08040079 CTTY OF CUPERTINONNE
BUILDINGDIVISION PEST CONTR:A.GTO ONFORMAT*ON,
ray resv,x$ ;wT>.. x' °kTtr. c 3. . �"Ti)�e os«k?r3.
BUILDING ADDRESS: PERMIT NO.
7411 RAINBOW DR TBD — TO BE DETERMINED 08040079
OWNER'S NAME: PERMIT LSUBDATE
NANCY LIU 04/14/2008
Ng SANITARY NO, CONTROL NO.
ARCHITEC tENGINEER: BUILDING PERMIT INFO
BLDG BLECr PLUMB MECH
0 0 0 0
30o LICENSED CONIRAC OWSDECLSRATION Job Description
Idi 1 barely affirm Wt 1 and thousand under Pmvisiou of Chapter 9(ouer—s-g
n�
with Secdon7WU)ol'DivisionJafWBuslrcmaMProfeuiouCndo,and mylicasueis FILL POOL W/SOIL
in full farce and effmL
l�� Llcenw Clan Lu.g
9 Dau Convector
` ARCHITECTS DECLARATION _
i i understood my Alar a"I W used u public mcoN,
j I+ccmd Professional
OWNER-BUILDER DECLARATION
C 0 s 1 hereby.affim(Seri Nu I a1.exempt from the Canine C's e:My c Law for nse
B°O following muco.(Smumn till I3,Buil•...and Ro(estimns Code:My city our county
+d 9 which nequirns•permit 1.couuvet,alar.Improve,demuliA.m repel,my atroerum
S^ prior m its issuance.also requires; applicant forsuch permit to file a signed sutememt
< uuiheislicensed puuuantuNepMvisImofthe Conuecim'alloc�Law(m+pu*9 Sq.Ft. Floor Area $ Valuation
(cove mem .g with Swd=7000)doivW.3.fu Bane .d Pmrns<imm erode)or 4 0 0 0
5$ that leu exempt therefrom and tie basis for the alleged assumption.My violation of
Z
Section 7031.5 by any applicant fee a permit wbjeer+the applicant m+civil pewty,ofNumber Occupancy Type
not fume Nun five hundred dollars(s� L 36231012 .V6
0I,uawmrofthepmpwy,mmyemployeeswithwq uNelrwlemmpamdon,
willde the wort,and Neswcturt trout rounded or offered fors l.(Sec.7044.Bulu
los
and Pmfawm.,Cera The Cmuecara Lt.Law dans out apply a an pro..or Required Inspections
property who build+ar Ire Proves Uurmn,and who docs such work himself or through his
own emplaym,provided thu such impnowmenu art out inwnOed ero@sed fmaln q
howmv,the Wilding m Improvement is sold within arc ver of aampuiion.the owmr-
buildu will have the burden of proving that M did out build or improve fee purpose of
sok.).
0 1,as owner of No property,+m exclusively measuring with Iuemd mnweran is
construct the project(gas.7044.Businesses and Profrsaions Code:)The Cmvactar's U.
sum law does not apply to an owner of property who Wilds or Improv therms,and
who mntmets for mca pmjec t with a sonuscmRO Ballad punum in the ConvamMs
Licpm law.
�l un esmpru Ba PC for u
YpOkKEkICISWPowner Dam
ENsnn DEcuRAnGN
1 hereby aim under penalty of perjury one of the fallowing me
1 haw:am will m dmajn a CaNOcateof Comet to self-Imre fa WoduYs Compen-
tadm.as provided fee by Section 37W of den Ispm code,ren the pedants re of the
work for which this permit is usued.
0 1 have and will maintain Wares's Compensation Insurance,u required by Section
3700 oflho LaWr Code,for the pcRarmmm of Ne work fro which this .I,is intend '
My Warkee.Compensadan Inaran cat catriturated Policy number are:
Cartier. Policy No.: -
CERTIFICATE OF EKEMP ION FROM WORKERS
COMPENSATION INSURANCE
(Thissecdm need out W completed if tie permit is rwmahunaedda0an(f100)
or leu)
I unify that in the performance of rk for whit rM permit is Issued.1 shall am
employ any penin in any member usIsce a War Non
Lam of flood.
