S 3092 (2) APPLICANTTO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY
CITY OF CUPERTINO BUILIIINC.-ELECTRICAL PE l'NO.
BUILDING DIVISION APPIACATION/PERMIT PLUMBING-MECHANICAL. 3092
BUILDING PROJP.CI'IDENTDTC'ATION
BUILDIN ADDREssi ,r, 0 - / SANITARY NtI. APPLICATION SUBMI'I'I'A1.UAII?
v S
ow Is�tOr �yt rHoyt:: oNT /t.R.PstKP.� [�(AME: I�jV
1 N/C CUNT/BOL#
WS A "TI' INET?k: LIC�.L At Fs: q/
NE:
'ST
zf tl7G3 $77�j E:1 Consultant Fees Paid by Applicant(Initial) BLDG BUIELECT PERMIT MB FD ECH
D I � . 9�"
s LICENSEDCONTR CfOR'SDECLARAI'ION QTY ELECTRIC PERMIT FEE
1 huchy nation that 1 am licensed ender previsions of chapter 9(rmnme^ear; JOB DESCRIPTION
MMM
IF�yOtUyO.V, wtNSecton]MXB of D
Jofthe luonelnmescslnar ` nCue and nrylicenx ix PERMIT ISSUANCE
IIAL
n farce and effect.
)
7a q-1
W [:I KITCHEN REMODEL
Lis.nx(' , c % 1 1:1 PLUMBING R'IbPIPE
Dale : I
N sty
ARCHITECT'S DECLARA'HON ❑MULTI-UNI T' ❑STRUCTURAL.
z p H Z 1 understand my plans shall be irwd as public records PANELS MODIFICATION
OZ�Q UP TO 200 AMPS El INTERIOR ❑CHIMNEY REPAIR
Licenvnl Precessional - pol.l(IINIAMPS IMPROVEMENT ❑SWIMMING POOLS
qy' OWNER-NUIhDIik DECLN2Kl'ION OVER BAIDAMPS C HATHREMODF.LIREPAIR 3DEMOLITION ,r
R'+6 f�� 1 hereby atrml that 1 am exempt rrem me Contracmr's License Law far me
2O a U following reason.(Section 7031.5,Business and Professions Col Any city or county SIGNS ELECTRICAL ❑OTHER r V
prio3 a y which itsuim.a permit requires
alter,improve,demolish,lire a sig any statement
_ ,
man he its cense ce,also requires p.....i iso for Cera Fermi,mi crest signed smtnnem SPECIAL CIRCUIT/MIST.
y shot he lx licensed purmmmmNe provisions of the Gminml.r'x License fuw ocrinee9
Q' (mnmmmcing with Seetin 17000)of De,,an Pof the Butene,and Pro reexie^,Core)or TEMP.M1ETl?R OR POLE.I NST. ER \
a o C that he is exempt therefrom and the basis for the alleged exemption.Auy,sick nn of NEW BLDG/ADDITION O DEMOLITION
^w
Section 7031.S by any application far a perad,snbaccu the applicant to acivil get shy of POWER DEVICES '+ ANT \ ❑FOOD SERVICE
lit,antic than five hundred dollars($500).
_ IMP 'M13NT
Q ❑1,ax nwnerof the pmpeny,or my entFloyces with wagesas theirsole compensation. LNG POOL ELECTRIC
Fs 'ill dnlhework,andmeskiuewm is not iniendcdoroReml In,sole 04 ,Brintra. OTHER
and Prol'e.dnnc Car, the Comforter',I Icenxe Lnw Nre,nn�l Owner of .. . SWITCHES-FIXTURES
property who Norther improve..daemon, who dos,such work hi through g
1 his own amployecs,presided that such improvements rix not intended or d for NEW RISIDO3 TIAL ELECTft SQ Fr..
sale.IL however.the building lir improvement is sold within on D:.mpletl SQ,FT.FLOOR AREA S/SQ.Cr
owner-builder will hove the harden of proving that he rid nm build unprnve far Pro
lasso lir sale). '
❑1,m owner of the tn+teny,em exclusively contracting witta
h liwnscd e rs m ��
construct the Fora,(Sec.]004.Business and Professions Cde.)The Contra i-
cense Law Jmx nm apP1Y lit an+.wner of troteny who builds or improves thereon. QTY PLUM6ING P IT FEE
who contracts for such poral with a contmetoas)licensed pursuant to the Consensuses
Lirm se l.ow.
