The URL can be used to link to this page

13020068 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11091 SANTA TERESA DR CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 13020068 CONDITIONING OWNER'S NAME: COLEMAN EUGENE M AND FRANCES S 1712 STONE AVE DATE ISSUED:02/132013 OWNER'S PHONE: 4082523960 SAN JOSE,CA 95125 PHONE NO:(408)293-4717 ❑ LICENSED CONTRA CTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class '�'f!3Lic.H^7E�$�7� REMOVE AND REPLACE 50 GALLON WATHER HEATER IN SAME Contractor flQ &21,oxy-e�. Date 2-13 -171 LOCATION 1 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:$1500 I 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 which this pPN Number:35616005.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is 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)agree to save 180 DAY RO 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 granting of this permit. Additionally,theapplicantunderstands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section Z4 - *�L—. 9.18: ��,q,� RE-ROOFS: Signature L Date l All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO 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 structureis not intended or offered for sale(Sce.7044, Business&Professions Code) 1,as owner of the property;am exclusively.contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE - - consuuct 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 I 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 1 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 the Health&Safety Code,Se/ck'ons 25505,255 34. Section 3700 of the Labor Code,for the performance of the work for which this permitis issued. Owner or authorized agent: 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 is to become subject to the Worker's Compensation laws of California. If,atter 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 deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name .APPLICANT CERTHrICAT10N 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 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 ®EN'ERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION I. 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 kp CURERTINC (408)777-3228 • FAX(408)777.3333 -building Dcuoertino.org 00 /Ill M 'S IC PLUMBING MECHANICAL ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS IMI 6bh l-q -Vt ('A �()\�,".p nPN A [ !^ OWNE.RHAME '�iA,�C � (a*w 1 1 P V 2- 0 el-VrMa 7 - MEET ADDRESS�Y`/III�"y�, Dr' \L(� (�11� FAX CONTACT NAME (1 Cii11rHONEy.�`9U�[,Sv,?JI'A/7t�(W-'S l e-M1L1II. STREET ADDRESS.nu swo�"� "��'l I�`tC1ry I6 �'Z tofQ�I • ❑OWNER ❑ OWNER-BUILDER Cl OWNERAOENT CONTRACTOR O CONTRACTOR ADEN' ❑ ARCHrnCT ❑ENOREER O OE'/ELOPER ❑ TFNAtfr CONTRACTOR NAMPI�IA F1jnA��{j UCTFhR ',Jr � UCEN �ip-t BUS.UC.�-u CONPANV NAME -'��,(yNN��r�Y�sI/L`�f �E.•\\MAII/`-(f Cj ` �/f `�/yt I�� FAX 4 •��TllA2 �( STREET ADDRESS (/L s a'(/ - 1� 6 P U U �/{V -411 ARC3cTECT2NODiEEA NAh® LICENSE NUNMER BUS.UC P COAIPANYNAA¢ - E-MAIL FAX STREET ADDRESS CrN,STATE,ZIP PHONE USE OF SFD Or Duplex ❑ Multi-Family PROJECT W WB.DLAND PROJECT M srnucnw: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No MOODZO ❑ Yes O NO DESCRIPTION OF WORK MTO . Gfu �/'I cc/ a./I`.{-00 I`v GQ) `\n \A cKff V\&Ity TOTAL vALUATION: Sli;w-W By MY signatum below.I certify to slw4f the fol ving: I am the property owner or authorized agent to act on the property owner's behalf. I have read this applicadon and the information I'Ave pr vide s co act. [have Rad the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state lawn Mahn to buil Ing co coon. I authorize representatives of Cupertino to enter the abo a-ide tified property for inspection purpoao. Signatureof Applicant/AgenO Date: SUp'pL4'My,i7A.L INFORMATION REQUIRED bJZ?A ueApp 201 Ldoe revised 03/16/11 CITY OF CUPERTINO jf2 COO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11091 SANTA TERES DR DATE: 02/13/2013 REVIEWED BY: MENDEZ APN: BP#: 'VALUATION: $1,500 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION PRWHEATR USE: PERMIT TYPE: WORK REMOVE AND'REPLACE 50 GALLON WATER HEATER SCOPE Mcch. flan Check Plumb.Plan Check 0.0 hrs $0.00 Elec.Plan Check Mech. Permit Fee: Plumb.Permit Fee: IPPERNBT rlec. Permit Fee: Other Meeh.Insp. Other Plumb Insp. 0.0 hrs $45.00 Other Dec.Insp. El ilech.Insp.Fec: Plumb. hasp.Fee: Dec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(ie.Planning,Public Works,Fire,Sanitary Sewer District,School District etc.). Thesefees ees are based on the re . .. a in ormadon available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053LE 7111121 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 F-1-1 # Plumbing Suppl. PC Fee: Q Reg. O'OT 0.0 1 hrs $0.00 $27.00 IPRWHEATR Water Heater PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp.Fee-.0 Reg. O OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 Construction Tax: Administrative Fee: IADMIN $42.00 O Work Without Permit? O Yes ON o $0.00 1 0 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRAVDOC $45.00 Building or Structure O Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 I� t. .iw�r'Iu." $133.50 $27.00 � �To1?ALtFEE $160.50 Revised: 01/01/2013 C�'uPaie-tit.3u Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Climate Zo (Page 4 of 5) - Zone# #of Stories Project Name: HVAC SYSTEMS-HEATING Configuration Minimum Duct or Piping g Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split, Type and Ca aci 1.2.3 ( \FUE or HSPF) Type and Location' R-Value Type Space,Package or H dronic) 1.Indicate Henning Type(Central Furnace.X 11 Furnace. Hear pump. Boller. 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 < 3 KW or 7.000 Btu/hr electric heating is con(r•olled 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 Jor additional requirements and check applicable bones. - 4. Indicate Type or Location(Ducts. Flvdronic 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 Ca I'mt l' SOP) Type and Location} R-Value Type Space,Package or H dronic) 1. Indicate Cooling Type(A/C.aci Heat pump. Evnp. Cooling, enc) - 2. Refer to the HERS Verification section on Page 4 of the CF-I R-ALT Form Jbr additional requirements and check applicable boxes. 3. Indicate Type or Location(Ducts, H dronic in Floor,Radiators, etc.J WATER HEATING Lisren heaters and boilers for both domestic hot water(DHW)heaters and hydronic space heating. Individual dwelling DHW heaters must be t wa gas or propane fired, and mqv not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the ki(chen(s)and on all underground hon 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 T el (Standard,Recin Lilatin )'- System Ca aci ( al) Thermal Efficiency R-Value3 1'tGIA `� L Indicate Type(Storage as, Heat Pump, Instantaneous,etc.) 2.Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§I50(n). The Prescriptive requirements do not allow the installation ofa recirculating water heating system for single dwelling units. 3. The external water heatinz tank and Pipes shall be insulated to meet the re uiremen(s o 150 . SPECIAL FEATURES The enforcement agenev should pc v special attention to the Special Features specified in this checklist below. These items may require written justification and documentation and special verification. NEW.ROOF ASSEMBLY-Radiant Barrier The radiant barrier requirement of 15 1( 2 does not apply to roof alterations. Slab Edge(Perimeter)Insulation ❑YES ❑NO YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation 13 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 ❑YES 0 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 13- Thermal Mass To obtain Compliance Credit for the installation of thermal mass,use the Performance Approach. Registration Number: Registration Dare/Time: HERS Provider: 2008 Residential Compliance Forms August 200 1302b000