08010134 CITY OF CUPERTINO
BUILDING DIVISION PERMIT (.`UNTRAGT(3R Il ' ' }RMA IQ
BUILDIV ADDRESS: PERMIT NO.
1035 COLONY HILLS IN AAA FURNACE & AIR 08010134
OWNER'S NAME:. PERMIT ISSUE DATE
ANDY FENG 1712 STONE AVE 01/22/2008
ONE: SANITARY NO. CONTROL NO.
ARCHTfECT/ENGINEER: REPLACE FURNACE 100K BTU Gc "Him BUILDING PERMIT LUMB MECH
300 LICENSEDCONTRd under
DECLARATION
rd U 1 hereby affirm But 1 am licensed Bu under and
Professions
of s Code, 9(commencing Job Description
with Section 7000)ofDivision 3o(thc BusineumdPrafessiuns Cade,and myliccnac is
n Z ut in full force and f(
D N Z License Class • L�.g _
Dale/..'fContC
CHRECTS DEC N
1 understand my plans shall M used As public records
U
4 a Licensed Professional
OWNER-BUILDER DECLARATION
S 1 hemley affren that I am exempt from the Contactoes License Law for the
i.o o following roman.(Section 7031.5,Business and Professions Code:Any city or county
$ whish requires.permit m conawcL alter,improve,demolish,or repair my mactuou
zprior In its issuance.also requires the applicmt for such permit Le fim a signed summer
g � that he is licensed pummel to Me provisions of the Connector's License Law(Chapmr 9 Sq.Ft.Floor Area - Valuation
LB (commencing with Section 7000)Of Division 3 of NC Business and Professions Code)or
s, .. the he Is attempt therefrom and the bum for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Immunity of
.1... APN NbOccupancy tmore Nm five hundred dollars Number QCCU anC
a(IISM. e
❑I.As owner often property,or my employee with wages As their.m compensation,
will do th..,k.and Nestruchme unotinmol da offered forum(See.7044,Business
and Professions Cade:The Connector's License Law does not apply to an Owner of Required Inspections
property who hu Ilds or i mprow thereon,and who doss such work himsel f m Nmugh his
own employees,provided Mut such improvements Are,not intended oro@red for We.If.
however,Ne building or improvement is mid within one year of completion,Ne owner.
builder will law Me burden of proving Nat Im did not build or impmw for pupae of
am.).
❑1,as Owner of the property,am exclusively contracting with licensed cunaactom to
construct the project(Sea 7044,Business and Professions Code)The Conowma's U.
cave law does not apply to an owner of propmoy who builds or improv thereon,and,
who contacts for such projects with a contactems)licensed pursuant to the Contractors
License Law,
❑I ons exempt under See ,B&PC fm this moon
Owner Data
WORKER'S COMPENSATION DECLARATION - -
I hemby.M m under Penaty of perjury ane of tiw following decl&ntiom:
I ham&ted will AmdmWA•CeNfiateof Conant m alf-iuum far WarkefsCompcn-
n,a provided fm by Section 3700 of the Labor Cade,for the performance of the
oe
for which this permit is issued.
❑1 haw aed will maintain Worker's Compensation Iaurmce,As mgmmd by Section
3700.1Me Labor Code.for the peRurmucc of Ne work forwhlch this permit is Issued.
My Worker's Com,(pensatii/o-�nn Insurance artier and Policy number are: -
Carrie t,( /L-Lill Policy No.:,/ _
CERTII}}77CA OF EMPTION FROM KERS
COMPENSATION INSURANCE
(Thu seOlon need nail be completed if the permit la far ec hundred dollars($100)
or less.)
I certify dor in the perfomtanee of the work far which this permit is issued,l shall not
employ anyper.n in any mural.As In boame subject 10 the Womkera'Compmnsatie
Lem,ofc.frorom,Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject 0 Ne Worked Compensation provisions of Ne labor Code,you mum
.J O forthwith comply with such provisions an this permit shall M deemed mmked.
CONSTRUCTION LENDING AGENCY
ti
[-� There by aRthi Nn theta issued IS .397,Cing agency for Ne performance of
CL Le week for which This permit u issued lSec.J097,Civ.Cd
W�Q Lenin's Namc
Lender's Redress
U Q 1 conifY that I have read this apPliadan and stale the the above information is
IL, eonc0.I agree to comply with all city and county ordinances and sum lave m W ng to
Q U Wilding construction,sod hereby authorize mprescnutim of this city to enter upon the
a &how-mentioned property for inspection purposes.
(We)agree to ave,indemnify ad keep homeless the City of Cupertino against
tea llabilides,judgments,casts and expenses which may in my way atom against cud City
r7.
U A APPLICANT
of the RSTAgrafflins of Nu Permit.WILL
/ �s
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:3 �&o Date (_
SOU RECULf ON
Re-roofs
r6nmurtofAPPliwnaCantracm D .. �/
HAZARDOUS MATERIALS DISCLOSIIR Type of Roof
Will the applicant a future building acupantmore orhandle hxvudon$materia
u de0ned by the CupeNe Municipal Code.Chapter 9.13,and the Heath and Safety
Code.
prem zss32(. )r All roofs shall be inspected prior to any roofing material being installed.
Me applicant or fP g
If a roof is installed without first obtainingan inspection,I agree to remove
Will uture building occupant use equipment or devices which
it hA0=..air canumioanu.deRncd by Ne Bay Area Air Quality Management all new materials for inspection.
rict7
Y.
1 haw mad the hemrd cad a m'mdals requirements under Chapter 6.95 of Nc Califor.
ria Hc-iN&Safely Codc,Secdau75S05,35533md25534.ImdemandthaifMe building
dace not currently haw a ImaL Mut It u my napensihility,he notify Me nccupmt of Me
requirements which must be met Prior to iuvana of a Certificate of Occu Signature of Applicant Date
o n ser; as Do All roof coverings to be Class"B"or better
.� o koz o t 5 i-I
CITY OF CUPERTINO
FURNACE/AC
•tuPERTwo PERMIT APPLICATION FORM
APN# 22 _
Date:
Building Address:
/43 3— (�10
Owner's Name: Phone#:
y 2 - ,76,61
Contractor: Phone#: Z 5? ,7_ y7/ 7
"AO Fax #:
Contractor License#: Cupertino Business License#:
Contact: Phone #:
Building Permit Info:
Elect Plumb ❑ Mech.
Resid inial ❑ Commercial ❑.
Job Description: `/
32'L //t 4 c /0,9 m P� �3� v 4 c of q Z If/C
For Residential Installations:
Attic ❑ I"floor 2"d floor ❑
Adhere to minimum setback requirement ❑
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
S IPO. ,e�
Strapped ❑ On Platform ❑ Bonded New Location ❑ Replacement
Valuation:
Imo.
Green Building: Must attach Green Building Check list to this application �—
CITY OF CUPERTINO
J ' FURNACE/AC
CUPERTINO FEE SCHEDULE
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 of controls regulated by 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 InstalURelocate 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 er outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed &riot incl in an appliance
ermit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,inc]
installation of controls regulated by
this code.
j 1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the instalUrelocate/or M
replacement of ea appliance vent
install ¬ incl in an appl ermit.
CITY OF CUPERTINO
FURNACE/AC
CITY OF
•CUPERTINO FEE.SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fixmace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
/ 1EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
/ 1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
[Business1BUSLIC License B
CITY OF CUPERTINO
FURNACE/AC
CUPERTINO FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
113CAIRHAN Commercial A/C Units <= l Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1 PGASCOM Commerical for ea gas piping System P
1-4 outlets
--- 1PGASRES Residential for ea-gas-pipirig system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more Per outlet. Comm/Resid
1BREMAIRHAN Residential A/C units <-- lOk CFM B
IMRRAA 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
1BUSLIC Business License B
•
CITY OF CUPERTINO
• 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35930001. 00
DATE ISSUED. . . . . . . : 01/22/2008
RECEIPT #. . . . . . . . . : BS000003755
REFERENCE ID # . . . : 08010134
SITE ADDRESS . . . . . : 1035 COLONY HILLS IN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA. ; . . . .