I um cxmnpr under Ser. .13&P C for of,ream' HISSUANC
( A ':R=D IN&VENT- T (HA)Owner Dam 1 VALUATION
WORKERS COMPENSATION DECLARATION Il I BACK PLOW iV E
I hereby affirm under penalty of perjury one of the following Jedumtinns:
I buvc nnJ will mainutinn Cenificamof Comm�uoaelf"inore far Worker's Con pen- 1,-,i IIRAM- .00R,RO(IB ARE D. STORIES 'I'VPE CONS'I'kUCT10N
kion,us provided far by Sectio^30110 kir the Labor Crvle,Far the Per5orrumm of the
d for which Nis permit is i....ed, FIXTURES-PER TRAP
1 have and will maintain Worker's Cm tEenwdoo Insurance,a,require)by Socams
37Mit(the Labor Codc,(orthe performance of Ne work for which this pernat is issued. j OCC.GROUP APE
My Worker's Compensation Nsumnce carrier and Policy number are: I
Ca1
rtier. Pol'my N..', GAS-M.SYSTEM-OVER 4(13A)
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GREASHANUUSS'RL WASTE INTERCF.CI'DR
BUILDING DIVISION FEES
(Thi,section need not be completed ifthe permit is for one hundmddollars(5100) GRP.ASETRAP
me lean) PI.ANC - EEEAs y O
m
I crab,that in the per ...^serif Ne work for which this permit is i..ued.I bull r
notom In mbaomexnli emtnthe Wrnkn','Cont BEWI?R-SANI'fpRV-STGHM EA.2IXIIT. I? FEE
comity any parson is any n sure,sons pen-
zZ ,alien laws of Culiforam.Date WATER BEATER WNF.N'PHLECTR
O Applicant GR )LNG FEE +
ti NOTICETO APPLICANT If,after making Nis Certificate of Exemption,you should WATER BY59Ebf/1'RGATING 5 IIS PEE
F become subject to the Worker's Compensation provisions of the Lalcorm
Cc.you must
forthwith comply with such provision or this permit shall R deemed revoked. WA'I HE SERVICE
Q a
5z CONSTRUCTION LENDING AGI3NCY NEW RESIDENTIAL PI.MB. SQ Cr. PAID
L)0 (hereby of rte that is a co^,wctio^lending agency for Ne performance.( Dam Racits4
U. the work for which this lm.it is issued(Sec.3157,Civ.C.)
0+` Le^dels Name TOTAL:
kUSL Le^dcr'n Address yl'A .
I certify that I have read this application and stutc that the shove iornrnmtinn e, roL )1 'PEI? a
it (1) exured.I agree t.comply with all city undeou^ty nrdinunttrs and state laws rdmingm QTY. MECHANICAL:PERMIT eFEE
UIZ building construction,and hereby notation repmcmatiws ofthis city m enter upon the 'A11 .FEE
abase-mentioned property for inspection purposes.
• (We)agree or save,inm
denify and keep hmmless the City of Criterion apt.'s PERMIT ISSUANCE ; EC WERE 2
Iiohill(m,,judgments,coxunnd expenses which Taymany way acme again'said City ALTER OR ADD TO MFCI I,
in nwiucnceof the granting of his perm it. FLU MING PGI?
