08040178 (2) CITY OF CUPHRTINO ' ° 3x4','z.adr«4
BUILdINO DIVISION PERMIT GU'NTRACTOR INFURMAT=ION; ''
BUIL41NG ApO�cESS: PERMIT NO.
G197b LINDY LN BETTER WATER HEATERS 08040178
OWNER'S NAME: PERMIT ISSUE DAIS
TONY TOMAS 351 FALCATO DR 04/24/2008
NE: SANITARY NO. CONTROL NO.
ARCHIIEC(ENGINEER: - BURRING PERMIT INFO
INSTALL •50 GAL WATER HEATER ffo O O O
LICENSED CONACIOWS DECLARATION
,op RI
Job Description
MU 1 sa eb arame this I am limmM under provisions of Chapter 9(commmem, P
O NNSmtion7 nMof Divinon3ofdm Bu . ftff * .and myl'zcn2is
^ m in fWl form soul [��DO
ip: umrise Clw Lle.g
n F p Dam ' Canuscmr
II7W ARCHITECT'S DECIA N
u 1 understand my plans Mall homed u public records
tra- Licensed Professional
503 OWNER-BUILDER DECLARATION
Z I herthy aRrm NR I em uempt from the Contractors License Iaw far the
C 00 following mason.(Section 7031.5,Business and Professions Cam:Any city or county
al which rtqulms a Permit to construc4 alum.nor .dCmllilah,or repair any structure'
i'y^ prior m its Women,also,mquiru the applicant for such Permit to rile.signed sutemem
z' Na he 1.licensed nossountmthe P.Aaromathe ContrOmr'License U.(Chapm9 Sq.Ft. Floor Area Valuation
$ (commencing with Section 7000)of Division 3 of the Bw
usinand Profwions Cudc)or
Nat he is emmpl thaefmm and the basis for Ne alleged emmption.Any violation of
Section'7031.5 by airy applicant for a pumit subjecu the applicant m•civil Pmalty of APN Number Occupancy Type
not mart Nan Run hundred dollars(S5(kp,
❑1,u owner of the property,or my employees with wages u their=in compensation,
will do the work,andNe structure is Out Intended o aaered fm aie(S=IDN.Bosioner ns Required Inspections
rofw
and PION Cade:The ConhaMY
mLicense Law does ml apply m an want of 9 P
property who builds or im poem thereon,end who does such work himself or through his
ownemployom,provided that such improvements art not intended oroRemd forale.If.
hum.,the building or ImProvemant is Old within ore year Of--PleOon,the owner
builder will law W hu dm of proving Nat he did not build or improve fa purpose of
.10.
O 1,ss moss of the properly am eOludvely contracting with Iimmed contractors m
coostmct Ne project(Sec.1014.Business and pmfaslons Cade:)TM Contaemra U.
come Taw dura oat apply to an ower of property who builds or improwa Merton.ad
who contacts for such project{with a contractor(s)licensed pursuant to the Contracloes
License law.
❑Imeeaemptunder See .BAPCfa Ntsmama
0 Dam
WORKERS COMPENSATION DECLARATION
1 hereby aRim under pemlty of Perjury ane or the folmwing declarWotsc
I have and will maintain•CeNfuate of Co..,to self-Insure far workers camper,
cWen,a provided for by section 3700 of the labor Code,for the performance of tie
mass fee which this permit is inmsed.
❑1 ban and will mainuin Wafers Compemauon Insurance,at required by section
3700 aft Labor Code.for the urformanm ofthe work fa which this permit is laded. '
My Workers Compemsstfen lrudernmem atria and Policy rmMAf ue: / s�
Cartm. lVF?V J "1q? 1 PoOcy No.: Fin-<� `� •
CERTIFICATE OF ID(FMPTION FROM WORKERS
COMPENSATION INSURANCE
mols.MIM Red not ban completed BNC permil lefaamc humNW doBN($100)
or )
I emify dot in the performance of ftwart fa which this permit is imed.I shall no
employ any person in my counter so as in become subject to lie Warks!Compeneadu
lawn aCalif nods.Data
Applicant
NOTICE TO APPLICANT.If. net making this Certincae of Exemption.you should
become Object m the Womkers Compensation provisions a the labor Code,you most
z foMonds mmpiy with such provisions or this permit shall be deemed molted.
icCONSTRUCTION LENDING AGENCY
y
[-+ I hereby affirm that there is a construction lending agency for the Performance of
gY > Ne work for which this perish is issued(Sec.3097,CN.C.)
