Ratters 0 1
❑ a.Engineered or FlnganJdnted Studs for Vertical Applications 0 1
❑ f.Oriented Strand Board for Sublloor 0 1 1
❑ g.Oriented Strand Board for Well and Roof Sheathing 1 0 1 1
3.Use FSC-Certfied Wood
❑ e.Dimensional Lumber,Studs and Timber:Minimum 40% 0 1 1 1 2 1
• ❑ b.Dimensional Lumber,Studs and Timber.Minimum 70% 0 2
❑ c.Panel Products:Minimum 40% 0 1
❑ d.Panel Products:Minimum 709: 0 1
02007 Build it Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
R PROJECT NAME . � . .
a.Use Solid Wall Systems(includes SIP,,ICFs,8 Any Non-Stick Frame Assembly)
❑ a.Fbds D 2 -_ 2
❑ b.Walls 0 1 2 2
❑ G.Roofs 0 2 _ 2_-
5.Reduce Pollution Entering the Home from the Gmage
❑ a.Tightly Seal the Air Samer between Garage and Living Ama 0 —t—�I- 1 _
❑ b.Inalalt Damage Exhaust Fan OR Build a Downed Gere e 0 1
6.Dadgxn Energy Heel,on Trusses(75%of Attic Insulation Height at Outside Ede of Exterior Well) 0 1
7.Design Roof Trusses to Accommodate Duchvork 0 1
e.Ube Recycled-Content Be"Studs for 00%of Interior Wall Foaming 0 I 1
S.Thermal Meq Well,:SMnch Drywall on All Invertor Wells or Wells Weighing mon than 401blcu.tL 0 1
10.Install Dverhengs and Guttero
❑ A Minimum 1BHwh Dverhengs and Glmers 0
❑ b,Militiamen 24-Inch Overhangs and Guties 0 I 1
Total Pound;Available In StruoWrd Building Frame and Envelope.36 0
B.RIITRRIOR PIMBH Points Available Per Measure
1.Uw R• Gad-Content No Virgin Plutic or FBC-Certified Wood Docking0 t 2
21nse11 a Rein Screen Well S stem 0 2
LJ 0.Use Durable and Noncombustible Siding Materiels 0 I 1
1.Soled Durable and Noncombustible Roofing annelids 0 1 2
Total Points Avalabe In Exterior Finish•7 0
P.IN817LATION Points Available Per Measure
1.Install Insulation With 75%Recycled Content
❑ a.Wells anNor Floors
❑ It.Ceflin s 0 1
2.Install Insulation that is Law-Emldng(Certified Section 0135D)
❑ a.Wells andfur Floors D 1 1
_t
❑ b.C,Illn s 0 1
J.inspect Quality of Insulation Installation before Applying Drywall 0 1
Total Peine Aval able in Insulation.5 0
O.PLUMBING Points Avaltable Per Measure
1.Distribute Domestic Hot WSW Efficwtiy,(Maximum 7 Polne)
❑ a.Insulate Hol Water Pipes from Water Heater to Kitchen 0 1 n 1
[3 b.Insulate All HM Water Pipes U
Elc.Use Engineered Parallel Piping _
❑ J.Use Engineered Parallel Pl ting with Demand Controlled Circulation Loop U
❑ e.Use Structured Plumbing With Demand Consoled Circhatlan Loop _
❑ f.Use Central Core Plumbin
2.Install Only High Efficiency Toilets(Dual-Flush or 5125 0 4
Total Points Available In Plumbing=Total 12 0
H.HMTMO VBNTIIATION R AIR CONDITIONMO Points Available Par Measure
1.Design and Install HVAC System to ACOA Manual J,0,and S Recommendations 0 1 4 1 i
2.Install Sealed Combustion Units
❑ a.Furnaces 0 --:—r-2--r—�-
❑ b.Water Heaters 0 I 2
].Install Zoned,Hydrants Radiant Heeling with Slab Edge Insulation 0 I 1 1
4.Install High Efficiency Air Conditioning with Environmentally Responsible Refrigerants 0 1 I
S.Design and Install Effective Ductwork
❑ a.Install HVAC Un0 and Ductwork Within Cautioned Space 0 _i.__3.
