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11050143
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10030 CARMONA CT CONTRACTOR:RELIABLE AIR PERMIT NO: 11050143 MECHANICAL OWNER'S NAME: MIKE FAIN 3670 D CHARTER PARK DR DATE ISSUED:05/18/2011 ( ?R'S PHONE: 4088737200 SAN JOSE,CA 95136 PHONE NO:(408)266-7267 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class �r b Lic.# � (1 MECH RESIDENTIAL COMMERCIAL Contractor j�/'W�Date ��"{�--( i I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:ADD NEW A/C UNIT AT ATTIC LOCATION (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:$3500 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 permit is issued. e pAPN Number:35716111.00 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 PERMIT EXPIRES IF WORK IS NOT 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-poin regulations per the Cupertino Municipal Code,Section Issued by: C �� Date J-- j 9.18. r ��1 Signa Date �� O RE-ROOFS: L OWNER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety 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 Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with 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&Safety Coe,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Owne r a iz a Compensation laws of California. If,after making this certificate of exemption,I Date: ( t 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Aork's APPLICANT CERTIFICATION 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 and state laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save in-'--nnify and keep harmless the City of Cupertino against liabilities,judgments, c and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION gt,...,mg 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 CITY OF CUPERTINO 5 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35716111. 00 DATE ISSUED. . . . . . . : 05/18/2011 RECEIPT #. . . . . . . . . : BS000013481 REFERENCE ID # . . . : 11050143 SITE ADDRESS . . . . . : 10030 CARMONA CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . MIKE FAIN ADDRESS . . . . . . . . . . : 10030 CARMONA CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PHILLIP A DORE CONTRACTOR . . . . . . . : PHIL DORE LIC # 32027 COMPANY . . . . . . . . . . : RELIABLE AIR MECHANICAL ADDRESS . . . . . . . . . . : 3670 D CHARTER PARK DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95136 TELEPHONE . . . . . . . . : (408) 266-7267 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 3, 500 . 00 1. 00 0. 00 1 .00 0. 00 1BREMAIRHA NO.UNITS 1 .00 63 . 00 0. 00 63 .00 0. 00 1BSEISMICR VALUATION 3, 500 . 00 0.50 0. 00 0 .50 0. 00 1MPERMITFE FLAT RATE 1.00 42 . 00 0. 00 42 .00 0. 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0. 00 42 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 148.50 0. 00 148 .50 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL GENERAL PERMIT APPLICATIONMEP COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CtJ tl q (408)777-3228 • FAX(408)777-3333-building(a?cupertino.ora misc PER N t9tvI ING %�IECHANICAL ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS C2 C2 7�t n CA f,,., rL OWNER NAME �J� p � ` PHONEE-MAIL STREET ADDRESS � �C //� CITY,STATE,ZIP FAX CONTACT NAME ' \ e PHONE qo l` _2-7/' E-MAIL STREET ADDRESS CTTY.STA ZIP 1 3 FFA ❑OWNER ❑ OWNER-1HollILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENAM' CONTRACTOR NAME LICENSE NUMBER Q,r LI Ll©© LICENSC E Bus.LIC tF COMPANY NAME E MAII, I J FAX �p STREET ADDRESS 0 �'ll►r��.��' �A`f- CITY,STATE,Z2i PHONE Im_ ARCHTSECTIENGINEER NAME P LICENSE NUMBER � "1 l b BUS.LIC N l7 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE TISE OF [AFD or Duplex ❑ Multi-Family PROJECT rN WI.DLAND PROJECT IN rRUC URE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes No FLOOD ZONE ❑ Yes ❑ NO DESCRIPTION OF WORK t` �✓''v1 o c-- E k-1 >—, NOW TOTAL VALUATION: vs ��,, By my signature below,I certify to each of lowing: I am the property owner or authorized agent to act an the property owner's behalf. I have read this application and the information provided correct I have read the Description of Work and verify it is accurate. I agree to comply with al]applicable local ordinances and state laws re ng to b ildin tructio I a e representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicantlAgent - ff Date: — t 1 SUPPLEMENTAL INFORMATION REQUIRED f� - - WE MEPMiscApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10030 carmona ct. DATE: 05/18/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$3,500 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK add new a/c unit at attic location. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $63 TOTALS: $63.00 Mech.Plan Check0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs $42.00 Li NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS tree Resolution 09-051 F f. 1.-'10) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $63.00 PME Permit Fee: $42.00 Work Without Permit? 0 Yes E) No $0.00 Travel Documentation Fee: ITRA VDOC $42.00 Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $148.50 $0.00 TOTAL FEE $148.50 Revised: 04/29/2011 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations Page 4 of 5) Project Name: i Climate Zone# ' i #of Stories C)-�� C� `"� HVAC SYSTEMS-HEATING Minimum Duct or Piping Configuration Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split, Type and Capacity 1,2,3 (AFUE or HSPF) Type and Iocation4 R-Value Type Space,Package or H dronic C,e 1.Indicate Heating Type(Central Furnace, Wall Furnace,Heat pu)np,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 KW or 7,000 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-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 (SEER/EER or Distribution Insulation Thermostat (Central,Split, Type and Capacity 1,2 COP) Type and Location R-Value Type Space,Package or H dronic) AC O J"fj, QAA 1.Indicate Cooling Type(A/C,Heat pump,Evap. Cooling, etc) 2.Refer to the HERS 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.) 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,Recirculati )2 System Capacity(gal) Thermal Efficiency R-Value3 i \J_ 41 a 1.Indicate Type(Storage Gas,Heat Pump,Instantaneous, etc.) 2.Recirculating systems serving multiple dwelling units shall meet a 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 of§1506). SPECIAL FEATURES The enforcement agency should pay special attention to the Special Feas}s ecifred in this checklist below. These items may require written 'usti rcation and documentation and special verification. ��''+++ Y NEW ROOF ASSEMBLY-Radiant Barrier ' The radiant barrier requirement of§151( 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.- e i ink-le 118-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 Zon 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 Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Page 5 of 5 Project Name: Climate Zone# #of Stories HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF-4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing& Testing HERS verification is required for this measure. ❑YES ❑NO YES: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 sealed per§152(b)1 Dii and the newly installed ducts are to be insulated per§151(f)10. ❑ EXCEPTION:Existing duct systems that are extended,which are constructed,insulated or sealed with asbestos. ❑YES ❑NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(b)1 Di. ❑YES ❑NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equi ment is replaced(including the replacement of the air handler, outdoor condensing unit of a split system,coolin or hea ing coil,or the furnace heat exchanger)the ducts are to be sealed per§152(b)1 E. ❑ EXCEPTION:Duct systems that are docume to o h v be n previously sealed confirmed through HERS verification in accordance with procedures in the Refe nce Residential Appendix RA3. ❑ EXCEPTION:Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION:Existing ducts stems constructed,insulated or sealed with asbestos. Refrigerant Charge- Split System HERS verification is required for this measure. ❑YES ❑NO YES:In Climate Zones 2 and 8-15,when the existing HVAC 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 furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b)1F. Central Fan Integrated(CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150 o do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ❑YES ❑NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced,the airflow and fan watt draw shall be verified per§152(b)1 Ci to meet the requirements of§15 l(f)7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurat Name: +' Sign re• � Company: i Date: P Address: ` S n `n If Applicable 13 CEA or❑CEPE Com,`t?�{ v_ �'/kr V_ e CJ (Certification#): City/State/Zip: l Phone: 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. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 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 agency for approval with this building permit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: _ For assistance or questions regarding the Energy Standards,contact the Energy Hotline at.I-800-772-3300. Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009