Loading...
11010086 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS. 10072 MOSSY OAK CT CONTRACTOR:VALLEY HEATING& TD IT NO: 11010086 COOLING OWNER'S NAME: ALICE WICHMAN 1171 N 4 TH ST ISSUED:01/14/2011 ER'S PHONE: 6504657227 SAN JOSE,CA 95112 E NO:(408)294-6290 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB �Li,enseClas;,--C–,-2,0— Lic.# �✓�SSt�O MECH r RESIDENTIAL r– COMMERCIAL Contractor G_ iy'Nr:'��i�7 � rd�SDate /�l /( I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FURNACE REPLACEMENT&ADD A/C WHOLE HOUSE DUCT (commencing with Section 7000)of Division 3 of the Business&Professions REPLACEMENT(OUTDOOR CLOSET) 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 Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$8540 permit is issued. APPLICANT CERTIFICATION APN Number:34232111.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section / 9.18. Date/,/0– 1 :•_ Signature Date t Issued by LI OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. 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 declarations: HAZARDOUS MATERIALS DISCLOSURE 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 performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 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 permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner of or gent: Dare: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save ,mnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address ,ts,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date Licensed Professional Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# UU OWNER'S NAME: 13\ %L tIN1 CV)MG1't1 PHONE# 40 8' ll a(qO GENERAL CONTRACTOR: Prll-ekg+t Ji Coot%nej BUSINESS LICENSE# �5 3-5440 ADDRESS: 1\111 l3 -TN L�TN - S} - `' CITY/ZIPCODE: S Avl :J US-e cjskt a. *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 14 1 1 Sign ture Dat Please check applicable subcontractors an4votnpiete the following information: V 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 ntrac�or Signature Daie s J sales `�� rk,- S -t E NONE 0 By.. S i � � f A { e Fs CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10072 mossy oak ct. DATE: 01/14/2011 REVIEWED BY: bobs. APN: I BP#: "VALUATION: 1$8,540 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: I PERMIT TYPE: WORK sfd furnace re lacememt at same location add a/c duct replacement throu ht out exisitnq dwelling. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $63 Furnace, Forced-Air 1MFR=<100 1 # $126 Heating System 1MRRAA 1 # $63 TOTALS: $252.00 Mech.Plan Check0.0 hrs $0.00 firth' l loo C`hccl, 1 1 - t;<<�. t'ran(.heck I I Mech.Permit Fee: 1MPERMIT F'Ifr vi" Permit 1":rn it F-1 Other Mech.Insp. 0.0 hrs $42.00 t)rht>f �,�., >Ir�sr� 0 CIr<'r>f�Iat°c.In-s,�. Alc(h. fa'p. F"( 11111fub, Kish. Fee tat r.Cush. haze� NOTE: Theseees are based on the preliminaryin ormation available and are onlyan estimate. Contact the Det or addn'1 info. FEE ITEMS (dee Resolution 09-051 E . 7"1110) FEE QTY/FEE MISC ITEMS Plan Checl, Fec°: Supp/. 1't.'Fee PME Plan Check: $0.00 I'er'rnit Fee Suhpl. Irish Fec> PME Unit Fee: $252.00 PME Permit Fee: $42.00 ('o11N11'1lcti017 I Q:1 ,4couslic al Ii'r`ic'h:F(V. Work Without Permit? 0 Yes E) No $0.00 I'lctnnist,:> 1�'c�es: Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: IBSEISMICR $0.85 Select an Administrative Item Bldf;Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $337.85 $0.00 TOTAL FEE: $337.85 Revised: 01/03/2011 Installation Certificate Prescriptive Method - HVAC-only Alteration CF-6R-ALT Project Title: Date'"' ©2005 CaICERTS f I L4 A Enforcement Agency Use Only Project Address: Climate Zon : Building Permit# I lod-1 a Moss.r 6Al< C-r . Installing Contractor: Telephone: 4a) Plan Check Date V IA t.Lam`? l,-,)q 4- b, Company Name: Field Check Date V A i 0,) C06 L tv) iI; . IMPORTANT: This CF-6R form is only for use when an HVAC-only alteration is made to an existing home Use one form for each system being altered. This is system#..L_of systems altered in this house. Copies to:Homeowner, HERS Rater,and Building Department List the specifications for the newly installed equipment. These must match the installed equipment exactly. Installed equipment must match type/location and meet or exceed efficiencies/R-values from CF-1 R. Equipment T e Manufacturer Model Number Efficiency Load** Ca acit *** Furnace IJN OX �LQ�MP Q AFUE �D 3Te� 17 1.OoC� Heat Exchanger `a C1 1 N/A Heat Pump fan coil N/A Hydronic fan coil N/A Other FAU Describe Package gas/AC AFUE SEER r.