F1 b.Use Duct Mute on All Duct Joint and Seems
E] _ -'
c.Install Ductwork under AtlD 1
ic Insulation Ducts) D _—
❑ d.Pressure Balance the Duchi System _
1 1
❑ a.Preach Ducts during Construction anti Clean All Duda before e Occupancy 0 I
ID B.Install High Efficiency HVAC Filer(MERV&1 0 1
❑
".Don't Install Fireplace or Install Soled Ge,Fireplaces with Efficiency Rating Not Lew Than 60% ° 1
using CSA Standards
B.Install Effective Exhaust Systeme In Bathroom,and Kitchens
❑ a.instill ENERGY STAR Bathroom Fans Vented to the Oxide 0
❑
It.All Bathroom Fans Are on Timer a Humldistat _0 _
❑ c.Install IOlchen Range Hood Vented a the Dundee D 1
9.Install Mechanical Venillatipn System for Cooling(Maximum 4 Points)
❑ a.install ENERGY STAR Ceiling Fan 6 Light da;In LNing Areas A Bedrooms U —
❑ b.Install Whole House Fan win Vadabla Speeds —0-.-
c.
_c.Automatically Canceled Integrated System D2
--_
El d.Automatically Controlled Integrated System with Variable Speed Control 0 I 3 T-7-
10.
—T10.Install Mechanical Fresh Air Ventilation System(Maximum 5 Points)
❑ a.Any Whole House Vent lotion System That Meets ASHRAE 622 0_ __ r_ 2
❑ It.Install Air-x-Alr Heat Exchanger that mads ASHRAE 622 0 1 2
11.Install Carbon Monoxide Alarm(s) 0 1
Total Points Available In Hes o ,Ventilation and Air Conditionin •30 0
02007 Build It Green Single Family GreenPolnt Checklist 2007 Version Page 2 of 4
r s �
• "PROJECT a a e
3
L RENMAELB ENERGY Points Available Per Measure
1,PlsPlumb for Soler Not Wotan Having 0 4
• L..l I Install Solar Water Heading System 0 i 10
3.Iruta11 Winn Conduit for Futuro Photovoltaic Installation 6 Provide 2DO fP of SoumFacing Roof 0 I 2 I I I
4.Install Photovoltaic(PV)Panels
❑ e.3D%of electric needs OR 12 kW(total B points) 0 6 1
E3 b.60%of electric nests OR 24kW(total 12 pants) 0 I 6 I
❑ C.90%of electric need OR 3.B kW(total 16 points) 0 6 I I
Total Availabla Pants in Renewable Energy=2B 0
J.BUILDING PERFORMANCE Points Available Per Measure
1.Diagnostic Evaluations
❑ a.House Passes Blower Dow Test D I 1 { I
El It.House Passes Combustion Safety Backdraa Test 0 I I 1 I
2 Design and Build High Performance Holmes-%above This 24-minimum 16%Required D I ..30
❑ 3,House Obtains ENERGY STAR with Indoor Air Package Callficadon-Pilot Measure(Total 45 point;read comment) 0 I I 5 2
Total Available Points In Building Performance=39 0
E.FINISHER Points Available Per Measure
❑ 1.Design Entrl to Ratio=Tracked in Contaminants 0 1
2 Use Low-VOC or Zem-VOC Point(Maximum 3 Points)
❑ a.Low-VOC Interior Wall/Calling Paints(<50 gpl VOCE(Flap and d50 gpl VOCs(Non-Flat)) 0
❑
It.Zem-VOC:Interior WalVCellin Palms(,5 got VOCs Flat)) 0 �' 3
❑ 3.Use Low VOC,Watm-Based Wood Finishes(d50 gpl VOCs) 0 I I 2 1 1
❑ 4.Use Law-VOC Caulk and Construction Adhesives(d0 gpi VOCs)for All Adhesives 0 1 2 1
❑ 5.Use Recycled-Conant Point 0 I 1 I
6.Use Environmentally Preferable Motorists for Interior Finish:A)FSC.Cerfli Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed
❑ a.Cabinets(5D%Minimum) 0
❑ - It.InteriorTom%0 Minimum)
0 1
❑
C.Shelving(50%Minimum) 0 ]
❑ d.Doors(50%Minimum) 0 I 1
❑ 0.Countertops(50%Minimum) 0 1 1
7.Reduce Formaldehyde In Interior Finish(CA Section 01350)
❑ a.Subfioor A Stair Trends(5D%Minimum) 0
• ❑ Id.Cabinets a Countenops(50%Minimum) 0 1
❑ c.Interior Tmn(50%Minimum) 0 ] �—
❑ tl.SheMin
of(50%Minimum) 0 1
❑ e.After Installation Finishes,Test of Indoor Air Shows Formaldehyde Level d7p b 0 3 1 1
Tots Available Penis in Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC-Certified Wood,S)Ractalmed or Refinished,C)Rapidly Renewable,D)Racycled-Content E)
Exposed Concrete,Flooring Adhesive Must Nave 60 Sol VOCs. _
❑ e.Minimum 15%of Floor Area D I I 1
❑ b.Minimum 30%of Floor Area 0
❑ c.Minimum 50%of Floor Arae 0 I I I
