The URL can be used to link to this page

11110096 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10929 NORTHSHORE SQ CONTRACTOR:BOGNEWS ALL AIR,INC PERMIT NO: 1111009 OWNER'S NAME: HEIKKINEN GREGORY J 5310 C SCOTTS VALLEY DR DATE ISSUED: 11/16/2011 OWNER'S PHONE: 4082525322 SCOTTS VALLEY,CA 95066 PHONE NO:(831)438-5154 op LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class d—ro r r r- MECH RESIDENTIAL COMMERCIAL Contractor M6 'N-LC AteUDate I l-lb'1I I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL NEW FURNACE&ADD A/C UNIT (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 fallowing two declarations: 1 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. I have and will maintain Worker's Compensation Insurance,us provided for by Sq.Ft Floor Area: Valuation:$6000 Section 3700 of the Labor Code,for the performance of the work forwhich this permit is issued. APN Number:31638029.00 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 to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point so f regular e s per the upertino Municipal Code,Section y � ��•�V' ` / 9.18• Issued b . Date: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: � All roofs shall be inspected prior to any roofing material being installed.If a roof is hereby affirm that I em exempt from the Contractor's License Law for one of installed without first obtaining an inspection,1 agree to remove all new materials for the following two reasons: inspection. I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the stmcture is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code), ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should 1 store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued, contaminants as denned by the Bay Area Air Quality Management District I will maintain rnmWa.,n,t,,rt1,',nrlending rtino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,l shall Health&Safe .,25533,end 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I Owner or become subject to the Worker's Compensation provisions of the Labor Cade,1 mustate: forthwith comply with such provisions or this permit shall be deemed revoked. ION LENDING Af.E CY APPLICANT CERTIFICATION I hereby affirmction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, , and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION ig of this permit.Additionally,the applicant understands and will comply N. II non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used us public records. 9.18. Licensed Professional Signature Date . CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31638029.00 DATE ISSUED. . . . . . . : 11/16/2011 RECEIPT #. . . . . . . . . : BS000015335 REFERENCE ID # . . . : 11110096 SITE ADDRESS . . . . . : 10929 NORTHSHORE SQ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HEIKKINEN GREGORY J ADDRESS . . . . . . . . . . : 10929 NORTHSHORE SQ CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : BOGNER'S ALL AIR IN CONTRACTOR . . . . . . . : STEPHEN J BOGNER LIC # 31407 COMPANY . . . . . . . . . . : BOGNER'S ALL AIR, INC ADDRESS . . . . . . . . . . : 5310 C SCOTTS VALLEY DR CITY/STATE/ZIP . . . : SCOTTS VALLEY, CA 95066 TELEPHONE . . . . . . . . : (831) 438-5254 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 1. 00 41.00 0 .00 41.00 0.00 1BCBSC VALUATION 6, 000.00 1. 00 0 . 00 1.00 0. 00 1BREMAIRHA NO.UNITS 1.00 65.00 0. 00 65.00 0.00 1BSEISMICR VALUATION 6, 000.00 0.60 0. 00 0 .60 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 325. 60 0. 00 325.60 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 325 .60 #8176 --------------- TOTAL RECEIPT 325.60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 M ' • CUPERTINO (408)777-3228• FAX(408)777-3333•buildingL8cuoer ino.ora SIC PLUMBING MECIIANICAL ELECTRICAL. MISCELLANEOUS PROJECI'ADDRESS 1o92�i 1�uHs.,^nC (� APNiI I I .q OWNERNAME (�L /V HUaL v PHONE400-7-67--53I:-MAIL `Y STREETADDRESS C' _ a CITY, STAIR,ZIP CA � � FAX CONTACT NAME `�CWr`pnEf PHONE E-MAIL STREET ADDRESS G/ � CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHOECT ❑ENGINEER ❑ DE NAM CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE DU LICA COMPANY NAME E-MAILFAX s 'r teue p7er'Sollair.Cap" Y.31-N3&- 3OZ STREET ADDRES� I �' / CITY ARCIRTECT/ENGINEER NAME l/ LICENSE NUMBER (� BUS.LIC II d COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PI ZONE USL' OF FDur DUPI'EX ❑ MUTAI-FAMILY PROIECTINWILDLAND ❑ YES PR011!CT IN ❑ YES ISTIIEBI.OGAN ❑ YES UILDING: ❑COMMI!RCIAL OMAN INTERFACE AREA NO FLOOD ZONE O EICHLERHOME1 NO DESCRIPTION 01'WORK I'G'I'AL VALUATION: 0- 6)WO Ud RECEIVED BY: By my signature below,l certify to each of the folloI am t openy