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT AIR HANDLING UNIT(TO IgWOCFM)
SOURCE REGULATIONS, M' UANICAI.PTai all
r AIR HANDLING UNIT(OVER 10.000 CFM) CON59 CTION TAX
Sigmmum urAppGcoHAZARDO Uu1c HXHAUS'1'IIDOD(W/DUC'q.URE HOUSING M I'1'IOAl10N PEE
j HAZARDOUSMATERIALS
r,mornhandl
Will the b,,hm Cittedo,Munibuilding lie Chaptxmm.r handle Health
nand Safe,, fIb:A9'ING IINI'f(To Iq).ap BTU)
as define)by the Cupertino Municipal Crile,Chapter 9.12,rand the Health and Safety
Code,Section 155321u)'1 HEATING UNIT(OVER 100,(1(10 BTU)
E3 Yes ❑Nn PAID
' VP.NTILA'I'ION PAN(SINGLf?REBID) pine RccuiPlp
Willtheapplicont or future building.ecupanl a o,c,m,maumdevicc,xhi,h BOILER-COMPGHPOR100,001I BTU)
emit hamNous air comami+mnts as refined by the Bay Area Air Quality Management
Dis¢ie% BOILER-COMP(OVE3R Hal 011 BTU)
' ❑Yet
❑N.
I
real lbe huratrdon,mmalulx rcynirementx under Chapter no'
of the
Coli- AIk CONUI'TIONER ISSUANCE DATE
fnmiu Health&Safety Ctde,Sabena 2551)5a is my a^d 25534.1 manda,nJ the if Ne NEW RESIDENTIAL MI3CI1. SQ.FT / _ / �r '��
building does^rate.7.yhuveatenan6 Nat it is myrcrrymsiIddymnotify thenccupem
idem
requitcerents which muss he met prior m issuance of a Cendicam or Oecuponey
Owner lir u."unii,ed arem Unm
6 ISSUED BY:
OFFICE
FROM : PHONE N0. Apr. 29 1999 09:35AM P2
99 02 :3-e PM Kink.THRU. INO. R . M1
' oea
��tt
KIATHAUlf INC. Consulting Engineer
10 Corals Cave, CetnPbell, CA 65001• fent/27144
Kelly-Gordon Development Corporation April 281h 1999
eras Saratoga-Sunnyvale Road (V� aCA
Saratoga,CA 95070RE: Supplemental,As-Built Structural Design Review fr theg Sign Ofl
for the Lot 16 Residence, Oak Valley Subdivision,Cupertlob No.: 98 120)
After my Jobsite meeting with Gordon and Scott on 4/26/99 and my review of the above referenced design, the following
list Itemlzes both what was visible and verified,and what has been concealed at this stage of construction:
1) Since the exterior wall stucco lath, the plywood floors and the roofing had been Installed prior to my visit, the
following Items could not be verified as properly completed during this visit. However, they may be verified as proper!;
done by revlewing the City of Cupertino's sign off paperwork.
a) The tbundatlons,underfloor grads clearances,anchor bolt and ground floor holdown bolt installations
b) The sublloor nalling,below walls and the upper Door walls to tower floor walls shear transfer(Note All
the upper floor shear walls on this resldance were Installed on the exterior walls).
0 The exterior shear wall and roof deck nailing,and upper floor holdown straps.
d) Some of the perimeter top plate splice straps and collector straps Installed on dee exterior,and covered.
e) All the bait insulation was installed,hiding some of the interior wall collector strap ends.
. 2) Based upon the limitations noted in item (1)above,the only items which could be verified by me at the time of this
visit are the following. (Note: All the items listed were found to substantially comply with the engineering design intent).
e) The ground floor holdown anchors were visible because they were observed on the Inside wall race.
b) The perimeter f leze block shear transfer detail at the second flow roof.
C) The roof strut bracing for the second floor roof
d) The Interior ground floor shear walls on grid lines 2,3,4,B,C,and D.
The only items of concern found during my briervisit were the necessity to stitch nail (with l6d f@ 3" o,c.) comer
transition studs at the bay window on grid line 2, and the front eomor of dte'garage for shear line 0. Alm% noted aas the
teed to perimeter edge nail/provide backing for the Installed ECC Cap at the garage/stairwell shear wsll tran0flon.
For the record. the 4 x 10 headers observed over the ground floor openings narrower than 0' are adequate despite
the speciricalion on the plans for 4 x 12h typical. Also, the HDR-9 and CB-5 beams were dropped below the Door joists
over the garage, instead of being flush,as indicated on the plans,not to problem.