Applicant
NOTICE TO APPUCANTNF.Ifteren n th' Celli te should
become subject an No Waiters Compensation provisions of the Iabm Cada.
.J O foMwide comply wife such provisions or this permit Nall W doomed mwkcd.
'yM CONSTRUCTION LENDING AGENCY
[r I hereby aIirm Nu them u+eosaVucOm lending agency for Ne pedm+bee of
TYi ti Ne work for which thio permit ls issued(Sa.3097,Civ.Q
W Lender's Name
MZ Landeh Addis,
C)Q 1 mossy the,I haw mad this application W atam that the+how InfomNm is
correct.I agree in comply with N city uW county un inanxv and sum saws totting in
0 rV^ Wilding conswNan,and hereby wNorm,representatives of Ni+city a enter umn the
W above-mentioned property for inspection Purposes
LL
rale)a&=to saw,indemnify ad keep hamlet the City of Cupertino against
I/) liabilities.judgments.costs and eapenws which may In my my+ccne against aid City
(„)Z in eomqumee of the Swung of this permit. / It APPLICANT UN STANDS ND WI COMPLY WITH ALL N N-P INT Issued by: Date —/ / t
SOURCE gEGLI IONS.
Re-roofs
SignadusTUTApigi.9.0015u
HAZARDOUS MA RI ISDISC tea Type of Roof
Will Nc applicant or fin bulldimg. corhandle her onsmnamed
u defend by the Cup"..Municipal Code.Chapter 9.13,W the Health and Safety
Co .Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
0 yu
Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without firs[obtaining an inspection,I agree to remove
t Incuml us at,mntaminants es deemed by he Be,A.Air Quality M......me all new materials for inspection.
Dyes
victT
I have need the luamr hovisds uimmrnuunderChapter6.95ofhoCalifm-
meHcalNaSafetyCode.Sections 2550525533 and n534.1 unndemanlthat lfthe Wilding
does out corrobdo3la a um4 thasiWrarry responsibility a ratify tiet of
mgmmmnuw .n W mat m r at.maroy� Signature of Applicant Date
Owner or a.thous . m 7` All roof coverings to be Class'R¢'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36231012 . 00
DATE ISSUED. . . . . . . : 04/14/2008
RECEIPT # . . . . . . . . . : BS000004468
REFERENCE ID # . . . : 08040079
SITE ADDRESS . . . . . : 7411 RAINBOW DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER NANCY LIU
ADDRESS . . . . . . . . . . : 718 CANOAS CREEK CIR
CITY/STATE/ZIP . . . : SAN JOSE, CA95136
RECEIVED FROM . . . . : LEONARD J BABIARZ
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
TELEPHONE . . . . . . . . :
tFEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 4, 000. 00 0. 50 0. 00 0 .50 0 . 00
1BUSLIC FLAT RATE 1. 00 110. 00 0. 00 110. 00 0. 00 _
1DEMORES SQ FEET 0. 00 490. 00 0. 00 490 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 600.50 0. 00 600.50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 600 .50 MC
---------------
TOTAL RECEIPT 600 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
opg007q
CITY OF CUPERTINO
1t1F
DEMO
P
CUIZINO PERMIT APPLICATION FORM
APN# _ 3 l IL Date: `f, l I f
m
Building Address: -74 /I Al��'^ ' �� / l y
vV o C.(v� l 0 9
Mailing Address (if different from building address):
Owner's Name: Phone: 41-O — gag —q9 92
NANj SI U 410 - y- 9 r_33 73
Contractor: Phone
Fax:
Contractor License #:
Cupertino Business License #:
Contact: SIV � Phone: c�/p� 1q,6'O _ 373
tC� Fax:
esidential �Sq Footage Commercial Sq Footage
Job Description:
Valuation: �O O 0
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
1BSEISMICOM Seismic Commercial B
1BUSLIC Business License B
OWNER-BUILDER VERIFICATION
1. (Check one) I or my immediate family (parent, spouse or child) will perform:
A. All the work authorized by this permit
B. A portion of the work
C. None of the work
If B or C is checked,complete 2 or 3 below.
2. A state licensed contractor will be hired to do:
A. _ All of the work
B. QP A portion of the work (complete section below)
Contractor Address/City Phone # State License # Type of work to
be performed
• 3. _ 1 will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number Type of work to be
performed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information (reverse side).
Property Owner's Signature: Qnt/ n ,/ Date: l �"
Job Address: -77 ll �\/`'l✓U h CZ Permit#
Any changes to the information provided on this form shall be submitted to the City of Cupertino Build
• Department.
t
City of Cupertino Building Departmen
CITY OF 10300 Torre Avenue
C U P E kT I N 0 Phone: (408)777-3228
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
the property improvements specified.
For your protection you should be aware that as owner-builder you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are
personally performing their own work. If your work is being performed by someone other than yourself, you
may protect yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all
permits for which they apply.
If you plan to do your own work,with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
If you are an employer, you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding,federal social
security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation
contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law,contact the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under state law,contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale,property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees,without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder
building permit,erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing
their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street,Sacramento, California 95814.
Please complete and return the enclosed owner-builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
Building Department,
City of Cupertino
Printed on Recycled Paper
Single Family GreenPoint Checklist date: �y-f/- Build It Green
The GreenPoint Checklist is based on the various green features Incorporated into the home and is the Smart Solman 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 meets the).minimum
ane points per category:Energy list
of Indoor tit Ouafity i
Halth(5),Resources(6),and Water(g).Please contact Build It Green for a list of qualified GreenPoint
• Raters if you are interested in pursuing third-party verification.
The green building practices listed below are described in the New Home Construction Green Building
Guidelines,available at www. ititoreen.Om.
ENTER PROJECTNAME
' FF
• � E � d i
A.BITEm Points Available Per Measure
1.Proopaoll end Mfnirrtize Disruption of Existing Planes It Trove
❑ a.Protect Topsoil from Erosion and Reuse after Construction 0 I I 1
❑ b.Limit and Delineate Construcfion Footprint for Maximum Protection - 0 I I 1
❑ 2.Deanswn Instead of Demolishing Existing Buildings On Sim 0 I I 3 I
3.Recycle Job Site Construction Warm Qncluding Green Wesco)
❑ a.Minimum 50%Waste 0iversion by Weight(Recycling or Reuse)-Required 0 R
❑ b.Minimum 65%Diversion by Weight(Recycling or Rause) 0 I 2
❑ c.Minimum 80%Diversion by Weigle(Recycling a Reuse) 0 I I 2
