13010093CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10771 S 13LANEY AVE
CONTRACTOR: AAA FURNACE & AIR
PERMIT NO: 13010093
-
CONDITIONING
OWNER'S NAME: PAVIT BRAR
1712 STONE AVE
DATE ISSUED: 01/172013
OWNER'S PHONE: 4154252835
SAN JOSE, CA 95125
PHONE NO: (408)293.4717
❑ LICENSEDCONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL L1 OMMERCIAL 11
License.Clas4/` 210 i'C/31Lic. H ? 6�- W
REMOVE AND REPLACE FURNACE IN EXISTING
LOCATION
Contractor TI �nT R 1 v�Nq Lam— Date ^ 4
I hereby affirm that I am licensed 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.
I 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: $2880
1 have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36934049.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANTS CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT E S IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 1 0 AYS 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) We to save
180 DAYS LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by: Date: �/
granting of this permit; Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18..
7
4
RE -ROOFS:
installed. If is
Signature Date
All roofs shall be inspected prior to any roofing material being a roof .
-installed
without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, 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 (Sec.7044,
Business &Professions Code)
I, as owner of the property, Am exclusively contracting with licensed contractors to
HAZARDOUS 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. I 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:
Health & Safety Code, Section 25532(a) should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I 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 I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
Code, for the of the work for which this
the Health & Safety Code, Sectio s 25505, 2553 , a 4.
/ /k
Section 3700 of the Labor performance
Owner or authorized agent: Date:
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
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after.making this certificate of exemption, I
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 deemed 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 theabove mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • 9UILDING DIVISION U `'1-9
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Q
(408) 777-3228 - FAX (408) 777-3333 • buildinaOcuoertino.ora
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PROJECT' ADDRESSS� IUnI �S' QIa
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APNa I _ pt .4 �� 1 Ci
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OWNER NAME B_y 11^
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PHONE �I (_ /1%�..2
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STREET ADDRESS I�I `-•\NN 1`�•
CITY, fj�/I•'[viAAZPI!CTOiH�I 2181
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERADENI
CONTRACTOR ❑CONRAOEXT ARCHRECT ❑ ENORIBER
❑ DEVELOPER ❑ TENANT
COMRAROR NAME ��.Q• % ta�
YM,1�
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UCFrN�ET 67,0
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STRADDRESS 11111 \slime/ RSC. �
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ARCHTTECT1ENODJEBRNA1vM
LICENSENUNMER
BUS. WCI
CO?APANYNAME
E-MAE.
FAX
STREET ADDRESS
CITY, STATE. ZIP
PHONE
USE OF SFD or Duplex ❑ Multi -Family
STRuCRJRE: ❑ Corrnamercial
PROJECT IN WB.DLAND
URBAN UTERPACE AREA ❑ Yes No
PROJECT IN y{'
FLOOD ZONE ❑ Yes o
fy "
DESCRIFRON OF WORK IyAj\� �Sfin
mGcv �,r'>G1 act
fM
1A
'
TOTAL VALUATION: MM. 1 00
By my signature below,, certify i f the 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the infonnadon have pro i d is co eL '1 have read the Description of Work and verify it is accurate, I agree to comply with all applicable local
ordinances and state laws relad to build, co cdon. I authorize representatives of Cupertino to enter the abo fiddo tamed property for inspection purposes.
Signature of Applicant/Ager:Date; 1.116-11--1
SUPPLE AL INFORMATION REQUEUD
MEFAfrscApp 201 Ldoc revised 03/16/11
CITY OF CUPERTINO
FF.Ti. FCTTMATOR — RITTI,DING DIVISION
LaADDRESS:
10771 s blaney ave
DATE: 01/17/2013
REVIEWED BY: mendez
APN:
I BP#:
'VALUATION:
$2,880
FPERMITTYPE: Building Permit
PLAN CHECK TYPE: Addition
PRIMARY SFD Or Duplex
P
IMPERMIT
PERMIT TYPE: FURNIAC
PERMIT
USE:
PME Plan Check:
-lec. Permit Fee:
Other Mech, Insp. 0.0 hrs
$ 45.00
WORK
remove and replace furnace in existing location
Permit Fee:
Other Elm Insp.
