11120022 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 915 S STELLING RD CONTRACTOR:VALLEY HEATING& PERMIT NO: 11120022
COOLING
OWNER'S NAME: YEE THOMAS K AND AMY C TRUSTEE 1171 N 4TH ST DATE ISSUED: 12/02/2011
R'S PHONE: 4082536937 SAN JOSE,CA 95112 PHONE NO:(408(294.6290
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r� ELECT r PLUMB
License Class C- '20 Lic.N_ 2 5T� C)
MECH r RESIDENTIAL r—) COMMERCIAL r
Contractor�atre- fr�ccy /'11e L n0 Date 12�2�(
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE ONE FURNACE AT SAME LOCATION
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license Is In full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1500
[.have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. APN Number:35906018.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ]8U DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Issued Datga✓
/J
Signature 15.1� 9A5;i �'°af�Da[er•Z 7�
RE-ROOFS:
OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,l agree to remove all new materials for
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of inspection,
the following two reasons:
1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: 1 have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(s)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should 1 use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
permit is issued.
1 certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's Ownef ore razed
Compensation laws of California. If,atter making this certificate of exemption,I r n..i..� �.;.,/i�/7z�/Date: 2 .2�
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
mfy and keep harmless the City of Cupertino against liabilities,judgments,
end expenses which may accrue against said City in consequence of the ARCHITECT"S DECLARATION
ing of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
• CITY OF CUPERTINO
6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35906018.00
DATE ISSUED. . . . . . . : 12/02/2011
RECEIPT #. . . . . . . . . : BS000015480
REFERENCE ID # . . . : 11120022
SITE ADDRESS . . . . . : 915 S STELLING RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : YEE THOMAS K AND AMY C TRUSTEE
ADDRESS . . . . . . . . . . : 915 S STELLING RD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4203
RECEIVED FROM . . . . : VALLEY HEATING & CO
CONTRACTOR . . . . . . . : ATKINSON, THOMAS LIC # 141
COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING
ADDRESS . . . . . . . . . . : 1171 N 4 TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 294-6290
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1 .00 41. 00 0. 00 41 .00 0 .00
1BCBSC VALUATION 1, 500.00 1. 00 0 .00 1 .00 0.00
1BSEISMICR VALUATION 1, 500.00 0.50 0.00 0 .50 0.00
1MFR=<100 UNITS 1.00 130 . 00 0 .00 130 .00 0.00
1MPERMITFE FLAT RATE 1.00 44 . 00 0 .00 44 .00 0 .00
1TRAVDOC FLAT RATE 1.00 44 . 00 0 . 00 44 .00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 260.50 0. 00 260 .50 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
i 2,EQ zZ
GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
• 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 M I
CUPERTINO (408)777-3228• FAX(408)777-3333•building0cuoertino.ora
/ sc
PLUMBING MECHANICAL LECTRICAL MISCELLANEOUS
PROJE.CTADDRESS �l /L S. ,fP//r2 ��- APNN � O
OWNER NAME T/ OP<4S iQ� I I PHONE
-25�.r5- p3 -� E-MAIL
STREET ADDRESS !1/ L G. StP/Ir ��. CITY.