QLenders we
7 z LaWera Add^..
V Q 1 catify that 1 have rad this application and sum that the above information is
w Correa,l agM1Y m Comply with 411 city and county oN11WmG and One laws relating to
buil41n,cus"clion,mdhembyauthodmmpmmnUiiMcf Ni.CiiymmwuP ndm
W alma-mentiuned Property for InspaNon Purposes.
(We)agree to ave,indemnify ad keep harseles,Ne City of Cupertino 30ML
Cn liabilities,judgments,costs and sermons which may in my my aectu against said City
f.) ten consequnee of the granting of this Permit. [,
^'m APPLICANT UNDERSTAN D WILL COMPLY WITH ALL NO -POINT Issued by: 9 Date � (.rte
SOU EGULATIONS
y Xfr- Re-roofs.
Signature of AppOmnuCanuacmr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tie ap,Ii.t or future building ampant oro or handle beraNeu material
ar dearth by the Cupertino Municipal Code.Chapter 9.11.and site HosIN and Safety
Cam,Section 2553:(./7 All roofs shall be inspected prior to any roofing material being installed.
❑Yrs .
`Will W applicant i (alum building bytheoccupant iso:equipment or Mara which
If a roof is installed without first obtaining an inspection,I agree to remove
1 hvallou sir tonuminanu u mud by the Bay Area Air Quality Management all new materials for inspection.
D W ct7
❑Ya o '
I have mad the baaNau materials mqu momesuderChspter6.95aftGlifor-
w Heal 8 Safety Cade,Sectims255M.25533 and 25531.1 undems al Nuif the huimlaI
dao est cunentiY have a tenant t is my responsibility m notify ft oaurcom of Ne
ressussanams which muttW Euroill reate aroma Signature of Applicant Date
Owner aOthmiredagent Dam I All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35627007 .00
DATE ISSUED. . . . . . . : 04/24/2008
RECEIPT # . . . . . . . . . : BS000004575
REFERENCE ID # . . . : 08040178
SITE ADDRESS . . . . . : 21996 LINDY LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TONY TOMAS
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : FRANS CARTWRIGHT
CONTRACTOR . . . . . . . : FRANS CARTWRIGHT LIC # 26514
COMPANY . . . . . . . . . . : BETTER WATER HEATERS
ADDRESS . . . . . . . . . . : 351 FALCATO DR
CITY/STATE/ZIP . . . : MILIPITAS, CA 95035
TELEPHONE . . . . . . . . : (408) 250-6672
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 1, 000. 00 0. 50 0. 00 0 .50 0. 00
1PPERMITFE FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00
1PRWHEATR UNITS 1. 00 24 .48 0. 00 24 .48 0. 00
1TRAVDOC FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 106 .56 0. 00 106 . 56 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT. CARD 106 . 56 VISA
---------------
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
518 WATER HEATER
CITY OF CUPERTINO
G WATER HEATER
• CUPEI,TINO PERMIT APPLICATION FORM
OFOL4017K
APN# Date:
2-7 607. 00 /0K
Building Address:
Li^'UY (. .,,j( (/Vj10L 1D
Owner's Name: Phone #:
Y r�m�s SUBIW1 T T qws GTS`IS-73
Contractor: Phone #:
waw, vvmFax #: 55?