�d..._ Package heatpump HSPF SEER EER* A/C Condenser �eIIJ t,5 Off( 14 ACA-C30 _ SEER '' + IT _ Heatpump Condenser Q 30 HSPF SEER Indoor DX coil EER* Hydronic coil Provide EER if needed for compliance(line 24 of CF-1 R-ALT). Installer must provide adequate documentation to verify EER. In some cases the specific furnace may need to be verified in order to achieve a specific EER. In some cases a time delay relay and/or TXV may need to ve verified in order to achieve a specific EER. *Loads are sensible for cooling. ***Capacities are sensible at design conditions for cooling and adjusted altitude,downflow,etc.)output for heating. XV: ❑ If TXV is required by the CF-1 R form(line 23 on CF-1 R-ALT form),it has been installed and access has been provided for visual verification by HERS rater. Sampling is allowed for TXV verification. Entirely New Duct System: (Line 5 of CF-1R ALT) ❑ For Entirely new duct systems,the required leakage is 6%rather than 15%for altered systems. The alternative to duct sealinq by increasing the efficiency of the equipment is not an option for entirely new duct systems. 1,the undersigned,verify that the equipment listed above is: 1)the actual equipment installed in the home;2)equal to or more efficient than required by the Certificate of Compliance(CF-1 R-ALT Form);and 3)equipment that meets or exceeds the appropriate requirements for manufactured devices(Appliance Efficiency Standards),where applicable. I,the undersigned,verify that diagnostic test results listed on this form were performeddin corlfoRance with the requirements for compliance and that the newly installed or retrofitted mechanical system components colh{'OrmNittl i n story requirements specified in Section 150(m)of the 2005 Building Energy Efficiency Standards. ' s Signed(Installer): Date: Notes: Version 03-10-06 Page 1 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com Installation Certificate Prescriptive Method - HVAC-only Alteration CF-6R-ALT Project Title: Date,-- ©2005 CaICERTS IMPORTANT: This CF-6R form is only for use when an HVAC-only alteration is made to an existing home Use one form for each system being altered. This is system# of systems altered in this house. Copies to: Homeowner, HERS Rater, and Building Department Duct Leakage test Results If duct testing is required per CF-1 R-ALT form) Step 1-Pre-test:Leakage of the system before any alterations. This test isoptional and is only used for the 60%reduction option 1 Pre-test leakage: ICFM25 2 Line 1 x 0.4= Farget for 60%reduction Step 2-Determine Total System Fan Flow: Use any of these methods.Use values fore ui ment after alterations. 3 Cooling: Condenser tonnage: tons x 400 CFM/ton= JCFM 4 Heating: Furnace output: Btuh x.0217 CFM/Btuh= CFM 5 Measured:(refer to ACM Manual Appendix RE,section 4.1)= ICFM 6 Measurement method: ❑flow hood ❑ plenum pressure matching ❑flow grid 7 Totals stem fan flow value to be used: I JCFM may use highest of lines 3,4,or 5. Step 3-Determine Targets: Ba Total System fan flow(line 7 from above)x 0.06= CFM25=6%leakage target(new duct systems) 8b Total System fan flow(line 7 from above)x 0.15= CFM25=15%leakage target 9 Total System fan flow line 7 from above x 0.10= CFM25=10%leakage to outside target Step 4-Alterations:Must be consistent with the CF-1 R form. 10 ❑ Seal all new connections with approved materials. 11 ❑ No newly constructed portions of the system can have unducted building cavities to convey system air. 12 ❑ If adding or replacing more than 40 feet of duct,insulate new ducts per package D for that climate zone Step 5-Final Leakage(regular duct leakage test,for 15%total and 60%reduction) 13 leakage= I ICFM25 refer to 2005 ACM appendix RC,Sections RC 4.3.1 14a ❑ If line 13 Is less than line 8a house passes the 6%leakage requirement,Go to Step 9. 14b ❑ If line 13 is less than line 8b house passes the 16%leakage requirement.Go to Step 9. 15 ❑ If line 13 is less than line 2 house passes the 60%reduction requirement,continue. 16 ❑ If either of lines 14a,14b or 15 are checked,HERS verification is required. Sampling can be used. 17 ❑ If line 15 is checked,but not 14a or 14b,Smoke Test and Visual Inspection of Accessible Duct Sealing is required.Go to Step 8 Step 6-Leakage to Outside: Similar to a regular duct blaster test but the house is pressurized to 25 pascals at the same time. 18 Ileakage= I CFM25 refer to 2005 ACM appendix RC,Sections RC 4.3.3 19 ❑ Iff llinelklsless than line 9 house passes the 10%leakage to outside requirement. 