13060114 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10541 GASCOINGE DR CONTRACTOR:GOGO ROOTER PERMIT NO:13060114
OWNER'S NAME: JULIE JOYCE 2530 BERRYESSA RD STE 509 DATE ISSUED:06/13/2013
OWNER'S PHONE: 4089123899 SAN JOSE,CA 95132 PHONE NO:(408)282-7026
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 1 COMMERCIAL°
License Class (�Lic.# e Q ct REPLACE(E)SEWER LINE&(E)FOUNDATION
( l5 N.
Contractor C� �O Date1 INSTALL
L(N)PROPERTY LINE CLEANOUT(SUNNYVALE
I hereby affirm that I am licensed under the provisions of Chapter 9 SANITARY)
(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:$5800
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 APN Number:37528005.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application andstate 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 • LED 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,the applicant understands and will comply j" y' % �— Date:
with all non-point source regulat ins per the Cupertino Municipal Code,Section
9.18.
6-14 .-
ld RE-ROOFS:
Signature ° �j�Date fl/ /D �� 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.
0 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 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 HAZARDOUS MATERIALS DISCLOSURE
construct 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 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's Compensation Insurance,as provided for by the Health&Safety Code,Sections.25 255
34.
Section 3700 of the Labor Code,for the performance of the work for which this p� /
permit is issued. Owner or authorized agent: Date: .-/O
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 as to become subject to the Worker's
•
Compensation laws of California. If,after 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 CERTIFICATION 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
.. .
& a
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274 E. Hamilton Avenue, Suite C
Campbell, California 95008-0240 \, -1J7 0Q ( 7
Voice:408-871-7273 Fax: 408-871-7274
Web:www.SMSEinc.com
Email: SMSEinc@aol.com
Wednesday, December 12, 2012 Fii!_E
az/1271.
SAW Construction
Steven Winklepleck
Saw42083@yahoo.com
408-476-8141
Re: Field Observation for epoxy anchors
Narayanan Residence
10109 Mello Place
Cupertino, CA 95014
SMSE Job Number: 4306-12
On December 12, 2012, I visited the aforementioned site, at the request of
Steven(Contractor)to provide structural observation for the installation of threaded rod
holdown anchors for new and/or retrofitted shear-walls. Listed below are my findings:
1. All holdowns were properly located.
2. "SET-XP" epoxy, by Simpson Strong Tie, was used as required. (ICC# ESR-2508)
3. I was informed that the drilled holes where wire brushed prior to my arrival.
4. The anchor depths were measured in my presence.
5. The anchor depths were in conformance with design documents. Any holes that
were not acceptable were drilled deeper:
• 10" minimum for 5/8" diameter threaded rod holdown anchors.
6. Sample holes where re-blown in my presence and found clean. Any holes that were
not acceptable were re-brushed and re-blown in my presence.
7. The epoxy was well mixed coming out of the nozzle when applied.
8. The epoxy was applied in conformance with design documents.
9. The holdown anchors were properly inserted into the pre-epoxied holes in
conformance with manufacturer's installation instructions.
Please call our office at 408-871-7273 ext. 3# if you have any further questions or
comments. Q�oFESS10N4
Sincerely, 4'ck- o�� H. PA, is
m
CJ ,•
John H. Park PE 13 *
EXP 6 .1�.
Senior Staff Engineer ,,C
s
CIV CSR'-/
` qT. QF CP '4'.