o r or authorized agent to act on the property owner's behalf 1 have read this application and the inlbrmation I have provided is 04101(t. I hu rea the ription of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building con ion. 1 th ri re enl fres of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicanUAgene IxeK 4Date: /Y7/ SUPPL NTAWNF710NR:QUIRED .1 OFFTCEUSEONLY OVER-TILE-COUNTER ❑ EXPRESSP',,' ❑ STANDARD •S ❑ LARGE _ AOL ❑ MAJOR MEPMiscdpp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION • ADDRESS: 10929 northshore square DATE: 11/16/2011 REVIEWED BY: bob s. APN: BP#: "VALUATION: $6,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK install new furnace add A/C unit. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $65 Furnace, Forced-Air 1MFR=<100 1 # $130 TOTALS: F $195.00 Meeh.Plan Check 0.0 hrs $0.00 Plumb. Plan Check filer. Plnn Ckcctr Meeh.Permit Fee: /MPERM/T 1'lunit Permit Fee: F7r.. J'ermw Fee: • Other Mech.Insp. 0.0 hrs $44.00 Other Plwnl,hup. Other Elec. limp. Li Mach.Inca Fee: Pluutb, htn'p. Fee: file(.Imp. 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 prelinina in ormation available and are only an estimate. Contact the Dept for addn'l infa FEE ITEMS /Fee Resolution 11-053 Efj 7//.111) FEE QTY/FEE MISC ITEMS Plan Check 1,ce: Stapp/. PC;`fea• PME Plan Check: $0.00 Permit h'ce: Suppl. Insp T'ee PME Unit Fee: $195.00 PME Permit Fee: $44.00 C oustructimt Tax Administrative Fee: IADMIN $41.00 Work Without Permit? O Yes 0 No $0.00 4drnnced 1'lttroainr�/gees, Travel Documentation Fee: ITRAVDOC $44.00 Strong,Motion Fee: 1BSEISM/CR $0.60 Select an Administrative Item • Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $325.60 $0.001, TOTAL FEE: 1 $325.60 Revised: 10/01/2011 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 JOB ADDRESS: (C Cq-Z 9 PERMIT# OWNER'S NAME: egaea PHONE# -2 •S`3 GENERAL CONTRACTOR: AjtlAk BUSINESS LICENSE# ADDRESS: G .St/ ZgCITY/ZIPCODE: *Our municipal code requires all businesses working in the co to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY SPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCON CTO HA OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: nat r Date Please check applicable subcontractors and complete a following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum / Wood Glass /Glazing V"Heating -5 AaAte iJC Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile ntr Sig tore Date Prescriptive Certificate of Compliance: Residential Iii lot! CF-IR-ALT Residential Alterations a e 1 of 5 • Project Name: $Y� ne N N of Stories G—IG 111 GI 1rlEt l 12F�tDgyc ✓ Z General Information Site Address: l yr ci Zq r,(o¢- ,Ig G Enforcement Agency: Date: Building Type Single Family ❑Multi FamilyCircle the Front Orientation:N,E,S,W,or degrees Conditioned Floor Area(CFA): -i I I i5n 44 Project Type: LJ AlterationsEnvelope Fenestration Roof HVAC Re lacement or Chan a Out Duct Replacement 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§150 for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H. ❑Replacement of entire assembly-Replacement ofan entire wall,ceiling,orfloor assembly requires the installation of Component Package-D insulation values in Table 151-C. Fill in Columns A-J O e ue Surface DetailS For the furred portioned of Mass Walls see Furring Strips Construction Table below. A T B C D .E F G H 1 J Proposed " a1 Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' or Type2 and Size' or Other' factor" Number' R-value6 R-Value Row/Cols U-factor, • Note:For furred assemblies,accountingfor Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furring Construction table belme. 1.For Tag/ID indicate the identification name that matches the building plans. 1.Indicate the Assembly Name or type:Roof/Ceiling, Walls, Floors,Slabs, Crawl Space, Doors and etc...Indicate in column G the Frame material and Size:For Wood, Metal, Meta/Buildings,Mass,enter 2x4,2x6,or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel, Logs,Straw Bale Panel and etc.... r' 4. Based on the Climate Zone;enter the equivalent U factor found in JA4 Table based on the R-Value from Table 151-B, C, or D .��' 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-valve that is being installed in the wall cavity or between the framing;otherwise,enter "0". 