12110146 CITY OF CUPERTINO BUILDING PERMIT
RIJILDING ADDRESS: 21753 CASTLETON ST CON'IRACI'OR:VALLEY HEATING& PERMITNO: 12110146
COOLING
OWNER'S NAME: MAKARAh1 NARAYAN AND SUJATA TRUSTER 1171 N 41'll ST" DATE ISSUED: 11282012
OWNER'S PHONE: 4089962166 SAN.IOSIi.CA 95112 fI fONENO:(408)294-6290
LICENSED CON'fRAC/FOR'S DFCLARATION BUILDINC PERMIT INFO: 13LDC r ELECT r PLUMB rl
License Clas '-ZG Lie.4 Ci Q O r r'1 c
/_r' plECll RESIDENTIAL COMMERCIAL
Dade7�3
1 hereby affirm that I am licensed under the provisions of Chapter 9 30B DESCRIPTION:REPLACE FURNACE AT SAME LOCATION
(commencing with Section 7000)of Division 3 of the Rosiness&Professions
Code and that my license is in full force and effect.
I hereby affirm tinder 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 Fluor Area: Valuation:$2780
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of die work for which this
permit is issued. APN Number:35618071.00 OecupaneyType:
APPLICANT"CERTI FICTION
1 cenify that I have read this application and state that the above information is
correct.l agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK ISNOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments. 180 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply .
with all non-point sou regulations per the Cupertino Municipal Code,Section Issued b�y�• ,�7 Dala'l�^ ZC�
9.18. �J
Signor Dad
RE-ROOFS:
OWNER-RUILDER DECLARATION All roofs shall be inspected prior m any roofing material behl;installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new,materials for
hereby affirm that I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
1,as owner of the property,or my employees with wages as their sole comp_nsation, Signature of Applicant: Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to At.[,ROOF COVERINGS"f0 RE CLASS"A"OR REI-I'ER
construct the project(Sec.7044,Business&Professions Code).
hereby affirm under penalty of perjury one of the following three IL\ZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Cenilicate of Consent to self insure for Worker's California Ilealth&Sore".Code,Sections 25505,25533,and 25534. I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ileulth&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous nulcrial.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally. 1 use equipment or devices%%Inch emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Ilay Area Air Quality Management District 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
F Ilealth&Safety Code,Sections 25505,25533,and 25534.
1 cenify that in the performance of the work for which this permit is issued,l shall
not employ any person in any manner so as to become subject to the Worker's Owner u prized agent: --77
Compensation laws of California. If,alter making this certificate ofexempiion,I
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. r CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of%%ark's
APPLICANT CERTI FIC\TTON for which this permit is issued(Sec.3097,Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
correct.I agree to comply with all city and county ordinances andstate laws relating
to building construction,mid hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against IiabilitiesJudgments, ,\I3CIII'1'FCI"S DECLARATIONcosts,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
GENERAL PERMIT APPLICATION
MEP
- -� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ,
10300 TORRE AVENUE •CUPERTINO, CA 950143255 I
CUPERTINO (408) 777-3228• FAX(408)777-3333• buildinc(cDCUDertino.org
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OWNERNAME 0- ka'Y CJ LA-L I PHONE /,jE-MAII-
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CONUCT NAME
CITY STA ZiP �/ I FAX G�
❑ OWn-m- OWNFR-BUYER ❑ OWNER A=— ❑ coN P.A=R ❑mYrRACroRAG_'VT. ❑ AR== 11.T'L7. l ❑ Dzv=,om ❑ I7iATT
CONIRACTORNAME I LC_-'JSE NUNS Z LICENSE nG, Z O I BUS.LC a
COMPANY NAME I E-m-'JL
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ARC=CT/L'NGD6EFR NAME (/ LICENSE NUMBER I BUS.LIC d
COMPANYNAP,LE' E-MAIL I FAX
STRE.T ADDRESS I CITY,STATE,ZIP I PHONE
USE of SFJ m 0UP1=Y ❑ MULTFFAMD.Y PROJECT N WD.DLAND ❑ )'FS PROJECT Bi ❑Y'3 LS Tf_BLDG AN ❑ YS
BVIIDYG: ❑GOIA,LIIC'_At. I URBAN GrEIU`ACB AREA ❑ NO I FLOOD zolr ❑NO EIC1D]i HOME? ❑NO
DESCL7nON OF WOR%
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TOTAL VALUATION: J � I RECEIVED BY:
By my sign,=below,I"mr-yV;o each of the toJlov.'iag: I as:he pmpery owner or vmu omzed agent to act on the prop:cWTIt.'s behalf. I have read this
application and the in;oraticn I have provided is couecL I have read the Description of Work and ven'N it is ac=mc. I ag;e-w conply With all applicable IM2J
ordi:z-,ces and stare laws relatLng m buil t. nszUcdon. [ o. ---pr_senmtives�s _ .. to enmr the above Id. dyed Dron_:,l for inspxdon pul;csm
Sig:atv.-of ApDlicznJP.geac Das: / �
-P =l i PLENAL INFORMATION REQUIRED OFFICE USE ONLY
v Zr–OVER-THE-COUNTER
❑ EXPRESS
V
❑ STANDARD
J
Z ❑ LAROE
❑ MAJOR,
hC-Plduc4pp_2011.doc revised 06121/11 '
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
ResidenlialAlleralions• (Pae 1 of 5)
Project Name: MAKARAM Climate Zone 4 #of23torics
General Information
Site.Add ress:21753 CASTLETON ST,CUPERTINO.CA 95014 Enforcement Agency:CITY OF CUPERTINO Date:10-23-2012
13uilding'fypc❑X Single Family El Multi Family Circle the Front Orientation: N,1? N'.or degrees
Conditioned Floor Arca(CFA): 1800 SF Project Type: LJ Alterations Envelope Fenestration x Roof MVAC
Replacement or Change Out Duct Re lacement❑Nater Beater
NOTE: This form is not to be used for Newly Constructed Buildings or Additions
Insulation Values Far Opaque Surfaces(for Furring use the Hass and Furring Strips Construction table befall)
Assembly Alteration
❑Opening of framed cavity alone-Alterations that involve the opening of the froned cavirr ofa wall,ceiling, or floor must huiall the
mandato"minimum insulation value per§150for the alered assembly. Fill in Columns A—C and enter mandatory insulation value in Column N.
[I 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.
0 ague Surface Details For the furred portioned of iN ss Walls see Furring Sir i s Construction Table below.
A B C D E F C UI 1 J
Proposed s"'"" Standard Values From JA4 Table
Framing Thickness. Framed Continuous JA4 Proposed
Tag/ Assembly Name Material Spacing. U- JA4 Table Cavitv Insulation Assembly Assembly
IDI or Tv c2 and Size' or Other' factor° Numbers R-valueb R-Value° Row/Cols U-factory
Note:For furred assemblies.accmuving far Continuous Insulation R-value,see Page JA4-3 and Equation 4-I. For mlcu/acing fiured vol/s use tine Alasau—and
Furring Construction table below.
1.For Tag7ll)indicate the identification name that matches the building plans.
1.Indicate the Assembly Name or Ape:Roof/Ceiling, Naffs, Floors.Slabs, Crmvl Space. Doors and etc...Indicate in column G the F am,e,.�:.
material and Size: For II'ood Afetal. Afetal Buildings, Ifass. enter 2r4. 2x6 or etc... see JA4 for otter possible frame nye assem
3. Enter the thickness jar mass in inches or Spacing between framing members enter,, 16"or 24-0C: or Other jar till otter assembl) scranaon
such as Concrete Sandwich Panel,Spandrel Panel, Logs, Straw Bale Panel and etc.... ..,��'��
4. Based or the Climate Zone;enter the equivalent U factor found in JA4 Table based on due R-Value from Table 1�tBk. D•
3. Enter to 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: ohenvise,ent IJA,v
7. Fater the Continuous Insulation R-value for the proposed assemblic othenvise,enter "0".
S.Enter the row and column of the U factor value based on Column F Table Munber and eater to Assennbl.0 -factor in C it J r -y
9.The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Cohan t E to ply.
Furring Stri s Construction Table for Mass Walls Only `
A r B C 1) 1 E F C tl I J I F L M
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
Walls From Reference in Furring Space from Reference
Joint Appendix Table 4.3.5,4.3.6,4.3.7 Joint Appendix Table 4.3.13
U
n '` �= U.. P Final
Assembly' �'- `o `o '_ `o m �'-
Mass Name or JA4 Table '" o = = 'o Assembly
'thickness' 'I'v c' Number' < > c ;! c ° > ? < t U-factor°' Comment
Registration Number: - RegislradorDbtefTime. _ TIERS Provider.-
2008
rovider:2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-I R-ALT;
Prescriptive Certificate of Compliance: Residential CF-IR-ALT ,
Residential Alterations (Page 2 of 5)
Pra;ert .ame.NARAYAN MAKARAM. Climate 4 No2f Stories
Nass and Furring Strips Construction(footnotes)
/. Indicate the 0pe of assembly to include:Holluv Unit Alas'o?n,(Valls.Solid Unit Alasonrr.Solid Concrete balls. Etc. Addiliornal assemblies can
be found Reference Joint Appendix JAd.
t. This is the U-Facior based on the thickness ofthe assembly in inches.
. The R-value of the insulation to be added on the interior or errerior of the assembly.
J. The Calculated R-Value is lite R-value of the furred out section of file assembly: -
-.-6.The Final Assembly is calculated using Fquation 4-2 or Fq ation d-sof the Reference Joint Appendkr JAd. The equation is the inverse ofCohmmn
added to Column L Column K is the inverse from column J.
7. Insert the calculated U-!actor value on to the Opaque Surface Details in Column J
FENESTRATION PROPOSED AREAS
❑Replacing window alone—Replacement windows shall meet the U-1--actor and Sl1GC Value requirements of Component Package D in
Table 151-C The Total Fenestration.and IVest facing Area requirements are not applicable.
❑ Adding 50ft2 orless ofsrindow area—Newey installed windows shall meet the U-Factor and SIIGC Value requirements ofCorgtonent
Package D in Table 151-C.
❑ Adding more than 50ft2 ofhvindow area— Newly installed windows shall meet flue U-Factor and Sl/GC Value and the Fenestration
Area requirements ofCornponent Package D in Table 15i-C. Complete the Altered Fenestration Allowed Area Table on Page 2 ofthe CF-IR-ALT
Orientation
Fenestration Type and Frame (North. East. PropsedAreal Maximum Maximum NI'RC or Default
(Window.Glues Door or Skeli hq South. West) (Inn) U-factor"3 SIiGC2-3•' Valuc5
1. Fenestration area is the area of rural glared product(i.e.glass plus frame). Exception: When a door is less than 50%glass, the fenestration
area metv be the glass area plus a -2 inch frame"around the glass. ,
2. Enter value from Component Package 0 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
Sl1GC value than that specified on the CF-1 R ALT Form.
J.Submit a completed I11S-31?Form if a reduced SIIGC is calculated with arterior shading.
j./flipplicable at this stage enter -A'FRC-for NFRC Certified windows or are CEC "Delbtdt"robes/found in Table 116-A or B.
ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft"of feneslralion is added)
A B C D E F G
CFA of Allowed Existing Allowed
Entire %of Fenestration Area Fenestration Area Proposed Area
�'9
Dwelling CFA',' Arca' Removed' Area Added° (A s 13) (GD)+C
Total Fenestration
Area l'(ft')
West Fenestration Arca
(Required In
CZ's 2.4 R 7-I5)
L The Proposed(Vest Fenestration Area includes (Vest-sloping skrdight area and any other skylight area with a pitch less them 1:12.
2. Enter 20%when no (Vest orientation restriction or 15%vs-hen (Vest fenestration is being installed in Climate Tones 2. a, & 7-15.Note that the
maximum allowed fenestration can on/v be 5%of the CFA as indicated in Column F. Column G must be equal to or less that?Column F.
3. In climate=ones 2. a. 7-15, no more ti mm 5%of the CFA is allowed for?vest-/acing glazing.
J. Existing Fenestration area must be counted toward the nnavinmm allowed 15%.or 20%of fine whole building and calculated in Colum G. The
Proposed Area must be less than or expel to Column F.
5. Enter tdefenestradon removed as parr ofthe alteration ifery in colunnn D.
6. Enter the Fenestration area that is being added as part ofthe alteration.
.Registration:\'umber: Registration DatelTime: HERS Provider:
2008 Residential Compliance Forms Harch 2010
Prescriptive Certificate of Compliance:.Residential CF-IR-ALT
Residential AHerationx (Page 4 of 5)
Prescri tiveCertificateofCompliance: Residential CF-IR-ALT
Residential Alterations (Page 3 of 5)
Project Name: Climate Zone N N of Stories
NARAYAN MAKARAM 4 2
ROOFING PRODUCTS(COOL ROOFS)§151(1)12
When the area of erterior roofsurface to be replaced exceeds more than 50%of the evisting roof area,or more than 1,000 ff,whichever is
less,the new roofing area must inert the rotfiag product"Cool Roof'requirements of§152(b)Illi. 152(b)l/ri,or 152(b)17ri1.
Check applicable alternative or arception below if the roofalteration is exempt from the roofing product "Cool Roof'requirements. Note: lfanv
one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Eminance requirements for roofing products in
§I IS(i)are lot 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 I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 51b/112.
Alternatives to§152(b)I Ili and§152(b)liii,Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance prat least 0.85 hrlt2.°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 scaled according to§151010:or
❑ In climate zones 10. 12 and 13.with 1 ft'-of free ventilation area of attic ventilation for every 150 ft'of attic floor arca,and
where at(cast 30 percent of the Gee ventilation arca is within'2 feet vertical distance of the roof ridge:or
❑ Building has at least I2-30 ceiling insulation:or
-❑ Building has radiant barrier in the attic meeting the requirements of§15102:or
❑ Building has no ducts in the attic:or
❑ In climate zones 10. if. 13 and 14.R-3 or greater roof deck insulation above vented attic.
Exception to§152(b)Illiii, Low-slope roof(pitch<_2:12)
❑ Building has no ducts in the attic.
Other Exceptions
[]Roofing area covered by building integrated:photovoltaic panels and solar thermal panels arc exempt from the below Cool Roof criteria.
Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft''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 Exemla from the Roofing Products"Cool Roof'Re uiremene
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number <_ 2:12 >2:12 < 5lb/flz > 5lb/ft2 9'v eReflectance t'' Emittance SRIS
❑ ❑ ❑ ❑ ❑t
❑ ❑ ❑ ❑ ❑t
❑ ❑ ❑ ❑ ❑t
❑ ❑ ❑ ❑ 1 ❑n
❑ ❑ ❑ ❑ 1
❑1
1. The CRRC Produel/D Number can be obtained from the Cool Roof Rating Council's Ruled product Directory to wu•w coolrooLs.org/nraluaslsearch ohm
2.Indicate the type of product is being used for the roof lop,i.e.single-ply roof,asphalt roof,mesal roof,erc.
3. /fthe Aged Reflectance is not mailable in the Cool Roof Rating Council's Rated Producl Directory then use die Initial Reflectance value front the same
directory and use the equation(01+0.7/pl1ulnl—02)to obtain a calndaied aged value Where pis the Initial Solar Reflectance.
4.Check bar if the Aged Rtfleciance is a calculated value using the equation above.
5.Calculate the SRI value by using the SRI-Worksheer at him-Mov v eneravca.eor/title?a/and enter the resulting value in the SRI Column above and attach acopr of
Me SRI- Worksheet to the CFI R.
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(1)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating ID Cement-Based Roof Coating Other
Registration Number: Registration DatelTime:. HERS Provider:
2008 Residential Compliance Forms March 2010
Prescriptive Certificate of Compliance: Residential CF-i R-ALT
Residential Alterations (Page 4 of 5)
Project Name:NARAYAN MAKARAM Climate Lone q ^ N 2StDries
HVAC SYSTEMS- HEATING
Minimum Duct or Piping Configuration
Fleating Equipment Efficiency Distribution Insulation Thermostat (Central. Split.
Type and Ca acity":.3 (AFUE or HSPF) Type and Location' R-Value Type Space, package or Hvdronic)
CENTRAL FURNACE,100,000Btu 80% AFUE DucTsiATTIC/CRAWL SPACE R-6 SETBACK CENTRAL
1.Indicate Heating Ti pe(Central Furnace, {Pall Furnace, lleat 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 A 11'or 7,000 Bndlur electric heating is controlled by a rime-Iimiiing device not exceeding 30 mirates). See es15I(b)3 exception.
3.Refer to the NIERS I'erification section.on Page 4 of the CF 1 R-ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location(Ducts, Itvdronic in Floor, Radiators,etc.)
HVAC SYSTEMS-COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEFR/EER or Distribution Insulation Thermostat (Central,SpliL
Type and Ca aein•l•' COP) Type and Location3 R-Value TvPC Space.Package or I h•dronic)
1. Indicate Coaling Type(.1/C Heat pump. Evap.Cooling,etc)
2.Refer to the NIERS I•erifucation section on Page a ofthe CI--I R-ALT Form far additional requirements and check applicable boxes.
3. Indicate Type or Location(Ducts, Ilbdronic in Door, Radiators.etc.)
WATER HEATING
List water heaters and bailers for both domestic bot water(I)MV)heaters and bt•dronic space heating. Individual dwelling DHIV heaters must be
gas or propane fired Hat water pipe inshdation f-om the DIIIV heater to the kitchen(s)and on all underground hat water pipes is required inal/
component packqges in all climate cones.
External Tank
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
T• el (Standard.Recirculatin )'- Svstein Ca achy(gull Thermal li(ficiencv R-Valuc3
I. Indicate Tape(Storage Gas. Heat Pump, Instantaneous.etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements ofsSl50(n). The Prescriptive requirements do
not allow the butallation ofa recirculating water heating system jar single dwelling units.
3. The external water healing tank ant! i es shall be insulated to meet the requirements oI SI S0(i).
SPECIAL FEATURES The enforcement agency shold par special auention to the Special I'eannres specified in this checklist below.
These items mavrequire written justification and documentation and special verification.
NEW ROOF ASSEMBLY-Radiant Barrier
The radiant barrier re augment of F I51(t12 docs nota k to roof alterations'.
Slab Edge(Perimeter)Insulation 1'ES NO
YES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation ❑ vES NO
YES: Slab edge insulation re aired for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation 1'ES ❑NO
YES: In Climate Zones 1,2, 11, 13. 14 K 16,R-8 insulation is required:in Climate"Zones 12 A 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: HERS Provider: _
2008 Residential Compliance Forms A4arch 2010
Prescriptive Certificate of Compliance: Residential CF-iR-ALT
Residential Alterations (Page 5 of 5)
Project Name:NARAYAN MAKARAM Climate Zone 4 g2Stories
HERS V ERI FICATION SUMMARY The enforcement agencv should pay special attention to the HERS Afeasures specified in this
checklistbelow. A completed and signed CF-4R Form for all the measures specifiedshall be.submitted to the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is requiredfor this measure.
❑ YES ❑X NO vFS: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)1 Dii and the newly installed ducts are to be insulated per§151(f)10.
❑ EXCEPTION: Existing duct systemsthat are extended,which are constructed,insulated or sealed with asbestos.
❑YES ❑x NO ITS:In Climate Zones 2 and 9-16, if the existing space-conditioning system(FIVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(6)I Di.
❑YES ❑x NO YES:In Climate Zones 2 and 9-16, if the existing FIVAC 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
scaled per$152(6)I E.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through ITERS
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 duct systems constructed,insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification is requiredfor this measure.
❑ YES El NO NTS: In Climate Zones 2 and 8-15.when the existing IiVAC 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 fumace 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 F I50(o)do not appiv to existing residential homes.
Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is requiredfor this measure.
❑ YES ❑X NO YES In Climate Zones 10 through 15,when the esis-ting space-conditioning system(IIVAC equipment and ducting)is
replaced.the airflow and fan%van draw shall be verified per§152(b)ICi to meet the requirements of§15 I(f)711.
Documentation Author's Declaration Statement
• 1 certify that this Certificate of Compliance documentation is accurate and co te.
Name: Signature:
MINOR Signature. I
Company: ALLEY HEATING, COOLING, AND ELECTRICAL Da1c:10-23-2012
Address: If
N. 4TH ST If Applicable CEA or CEPS
(Certification q):
City/State"'p: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 ccnify that the energy features and performance specifications for the building design identified on this Certificate of Compliance confoml
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 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
a encv for approval with this building permit application.
Name:ROB MINOR I
Signature
Company,VALLEY HEATING, COOLING, AND ELE TRICAL Da1C:10-23-2012
Address: License:N. 4TH ST """'258540
City/Statter'Zip:SAN JOSE, CA 95112 ''h°"`408-294-6290
For assistance or questions regarding the Energy Standards,contact the F_nergr Hotline at: 1-800-771-3301).
Registr6tian,Number: Registration Dale/Time: HERS Provider:
2008 Residential Compliance Forms March 2010
Simpliftetf Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-IR-ALT-HVAC
Climate Zones I anrd 3-7
Site Address:21753 CASTLETON ST,CUPERTIINO,CA 95014 Enforcement Agencr'CITY OF CUPERTINO Date:10-23-20121 Pernnit k:
Conditioned Duct insulation
Equipment Tv e, List Minimum Efficicncv'' Floor Arca requirement Thermostat
Packaged Unit n Over 40 ft of ducts
% Furnace ❑X AFUE80% eCOP ❑x Setback
Served by system added or replaced in
e Indoor Coil ❑SEER= NSPF 1800 (Ifnol alreaeh presev.mtalbe
nsing Unit ❑):ER ❑Resistance s( unconditioned space installed)
E3= ❑It 6 (C!_ 1, 3-5J
/. Equipment Type:Choose the equipment being installed: if more than one system,use another CF-I R-ALT-1 IVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER. 78%AFUE. 7.714SPF for typical residential systems.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of compliance.
• I certify that the energy features and performance.specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24.Parts I and 6 of the California Code of Regulations.
• The design features identified on this Certificmeof Compliance are consistent with the information documented on other applicable
compliance forms-.worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name:ROB MINOR Signature:
Company HEATING, COOLING AND ELECTRI AL Date:
10-23-2012
Address:1171 N 4TH ST License:258540
Cit•/State/Zip:SAN JOSE, CA 95112 Pho x:408-294-6290
2008 Residential Compliance Forme March 2010