This lanai was It u " d engineering principles and ttthniqucs subject to the limitations noted above This
document is into to be sw2gleontall review of tllc exposed Gaming visible during my visit and should be considered
as a stand eeume . Inde p dent of the
City of CupCAinn inaprrtions. Should there be any additional que_rions,
please do of itate to II or at(408)379-8430,
- gt)f ESS/p�
imothy . Ki I au so. CO
R.C.E. 834 Ftpsj c
d'j a
• \��rf Of CnttfOt`�
KWTHAU, INC. Consulting Engineer
• 1030 Connie Drive, Campbell, CA 95008 . (408)379-6561
Kelly-Gordon Development Corp. March 26th 1999
12241 Saratoga-Sunnyvale Road, #C
Saratoga, CA 95070
RE: Observations and Report of Installation of the Retrofit Holdown
Anchors for Lots I6 and 19, Unit 4, Oak Valley Subdivision, Cupertino
(Our Job No. 98120)
As per the request of Gordon from your.office and the requirements of my shear wall repair memo dated
3/24/99;1 visited the above referenced residences today to observe the installation of the retrofit 5/8" and
7/8" diameter threaded rod anchors at the added 2' long shear panel on the Lot 16 garage front and the
living room fireplaces for both lots. The purpose of these observations was to satisfy the "special"
inspection requirements of the manufacturer's installation specifications. The epoxy system used was the
Simpson SET, 2-part epoxy tie system which falls under the purview of ICBG Report No 4945. All the
anufacturer's instructions were followed and the epoxy was installed in the properly sized x 10" or 15"
(min. embed.'in existing foundation stems) holes after being thoroughly cleaned. The threaded rods were
installed during my visits and secured to receive the proper bond. This letter formalizes the verbal
approvals given in the field regarding the anchor installations.
Also, to clarify the rebuilt shear walls at the front of Lot 16 garages are now assumed to be 7' effective
height shear walls with anchor bolts and holdown rods extended through any mud sill build up blocking
necessary to establish this height. That is to say, the center panel and (2) end panels shall be reinspected
` for compliance for anchorage and nailing by the City of Cupertino building inspector. This letter is formal
documentation of this requirement.
Please note that this short visit was intended to remedy a situation different than the approved design/plans
and was not intended as a verification of construction for any areas other than those specifically
mentioned inthis letter. T n responsibilities for the remainder of this construction belong with
the City of Cupe and n hing wri en or inferred in this letter changes that fact. Should you have any
questions re ng this or any othe matter on this residence, please do not hesitate to call or contact my
office.
M.
Timothy ihl au I
110 co
u 4
R.C.E 40834
xsj\C vl'. P /
JAN-OB-BB 05,42 PROM-HARZA�ENGINEERING I0.408443B024 PAGE ' 1/1
Consulting Engineers and Scientists ,. '' -v Ra
425 ROLAND WAYAOL raaacr
OAIQAW O,CA 94821 Kc/l
(610)5684001 wurcx
TO `Ke
cq�c�rrsday ,>�P. 81 •,U,, -
T M.at 'FIMHera Charged TO IaOkot '�' N��DeAy� OS rFumrt Ar
Fklq Teak Nranber '7�'`f l (! '
c«�orele ay�hae�o � _ �
THE FOLLOWING WAS NOTED;
uJ;141 Goff Kali ,
/e.
—Ec1�rvH�t�vt Q.�a�i rY� 'T1� !Sr '�n M/nr'at � u,�•!''h Drcr '
Or, FCn1nMi CQ/ 1�C[Mn A r'i11 nN^ Or�rlY
v
Tor—
:owes TO
SIGNED
ORIC3IN
FROM PHONE NO. Jan. 13 1999 12:49PM P2
JAN-Nil-ma WJ'Ye �'RVL1•III•IR4L1 u..•++ .++.+... .. ... . ...
Consult/ng Engineers and SWentlsts i . S - 99 rn 234 - G
425 ROLAND WAYOAKLAND.CA 94621 i!c 11
(510)666-4001 0G o
Ke i I e./ I-p.,e,t o Ma
.. r ,may moo. 2t AM
PU
Hwrecharged To PAleet NWI-V D"^To=
tssmer.r
• rl
!s�a n.�Ntpnt er T'i 17- cawgto eymee e
THE FOLLOWING V"NOTED!