S:\00 Sezen and Moon Structural Engineering Inc\00-2012 Jobs\O Jobs 4301 -4350\4306-12 Narayanana Residence,Cupertino\03 Field
Visits\01 12Dec12 Epoxy Inspection\Epoxy Observation-HO.doc
. - y . „ Dc
274 E. Hamilton Avenue, Suite C
Campbell, California 95008-0240
Voice: 408-871-7273 Fax:408-871-7274
Web:www.SMSEinc.com
Email: SMSEinc@aol.com
Holdown
inspected
S
2/2
S:\00 Sezen and Moon Structural Engineering Inc\00-2012 Jobs\O Jobs 4301 -4350\4306-12 Narayanana Residence,Cupertino\03 Field
Visits\01 12Dec12 Epoxy Inspection\Epoxy Observation-HO.doc
/ Building Department
City Of Cupertino
10300 Torre Avenue
01 191., Cupertino,CA 95014-3255
ti Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST--
JOB ADDRESS: /G/09 GtLe0 PL¢GC PERMIT#
OWNER'S NAME: 13M-t /J Am-YA-J t PHONE#_::(41vt) Tri 23)7
GENERAL CONTRACTOR: S7-EvE-AJ FNS(j BUSINESS LICENSE•# 33 a-'-
ADDRESS: 62-91 („)t1-tT ' f1.2i�1E- CITY/ZIPCODE: 74 CIA.R4 , G4 96vS/
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSP CTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRAC FORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors: —
_ / - � - /3
,Signature Date
Please check applicable subcontractors and complete the following information
d 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
Ltiff " t /3
Owner/Contractor Signature __ Date
▪ =� B tiding Department
City Of Cupertino
10300 Torre Avenue
S-c i �▪� i�pertino; CA 95014-3255
:i - elephone: 408-777-3228
CUPERTINO a �T ;, Fax: 408-777-3333
CONTRACTOR/SUBCONTC a r� L
JOB ADDRESS: l DO o I N .�C �N Zfi `23;1V PED --.-- ---:::,..--:—_,,s.,_%,::„....4
� ; `� 3
OWNER'S NAME:�'A- TY Tu it-i-E� 3 PFi0;l � � - -40-'--.;' _.•LF 74
GENERAL CONTRACTOR: Vut-Lc �a STS�?� :� BUS ESS z: cam,'
ADDRESS: 3 /n A 7'r t w 51 "` /� PC( l�/'co-S`d
*Our municipal code requires all businesses working in the city to have,a Czo �u1no business license,
NO BUILDING FINAL OR FINAL OCCUPANCY':INSPECTION(S) ., , .? e p DULED UNTIL THE
GENERAL CONTRACTOR AND PALL SUBCONTRACTORS HA 'OA* 2 t ITY OF CUPERTINO
BUSINESS LICENSE. = � '� s �`
I am not using any subcontraclorsc
3� �, .,
Signature Mi- y Date -
- s
Please check applicable subcontractors and co tplete the.foil wing ui "
v' SUBCONTRACTOR BUSINESS NAME 'NESS LICENSE#
Cabinets & Millwork � Y
Cement Finishing
1,,-"--Electrical
Excavation ../ �`.
.: . . w ;
Fencing
Flooring/Carpeting �� 1•
Linoleum/Wood } r=
Glass/Glazing
Heating
3
� _ _.
Insulation '
Landscaping �. 4 :,
Lathing �,
Masonry f t
..-_
Painting/Wallpaper , .. �.,
Paving - � }
Plastering
` ,
Plumbing j : v;.
Roofing
•N= i
Septic Tank :..
eh
? ,x
Sheet Metal
Sheet Rock r
Tile - - Y;
�`:
T
•
owner/Contractor Signature Date
z :
ROBERT W. STEUER
CIVIL ENGINEER
1133 FAIRVIEW AVENUE
SAN JOSE CALIFORNIA
C. E. 37251
December 12,2012 FILE
/fir /Z /2
City of Cupertino
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Re: Addition/Remodel, 1025 Cranberry Drive, Cupertino, CA
Subject: Epoxy anchor installation
To Whom it may concern:
On December 11,2012,I observed the installation of epoxy holdown anchors associated
with the addition and remodel of the residence, located at 1025 Cranberry Drive,
Cupertino, CA. The type and diameter of the threaded rods installed and the diameter of
the drilled holes were as specified by the holdown and epoxy manufacturers. The depth
of the drilled holes were as specified on the approved plans. The drilled holes were clean
and the installation complied with the recommendations of the epoxy manufacturer.
Should you have any questions feel free to contact me at(408)981-5844.
Respectfully submitted, COs OFESS/0kl ti 2-t
(c24/4
b ?���� W. 51�Fye
rri
No.37251 �D
Robert W. Steuer * E fr.3o.l4. ,
Civil Engineer
C.E. 37251 cf> ClVId.. � 'j
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CONTRACTOR:
SAW Construction
Steven Winklepleck
saw420830yahoo.com
408-476-8141
June 27. 2012
Revisions
No. Date Description
/ ' \07/25/12 Plan Check 01
/2\09/21/12 Client Change 01
/3\11/30/12 Field Change 01
Job Number. Drawn By:
4306-12 Park
Designed By: Checked By:
Park Sezen
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Date: 11/30/2012 Sezen&Moon Structural Engineering,Inc. Page:8
Time: 11:04 AM 274 E.Hamilton Ave.,Ste.C Voice:408-871-7273
s� f�y� rF �,1f �
rL`a ananf:"�L�s1 a�a.'��a' ` '� �`��7 ,v,,�3`w��6`;'1.\ 'r
isl #Inar sli ear,walls,Y
Gi xcl1ine:A., 04 4, <94,41.1b quantayilieaicwfasegittettts -`1 x -6.in holdown distance
from wall edge.