SCOPE
0,0
NOTE: This estimate does not includejees due to other uepartments (Le. manning, rubuc morns, r.re, a,.nn..ry �rrv�...w......,
rantaet the Dent for addn'l into.
FEE ITEMS (Fee Resolution 11-053 Elf 711112)
FEE
QTY/FEE
MISC ITEMS
Mech. Plan Check 0.0 1 hrs
$0.00
Phonb. Plan Check
F 1 1#
$133.00
Mechanical
IMFR=1100 Furnace, Forced -Air
Dec. Plat? Check
Meeh. Permit Fee:
IMPERMIT
I Plumb.
Permit Fee:
PME Plan Check:
-lec. Permit Fee:
Other Mech, Insp. 0.0 hrs
$ 45.00
Other Plumb Insp.LLJ
Permit Fee:
Other Elm Insp.
.11ech. Insp. Fee:
0,0
Plumb. /pep. Fee:
$0.00
Elec. Insp. Fe.c'
PME Unit Fee:
$0.00
PME Permit Fee:
$45.00
Construction Tax:
, S gni
NOTE: This estimate does not includejees due to other uepartments (Le. manning, rubuc morns, r.re, a,.nn..ry �rrv�...w......,
rantaet the Dent for addn'l into.
FEE ITEMS (Fee Resolution 11-053 Elf 711112)
FEE
QTY/FEE
MISC ITEMS
Mech. Plan Check 0.0 1 hrs
$0.00
Phonb. Plan Check
F 1 1#
$133.00
Mechanical
IMFR=1100 Furnace, Forced -Air
Dec. Plat? Check
Meeh. Permit Fee:
IMPERMIT
I Plumb.
Permit Fee:
PME Plan Check:
-lec. Permit Fee:
Other Mech, Insp. 0.0 hrs
$ 45.00
Other Plumb Insp.LLJ
Permit Fee:
Other Elm Insp.
.11ech. Insp. Fee:
0,0
Plumb. /pep. Fee:
$0.00
Elec. Insp. Fe.c'
NOTE: This estimate does not includejees due to other uepartments (Le. manning, rubuc morns, r.re, a,.nn..ry �rrv�...w......,
rantaet the Dent for addn'l into.
FEE ITEMS (Fee Resolution 11-053 Elf 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
F 1 1#
$133.00
Mechanical
IMFR=1100 Furnace, Forced -Air
Suppl. PC Fee: Q Reg. Q OT
.0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0,0
1 Ins
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$45.00
Construction Tax:
Administrative Fee: IADMIN
$42.00
O
0
Work Without Permit? O Yes Q No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
�A
Travel Documentation Fee: ITRAVDOC
$45.00
Strong Motion Fee., IBSEISAHCR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
tugs„"s
b11>e�M�>a6mnl
-1S€ih?
$133.50
$133.00
$266.50
$266.50
Revised: 10/01/2012
(-1ur')?IttI11JL,
HVAC SYSTEMS - HEATING
Minimum Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central, Split,
R T S ace, Package or H dronic)
Type a Ca aci 1•2'3 ( �FUE or HSP F Type and Location' -Value PC
1Ceej 00 _ 0
External Tank
Water Heater Type/FuDistribution
Type
Number In
I. Indicate Heating Type (Cewal 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
< ? KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(6)3 exception. s
3. Refer to the HERS Verification section on Page 3 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 (SE EER or
Distribution Insulation Thermostat (Central, Split,
Type Space, Package or H dronic)
T 1.2e and Ca acit �SOP)
Type and Locations R -Value
1. Indicat poling Type (A/C. Heat pump. Evnp. Cooling, etc) -
2. Refe to the HER 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.)
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kiichen(s) and on all underground
ka 1/ ito zones
hot water res is required to all component ac es m i
SPECIAL FEATURES The enforcement agency should pav special attention to the Special Features specified in this checxttsr De/OW.
These items may require written justification and documentation and special verification.
