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11100073 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10220 VISTA DR CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 11100073 CONDITIONING OWNER'S NAME: CHU YAO K AND HUEI-LAN C 1712 STONE AVE DATE ISSUED: 10/11/2011 C ,R'S PHONE: 6507764407 SAN JOSE,CA 95125 PHONE NO:(408)293-4717 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Clas�u Lic.# -7 ID k 81/ r ��Ft,rNc►C,z MECH RESIDENTIAL COMMERCIAL Contractor Date 11 — It I hereby a Trm that I lie used under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE&REPLACE FURNACE&DUCT WORK;ADD A/C (commencing with Sec' n 00)of Division 3 of the Business&Professions UNIT 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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$7909 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:31624017.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHI AYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DA M LAST CALLED INSPECTION. granting of this pZ. d i ally,the applicant understands and will comply with all non-po' t sations per the Cupertino Municipal Code,Section J 9.18. Issued by: ` 1 ! Date: Signature -Date 1a L OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 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, Signature of Applicant: Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as definj by the Bay Area Air Quality Management District I will permit is issued. maintain cor ian _th the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health a e,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I OwTr r aut rized agent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CO RUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address -mify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31624017. 00 DATE ISSUED. . . . . . . : 10/11/2011 RECEIPT #. . . . . . . . . : BS000015009 REFERENCE ID # . . . : 11100073 SITE ADDRESS . . . . . : 10220 VISTA DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : CHU YAO K AND HUEI-LAN C ADDRESS . . . . . . . . . . : 10220 VISTA DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2024 RECEIVED FROM . . . . : RANDO AAA HVAC, INC CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050 COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING ADDRESS . . . . . . . . . . : 1712 STONE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 293-4717 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 7, 909. 00 1. 00 0. 00 1 .00 0. 00 1BREMAIRHA NO.UNITS 1. 00 65. 00 0. 00 65 .00 0. 00 1BSEISMICR VALUATION 7, 909. 00 0. 79 0. 00 0 .79 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. 79 0. 00 325 .79 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 325.79 #39202 --------------- TOTAL RECEIPT 325 .79 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL I I I (Dov­7 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333 •buildingaacupertino.org MISC ❑PLUNIBING [ iiECHANICAL ©ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS I ) � r� � � 'G �(' o- APN# OWNER NAME (+11()n I U PHONE - E-MAIL STREET ADDRESS r2j.) 1 C CITY. STATE.ZIP /y„ ��r�NO ^� ^ Jll FA}C CONTACT NAMENE MAM G a,-4 A(.l7 L-1 2 409 5 2,-4f E ''----------^' STREET ADDRESS y I^ / C STATEZIP-!,' �S/ �r ;f 2� ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT JeCONTRACrOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME q pr ,r r�Q LICENSE NUMB ,� I INCENSE t U BUS.LIC Y COMPANY NAME A -u r E-MAIL _ 7- STREET ADDRESS I I S- / C STATE.ZIP 0/Z P ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC R (� COMPANY NAME E-MAIL FAX STREET ADDRESSCITY,STATE,ZIP PHONE / USE of 9 SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA Cl Yes ❑ No FLOOD ZONE ❑ Yes ❑ No DESCRIPTION OF WORK e�(!Mo vF a Aj Q CV TOTAL VALUATION: (DqO C) By my signature below,I certify to each of the following: I a the erty 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 av the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel g to 'Iding construction. orize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicandAge Date: io PLEIVENTAL INFORMATIO UIRED -urya0tQ2 'aJ 07 ` <r 6 _ .'ate_ MEPMisc,4pp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10220 Vista Dr. DATE: 10/11/2011 REVIEWED BY: gs APN: BP#: "VALUATION: 1$7,909 °PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK Remove and replace furnace and duct work. add A/C unit. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $65 Furnace, Forced-Air 1MFR=<100 1 # $130 Air-Handling (<=10K cfm) 1 # $65 TOTALS: $260.00 Mech.Plan Check0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs 1114.00 Li NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the relinina information available and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS (1 ee Resolution 11-053 Ef 7;1'/11) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $260.00 PME Permit Fee: $44.00 Administrative Fee: ]ADMIN $41.00 Work Without Permit? Yes 0 No $0.00 Travel Documentation Fee: ITRA VDOC $44.00 A Strong Nlotion Fee: IBSEISMICR $0.79 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $390.79 $0.00 TOTAL FEE: $390.79 Revised: 10/01/2011 ((�PtLt1�� U Preseri tive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Page 4 of 5) Projecme: Climate Zone# #of Stories t a 4 n ' U HVAC SYSTEMS-HEATING Minimum Duct or Piping Configuration Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split, Type and Capacity 1''_'3 (AFUE or HSPF) Type and Location R-Value Type Space,Package or H dronic) fAArNA C9� ° a 1.Indicate Heating Type(Central Furnace, Wall Furnace. Heat pump, Boiler, Electric Resistance, etc.) ?.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 .71000 Btu/hr 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-1 R-ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location(Ducts. Hvdronic 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,Packa e or H dronic C 3.4/OA-03(4 1. Indicate Cooling Type(A/C, Heat pump, Evap. Cooling, etc) 2. Refer to the HERS Verification section on Page 4 of the CF-1 R-ALT Form for additional requirements and check applicable boxes. 3. Indicate Type or Location(Ducts, Hydronic 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, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s)and on all underground hot water pipes is required in all com onent packages in all climate zones. External Tank Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation Type' (Standard,Recirculating)' 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 i es shall be insulated to meet the requirements o 150 ). SPECIAL FEATURES The enforcement agencv should pav special attention to the Special Features specified in this checklist below. a These items my require writtenjustification 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 ❑YES ❑ NO YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation ❑ YES ❑ NO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table I 18-A of the standards. Raised Slab Insulation ❑ YES ❑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: HERS Provider: 2008 Residential Compliance Forms August 2009