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 0 I 1
❑ b.Roadway Base D 1
Total Points Available in Site 12 D
B.FOUNDATION Points Available Per Measure
1.Repma Portland Cement In Concrete with Recycled Flyash or Slog
❑ e.Minimum 20%Flynn or Slag 0 ] I
❑ to.Minimum 25%Flash a Slag 0 1
❑ 2 Use Frosl-Protected Shallow Foundation in Cold Areca(C.EC.Climate Zone 16) 0 1 3
❑ 3.Use Radon Resistant Construction On At-Risk Locations Only) 0
4.Design and Build Structural Peat Controls
❑ a.Install Termhe Shields If Separate All Exterior Wood-to-Obncrom Connections by Moral or Plastic PastanerslDividerc D I
b.All New Plants Have Think,Base,or Stem Located At Least 36 Inches hem Foundation 0 1
Total Points Available In Foundamon=e Foundation= 0
C.LANDSCAPING Points Available Per Measure
1.Construct I eso encsEfficiant Landscapes
❑ a.No InVaave Species Listed by Cel-IPC Are Planted 0 1
• ❑ b.No Plea Species Will Require Hedging 0 1
❑ c.75%of Plants Are Dmught4olorem California Natives,Mediterranean,or Other Apiowdate Spades 0 I 3
2.Use Fii Landscaping Techniques D 1 I I
3.Minimize Turf Areas in Landscape Installed by Bulmer
❑ a.All Tud Will Have a Water Requirement Lass than a Equal to Tall Fescue(50.8 plant factor) 0 I ( 2
El It.Turf Staff Nat Be Installed on Slopes Exceecing 10%or in Areas Less than 8 Feet Wide 0 I I 2
E] c.Turf Is 533%of Landscaped Area(total 2 points) p 2
❑ J.Turf is<_70%of Landscaped Area(oW 4 points) 0 1 2
4.Plant Shade Trees 0 I I 1 3
5.Group Plants by Water Needs Hydrozonin ) D I 1 2
S.Instal Hlgh-Efficiency Inigation Systems
❑ a.System Uses Only Low-Flow Drip,Bubblers,a Low-sax Sprinklers 0 I 2
❑
to.System Hes Smelt Controllers 0 3
7.Incorporate Two Incbes of Compost In the Top 6 W 12 Inches of Soil 0 I I 3
LJ B.Mulch All Planting Beds to the Greater of 2 Inches or Local Water Ordinance Requirement 0 I I 2
LJ 9.Use 50%Salvaged or Recycled-Concord Materials for 5y%of Non-Plant Landscape Elements 0 I ( 1
LJ 10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0 1 I I
Total Points Available in Landscaping=31 0
D.STRUCTURAL FRAME h BUILDING ENVELOPE Points Available Per Measure
1.Apply Optimal Velua Engineering
❑ a.Piece Rafters and Studs at 244noh On Center Framing 0 ) 1 I
❑ b.Slee Door and Window Headers for Lad p 1
E] u Use Only Jack and Critics Studs Required for Load 0 1
2 Use Engineered Lumber _
❑ a.Beams and Headers 0 I 1
❑ b.Insulated Engineered Hoopes 0 1
❑ C.Wood IJolsts a Web Trusses for Flooe 0
❑ d.Wood Wdsta for Roof FeBars 0 1
❑ e.Engineered or Fmger-JDlnted Studs for Vertical Applications 0 I
❑ I.Oriented Strand Board for Subfioa 0 I 1
❑ g.Oriented Strand Board for Well and Roof Sheathing D I
3.Use FSC.Certified Wood
❑ e.Dimensional Lumber,Studs and Timer:Minimum 40% 0 I I 2 I
O ❑ b.Dimensional Lumber,Surds and Timber.Minimum 70% D 2
❑ c.Panel Products:Minimum 40% 0 I 1
❑ d.Panel Products:Minimum 70% 0 1 I
02.007 Build It Green Single Family GreenPoint Checklist 20D7 Version Page 1 of 4
$ 5
ENTER PROJECT NAME
4.Un Solid Wall Systems(Includes SIPS,ICF,6 Any Non-Sdck Frame Assembly)
❑ 9.Fbas2 2 _
El b,
Wells 0
t—~
2 2
El c. Z c.Roofs
5.Reduce Pollution Entering ttu Home from the Garage
❑ a.Tightly Seel the Air Banner between Garage and Living Area 0
