12060031 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21715 NOONAN CT CONTRACTOR:FLANDERS IiGAI'&AIR PERMIT NO: 12060031
OWNER'S NAME: SI HOU Cl IJANG RUANG SVSTEMS.INC. DATE ISSUED:06/052012
OWNER'S Pl IONF.: 4087300445 PLEASANTON.C\ 94566 PUONE NO;(925)461-3333
❑ 1 TNSF.D 'TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class .ie,.q r r r
MECH RESIDENTIAL COMMERCIAL
Contractor Dale
hereby affirm that I am licensed under the provision of 'h le JOB DESCRIPTION: INSTALL.IURNACIi AND AIR CONDITIONER FOR SINGLE
(commencing,with Section 7000)of Division 3 of the sines. &Professions
FAMILY DWIiLLING
Code and that my license is in full force and effect.
I hereby affirm under penally of perjury one of the following two declarations:
I have and will maintain a cenilic;de 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 lir which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code, lir the performance of the work for which this Sq.Ft Floor Area: Valuation:$5700
permit is issued.
:\PPLICANT CERTIFICATION APN Number:35719076.00 Occupancy'fype:
I certify Ilial I have road this application and stale that the above information is
correct. I agree to comply with all city and county ordinances and stale Imus relating
to building construction,;rad hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemail'yand keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City inconsequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this penton. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all nun-point source regulations per the Cupertino Municipa Code Section
9.18. l
Issued Date:
Signature LL�457
❑ OWNER-RUILDER DECLARATION
RI:ROOFS:
hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall he inspected prior to any rooting material being installed If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner mf the properly,or my employees with wages as their sole compensation, inspection.
will do the work,mrd the strudure is not intended or offered for sale(Sec 7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sce.7044.Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR RENTER
I hereby affirm under penalty of perjury one of the following three
declarations: IIA"/.ARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to selr-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California llealth&Safety Code,Sections 25505.25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Cade,Chapter 9.12 and the Ilealth&
Scdion 4700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally.should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify Ihm in the performance of the work forwhich this permit is issued,l shall maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Cade,Sections 25505,25533,and 25. 4.
Compensation laws of California. If,after making this certificate orexemplion,I
become subject to the Worker's Compensation provisions of the Labor Code,I must finer or authorized agent: J�
forthwith compl} with such provisions or this permit shall be deemed revoked. Date' /
CONS"1'RIIC'f10N Lh;NDI NG A( ;NC\'
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby aRrm dim there is a construction lending agency for the performance of work's
correct. I agree to comply with all city and county ordinances and slate laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of flus permit.Additionally.the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code.Section
9A8. I understand my plans shall be used as public records.
Signature Date Licensed Professional
Prescri five Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations 1C1667i an (Page 4 of 5)
Project Name: 1 Climate Zone# -r3 Stories
HVAC SYSTEMS-HEATING
Minimum Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central.Split.
Tye and Capacity,
a acit , (AFUE or HSPF) Type and Location' lue, t Type Space.Package or Hvdronic)
1 l� s 1
r
1.Indicate Hearing Type(Central Furnace, Wall Furnace. Heat pump. Boiler, Electric Resistance, etc.)
- 5.Elecn is resistance heating is allowed only in Component Package C, or except where electric heating is supplemental(i.e., if total capaciry
< 5 KW of 7,000 Badhr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See g 151(b)3 exception.
3.Refer to the HERS Verification section on Page 4 of the CF-1 R-ALT Form Jor 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 k(SEEP/EER or Distribution Insulation Thermostat (Central,Split,
Type and Ca acit COP) Type and Locp4onr Valu Type S .Pac a e or H dronic)
—�
J
1.Indicate Cooling Type(A/C.Hear pump. Evap. Coaling, etc)
5. Refer to the HERS Verification section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes.
3. Indicate Tv e or Location(Duns,Hvdronic in Floor. Radiators, etc.)
WATER HEATING
List water heaters and boilers for both domestic hot water(DHfV)heaters and Hvdronic space heating, Individual dwelling DHIV heaters must be
gas or propane fired,and may not exceed 50 gallons. Hat water pipe insulation from the DHIV heater to the kitchen(s)and on all underground
Trot water pipes is required in all component packages in all climate=ones.
External Tank
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
Type' (Standard,Recirculating)' System Capacity(gal) Thermal Efficiency R-Values
- 1. Indicate Tvpe(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 eeter-nal water heating tank and pipes shall be insulated to meet the requirements n'0150(7.
.. SPECIAL FEATURES The enforcement agencv should pav special attention to the Special Features specified in this checklist below.
There items inav re uire written 'usti icadon and documentation andspecial veri ication.
NEW ROOF ASSEYIBLY-Radiant Barrier
The radiant barrier requirement of§151(f)2 does not apply to roor alterations.
Slab Edge(Perimeter)Insulation ❑YES ❑NO -
YES: In Climate Zone 16 in Component Packages D.R-7 insulation is required.
Heated Slab Insulation O YES ❑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 O YES ❑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.
ThermMass
To obal tain Compliance Credit for the installation of thermal mass,use the Performance Approach.
_ Regisirar/ar Number.' fration DaelTimer )ES � HERS Provider:
'2008 Residential Compliance Forms August 2009
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
CUPEkTINO
Building Department
JOB ADDRESS: 2 �f �Clooe7c., PERMIT #
IMA �1
t
OWNER'S NAME: 1 OV\- PHONEGENERAL CO O FAX #
I am not using any subcon Signature
Please check applicable subcontractors and complete the followinginformation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring. Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
7 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35719076 . 00
DATE ISSUED. . . . . . . : 06/05/2012
RECEIPT #. . . . . . . . . : BS000017007
REFERENCE ID # . . . : 12060031
SITE ADDRESS . . . . . : 21715 NOONAN CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHIOU CHUANG HUANG
ADDRESS . . . . . . . . . . : 21715 NOONAN CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : BRET R FLANDERS
CONTRACTOR . . . . . . . : BRET FLANDERS LIC # 28533
COMPANY FLANDERS HEAT & AIR
ADDRESS . . . . . . . . . . : SYSTEMS, INC.
CITY/STATE/ZIP . . . : PLEASANTON, CA 94566
TELEPHONE . . . . . . . . : (925) 461-3333
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 5,700.00 1..00 0 .00 1 . 00 0. 00
1BREMAIRHA NO.UNITS 1.00 65 .00 0 . 00 65.00 0.00
1BSEISMICR VALUATION 5, 700 .00 0 .57 0. 00 0 .57 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 .57 0 . 00 325 .57 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL