08030087 (2)BUILD NC DIVISIPERbIITr�b3�L14`1TQA�ujYSltsl3"�xa&f
BUILGfTA0L�3gE5b PORTAL AVE
J
ATLAS-TRILLO HVAC
PERMIT NO.
08030087
WNER'S NAME:
PEtMR'L%UEDATE
f-
STICKEL ORVILLE L AND PHYLLIS
1965 KYLE PARK CT
03/17/2008
NE:
-
SANITARY NO. CONTROL NO.
ARCHIlECTAINGINEER:
BUILDING PERMIT INPO
RMV&RPLC FURNACE,ADD A/C BLDG SECT PLUMB MECH
O O O O
LICENSED CONTRACTOR'S DECLARATIONas"
Job Description612
hereby .flim that Ism restated under iumvisialu of CMpmr 9 (commencing
with Section 70111) ar Division 7 of Ne Businmand Profmiurs Code.and my license is
in fullr ode
IJcmse s LIC.,
Dam Coninate, 41 IZA
RCHIECTS DECLARATION
1 understand my plans mall W used as public nxords
Licensed Professional
OWNER -BUILDER DECLARATION
I bemhy affirm that I am exempt from tiro Contranor's License Law for de
folmo inr won. (Second 701.5. Business and Pmresaiou Code: Any city or muni,
which mquims s permit m conumel. sloe Wprove, dcmalWh, or vpsir sty suoctund
prior in its issuance. also volumes lW applicant for each Permit to file a signed statement
M de of dao Contractor's Lieu. Law 9
Sq. Ft. Floor Area
Valuation
that he is licensed pursuant prevision, (chapter
(commeneing with SeNon 7000) of Division 3 of the Bustnev and Professions Crude) or
dant he Is exempt therefrom and the bub for the alleged exemption. Any vloladon of
APN Number
Occupancy Type
Semon 7071.5 by ssry Applicator for a permit subjects the applicant N a civil penalty of
not some than Rw hundred dollars ($500).
❑ L u owicr bf IW property, ce my employees with wads Nob role cmnpens
Required IDspeC[IOOS
ad s 70th, inns
will dothe wmk,nde:
owner o.
dosinsists
net a(Sec.
an CombnorsLicandoraw
and Ra(esdorm code: 71rc ConlrscNYs Liam Law dao net apply b an owner of
property who WlltlsorimprevenNeem, andwhoduessuch work himselforthmug), his
ow emplayw, provided than such improvements she not Intended oroQertd for,aln IL
howews, the building or improvement is said within one you ofmmpleood. than owner-
bunder will haw than bode^ of proving Nal W did and Wild or improve for purpose or
YIe.).
0 1. al owner of tiro property. am uclusively ConlMing with licensed rnnuaclars to
Convect that project (Sec. IOM. Business and Prnfusiorm Cade:) The Commodes Li.
Counts law does not apply in an owner of property who build, or ImProsss demon, and,
who cmtrsms for such projects with ammseNr(s) licensed pursuant to the Conu,ciaM1
Lim. Law.
.
❑ I un exempt antler See .B k PC far the
rcr Dam
WORKER'S COMPENSATION DECLARATION
I hereby, murder pensltY or perjury oroofdie following decimations:
0 1 ban: and will ma atim a CeNOcemor Gruen) m XI(-luurt for WarkeYa Compere
rsom, at Provided for by Section 3700 or the labor Code, for the performance of tic
work for which this permit is Issued
- -
0 1 have and will maintain Worker's Compensation Ivurvce, an required by Section
3700 of Ne labor Code for the performance of the work for which this permit is Issued
GMyrtWieorrkeY c^mpenWroi""ver antl Polcy r umbcoe.
Policy No.; yW �'_
n NFRO
SM
COMPENSATION INSURANCE
Tf b s section need nm ho com plewl B th permit Is for ane hundred dolt= (SIM)
or lest)
I certify that in the performance of the work for which this person is issued, L Nall not
employ guy town In my summer an as in become subject in the Worksat L'malW,llan
Law of Csiifomit Dam
Applicant
NOTICE TO APPISCANM If, after making this Cer illaald of Exemption, you should
become subject to Ne Workers Compensation provisions of the labor Crude, you a"
,
' rorNwith comply with such provWnu or this permit Nall W deemed rewked.
i CONSTRUCTIONLFNDINGiAOENCY
1 hereby hue N.t then is. bndina asetry for the performance of
whic ed (Sm.tion
' the work far which Nis permit b Issued (Sec. 7097, CH. C)
'
Lender's Num
Lendefs Address
1 ceNfy Nat 1 have read this application and state that Ne above information b
c^tvm l agree to comply MN all city and county ordinances W sue law miatins m
Wilding construction, and hemby,uNMm mi msmudves of vita city m enter upon oto
,love-memioned pmpmy fm irmpecdon purposes.