Cupertino Business License #: Contractor State License #:
97-9pq 6-3(e
Contact: Phone #: y,,f 2�D 2-
41
Fax #: q°K 55 7 'rV9
Building Permit Info:
Bld ❑ Elect Plumb Mech E--
Residential L. Commercial ❑
Job Description: 19;;24, So 6gy wA.^ Y— 0),j 914�,D pJ 6f L4*f
Strapped [ On Platform Bonded ❑ New Location ❑ Replacement
Valuation: Ili
Green Building Check must be completed and attached to this application.
Green Building Points.achieved: 2- -
•
CITY OF CUPERTINO
WATER HEATER
CUPEkTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
IBSEISMICOM Seismic Commercial B
1 PRWHEATR Residential Water B PRWHEATR
HeaterNent
1BSEISMICRE Seismic Residential B
IPPERMITFEE Plumbing Permit P
/ 1 TRAVDOC Travel & B
Documentation
1BUSLIC Business License B
•
4
Single Family GreenPoint Checklist. Build It Greed
a Smart Solutions From rite Ground U
The GreenPoint Checklist is based on the various green features incoryorated Into the home and is the P
basis for the GmimPolnt Rated program.A home can be considered green it It fulfills the prerequisites,
some at least50
ices(and meals the minimum paints per category,Energy list
of Indoor Air Duality/ ��
Health(5),Resources(6),and Water(g).Please contact Build It Green for a Ilsl of qualified GreenPoint
• Raters if you are interested In pursuing third-party varlficallon.
The green building practices listed below are descrbed in the New Home Construction Green Building
Guidelirr_s,available at www.builditareeaom.
n-
ENTER PROJECT 4ME
V s Q
A.SITHmlm i V yL 7 Points Available Per Measure
1.Prot opsoil entl l,intDisruptlon of Existing Plants 6 Two
❑ a Protect Topsoll from Erosion and Reuse after Consul 0 1 1
❑ b.Limit and Delineate Construction FDogrint for Maximum Prmaction -p -- --
❑ 2 Deconstruct Intel of Demolishing Eudl Sullaings On Site 0 - 3
3.Recycle Job SIM Construction Waste(Including Green Waste)
❑ a.Minimum 50%Waste Diversion by WeigM(Recycling or Rouse-Required 0 R
❑ b.Minimum 65%Orrersionby Weight(Recycling or Reuse) p- - ------"-" _z--- -
❑ c.Minimum 110%Diversion by Weight(Recycling or Rouse) 0 -- - '-"----'
4.Use Recycled Content Aggregate(Minimum 25%)
❑ a.Walkway and Driveway 01
El b.Roadway Base —
a 1
Toll Points Available In Site=12 0
H.FOUNDATION Points Available Per Measure
1.Replace Portland Cement in Concrete with Recycled I'll or Slog
❑ a.Minimum 20%Flyash or Slag p
❑ h.Minimum 25%FI ash or Slag D 7
❑ 2 Use Frost-Prololed Shallow Foundation in Cold Areas C.E.C.Climate Zone 16) 0 3
❑ 2.Use Radon Resistant Construction Un At-Risk Locations Only) 0 1
4.Design and Build Structural Pest Control
❑ a.Install Termite Shlelds S Separate All Exterior Wood-tOConcrel Connections by Mata or Plastic FasteneRJDMItlars 0
b.AO New Pierce Have Trunk,Base,Or Stem Located At Least 36 Inches from Foundation 0 _ 1
Toll Point Available In Foundation=e 0
C.LANDSCAPING Points Available Per Measure
1.Construct Resourco-ERcient Landscapes
❑ a.No Invasive Species Listed by Cel-IPC Are Planted 0 1
• ❑ b.No Plant Spades Will Require Hedging
EI _0__ _
c.75%of Plants Are Drought m orenl CelNpmla Natives,Medanam0m�,or Other Appropriate Species I 3
2 Use,Fira-Safa Landscaping Techniques 0 1
s.Minimize Turf Areas in Landscape Installed by Builder
❑ a.All Tud Will Have a Water Requirement Less than or Equal to Tall Fescue(50.6 plant factor) 0 I-