Cn 5;0-e- raf- Pmw v%a_ ob 5eri;a h'a-,n Le 4s -f/- /Z. n,..vl
i
'i'• /4 ;a Qrtn t I _ S Mch cJ;k4i 54rlf Ke-l! oC Ke&X L4a2liM
c�tmE- r CL/ Ceoh' _s Trr..1r�" e.. /oh 'i-IG N-i9 Glt
e� eFI'ns °Je er n/ lM _ 5r;I-
Wtn •n t.u„Y -Sbru.tl-rte a / fi'l
CSLA_F4'1nMMi CQ/ rC.�61nti aE•r•u+n �dIGG L/� �'Y1 =alt- p/i!!Y
•
pREs To LQ .
SIGNED
ORIGIN
FROM PHONE NO. Jan. 13 1999 12:49PM P2
JN1H'N0�9a maxYd rw�vv.unrtun u••............ .. .. ..- . . __
JOB W.
&sulting Engineers slid Scientists / . 5' .
426 ROLAND WAY a fw
. OAKLAND. CA 94621 ( Ke/L
(610)568-4001 00"a
` !L
cXGn�uli,r 5=`19 TracSde�y �eiQ'1C, - ��"�. yl�at aM
' �•a[ anG
Hours Chargee To Pieieot .Z rurcleu Dowry Tess Ol r+assv.r e
K 1r
FNd 7blk`%mbar 'T'j l�{^ Concrete Cytlnd"
THE FOLLOWING WAS NOTED;
Or_ S- -e as rr?%4eal-eA 4�w- A01--5 Al 14, ` e�./
A> - /4 ;13 Q d * I S MG/- ecJ 'hh 5Ce1-f- Kelt off' xellm tkc
ter.').,. F- aL27 e- nil ivoh'H�Iej VV, fof-S Af -le z- -j-A9 Q/l
Evu-Vhi1'vt� 4 ^r�l Td L]/ n nrn al CO,.h+� Qrcr
wf��tl✓li C'�Ll /"CLiw.� �Lx Grufe, e4),'Pk
�_ Td 4eaAI1'na 5G
'i .
WES TO
S1GNE0 r
ORIGIN
•
KIHLTHAU, INC. Consulting Engineer
• 1030 Connie Drive, Campbell, CA 95008 • (408)379-6561
Kelly-Gordon Development Corp. March 26th 1999
12241 Saratoga-Sunnyvale Road, #C
Saratoga, CA 95070
RE: Observations and Report of Installation of the Retrofit Holdown
Anchors for Lots 16 and 19, Unit 4, Oak Valley Subdivision, Cupertino
(Our Job No. 98120)
As per the request of Gordon from your office and the requirements of my shear wall repair memo dated
3/24/99, 1 visited the above referenced residences today to observe the installation of the retrofit 5/8" and
7/8" diameter threaded rod anchors at the added 2' long shear panel on the Lot 16 garage front and the
living room fireplaces for both lots. The purpose of these observations was to satisfy the "special"
inspection requirements of the manufacturer's installation specifications. The epoxy system used was the
Simpson SET, 2-part epoxy tie system which falls under the purview of ICBG Report No 4945. All the
manufacturer's instructions were followed and the epoxy was installed in the properly sized x 10" or 15"
(min. embed. in existing foundation stems) holes after being thoroughly cleaned. The threaded rods were
installed during my visits and secured to receive the proper bond. This letter formalizes the verbal
approvals given in the field regarding the anchor installations.
F
Also, to clarify the rebuilt shear walls at the front of Lot 16 garages are now assumed to be 7' effective
. height shear walls with anchor bolts and holdown rods extended through any mud sill build up blocking it
necessary to establish this height. That is to say, the center panel and (2) end panels shall be reinspected V
for compliance for anchorage and nailing by the City of Cupertino building inspector. This letter is formal
documentation of this requirement.