OWNER . : . . . . . . . . . . : ANDY.FENG
ADDRESS 1035 COLONY HILLS IN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5801
RECEIVED FROM . . . . : JIM RANDO
CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050
COMPANY AAA FURNACE & AIR CONDITIONING
ADDRESS 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 293-4717
. FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 5, 700. 00 0. 60 0. 00 0 . 60 . 0. 00
1EPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
IMPERMITFE 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
1TRAVDOC FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 224 . 95 0. 00, 224 .95 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 451. 00 VISA
---------------
TOTAL RECEIPT 451 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------ ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: patg
•
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35930001. 00
INVOICE DATE. . . . . . : 01/22/2008
REFERENCE ID # . . . : 08010134
SITE ADDRESS . . . . . : 1035 COLONY HILLS LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ANDY FENG
ADDRESS . . . . . . . . . . : 1035 COLONY HILLS LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5801
CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050
COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING
ADDRESS .. . . . . . . . . . : 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 293-4717
FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE
--------------------------- ---------------- ---------- ---------- ----------
• SEISMIC RESIDENTIAL PRINTING PERMIT 0 . 60 0. 00 0.60
ELEC PERMIT ISSUANCE PRINTING PERMIT 40.79 0. 00 40.79
MECH PERMIT ISSUANCE PRINTING PERMIT 40.79 0. 00 40 .79
RES MECH REPAIR/ALT/ADD PRINTING PERMIT 61 . 19 0. 00 6 .19
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40.79 0. 00 40��
TRAVEL & DOCUMENTATION FEE PRINTING PERMIT 40 .79 0. 00 40.79
._ --------- ---------- ---------
224 . 95 0. 00 224 .95
VOICE ID DESCRIPTION VOICE ID DESCRIPT N
-------- ---------------------------- -------- ----------------- ---------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL.
l/s le
Single Family GreenPoint Checklist date: 9) Build It Green
The GreenPoint Checklist is based on the various green features incorporated into the home and is the SmartSolutions From Tnfi Ground Up
basistt the GreenPoint Rated program.A home can be considered green If It fulfills the prerequisites,
at
r—v r—x
cams at least 50 points,and meats the minimum points per category:Energy(30),Indoor Air Quality/ I JI IL JI
Health(5),Resources(6),and Water(9).Please contact Build It Green for a list of qualified GreenPoint L
Raters it you are Interested in pursuing third-parry vedficagon.
The green building practices listed below are described in the New Home Construction Green Building
Guidelines,available atwww.bullda reenora.
ENTER PROJECT l c,g E ry
U S �
A.SITE Points Available Per Measure
1.Protect Topsoil end Minimize Disruption of Existing Plants 6 Tram
❑ a.Protect Topsoil from Erosion and Reuse after Consiradlen 0 _ 1 __ 1
❑
b.Limit and Delineate Construction Footprint for Maximum Protection 0 1 1
❑ 2.Deconstruct Instead of Demolishing Existing Buildings On Site 0 3
3.Recycle Job Site Construction Waste(Including Green Waste) I
❑ e.Minimum 50%Waste Diversion by Weight(Rai orReuse)-Required 0 fl
❑ b.Minimum 65%Diversion by Weight(Recycling or Reuse) 0 2
❑ c.Minimum 80%Diversion by Weight(Recycling or Reuse) 0 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0 1
❑ b.Roadway Base 0 1
Total Points Available in Site=12 0
B.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled Flyash or Slag -
-❑ a.Minimum20%Flyesfioror Slag 0 1 _ 1
❑ b.Minimum 25%Flash or Slag 0 1
❑ 2.Use Fros4Protemed Shallow Foundation in Cold Areas(GE.C.Climate Zone 16) 0 3
❑ 3.Use Radon Resistant Construction(In At-Risk Locations Only) 0 1
4.Design and Build Structural Past Controls
❑ a.Install Termite Shields 8 Separate All Exterior Wood-to-Concrete Connections by Metal or Plastic I'marorsfDividers 0
b.All New Plants Have Trunk,Base,or Stem Locust At Least 36 Inches from FOandaflee 0 1
Total Points Available in Foundation=8 0
C.LANDSCAPING Points Available Per Measure
1.Construct Resource-Efficient Landscapes
❑ a.No Iwasive Stories Listed by Cal-IPC Are Planted 0 1
❑ b.No Plant Species Will Require Hedging0 1
• ❑ c.75%of Plants Are Drought-tolerant California Natives,Mediterranean,or Omer Appropriate Spades 0 3
2 Use Frre-Safe Landscaping Techniques 0 1
3.Minimize Tud Areas in Landscape Installed by Builder
❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.8 plant factor) 0 2
E] b.TurfShall Not Be Installed on Slopes Exceeding 10%or in Areas Less than 8 Feet Wide __0, 2
❑ c.Tud is S33%of Landscaped Area(total2 points) p 2
❑ d.Turf is 510%of Landscaped Area(total 4 points) p J 2
❑ 4.Plant Shade Tram
❑ S.Group Plants by Water Needs(Hydromnin ) 0 2
6.Install High-Efficiency Irrigation Systema \�
❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers —
❑ b.System Has Smart Controllers 3
❑ 7.Incorporate Two Inches of beneficial in the Top 6 to 12 Inches of Soil L7 0 3
e.Mulch All Plantin Beds to Greater of 2Inches or Local Water Ordinance Requirement 2'
_9U 50%Selvaged or Recycled-Content Materials for 50%of NomPlant Landscape Elements 1
❑ 10.Reduce Light Pollution by Shieldin Fixtures and/or Directing Light Downward 1 1
Total Points Available in Land 0
D.STRUCTURAL FRAME h BUILDING ENVELOPE lr Points Available Per Measure
7.Apply Optimal Value Engineering
❑ a.Place Rafters and Surds at 24-Inch On Center Framing 0
❑ b.Size Door and Window Headers for Lead 0 1
❑ c.Use Only Jack and Cripple Studs Required for Lead 0 1
2.Use Engineered Lumber m
❑ e.Beams and Headers - 0
[I b.Insulated Engineered Headers 0 1
E] c.Wood I-Joists or Web Trusses for Floors - 0 1
❑ J.Wood IJoists for Roof Rafters 0
❑ e.Engineered or Finger-Jointad Studs for Vert Applicatlons 0 1
❑
I.Oriented Strand Board for Subgoor 0
❑ g.Oriented Strand Board for Well and Roof Sheathing 0 1
3.Use FSC-Certified Wood
