GREEN BUILDING APPLICATION RlThis application is intended to explain the requirements, and review and enforcement procedures for PaloAlto Municipal Code Chapter 16.14, California Green Building Code with local amendments, and assistin application for rebates. The City of Palo Alto has expanded the types and scopes of projects coveredby the California Green Building Code, and the level of green building required. Within the Code theCity requires use of the Build It Green, GreenPoint Rated program as opposed to the Codes mandatoryand voluntary provisions in Chapter 4 and Appendix A4. Applicants may use the Code instead ofGreenPoint Rated so long as they show equivalency. The program goal is to design, build and operate anew generation of efficient, environmentally responsible, and healthy buildings in the City of Palo Alto.

For questions about the Palo Alto Green Building Program contact:Kristin Parineh Sustainability Planner250 Hamilton Ave Palo Alto, CA 94303P 650.329.2189 F 650.329.2240kristin.parineh@cityofpaloalto.orgvisit: http://www.cityofpaloalto.org/depts/pln/sustainability green building/green building

Project Types Covered By This ApplicationProject Types Project Scope Green Building RequirementCovered StandardResidential Multi- New construction, Build It Green, The project must meet theFamily rebuilds* and Renovations GreenPoint Rated GPR minimum requirements

or alterations 2:50% of the (GPR) and achieve 70 points. Inexisting units sf, that that addition, the project mustincludes replacement or claim GPR credit A. SITEalteration of at least two of 2.c. 80% waste diversion,the following: HVAC, and 15 points in waterenvelope, hot water system efficiency. **or lighting system.

Residential Two- New construction, Build It Green, The project must meet theFamily and Single rebuilds* and additions 2: GreenPoint Rated GPR minimum requirementsFamily 1,250. (GPR) and achieve 70 points + 1

point per additional 70 sfover 2,550 (150 pointsmaximum). In addition, theproject must claim credit A.SITE 2.c. 80% wastediversion, and 15 points inwater efficiency**.

* Rebuild means any remodeled building or structure where the remodel includes exposure of insulation, or the removal ofexterior sheathing on 25% or more of the exterior walls for a residential project.**For projects with landscapes over 5,000 sf at least 15 points must be claimed for outdoor water efficiency in the GPRsection C. Landscaping OR show compliance with the CA Department of Water Resources Water Efficient LandscapeOrdinance.

Updated January 2011Page 1 of 5

APPLICATION SlJBMITTAL AND REVIE\V INSTRUCTIONSA complete green building application can ensure efficient review of your project. Below you will find what isexpected at the various phases of design and construction. Check your phase of construction for what is expected.At the Building Permit phase, a project can be verified/reviewed by either Build It Green (BIG) or the City of PaloAlto. The benefits and costs of the two verification options are outlined on the green building website underFAQ's. Below are the submittal reguirements for verification through Build It Green. Please contact the City'sSustainability Planner for instructions for using the City. Regardless of the verification option chosen the Owner isrequired to hire a Certified GreenPoint Rater. Searchable Rater Directory:http://www .builditgreen.org/ en!directories/search. asp

".--~~---..,."~,,,,~,,-.....,.--- .••~--.--; ~~~~-- - - -- ~~--- -- ..•.-~-...,...-¥- - _.- - ----. - -=----."..----- ----.-,.----- -~-.,...,.....-~fBiiilding' Pliase' '''-" Check - : Required Documentation' "" > ,',,- '-, - '. ''''''':':'~:'.<·ff!~_~__ - ____ .___ ~ ~ ,f _______._-' __ ~~__ _ _~ .: ~ _. __ __ _ _ > _. ______ .., ______ " __ • ___ ' ~_ J~~;;'(~,~~Prior to 0 Green Building Application for Building Permit and Utilities Rebate ReservationBuilding Permit Form (page 3)Issuance 0 Submittal Checklist and C&D Debris Estimation (page 2)

0 Plan Sets Shall Include• The Title 24 Energy Efficiency Reports shall include the GPR-IR and/or

CF-IR Forms or MF-IR, AND if using EnergyPro, provide the ECON-Iform. If using Micropas, provide the "summary" table that shows each enduse (heating, cooling, ventilation fans, water heating) by fuel type (kBtu andkWh) by month, AND if HERS Verification is required, provide either theCEC or CALCERTS registration number on the energy report.

• GB-I Plan Sheet - The completed GB-l form (page 5) must be placedalong with the project GreenPoint Rated checklist into the plan set. It shouldbe placed on the farthest right comer of the sheet. It is recommended thatthe GreenPoint Rater provide the architect with the "blue print" checklistincluding only points claimed so that the GB-l form and checklist can fit onone sheet if possible.

During 0 The GPR is required to perform an on-site inspection at minimum prior toConstruction scheduling the roof and exterior sheathing, and insulation building inspections.Prior to Final 0 Green Building Post Construction GB-l Form (found in plan set) andInspection and Attachments (page 5)OccupancyWithin 6 0 Proof of BIG GPR CertificationMonths from

0 Final BIG GPR Checklistthe Date of FinalInspection 0 BIG GPR Climate Calculator Inputs

PALO ALTO C&D DEBRIS ESTIMATIONEstimate below the projects debris based on a national conversion factor from the US EPA for the amount ofconstruction and demolition debris typically generated from residential new construction, If you disagree with theamount calculated, you may submit an alternative debris estimate for review and approval. The alternative estimatemust include a breakdown of materials by weight. Spreadsheets are available at the City's Development Center forassistance in calculating debris,

x 4.38* / 2000lbs

Estimated C&D debris (Tons)Project Sqft. Conversion FactorSource: http://www ,epa,gov/epaoswer/hazwaste/sqgi c&d-rpt.pdf

ALL DEBRIS MUST BE TAKEN TO A CITY APPROVED FACILITY (PAGE 4). RETAIN RECEIPTS,INDICATING WASTE TYPE AND WEIGHT, FOR COMPLIANCE AFTER CONSTRUCTION.

Updated January 2011Page 2 of 5

GREEN BUILDING APPLICATION FOR BlllLDING PERMIT andlJTILITIES REBATE RESERVATION FORM

Residential Green Building Application Type 1

Permit Number: 11-------- Permit Address:

Proiect Valuation: $EstimatedOceu ane

GPR Point Allocation (found on completed GPR checklist)

Community Energy IAQ / Health Resources Water

Total Project Sqft.

Total Landscape Area Sqft.

This includes all square feet undergoing construction including garages,accesso structures, and second dwellin units.

This includes all ervious sur aces.

Green Building Sqft.

GPR Points Reguired

The green building sqfl is determined by adding the total sqfl of the unitsplus % the sqfl of any garages. Add the entire sqfl of the garage ifconditioned s ace.

A project may claim more points than the City requires to increase theefficiency and decrease the environmental impact of the home, as well asto become eligible for rebates and incentives. The amount of points maychange during construction so long as the home does not fall below the

GPR Points Claimed minimum number 0 oints re uired.

70points + 1point per additional 70 sf over 2,550 (150 pointsmaximum).

Utilities Rebate Eligible PointsUtilities Rebate AmountReserved

= (Energy Points + Water Points) - 45 Points Required - Pointsfor Solar Hotwater or PV Systems which are rebated through aseparate City rebate program.

= Rebate Eli ible Points x $30ACKNOWLEDGEMENTI, the property owner / legal representative, acknowledge and understand the green building programrequirements, obligations, and penalties (PAMC Chapter 16.14). I am ultimately responsible for meetingthe program requirements, including all activities performed by design team members, contractors andsubcontractors. If the requirements of this program are not met, I am subject to fines starting at $50 perton or $1000, whichever is greater for waste not diverted, and $500 per day for green building noncom liance.

o BIG GPR

o City of Palo Alto

Verification - The following verification method will be used, and I understand Ican not change this selection after building permit issuance.

o Utilities Rebate Reservation - I have read, agree to, and understand the termsand conditions and would like to be eli ible for a rebate.

Signature Date

FA1:.Ekh VE,eGA$ot!Print Name

-.£,,-1 q% fciJ SbcJLogAL. AlEt 15"0- t;lt-- 7-1Email Phone

'11-0 Rtlt4YE# AY~ /?I/O .?Ilio, crt tj'l~t?/-/222

PALO ALTO APPROVED FACILITY LIST FOR C&D DEBRISOnly take non-hazardous debris to one of these facilities. DO NOT put hazardous materials (asbestos, solvents, paint,mercury, and pressure treated wood) in mixed C&D debris boxes. Hazardous materials are not recyclable or salvageable. DOask these facilities to give you receipts with material disposed of by weight.

For mixed debris boxes it is required to use the City hauler GreenWaste.

GreenWaste 2000 Geng Rd. Palo Alto 650-493-4894

For on-site sorting and hauling, it is required to bring the waste to one of the following facilities, or a facility listed onSan Francisco or San Jose's approved lists.