he ghtplate= 8 ft Li=4 4 a.0 'L54=Qrft Lwall:= LI +L2+ L3 + L4+ L5
Lwindpw = (0=1- 0+0*0 t£ 9 ••, x:,,p s vwall
�. ..,., _... .• Lnet—Lwindow
segme11twall>w1Wth � x BASO
segmentwaneight
commentato:= if 3.5,„Inadequate aspect","Acceptable aspect" ;0;4 s >[
segmentwall.width
segmentll.height 22•segment l.width 1asectato•— if
z�. .4”
segmentwall.width segment lI.height
vwall
Vwall
as ect .H
p ratio
shearwall:= W567 F if(vwaii 5 860p1f,"W5",if(vwaii 5 1100•plf,"W6",if(vwaii 5 1460•plf,"W7" ,"Shear too high")))
W34 t- if(vwaii 5 550•plf,"W3",if(vwall 5 730•plf,"W4",W567))
W12 f-- if(vwap <_280•plf,"W1",if(vwall5 430•plf,"W2",W34))
Check shearwall uplift forces.
UPfrab•ove 'p lb Uplift forces from above(ie,shear-wall above)
OTM:= V•hei ht OTM=22632lb•ft U OTM +U li
g plate p�= P frabove
Lnet
HD:= HD19 E-- if(Up 5 19070•lb,"use HD19(1-1/4")'w/6x post"","Tension too high; Use other holdown method")
HDU14 E-- if(Up <_ 14925.1b,"HDU14(1.0")w/6x post,or DBL CMST12 strap",HD19)
HDU11 +- if(Up 5 9215.1b,"HDU/1 (1.0")w/6x post or CMST12 strap",HDU14)
HDU8 F if(Up<_6490•lb,"HDU8(7/8")or CMST14 strap",HDU11)
EMUS E- if(Up 5 5645•lb,"HDU5(5/8")or MSTC66 strap",HDU8)
HDU2 E- if(Up 5 3075•lb,"HDU2(5/8")orMSTC52 strap" ,HDU5)
none if(Up 5 500•1b,"Tension low; Holdown not requireid",HDU2)
,. 5
INSTALLATION CERTIFICATE CF-6R-ENV-01
Envelope—Insulation; Roofing; Fenestration (Page 1 of 3)
Site Address:�1 Enforcement Agency: Permit Number:
L.O 4;1 Cr'1, -6 /in OO C 1
If more than one person has responsibility for installation of the items on this certificate,each person shall prepare and sign a certificate
applicable to the portion of construction for which they are responsible;alternatively,the person with chief responsibility for construction shall
prepare and sign this certificate for the entire construction. All applicable Mandatory Measures with check boxes require to be checked to ensure
the mandatory measures have been met.
FIDescription of Insulation I...E
1. RAISED FLOOR 1 22—►
L
Material: /34f f Brand Name: fed Lst
Thickness(inches): SY,. '' Thermal Resistance(R-Value): /Y
121150(d):Minimum R-13 insulation in raised wood-frame floor or equivalent U-factor.
2. SLAB FLOOR/PERIMETER
Material: Brand Name:
Thickness(inches): Thermal Resistance(R-Value):
Perimeter Insulation Depth(inches):
0 §150(1):Water absorption rate for the insulation material alone without facings is no greater than 0.3%;water vapor permeance
rate is no greater than 2.0 perm/inch and shall be protected from physical damage and UV light deterioration.
3. EXTERIOR WALL
a. Insulation Type(e.x.Batt,Loose Fill, Spray Foam)
a. Thermal Resistance(R-Value): /3
b. .Insulation Type(e.x. Batt,Loose Fill, Spray Foam) b. Thermal Resistance(R Value):
Brand: icy &4t
Spray/Loose fill)Installed Actual Thickness Spray/Loose fill)
(inches): Contractor's min installed weight/ft2 lb
Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value)
§150(c):Minimum R-13 insulation in wood-frame wall or equivalent U-factor.
Exterior Foam Sheathing(rigid Insulation)
Material: Brand Name:
Thickness(inches) : Thermal Resistance(R-Value) :
4. FOUNDATION WALL
Material: Brand Name:
Thickness(inches): Thermal Resistance(R-Value):
5. CEILING
Batt or Blanket Type: /3,ft Brand Name: ice &
Loose Fill Type: Thermal Resistance(R-Value): /9
Spray Foam Type: Brand Name:
Installed Actual Thickness (inches): SYN." Contractor's min installed weight/ft2 lb
Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value):
la §150(a):Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor.