❑ a.Dimensional Lumber,Studs and Timber:Minimum 40% - rD 1 2
E] b.Dimensional Lumbar,Studs and Timber.Minimum 70%FT c. ��1
Panel Products:Minimum 40%
❑ L d.Panel Products:Minimum 70°k
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
5
a �
ENTER PROJECT NAME
4.Use Solid Well Symms(includes SIPS,ICFs,6 Any Nonstick Frame Assembly)
❑ a.Floors _0 _ 2 2
❑ b.Walla 0 2 2
❑ C.Roofs 0 2 2
5.Reduce Pollution Entering the Home from the Garage
❑ e.Tightly Seal the Air Berner between Garage and Living Area
❑ b.Install Garage Exhaust Fen OR Build a Detached Garage 0 1
e.Desl n Energy Heels on Trustee(75%of Auto Insulation Height at Outside Edge of Exterior Well) 0 1 I
❑ 7.Design Roof Trusses to Accommodate Ductwork 0 1
B.Use Recycled-Content Steel Studs for 9D%of Interior Well Framing 0 1
g.Thermal Meas Walla:5104nch Drywall on All Interior Wells or Wells Weighing more than 4D Ituft.ff. 0 1
10.Install Overhangs and Gutters
❑ a.Minimum 164nch Overhangs and Gulters 0
❑ b.Minimum 24-Inch Ovethens and Gutless 0 1 1
Tote)Pointe Available In Structural Building Frame and Envelope=3B 0
E.EXTERIOR FINISH - Points Available Per Measure
1.Use Re cletltonfent(No Virgin Plastic)or FSCCertlOetl Wood Docking 0 I i 1 2 I
2.Install OR in Screen Wall System D 1 2 1
3.Uae u
and Noncombustible Siding Materials 0 ' 1
-.Select Durable and Noncombusi ble Roofing Materials 0 1 I 2
Total Points Available in Ededor Finish=7 0
F.INSIII.ATION Points Available Per Measure
1.Install Insulation with 75%Recycled Content
❑ a.Walls and/or Floors
El— __b.Cellin s---- -- — - _ — — ___—__ p -
2.InsMll Insulation thmis Low-Emitting(Certified Section 01350)
❑ a.Wells and/or Floors 0
❑ b.Collings 0
❑ 3.Inspect Quality of Insulation Installation before Applying Drywall 0 1 I
Total Points Available In Insulation=5 0
O.PLUMBING Points Available Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points).
❑ a.Insulate Hot Water Pipes from Water Heater to Kitchen 0 1 _ 1
❑ b.Insulate All HW Water Pipes 0 1 1
❑ . c.Use Engineered Parallel Piping 0 _ 1
El d.Use Engineered Parallel Piping with Demand Controlled Circulation Loop 0 _ 1
❑ a.Use Snctured Plumbing with Demantl Controlled Circulation Loop 0 ___ _ 1 2
❑ 1.Use Central Core Plumbing D 1 1 2
2.Inmell Only High Efficiency Toilets(Due-Flush or 51.2e f) 0 I 4
Total Points Available In Plumbing=Total 12 0
q)jjEATING.VENTDdTION R AIR CONDITIONING Points Available Per Measure
1.Design and Install HVAC System to ACOA Manual J,0,antl 5 Recomitendationa 0 1 4 i
2.Install Sealed Combustion Unita
e.Furnaces D 2 Z
b.Water Heaters, 0 2
3.Install 2onetl,Hydmnic Ratlient Hawing with Slab Edge Insulation 0 1 1
stall HIS ,
Air Condtioning with Environmentally Responsible Refrigerants 0 1 /
S.Design and Install Effective Ductwork
❑ a.Install HVAC Unit and Ductwork within Conditioned Space 0 3
❑ b.Use Duct Mastic on All Duct Jonts and Seams 0 1
❑ c.Install Ductwork under Attic Insulation(Burled Ducts) 0 __ 1
❑ d.Pressure Balance the Ductwork System 0 _ 1
❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0 l 1
6.Install High Efficiency HVAC Pilot(MERV 60 0 1
❑ 7.Don't Install Fireplace or Install Basted Gas Fireplaces with Efficiency Reding Not Len Than 60% p I 1
using CSA Standards