❑ to.Install Garage Exhaust Fen OR Build a Detached Garage 0 1 —
Lj e.Design Energy Heels on Transit(75%at Adic Insulation Height at Omdde Ede of Exterior Wal 0 1
❑ 7.Desi n RoolTrvues to Anommadete Ductwork D 1
e.Uae RerydedLontent
Shoal Surds for 90%of Interior Well Framing 0 I 1
LJ D.Thenal Man Walls:N-Inch Drywall an All Interior Walls or Walls Weighing mon dun AD Ihku.fL 0 1
10.Install overhangs and Gutters
❑ a.Mlnlmum 16-Inch Dverhangs and Gullers 0 t 1 �_
❑ b.Minimum 244nch Dverhan s and Gulters 0
Total Points Available in Structural Building Frame and Email=35 0
B.EXTERIOR FINISH Points Available Per Measure
1.Uses RecycletlLontem(No Virgin Plastic)or FSCLeNned Wood Decking 0 I 2
2.Install a Rein grown Well System 0 I ! 2
3.Use Durable and Noncombustible Siding Materiels 0 ( I 1
4.Select Durable and Noncombustible Roofing Materials 0 2
TOW Prints Available In Exterior Finish=7 0
F.INSULATION Pointe AVellabie Per Measure
1.Install Insulation with 75%Recycled Conten
❑ e.Wells and Flows 0
❑ b.Callings 0 �— 1
2.Install Insulation that is Low-EmlWng(CoN6ed Section 0135D)
❑ a.Walls andla Floor _0 _. --t- 1 --+ -
❑ b.Callings 0 r t 1
❑ 3.inspect Quality of Initiation Installation beton Applying Drywall 0 1
Total Pointe AVallabie in Insulation=5 0
G.PLUMBING Points Avellable Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Points)
❑ a Insulate HM W6too Pipes from Water Heater to KMhan 0 1 1
❑
to Insulate Ali HN Water Pipes 0
❑ c.Use Engineered Parallel Plping _0 1
❑ it.Use Engineered Parallel Piping Win Demand Crumpled Gmuldlon Loop _ 0 _ �— 1
❑ a.Use endured Plumbing with Demand Controlled Circulation Loop _0 11 �
E:1 f.Use Central Core Plumbing 0 1 fi 1 2
❑ 2.Install Only High Efficiency T011els D=pFlush or 5120 B 0 - 4
Total Prime Available in Plumbing=TOW 12 0
H.HEATING VBNTUATION R AIR CONDITIONING Points Available Per Measure
❑ t.Design and Install HVAC System to ACCA Manual J,D,end S Recammentlations 0 4
2.Install Sealed Combustion Unice
❑ a.Furnaces 0 j 1 2 T__�__
❑ b.Water Heelers 0 2
D.Insall Zoned,Hydronnc Radiant Heating with Sub Edge Insulation D 1 1
e.Install High Efficiency Air Conditioning with Environmentally Respondble Refrigerants D 1 I
5.Design and Install Eflectin Duchvork
❑ a.Install HVAC Unit no Ductwork wlMin Condmmed Space 0-- 3
❑
to Use Duct Mastic an All Duct Joins and Seams
❑ c.install Duchvom under Aaic Insulation(Buried Ducts) D 1 _
❑ d.Pressure Balance the Duclaark System D 1
❑ e.Protect Ducts during Construction and Clean All Ducts before Occupancy 0
9.Install High Efficiency HVAC Filter(MERV 6.) 0 1
❑ 7.Don't Install Fireplace or Instell Sealed Gas Fireplaces with Efficiency Rating Not Len Than a0% 0 ! 1
using CSA Standards
5,Install Effective Exhaust Systems In Bathrooms and Kitchens
❑ o Install ENERGY STAR Bathroom Fans Vented to the Ductal 0 1 r
❑ b.All Bathroom Fane Are on Timer a Humidisul 0 _ 1
❑ c.Install Kitchen Range Hood Vented to the Outside 0 1 1
9.Install Mechanical Ventilation System for Coaling(Maximum 4 Points)
❑ e.Install ENERGY STAR Ceiling Fens s Light Kits in LNnng Anes 5 Bedrooms 0
❑ b.Install Whole House Fan with Variable Speeds _0 1
❑ c.Aunimadcally Controlled Integrated System 0 2 f__L
❑ d.Auomancally Controlled Integrated System with Variable Send Carmol 0 3—r
