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13060007 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7670 ORANGE BLOSSOM DR CONTRACTOR:ONE HOUR HEATING PERMIT NO: 13060007 AND AIR OWNER'S NAME: MARIE FIRL 1400 PETALUMA HILL RD DATE ISSUED:06/03/2013 OWNER'S PHONE: 4082550391 SANTA ROSA,CA 95404 PHONE NO:(707)545-1800 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE] License Class 746 9 I— Lic.# C'/.D C REMOVE AND REPLACE HVAC IN SAME LOCATION Contractor Date I hereb .fffi h. am licensed under the provisions of Chapter 9 (co er n Section 7000)of Division 3 of the Business&Professions Co d 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:$15800 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:36611093.00 Occupancy Type: permit is issued. APPLICANT'CERTIFICATION Icertify that I have read this application.and state 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 DA F OM LAST CALLED 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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatur Date i "3 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 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,asprovided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section.3700 of the Labor Code,for the performance of the work for which this Owner or authorized - permit is issued. 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(See.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,theapplicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,j�� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 � 'CUPERTINO (408)777-3228•FAX(408)777-3333•building(&cupertino.org 0bo sc ❑PLUMBIN/G� y [—]MECHANICAL Q �►A D [—]ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS 7670 0�2f�1VC16 VLOMf4 DTA. APN# / ! n 1 0 613 OWNERNAME m 4v; s Ftl Z � •^*-+ o^,� E-MAIL STREET ADDRESS j/G^O. pp q �M pQ. C TAT ZIP 0 `� ` FAX CONTACT NAME ( ( PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRAC R NAM �� LICEN LICENSE TYPEBUS.LIC# C 2-14 COMPANY NAME E-MAIL FAX STREETPHONE S Pr mw t4 p• CITY STATEZIP a -j0-7-STS-j oO B, ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD u DUPLEX ❑ MULTI-FAMILY PROJECT IN WH DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK TOTAL VALUATION: I� �I, 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 rop 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 b ' g construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 473 7Y 3 S EMENTAL INFORMATION REQUIRED OFFICE USE ONLY yy OVER-THE-COUNTER F ❑ EXPRESS U w ❑ STANDARD x U Z ❑ LARGE a ❑ MAJOR MEPMiscApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 7670 ORANGE BLOSSOM DR DATE: 06/03/2013 REVIEWED BY: MENDEZ' 191APN: BP#: *VALUATION: 1$15,800 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK REMOVE AND REPLACE HVAC IN SAME LOCATION SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $67 TOTALS: ;$ $67.00 M Qk— i ...yin Mech.Plan Check 0.0 hrs $0.00 Phunb.Plan Check Elec.Plan Check Mech.Permit Fee: 1MPERMIT Plumb.Permit Fee: Elec. Permit Fee: Other Mech.Insp. Fo.0 hrs $45.00 Other Plumb Insp. Other Elec.Insp. Li Alech.Insp.Fete: Plumb. Insp.Fee: Elec,Insp.Fee., NOTE:This estimate does not include fees due to other Departments(La Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prehimina information available and are only an estimate. Contact the Dept-for addn'1 info, FEE ITEMS(Fee Resolution 11-053 E . 7�f /1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC:Tee PME Plan Check: $0.00 Permit.Fee: .Suppl. 111sp Fee PN1E Unit Fee: $67.00 PME Permit Fee: $45.00 Construction .Tca: Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning?Fees: Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion.Fee: IBSEISMICR $1.58 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $201.58 $0.00 �RAW -M $201.58 Revised: 04/29/2013 Simplified Prescriptive Certificate of Compliance:2008 Residential BVACAlterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 O 01 9 NC %=OM DV.- ErrroreemerrrAgency: ��L(3 PV"* Conditioned Duct insulation Equipment T uI i`st' Tfflciency2i<loor Area reguirement Thermostat, 13 Packaged Unit :; . >'' Over 40 ft of duds urnace AFUE. COP ad, system added or replaced in 13 Setback Indoor Coil PISPF (If not alreadypresau,must be Condensing Unit EER ®Resist ce sf unconditioned space mstatled� �er E3 R 6 (CZ 1,3-5) , 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER,78%AFUE,7.711SPF 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 infonnation docurnented on other applicable compliance forms,worksheets,calculations,pians and specifications submitted to the enRmement agency for approval with the permit application. Name: 3t0 s S ` .tee Signature: Company: rC n Nfi ZAP- Date:ON 3 3 Addxessj"l o Fe_r tWM {41U. License:7WM41 CitylstatelZip:5 AN A A CA) CIS d Phone: -707—S$9-1806 r 2008 Residential Compliance Forms.doc revised 04110112 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL GUPERT[NO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building Q-cupertino.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 and violation of the building laws, including the California Building Code, and local permit requirements constitutes a cause for disciplinary actionfrom 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 PlotI�Ign of A/C Locaff n- Mayie. Fi Jdb Naple Lan— Ad.dressl 00ell r, 4,pr�1n, CA IJ Di-wving must to P170part-Y Iihe from.A/C 0 Draw x1 all.property 1-hies(pualjy the:fe11ce). UIPEE . -CFTINO 11 Changethe.sbapt of the box.to.represent the.hcm6 2"' _D 0 Place A/C unit 12"*.om home acid label as such, 11Draw in the streets that border.the.ho-use. MUST be kept at the Show electrical panel,furnace 8c.garage, it is unlawful to make any ioi;�-'on same,or to deviate 11. This gigp it reqtAnd.for Santa.Rosa,Maluma.and So approval from the uilding Official. -J! ^eof this pinn and sp—scifications SHALL NOT r HL t or to e an approval of the violation qT aniy City Ordinance or State Law. 0 (1) LLJ C) z z rD LLJ a p) 0 D A C=D C.) Lu CD 0 M M a 5 X 0 U_ EW LLI j PLOT PLANS CI%CKED BY nAqW --q?L'A—NNING DEPT. DATE L F , C-\Documpnts-an 'settings\ownOr�MY.D.ocunes che. klists\CA Pape Plan 1LA= E COPI