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13090067 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22836 POPLAR GROVE SQ CONTRACTOR:BRIAN KOSKI HEATING PERMIT NO:13090067 OWNER'S NAME: SHARMA DEEPAK K AND ABHA 111 GLENN WAY STE 16 DATE ISSUED:09/11/2013 OWNER'S PHONE: 6507969884 SAN CARLOS,CA 94070 PHONE NO:(650)267-0373 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class '),t7 Lic.# 3,1;- INSTALL A/C UNIT IN REAR OF SFDWL Contractor l_ Date I hereby affirm that I am licensed under the provision of Chapter 9 (commencing with Section 7000)of Division 3of 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:$5000 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:34233022.00 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 WITBDV90 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 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 9!( Issued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature /f Date 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 yunicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect' ns 215505.29533,an 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. 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 GENERAL PERMIT APPLICATION MEP 10 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingCcDcupertino.ora U MISC Y� ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESSP(AIC re 6rove, APN# ?�-3 0'2 OWNERNAMEPH `�� EWj , r STREET ADDRESS / ♦J CP O(�or 51 FAX (� ITY„ST TE, 0 CONTACT NAME PH q tA /, E-MA STREET ADDRESga' CIT STrt1 /J (J �/q FAX OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LIC R LICENS T BUS.LIC# COMPANY N r FAX �OSJ E- r ),A �i40 STREET yS6 CI Y TATE,ZIP /' P ONE ARCHITECT/ENGINEER NAME LICENSE NUMBER V BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD.,DUPLEX ❑ MULTI-FAMILY PROJECT IN WI 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 � 4 an & _ L, L 4nd 17YAin TOTAL VALUATION: 45c/_ RECEIVEDBY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prope 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. gree to comply with all applicable local ordinances and state laws relating builddinng�construc n. I an orze representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicanUAgent:—�u�K- Z 4 Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W ❑ OVER-THE-COUNTER a H ❑ EXPRESS U ❑ STANDARD V Z ❑ LARGE a ❑ MAJOR MEPMiscApp_201 Ldoc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 2283 poplar sq DATE: 09/11/2013 REVIEWED BY: Mendez APN: BP#: 'VALUATION: 1$5,000 *PERMIT TYPE: Buil di g Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK install a/c unit in rear of sfdwl SCOPE Mech.Plan Check 0.0 hrs $0.00 PhanL Plan Cheek Elec.Plan Check Mech.Permit Fe;: IMPERMIT Plumb.Permit Fee: Elec. Permit Fee: FOther Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. E3--L- Other Elec.Insl). Li Insp.Fee: Plumb. hrsp.T etz: Elec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These fees are bused on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info, FEE ITEMS(Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Mechanical Suppl.PC Fee: Q Reg. Q OT 0.0 1 hrs $0.00 $70.00 IBREMAIR A/C Units(<=10K cfin) PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. ®OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Construction Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? j ®Yes Q No $0.00 Advanced Planning Fee. $0.00 Select a Non-Residential 0 Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure i Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee; IBCBSC 1 $1.00 $139.50 $70.00 $209.50 Revised: 08/01/2013 Pei 4k ��I �Y�`�i/��j''ti oil 6'1 Pop* , t r i✓► c�� , 1- cc: O c � -1 N �z 32 E-5 CD .1 54,1j4re, W m ° W C fn coN4J �Z cc oa c m — 2 - - - - z � N E ° � �f ! 0 1 wE N «s 0 0-0 O vc ° r- 2 o � o65 � � oc > m �, a� U v cm cl 0 CL co oz ro aL o 0 o 'vo � o `� o p g 0° E Q ° ° O o o ! w >_ in cG LU L O ... ® J F f` F- F co a a R I n PLOT PLANS CHECKED BY DATE 1 r cUPERTINO Building Department PIAN I EPT. `"' � � 1 2013 DATE ^` ! REVIEVJED FOR CODE COMPLIANCE BLDG. DEPT. B --�j •• D' Reviewed y: j f i COMMUNITY MANAGEMENT SERVICES September 6, 2013 Deepak Kumar/Sharma Abha Sharma 22836 Poplar Grove Square Cupertino, CA 95014 Re: DeAnza Oaks Homeowners Association Lot 53) Dear Owners: The Architectural Committee has approved OPTION 2 on your application for the installation of an air conditioning condenser and plumbing lines per the General Description Of Proposed Work section of the enclosed application. The metal conduit must be painted to match the exterior surface on which it is affixed ithin 30 days of installation. Paint color information is available on the association's website at w\\.deanzaoakshoa.com. Since ly, C mmunity