(We) agree to ave, indemnify and keep harmlm Ne City of Cupertino apinsl
j liabilities, judgments, cuts and expenses which may in any way aeric against aid City
of O WILL COMPLY WITH ALL NON -POINT
me II APP�CUTZNDS
Issued by: Date / 7
SOU
G
Re -roofs.
/
Type of Roof
Sip um of Apphan Conuase D c
HARAROOUS MA FS^reit
WIIINeeCupantar issue Wildingof In hsmat
e. Clamwmorsoul andlous d
Code. Chaplet 9.13. and tic HnIN and S.feq
u defined by 0c CupertinYfut.
. Section zss3zU)?
All roofs shall be inspected to any roofing material being installed.
❑ Yn
prior
If a roof is installed without first obtaining an inspection,agree to remove
Will Na Application
pplicantding ocesp.m use equipment or devices which
emit haurdnu sir can nano ss de0eed by Ne Bay Area Air Quality Manapment
,l
all new materials for inspection.
District?
Dyes 4.
I h,w mad Ne hu rouerid>mquimments under Ch.pmrg.95 ofIW Califon
ria Health kSaiC ode, 251 533wu115531.1undvwed"ifac Wilding
CK IL
dues m c Y w a tenant. u my maponsiNlltY m moTY Ne =eupani of IW
_ "-.g
re9mre n sous rmissuattmof.cenimm^ Oce
$ignatu AppliCan to
All roof coverings to be Class'W' or better
Dam
owerarmen apo
0
7 ITEMS OF 19
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36909004.00
DATE ISSUED.......: 03/17/2008
RECEIPT #.........: BS000004175
REFERENCE ID # ...: 08030087
SITE ADDRESS .....: 10233 S PORTAL AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
VOICE ID DESCRIPTION
-------- ----------------------------
505 FINAL ELECTRICAL
508 FINAL MECHANICAL
VOICE ID DESCRIPTION
-------- ----------------------------
507 FINAL PLUMBING
OWNER ............:
STICKEL ORVILLE L AND
PHYLLIS
ADDRESS ..........:
10233 S PORTAL
AVE
CITY/STATE/ZIP
...: CUPERTINO CA,
95014-3349
RECEIVED FROM ....:
ATLAST-TRILLO
CONTRACTOR .......:
TRILLO, STEVE
LIC #
4269
COMPANY ..........:
ATLAS-TRILLO HVAC
ADDRESS ..........:
1965 KYLE PARK
CT
CITY/STATE/ZIP
...: SAN JOSE, CA
95125
TELEPHONE ........:
(408)286-8931
FEE ID
----------
UNIT QUANTITY AMOUNT PD -TO -DT
THIS REC
NEW BAL
1BSEISMICR
------------- ---------- ---------- ----------
VALUATION 12,000.00 1.20
0.00
----------
1.20
----------
0.00
1BUSLIC
FLAT RATE
1.00 110'..00
0.00
110.00
0.00
1EPERMITFE
FLAT RATE
1.00 '..,.'40..79
0.00.
40.79
0.00
1MPERMITFE
FLAT RATE
1.00 40.79
0.00
40.79
0.00
1MRRAA
UNITS
1.00 61.19
0.00
61.19
0.00
1PPERMITFE
FLAT RATE
1.00 40.79
0.00
40.79
0.00
ITRAVDOC
FLAT RATE
1.00 40.79
0.00
40.79
0.00
TOTAL PERMIT
---------- ----------
335.55
0.00
----------
335.55
----------
0.00
VOICE ID DESCRIPTION
-------- ----------------------------
505 FINAL ELECTRICAL
508 FINAL MECHANICAL
VOICE ID DESCRIPTION
-------- ----------------------------
507 FINAL PLUMBING
Uo3 047
CITY OF CUPERTINO
FURNACE/AC
CUPERTINO PERMIT APPLICATION FORM
APN # 90 OCA �, (� O
Date: 7 l - G
Building Address:
Pbyw Ave
Owner's Name:
Phone #:
/
f �YI Vl f I e
Contractor:
lft l
Fax #: [ 0/
Contractor License #: _
Cupertino Business License #: (�
13
Contact:
Phone #-. SO4-zr
Fax #:
Building Permit Info:
Elect ❑ Plumb ❑
Mech ❑
Residential
Commercial ❑.
