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09010037 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 3) CF-IR 51,1101'e Project Title o -21g R 1 7n or i �'��rC¢ �� �avn it r�9 v 100 3 Z Project A res, (b eo _ 4 _ �J/ Buildings# Documentation Author Telephone� j Pian Check/Date �/� Field Check/Date Compliance Method(Package or Computer) Climate Zone sn orcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Area ftZ Average Ceiling Height: ft Conditioned Slab Floor Area ft, Building Type: Single Family Addition (check one or more) Multi-Family Existing-Plus-Addition Front Orientation: 4 North/South/East/West/All Orientations (input front orientation in degrees from True North and circle one) Number of Stories_112� Number of Dwelling Units: Floor Construction Type: Slab/Floor(circle one or both) RADIANT BARRIER(required in climate zones 2,4,8-15) Required for this submittal_yes no BUILDING ENVELOPE INSULATION Component Frame Type Cavity Sheathing Total R- Assembly Location/Comments Type wd=wood Insulation Insulation Value' U-Factor' (attic,garage,typical,etc.) stl=steel R-Value R-Value Wall 3 117 �I Wall Roof LA - C - ��v Z Roof Floor - Floor Slab Edge For prescriptive compliance Total R Value and Assembly U-Factor are not required for a wood-framed wall that meets cavity R-value insulation requirements for the Prescriptive Package. FENESTRATION Shadin Devices Fenestration Orien- Area Fenestration Fenestration Exterior Overhangs/ #/T e/Pos. tation ftZ U-Factor SHGC Shadin Att. Fins Front 0,3 Front 0, 37 Left l 4) �- Left Rear O Rear _V Right 0 37 Right 0 Skylight Skylight Compliance Forms August 2001 A-2 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 3) CF-IR inalP �n om & — 4- r;- 1y Project Title J Date HVAC SYSTEMS Note:Input hydropic or combined hydronic data under Water Heating Systems,except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Heat Pump Type(furnace,heat Efficiency Location Piping Thermostat Configuration pump etc) (AFUE or HSPF) (ducts attic etc.) R-Value Type (split or package) CENTRAL EUNACE qok _ NVA C C C Cooling Equipment Mmrmu Duct Heat Pump Type(air conditioner, Efficiency Location Duct Thermostat Configuration heat pump evap cooling) (SEER) (attic etc.) R-Value Type (split or package) G A tet E 9- s 3 L Wks:Vr 1 C 6. 0IT LEM SEALED DUCTS and TXVs(or Alternative Measures) Sealed Ducts(all climate zones) (Installer testing and certification and HERS rater field verification required) ❑ TXVs,readily accessible(climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) ❑ Refrigerant Charge/Air Flow(climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater or field verification required) OR ❑ Alternative to Sealed Ducts and TXVs(see Package C or D Alternative Package Features for Project Climate Zone) Climate Zone Window SHGC Window U-Factor SEER Heating WATER HEATING SYSTEMS Energy' External Rated' Tank Factor or Tank Water Heater Distribution Number Input(kw Capacity Recovery Standby' Insulation Type Type in System or Btu/hr) (gaeons Efficiency Loss % R-Value 1. For small gas storage water heaters(rated inputs of less than or equal to 75,000 Btu/hr),electric resistance,and heat pump water heaters,list Energy Factor. For large gas storage water heaters(rated input of greater than 75,000 Btu/hr),list Rated Input,Recovery Efficiency and Standby Loss. For instantaneous gas water heaters,list rated input and recovery efficiencies. SPECIAL FEATURES (add extra sheets if necessary). Package C and D: TXVs,Sealed Ducts,Radiant Barriers(see installation requirements for radiant barriers in Section 8.13 of the 2001 Residential Manual). Package C: thermal mass(thermal mass type,covering,thickness,and description). Compliance Forms August 2001 A-3 CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 3 of 3) CF-1R d T-A klq .1L P0u -s- z��/ Project Title J Date COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. The undersigned recognize that compliance using duct sealing and TXVs requires installer testing and certification and field verification by an approved HERS rater. Designer or Owner(perp Business and Professions Code) Documentation ,Author Name: 51A P 1 i1 h 2 rl u ��' Name: �f��2 ck:.&h Title/Finn: o W N -c/.rz--., Title/Firm: /v{ c / ,,�So G/65r7a Address: 02� ) D to rp- t &-,e_ Address: ( Z Z`i p !. p C��t -�'G yth V,-& '`o( if 2-09, Telephone: x!-09 56R - V6 / Telephone: %L Lic.#: (signature) (date) (signature) (date) Enforcement Agency Name: Title: Agency: Telephone: (signature/stamp) (date) Compliance Forms August 2001 A-4 INSTALLATION CERTIFICATE (Pagel of 13) CF-6R 2f&8) Dc?I(ai " Parc _ o A l:- j o o 3 �Z Site AddressC��j FiLf 1 UJ Cck q3V f V Permit Number An installation certificate is required to be posted at the building site or made available for all appropriate inspections.