10,Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ e.Any Whole House Ventilation System That Masts ASHRAE 622 0_ 2 _
❑ to.install Air.InAlr Heat Exchanger that masts ASHRAE 622 D 2 1
11.traded Carbon Monoxide Alarm(s) I D S I
Total Points AnuleGe In Hosting,Ventilation and Air Conditioning.301 0
0 2007 Build It Green Single Family GreenPoinl Checklis12007 Version Page 2 of 4
ENTER
s
I.RENEWABLE EN&RGT - Points Available Par Measure
LJ 1.Pre-Plumb for gull Hot Water Hoofing 0 1 4 1 1 1
2.Install Sulu Water Heading System 0 1 SO 1 1 1
9.Instsll Wlrin Condu&for Future Photovolhic mut u lion B Provide 2DD W of South-Facing Root 0 1 2 1 1
4,Irish Photovoltaic(PV)Panels
❑ e.3D%l electric needs OR 12 kW(total 6 points) 0 1 6 1 1
❑ b.BO%of electric needs OR 2.4kW(tial 12 points)
❑ c.DD%l eusuic need OR 3.6 kW(total lB points) 0 1 6 I
Total AwileMa Points in Renewable Energy=26 0
J.Bl1QOING PERFORMANCE Points Available Per Measure
1.Diagnostic Evaluators
❑ a.House Passes Blower Door Tel 0 1 1 I
b.House Passes Combustion Sat Beckdreff Test 0 1 1
L Design and Build High Performance Homes-%above Titre 24.minimum 15%Required 0 I no
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-Pilot Massure(TOW 45 points;rod comment) g I I 5 I 2
Tout Available Points in Building Performance=39 0
E.FIMSIM Points Available Per Measure
❑ 1.Design Entryways to Reduce Tracked in Contaminants 0 1 I
L Use Low-VOC or Zero-VOC Paint(Maximum 3 Points)
❑ a.Low-VOC Intel Wall Paints(<50 gPi VDCa(Flat)and c150 gpl VOCs(Non-Flag) 0 I 1 I
❑ It.Zom-VOC:Interior Wall/Collin Paints d gotVOCs(Fill) 0 1 1 3
❑ 3.Use Low VOC,Weser-Based Wood Finishes(Q50 gull VOCs) 0 1 2 1
❑ 4.Use Lol Caulk and Construction Adhesives d0 gpi VOCs)for All Adhesives 0 1 ) 2 I I
❑
S.Use Recycled-Commnt Paint 0
S.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,B)Reclaimed,C)Rapidly Renewable,D)Recycled-Content
or E)Finger-Jointed -
❑ a.Cabinets(50%Minimum) 0 1
❑ o.Interior Tim(50%Minimum) 0 1
❑ a Shelving(50%Minimum) 0 3
❑ d.Coon(50%Minimum) 0 1 I
❑ e.Counted s(5D%Minimum) 0 I 1
7.Reduce Formaldehyde in Interior Finish(CA Section at 350)
❑ a.Sulloor It Stair Treads(50%Minimum) 0 1 I
• ❑ b.Cabinets&Countertops(50%Minimum) 0 1
❑ C.Interior Thin,(50%Minimum) 0 1 1
❑ d.Sti (50%Minimum) D 1
❑ 9.Aller Installation of Finishes,Test of Indoor Air Showa Formaldehyde Level d7ppb 0 i 1 3 1
Total Available Pants In Finishes=21 0
L.FLOORING Points Avagahle Per Measure
1.Use Environmentally Preferable plotting:A)FSPCeNOed Wood,B)Reclaimed or Refinlahod,C)Rapidly Renewebla,D)Recycled-Consent,E)
Expand Concrete.Flooring Adhesive MulRaw cSOgpI VOCs
❑ a.Minimum 15%of Floor Area 0 I I 1
❑ b.Minimum 30%of Floor Area 0 1
❑ c.Minimum 50%of Floor Area 0 1
❑ d.Minimum 75%l Floor Area 0 I 1
❑ L Thermal Mass Floors:Floor Covering Other then Carpet on 5D%or More of Concrete Floors 0 1
❑ 3.Flooring Mows Section 01350 or CRI Green label plus Requirements(5M Minimum) 0 1 1 2 1 I
Total Available Poll in Flooring=7 0
M.APPLIANCES AND LIGHTING Points Available Per Measure
1,Install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(total t points 0 I 1 I
❑ b.Dishwasher Uses No Mora than 6.5 GellonslC cse total2 Orris 0 I - 1 1