6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER
Material: I3 Brand Name: c 6c1,it
Material: Brand Name:
Thickness(inches): Thermal Resistance(R-Value): 3 co
2 §118(a): Insulation installed meets Standards for Insulating Material.
❑ §150(g):Mandatory Vapor barrier installed in Climate Zones 14 or 16.
2008 Residential Compliance Forms August 2009
y
•
INSTALLATION CERTIFICATE CF-6R-ENV-01
Envelope—Insulation; Roofing; Fenestration (Page 2 of 3)
Site Address: /� Enforcement Agency: Permit Number:
Zc2C i Cre.�.l.1 6„-t. /1/i DOCoZ
Description of Roofing Products
CRRC Product ID Manufacturer Product Roof Roof Product Initial Solar Aged Solar Thermal
Number' Information Brand/Model Type Area Slope Weight 2 Reflectance Reflectance° Emittance
❑3
❑3
❑3
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at
ww.coolroofs.org/products/search.php
2. The weight in lbs per square feet of the roofing product being installed.
3. Check box if the Aged Reflectance is a calculated value using the equation below,footnote 4.
4.If the aged reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the initial reflectance value from the
directory and use the equation(0.2+0.7(pinitial—0.2)to obtain a calculated aged value.
✓OCHECK APPLICABLE BOX BELOW IF EXEMPT FROM THE ROOFING PRODUCT"COOL ROOF"REQUIREMENT:
❑ The roof area covered by building integrated photovoltaic panels and building integrated solar thermal panels are exempt from the above Cool
Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with a weight of at least 25 lb/ft2 is exempted from the above Cool Roof
criteria.
To apply Liquid Field Applied Coatings,the coating must be applied with a minimum dry mil thickness of 20 mils across the entire roof surface and
meet minimum performance requirements listed in§118(i)3 and Table 118-C. Select the applicable coating
❑Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other
✓ 0 CRRC-1 Label Attached to CF-6R
(Note if no CRRC-1 label is available,this compliance method cannot be used and another method is required to meet compliance).
FENESTRATION/GLAZING
Product # Total Quantity Add.Exterior Comments/
Manufacturer/Brand Name U- Product of NFRC of Like Product Area Shading Dev. Location/Special
Item (GROUP LIKE RODUCTS) factor' SHGC' Panes Certified)•2 (Optional) ft2 or Overhang Features
2 A
454% .a .3a yes I 3R
3 4114,4,1 .2r, .2/ yes
4 vc ,92 .2 S }/e • $ �o
5 20
6
7.
8.
1. Use values from a fenestration product's NFRC Certified Label.For fenestration products without an NFRC label,use the default values from Section 116,Table
116-A and 116-B of the 2008 Energy Efficiency Standards.
2.NFRC Label Certificates shall not be removed until the building inspector has verified the efficiency.Enter Yes or No.
116(a)1:Doors and windows between conditioned and unconditioned spaces designed to limit air leakage.
1311116(a)2 and 3:Actual fenestration products installed are equivalent to or have a lower U-factor and/or a lower SHGC than that specified on
the Certificate of Compliance(Form CF-1R).
Ali§116(a)4:Fenestration products(except field-fabricated windows)have a label listing the certified U-Factor,certified Solar Heat Gain
{i1§117:
Coefficient(SHGC),and infiltration that meets the requirements of§10-11 1(a)
§117:Exterior doors and windows weather-stripped;all joints and penetrations caulked and sealed.
2008 Residential Compliance Forms August 2009
y i
A
•
•
INSTALLATION CERTIFICATE CF-6R-ENV-01
Envelope—Insulation; Roofing; Fenestration (Page 3 of 3)
Site Addres • Enforcement Agency: Permit Number:
62- f rcif (.o..c t //// 00 6 '�
DECLARATION STATEMENT
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative
of the person responsible for construction(responsible person).
• I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)conforms
to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement
agency.
• I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met.
• I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a
signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building
owner at occupancy.
e7rn Ne: (Installing Subcontractor or General Contractor or Builder/Owner)
L C C901$—f.-gc,--tlf-)
Responsible Person's Name: Responsible Person's Signature:
' /7/ - / l G —
l/
CSLB License: Date/Signed: Position With Company(Title):
1c 779 7 1/ W/3 o
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-LTG-01
Residential Lighting (Page 1 of 3)
Site Address: Enforcement Agency: Permit Number:
SO C al- G49 ((met-- //// cv ea.
1.Kitchen Lighting
Does project include kitchen lighting?
J2KYes,complete section 1 0 No,go on to section 2
C "Yes .1 §I50(k)3:The wattage of permanently installed luminaires(lighting fixtures)has been determined as specified by§130(d).
❑Yes IJ No §150(k)3:In the kitchen,are there electrical boxes finished with a blank cover or where no electrical equipment has been
installed,and where the electrical box can be used for a luminaire or a surface mounted ceiling fan?If yes,the following row must also be yes:
❑Yes 0 NA Wattage has been calculated as 180 watts of low efficacy lighting per blank electrical box.
§150(k)8 Kitchen Lighting must comply with either method(a),(b),or(c)below:
(a)All high efficacy luminaires
4.41 Yes,complies because only high efficacy luminaires have been installed in the kitchen.
❑ No,complies with method(b)or(c).
(b)>50%watts used by high efficacy luminaires
❑ Yes,complies because at least 50%of the installed watts are from permanently installed high efficacy luminaires
as demonstrated in the table below:Total A>Total B.
Er No,complies with method(a)or(c).
Fill out the following table if complying with either method(b)or(c).
Table(b)
Efficacy
Luminaire Type High Low Watts x Quantity = High Efficacy Watts or Low Efficacy Watts
❑ ❑ x = or
❑ ❑ x = or
❑ ❑ x = or
❑ ❑ x = or
o ❑ x = or
Complies with method(b)if A>B Total: A: > B:
(c)Additional Kitchen Low Efficacy Lighting
O Yes,complies because the kitchen lighting qualifies for additional low efficacy lighting
and as demonstrated in table in(b)(above)and the table in(c)(below)that(A+C)>B
LTJ No,complies with method(a)or(b).
Additional kitchen low efficacy lighting is available only if all of the following are true:
❑ Yes. All low efficacy luminaires in the kitchen are controlled by a vacancy sensor
Dimmer energy management control system(EMCS)or a multi-scene programmable control system.
$'Yes. Permanently installed luminaires in garages laundry rooms closets greater than 70 square feet and utility rooms are high efficacy
luminaires AND are controlled by a vacancy sensor.
Table (c)
Use 50 W for dwelling units<2,500 ft2
From the Table in(b) Use 100 W for dwelling units>2,500 ft2 Add Yes/No?
A B C A+C Is(A+C)>B?
2.Lighting Internal to Cabinets
Does project includes lighting inlemal to cabinets?
O Yes, complete section 2 l No,go on to section 3
❑Yes,§I50(k)9:Permanently installed lighting internal to cabinets uses<20 watts of power per linear foot of illuminated cabinet.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-LTG-01
Residential Lighting (Page 2 of 3)
Site Address: Enforcement Agency: Permit Number:
cg-b //l/ 2 p
3.Installed Devices and Components Have Been Certified to the Energy Commission
Does the project include any of the devices or components listed below?lEi Yes,complete section 3 0 No,go on to section 4
LTJ Yes
§119 and§150(k)7(F):Any of the following devices and components which have been installed have been certified to the Energy Commission
according to the applicable provisions of§119:All LED lighting systems that are classified as high efficacy,ballasts used in recessed luminaires,
vacancy sensors(automatic off/manual on occupant sensors),dimmers,track lighting integral current limiters,and outdoor motion sensors.
4 Lighting Controls Complete section 4
MIYes 0 NA §150(k)7A:Permanently installed low efficacy luminaires are controlled by switches separate from those controlling high
efficacy luminaires.
▪ Yes 0 NA §150(k)7B:Exhaust fans with integral lighting systems are switched separately from lighting systems,OR have a lighting
/ system that can be manually turned on and off while allowing the fan to continue to operate for an extended period of time.
® Yes ❑ NA §150(k)7C:All permanently installed luminaires are switched with readily accessible controls that permit the luminaires to be
/ manually switched on and off.
®1 Yes 0 NA §150(k)7D:All lighting controls have been installed in accordance with the manufacturer's instructions.
1J Yes 0 NA §150(k)7E:All lighting circuits that are controlled by more than one switch,where a dimmer or vacancy sensor has been
installed to comply with§150(k),no controls bypass the dimmer or vacancy sensor functions.
5.Luminaires(Lighting Fixtures)
D es the project include the installation of any luminaires(indoor or outdoor)?
Sai Yes,complete section 5 ❑No,go on to section 6
IA Yes,high efficacy luminaire classification has been determined according to§150(k)1,and low efficacy luminaire classification has been
J determined according to§150(k)2.
IBJ Yes 0 NA §150(k)4:Fluorescent lamps rated 13 watts or greater have an electronic ballasts having an output frequency no less than 20
kHz.
❑ Yes l ( NA §150(k)5:Permanently installed night lights,and night lights integral to permanently installed luminaires or exhaust fans,
contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and do not contain a line-voltage
socket or line voltage lamp holder,OR the night light is rated to consume no more than 5 watts of power and does not contain
a medium screw-base socket.
d Yes ❑ NA §150(k)6: Lighting integral to exhaust fans,in rooms other than kitchens,meet the applicable requirements of§150(k).
❑ Yes Lel NA Any electrical box finished with a blank cover or where no electrical equipment has been installed,and where the electrical
box can be used for a luminaire or a surface mounted ceiling fan,has been treated as low efficacy luminaires for compliance
with§150(k).
/ Does the project include any luminaires that are recessed into insulated ceilings?
SI Yes,complete the rest of section 5 0 No,go on to section 6
▪ Yes,§150(k)12: Luminaires that are recessed into insulated ceilings meet all of the following conditions:
CEJ Yes,are listed,as defined in§101,for zero clearance insulation contact(IC)by UL or other nationally recognized testing/rating
laboratory,and
141 Yes,have labels that certify the luminaires are airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance
with ASTM E283(Exhaust fan housings are not required to be certified airtight),and
156 Yes,are sealed with a gasket or caulk between luminaire housings and the ceiling,and all air leak paths between conditioned and
unconditioned spaces have been sealed with a gasket or caulk.(including all exhaust fan housings),and
Yes,allows ballast maintenance and replacement to be readily accessible to building occupants from below the ceiling without
requiring the cutting of holes in the ceiling.
6.Indoor Lighting(any indoor room that is not a kitchen)
D es the project include permanently installed luminaires in any room that is not a kitchen?
I Yes,complete section 6 0 No,go on to section 7
CSi Yes 0 NA §150(k)10:Permanently installed luminaires in bathrooms,garages,laundry rooms,closets>70 ft2,and utility rooms are high
efficacy luminaires OR are controlled by a vacancy sensor.
LSI Yes 0 NA §150(k)11:Permanently installed luminaires located in rooms or areas other than in kitchens,bathrooms,garages,laundry
rooms,closets,and utility rooms are high efficacy luminaires,OR are controlled by a dimmer switch OR are controlled by
a vacancy sensor.
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-LTG-01
Residential Lighting (Page 3 of 3)
Site Address: Enforcement Agency: Permit Number:
2c2 7 0045 Co.,-• ///1 aa‘€2--
7.
a7. Outdoor Lighting
D5es the project include any permanently installed outdoor lighting?
Lel Yes,complete section 7 0 No,go on to section 8
Pr Yes 0 NA §150(k)13:Luminaires providing outdoor lighting,including outdoor lighting for private patios on low-rise residential buildings
with four or more dwelling units,entrances,balconies,and porches,and which are permanently mounted to a residential
building or to other buildings on the same lot are high efficacy luminaires OR are controlled by a manual on/off switch,plus a
motion sensor not having an override or bypass switch that disables the motion sensor,plus one of the following three
additional control methods:
a. A photocontrol that does not have an override or bypass switch that disables the photocontrol;or
b. An astronomical time clock not having an override or bypass switch that disables the astronomical time clock;
or
c. Energy management controls systems(EMCS)not having an override or bypass switch that allows the
luminaire to be always on.
❑ Yes Iii NA Exception 2: Low efficacy outdoor luminaires used to comply with Exception 1 to§150(k)13 are controlled by an override
switch which temporarily bypasses the motion sensing function,and the motion sensor is automatically reactivated within six
hours.The luminaire is controlled by a photocontrol,astronomical time clock,or EMCS as required by Exception 1 to
1 §150(k)13.
El Yes l? NA Exception 3: There are permanently installed luminaires in or around swimming pools,water features,or other locations
subject to Article 680 of the California Electric Code which do not need to be high efficacy luminaires.
❑ Yes IiINA §150(k)14: Internally illuminated address signs comply with§148,OR do not contain a screw-base socket and consume no
1 more than 5 watts of power as determined according to§130(d).
El Yes I�NA §150(k)15 Lighting for parking lots and carports with a total of 8 or more vehicles per site have lighting that complies with
§130,132, 134, and 147.Lighting for parking garages for 8 or more vehicles comply with§130, 131, 134,and 146.
If yes,the Nonresidential compliance forms must be submitted
8.Common areas of low-rise residential buildings
Does the project include the installationJof any luminaires in common areas of low-rise residential buildings?
CI Yes,complete section 8 la No,go on to section 9
❑ Yes,§150(k)16: Permanently installed lighting in the enclosed,non-dwelling spaces of low-rise residential buildings with four or more
dwelling units shall be high efficacy luminaires OR are controlled by occupant sensor(s)certified to comply with§119(d).
DECLARATION STATEMENT
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct.
' • I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized representative
of the person responsible for construction(responsible person).
• I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)conforms
to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement
agency.
• I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF-IR that apply to the installation have been met.
• I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a
signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building
owner at occupancy.
CompanName: (Installing Subcontractor or General Contractor or Builder/Owner)
n�6 L ( 4m.,,3 f�µen'/��
Responrle Person's Name: Responsible Person's Signature:/
CSLB License: Date Signe Position With Company(Title):
9v •9 Yid//3 ®wrlh.,
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-04
Space Conditioning Systems,Ducts and Fans (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number.
. yea C ��� /1//v77.2
Space Conditioning Systems
Heating Equipment
Duct
Efficiency Location
Equip (AFUE, (attic,
Type ARI #of etc.)1.3 crawl- Heating Heating
(package- CEC Certified Mfr.Name Reference Identical ( CF-1R space, Duct Load Capacity
heat pump) and Model Number Number 2 Systems value)4 etc.) R-value (Btu/hr) (Btu/hr)
F,.fNN6 onrtr 33$ f / qs ' m' 6,17 coact fuufcm,
rw . re/ SGVk%52./ 40eAl�,D
Cooling Equipment
Efficiency Duct
Equip (SEER Location
Type and EER) (attic,
(package #of 1'3 crawl- Cooling Cooling
heat CEC Certified Mfr.Name ARI Reference Identical (SCF-1R space, Duct Load Capacity
pump) and Model Number Number 2 Systems value)4 etc.) R-value (Btu/hr) (Btu/hr)
141C- Ca rw,/e.,r, 33Z/
073_ 13.O a l.`c 6,0 S toil S te,
24/1(3836QW 2
1.If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative
compliance.
2.ARI Reference Number can be found by entering the equipment model number at http://www.aridirectory.org/ari/ac.php#
3.Listed efficiency on this page must be greater than or equal(?)to the value shown on the CF-IR form.
4. When CF-1R is reference it is also applicable to the CF-1R, CF-IR-AA or CF-1R-ALT
4L BOXES MUST BE CHECKED TO BE A VALID FORM
Did §110-§113:HVAC equipment is certified by the California Energy Commission.
§150(h):Heating and/or cooling loads calculated in accordance with ASHRAE,SMACNA,or ACCA.
(�§150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of§i12(c).
Er§150(j)2:Pipe insulation for cooling system refrigerant suction,chilled water and brine lines meets minimum
requirements of Table 150-B andineludes a vapor retardant or is enclosed entirely in conditioned space. •
2008 Residential Compliance Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-04
Space.Conditioning Systems,Ducts and Fans =: (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
2.061 C,u:49\ !t GAB
Ducts and Fans
§150(m):Duct and Fans
Er 1.All air-distribution system ducts and plenums installed,sealed and insulated to meet the requirements of CMC
Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a
minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic,tape
or other duct-closure system that meets the applicable requirements of UL 181,UL 181A,or UL 181B or aerosol
sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch,the
combination of mastic and either mesh or tape shall be used;and
iff 1.Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other
than seated sheet metal,duct board or flexible duct shall not,.be.used for conveying conditionec(,air. Building,cavities
and support platf may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to
cause reductions in the cross-sectional area of the ducts.
2D.Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive
duc tapes unless such tape is used in combination with mastic and draw bands.
ie 7.Exhaust fan systems have back draft or automatic dampers.
Er 8.Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually
operated dampers.
Er 9.Protection of Insulation.Insulation shall be protected from damage,including that due to sunlight,moisture,
equipment maintenance,and wind.Cellular foam insulation shall be protected as above or painted with a coating that is
water retardant and provides shielding from solar radiation that can cause degradation of the material.
Er 10.Flexible ducts cannot have porous inner cores.
DECLARATION STATEMENT
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized
representative of the person responsible for construction(responsible person).
• I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)
conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation: I certifythat the requirements detailed on the CF-1R that apply to the installation have been met.
• I will ensure that a completed,signed copy of this Installation Certificate shall be,posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to
the building owner at occupancy.