❑ b,Tud Shall Nb Be Installed on Slopes Exceeding 10%Orin Areas Lass than 6 Feet Wide _�-T 2 _
❑
C.Tun Is S33%of Landscaped Area(total 2 pdn%) 0 2
❑ a.Turf Is 510%of Landscaped Area petal 4 points) 0.... T .i 2
❑ 4,Plant Shade Two
0 3
❑ S.Group Plant by Water Needs Hytlmzonin 0 I I 2
S Install High-Efficiency Irrigation Systema
❑ a.System Uses Only Low-Flow Drip,Bubblers,or Low-flow Sprinklers 0 f ( 2
❑ b.System Has Smart Controller
❑ 7.Incororam Two Inches of Compost In the Top 6 to 12 Inches of Soil 0 I 3
(Mulch All Plntin Bods to the Greater of 2 Inches or Local Water Ordinance Requirement 0 2
9.Use 5D%Salvagatl or Racyetd-Content Materials for 50%of Non-Plant Landscape Elements 0 1
❑ 10.Reduce Light Pollution by Shielding Fixtures and/or Directing Light Downward 0 1 I
Toll Points Available In Landscaping=31 D
D.STRUCTURAL FRAME&BUELDING ENVELOPE Points Available Pel Measures
1.Apply Optimal Value Engineering
❑ a.Place Rafters and Studs at 24-Inch On Center Fmming
1
❑ b.Sim Door and Window Heatlers for Load
❑ c.Use Only Jack and Cripple Studs Required for Load 0 7.
2.Use Engineered Lumber
❑ a Beams and Headers 0 1
❑ b.Insulated Engineered Headers 0 i 1-T-_
❑ c.Wood WOWS or Web Trusses for Floors -0 -
❑ J.Wood I-Jolsts fa Roof Rafters0
--'— - ---
❑ e.Engineered or Finger-Jointed Studs for Vertical Applications - 0 ---i --
1
❑ f.Oriented Strand Board for Subiloor p� --
❑ g.Odemed Stand Board for Well and Roof Sheathing 0 I '
3.Use FSC-Certified Wood
❑ a.Dimensional Lumber,Studs and Timber.Minimum 40% 0 2
❑ b.Dimensional Wmber,Studs and Timber.Minimum 70% p - -- '—'- _-___•
E) 2 --
c.Panel Products:Minimum 4096 _ 0 _ _ _1'1
❑ d.Panel Product:Minimum 70%
0 l
02D07 Build It Green Single Family GreenPoint Checklist 20D7 Version Page 1 of 4
ENTER PROJECTNAME
Manual
r
4. BeUSolid Wel:Syoleme(Includes SIPS,ICFs,6 Any Non-Stick Fmine Assembly)
❑ a more 0 2
❑ b.Wells —0
❑ c,Roofs 0 2 —S.Raducs Pollution Entering the Home from the Damage
❑ a.TIM Seal the Ah Bartter balwean Garage and Living Area _ 0_ ]
❑ b.Ines Geroge Exhaust Fen OR Build a Detached Game 0 1
6.Design Energy Heats on Trustee(75%of Attic,Imuletion Height at Outside Ede of Exterior Well 0 1
❑ 7.Design Boot Trussu to Accommodate Duchvork 0 1
e.Use Recycled-Cantata Steel Santa for a0%of Interior Wall Framing D - 1
6.Thermal Mau Walls:Winch Drywall on All Interior Wells or Wells Weighing more than 401Wcu.fL 0 1
10.Install Overhangs and Gutter,
❑ a Minimum 16-Inch Overhangs and Gumn _ 0 _ 7
❑ b.Minimum 24Hpeh Overhangs and Gu0en 0 ]
Total Points Available in Spectral Building Frame and Envelope=36 D
E.ECXTRRIOR FIMSH Points Available Per Measure
EF 1.UN Regaled-CDmenl o Virgin Plastic or F13C-0aeiffed Wood Docking 0 2
2.Install a Rain game Wall System 0 2
S.Use Dumble and Noncombustible Siding Materiels 0 1
A.Select Durable and Noncombustible Rooling Materials 0 2
Total Points AveSable N Exporter Finish.7 0
F.INSOLATION Points Available Per Measure
1.Install Insula0on with 75%Recycled Content
❑ a Wide and/or Floors 0 ! 7
❑ b.Collings —6'
2.Install Imulaticn that Is Low-Emitting(Certified Section D1350)
❑ .a.Walls udlor Floors 0
❑ b.CeilingsD 1
❑ 9.Intelsat Duality of Insulation Installation before Applying Drylvall 0 1
TOW Points Available in Insulation=5 0
G.PLUMBING Points Available Per Manure
1.Distribute Domestic Hot Water EKcien0y(Maximum 7 Points).