Job Description: Ge
-Add .A -/C Win, f
a(a C (T
For Residential Installations:
Attic ❑ 151 floor ❑
f' floor ❑
Adhere to minimum setback requirement
For Commercial Installati ns•
Replacement same weight
Additional weight (structural calcs) ❑
Structural Calculations req ed for new installation
El
New installation Planningroval Required ❑
Cost of Project: v O. U Type of Construction (Usage Class):
Strapped 17 On Platform Bonded ❑ New Location El Replacement ❑
Valuation:
Green Building: Must attach Green Building Check list to this application
i
010Ft
CUPERTINO
CITY OF CUPERTINO
FURNACE/AC
FEE SCHEDULE
0
Quantity
Fee ID
Fee Description
Fee
Permit Type
Group
FURNACE
FURN/AC
1MCRAA
Commercial-Repair/Alteration/Add.to
M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
_installation_ofcontrols regulated ti_y_this
code.
1MCREPALT
Commercial for the repair of alt/add to
M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR
Commercial Install/Relocate ea
M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM
Commerical for ea gas piping System
P
1-4 outlets
1BPGAS
For each gas piping system of 5 or
P
more per outlet.
1MCAPPVNT
Commercial for the install/relocate/ or
M
replacement of ea appliance vent
installed &riot incl in an appliance
pen -nit.
1BSEISMICO
Commercial Seismic
B
1MRRAA
Residential Repair/Alteration/Add to
M
ea heating appliance,refrigeration unit,
f
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR
Residential InstalI/Relocate ea
M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT
Residential for the install/relocate/ or
M
replacement of ea appliance vent
install & not incl in an applpen-nit.
•
CITY of
CUPEkTINO
CITY OF CUPERTINO
FURNACE/AC
FEESCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
FURNACE
FURN/AC
1PGASRES
Residential for ea gas piping system of
1-4 Outlets
P
1BPGAS
For each gas piping system of 5 or
more per outlet.
P
1BSEISMICR
Residential Seismic
B
1MECPLNCK
Mechanical Plan Check
M
Qf
IMFR=<100
Furnace Syst <=I00k BTU install or
relocate ea forced-air/gravity type
furnace/bumer, incl, ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
M
1MFRN>100
Furnace Syst> 100k BTU install or
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
M
r
IEPERMITFEE
Electric Permit Fee.
E
/I
IMPERMITFEE
Mechanical Permit Fee
M
1PPERMITFEE
Plumbing Permit
P
/
i
ITRAVDOC
Travel Documentation
B
1BUSLIC
Business License
B
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
AIR
CONDITIONING
FURN/AC
1BCAIIR.HAN
Cornmercial A/C Units <= 10k CFM
B
1MCRAA
Commercial Mech Repair/alt/add
M
1BSEISMICO
Seismic Cormnercial
B
1PGASCOM
Commerical for ea gas piping System
1-4 outlets
P
-1PGASRES
-Resid-e-ntial-for ea -gas system
of 1-4 Outlets
—P—
1BPGAS
For each gas piping system of 5 or
more per outlet. Comm/Resid
P
1BREMATRHAN
Residential A/C units <= l0k CFM
B
1MRRAA
Residential Mech Repair/alt/add
M
1BSEISMICR
Seismic Residential
B
IEPERMITFEE
Electric Permit
E
1MPERMITFEE
Mechanical Permit
M
1PPERMITFEE
Plumbing Permit
P
1TRAVDOC
Travel Documentation
B
IBUSLIC
Business License
B
0
- -Shgle Family GreenPoint Checklist data: �-1't —�d—
The GreenPoint Chacidist is based on the various green features Incorporated into the home and Is the
basis for the GreenPoint Rated program. A home ran be considerad green If It fulfills the prerequistma,
same at least 50 points, and meets the minimum points par M10pDry Energy (30), Indoor Air Ouailtyl
• Health (5), Reaoumes (6), and Water (9). Please Donald BLOW It Green for a list of qualified GreenPoint
Raters If you era Interested In pursuing third -party verification.