(;ATE
ZIP
L 45ary FAX
CONTACT NAME I \ [Melte /kX. K- PHONE* l ¢ — QO E-MAIL
STREET ADDRESS CITY,STATE,ZIP 1 FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTORCOO RACTORAGENT ❑ ARCHOECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR AME 11 / LICENSFyjJUMBF�R.G LICE?E�PQIF BUS.LIC V4I P "I.• COO •� LS 'JZf
COMPANY NAME , E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
if-it rr. Kfih S�! s4r, osr c4 r5112 246
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC N
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
• USE OF FDor DUPLEX ❑ MULTI-FAMILY PROJECTIN WILDLAND ❑ YES PROTECT IN ❑VES IS THE BLDG AN ❑ YES
BUILDING: ❑COMMERCIAL URDAN INIERFACEAREA ❑ NO FLOODZONE ❑NO EICHLER HOME? ❑ NO
DESCRIPTION OF WORK j
L � Furrtgce OK
TOTAL VALUATION: IJ 500-- RECEIVEDBY:,1 %; '•
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information 1 have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to comply With all applicable local
ordinances and stale laws relating to buildingconstruction. 1 authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
SigmtureofApplicanUAgent: A : < Date: 1Z/2 (
SUPPLEMENTAL INFORMATION REQUIRED „.,., 0MCE USE ONLY
•'� r ErIOVER-THE-COUNTER
s
'��+' •❑ EXPRESS'
6
' ❑ STA_
NDARD
2 ❑ LARGE .r
- , ❑ MAJOR p .I,• 1, J ••l;
MEPMiscApp_1011.doc revised 06121111
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
• ADDRESS: 915 s. Stelling rd. DATE: 12/02/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: $1,500
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY SFD or Duplex - PENTAMATION FURN/AC
USE: PERMIT TYPE:
WORK re lace 1 furnace at same location.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 1 # $130
TOTALS: $130.00
Meeh.Plan Check 0.0 hrs $0.00 Piamb. Plan C'hcak EG. Fran C harp
Mech.Permit Fee: IMPERMIT Plumb. Peopm fee: Fier. Pernm Fire:
• Other Mech.Insp. 0.0 hrs $44.00 Other Plumb hup. other Ide;:. bega
3freh tnsp. fee.' Plumb. Insp.Per: filer.fncp. Fee:
NOTE: This estimate does not Include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc. . These fees are based on the prelindina In ormadon available and are only an estimate. Contact the Dept for addn7 Into.
FEE ITEMS (lee Resohaion 11-053 E'f. 71LI fl FEE QTY/FEE MISC ITEMS
Plan Check Fec:
supp/. YC'.Fee
PME Plan Check: $0.00
Permit Fce:
Suppl. hisp Fee
PME Unit Fee: $130.00
PME Penn it Fee: $44.00
Construetion Tar
Administrative Fee: IADMIN $41.00
Work Without Permit? O Yes (F) No $0.00
Ai/ra�ncr;:rl Plrmnin Fees:
Travel Documentation Fee: ITRAVDOC $44.00
Strone Motion Fec: IBSEISMICR $0.50 Select an Administrative Item
. Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: E260.50 $0.00F TOTAL FEE: $260.50
Revised: 10/01/2011
(ENFORCEMENTAGENCY
CAN CUSTOMIZE WITH LETTERHEAD/SEAL),
• 2008 Building Energy Efficiency Standards Residential HVAC Alterations
Climate Zones 1 and 3 through 7
BUSINESS AND PROFESSIONS CODE,SECTION 7110
Willful or deliberate disregard and violation of the building laws,including the California Building Code,and
local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board
working in conjunction with the local building department. This action may consist of fines up to $5,000 per
violation or suspension/revocation of a contractor's license.
WHEN IS A PERMIT REQUIRED?
A written construction permit shall be obtained from the enforcement agency prior to the erection,construction,
reconstruction, installation,relocation,or alteration of any mechanical system,except as permitted in Appendix
Chapter I,Section 112.2 of the 2007 California Mechanical Code. Projects requiring permits include,but are not
limited to:
• New HVAC installation
• HVAC Changeout
• Replacement of furnace,coil, FA U,or condenser
• Relocation of an existing HVAC unit
• Adding or replacing more than 40ft ducting in unconditioned space Ll/
2008 BUILDING ENERGY EFFICIENCY STANDARDS Title 24 Part6 RE UIREMENTSINC UDE• Q �
I. Heating equipment must have a minimum 78% AFUE (Exception: Wall & floor furnaces; room heater 0 O
2. Central air conditioners& heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. LLJ LL!
4. A setback type thermostat(24 hr clock with four set points)is required for all alterations.
5. New or replacement ducts must meet the mandatory requirements of Section 150(nn U
• A11 joints and openings in the in the HVAC system must be sealed. ..1
• • Only UL 181, UL 181 A,or UL 181 B approved tapes or mastic shall be used to seal duct opening . Ly
• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. FIa�R.ctay� J
must be connected using a metal sleeve/coupling. �1 S1{y) Q�
• Flex ducts that are suspended must be supported every 4ft, max for horizontal runs with no mo th 2:
of sag between supports and 6 ft. max for vertical runs. < O
6. The CF-6R-M ECH-04 m ust be completed and signed by the installing contractor. The Inspector will c I15
this form and verify that the model numbers are the same as the installed n . m
PM468IVli�n Z 0
DEC 0 2 2011 c/1
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF-IR-ALT-HVAC
Climate Zones I and 3-7
Site Address:915 S . Stelling R d Enforcement Agency: Dare: Permit q:
Conditioned Duct insulation
Eui mentT et List Minimum Efficienc a Floor Area requirement Thermostat
Packaged Unit Over 40 ft of ducts
x Furnace DAFUE80% COPSetback
Served by system added or replaced in
Indoor Coil EER HSPF_ 1400 (if not already presen4 must 6e
13
Condensing Unit �BF.R— Resistance ----sf unconditioned space Installed/
Other
R 6 (CZ 1,3S)
/. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system.
2.M inimum Equipment Efficiencies: 13 SEER,78%AFUE,7.7HSPF for typical residential systems.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Signature:
Company:Valley Heating and Cooling Date:
Address:1271 N4Th Street License:258540
eity/state/zipsan Jose,Ca 95112 Phone:408-294-6290
•
•
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Page 1 of 5
• Project Name:Thomas Yee Climate Zone N�'F A 1aof Stories
General information
Site Address:915 S.Stelling Rd. Enforcement Agency: Date:
Building Type[@ Single Family ❑Mulli Family Circle the Front Orientation:N,E,S,W,or degrees
Conditioned Floor Area ICFA): 1400_____ Project Type: Alterations Envelope Fenestration Roof xHVAC
Replacement or Change Out Duct Re lacem ant Water Heater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
❑Opening of framed cavity alone—Alterations that involve the opening of the framed cavity ofa wall,ceiling,orfoor must install the
mandatory minimum insulation value per§1.50 for the altered assembly.Fill in Columns A —C and enter mandatory insulation value in Column H.
❑Replacement of entire assembly—Replacement of an entire wall,ceiling,orfoor assembly requires the installation of Component
Package-D insulation values in Table 151-C. Fill in Columns A—J.
0 ague Su rfaCe Details For the furred portioned of Mass Wells see Furring Stri s Construction Table below.
A B C D E F G H I J
Proposed 01 Standard Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
ID' orType' and Size' or Other3 factor' Number' R-value' R-Value' Row/Cols U-factor'
• Note:Forfurred assemblies,accountingfor Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculaungfurred walls use the Mass and
Furring Construction table below.
1.For Tag/1D indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:RoafiCeiling, Walls,Floors,Slabs,Crawl Space,Doors and etc...Indicate in column G the Frame
material and Size:For IPood,Metal,Metal Buildings,Mass,enter 1x4,1x6,or etc... see JA4 for other passible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 14"OC;or Other for all other assembly description
such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc....
4.Based on the Climate Zane;enter the equivalent U factor found in JA4 Table based on the R-Value from Table 151-B,C,or D
S. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R-value that is being installed in the we//cavity or between the framing;otherwise,enter "0".
7. Enter the Continuous Insulation R-value for the proposed assembly:otherwise, enter "0".
8.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly U factor in Column J
9.The Proposed Assembly U factor, Column J, must be equal to or less than the Standard 11factor in Column E to comply.