❑ a Insulate HM Water Pipes tram Water Header to Kitchen 0
❑ b.Insulate All Hot Water Pipes 0
❑
C.Use Engineered Parallel Piping 0
❑ I.Use Engineered Parellal Piping vAm Demand Controlled Cimulabon Loop _0 _ ____ __ _ _1
❑ e.Use Mounted PlumBing Mth Demand Conbolled Circulation Loop —0
❑ 1.Use Control Core Plumbing D
❑ 2.Imtall Only High Efficiency Toilab Ounl-Flush or$1.26 g 7) D 4
Total Palms Available In Plumbin .Total 12 0
H IffiATING VENTG.ATTON @ AIIt CONDIT[OMNO Points Available Per Manure
1.Design and Install HVAC System to ACCA Manual J,D,and S Recommendations 0 1 4
2.Install Sealed Combustion Unita
❑r a.Furnaces 0 _— _1 2
Iy
It.Walsh Heaton 0 2
3.Install Zoned,Hydronic Radiant Hating with Slab Edge Insulation 0 1 1
4.Install High EfOUury Air Conditioning with Environmentally Responsible Refrigerants 0 1 1
5.Design and Install Effective Ducteork
❑ a.Install HVAC Unit and Ductwork within Conditioned Space _ 0 _ y 3
❑ b.Use Duct Mastic on All Duct Joints and Seams _ 0 _ 1
❑ c.Install Ductwork under All Insulation(Buried Ducts) _ 0 _ 1 t—
a
❑ d.Pressure Balance the Duchvak System 0
❑ e.Protect Ducts being Construction antl Clow All Ducts before Occupancy 0 1 f +
LJ S.Install High Efficiency HVAC Fitter(MERV S+) 0 1
❑ 7.Don't instal Fireplace or Install Suled Gas Fireplaces with EIDUancy Rating Not Less Than so% 0 1
using CSA Standards
6.install Effective Exhaust Systems in Bathrooms and Kitchens
❑ e.Install ENERGY STAR Bathroom Fans Vented to the Outside
❑ b.Al Bathroom Fens Are an Timer or Humidistat 0
❑ c.Inti Kitchen Range Hood Vented to the Outside 0 ,1
g.install Mechanical Ventilation System for Cooling(Maximum 4 Points)
❑ a looted ENERGY STAR Calling Fane 6 Ughl Kits In Living Amu a Bedrooms 0
❑ a Instal Whole House Fan Win Variable Speeds 0
❑ c.Automatically Controlled Integrated System
❑ d.Automatically Controlled Integrate System with Variable Speed Control 0 1 3
10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
❑ a.Any Whole House VOntlletion System That Neste ASHRAE 62.2 _0_ _I 2
❑ b.install Ar-lo-Air Heat Exchanger that most&ASHRAE 622 0 1 2
11.Install Carbon Monoxide Aamn(s) 0 1
Tot Points Available In Feeling,Ventilation and Ali Cautioning=30 0
02D07 Build It Green Single Family GreenPolnl Checklist 2D07 Version Page 2 of 4
