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13050160 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS.;'20199 PACIFICA DR CONTRACTOR:ABS HEATING&A/C PERMIT NO:13050160 OWNER'S NAME: BHUPINDER KHATTRI 334 SHAMROCK DR DATE ISSUED:05/22/2013 OWNER'S PHONE: 6502246646 CAMPBELL,CA 95008 PHONE NO:(408)238-7178 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11COMMERCIAL0 ZLDgc� REPLACE FURNACE&A/C UNIT,.ADD ADDITIONAL A/C License Class G Li,.# UNIT TO EAST SIDE OF SFDWL Contractor I hereby affirm that T am licensed under the provisions;of Chapter 9 (commencing with;Section 1000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby.affirm under penaltyof 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:$10000 I have andwill maintain Worker',s Compensation Insurance,as provided for by Section 3700 of the'iabor Code for the performance of the work for which this APN Number:36929011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l have read',this application and state thaYthe above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct,lI 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 DA F M LAST CALLED INSPECTION. indemnify and keep harmless the Cityof Cupertino against liabilities,judgments, costs,and expenses':wwhich may accrue against said City in consequence of the granting'of this permit, Additionally;the applicant understands and will comply Issued by: Date: with"all non-point source regulationsper the.Cupertino Municipal Code,Section 9.18—! RE-ROOFS: Signature Date 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 Signature of Applicant: Date: I 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 dte strpcture,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(Secy 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 per 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 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'is Compensation Insurance;as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 ofthe iLaboi Code for the performance of the work for which this Owner or authorized agent: permitj$issued.,i I 6ertifyl that in thepelrforrtance��f the,workffor which this permit is issued,I shall not employ an�. r o m any m�imer,,so as to become subject to the Worker's 7 CONSTRUCTION LENDING AGENCY Compensation lawsiof r. ifprnIa I after making this certificate of exemption,I becorn subject to'tfitd jWdrker s ompensation!provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwitb,comply w1, sueh'prouisions 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 certif}thal,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 cons"ction,and hereby'authorize representatives of this city to enter upon) a above mentioned propertyfor�inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmlessth . e Cit�4 Cupertino against liabilities,judgments, costs,and expenses iwhich 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. i , Signature Date GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 b lY CUPERTINO (408)777-3228•FAX(408)777-3333•building(ftuoertino.org 0 06 MISC [:1 PLUMBING EIMECHANICAL [:]ELECTRICAL MISCELLANEOUS PROJECT ADDRESS j /j /G�! / � APN# OWNER NAME j V e C/ �• �� PHONE �o ;J/,f_ J E-MAIL STREET ADDRESS CITY, STATE,ZIP A�7 FF CONTACT NAME PHONE G E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME j LICENSE NUMBER( �� LICENSE TYPE�p ry BUS.LIC# COMPANY NAME S- ,/ E-MAIL STREET ADDRESS CITY,STATE,ZIP /��/`/FJ P �� �fJ J✓f ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ifrSFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WIIALAND ❑ YES PROJECT IN ❑YES IS TIM BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK G4e TOTAL VALUATION: RECEIVED BY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the 6roperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to uilding construction. I autj4orize representatives of Cupertino to enter thea ove-idem' ed.property for inspection purposes. Signature of Applicant/Agent: Date: P NTALIINFORMATION REQUIRED OFFIC ,F�SE ONLY W OVER-THE-COUNTER ❑ EXPRESS U ❑ STANDARD UU a ❑ LARGE a ❑ MAJOR MEPMiscApp_201 1.doc revised 06/21111 - CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20199 PACIFICA DR DATE: 05/22/2013 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: $10,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: FURN/A WORK REPLACE FURNACE&A/C UNIT ADD ADDITIONAL A/C UNIT TO EAST SIDE OF SFDWL SCOPE Mech.Plan Check 0.0 his $0.00 Plumb.Plan Check Elec,Plan Check Mech.Permit Fee: IMPERMIT plumb.Permit Fee: Elec.Permit Fee: Other Mech.Insp. 0.0 hrs $45.00 CJtlrt>r Plumb Insp. 01her Elec.Insp. LJ . .Mech.Insp.I'ee: Plumb.Insp.Fee: Elec.Insp. Fcc: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelhiniina information available and are only an estimates Contact the De t or addn'l info, FEE ITEMS(Fee Resolution 11-053 E ._7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0,001= # Mechanical Suppl.PC Fee: Reg: OT 0.0 1 hrs $0.00 $133.00 IMFR=<100 Furnace,Forced-Air . PME Plan Check: $0.00 F 2 1 # Mechanical .Permit Fee: $0.00 $134.00 1BREM4IR A/C Units(<=10K cfin) Suppl.Insp:FeelD Reg. :Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee:. $45.00 Construction Tax:. Administrative Fee: IADMIN $42.00 Work Without Permit? ® Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential 0 Travel Documentation Fee: I TRAVDOC $45.00 Building or Structure i Strong Motion Fee: IBSEISMICR $1.