Furri 2' Strip s Construction Table for Mass Walls Onl
A B 1 C I D I E F G I H 1 J K L M
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
Walls From Reference in Furring Space from Reference
,Joint ADDendix Table 4.3.5,4.3.6,4.3.7 Joint Appendix Table 4.3.13
Vo T
v
u V
U Final
Assembly �> > `o�.. Assembl
Mass Nameor JA4 Table
y e E
: ' ¢ > R s " " @ ° ' ' ¢> ' U•factor°•' Comment
Thickness Type' Number
•
�Regtstranoh NumTber�"'"�y�"'�'I'�.if tt'.v, �I"c g�p ''NER9 Provl ter. .
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Page 2 of 5
• Project Name:Thomas Yee Climate Zone qYrt 1N of Stories
Mass and Furring Strips Construction(footnotes)
1. Indicate the typeofassembly to include;Hollow Unit Masonry Walls,Solid Unit Masonry,Solid Concrete Walls,Etc. Additional assemblies can
efound Reference Joint Appendix JAI.
. This is the U-Faclor based on the thickness of the assembly in inches.
3. The R-value of the insulation to be added on the interior or exterior of the assembly.
4. The Calculated R-Value is the R-value of the furred out section of the assembly.
-6,The Final Assembly is calculated using Equation 4-2 or Equation 4-4af the Reference Joint Appendix JA 4. The equation is the inverse of Column
added to Column 1, Column K is the inverse from column J.
7. Insert the calculated U-actor value on to the Opaque Sur ace Details in Column J
FENESTRATION PROPOSED AREAS
❑Replacing window alone—Replacement windows shall meet the U-Factorand SHGC Value requirements of Component Package D in _
Table Iii-C. The Total Fenestration and West-facing Area requirements are nol applicable.
❑Adding 50ft'or less ofwindow area —Newly installed windows shall meet the U-Factor and SHGC Value requirements of Component
Package D in Table lit-C.
❑Adding more than 50fl'of window area— Newly installed windows shall meet the U-Factor and SHGC Value and the Fenestration
Area requirements of Component Package D in Table 151-C.Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF-IR-ALT
Orientation
Fenestration Type and Frame (North,East, Prop ledAreal Maximum Maximum NFRC or Default
(Window,Glass Dooror Skylight) South,West Ifl'I U-faclor''' SHGC''''' Value'
•
1.Fenestration area is the area of total glazed produce(i.e.glass plus frame). Exception: When a door is less than 50% glass,the fenestration
area may be the glass area plus a "2 inch frame"around/he glass.
2. Enter value from Component Package D Requirements in Table 151-C,
3.Actual fenestration products installed and as indicated in CF-6R-ENV Form shall be equivalent to or have a lower U factor and/or a lower
SHGC value than that specified on the CF-IR ALT Form.
4.Submit a completed WS-31?Form if a reduced SHGC is calculated with exterior shading.
5.1faliplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default"values ound in Table 116-A or R.
ALTEREDFENESTRATION ALLOWEDAREAS (Complete ifmore than 50fo enestrationisadded)
A B C D E F G
CFA of Allowed Existing Allowed
Entire %of Fenestration Area Fenestration Area Proposed Areae'
Dwelling CFA''' Area' Removed' Area Added' (AxB) (E-D)+C
Total Fenestration
Area"(ft)
West Fenestration Area '
(Required In
CZ's 2,4& 7-15)
1. The Proposed West Fenestration Area includes West-sloping skylight area and any other skylight area with a pitch less than 1:12.
1.Enter 20% when no (Vest orientation restriction or 15% when West fenestration is being installed in Climate Zones 1, 4, & 7-15.Note that the
maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F.
3. In climate zones 2, J, 7-15,no more than i% of the CFA is allowed far west facing glazing.
4. Existing Fenestration area must be counted toward the maximum allowed 15% or 10% of the whole building and calculated in Column G. The
Proposed Area must be less than or equal to Column F.
i. Enter the fenestration removed as purl of the alteration if any in column D.