ENTER'PROJECT NAME
=Bull
1.RENEWABLE ENERGY Points Available Pai Measure
1.Pre-Plumb for Solar Hol Watsr Heating 0 4
• LJ 2.10.11 Solar We Heatn System 0 10
3Insrall Widn Conduit for Future Photovoltaic Installation 6 Provide 200 fe of South-FacIng Roof 0 2
4,Install Photovoltaic(PV)Panels
❑ a.30%of electric needs OR 12 kW(mill 6 points) 0 6
❑
It.60%of electric needs OR 24kW(IoW 12 points) p �-
❑ C.9D%of electric need OR 3.6 kW(total 13 pours) 0 —. 6
Told Available Panic in Renewable Energy=28 0
J.BUILDING PERFORMANCE. Points Available Per Measure
1.Diegnosfic Evaluations
❑ a.House Passes Blower DDor Test _D
El It.House Passes Combustion Safe Backdraft Test p - _ --- -—
2.Deign and Build High Performance Homes-%above Title 24-minimum 15%Required 0 2:30
❑ 3.House Obtains ENERGY STAR with Indoor Air Package Certification-POm Measure(Total 45 points;read comment) 0 5 2
Taal Available Points In Bullar, Performance=39 0
R.FIMSHRS Pointe Available Per Measure
❑ 1.Design Eniryweys m Reduce Tracked In Contaminants 0 1
2.Use Low-VOC or Zeno-V00 Paint tMeximum 3 Points)
❑ a.Low-VOC Interim WeIVCelling Paints(60 gel VOCs(Flat and<150 gpl VOCs(Non-Flap) p 1
❑ It.Zero-VOC:Interim WelllCellin Palms(d go VOCs(Fl ) p .l
❑ 3,Use Low VOC,Water-Basetl Wood Finishes(Q50 g I VOCs) 0 2
❑ 4.Use Low-VDC Caulk and Construction Adhesives <70 I VOCE for All Adhesives
( AP 0 2
❑ 5.Use RerycletlCommrt Paint '
D 1
B.Use Environmentally Preferable Materials for Interior Finish:A)FSC-Certified Wood,S)Reclaimed,C)Rapidly Renewable,D)RecycledCDmant
or E)FingerJolntad
❑ a.Cabinatc(50%Minimum) 0
❑ It.Interior Trim(50%Minimum) -
❑ c.Shelving(50%Minimum) 0 j ]
El I.Do=(50%Minimum) p -----_T 1
❑ e.Counterfeits SD%Minimum) 0 ---
7.Reduce Formaldehyde In Inferior Finish(CA Section 01350) -
❑ a Subflm 6 S alrTreads(50%Minimum) 0 q
• ❑ b.Cabinets i (5D%Mps um) Minimum) 0
❑ C.Intatw Trim(5D%Minimum) 0
❑ d.Sh6in (50%Minimum) 0 —' 1
❑ 6.After Installation of Finishes,Test of Indoor Air Shows Formaldehyde Level Q7ppb 0 3 1
Total Available Points in Finishes 21 0
L.FLOORING Pointe Available Per Measure
1.Use Environmentally Preferable Flooring:A)FSC.Certlfiotl Wood,B)Roclalmotl or Refinished,C)Fill Renewable,Of Rerycled-Comant,E)
Exposed Conorete Flooring Adhesives Most Hama dO gel VOCs.