Ma nt Services, Inc. ubbard, Association Manager DeAnza Oaks Homeowners Association BH!st Enclosure cc: Board of Directors 1935 Dry Creek Road, Suite 203 Campbell,CA 95008-3631 voice (408) 559-1977 fax (408) 559-1970 INSTALLATION CERTIFICATE CF-6R-MECH-04 Space Conditioning Systems,Ducts and Fans (Page 1 of 2 B�AC — Site Address: Lo Enforcement Agency: Permit Number: 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 um and Model Number Number 2 Systems value a etc.) R-value Btu/hr (Btu/hr A L frAyle3v d I goqul ^�. Cooling Equipment Efficiency Duct Equip (SEER Location Type and EER) (attic, (package #of �'3 crawl- Cooling Cooling heat CEC Certified Mfr.Name ARI Reference Identical (>_CF-1R space, Duct Load Capacity um ) and Model Number Number 2 Systems value)4 etc. R-value (Btu/hr) (Btu/hr 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:1Avww.aridirectory.org/ari/ac.php# 3.Listed efficiency on this page must be greater than or equal(>_)to the value shown on the CF-1 R form. 4. When CF-IR is reference it is also applicable to the CF-IR, CF-IR-AA or CF-IR-ALT ALL BOXES MUST BE CHECKED TO BE A VALID FORM CR §1 10-§113:HVAC equipment is certified by the California Energy Commission. ❑ §150(h):Heating and/or cooling loads calculated in accordance with ASHRAE,SMACNA,or RCCA. §150(i): Setback Thermostat on all applicable heating and/or cooling systems meet the requirements of§112(c). ® §1500)2:Pipe insulation for cooling system refrigerant suction,chilled water and brine lines meets minimum requirements of Table 150-B and includes 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: 7 ermit Number: Ducts and Fans §150(m):Duct and Fans ❑ 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 ❑ 1.Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other than sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms 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 duct tapes unless such tape is used in combination with mastic and draw bands. ❑ 7.Exhaust fan systems have back draft or automatic dampers. ❑ 8.Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. ❑ 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. ❑ 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 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 shallbe postedi 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. Com V Name: (Installing ubcontractor oy'eneral Contractor or Builder/Owner) Respo ible Person's N e: x171 IjV Res sible Person's lure K05AI . CSLB License: VE ed Position With Company(Title): J �Uj tl 2008 Residential Compliance Forms August 2009 i HVAC ALTERATIONS ENERGY COMPLIANCE FORM L' COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL GUPERTthlO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinaacupertino.ora 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 rep lac ',f tent,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 I SIA, 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 suspeded must be supported every 4 ft. max for horizontal runs with no more than 2"of sag betwien�s pports and 6 ft. max for vertical runs. 6. The CF-6R-MECH-04 must be complted and signed by the installing contractor. The Inspector will collect this form and verify giat the,model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 .Y. Shpplifted Prescriptive Certificate of Compliance:2008 Residendad HVACAiterations CF-IR-ALT-AVA C - Climate Zones 1 and 3-7 Site Address: Enforc�nentAgency: �trie _ 'errnit#: 3 L &Ue 54Are Consf boned Duct insulation ent Type, 3si'rfmiiin Mcy- El a re ,- Tmosh�i Packaged-Unit Over 40 8 of darts Furnace AFfJE COP ed`hy system added or replaced m Setback Indoor Coil (3Stt� HSPF_ (dfaoialrradypreseAnnwbe Condensing Unit ®EER E3 Resistance sf unconditioned spasx - .:. Other 1 1E3 R 6 (CZ 1,3-5) • 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF- HVAC.for each system 2.Afinimam Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for t3pic2l residential systems. Contractor(Documentation Author's/Responsible Desiper's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and compkte. • 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 speeificaions 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 feaawes identified on this Certificate of Compliance are consistent with the infornration documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit IicaSon. Name - Signatrue: Company: 4 ' f '{1 Dater �/ 1�1 .r Address j / i ool n (;U4 ,/► ' Litxnsel� .f City/StwAzipr 5 M1 Phnne: �. 2008 Residential Compliance Forms.doc revised 04110112 Dee p I� 5h4rmA In S+4 ,++ibn Of Al i, d Govt,)e�ger ot, popes %uArc 6rvve2 13 Powe-r Ak unit TINO CUPER Building Department 11 2013 REVIEVV'E' F0'R OC—DE COMPLIANCE Reviewed By: y` �-G �� by rm e