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12010112 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10440 STOKES AVE CONTRACTOR:VALLEY HEATING PERvnT NO: 120101 12 &COOLING OWNER'S NAME: OKUBO EDWARD K AND JUDY S 1171 N 4 TI-1 ST DATE ISSUED:01/17/2012 OWNER'S PIIONE: 4084460743 SAN JOSE, CA 95112 PHONE NO:(408)294-6290 LICENSED CONTRACTOR'S DECLARATION BUILDING PEKN11'1'INFO: BLDG ELECT PLUMB �' License Class r— 7 Lic.# f /F Q 6q 6 F MECII RESIDENTIAL COMMERCIALContractor V,//e, Zt�� Date /A yZ/ JOB DESCRIPTION: REPLACE FURNACE.IN SAME LOCATION 1 hereby affirm that I am licen d under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 1 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:$3030 1 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 ks,41ich th > AI,\Number:32647022.00 Occupancy"Type: permit is issued. ;�PPLICA.\"f CER"fIFICA'1'10N � I certify that I have read this application and state that the above inforttatlo�s PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agrec to save 180 DAY FROM LAST CALLED INSPE TIO indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section If 9.18. -7 RE-ROOFS: Signature /3,��t, — rcL ' w�/ Date G All roofs shall be inspected prior to any roofing material being installed. 11'a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant Date: I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGSTO BE CLASS"A" OR BETTER 1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sce.7044. Business&professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to IIA""/.rV2DOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Ilealth&Safety Code,Section 25532(x)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Ilealth&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this rised agent: Owner or autho permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. I ,after making this certificate of'exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code. I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be decmed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's'Name APPLICANT CERTIFICATION Lender's Address 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 upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, :%RCIITTECI"S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed professional 9.18. Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: ic)qY6 PERMIT# OWNER'S NAME: _ a PHONE# _K I.��D 74-3 GENERAL CONTRACTOR: �„(( f; Y G ,�„ BUSINESS LICENSE# l`? ADDRESS: ith St CITY/ZIPCODE: *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. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V 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 (ENFORCEMENT AGENCY 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 1, 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,FAU,or condenser • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconditioned space 2008 BUILDING ENERGY EFFICIENCY STANDARDS(Title 24,Part 6)REOUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall&floor furnaces;room heaters). 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. 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(m): • All joints and openings in the in the HVAC system must be sealed. • Only UL 181,UL 181A,or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4ft.max for horizontal runs with no more than 2" of sag between supports and 6 ft.max for vertical runs. 7 �V 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The InspectoL v Ncf this form and verify that the model numbers are the same as the installed equipment. INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems,Ducts and Fans (Page 1 of 2 Site Address: !o Ll-10 Enforcement Agency: Permit Number: Space Conditioning Systems Heating Equipment Duct Efficiency Location Equip (AFUE, (attic, Type ARI #of etc.)"' crawl- Heating Heating (package- CEC Certified Mfr.Name Reference Identical (>_CF-1R space, Duct Load Capacity heat um ) and Model Number Number 2 Systems value)4 etc. R-value Btu/hr Btu/hr �.�.► 1, 9C F-T Cooling Equipment Efficiency Duct Equip (SEER Location Type and EER) (attic, (package #of 1'3 crawl- Cooling Cooling heat CEC Certified Mfr.Name ARI Reference Identical (>_CF-1R space, Duct Load Capacity um and Model Number Number 2 Systems value)4 etc.) R-value I (Btu/hr) Btu/hr) 1. Ifproject is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative compliance. 2.ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.orglarilac.php# 3. Listed efficiency on this page must be greater than or equal(>_) to the value shown on the CF-1R form. 4. When CF-IR is reference it is also applicable to the CF-1R, CF-1R-AA or CF-1R-ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM §110-§113: HVAC equipment is certified by the California Energy Commission. Pq §150(h): Heating and/or cooling loads calculated in accordance with ASHRAE,SMACNA,or ACCA. [R §150(1): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of§112(c). &§1500)2: Pipe insulation for cooling system refrigerant suction,chilled water and brine lines meets minimum requirements of Table 150-B and includes a vapor retardant or is enclosed entirely in conditioned space. 