The gram building practices listed below are described In the New Home Construction Green Building
Guidelines, evalfabie at www.hulldtotseaom.
•
•
9)Build It f reed
Smart Solutions From The Ground Up
F-1
B. FOUNDATION'
Points Available Per Measure
Points Available Per Measure
❑
❑-
1. Replace Portland Cement in Lonaote will Reryciod Flyeh or Slag
a Minimum 20% Finish or Slag
b. Minimum 25% Flyinalftor Slag
1. Construe Reaurce-Effieienl Landscape
e. No Imeive Species Usted by Cal -IPC Are Randall
h. No Plant Species Will Require Hedging
c. 75% of Plants An Dmuphf-tolarem California Natives, Medltertaneen, or Clher Appropriate Spades
❑
a Placa Raft's and Studs e124 -Inch On Center Framing
0
D
�- 1
❑
2 Un Frost -Protected Sheliow Foundation in Cold Areas (FEC. Cflmam Zone 16)
D
3
g
d. Use Radon ResisLnnt Construction On At -Risk LDeetlons Only)
0
1
❑
El
4. Design and Build Strudunal Pest Controls
a. Install Termite Shiaids a Separate All Exledor Wood-IDAonaate CDnneDbona by Noted or Plastic FaslartmOlviders
C All New Plants Have Trunk, Base, a Stem Lonaiad At Least 36 inches from Foundation
p I
o
0
0
1
1
a Seams and Headan
C. I.ANDSCAPDQG
Points Available Per Measure
Points Available Per Measure
1. Apply Optimal Value Engineering
❑
❑
❑
1. Construe Reaurce-Effieienl Landscape
e. No Imeive Species Usted by Cal -IPC Are Randall
h. No Plant Species Will Require Hedging
c. 75% of Plants An Dmuphf-tolarem California Natives, Medltertaneen, or Clher Appropriate Spades
❑
a Placa Raft's and Studs e124 -Inch On Center Framing
0
0_ - 1 — _
- - ---- - r—
_
D
3
❑
2 Use Flre,Sefe Landsmping Techniques
0
1 I
g
❑
❑
❑
❑
D. Minimize Tud Areas In Landscape Installed by Builder
a All TW Will Have a Water Requirement Lou; than a Equal tD Tell Fescue (50.8 plant faolrQ
h, Tud Shall Not Be Installed on Slopes Exceeding 10% min Areas Leu than 8 Feet Wide
c. Tud Is Sia% of Landscaped Area (total2 points)
d. Turf Is 510% of Landscaped Area (hotel 4 points)
0
!
p I
o
0
❑
a Seams and Headan
0
❑
❑
4. Plant Shade Tree
0
❑
3
S. GroupPlants by Walar Needs Hydmzoning)
D
d. Wood I -Joists for Roof Rafters
a. Engineered or FlngarJointed Studs for Vertical Appllcations
2
❑
❑
LJ
6 install High-Efficlenoy IMgetlon Systema
a. System Uses Only, LmvFlow Drip, Bubblers, or Lox -flow Sprinters
b. System Has 5men CorNollere
7.
7. Incorporate Two Inches of Compost in the Top 6 to 121nche of Soil
T. Oriented Strand Scall for SuhOoer
p )
z
_
� I
0 1
3
3
---- -- -
r
8. Mulch All Planting Beds to the Greater of 2lnches or LDcal Water Ordinance Requirement
D
1
2
❑
9. Use 50%Salvaged of pec tied -Contort Idea is for So% of Non -Plant Landscape Elemants
10. Red Los Light Pollution by Shielding Fixtures eNor Directing Light Downward
D
p
11
I1 )
p
D. STRUCTURAL FRAME a BUmDjNa ENVELOPS
Points Available Per Measure
1. Apply Optimal Value Engineering
❑
a Placa Raft's and Studs e124 -Inch On Center Framing
0
li
❑
b. Size Door and Kindow Headers for Load-----
1
g
❑
c. Use Only Jack and Cripple Suits Required for Load
0
!