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $134.00 $267.00 $401.00 Revised: 04/29/2013 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTIN0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 FAX(408)777-3333•buildingacupertino.org WHEN IS A PERMIT REQUIRED A construction permit shall be obtained from the enforcement agency prior to the erection, construction,reconstruction, installation, relocation, or alteration of any mechanical system, except as permitted in Chapter 1,'Section 112.2 of the 2010 California Mechanical Code. Projects requiring permits include, but are not limited to: • New HVAC installation • HVAC Changeout • Replacement of furnace, coil,FAU or condenser • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconditioned space BUSINESS AND PROFESSIONS CODE, SECTION 7110 Willful or deliberate disregard Iand violation of the building laws, including the California Building Code, and local permitrequirements constitutes a cause for disciplinary action from the Contractors State License Board working in conjunction with the local building department. This action may consist of fines up to $5,000 per violation or suspension/revocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces; room heaters). 2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. 4. A setback type thermostat(24 hr clock with four set points) is required for all alterations. 5. New or replacement ducts must meet the mandatory requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no more than 2"of sag between supports and 6 ft.max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 Simplified Prescriptive Certificate of Compliance:2008 Residenthd HVAC Iterations CF-IR-ALT-FIVAC Comte Zones 1 and 3-7 Site Address: Enforcement Agency: Date: Permit M : Conditioned D ation Equipment Type' List Wmimum Efficiency' Floor Area Thermostat, P unit e� COP Over 40 ftof d'cts Setback ®A�htTE door Coil (SEER HSPF_ S�,�Y j s stem added of cerep ce (�'nw already prese t nnw be Condensing Unit 13 EER Resistance inwalled) 0 Other R 6 (CZ I, -S) . 1.Equipment Type:Choose the equipment being installed;if more than one system,use another F-1 R-ALT-HVAC for each system. 2.Afinimum Equipment Efficiencies.13 SEER,78%AFUE,7.7HSFF for typical residential stems. Contractor(Documentation Author's/Responsible Designer's Declaration Stat ent) 13 • I certify that this Certificate of Compliance documentation is accurate a�complete. * I am eligible under Division 3 of the California Business and Professions Code to a responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design idea' ed on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California.Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with th information documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to th enforcement agency for approval with the permit lication. _ Name: j7! �/ Signature: Companyx Date: ��• /� Address: � LicenseZZ City/State/Zip: �' � �� Phone: 2008 Residential Compliance Forms.doc revised 04/10/12 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building a.cupertino.ong WHEN IS A PERMIT REQUIRED A construction permit shall be obtained from the enforcement agency prior to the erection, construction, reconstruction, installation,relocation, or alteration of any mechanical system, except as permitted in Chapter 1, Section 112.2 of the 2010 California Mechanical Code. Projects requiring permits include, but are not limited to: • New HVAC installation • HVAC Changeout • Replacement of furnace, coil,FAU or condenser • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconditioned space BUSINESS AND PROFESSIONS CODE, SECTION 7110 Willful or deliberate disregard and violation of the building laws, including the California Building Code, and local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board working in,conjunction with the local building department. This action may consist of fines up to $5,000 per violation or suspension/revocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall & floor furnaces; room heaters). 2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. 4. A setback type thermostat(24 hr clock with four set points) is required for all alterations. 5. New or replacement ducts must meet the mandatory requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings.. • Connections of metal ducts and the inner core of flex ducts shall,be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no more than 2"of sag between supports and 6 ft.max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAIterations CF-IR-ALT-HVAC Climate Zones I and 3-7 SiteAAh-m: Enforcement Agency: Date: Permit#: . Conditioned Duct insulation ent T t last Minimum Efficiency'- Floor Area r e i. ent Thermostat Packaged Unit '-' Over 40 a of ducts E3 F- ce ®Al CTE_ COP Setback ed system added or replaced in oor Coil SEER U HSPF_ ' �A7 sf unconditioned space i7fnotalready present,mum be M Oiadensing Unit ®EER Resistance / buta R 6 CZ 13-S lled) ®other © l ) ' !.Equipment Type:Choose the equipment being installed;if more than one_systern,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application. Name: / Signature: y- company- Date: Address: / � License: City/Sta caip:G / �r �� Phone• 2008 Residential Compliance Forms.doc revised 04/10/12 CUP Building Department COMMUNIY DEVELOPMENT DEPARTMENT V1,01 T I , -CUPERTINO le,013 A BUILDING DiViSION 21 MAY 22 2013 A `7 7�M Pi of-7 ST be kept at the )XTS nd sp�,-.jf;lcations MU ODE CO l,cis Unlavviful to rri��',ke any REVIEWED FOR C I or to V V 0: —r-1--te�. Reviewed By: n the :U01TIq AT S',,!ALl-NOT \j I o!all,ic n PER 01- �jte Law. lawov'r'00� 5- 1 �:V§,SvIS6�V - L/Xi All, W