2008 Residential Compliance Forms August 2009 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems,Ducts and Fans (Page 2 of 2 Site Address: 1 6'Lt LA CJ C"M 4-C-6 -,-t� Enforcement Agency: Permit Number: LQ-P - t rr � C`1 `�-t"�C a9 G!v''��-► � Ducts and Fans §l 50(m): Duct and Fans A1.All air-distribution system ducts and plenums installed,sealed and insulated to meet the requirements of CMC Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable requirements of UL 181,UL 181A,or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch,the co bination of mastic and either mesh or tape shall be used;and 1. Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other th n sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to se reductions in the cross-sectional area of the ducts. 2D.Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. 7. Exhaust fan systems have back draft or automatic dampers. 8.Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. 59. Protection of Insulation. Insulation shall be protected from damage,including that due to sunlight,moisture, qipment maintenance,and wind.Cellular foam insulation shall be protected as above or painted with a coating that is w ter retardant and provides shielding from solar radiation that can cause degradation of the material. 10. Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT • I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation) conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. • I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Comy Name: (Installing Subcontractor or General Contractor or Builder/Owner) p Responsible Pers 's Name: Responsib erson's Signature: Ki CSLB License: Date Signed: Position With Company(Title): �Sry,-v�� 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations age 1 of 5 Project Name: Ed Oku bo Climate Zone#^ #of i tories General Information Site Address:10440 Stokes Ave, Cupertino, CA 95014 Enforcement Agency:City of Cupertino Date:1-13-212 Building Type Single Family 0 Multi Family Circle the Front Orientation:N,E,S, ,or degrees 1800 Project Type: Alterations Envelope Fenestration Roof 2S HVAC Conditioned Floor Area(CFA): Replacement or Change Out rl Duct Replacement rl 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 of a wall, ceiling, or floor 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. 0 Replacement of entire assembly-Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package-D insulation values in Table 151-C. Fill in Columns A-J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B C D E F G I H I I 11 J Proposed See Note 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 Type 2 and Size' or Othe? factor Numbers R-value6 R-Value' Row/Co18 U-factor9 Note:Forfurred 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 below. 1.For Tag/ID indicate the identification name that matches the building plans. 2.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, Metal 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.... 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-value that is being installed in the wall 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 U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A B C D E F G H I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint A vendix Table 4.3.5,4.3.6,4.3.7 Joint Appendix Table 4.3.13 v o v U y Assembly d� � $ o >� U Final Mass Name or JA4 Table ; ;r °o w Assembly Thickness' Type Number' 4 > x ¢ > U-factor' Comment R+�gistrttlart the ', Reistxti4rt.�ate1 Arne .;, iw l't +zr.. . 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 2 of 5 Project Name•Ed O ku bo Climate Zone# ^ #of Stories Mass and Furring Strips Construction(footnotes) 1. Indicate the type of assembly to include;Hollow Unit Masonry Walls, Solid Unit Masonry,Solid Concrete Walls, Etc. Additional assemblies can be found Reference Joint Appendix JA4. 2. This is the U-Factor 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. 4 The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column radded to Column I. 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 0 Replacing window alone—Replacement windows shall meet the U-Factor and SHGC Value requirements of Component Package D in Table 151-C. The Total Fenestration and West facing Area requirements are not applicable. Adding 50ft2 or less of window area—Newly installed windows shall meet the U-Factor and SHGC Value requirements of Component Package D in Table 151-C. Adding more than 50ft2 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, PropsedAreal Maximum Maximum NFRC or Default (Window,Glass Door or Skylight) South,West) (ftp) U-factor'3 SHGC2'3'4 Values 1.Fenestration area is the area of total glazed product(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 the 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.I applicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default"values bund in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50f?offenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire %of Fenestration Area Fenestration Area Proposed Areae 4 Dwelling CFA 2,s Area4 Removed Area Added A x B (E-D)+C Total Fenestration >_ Area fe) 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. 2. Enter 20%when no West orientation restriction or 15%when West fenestration is being installed in Climate Zones 2, 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, 4, 7-15, no more than 5%of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must be counted toward the maximum allowed 15%or 20%of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. 5. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as part of the alteration. .............._................................. Regtx mfion lUttrrtbet:.. 1Z�gistralin,1� lme �tt .. 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 3 of 5 Project Name: Climate Zone# 4 #of Stories Ed Okubo 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 ft"whichever is less,the new roofing area must meet the roofing product"Cool Roof'requirements of§152(b)IHi,152(b)1Hii,or 152(b)1Hiii. Check applicable alternative or exception below if the roof alteration 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 Emittance requirements for roofing products in §118(1)are not applicable. Do not fill table below. - 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 1 through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 5lb/ft2. Alternatives to§152(b)1Hi and§152(b)Hii,Steep-slope roof(pitch>2:12) E] Insulation with a thermal resistance of at least 0.85 hr-ft2•°FBtu 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)l0;or El In climate zones 10, 12 and 13,with 1 fl of free ventilation area of attic ventilation for every 150 ft of attic floor 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(f)2;or Q 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)1Hiii,Low-slope roof(pitch<_2:12) E] Building has no ducts in the attic. Other Exceptions Q 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 lb/ft2 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 t from the Roofing Products"Cool RoofRequirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 >2:12 < 5lb/ft2 > 5lb/ft2 Type 2 Reflectance3'4 Emittance SRIS El U f El 0 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.orelproducts/search.pho 2.Indicate the type of product is being used for the roof top,i.e.single ply roof,asphalt roof,metal roof,etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation(0.2+0.7(A iiipt—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4.Check box if the Aged Reflectance is a calculated value using the equation above. 5.Calculate the SRI value by using the SRI-Worksheet at http 11www.energy ca.eov/title24/and enter the resulting value in the SRI Column above and attach acopy of the SRI-Worksheet to the CF-1R. 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§118(i)4. Select the applicable coating: 1 Aluminum-Pigmented Asphalt Roof Coating Q Cement-Based Roof Coating Other Registrtxti A aitttr , 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Page 4 2L5) Project Name:Ed Oku bo Climate Zone# ^ #of Stories HVAC SYSTEMS-HEATING Minimum Duct or Piping Configuration Thermostat (Central,Split,Hating Equipment Efficiency Distribution Insulation x'2'3 or 4 al Te and Capacity (AFUE HSPF) Type and LocationR-Value Type Space,Package or H dronic CentrFace/90000Btu 80% AFUE Ducts R-6 Set Back Central 1.Indicate Heating Type(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., if total capacity <2 KW or 7,000 Btulhr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See§151(b)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 1'2 COP) Type and Location; R-Value Type S ace,Package or H dronic) 1. Indicate Cooling Type(A/C,Heat pump, Evap. Cooling, etc) 2. 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 hot 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 zones. External Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation Type' (Standard,Recirculating)2 System Capacity(gal) Thermal Efficiency R-Value3 1. Indicate Type(Storage Gas,Heat Pump,Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the requirements o §1506). . SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written 'usti ication and documentation and special verification. NEW ROOF ASSEMBLY-Radiant Barrier The radiant barrier requirement of§151(f)2 does not apply to roof alterations. Slab Edge(Perimeter)Insulation _J. YES LXJ NO YES:In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation []YES X'NO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation -' YES ®x NO YES: In Climate Zones 1,2, 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. Registration.Number- Registration,Date/Time. 