2. Use Engineered Lumber
1 I
❑
a Seams and Headan
❑
b. Insulated Engineered Headan
❑
C. Wood IJouns or Web Tmsms for Floors
—
❑
❑
d. Wood I -Joists for Roof Rafters
a. Engineered or FlngarJointed Studs for Vertical Appllcations
--
-
g
❑
T. Oriented Strand Scall for SuhOoer
E]g.
Oriented Strand Board for Well and Roof Sheathing
--
0
---- -- -
r
3. Use FSC-GerWood
tified
❑
a Dim rosonal Lumber, Studs and Timber. Minimum 40%
p
•. 2
❑
h. Dimensional Lumbar, Studs end Timber. Minimum 70%
---�---
-- .---
❑
c. Panel Products: Minimum 40%
--
-p -
"- - ---� -- --
❑
tl. Panel Products: Minimum 70%
"- ' - ---
3 - ---
---�— j -
0
3-
®2007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
G. PLUMBING
TING VENTILATION h AIR CONDITIONING
Points AvmeOle Per Measure
Points Available Per Measure
1. Distribute Domestic Hot WNW Efficiently (Maximum 7 Points)
D
I 4
❑
❑
a Insulate Ho Water Pipes tram Water Heater to IOtchan
b. Inoulme All Hot Water Pipes
0
0
❑
c. Use Engineered Parallel Piping
0
1 2 1
77
❑
d. Use Engineered Po l Piping with Demand Controlled Circulation Loop
0
—_
E]
❑
a. Use Structured Plumbing with Demand Carl C6culatlon Loop
1. Use Cemol Caa Plumbing
0
0
_ _ __
1 i 1
2
2
❑
2 Install Only Haigh Ef Dien Tell (Dua lush or 926
o
I
4
Tmal Penh Available In Plumbine.Tntal 12 n
R.
TING VENTILATION h AIR CONDITIONING
Points Available Per Measure
1. Design and Install HVAC Syotam to ACOA Manual J, D. and S Recommendations
D
I 4
2lnstall Reeled Combustion Unita
a Fumazea
b. weer Homers
0
2
0
1 2 1
77
].Install Zoned. Hydronie Redland Heeling with Slab Edge Insuition
0
1
1
4. Install High Efimency Air Conditioning with Environmentally Responsible Refdperante
0
1 i
/
❑
❑
6. Del and Install Effective DuawOrk
a Install HVAC Ung end Ductwork within Conditioned Specs
b. Use Dum Mastic on AP Duct Jolme and Sam
c. Inadadl Dumvmrk under Attic Insulation (Buried Oxime)
e Pressure Balance the Ductwork System
Z e. Protect Duch during Consauctlon and Clean Ali Duct, betas Occupancy
D 3
o 1
D
11. Instal High Efficiency HVAC FlItar MERV tar
0
i 1
❑-
7. Dont Install Flrapace or Install Stated On Flroplin es with Efndency, Rating Not Lass Than BO%
using CSA Standards
0
❑
❑
❑
I. Install Effective Exhaust Systems In Bathrooms and Kiehena
a Instill ENERGY STAR Bathroom Fans Vended in the Outside -
b. All Bathroom Fens And of Tuner or Hums6stat
a Instal 1plchan Range Hood Varied to the Outride
0
0
I
❑
❑
❑
❑
9. install Mechanical Ventilation System for Cooling (Maximum I Points)
a Install ENERGY STAR Gelling Fane a Ught Kill; In Living Ames 6 Bedrooms
b, Install Whole House Fen with Variable Speeds
c. Automatically Controlled Integrated System
d. Automatically Controlled Integrated System with Variable Speed Control
D 1 _
=,—E!