5,Install Effective Exhaust Systeme In Bathrooms and Kitchens
❑ a,Install ENERGY STAR Bathroom Fane Vented to the Outside 0 ]
❑ b.All Bathroom Fans Are on Timer or Humitlistat 0 1
❑ c.Install Kitchen Range Hood Vented to the Outside 0 1
a.Install MechanlelcVanWation System for Cooling(Maximum 4 Points)
❑ e.Instal ENERGY STAR Calling Fans A Light Kits in Living Areas a Badmom9 T 1
❑ b.Install Whole House Fan with Variable Speeds 1
E] c.Automatically Controlled Integrated System 2
E] d.Automatically Controlled Integrated System with Variable Speed Control 3
10.install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ e.Any Whole House Ventilation System That Meets ASHRAE 622 0 _ _ 2
E] b.Install Air- -Air Heat Exchanger that meets ASHRAE 62.2 0 1 2
11.Install Carbon Monoxide Alerm(s) 0 1
Total Points Available In Hearing,Ventilation and Air Contlitionin =30 0
02007 Build It Groan Single Family GreenPoinl Checldis12007 Version Page 2 of 4
ENTER PROJECT 4 Munn
me
I.RENEWABLE ENERGY Points Available Per Measure
1.PwPlumb for Solar Hot Water Heading 0 4
2.Install Solar Water Heating System 0- 10
® 3.Install Wiring Cenci Future Photovoltaic Installation&Provide 200 le of Soudir-Facing Boot 0 2
4.Install Photovoheic(PV)Panels
❑ a.3D%of electric needs OR 1.2 kW(total 6 points) D 6 1
❑ b.60%of ohdrt needs OR 2.4kW(total 12 points) 0 _ 6
❑ c.90%of electric heed OR 3.6 kW(total 16 points) 0 I 6 T
Total Available Points in Renewable Energy=26 0
J.BOHAING PERFORMANCE Points Available Per Measure
1.Diagnostic Evaluations
❑ a.House Passes Blower Door Taid _0 1
❑ b.House Passes Combustion Safety Backdraft Test 0 1
2.Design and Builtl High Performance Horise-%above Title 24-minimum 15%Required 0 >_30 1
❑ 3.House Obtains ENERGY STAR with Indoor Air package Certification-Pilot Measure(Total 45 pointe;rend commanU 0 ( 5 i 2
Total Available Points in Building Performance 39 0
E.FINISHES Points Available Per Measure
❑ 1.Design Entryways to Reduce Tracked in Contaminants 0 1
2.Use Low-VOC or Zem-VOC Paint(Maximum 3 Points)
❑ a.Low-VOC Interior WaIVCailing Paints(<SD gpl VOCs(Flat)and<150 API VOCs(Non-Flat)) 0 1
❑ b.ZnOC:Interior Wall/CeilingPaint(,S pI VOCs Flat)) 0 3
❑ 3.Use Low VOC,Water-Saeed Wood Finishes(Q50 gpI VOCs) 0 2
—❑-4.Use Low-VOC Caulk and Construction Adhesives(<70 gpI VOCs)for.All Adhesives 0 1 _2-1 —)
❑ 5.Use Recycled-Content Paint 0 1
6.Use Environmentally Preferable Materiels for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,D)RecyciedContenl
or E)Finger-Jointed
❑ a.Cabinets(50%Minimum) - 0
❑ b.Interior Thin(SD%Minimum)
❑ c.Shelving(50%Minimum) 0 _ T --I{--1
❑ rs
.Doom 0
9 1 L_
❑ e.Countertops(50%Minimum)
0 1
7.Reduce Formaldehyde in Interior Finish(CA section 0135(1
❑ a.Subiloor&Stair Treads(50%Minimum) 0
❑ b.Cabinets&Countertops(50%Minimum) 0
® ❑
C.Interior Trim(50%Minimum) 0 _ 1
❑ d.Shelving(50%Minimum) 0 — 1
❑ &.After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Level'27ppb 0 1 3 1
Total Available Points in Finishes=21 0
L.FLOORING Points Available Per Measure
1.Use Environmenmlly Preferable Flooring:A)FSCCartified Wood,B)Reclaimed or Refinished,C)Rapidly Renewable,D)Recycled-Content E)
Exposed Concrete.Flooring Adhesives Mush Have c50gpl VOCs.
