13090046 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22087 SAN FERNANDO CT CONTRACTOR:RESIDENTIAL HEATING PERMIT NO:13090046
AND A/C INC
OWNER'S NAME: CHEN DANIEL AND JEAN KU TRUSTEE 65 CRISTICH LN DATE ISSUED:09/09/2013
OWNER'S PHONE: 4089304818 CAMPBELL,CA 95008 PHONE NO:4083774073
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL
License Class_ Lie.# —7O�5 5 L ADD A/C UNIT TO SIDE YARD AT SFDWL
Contractor ' Date q1q 1
I hereby affirm that I am licensed under thl 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:$1920
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:35712061.00 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 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 DAYS O LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, / Q
costs,and expenses which may accrue against said City in consequence of the Issued b Date: /./�•
granting of this permit. Additionally,the applicant understands and will comply Y'
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature DateQll 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 25 0 ,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 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
GENERAL PERMIT APPLICATION MEP
Lai COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION�V(pA
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINQ (408)777-3228•FAX(408)777-3333-building a�cupertino.orcl misc
1�
❑PLUMBING MECHANICAL pp //��❑` ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS �'�J 2.O Q I +_Scm /'I��/� i/�/1 APN#&-5 I
OWNER NAME C/ ChM 1/'l `ve�O /O /O E-MAIL
STREET ADDRESS2WI �J ( j CITY, STATE,ZIP `Z n,\ (A FAX
CONTACT NAME nn �+ ^J PHONE� E-MAIL
STREET ADDRESS 0!5 "�rtt� �/ CITY,STATE,ZIP Cw"�� FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ff-C-0-NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME' (�/� � Ria LICENSE NUMBER JO SS5 L4 LICENSE TYPE BUS.LIC#
COMPANY NAME i//��• I C A/C
E-MAIL / FAX
STREET ADDRESS Cy, �l � (J CITY,STATE,ZIP l(\ PHONE -M7-q073 07
ARCHITECT/ENGINEER NAME �/ LICENSE NUMBER vJ o BUS.LIC# fJ "t,�
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES
BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑ NO
DESCRIPTION OF WORK '
an Alc
TOTAL VALUATION: ( wl, - r
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act n t roperty 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 ac ate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of pertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date:
na 9
SUPPLEME AL INFORMATION REQUIRED � `��
OtTICQtII+
n.
i' i '�I�i`AAlDAR1rJ
D LARC�1
MAJQR
MEPMiscApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 22087 san fernando ct DATE: REVIEWED BY: mendez
APN: I BP#: 'VALUATION: $1,920
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Du lex PENTAMATION FURN/AC
USE: p PERMIT TYPE:
WORK add a/c unit to side yard at sfdwl
SCOPE
,a
X03
Mech.Plan Check 0.0 hrs $0.00 Phunb.Plan Check Elec.Plan Check
Mech.Permit Fee: IMPERMIT Plumb.Permit Fee: Elee.Permit Fee:
Other Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. 011ier£'leu.Insp.
1llech.Insp. Fce: Plumb. Insp.Fee: bleu.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 fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l in o.
FEE ITEMS (Fee Resolution 11-053 E f 7/1112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Mechanical
Suppl.PC Fee: Q Reg. 0 OT0.0 I hr's $0.00 $70.00 1BREMAIR A/C Units(<=10K cfm)
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Feele Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $47.00
(.'onstr action Tax.
Administrative Fee: 1ADMIN $44.00
Work Without Permit? ®Yes (j) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure ®,
Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.001 i
K4,4t All
$139.50 $70.00 <,�A4 1i $209.50
Revised: 07/01/2013
HVAC ALTERATIONS ENERGY COMPLIANCE FORM
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL
CUPERTtN0 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 $5,000 per violation or suspension/revocation of a contractor's license.
2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6) REQUIREMENTS
INCLUDE:
I. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces; room
heaters).
2. Central air conditioners &heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2.
4. A setback type thermostat(24 hr clock with four set points) is required for all alterations.
5. New or replacement ducts must meet the mandatory requirement of Section 150(m).
• All joints and openings in the HVAC system must be sealed.
• Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct
openings.
• Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened.
Flex ducts must be connected using a metal sleeve/coupling.
• Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no
more than 2" of sag between supports and 6 ft. max for vertical runs.
6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector
will collect this form and verify that the model numbers are the same as the installed equipment.
2008 Residential Compliance Fonm.doc revised 04/10/12
Simplified Prescriptive Certificate of Compliance:2008 Residential.HVACAIteradvnis. CF-IR-ALT-HVAC
CAmate Zones 12u 3-7
McAddress: EnforcemerrtAgerrcy: Deme:;;, PMrmit;+:.-;
2/40 7 Sc-r\Fecrund,a
Conditioned Duct insulation
EquiPment T rI iii f. iuin-Efucien Floor Aiea re , I ostsi
Packaged Utut Over 40:ft of duds''` '
CI Fttrisace ®- CCP Serve&hy system� addd or repced ffi Setbk
PF adoor Cot?._ fr r
Pota-ust be
sf unconditioned spaces, .
Eff Condensing Unit ®EER Resistance E3 R 6 (CZ 1,3-5) ;
El>
1.Equipment Type:Choose the equipment being installed,if mole than one-system,use another CF-7R-ALT-$VAC for each sysLsn
2.Yfinimum 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 an eligible under Division 3 of the California Business and Professions Code to acceptresponsibility for the design identified on this
Certificate of Compliance.
• 1 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 l 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 foins,worksheets,calculations,plans and specifications.submitted to the enforcement agency for approval with the permit
applicatioa.
Name: i Signature:
Company: inn C' ate: r
Address l License:
City/StatefZip: '.C" ; : .:.:. , ,: Phone: --:.3':�7., -
" 2008 Residential Compliance Forms.doc revised 04110112
Chen Residence-22087 San Fernando Ct
Garage
�{t f• r
OF r
t t
1 .
�C OJT l
Mitsubishi Hlgh
Wall Fan Coll f
v /
Chen Residence
Mitsubishi High Mitsubishi High C
Wall Fan Coil Wall Fan Coil
CO ?n,I;=NIT D'=PRRTMENT
CUPERTINO
Condenser PED
d
mal MUST be kept at the
10'-0" :ic.n. It Is unlawful to maka any
s o!I same,or to dteviz_e
r.: ;=rcjal frcm the Building Of ficial.
17'-0"
�oifications SHA!I_NOT
rova.l of the vio 1 icn
vl .`.� � I��.;,".:.i,ilailCe01'.S'tc^. E;._cVJ.
s
BLOT PLAINS ER'TINO
CHECKED BY �U� De artment
Building P
DAT;LgVAN4
4 2013
_5
NING DEPT. � l CE
REVIEWED FOR CODE COMpL1AN
f�
DATE '
Reviewed BY.
d l
Job u:Chen090913 Residential Heating8Alr Condition... s.aie:1/4" 1V
Performed by Residential Heating 8 AIC,... page 1
Chen ResWence 65 Cmtich Lane Cpmbrt�ider bYWrphbel
220879 F.--Ct CalnpbA CA 95008 13➢D1 R8UOM51
C—A—CA95014 Ph—408-3774073 Fac 40&38-9850 _p.ppaskCp'LM1en Kastle ac eivp
.residmtialleang—cm Re9ihe3@..L—