6.Enter the Fenestration area that is being added as part of the alteration.
•
rR g'IslrpijOWERun"iter:r"!,!" '�"'W717"'
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Page 3 of 5
• Project Name: Climate Zone# #of Stories
Thomas Yee 1
ROOFING PRODUCTS (COOL ROOFS)§l51(f)12
When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area,or more than 1,000f ,whichever is
less,the new roofing area must meet the roofing product"Cool Roof'requirements of§152(b)IHi, 152(b)IHii,or 151(b)IHiii.
Check applicable alternative or exception below if the roofalteration is exempt from the roofing product "Cool Roof'requirements.Note:If any
one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Emiaance requirements for roofing products in
§l 18(i)are not applicable.Do nal fill table below.
EJ Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch.
[]Cool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 511b/ft'.
Alternatives to§152(b)1Hi and §152(b)Hii,Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance of at least 0.85 its ft'"F/Btu or at least a 3/4 inch air-space is added to the roof deck
over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to §151(010;or
❑ In climate zones 10, 12 and 13,with I B'of free ventilation area of attic ventilation for every 150 B'of attic Boor area,and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(1)2;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10,11,13 and 14,R-3 or greater roof deck insulation above vented attic.
Exception to§152(b)l H iii,Low-slope roof(pitch 51:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑Roofing area covered by building integrated;.photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
• Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft'is exam t from the below Cool Roof criteria.
Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable box below if Exem t from the Roofing Products"Cool Roof' Re uiremen1:
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number 5 2:12 >2:12 < Slblft' > 5lbID' Type' Reflectance j,4 Emittance SRI'
❑ ❑ ❑ ❑ rQ�
❑ ❑ ❑ ❑ rL-JN
❑ ❑ ❑ ❑ LJs
❑ ❑ ❑ ❑ [1
1.The CRRC Product ID Number can be obtained from the Coal Roof Rating Council's Rated Product Directory al www.coolroofr.ore/arnducisisearch.oho
1.Indicate the type of product is being used far the roof top,i.e.single-ply roof,asphalt roof,metal roof,etc.
. If the Aged Reflectance is not available in the Coal Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use she equation(0.2+0.7(pimltwt-0.1)to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
.Check box if the Aged Reflectance is a calculated value using the equation above.
.Calculate The SRI value by using the SRI.Worksheet at hun Wwww.ener2v.ca.rovniae241 and enter the resulting valuein the SRI Column above and anach atopy of
the SRI-Worksheet to the CF-IR.
To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§I18(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating ❑Cement-Based Roof Coating Other_
•
HER§ProvJdere. . f'
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Page 4 of 5
• Project Name:
Thomas Yee Climate Zone 4A 1M of Stories
HVACSYSTEMS- HEATING
Minimum Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split,
Type and Capacity""' AFUE or HSPF Type and Location R-Value Type Space,Package or H dronic)
Central/70k 80% attic r-6 setback CENTRAL
I.Indicate Heating Type(Central Furnace, Wall Furnace,Heat pump,Boiler, Electric Resistance,etc)
1.Electric resistance heating is allowed only in Component Package C,or except where electric hearing is supplemental(i.e.,if total capacity
< 1 KIT or 7,000 Btu/hr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See§151(6)3 exception,
3.Refer to the HERS Verification section on Page 4 of The CF-IR-ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location (Ducts,Hydronic in Floor, Radiators,etc)
HVAC SYSTEMS -COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central,Split,
Type and Capacity"' COP) Type and Locations R-Value Type S ace,Package or H dronic)
1.Indicate Cooling Type(A/C,Heat pump,Evap. Cooling,etc)
1.Refer to the HERS Verification section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location Ducts,H dronic in Floor,Radiators,etc.
WATER HEATING
• List water heaters and boilers for both domestic hat water(DHW)heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s)and on all underground hot water pipes is required in all
component packages in all climate:ones.
