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 0.6-1.2 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 (6-74,002 gene copy number/mL) compared to cold water (2-597 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: 60-105, hot: 21-69 event/month) compared to the other fixtures in the building (cold: 145-856, hot: 326-2230 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.