1.4� 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 FTable Number and enter the Assembly U factor in Column J 9.The Proposed Assembly Ufacror, Column J,must be equal to or less than the Standard U factor in Column E to comply. Furrin Strip s Construction Table for Mass Walls Onl A B C D I E F G H I J I K I Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference sT---� Joint.Appendix Table 4.3.54.3.6 4.3.7 Joint Appendix Table 4.3.13 e'a f1 b L� u a° `a, ^ u � Assembly . p � = Prescriptive CCF-IR-ALT ertificate of Com F Residential F liance: e 2 of 5 Residential Alterations s of stories Climate Project Name: zone q Wass and Furrin Stri s Construction ootnotes /. Indicate the type ofassembly to include;Hollow Unit Masonry Walls,Solid Uni(Masonry,Solid Concrete Walls, F.to. Additional assemblies can be found Reference Joint Appendix JA4. 2. 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 oflhe fivred out section of the assembly. .-6.The Final Assembly is calculated using Equalion 4-1 or Equation 4-4of she Reference Joint.I ppendix JA4. The equation is she inverse of Column D added to Column I. Column Kis the inverse frnm column J. 7.Insert the calculated U-actor value on to she Opaque Surface Details in Co/umn J FENESTRATION PROPOSED AREAS ❑Replacing window alone—Replacement windows shall meet the U-Faclor and SHGC Value requiremems ofComponent Package Din Table 151-C. The Total Fenestration and West facing Area requirements are 1701 applicable. Adding 50f1'or less of window area—Newly installed windows shall meet she U-Faclor and SHGC Value requirements of Component Package D in Table 151-C. Adding more than 50ft'of window area— Neudy instal/ed windows shall meet the U-1--actor and SHGC Value and the Fenestration Area requirements of Component Package Din Table 151-C. Complete the Ahered Fenestration Allowed Area Table on Page 1 of the CF-IR-ALT Orientation Fenestration Type and Frame (North,Bast, PropscdAreaI Maximum Maximum NFRC or Delault Window Glass Door or Sk li ht) South,West) (ft U-factor=' SHGCts'' Values • 1. Fenestration area is the area of total glazed producl(i.e.gloss plus frame). Exception: When a door is less ihan'50%glass she fenesiralion area may be the glass area plus a "2 inch fi-ane"around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3.Acetal fenestralion products installed and as indicated in Cl'.6R-F.NV Form shall be equivalent to or have a lower U factor and/or a lower SIIGC valise than that specified on the CF-IR ALT Farm. 4.Submit a completed WS-31?Form ifa reduced SHGC is calculated with exterior shading. applicable al this stage enter "NERC" or NFXC Certified windows or are CEC"Default"values ound in Table 116-A or R. 5.l [Pn D FENESTRATION ALLOWED AREAS (Com leve ifmore llian 50 rr offenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire %of Fenestration Area Fenestrations Arca Proposed ACa�'° Dwellin CFA''' Area" Removed' Area Added A x B Fenestration > rea'' 0' estration Area > quired In 2,4&7-IS posed Wesl Fenestration Area includes Wesi-sloping skylight area and any other skylight area wish n pitch less Bron /:/2. 0%when no Wes(orientation restriction or l5%when (Vestfenestration is beinginvalled in Climate Ganes 1, 4, Rr 7-15. Note/hal the m allowed fenestration can only be 5%of the CFA as indicated in Column F Column G must be equal to m•less short Column F.n climate zones 1, 4, 7-15, no more than 5%of the CFA is allowedfor westfacing glazing. risling Fenestration aren must be casm1, toward she maximum allowed 15%or 20%of the whole building and calculated in Column G. The roposed Area must be less'than or equal to Column F. J. Enter the fenesiration reproved as part of the alteration If any in column D. 6. Einer the Fenestration area that is bei--added as parl of the alteration. • M h 2010 7008 Residential ' HERS Provider: ber•,^ —�� Reglssrariori RegrsfraiVon NuM "� �'��" arc Compliance Forms �r Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 3 of 5 Project Name: Climate Zone N it of Stories • GSL ll, 1 _d\ Z ROOFING PRODUCTS(COOL ROOFS)§151(1)12 When the area of exterior roof surface to be replaced exceeds more Than 50%of the existing roof area,or more than 1,000 f ,whichever is less,the new roofing area must meet the roofing product "Cool Roof'requirements of§152(b)IHi, 152(6)1 Hii,or 152(b)/Hiii. Check applicable alternative or exception below if the roofallerenion is exempt from the roofing product "Cool Roof'requirements.Note:If any one of the alternatives or exception below is checked, the Aged Soler Reflectance and Thermal Finittance requirements for roofing products in §I 18N are not applicable. Do not fill table below. LJ 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 NMI'. Alternatives to§152(6)1 Hi and §152(b)llii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of al least 0.85 hr B'°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(f)10;or ❑ In climate zones 10, 12 and 13,with I B'of free ventilation area of attic ventilation for every 150 