❑ a.Minimum 15%of Floor Area 0
❑ to Minimum 30%of Floor Area 0
❑ c.Minimum 50%a Flow Area
❑ d.Minimum 75%a Floor Area 0 1
❑ 2.Thermal Mess Floors:Floor Covering Other than Carpet on 50%or More of Concrete Floors 0 1
❑ 3.FIDwIn Meets Sector,01350 or CRI Green Label Plus Requirements(50%Minimum) 0 i ! 2
Total Available Points in Fluorin =7 0
M.APPLIANCES AND LIGHTING Pants Available Per Measure
1.install Water and Energy Efficient Dishwasher
❑ a.ENERGY STAR(land l point 0
❑ b.Dishwasher Uses No More than 6.5 Gallon cls total2points) 0 �- 1
2.Install ENERGY STAR Clothes Washing Machine with Wafer Factor of 6 or Less
❑ a.Meets Energy Star and CEE Tier 2 requirements(modified energy factor 2.0,Water Factor 6.0)(tool3 points( 0 __ 1 1 1 '______' _2 _
❑ b.Mels Energy Star and CEETisr3 requirements(modKed energy factor 22,Water Factor 45 or less) ^� Z
total 5 lois C
3,Install ENERGY STAR Refrigerator -
❑ a.ENERGY STAR Oulifod 6<25 Cubic Feet Capacity 0 _1 I_ _
❑
It.ENERGY STAR Qualified 6<2D Cubic Feat Capi 0 1 i
4.Install Sult4n Recycling Center 0 - -
❑ a.Bula-In Recycling Centro o i
❑
It.Built-in Composting Center --0- — --'--'�—1
Taal Available Points in Appliances and Ughfin =12 0
N.OTHER Points Available Per Madams
❑ 1,Incorporate GmenPolnt Rated Checklist In Blueprints-Required 0 .R
❑ 2.Develop Homeowner Manuel of Green FeaturnNBenefite 0 1 1 1
• 3.Community Design Measures 61.014 PODritss:See ins Community Planning&Design section In Chapter 4 of the New Home Guidelines for
measures.Maximum of 20 Points for suggested messums.Local requirements may also be listed here.
0 2007 Build It Green Single Family GreenPolnt Checklist 2007 Version Page 3 of 4
,r
ENTER PROJECT NAME
- r.
3
_Enter deem'pllan here,and enter ports available In meuurs In approp ss categories to the right 0 D D 0 0 D
Ens,dewdption herr and Neer lines available la meesun in appropdete categories to the right. 0 D D 0 0 D
Enter description hen,and entor nems evellable In manus In ap nopdete celagorin to the dghL D 0 0 0 0
Enter door onion hen,and enter point avalladu fn resume M appmpdate categories to the right. 0 0 D 0 0
4.Innovation:List Innovative measures that meet the groan building objectives of the Guidelines.Enter up toe @slid n Green Checklists end
maximum combined total of 20 pts.See Innovation Chscklist for suggested measures,using the link to the right Guidelines
Li Inrrovatim M Common :Enter dr ion here,and mer evallade for mauun rt u cue es to the 0 0D 0 0 0
Met
En .Enter horn,and enter points Notable In mauun In es c ore to the ti0 0 a 0 0 0
Metion MM IAORWIth:Enter deodulphon hen,end enter pointer avelsble for mauun in appropriate catogioren to the right 0 0 0 0 0 0
Innovation In Resume:Enter ser ion here,and order pointe nalshe for manure M itexopirlam cats odor to the right. 0 0 0 D 0 0
Irenwalion In Wow.Enter dowry' Itin here,and Inter points available for measure In appropriate nlegFi s to the right. _ 0 g_ 0 0 0 0
Tol-I Available Poins In Other•43 0
Summary
Total Available Points In Specific Categones- 4+ 96+ 42+ 66+ 43+
Minimum Points Recut rad In Specific Categories 0 30 5 6 9
1 1 1 1 1 1
Pm1oct hits not yet met the following recommended minimum requllroments:
-Total Project Score of At Least 50 Points
-Required measures:
43a:50% waste diversion by weight
-.R: 15%above Title 24
-NI:Incorporate Green Point Rated Checklist into blueprints
-Minimum points In specific categories:
-Energy(30 points)
-IAQ/Health(5 points)
-Resources(6 points)
-INater(9 points)
t
02007 Build It Green Single Family Greanloolm Checidist 2007 Version Page of 4
Community Development
10300 Torre Avenue
ti
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
6UPEkTINO
Building Department
JOB ADDRESS: L2o Lg &1 Np y 4W,(' PERMIT #
Gv nro 9 f ?
OWNER'S NAME: M PHONE # 0 3
GENERAL CONTRACTOR: wit.- FAX # W
SU
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
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date