2,Install ENERGY STAR Clotho Washing Machine with Water Factor l6 or Less
❑ a.Meeh Energy Stu and CEE Tiar 2 requirements(modified energy factor 2.0,Water Factor 6.0)(toll 3 points) 0 1 2
❑ b.Meets Energy Star and CEE Tier 3 requirements(modified energy factor 22,Water Factor 4.5 u less) 0 I 2
totals points)
3.Install ENERGY STAR Refrigerator
❑ a.ENERGY STAR Oulifi rd 6<25 Cubic Fel Caul 0 I 1
❑ b.ENERGY STAR Qualified It<20 Cubic Feel Capacity 0 1
4.Install Built-In Recycling Center 0
❑ e.Built-in Recycling Center 0 I 2 I
❑ b.Built-In Composting Center 0 1
Total Available Points in Appliances and V htin 12 0
N.OTHER Points Available Per Measure
❑ 1.Incorporates GreenPoinl Rated Checklislin Blueprints Required 0 I R I
❑ 2.Develop Homeowner Manual of Green FeatureslBenefts 0 1 1 1 1
3.Community Design Measures&Lou]Priorities:See the Community Planning&Design section in Chapter 4l the New Home Guicefines for
• measures,Maximum M 20 points for suggested measures.Local requirements may also be listed here.
0 2007 Build It Green Single Family GreenPoint Checkli512D07 Version Page 3 of 4
Waufl
ENTER
s • ,Emar escdptiot Mm,aim anter pains mft*to m out M appropriate®shin to MS0 0 D 0
Enter description hem.and enter Pointe"able to meson M gpopdas caleAedas Io tl•di _0-- 0 D 0 0 0
Einar description ham,and mar pointe avakaNa to measure In approxial•meagoeas to the right. _ 0_ 0 0 0 0
❑ Eeer dncrptlon Nm,and neer polns"able tar meewra M gpoPdate casgerias b Dw right _ _ , — _ _ -_ - _ 0 D 0 0 0 0lip
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a Gulltl It Green Checklists and
maximum combined total of 20 pts.See Innovation Checklist for su ested measures,usingthe link to the right. __ _ _uideline8 1-0Imwatim MCarmani :Ensrd - hare.and ensr &WAN&MMsemM w Nina ; 0 0 00
Imiwaam In Energy:Eeer desal�m ham and erlMrpdnm avellada for meeaun M gp_Nrlam cetaDMB to the dgM, 0 0 0 0 0 0
Innoma n In IAQHnith:Eller di here.and Weer points evallatia tin measure In appraprati,cam •s to am d L D 0 0 0 0 0
Innovation M Resources:Ener deamom hare,and elver Prints 9ve0am hr mnurts N appropriate,9NMu a IM Minn. 0 D D 0 0 0
Imavation In Waaler:EMU decrgaim non,ane Winer poNb avaNaMa Io measure in q{soprlas ameQanas s Ina rigid.. __ - -_. _ _ _ 0_ 0 _D 0 0 0
Total AvallablePolns In OMer=4 0
Sunhinnary
Total Available Points In Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required In S eclfic Categodes 0 30 6 8 9
otal Points Achieved • I 1 1 a 1
<_143
Project has not yet mot the following recommended minimum requirements: �–
-Total Project Score of At Least 50 Points
-Required measures:
-A3a: 50% waste diversion by weight
-J2: 15%above Title 24
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-Minimum points in specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(6 points)
-(Nater(9 points)
02007 Build It Green Single Family GreenPoinl Checklist 2007 Version Page 4 of 4
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
*UPERTINO
Building De artment
JOB ADDRESS: 7th I �n 'N . f� p PERMIT #
N �IJV� Q d-O t-( OOr7q
OWNER'S NAME: J/ PHONE #
GENERAL CONTRACTOR FAX #
I am not using any subcontractors:
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 CitC
Lathing <
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date