f'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 ol'§151(02;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 uuic. Exception to§152(b)1 Hili, Low-slope roof(pitch 52:12) ❑ 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/B'is exempt 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 of from the Roofing Products"Cool RoofRe uirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number) 5 2:12 >2:12 5 5lb/B' > 5lb/B' -rypeReflectance j° Emiaance SRIs 1:10 El 1:1tp[1- El 1:1 1:1 Elu ❑ ❑ ❑ ❑ LEJp El 11 11 ❑ Cl ❑ ❑ 13, 1. The CRRC Produce ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at wwmv coolroofs org/producisl5earch oho 2. Indicate the nye ofproduci is being used for the rooftop.i.e.single-ply roof.'asphalt roof,metal roof etc. 3. If the Aged Reflectance is not mailable in the Cool Roof Rating C'ouncil's Rated Product Directory then use the Initial Reflectance value(an,the some directory and use the equation(0.2 n 0.7(pi„io,d-0.2)to obtain a calculated aged value. Where p is the lnitial Solar Reflectance. 4.Check box if the Aged Reflectance is a calculated value using the equation above. S.Calculate the SRI value by using the SRI. Htorluheet of into'/hvuv ener"cagovhide24/arrd enter the resulting value in die SRI C'alunnt above and attach atopy of the SRI.Worksheet to the CF-I R. To apply Liquid Field Applied Coatings,the coating must be applied across file entire rool'surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in§I I8(i)4. Select the applicable coating: Aluminum-Pigmented Asphalt Roof Coming ❑Cenment-(lased Roof Coating Other • Regtslrpligri;Num6er.'. Registration Date7fime. HBRSProvider: 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 4 of 5 Project Name: Climate Zone q N of Stories • G i!,- z Irk IGEN z HVAC SYSTEMS- HEATING Minimum Duct or Piping Configuration Heating Equipment El7iciency Distribution Insulation Thermostat (Central.Split, Type and Capacity 1'='3 AFUE or HSPF) Type and Location° R-Value 'rype Space,Package or I l dronic CE-WNV r- L �7ggN G 0' DLtCiS et 161r. N11C-5e 5 tT 1.Indicate Heating 7ype(Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance,etc.) 2.Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental(i.e., iftolal capacity <2 KW or 7,000 Btu/hr electric heating is controlled by u lime-limiting device not exceeding 30 minutes). See§151(b)3 exception. 3.Refer to the HERS Verification section on Page 4 of the CF-I R-ALT I•brm 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 (SI7ER/Ea4R or Distribution Insulation Thermostat (Central,Split, 'f and Capacity 1'2 COP) Type and Location' R-Value Typc Space,Package or H dronic I.Indicate Cooling Type(A/C, Ilea[pump, Evap. Cooling,etc) 2. Refer to the HERS Verification section on Page 4 ofthe CF-I R-ALT Form for additional requiremems and check applicable boxes. 3. Indicate Type or Location Ducts, Hydronic in Floor, Radiators, etc. WATER HEATING • List water heaters and boilers for both domestic hot water(/)//Ml)healers and Irvdronic.space heating. Individual dwelling DIIN'healers muss be gar or propane fired. Hot water pipe insulation fn•on the DIIW healer to the kitchen(s)and on all underground lot water pipes is required in all component packages in all climate=ones. External Tank Water Heater'type/Fuel Distribution Type Number In 'rank Energy Factor or I Insulation Type' (Standard, Recirculating)' System Capacity( al) 'thermal Efficient R-Values l5 I, Indicate Tvpe(Storage Gas, heat Purnp, lnstawaneous, etc.) 2. Recirculating systems serving multiple dwelling units.shall meet the recirculation requirements of§150(n). the Prescriptive requirementsdo not allow the installation ofa recirculating water heating system for single dwelling units. 3. The external waler healing tank and pipes shall be insulated to meet the requirements of§150 . SPECIAL FEATURES The enforcement agencv should pay special attention to the Special Features specified in this checklist below. These items may require wriaen Usti nation and documentation ands tial verification. NEW ROOF ASSEMBLY-Radiant Barrier The radiant barrier rc uircment of p I51 Q2 does nota I to roof altcrat ions. Slab Edge(Perimeter)Insulation YES NO YES:In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation YES LJNO YES:Slab ed c insulation re tired for all heated slabs in all Climate Zones. Sec details in Table 118-A of the standards. Raised Slab Insulation 1'ES 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. • Regislralion Number: i Registration Dolefhne:. HERS Provider: 2008 Residenlial Compliance Dorms March 2010 / Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 5 of 5 Project Name: ``11e NTT 