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13070061
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10889 NORTHSHORE SQ CONTRACTOR:PELLE HEATING&AC PERMIT NO:13070061 INC OWNER'S NAME: ZEH CHEN&PEN YUN WU LIU 3751 D CHARTER PARK DR DATE ISSUED:07/09/2013 SAN JOSE,CA 95136 PHONE NO:(408)978-7060 OWNER'S PHONE: 4087251827 cNCONTRACTOR'S DECLARATION License Class SED JOB DESCRIP'T'ION: RESIDENTIAL LJ COMMERCIAL[] ❑ LICE C'-ac) Lie.# S-0 9��7 REPLACE(E)FURNACE IN GARAGE AREA ff Contractor IN-4- �.4' 1,24 r—Date T 4 I hereby affirm that I am licensed under the provision of C apter 9 (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 Valuation:$2000 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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:31638033.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify 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 P ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter ED INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS F S indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Secti 9.18. RE-ROOFS: Signatur Date 7 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without fust 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to 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 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and performance of the work for which this permit is issued. the Health&Safety Code,Section 505,25533,and 25534. 1 have and will maintain Worker's Compensation Insurance,as provided for by 7 /9 /7 � /3 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date 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 CONSTRUCTION LENDING AGENCY 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 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 � 1 �0© CONSTRUCTION PERMIT APPLICATION �b COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION`, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (4 8)777-3228•FAX(408)777-3333•building(a)cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFE GINAL PERMIT# PROJECT ADDRESS APN# C Q i OWNER NAME PHONE E-MAILZe U STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX l ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME �Q� y ,/� I i LICENSE NUMBER LICENSE TYPECW BUS.LIC# COMPANY NAME 1 vv tT/•c�j�WCJc E-MAIL FAX rq ,e,Q - 1t►�►b•C� 1,0 n o -KSS 4 IbO STREET ADDRESSSTATE Y, ZIP PHONE Id 0� �i As13b y®� moi}$ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORKIry ' EXISTING USE PROPOSED USE CONSTR TYPE 1 #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: UDETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES 1110 Iamfg TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LEl-rER E[CHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorize Int property caner s I have read this application and the information I have provided is correct. I have read the Description of Work and verify it' curate. ee to comply with applicable local ordinances and state laws relating to buildinloonstruction. ILgLuthorizewepresentatives of Cupertino to enter the a ove-identified property for inspect-ton purposes. Signature of Applicant/Agent: Date: O$ SUPPLEME TI REQUIRED rCK"fi, E _New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of buildmg permit for new building. [ ,"EzcPiEss" C rLANrtity PA W; _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure t , STANDARD "pusLrCwoRKs form if any Hazardous Materials are being used as part of this project. CI TAItF. CI°"FIxEDEPT_ _Copy of Planning Approval Letter or Meeting with Planning prior to .k submittal of Building Permit application. s© wo ` L ©,tiNvutotvrT B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10889 NORTHSHORE SQ DATE: 07/09/2013 REVIEWED BY: MELISSA APN: 316 38 033 BP#: "VALUATION: $2,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY PENTAMATION FURN/AC USE: SFD or Duplex PERMIT TYPE: WORK REPLACE E FURNACE IN GARAGE AREA SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: $139 00 �< Mech.Plan Check 0.0 hrs $0.00 Plumb,Plum CheckElec.Plan Check Mech.Permit Fee: IMPERMIT Plumb.Permit Pee: t lec. Permit(ee: Other Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. Lj 011ier Elec.Insp. EIF i7ech. Insp.Fite: Plumb. Insp.Feta: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These ees are based on the relimina information available and are onlyan estimate. Contact the De t or addn'l in o. FEE ITEMS LEee Resolution 11-053 E . 7f� /1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC.Fee PME Plan Check: $0.00 Permit.Fee: .Supj)/. Insp Fee PME Unit Fee: $139.00 PME Permit Fee: $47.00 Construction Tax: Administrative Fee: 1ADMIN $44.00 Work Without Permit? ®Yes (E) No $0.00 Advanced Planning?Fees: Travel Documentation Fee: ITRAVDOC $47.00 i Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg-Stds Commission Fee: IBCBSC $1.00 aim 78.501 $278.50 g $278.50 Revised: 07/01/2013 _ s Simplified Prescriptive Certificate of Complianee:2008 Residential BVACAlterations CR-IR-ALT-HVAC-., . Climate Zones 1 rad 3-7 ,� S Enforcement Agency: Bute: . ermft Conditioned Dcinsulation isJffcin, , l Thmosent T tat Packaged Unit ' Over 40 ft of duds'' '�l`urace in AF,Ul "r' CflP Served by system added or replaced in etback Indoor Coil [ SEI ®HSP}r unconditioned alreadypresait must be sf ditioned space (Ifnot . Condensing Unit ®SER Rssistanice ®R 6 (CZ 1,3-5) ;t Other � 1.Equipment Type;Choose the equipment being installed;ifmore than one-system,use another CF-1R-ALT-IVAC.for each system. 2.Afinimam Equipment EfSclencies:13 SEER,711%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 ofthe California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and perfoimancespecifications 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 V 1/� Signatmre: C p Date: License: Citylswelzip: L,c, 6. Phone:ClC1� g 7,� 7 c,�Ci 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 CUPERTthIU 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinana cupertino.ora VVHEN 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