Residential plumbing is critical for the health and safety of populations worldwide. A case study was conducted to understand fixture water use, drinking water quality and their possible link, in a newly plumbed residential green building. Water use and water quality were monitored at four in-building locations from September 2015 through December 2015. Once the home was fully inhabited average water stagnation periods were shortest at the 2nd floor hot fixture (90 percentile of 0.61.2 h). The maximum water stagnation time was 72.0 h. Bacteria and organic carbon levels increased inside the plumbing system compared to the municipal tap water entering the building. A greater amount of bacteria was detected in hot water samples (674,002 gene copy number/mL) compared to cold water (2597 gene copy number/mL). This suggested that hot water plumbing promoted greater microbial growth. The basement fixture brass needle valve may have caused maximum Zn (5.9 mg/L), Fe (4.1 mg/L), and Pb (23 μg/L) levels compared to other fixture water samples (Zn 2.1 mg/L, Fe 0.5 mg/L and Pb 8 μg/L). At the basement fixture, where the least amount of water use events occurred (cold: 60105, hot: 2169 event/month) compared to the other fixtures in the building (cold: 145856, hot: 3262230 event/month), greater organic carbon, bacteria, and heavy metal levels were detected. Different fixture use patterns resulted in disparate water quality within a single-family home. The greatest drinking water quality changes were detected at the least frequently used fixture.