Please note that this short visit was intended to remedy a situation different than the approved design/plans
and was not intended as a verification of construction for any areas other than those specifically
mentioned inthis letter. T . n responsibilities for the remainder of this construction belong with
the City of Cupe and n hing wri en or inferred in this letter changes that fact. Should you have any i
questions re ng this or any othe matter on this residence, please do not hesitate to call or contact my i
office. j �; i
Ha. 4 ` I , I
C04Cif
Timothy ihl au =' E^p �� I
R.C.E 40834 ,�'��
J}q C V I
��FOF
BONSON fn'; .i�(':.il!I?:� il_ I�1I1ili.tii�t�'..;.•.iii ji� ili�,
3633 FARMHILL BLVD.
COMMERCIAL AND RESIDENTIAL REDWOOD CITY, CA.
STATE LIC. #36494 94A.
BONDED AND INSURED
061
SERVING THE BAY AREA SINCE 1964
650-368-3245
SUBMITTED. TO JOB NAME AND LOCATION
TO WHOM IT MAY CONCERN LOTS #/6 AND 19
KELLY GORDON
JOB DESCRIPTION
LOTS 46 AND 19 HAVE BEEN LANDSCAPED AS PER PLAN.
FINAL PLANNING SIGN OFF
DATE '
SIGNATURE� �,
a-2?1-1999 9:A6Ati FROM P, 3
• - Nal LN.4Y Bv:SN E /b lBvaSY lb v:N.
j&P
A
Certificate of Conformance
certificate `0'5260 5
THIS IS TO CERTIFY that the gluvi 4nminated timber products klentHFed with a edlective mark of
1 Engineered Wood Systema fE'WS) were manufactured in accordance With the applleapte Standards
and associated apeoilfttiona Indicated oe1oW:
ANSI Standard Al 90.1-1992,For Wood Products—Structural Gilled
Laminaiad Timber
NER-4138 duQd Lmmirwtad Xtmber Combinations And"GAP"
ComWai.Program For Determining Design streasas
AITC 117.93—MaM facturing—Standard Speclttcations For Structural
Glue!Laminated Timber Of Softwood Species
IT IS HEREBY CERTIFIED that the ARA EWS trademarked Structure{glued laminated timber members
were produced In a manulacturtny facility aubjW to regular audita in accordance with the Enghteemd
Woad Oyeterna (EWSJ Quality Assurance ]grogram. Routine audits include inspection of th9
' • manufacturing process and evaluation of the In-plant CA program with adequate sampling to verity '
cOn4wmance to industrf standards for lumber grade and giueline bond quality.
�.... .
3 / ?C t'��/1 ��i"11' C7"�r.�Mh Srto !'v ��oH•v S.N {J�fl IPo. 3051 Ac 14-6-M
3'!a x
lu
�•``�Ca W 0 0 .44t, a
bySw Thomas G.WMIAmeon
Exacudve Vice President
��h�aBHN����► I
CA16"OhOM W787YMUSaa 164M OMXFOOk *PAPA.7M!WWW N 0*=A$WCW[OV
' TMeplp+5•(!Nr 6BSW00-rvY lixeMNr.p57)5!6.7986 I '• .
a
• I
6-20-1999 9:36AM FROM P. 2
� r ntt eneomrrrrwr•w
i
Izmir
Certificate of Conformance
Certiricate o 5-�,�0 6,•, -�
THIS IS TO CERTIFY that the glued laminated timber poducts Identified with a collective mark of
Enpineerad Wood Systems (EWS)were manufactured In accgroarne W.1h the applicable standards
and associated specifica66iis indlcated below:
ANSI Standard Al 90.1-1992- For Wood Products- Structural Glueo
Laminatod Timber
NER-48b Glued Lamtnated Timber Combinations And-C-4f-
Computer Program for Determining Design Strasses
AITC 117.93-Manufacturing-Standard Specitications For Structural
Glued Ltimirtated Tkabw Ot SoNwvod Species
• IT IS HEREBY CERTIFIED that the AAA EWS trademarked structural gWad taminaled timber mambere
were produced in a manufacturing facility,subject to regular audits in accordance wftn the Fogirio q
Wvbd Systeall (EWS) Quality Assurance Program, Routine audits include inspection of the
manutacturing process and Ovalualion of the in-plant QA program with adKuate sampiing to verify
conformence to industry standards for lumber grade and glueline bond qual ty. t�
V,7LIL Td HNf.Yti 14^ Po• $ygl Ac 19YtSJ
a»tiswurrpr 1 ��' C tp
a�4oPPd F
"A by Thomas a.wlulamaon
q EXecvm Vice preswrd
aHa�G °.� �
f%WVtrAeO ADM.$YarW9 ro Wd cahp�V�-rr4 VOWA-CM0 VADW A970CMr1PN .
d�FROM ASCO RIR PHONE NO. : 4087796373 Jun. _7 1999 09:50PM P2
• .7.;1.:5.•9Cc 3t PFVNE prl.
'a4J n ,, r�•io,,; /r Z ��� :'399
05:0LJS:FJEFaI Pc
np
uc-
IN5A1,:1TIN TISI
Y , drlal .dI�
ita,mtk>tIl Kew 1940 to mpind td bd parted et tno ball"' Itte ar afedrwatLbla for all tp !ell ierpa4ero C?he 1
le1L aCra •1 }a thla(am 4 naaltad;h90,6*,un dtlhl &-Z u Rmidr w Llfet7lainn it"ptloml,)App >
s++spleti % real"94%a etre twat be►w•bod r lk kdldtaa dearr.,nal(on"quw)rad Ito eu8dlap awoer a •,,
aaupeaay,, Aerym tO.lfl3ChL
raw 81Dda1k' 9rx Odrr Mafia .Ti .
a trWlpp., 084 rI PtONttrr tlel4lad (MtlG a:aSl WWe. mlrla8 3,eai Rigrtia'
loll
Wawdwr rer It.aor wa Gel ne ay.r
i NfaeMl Uaapa Ciera.ely` Laaean Dms Lou
L pe a rep+ 4'm Zipmet Itktd ilia"In :)D me temet40ftut WMIled 3)WOVOEam u as gym.
tbea
Is W cuu mm of 0alpllamee Qlam W-04 dabmimd of eea^pluee wh tda SWV
�qte mr rdeblem44 bulldfap "d 3;etalpmtat thgmun of and,lhi to Ngwft"s 4r
a rf►+ry Artrdwr4ar er port p,adle"e tppll lea4 e.
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a N1�MW a.qe tyre atmaea a.edmroanMt r.w r,hienWr.rpa*i+turwtm lmt frm
. 'Ar 1ll�Iarefdl{Ufi�pJ�ra78llaMlq'ar��R111d ��rd�' '�7fia1Nl{a/r� ^� 'i.
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=� 06!15!1399 11:1B 6509410747 SELECT WINDOWS PAGE 02
FROM
• � PMCNE h10T Jun, 15 1939 11 : 1-441 Ft
INSTALLATION CERTIFICATE (page 2 of 4) CF-6R
tte ress , ermit Numver
Maaarae ,14
09erotnr Produces
True(a a., Labeled SULDIA41111111111 Total
fixed, Unalua(sa of De4ult Qw elty g4wrs eommmtst
1t -1R 13 •Val s oldoldop9h raw speal4j4prules
(GUP U E PRO CYS) ((`'7
j. .xiSu J—LL,TiII- _
4,
7 —
a. -—
11.
11.
14.
e Installed U•value must be leas than or equal to value from CF-1K. Alternatively,installed weighted
average!)-value for the total fenestration area is less than or equal to value from CF-IR,
1,the undersigned, verify that the feneaaatloNglazing listed above my signal=; 1) Is the actual fateestredon product
installed;2)is equivalent to or more ef8cknt than that spaolAod in the certif=ts of compltmoe(Poem CF-IR)submitted
for compliance with the EnrV Eficienay Sfondar& for raldential bultdltlgg and 9)the product mints or ax ds the
appropriate requlremcnu for manufactured d4vlce3(from Hart 6),where applicable.
Item 8s signaturc.Dau m e utj Su con etor Name
(if applicable) 0eneral Contractor(Co.Name)OR Owner
1511%Me Signature,Date liestliftgSubconeacor(Co.Name)OR
(if applicable) General Contractor(Co.Name)OR Owner
om�� 51pature,Date ams
CouC(if applicable)
Name)OR Owner
COPY TO: Building Vepartrnent
Building Owner at Occupancy
Revised March 1,1996