_ D _ 2
0 3
;--
❑
❑
10. InaWl Mechanism Fresh Alr Vemllarl System (Maximum a Points)
a Arry Whole Horse Ventral System Thad Moot; ASHRAE 622
b. Incest A 4r 4 Head Exchanger that mems ASHRAE 622
0 _ I
0 1
i 2' '
2
LJ
11. Install Carbon Monoxide Alarms
D
1
Teal Pointe Available In Hearing, Ventilation and Air Conditioning .301 D
02007 Build It Green Single Famlly GreanPoint Chacklls12007 Version Fall 2014
•
•
T 1 e..=n.,.,. o,a.k a _ o.1 n 1
J. EOH.DING PERFORMANCE
Point; Available Per Maasure
1. Diagnostic Evaluations
❑ e Home Process Blower Dom Test
h. House Penes Combuaton5 BackdreflTest
0
p 1
5
2 Designand Build High Perlwarmro Homes -%above Tine 24 -minimum 15%Required
0
PROJECT NAME
❑ 3. House Obtains ENERGY STAR with Indoor Air Package Certification - Piot Memare (TDW 45 points-, read Moment)
0 5 2
E
❑
e. Lm VOC interim WaTCemng Peaty (60 gel VOCs (Flet) and 051 VOCs (Non -Flag)
0
1
-Mon
L RENEWABLE ENERGY
I
Points Available Pel Measure
r 3
t. Prt-Plumb for Soler Not Water Hearing
'0
3. Use Low VDC, Witter -Based Wood Finishes (Q50 g I VOCs)
( 4 1
2
Ll
2. Imita Solar winter Heading stem77
0
- 2
10
❑
S. Use Recycled-Contnt Paint
D
S. Install Mining Conduh for Future Photovoltaic m5nalbli 6 Provide 20D iP of South-Faiding Root
0
1 2 i
-
4.install Photovoltaic (PV)Panels
or Ej FingerJofnttl -
❑
s. 30% of discard -needs OR 1.2 kW (Intel 6 points)
0
6
t 7
❑
❑
b. 60% N slawic needs OR 2.01N (trial 12 proms)-
_
_
❑
C. Shei(5D% IWnimm)
❑
C. BD%of Madrid need OR 3.6 kin (total I prima)'
0
{ 6 I
d Dome (50% Minimum)
D
T 1 e..=n.,.,. o,a.k a _ o.1 n 1
J. EOH.DING PERFORMANCE
Point; Available Per Maasure
1. Diagnostic Evaluations
❑ e Home Process Blower Dom Test
h. House Penes Combuaton5 BackdreflTest
0
p 1
1. Design Entryways to Reduce Tracked in Contaminant
2 Designand Build High Perlwarmro Homes -%above Tine 24 -minimum 15%Required
0
230
❑ 3. House Obtains ENERGY STAR with Indoor Air Package Certification - Piot Memare (TDW 45 points-, read Moment)
0 5 2
Total Avetable Polnd, in Rdldinn Padnrmmsa = 3DI n I
IL FINISHES _ -
Points Available Per Measure
1. Design Entryways to Reduce Tracked in Contaminant
0
i 1
2. Use Low-VDC or Zerd-VOC Pains (Maximum 3 Point)
❑
e. Lm VOC interim WaTCemng Peaty (60 gel VOCs (Flet) and 051 VOCs (Non -Flag)
0
1
❑
It. Zsm-VOC: Interim WRIPCORIn Palms (6 go VOCs
_
0
r 3
❑
3. Use Low VDC, Witter -Based Wood Finishes (Q50 g I VOCs)
0
2
❑
4. Use Low-VOC Caulk and Construdgon Adhesives (<70 gpI VDCs) for All Adhesives
p
- 2
❑
S. Use Recycled-Contnt Paint
D
1
S. Use Environmentally Preferable Materials for Interior Finish: A) FSC-Carttfietl Wood, B) Remelmad, C) Rapidly flaneweble, D) ReryeiedConlent
or Ej FingerJofnttl -
❑
s.CaNneh(50%Minimum)
p
!
t 7
❑
b. Interim Trim (50% Mlnimum)
❑
C. Shei(5D% IWnimm)
—p
❑
d Dome (50% Minimum)
D
1
❑
e. Courmi s (5D% Mlnimum)
- p-
7. Rodude Fommldehyde in Inenor Finish (CA Section m35D)
❑
a. Subfioor s Stair Treads (5D% Minimum)
p
T
r
❑
b. Cabinet Is Coundomms (50% Minimum)
p
❑
c. Interior Trim (50%Minimum)
p
-
❑
d. Shu,in (50% Mlir mum)
❑
S. After Installation of Finishes, Test of Indoor Air Shows Formaldehyde Leval ¢7ppb
0
3
Total Available Points In Finishes 21
0
'
L. FLOORING
Points Available
Per Measure
1. Use Environmentally Preferable Flooring: A) FS -Cmtifim Wood, B) Reclaimed or Refinished, C) Rapidly Renmable, D) Raryded-Content, E)
Exposed Genii. Flooring Adhesives slow Have SD gel VOCs.