❑ a.Minimum 15%of Floor Area 0
❑ b.Minimum 30%of Floor Area 0 _ �-1—
❑ c.Minimum 50%of Floor Area 0 1
❑
J.Minimum 75%of Floor Area 0
❑ 2.Thermal Mass Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floors 0 1
❑ 3.Flooring Meets Section 01350 or CRI Green Label Plus Requirements(50%Minimum) 0 1 2 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(total 1 point) 0
❑ b.Dishwasher Uses No More than 6.5 Gallons/Ccle(total 2 points) 0 l 1
2.Install ENERGY STAR Cloth"Washing Machine with Water Factor of 6 or Less
❑ a.Meets Energy Star and GEE Tier 2 requirements(modified energy factor 2.0,Water Factor 6.0)(total 3 points) _0
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 2.2,Water Factor 4.5 or less) 0 2
totalspoints)
3.Install ENERGY STAR Refrigerator _
❑ a.ENERGY STAR Qualified&<25 Cubic Feel Capacity 0
❑ b.ENERGY STAR Qualified&<20 Cubic Feel Capacity 0
4.Install Built-in Recycling Center 0
❑ a.Built-In Recycling Center 0 ( 2
❑ b.Built-In Composting Center 0 1
Total Available Points in Appliances and Lighting 12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporate GreenPoint Rated Checklist in Blueprints-Required 0 R
❑ 2.Develop Homeowner Manual of Green Features/Benefits D 1 1 1
3.Community Design Measures It Local Priorities:See the Community Planning&Design section In Chapter 4 of the New Home Guidelines for
measures.Maximum of 20 points for suggested measures.Local requirements may also be listed here.
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 3 014
ENTER 3
a
MUM
❑ Enter dearmilmon here,and enter petals available for measure In appropriate categories to the night. 777_ 0 D 0 0 0
Enter desomed n here,and enter points available for measure In appropriate categorise to the night. O__ 0 0 0 0 0
Enter description here,and enter pelma available for measure In appropriate,cobalt ones to the night. 0_ 0 0 0 0
❑ Enter dBstlption hem,and eater poinb BVBI BblB for mBesum In Bpprconeto LotBgorleo to nB ni he 4 _ _ _ _ 0 0 0 g 0 D_
4,Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Build It Green Checklists end
maximum combined total of 20 pts.See Innovation Checklist for suggested measures,using the link to the right. __ uuncenne_ s_ __
Innovation in Community:
Enter description hem,and enter parts available an measure In ate cats odea to the 0 0 0 D 0 0
Innwetion In En!W:Enter description hem,and enter points available for measure In appropriate categories to the right. _ 0 0 0 0 0 0
Innovation m IAO4lnith:Enter description here,end enter points available for measure in appropriate categories to the right. 0 _ o 0 0 0 0 _
❑ nnovaticn In Resources:Enter description here,and enter an available for measure n 0 opdale categories to the right _0 o 0 0 0 0
I LJIonovotion In Water:Enter dascritutm here,and enter points available for measure in ailpropdme categories to the dgM_ _� 0 0_ 0 0 0 0
Total Avallebla Points In Other=43 0
Summary
Total Available Points In Specific Categodes' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categodes 0 30 5 6 9
. a a a a a a
7 ii
Project hes not yet met the following recommended minimum requirements:
-Total Project Score of At least 50 Points
-Required measures:
43a: 50%waste diversion by weight
-32: 15%above-7-itle 24_— __ _____ _—_ _ _
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(6 points)
-Water(9 points)
•
02007 Build It Green Single Family GreenPoint Checklist 2007 Vemlon Page 4 of 4
Community Development
10300 Torre Avenue
4 Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
..CUPEkTINO
Building Department
JOB ADDRESS: PERMIT # Ol a
4) 3s- & l
OWNER'S NAME: — PHONE # edP,7p o
GENERAL CONTRACTOR ,��/�L FAX #
I am not using any subcontractors: d�L2-z
Signa a 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
r Glass / Glazing
Heating r,'V
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date