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Responsible Person's Name: Responsible Pe'in's Signature:
61e1 I-44"
CSLB License: Date Si ed/ Position With Company(Title):
41 7 7 9 1//7// 3 pt,00w44_
2008 Residential Compliance Forms August 2009
1
J
INSTALLATION CERTIFICATE CF-6R-MECH-01
Domestic Hot Water(DHW) (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number:
2cooa: 4 C't aAel— • PI/ ro G
1. WATER HEATING SYSTEMS:
Distribution Rated
CEC Type If #of Input(kW Tank Standby
Heater Certified Mfr Name&Model (Std,Point-of- Recirculation, Identical or Volume Efficiency Loss
Type Number • Use,etc) Control Type Systems Btu/1101 (gallons) (EF,RE)t (%)t
KGs 8101 ; STd- /71000
IN 1 Pe-
Note 1:For small gas storage(rated input less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters,list
Energy Factor(EF).For large gas storage water heaters(rated input of greater than 75,000 Btu/hr),list Recovery Efficiency(RE),
Thermal Efficiency,Standby Loss and Rated Input. For instantaneous gas water heaters,list the Thermal Efficiency and Rated Input.
2. Mandatory Measures
TO�COMPLY-ALL BOXES MUST BE CHECKED
U §110-§113:Water heaters,showerhead and faucets are certified by the California Energy Commission.
§150(j):Water System Pipe and Tank Insulation.And Cooling Line Insulation
1. Storage tank insulation
A.Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are
L7 externally wrapped with insulation having an installed thermal resistance of R-12 or greater;and
B.Unfired storage tanks or other indirect hot water tanks have R-12 external insulation or R-16 internal
insulation where the internal insulation R-value is indicated on the exterior of the tank.
2. Water piping and cooling system line insulation thickness and conductivity
First 5 feet of hot and cold water pipes closest to water heater tank,non-recirculating systems,and entire
/ length of recirculating sections of hot water pipes are insulated per Standards Table 150-B;and
E / Pipe insulation for steam hydronic heating systems or hot water systems>15 psi,meets the requirements of
Standards Table 123-A.
liInsulation is protected from damage,including that due to sunlight,`moisture;equipment maintenance,and
wind.
§151(f)8D:If indicated on the CF-1R,all hot water piping that runs from the hot water source to the kitchen'-fixtures is
insulated per Standards Table;150-B.
2008 Residential Compliance Forms. August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-01
Domestic Hot Water(D1-1W) (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
Zc2// /
.T 2 `_.(/'� (prier-L._ .,. . 1/// 08
3. Central Water Heating in Buildings with Multiple Dwelling Units(required for prescriptive)
TO COMPLY-ALL BOXES MUST BE CHECKED
❑. All hot water piping in main circulating loop is insulated to requirements of§150(j)
❑ Central hot water systems serving six or fewer dwelling units which have(1)less than 25'of distribution piping
outdoors;(2)zero distribution piping underground;(3)no recirculation pump;and(4)insulation on distribution
piping that meets the requirements of Section 150(j)
❑ Central hot water systems serving more than 6 dwelling units-presence of either a time control or a
time/temperature control
•
DECLARATION STATEMENT
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction,or an authorized
representative of the person responsible for construction(responsible person).
• I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation)
conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on'the CF-1R that apply to the installation have been met.
• I will ensure that a completed,signed copy of this Installation Certificate shall be posted,or made available with the building
permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand
that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to
the building owner at occupancy.
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
Responsib e Person's Name: Responsible Person's S' ature:
\` ., LB License: Dat Signed Position With Company(Title):�•,_, 077/7 1/17/ /3
k`,�
2008 '- .ential Compliance Forms August 2009
The
WESTWOO D
COMPANY 1855 Park Avenue
San Jose,California
INVESTMENT 95126-1698
PROPERTIES (408)984-4800
November 26, 2012
Mr. Larry Squarcia I _
Senior Building Inspector
City of Cupertino 0-
-
10300 Tone Avenue '--)
Cupertino,CA 95014-3255
Re: 10020 N. DeAnza Boulevard/Comerica
Dear Mr. Squarcia:
Please let this letter serve as the Landlord's request that the City of Cupertino
perform a final inspection at the Comerica premises which is now completed.
One of the Comerica conditions required Landlord to remove and pour a new
sidewalk to meet ADA standards. Please note Landlord has taken out a permit Reference
ID#12110024, see enclosure,whereby Westwood Company-Cupertino,LLC(Landlord)
will be doing extensive work as soon as the permit is issued.
Per our conversation on November 6,2012 the City of Cupertino was to allow
Comerica to receive a temporary occupancy permit for work to be completed with the
Old Republic Title Company ADA exterior work.
I hope this letter suffices for the City to contact Mr. Steve Wall to set up an
appointment at the Comerica premises at 10020 N. DeAnza Boulevard to inspect the
construction and issue a temporary occupancy pe s
Sinc- -
10
/ —
• thony' . Morici
M1
Enclosure
cc: Steve Wall