'
. e Minimum 15% of Flom Area
D
�_ �___-__
b. Minunum 3D% of Flom Area
_
0
)
❑
d, Minimum 50% of Floor Area
p
j
❑
J. Minimum 75% of Floor Area
p
_.__ I
-� -----
,- -�--
1
❑
2. Thermal MSM Moore: Floor Covering Dther than Carpet on 5D% or More of Concrete Floors
0
1
❑
3. Flooring Meet Section DI 350 or CRI Green Label Plus Requirements SD%Minimum)
0
1 1 2
r
Toll Available Points In Flowing=7
0
M. APPLIANCES AND LIGHTING
Foams Available Per Measure
1. Install Water and Energy Efficient Dishwasher
❑
a ENERGY STAR (toll 1 pohl)
0
❑
It. Dishwasher Uses No More than 65 GaDmuCycle MW 2 and
D
1
2. Install ENERGY STAR Clothes Washing Machine with Water Factor of s or Luse
-
❑
a Mans Energy Star and CEE Ter 2 race irament (modified energy factor 20, Water Factor 6.0) (Intel3 point)
D
-7
❑
b. Meds Energy Star and CEE Ter 3 requirements(mollfied energy factor 22, Water Factor 45 or leas)
_
_ _
a15points)0
3. Install ENERGY STAR Refrigerator
❑
a. 24ERGY STAR Duellfed s c 25 CUbid Feat Capacity
p
r 1
❑
b. ENERGY STAR Ouellfied s c 20 Cubic Feet Ca,3djy
4. Install Built4n Recycling Caner
p
❑
a BuOHn Recycling Canter
p
2
❑
b. BDB�n Compostlng Center
0
i
! 1
andlI torn =Iz D I
N. OTHER Forms Available Per Measure
❑ 1. Incorporate GreenPaint Rated Checklist in Blueprints - Required D R
❑ t Develop Homeowner Manual of Green FeatureslSenefit 0
3. Community Design Measures s Local Priorities: See the Community Planning A Design section In Chapter of the New Home Guidelines for
measures. Maximum o120 points for suggested measures. Local requirements may also be lined hare.
0 2007 Build It Green Single Family GrearrPoial Checklist 2DD7 Version Page 3 of 4
PROJECT NAME
Erdw d�mapl�m nrm, ane smw pohtb.v.Ndr to m..nm m tgvopbu uUpaln b m� npM1. _ _ 0 0
Emw aw0tylion Mn entl.ntbU.vaOeMe is maawnmeepq.Un cetepatn to ma npM _ __ _ _ _ D _ _0_ 0_
Emar dewaptlon hen ena.ma polnU evallmaia mae.un In gpplgaleb ceUpalae to ma rIRhL 0 0 0 _ p
Entn Ib0 hm, and anter pointe oveilebb I
la lot maa.un gapmprlela oetepwie—no rig*. _ _ _ _ _ o _ 0 _ _ 0 - 0 _ _ D 11
aesot
4. Innovation: List Innovative measures that most the green building objsctives of the Guidelines. Fater up to a Build It Green Checklists and
n ad.n
Total Available Pointe In SpDclfic Categories-
ilmum Points Required In SoeClfic Cateoodas
Project has not yet met the following repo unendod minimum requirements;
- Total ?reject Score of At Least 50 Points
- Required measures:
43a: 50% imeste diversion by weight
J2: 15% above Title 14
-IJI: Incorporate GreenPoint Rated Checklist into blueprints
- Minimum points in specific categories:-
-Energy (30 points)
-IAQIHealth (5 points)
-Resources (6 points)
-Water (9 points)
D
0
0
0
0
0
D_
0
D
0
D
0
0
0
_
0
0
0
0
0
--
D
o—
F
D
0
D
D
'o
4+ 96+ 42+ 66
0 30 8 8
t
' 1
U
*2007 Build It Green Single Family GreanP0lnt Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
10 Fax (408) 777-3333
Building De artment
JOB ADDRESSS PERMIT #
0
OWNER'S NAME: PHONE
GENERAL CONTRACTOR: QJ -7� ,t FAX #
I am not using any subcontractors: j� p
Signature Date
Please check applicable c„hrnnirar+n,c n,,,4 A c n _.-:__ :_t_—_
Owner/Contractor Signature
.3
Date
SUBCONTRACTOR
BUSINESS NAME
u uv11110.uV1L.
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
.3
Date