11 Climate Zone 4 9 of St ries • 2 1-16), (1'I ` HERS VERIFICATION SUMMARY 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 bejbre final inspection. Duct Sealing& Testing HERS verification is required for this measure. ❑ YES ®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 ducts are m be sealed per§152(6)1 Dii and the newly installed ducts are to be insulated per§151(1)10. ❑ EXCEPTION: Existing duct systems that are extended,which are constructed,insulated or scaled with asbestos. DYES ®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. [DYES ®NO 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 fumace heat exchanger)the ducts are to be scaled per§152(6)l E. ❑ EXCEPTION: Duct systems that are documented to have been previously scaled 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. EXCEPTION: Existing ducts stems constructed,insulated or scaled with asbestos. Refrigeranpt.Charge-Split System HERS verification is requiredfor thismeasure. El YES Y NO YES:In Climate Zones 2 and 8-15,when the existing MVAC 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 b I P. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of§150(o)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airilow HERS verification is required for this measure. ❑ YES NO YES: In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is re laced,the airflow and fan watt draw shall be verified per 152(b)ICi to meet the requirements of I51(QTB. • Documentation Author's Declaration Statement • 1 certify that this Certificate of Compliance documentation is accurate and coninhye. Name: �L Signature: Company: t ate: 30GTNt_2 Atm PI� �r��• Address: If Applicable LJCFA or upi--, 53i0G 5co 5 At,-y- `p(z_ (Certification U): City/State/Zip: ( Phone: xCS VArx � B31 43�0 - �2s4- 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. • I 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,Pans I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consiste with the information provided to document this building design on the other applicable compliance forms,worksheets,calculations, tans and. •cil 1 ns submitted to the enforcement agency for approval with this building permit atiolication, Name: Signatures Q 1-� k�.rQ nI EQ— Company: h Da : Ll. K --, t_ Address: license: 1203 G. Ci /StatetZi Seo ,M . �7— Phone: ry p' gar430-5z54 For assistance or questions regarding the Energy Standards,contact the Energv Hotline at: 1-800-772-3300. Reiisl�dilion)lur'Abier-; • . - 1 Re'gistrbfiodDpte/f mer` " : ' HERS Jur ovider: 2008 Res . denial Compliance Forms March 2010 NORTHPOINT'HOMEOWNERS ASSOCIATION PROPERTY MODIFICATION NOTICE Please indicate below which modifications) are planned for your property. Provide • bmehum(s) If possible and a copy of any proposel(s), including the contractor's license number. Any modification not expressly listed herein, or not conforming to the restrictions and requirements listed herein for that modification will require an Architectural Review Application to be submitted to the Grounds and Architectural Committee and the Board of Directors for approval. Satellite Dish installation has a separate form to be completed and submitted for approval. ModMeation Restriatione and Requirements Air conditioning unit Unit will be designed for quiet residential use, Unit will be located within the enclosed yard of the property. There will be no part of the unit visible to common areas. Installed by a licensed contractor. Replacement wlndow/ Must be same size aperture and Sliding door location of existing window or sliding door. Any necessary touch-up painting is the responsibility of the Homeowner. Installed by a license contractor. • Garage door Must be windowless and in conformity with general architectural style of the complex, Repainting to conform to exterior color scheme is responsibility of the Homeowner. Installed by a licensed contractor. Any damages caused to property as a result of modifications will be the homeowner's responsibility. All prohibitions, restrictions, conditions, and rights of the Association enumerated under Article V of the amended and restated Covenants, Conditions and iteatrlotions of the Northpoint Homeowners Association are applicable to modifications Contained herein. City permits may be required. Homeowners Please nt Property Address:_/l',1; , Phone:_/� Date of Notification:_4LI%_i �/ Data of Completion:_ Homeownei has a months to complete the designated modtilcations and is responsible for n man ement upon 'rolect completion Notification received by: { OM� Use Only Completion verified a appro ed by: Date: • � Data: t = � •- Form adopted 8/10/1999 Revised 6/00