NEW_ROOFASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151(£)2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation Ll YES ❑ NO
YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation ❑ YES ❑ NO
YES: Slab ed a insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation ❑ 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.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number: Registration Dote/Time: HERS Provider:
2008 Residential Compliance Forms August 2005
a c ia
External Tank
Water Heater Type/FuDistribution
Type
Number In
Tank
Energy Factor or
Insulation
Type'
(Standard, Recirculating)-
System
Capacity (gal)
Thermal Efficiency
R -Value
I. icate 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 ofa recirculating water heating system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements of §1506).
SPECIAL FEATURES The enforcement agency should pav special attention to the Special Features specified in this checxttsr De/OW.
These items may require written justification and documentation and special verification.
NEW_ROOFASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 151(£)2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation Ll YES ❑ NO
YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation ❑ YES ❑ NO
YES: Slab ed a insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards.
Raised Slab Insulation ❑ 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.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Approach.
Registration Number: Registration Dote/Time: HERS Provider:
2008 Residential Compliance Forms August 2005
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Tone Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: ) (M� F'- Y1
PERMIT #
OWNER'S NAME:
PHONE #
GENERAL CONTRACTOR:— rN
BUSINESS LICENSE #
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires. all:businesses working in the city to have a City of cupernno uusmess ncense.
NO BUILDING FINAL OR FINAL: OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONT VE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. _
I am not using any subcontra�cs:
Signatue Date
Please check apnlicablesubcontrahors and complete the following information:
Owner / Contractor. Signature
Date
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
rd�7i
/3 �l�d23
CEIVED
JAN 2..l.,;2015
BY
CERTIFICATE OF COMPLIANCE CKR-ALT-02-E
4lterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: P. BRAR Date Prepared: 2014-12-15
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be
documented, use one CF1R-ALT 02 document for each dwelling unit. --
01
Project Name
P. BRAR
02
Date Prepared
2014-12-15
03
Project Location
10771 S. BLANEY AVENUE
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
P. BRAR
07
Zip Code
95014
08
Dwelling Unit Conditioned
2022
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by this SC
ducted
containing
system
Number of space conditioning
entirely new
09
Climate Zone
4
10
(SC) systems in this dwelling
1
component?
components?
feet of ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04'. ''
05
06
07 ,'
08,
09
10
Is the. SC "
..'14stalling a
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
DUCTS
WHOLE HOUSE
2022
Yes
No
No
Yes
No
No
Extension of existing
duct system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
01
02
System Identification or
Name:
New Duct R -Value:
DUCTS
R-6
Reaulred Documentation:
Registration Number: 214-A0159243A-000000000-0000 Registration Date/Time: 2014-12-15 11:13:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-15 11:14:09
Schema Version: 0.551SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 )
MR -MCH -01-11 -Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6. \
CF2R & MR -MCH -20-1-1 —Duct Leakage Verification
- Leakage rate compliance: 5 15%, or 5 10% leakage to outside, or seal all accessible leaks
Exceptions:
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 duct leakage testing requirements
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 214-A0159241A-000000000-0000 Registration Date/Time: 2014-12-1511:13:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-15 11:14:09
Schema Version: 0.5515DD
w_.�f���
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:
Rando, Eric
Company:
Signature Date:
RANDO AAA HVAC INC
2014-12-15 11:13:14
Address:
CEA/ HERS Certification Identification (if applicable):
1712 STONE AVENUE
N/A
City/State/Zip:
Phone:
SAN JOSE CA 95125
(408) 293-4717
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and. Professions Code to accept.responsibility forthe building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance, specifications, materials,. components;and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit. application.
S. I will ensure that a registered copy of this Certificate of Compliance shall bemade 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 registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Rando, Eric
Company:
Date Signed:
RANDO AAA HVAC INC
2014-12-15 11:13:14
Address:
License:
1712 STONE AVENUE
768871
City/State/Zip:
Phone:
SAN JOSE CA 95125
(408) 293-4717
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information.
Registration Number: 214-A0159241A-000000000-0000 Registration Date/Time: 2014-12-15 11:13:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-12-15 11:14:09
Schema Version: 0.5515DD