(The information provided on this form is required;however,use of this form to provide the information is optional.)After completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at occupancy,per Section 10-103(b). HVAC SYSTEMS: Heating Equipment Equip. #of Efficiency Duct Duct or Heating Heating Type(pkg. CEC Certified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity heat um and Model Number Systems >_ F-1 R value (attic,etc. R-value Btu/hr Btu/hr �cIi - VVIC, A—+c. ---&-0 b c� Cooling Equipment Equip. CEC Certified Compressor #of Efficiency Duct Cooling Cooling Type(pkg. Unit Mfr Name and Identical (SEER,etc.)' Location Duct Load Capacity heat um Model Number Systems >_CF-1R value attic etc. R-value Btu/hr Btu/hr — — !��v _ �_�� c' VL, 5 L >reads gre t tAa o PAArl to. I,the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2)equivalent to or more efficient than that specified in the certificate of compliance (Form CF-1R) submitted for compliance with the Energy Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable. (l 4SignatuAre,Date Installing Subcontract (Co.Name) OR General Contractor(Co.Name)OR Owner WATER HEATING SYSTEMS: Distribution If Recir- #of Rated' Tank Effi- External Heater CEC Certified Mfr Type(Std, culation, Identical Input(kW Volume ciency' Standby' Insulation Type Name&Model Number Point-of-Use) Control Type Systems or Btu/hr) (gallons) EF,RE Loss % R-value' 2 For small gas storage(rated input of less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters,list Energy Factor. For large gas storage water heaters(rated input of greater than 75,000 Btu/hr),list Recovery Efficiency,Standby Loss and Rated Input. For instantaneous gas water heaters,list Recovery Efficiency and Rated Input. 3. R-12 external insulation is mandatory for storage water heaters with an energy factor of less than 0.58. Faucets&Shower Heads: All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Section 111. I,the undersigned,verify that equipment listed above my signature is: 1)the actual equipment installed;2)equivalent to or more efficient than that specified in the certificate of compliance (Form CF-IR) submitted for compliance with the Energy Efficiency Standards for residential buildings; and 3) equipment that meets or exceeds the appropriate requ'rements for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable. gnature, ate Installing Subc tractor(Co.Name)OR General Contractor(Co.Name)OR Owner COPY TO: Building Department HERS Provider(if applicable) Building Owner at Occupancy Compliance Forms August 2001 A-23 Delancy ENERGY STAR 12 1/4" High Outdoor Wall Lantern LampsPlus.com Page 1 of 5 LAMPS PLUS, eyvard or tem- Search Home Decor SALE - Save 10-50% on 100's of item! .Shor) Sale LAMPS PLUS>Outdoor Lighting>Country Cottage>Delancy ENERGY STAR 12 1/4"High Outdoor Wall Return To Pro Lantern Delancy ENERGY STAR 12 114" High Outd r Wall Lantern (37127) This ENERGY STAR certified outdoor light features A and Crafts styling and dusk-to-dawn operation. Our Price$129.99 FREE SHIPPING" ras rte:,,; In Stock-Item Ships in 1 to 2 Days ; s ! r O Add to Proiect QTY: 1 R ©Print This Item Compare/Add to Portfolio r"a E-mail This Item view Similar Items View Related Items °o°Oo Liahtina Collections 000— +* Hot Trends Check size&position before you buy! Printable Life-Size Image Zoom In Larger View In Scene Product Rating (14 Ratings) Write a Review Read 14 Reviews Review This Item For a Chance to Win$500! view rules Live Chat ENERGY STAR certified outdoor fixture by Minka includes a built-in photo cell for automatic dusk-to-dawn operation MINKA and a flicker-free electronic ballast. Great Mission style LAY ER Ls Personal lantern look in a multi-step, hand applied iron oxide finish. Callback Double French scavo glass. • Iron oxide finish. • French scavo glass. • ENERGY STAR certified. • Automatic dusk-to-dawn operation. • California Title 24 Compliant. • Includes one 13 watt CFL bulb. • 6" wide. • 12 1/4" high. • Extends 8"from the wall. Coordinating Items: Select items below and add them to your Portfolio or Cart! Add Selected to: Portfolio I Shopping Cart Select All 1 Select None DISTRICT MANAGER-ENGINEER ��►�SAHITA*p40, � 7 ��+. BOARD OF DIRECTORS MARK THOMAS&COMPANY,INC. a WILLIAM A.BOSWORTH SEP RICHARD K.TANAKA Ss JOHN M.GATTO DISTRICT COUNSEL YEARS OF CURTIS B.HARRISON ATKINSON•FARASYN,LLP. �'rl,�eLISH6p 10WICE *4 W CHRISTNDELLOPHER H.R C.L E HAROLD S.TOPPEL CHRISTOPHER C.LEE 20833 STEVENS CREEK BOULEVARD,SUITE 104 CUPERTINO,CALIFORNIA 95014-2154 (408)253.7071 PHONE • (408)253-5173 FAX www.cupertinosanitarydistrict.com File: CuSD—MOP Building Dept. —Cupertino City of Cupertino Attn.: Building Department 10300 Torre Ave. Cupertino, CA 95014-3202 Subject: 2-Story SFDWL Name: Hsu Residence Address: 21881 Dolores Ave j tPqo1oD3-7 APN: 357-14-026 Permit No.: 09010037 ■ Videotape and Property Line Cleanout inspected. No additional conditions/requirements by the District. Inspector: David Souza/Tony Soares.. .. ................ ........ Date:...12-10-2010................... Sanitary Sewer Location: cc: Property Owner 24' Lt P/I, 30' Long 4.5' Deep SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS