Loading...
13100084 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1095 NOVEMBER DR CONTRACTOR:ATLAS-TRILLO HVAC PERMIT NO:13100084 OWNER'S NAME: NELSON EDITH C 1965 KYLE PARK CT DATE ISSUED: 10/11/2013 OWNER'S PHONE: 4085939474 SAN JOSE,CA 95125 PHONE NO:(408)286-8931 ff— ❑ LICENSED CONTRACTOR'S DECLARA~TIIOON JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class �2V Lic.# �D ` REPLACE(E)FURNACE,SAME LOCATION&ADD(N)A/C UNIT IN REAR YARD AREA Contractor l'�C rtyl L�L f�1�� � Date U 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:$5000 d 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:36216027.00 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 + 'ALLED 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 ed Date �� /� 3 granting of this permit. Additionally,the applicant understands and will comply with all no - oint s ce r gulations.per the-Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date 1 11-3 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 isnot intended or offered for sale(Sec.7044, Business&Professions Code) 1,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 upertino Municipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 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 .-q i4Tq GENERAL PERMIT APPLICATION �A MEP La COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPEItTiNO (408)777-3228•FAX(408)777-3333•building(cilcupertino.org \, misc ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL [:]MISCELLANEOUS PROJECT ADDRESS APN# '3( _ (! - O OWNER NAME � r E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 1 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑. CTOR ❑CONTRACTORAGENT ❑ ARCHITECT 11 ENGINEER 11 DEVELOPER ❑ TENANT ME CONTRACTOR NAA ` A LICENSE NUMBED \ LICENSE T BUS.LIC# COMPANY NAME E-MAIL (� FA STREET ADDRESSVM v (I CITY,STATE,ZIP CSI PHO a . ly ARCHITECT/ENGINEER NAME LICENSE NUMBER B LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WII,DLAND ❑ YES 7PROOJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO D ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK TOTAL VALUATION: By my signature below,I cerAy to e c following: I am the property owner or autho agent to act on the) '-owne;'rfehalf I have read this application and the information I h ovi is correct. I have read the Description of Work and verify it is accurate.-T-dgm'6 to comply with all applicable local ordinances and state laws relatin o buil i onze re sentatives of Cupertino to enter the above-ydenf /pro erty for inspection purposes. Signature of Applicant/Agent: Date: iwl ` / 41 a ' S RTAL INFORMA-Tt@NXEQUIRED �'�,. ,o�tcExJSEoigi, ov R �Tc[frm n , k� ' d ry NMic MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 1095 NOVEMBER DR DATE: 10/11/2013 REVIEWED BY: MELISSA APN: 36216025 BP#: "VALUATION: 1$5,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK REPLACE E FURNACE SAME LOCATION &ADD N A/C UNIT IN REAR YARD AREA SCOPE APPLIANCE/EQUIP TYPEFE�ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $139 A/C Units (<=10K cfm) 1BREMAIR 1 # $70 $209.00 TOTALS: " a Mech.Plan Check "00 $0.00 Plumb. Plan Check Elec.Plan Check Mech.Permit Fee: IMPERMIT Plumb.Permit ree: Elec.Permit Tee: F01,her Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. Ober Elec.Insp. Insp..f'eee: I'turnb. Insp. ree: Elee.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 relimina information available and are only an estimate. Contact the Dept-for addn'1 info. FEE ITEMS (Fee Resolution11-053 E . 7f /1/13) FEE QTY/FEE MISC ITEMS Plan Cheek Fee: suppl. PC f ce PME Plan Check: $0.00 Permit Fee: Suppl-Insp Fee PME Unit Fee: $209.00 PME Permit Fee: $47.00 Conslruciion Tax: Administrative Fee: IADMIN $44.00 Work Without Permit? ®Yes (E) No $0.00 Advanced Planning Fees: Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldp-Stds Commission Fee: 1BCBSC $1.00 �..� `E�r` 348.50 r $348.50 $0.00 $ Revised: 10/01/2013 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTthlC) 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333-building a1cupzrtino.org V;HEN IS A PERAUT 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 $5,000 per violation or suspension/revocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6) REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces; room heaters). 2. Central air conditioners &heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. 4. A setback type thermostat(24 hr clock with four set points) is required for all alterations. 5. New or replacement ducts must meet the mandatory requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings. . • Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no more than 2"of sag between supports and 6 ft. max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 F' z ' Simplified Prescriptive Certificate of Compliance:2008 Resirienf alHIVACAlierations. CF-M-ALT-RYAC Climate?anes 1 and 3-7 ,Site Addr*t �/f K V V Enforcemetrl A$ettt3'. I2 "'�>r / 2 v A f V C ffitimed Duct insulation l 7 Equipment T i`i i'2vfmiaiiam' cien Ploor Aiea re" Thtnostat Packaged Unit over 40$of ducts" Furnace AFUE �• cop ( Setbatd` 7® Served'by s}'steam silded or replaced.i3m indoor Cott Sit HSPF {Ifaorulieadypresmt aivst be sf unconditioned space Condensing Unit ®EER itesistaace R 6 (CZ 7,3-Sj Other 1.Equipment Type:Choose the equipment being installed;if more than one.system,use another CF-JR-ALT-HVAC for each system. 2.Nfmimum Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for typical residential systems. Coritmctor'(Doetrmentation Author's/Responsible Deft nner's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and com6iete., ; • 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. • 1 certify that the energy feah :s 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 ate consistent with the information documented on other applicable compliance forms,worksheets,calculations,plans and specifications.submitted to twenforopment agency for approval:with the permit lication. . - Name: A{^ Iy jb , / Signature: I Company ) I. A [�Q A� D� C �l 1 Address. Q Lime: � 3 City/State2ip: '� - .. P3ione: O � .. 2008 Residential Compliance Forms.doc revised 04110/12 DWAA,enpS NAM4 &444,� Wsan AD OW'5 -- 10 Yb� lqtjv4VU� - � �� �� X5 -� � c A Gvp�R�a�`O�� 3v�1d1�4 hep d� �Mp11PN C'�-1 �, COMMUNITY D91ELOPMENT DEPARTMEP T BUILDING DiViSION-CUPERTINO APPROVED This Set Of plans and specifications cifiCations MUST be kf pt at the construc-J:on. It is unlawf- I, I Chz�;-I-es, -u LO ril any Hat( Z� ('r alteration.3 on sar"le,or to devi, thel,61"r0m, Without aPPf*OVRI from the Building()ff;cial. Thiki�-,'crnPhlg of this - specifications SHA-L NOT tO 01,L', proval of the vic 0,a—,-- - anon ' Ons rdinance or Stat E Law. .")FFICE COPY, Y t�� 7 DATE I'M PERMIT NO. pl.t-)T- PI-ANS CHECKED BY, DATE I )-3 AAeN,1�,G EPT. DATE R1,0jG. DFPT.