American Metal and Iron 11665 Berryessa RoadFerrous metal. Non-ferrous metals (aluminum, copper, brass, stainless, tin, iron).Bio Fuel Systems 30 Greenville RoadClean wood, green waste, tree stumps, and shingles (no tar paper).Blue Line Transfer, Inc. 500 East Jamie CourtMixed C&D materials.Curtner QuarryConcrete, asphalt and dirt.Danny's Pad and Foam Recycling 1745 Walsh Avenue Santa Clara 408-492-9033Cushion foam, scrap aluminum, scrap electrical wire, CRY beverage containers, and carpet padding and wood.Davis Street Transfer Station 2615 Davis Street San Leandro 510-638-2303Asphalt, carpet padding, concrete, dirt, green waste, ferrous metals, mixed c&d, paper, roofmg, gypsum.Graniterock Company 100 Graniterock Way San JoseConcrete, asphalt, AC grindings, and concrete with rebar.Guadalupe Landfill 15999 Guadalupe Mines Road San Jose 408-268-1670Mixed C&D materials. Separated wood, metal, dirt, concrete, asphalt, gypsum, cardboard, roofing and green waste.Mission Trail Waste Systems 1060 Richard Avenue Santa Clara 408-727-5365Mixed C&D materials. Separated wood and green waste.Newby Island Landfill 1601 Dixon Landing Road San Jose 408-262-1401Mixed C&D materials. Separated wood, metal, concrete, asphalt, gypsum, cardboard, roofing, carpet, block foam and greenwaste.Pacific Coast Recycling 5895 Obata Way Gilroy 408.848.6811Mixed C&D materials, wood, metal, concrete, asphalt, gypsum, cardboard, roofmg, green waste, carpet, plastic, dirt, brick,porcelain, and green waste.Premier Recycling 260 Leo Ave. San Jose 408-297-7910Mixed C&D materials accepted from Premier debris boxes. Separated wood, metal, concrete, asphalt, cardboard, carpet, andappliances.Raisch Products

San Jose 408-452-0777

Livermore 925455-5908

South SF 650.589.4020

2000 Scott Creek Road Fremont 408-942-1230

408-574-3000

55 Hillsdale Ave. San Jose144 Borregas Ave. Sunnyvale7010 Auto Mall Pkwy Fremont

Concrete, concrete with steel, concrete block, asphalt, brick, roofing tiles (clay and concrete only), dirt (not in Sunnyvale),ceramics, porcelain (with hardware removed).Recology San FranciscoMixed C&D materials.Reed & Graham, Inc. 690 Sunol Street San Jose 408-287-1400Asphalt grindings, asphalt with Petromat (contact for prior approval), broken asphalt from roads or parking lots, base rock,broken cement sidewalks (contact for prior approval).Sims Metal 1800 Monterey Road San JoseFerrous metal. Non-ferrous metals including aluminum, copper, brass, stainless, alloys and insulated wire.SRDC Recycling 475 Seaport Boulevard Redwood City

11740 Berryessa Rd. San JoseWood, metal, concrete, asphalt, sheetrock, cardboard, yard trimmings, roofing, bricks, ceramic tile and soil.Stevens Creek Quarry 12100 Stevens Canyon Road Cupertino 408-253-2512Concrete, asphalt, and clean fill.Valley Recycling 1615B South Seventh StreetMixed C&D materials. Separate metal, wood, concrete, cardboard, and roofing.Whole House Bulldlng Supply 1955 Pulgas Ave.Call first to confirm acceptable materials.Zanker Materials Landfill & Processing Facility 675 and 705 Los Esteros Road San JoseMixed C&D materials. Separated wood, metal, concrete, asphalt, gypsum, cardboard, roofmg and soil.

408-227-9222

501 Tunnel Ave. San Francisco 415.330.1400

408494-4200

650-298-9228

San Jose 408-297-5352

East Palo Alto 650-328-8731

408-263-2384

Updated January 2011Page 4 of 5

This project is required to comply with the green building requirements in Palo Alto MunicipalCode Chapter 16.14, using the Build It Green, GreenPoint Rated system. The design team, ownerand contractor are required to coordinate with a GreenPoint Rater to have the home certified tothe required green building level as specified in the measures indicated in the checklist on thisplan sheet.

GreenPoint Rater Verification Summary

GreenPoint Rater: Rater Certification #----------------------------- ------------Phone: ------------------------- Email: -------------------------------------

Pre-Construction Plan Review Verification

GreenPoint Rated Points Claimed c=J GreenPoint Rated Points Required c=JI have reviewed the project plans and specifications, and they are in conformance with theGreenPoint Rated points claimed.

Rater Signature Date

Post Construction (Pre-Final) VerificationI certify that:• GreenPointRated inspectionswere performedthroughout construction;• the home has met at least 75% of its City requiredpoints and is on track to meet those remaining;• through a combination of onsite inspections and confirmation from the Contractor there have been no

alterations that impacted the energy report for the home, unless the new report is provided as anattachment;and that

• within six months (6) from the date of final inspection I will provide the City with the final BIGCertificate, final GreenPointRated Checklist and BIG ClimateCalculatorinputs.

Rater Signature Date

o If HERS testin was re uired er the homes ener re ort, attach the com leted CF-4R 's .o If there were alterationsduringconstructionthat impactedthe energy report (i.e. R values,U

factors or SEERvalues rerun the re ort and attach it.o Constructiondebris recei ts from an a roved facili .

*/f the home was eligible for a rebate at the time of permitting, this form, its attachments, and final submittals within6 months from the date of final inspection will be provided to close out the rebate application with the UtilitiesDepartment.

City of Palo AltoGreen Building Project GB-l