❑ d.Minimum 75%0 Floor Area 0 1 i
❑ 2 Thermal Mess Floors:Floor Covering Other than Carpet on 50%or More of Controls FiDore 0 1 1 1
❑ 3.Flooring Meeh Section 01350 or CRI Grain Label Plus Requirements(50%Minimum) 0 I i 2 1 1
Total Available Points in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
1.Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR f otal 1 point) 0 —I} ] I
El b.Dishxxshor Uses No Mors than 6.5 Gaidn cls tots 2 pane 0 1
2.Install ENERGY STAR Clothes Washing Machine with Walter Factor of 6 at Less
❑ a.Meets Energy Star and CEE Tier 2 requirements(modified energy factor 2.0,Water Factor 6.0)(total 3 points) 0 1 I 2
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 22,Water Factor 4.5 or less) 0 I I 2
(total 5point)
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Qualified 3<25 Cubic Feet Capacity D 1 I
❑
In.ENERGY STAR Qualified&c 20 Cubic Feet Capacity 0 1 I
4.Install Built-In Recycling Cantor p
❑ a.BuilNn Recycling Center 0
❑ b.Built-In Composting Center - 0 ( ( 1
Tots Available Prints In Appliances and 0 htin 12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporate Greerooint Rated Checklist in Blueprints.Required 0 R
❑ 2 Develop Homeowner Manuel of Green FietureclBenefita D 1 1 I 1
3.Community Design Measures a Local Priorities:See the Community Planning&Design section in Chapter 4 of the New Home Guidelines for
• measures.Maximum of 20 pants for suggested measures.Local requirements may also be listed here.
02007 Build It Green Single Family Greeir lnt Checklist 2007 Version Page 3 of 4
ENTER PROJECT NAMEMR a HUI 3"�
❑ Enter description Mn,ad enter onions avdeae to musure in eppmplho cetegotes 10 he right _ D_ 0 0 0 0 0
Enter description here,end enter points evellable fa measure In a sassIDa c4mg(rtes to he right. 0_ a 0 0 0 0
Enter description hen,moi enter points sanit for muses,in gpap"categories to to hphl 0 0 0 0 0
Enmr_tlew±ip0m erns,antl mar pdmt wagade Ior meeeae In ap{ao0ritu cetepoiiu tome right - _ _ _ _0_ 0 _ 0 1 0 1 D 0
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Sulltl It Green Checklists end
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the d ht. __ Guidelin_ es _
Innovation In Community:Enter description hen,and enter points"a61e for mmmo in its to the fight o 1-0
_0 D 0 0
II soon in Enngj.:Enter tlalpipaon Mie Bron aro porN rvegrOts formeerae h Ilppnpita sea roped 0 0 0 0 0 0
Inn on In IAGHuhh:Enter do"on hone end arta Peons avegabil fa measure,in gpapraa ceag_mal to he right. 0 0 0 0 0 0
Imwetlm In Hesaurw:Enter description tan,and enter ts wastoa he tress"in gVeoplas u to he right 0 0 0 0 0 0
Imwthon in Wetic.1mn description erne,end mbar points available lor matron h cahgmier a hx right. _ 0 0_ o 0 0 _0_
Teal Amite o Points In Other 4 D
Total Available Points In Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required In S sclfic Cate odes 0 30 5 6 9
PointsTaint 1 1 1 1 1 1
Project has not yet mot the following recommended minimum requirements: /
-Total PmJect Score of At Least 50 Points C�
-Required measures:
-A3a: 50% waste diversion by weight
-J2: 15%above Title 24
-N1:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific Categories:
-Energy(30 points)
-IAOIHealth(5 points)
-Resources(6 points)
-Water(9 points)
m 2DD7 Build It Green Single Family GremPond Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
i 7 -40 Cupertino CA 95014
" Telephone(408)777-3228
CITY OF Fax(408)777-3333
,6UPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
14515 L\.l CKO L-CaoI-r`
OWNER'S NAME: ,M, &j PHONE # o Aq 6 - 2'g4 I
GENERAL CONTRACTOR: u,lL- FAX # 931 i7-f. qao$
I am not using any subcontractors: z `i - lit' oe)
igna a Date
Please check applicable subcontractors and co e 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