External Tank
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
Type' (Standard,Recirculating)' System Capacity(gal) Thermal Efficient R-Value3
1.'=serving
(Storage Gas,Heat Pump,Instantaneous,etc.)
1. Recirculating systems serving muhiple dwelling units shall meet the recirculation requirements of§I50(n). The Prescriptive requirements do
not allow the installation of recirculating water heating system for single dwelling units.
3 The external water heatin tank and i es shall be insulated to meet the requirements o 150(j).
SPEC 1A L F E A T U R ES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written 'usti nation and documentation andspecial verification.
NEW ROOF ASSEMBLY• Radiant Barrier
The radiant barrier requirement of§I51 2 does not n I to roof alterations.
Slab Edge(Perimeter)Insulation YES NO
YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required.
Heated Slab Insulation []YES NO
YES:Slab ed a insulation re aired for all heated slabs in all Climate Zones. See details in Table 118•A of the standards.
Raised Slab Insulation YESLJ NO
YES: In Climate Zones I,2, 11, 13, 14& 16,R-8 insulation is required;in Climate Zones 12& 15,R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass,use the Performance Approach.
• .Registra�l oNumberI'I''"�f".'".ry"` .,7t ,;7 771 Regis q 11 ntp*7Ttmc.5"771, _�r.. ,�.HERE ivo de �7
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Page 5 of 5
• Project Name:Thomas Yee Climate Zone NA 1N of Stories
H E RS V ER I FICA T[ON SU M M A BY The enforcement agency should pay special attention to the HERS Measures specified in this
checklist below. A completed and signed CF-41?Form for all the measures specified shall be submitted to the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is requiredfor this measure.
❑Y ES ❑x NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space,the duels are to be sealed per§152(b)IDii and the newly installed ducts are to be insulated per§151(f)10.
❑ EXCEPTION: Existing duct systems that are extended,which are constructed,insulated or scaled with asbestos.
[]YES ❑% NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(6)1 Di.
❑YES ONO YES:In Climate Zones 2 and 9.16,if the existing HVAC equipment is replaced(including the replacement of the air handler,
outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be
sealed per§152(b)IE.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
rl F.XCF.PTION: Existing ducts stems constructed,insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification isrequiredfor this measure.
❑ Y ES El NO YES: In Climate Zones 2 and 5-15,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat
exchanger)a refrigerant charge measurement shall be verified per§152(6)1 F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The ventilation requirements of§150(o)do not apply toexisting residential homes.
DuetedSplitSystems-Air Conditioners and Heat Pumps: Airflow HERS verification is requiredfor this measure.
❑YES El NO YES: In Climate Zones 10 through 15,when the existing space-conditioning system (HVAC equipment and ducting)is
• replaced,the airflow and fan watt draw shall be verified per 152(b)ICi to meet the requirements of I51(I)
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name: - Signature:
Company:Valley Heating and Cooling Date:
Address: If N4Th Street If Applicable CE-A or CEPE
(Certification N):
City/state/Zip:San Jose,Ca 95112 Phone:408-294-6290
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24,Parts I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement
agencv for approval with this building permit application.
Name: Signature:
Company:Valley Heating and Cooling Date
Address:1171 N4Th Street License:258540
City/statelZip:San Jose,Ca 95112 Phone:408-294-629
• For assistance or questions regarding the Energy Standards,contact the Energy Hotline at: 1-800-772-3300.
HERS Provider:�;
2008 Residential Compliance Forms March 2010
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOBADDRESS: S. S PERMIT# /L
OWNER'S NAME: -rhoY PHONE#
GENERAL CONTRACTOR: �y , BUSINESS LICENSE#
ADDRESS: ItTt t4,YfILS CITY/ZIPCODE: 5am Toj5qAS02-
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. 4 Z � 5,� l?�24(
1 am not using any subcontractors: --. � t'
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum /Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date