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Enrollment Form

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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.: __________________ GB Rating (level & points) ________________

… Single Family … Multi-Family … Commercial


… Custom Type _______________ Type ______________________
… Standard Plan
… Remodel

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

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