20 ❑ lif line 19 passes,HERS verification is required. Sampling can be used. Step 7-If the house does not pass any of lines 14,15 or 19. 21 ❑ Smoke Test and Visual Inspection of Accessible Duct Sealing is required. See Step 8. 22 ❑ linstall required label per ACM Appendix RC,Sections RC.4.3.5. Step 8-Smoke Test and Visual Verification See 2005 Residential ACM Appendix RC Sections RC 4.3.5-7 23 ❑ Perform smoke test per ACM Appendix RC Sections RC 4.3.6. 24 ❑ Perform Visual Inspection and repair of excessively damaged ducts per ACM Appendix RC Sections RC 4.3.7. 25 ❑ Seal register boots to surrounding material per ACM Appendix RC,Sections RC 4.3.7. HERS Verification 26 ❑ If line 14 is checked. 15%leakage to be verified by HERS rater. Sampling is allowed. 27 ❑ If line 15 is checked. 60%leakage reduction to be verified by HERS rater(post test only)AND Smoke Test and Visual Verification to be performed by HERS Rater. Sampling is allowed. 28 ❑ If line 19 is checked. 10%leakage to outside to be verified by HERS rater. Sampling is allowed. 29 ❑ If none of lines 14,15 or 19 are checked Smoke Test and fix all accessable leakes. No sampling allowed. Sampling-Only if house passes on lines 14,15 or 19. 30 ❑ 1.)Homeowner chooses to be put into a group of homes fol random third party HERS sampling. 2.)Homeowner,installer and rater must sign the three-party agreement. 3. All above tests must be completed by the installer or their representative,not the third party rater. No Sampling-House does not pass by lines 14,15 or 19;OR homeowner chooses not to be part of a sample group 31 ❑ 1.)House to be tested by a third party HERS rater selected by installer. 2.)Homeowner,installer and rater must sign the three-party agreement. 3.)All above tests may be completed by the installer or their representative,and then verified by a third party rater. OR all above tests may be performed solely by the third party rater. 32 ❑ 1.)House to be tested by third party HERS rater selected by homeowner. 2.)All above tests may be completed by the installer or their representative,and then verified by a third party rater. OR,all above tests may be performed solely by the third party rater. Version 03-10-06 Page 2 of 2 This form can only be used on projects being verified by CaICERTS certified raters. www.calcerts.com CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34232111 .00 DATE ISSUED. . . . . . . : 01/14/2011 RECEIPT #. . . . . . . • • : BS000012490 REFERENCE ID # . . . : 11010086 SITE ADDRESS . . . . . : 10072 MOSSY OAK CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ALICE WICHMAN ADDRESS 10072 MOSSY OAK CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : VALLEY HEATING & CO CONTRACTOR ATKINSON, THOMAS LIC # 141 COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING ADDRESS 1171 N 4 TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE (408) 294-6290 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ------ 1BCBSC VALUATION 8, 540. 00 1 .00 0.00 1. 00 0 .00 1BREMAIRHA NO.UNITS 1. 00 63 .00 0 .00 63 . 00 0 .00 1BSEISMICR VALUATION 8, 540. 00 0 .85 0. 00 0.85 0 .00 1MFR=<100 UNITS 1. 00 126 .00 0 . 00 126 . 00 0 . 00 1MPERMITFE FLAT RATE 1. 00 42 .00 0. 00 42 . 00 0 .00 1MRRAA UNITS 1. 00 63 .00 0 . 00 63 . 00 0 .00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0.00 42 . 00 0 .00 ---------- ---------- ---------- ---------- TOTAL PERMIT 337 .85 0.00 337.85 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 337 .85 #21572 --------------- TOTAL RECEIPT 337 .85 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF. CITY OF CUPERTINO FURNACE/AC CUP RT1N0 PERMIT APPLICATION FORM APN# q23Z ( Date: Building Address: � Owner's aRe: Phone#: (A,u( Q . �I)t( bman 0 - • � �- Contractor: 1 /► r Phone#:'f0$'-.2 42q-&Z2 Va ll e �fe�f�-� COO (iit, Fax#: Ufa y -Z zq Contractor License#: Cupertino Business License#: Contact: _ _ Phone#: gagg-Z Q,Y-6 Z q d Fax#: 40,11acig 8,2-1q Building Permit Info: Elect Plumb Mech Residential X Commercial ❑ Job Description• �Fvrr c� ecu mein+ lid. P IL WMI-p d. - VQ1a0*Layk �d-o� sir For Residential Installations: Attic ❑ 1"floor � 2°d floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Re uired ❑ Cost of Project: Type of Const 'on (Usage Class): I �IJ()--- Strapped On Platform [f'— Bonded ew Location�- Replacement Project Size: Express ❑Standard ❑ Large ❑ Major❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist& attach it to the application or if applicable,include in plan set&the sheet index. G11- Revised 01/07/09 a.