Enrollment Form

City of Scottsdale

Green Building Program GREEN BUILDING ENROLLMENT FORM An enrollment form must be submitted for each project, along with a completed checklist. A meeting is required prior to plan review submittal to qualify each project into the program. For further information or to schedule a meeting, please call 480-312-2346 or visit www.scottsdaleaz.gov/greenbuilding.

GB Case No.: __________________ … Single Family … Custom … Standard Plan … Remodel

GB Rating (level & points) ________________

… Multi-Family Type _______________

… Commercial Type ______________________

Square Footage ____________ Conditioned Area __________

Un-Conditioned Area _______

Project or Owner’s Name: ____________________________________________________________ Project Address: ____________________________________________________________________ Subdivision (where applicable): _________________________________Lot No.: ________________ Production Model No. (where applicable): ________________________________________________ Architect/Designer: __________________________________________________________________ Phone: __________________________________________Other: ____________________________ Builder: ___________________________________________________________________________ Phone: __________________________________________Other: ____________________________ SUBMITTED BY: _________________________________________________________________________________ NAME (PRINT) TITLE _________________________________________________________________________________ SIGNATURE DATE _________________________________________________________________________________ APPROVAL BY STAFF: _________________________________________________________________________________ NAME (PRINT) _________________________________________________________________________________ SIGNATURE DATE 12/18/2006