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13070125CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20966 ALVES DR i CONTRACTOR: VALLEY HEATING & PERMIT NO: 13070125 COOLING OWNER'S NAME: VIDIS JO ANN M 1171 N 4TH ST DATE ISSUED: 07/19/2013 OWNER'S PHONE: 4082535072(15 SAN JOSE, CA 95112 PHONE NO: (408)294-6290 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALL] qr�� C-20 # 2 5' (J7� ` ADD (N) HVAC UNIT IN SIDE YARD AREA (DUCTLESS License Class Lic. SYSTEM WITH EVAPORATOR INSIDE) Contractor V/III to L nL / Date � IJ I hereby affirm that I am licensed under, the provisions of Chapter 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 performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $5850 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32631005.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 DA RMIT 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 D OM LAS =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 at e: granting of this permit. Additionally, the applicant understands and will comply slue Y. with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. /�� Signatur Date 711� 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. 1 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: � Date: 7, 1/11 // 77 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 a V � CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20966 ALVES DR CONTRACTOR: VALLEY HEATING & PERMIT NO: 13070125 COOLING OWNER'S NAME: VIDIS JOHN ✓t 7J (s 1171 N 4TH ST DATE ISSUED: 07/19/2013 OWNER'S PHONE: 4082535072 'tlk SAN JOSE, CA 95112 PHONE NO: (408)294 -6290 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[] LICENSED CONTRACTOR'S DECLARATION License Class C'ZO Lie. # 2'JrgS t% ADD (N) HVAC UNIT IN SIDE YARD AREA (DUCTLESS SYSTEM WITH EVAPORATOR INSIDE) Contractor Va Itf ea Date 5(1�19 _ UPGRADE (E) ELECTRICAL PANEL TO 200 AMP, SAME I hereby affirm that I am licensed un er the provisions of Chapter 9 LOCATION (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 Sq. Ft Floor Area: Valuation: $5850 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 APN Number: 32631005.00 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 PERWT 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 DAYS FRO 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 I granting of this permit. Additionally, the applicant understands and will comply Is ! with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: Signature O t4dc Date �T %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. ❑ 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. 1 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 25505, 25533, and 25534. 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 Compensation laws of California. It 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 GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin4(cDcupertino.org A/ MEP misc ❑ PLUMBING MECHANICAL [:]ELECTRICAL ❑ MISCELLANEOUS PROJECT ADDRESS , �� / tvC C /•t APN # 3 3 ( ` U v \� J OWNER NAME 64 r- PHONE +�� CV0�253- 56 ( E-MAIL STREET ADDRESS ! ��.iGS C[ CITY, STATE, ZIP _� FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR bCONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME, /a/` v / LICENSENUMBER 'T LICENSE PE BUS. LIC# /,Jr -( t COMPANY NAME jr < < E-MAIL FAX STREET ADDRESS � I CITY, STATE, ZIPSQ2 q 5 ,! � PHONE�� o P ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 9bsFD or DUPLEX ❑ MULTI-FAmmy PROJECT IN W B,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 =sz �ar Gfl/ 5 sfe(Ca -f406f- a� G65 iti�S - TOTAL VALUATION: 5 Cr5O By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prope ne ' f. 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 e to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED / dl¢ U5y e © I AI6E ii 01 y ❑ "MAJOR MEPMiscApp_201 Ldoc revised 06/21/11 p� CITY OF CUPERTINO Ti i iv Ti 4ZT7M A rnM — RT T1111INf D11V1q10N LaiADDRESS: 20966 ALVES DR DATE: 07/19/2013 REVIEWED BY: MELISSA UNITS APN: 369 10 005 BP#: *VALUATION: 1$5,850 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex # PENTAMATION FURN/AC PERMIT TYPE: USE: Heat Pump (<=10K cfm) 1BREMAIR WORK UNIT IN SIDE YARD AREA DUCTLESS SYSTEM WITH EVAPORATOR INSIDE # [Agq-jN)HVAC SCOPE PME Unit Fee: APPLIANCE / EQUIP TYPE FEE H) QTY/FEE QTY UNITS BP FEES Evap Cooling System 1MRRAA 1 # $70 Heat Pump (<=10K cfm) 1BREMAIR Suppl. Insp I'ce 1 # $70 PME Unit Fee: $140.00 PME Permit Fee: $47.00 Conslivetion Tar: Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 TOTALS: A Travel Documentation Fee: ITRAVDOC $140.00 N I N ^� Mech. Plan Check I 0.0 I hrs $0.00 Phwmb. Plan Check Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: Other Mech. Insp. 0.0 hrs $47.00 Other Plumb Insp. Afech, Insp. Fee: Plumb. Insp. Fee: Elec. Plan. Check Elec. Permit Fee: Other Elec. Insp. Elec. Insp, Fee: NOTE: This estimate does not include fees due to other uepartmems (Le. r/ammng, runrsc rr urna, u"19—1y Contact the Dent for addn't info. I/LSLr L1: L, ug"Z. LLLGJc a:cu w FEE ITEMS (Fee Resolution 11-053 E . 7ff 112) - ---'- -- FEE QTY/FEE MISC ITEMS Plan Cheep 14'ee: Suppl. PC Fee PME Plan Check: $0.00 1 erinit .Fee: Suppl. Insp I'ce PME Unit Fee: $140.00 PME Permit Fee: $47.00 Conslivetion Tar: Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fees: A Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: 1BSEISMICR $0.59 Select an Administrative Item 51 $0.00 4 $279.59 Bldg Stds Commission Fee: 1BCBSC $1.00 $279.59 �. Revised: 07/01/2013 y She Addreys.- br. Daw .262(4f e s 7,/—/.—?//3 Conditioned Dud insulation FCRi=-t Type Fjg6i, I stat Pack -aged Unit Furnace low P Over 40 ft of ducts" in Indoor Coil Condensing Unit. . /y EER LH9SP,'F' Resistance I Serve0y system Sf added or replaced unconditioned spare f7f notdreadypr=ent, mart be E3 R 6 (CZ 1. 3-5) • Other I 1. Equipment Type; Choose the equipment being installed; ffm ore than one _*,stem, use another CF- I R-ALT-,HVA,C for each system 2. Afinimum Equipment Efficiencies: 13 SEER, 78% AFUF, 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 tris Certificate of Compliance. 9 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Tide 24, Parts I and 6 of the California Code of Regulations. * The design features identified on Ns 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 aplAication, Name Company 4 / V aleD:,7 /7 I I/tog Address. 1/71 tv, qtk- St License: CiIYISIwC4LiP--< Phofie: if68-.2?q;v12-q d I -yi -.. 2008 Residential Compliance Forms.doc revised 04110112 CUPERTINO HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.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 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 I COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set of plans and specifications MUST be kept at the job site during construction. It unlawful to make any changes or alterations on same, or to deviate therefrom, without approval from the Building Official. The sA : aping of this pl[An-and specifications SHALLON T b' held to permit" or to be an approval of the violation of any proms finance or State Law. 1 DA 13; PERMIT NO. i Ll �1 PLOT 'OFF"'ICE tA*;, 1' �v P�N gUilair? ORT/�O pa REVIE�E� UC 19 20'3 �naRg FOR 13Y.e _