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 5 of 5 Project Name: Ed Oku bo Climate Zone#r1 #o1 Stories 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 before final inspection. Duct Sealing& Testing HERS verification is required for this measure. D YES E]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 to be scaled per§152(b)IDii and the newly installed ducts are to be insulated per§151(010. 0 EXCEPTION: Existing duct systems that are extended,which are constructed,insulated or sealed with asbestos. DYES ONO 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(b)IDi. 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 furnace heat exchanger)the ducts are to be sealed per§152(b)I E. Q 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 EXCEPTION: Existing ducts stems constructed,insulated or sealed with asbestos. Refrigerant Charge- Split System HERS verification is required for this measure. YES El NO YES:In Climate Zones 2 and 8-15,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(b)IF. 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: Airflow HERS verification is required for this measure. YES Q 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)I Ci to meet the requirements of§151(f)7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete, Name:Rob M I n o rI ) Signature: Company:Valley Heating, Cooling and Electrical Date:1 -13-2011 Address:l 171 N. 4th ST If ApplicableCEA CEA or CEPE (Certification#): 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. • 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,Parts l 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 agency for approval with this building permit application. Name:R06 Minor Signature , Company:Valley Heating, Cooling and Electrical Date:1 -13-2012 Address:1171 N. 4th ST License:258540 City/State/Zip:San Jose, CA 95112 Phone:408-294-6290 For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300. l�egi��^�xtir� �Uter�6�r;�; ; , ,:...,. �e �'tr�txzr�r i��e�f'ze:;., ,: �. ' l� 'R��'�'��►x�r„ d ,�, .d. 2008 Residential Compliance Forms March 2010 CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 32647022 . 00 DATE ISSUED. . . . . . . : 01/17/2012 RECEIPT # . . . . . . . . . BS000015760 REFERENCE ID # . . . : 12010112 SITE ADDRESS 10440 STOKES AVE SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER OKUBO EDWARD K AND JUDY S ADDRESS 10440 STOKES AVE CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1247 RECEIVED FROM . . . . : VALLEY HEATING 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 BAL ---------- ------------- ---------- ---------- --------- 1ADMIN HOURS 1 . 00 41 . 00 0 . 00 41 . 00 0 . 00 1BCBSC VALUATION 3 , 030 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 3 , 030 . 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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -- - -- - --- ------ - ---- --- - ---- - CHECK 260 . 50 23171 - ------------ -- TOTAL RECEIPT 260 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ----- --- -- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ' ADDRESS: 10440 stokes ave. DATE: 01/17/2012 REVIEWED BY: bobs. APN: BP#: `VALUATION: 1$3,030 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTANIATION FURN/AC USE: PERMIT TYPE: !FORK replace furnace at same location. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $130 _j TOTALS: $130.00 klech.Plan Check 0.0 hrs $0.00 T_ Mech.Permit Fee: IMPERMIT Other klech.Insp. 0.0 hrs $44.00 ATOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). TheseLees are based on the relinina information available and are only an estimate. Contact the De t or addn 7 in o. FEE ITEMS e _. s:• 11 €1_y.3.z.1 :''1.'11 i FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $130.00 PME Permit Fee: $44.00 F-1 Administrative Fee: ]ADMIN $41.00 Work Without Permit? Q Yes Q No $0.00 Travel Documentation Fee: ITRA VDOC $44.00 Nj 3horie-': 1BSE15MICR $0.50 Select an Administrative Item 1-ee� IBCBSC $1.00 SUBTOTALS: $260.501 $0.00 TOTAL FEE: $260.50 Revised: 1/01/2012 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 LM (408)777-3228• FAX(408)777-3333•buildinaC�cuoertino.ora MISC CUPERTINO ❑PLUMBING MECHANICAL ❑ELECTRICAL [:]MISCELLANEOUS PROJECT ADDRESS / C �C/) kz. APN# 32-1-c , 1 -c 4q ,-7 02- 2-OWNER NAME 4- PHONE /1 L"t O PHONE ,t- ^� o I q 3 E-MAIL STREET ADDRESS V !\ CITY, STATE,ZIPFAX -rr d CONTACT NAME PHONE E-MAIL (5'" 29 4(-6 STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR �NTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NA LICENSE NUMBER LICENSE TYPE BUS.LIC# f' COMPANY NAME' (� G E-MAIL FAX �0 n `l�"0 2'T STREET ADDRESSI / 54 CITY,STATE,ZIP eislrz PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ' SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECTIN ❑YES IS THE BLDG AN ❑YES BUILDING: COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK TOTAL VALUATION: 3 61}CJ -- RECEIVED BY: 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 I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: /� ` Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY LJ OYER-THE-COUNTER a — NN ❑ EXPRESS r�`i ❑ STANDARD ❑ LARGE ❑ MAJOR MEPMiscApp_2011.doc revised 06/21/11