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13110063 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10413 MARY AVE CONTRACTOR:COLD CRAFT INC PERMIT NO: 13110063 OWNER'S NAME: ZDENA PIPKOVA 181 LOST LAKE LN DATE ISSUED:11/12/2013 O ER'S PHONE: 4082532430 CAMPBELL,CA 95008 PHONE NO:(408)374-7292 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIP'T'ION: RESIDENTIAL 11 COMMERCIAL License Class C 10/)-0 1 N)Lic.# 3 7 REPLACE(E)FURNACE&A/C UNIT,SAME LOCATION yt, ON Contractor Date 1 l ROOFTOP,LIKE FOR LIKE 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 7p rformance of the work for which this permit is issued. . Sq.Ft Floor Area: Valuation:$6581 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:32652049.00 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 WITIHN 180 DAYS OF PERBUT 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 13 -3Z granting of this permit. Additionally,the applicant understands and will complyJAIII LI with all point source regulat' n perthe.Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signatur Date y roofs shall be inspected prior to any roofing material being installed.If a roof is nstalled 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 wit a Cupertino Munici Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,S tlo 255 5533,a 5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date 12 1 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 indemnify and keep harmless the Cityof Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 perthe Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION b MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION o0 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(ftupertino.org l h\ MISC ❑PLUMBING MECHANICAL ❑ELECTRICAL /[]MISCELLANEOUS PROJECT ADDRESS ` APN# 3' l^ (� 0 f/ OWNER NAME L PHONEq`�v � /( p`� MAILf _ / An Cb WX4)- STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME .� PHONE(r E-MAIL6?,,,, � STREET ADDRESS C ,STATE,ZIP Q FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NA LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY N E-MAIL FAXVa STREET ADDRESS ARCHITECf/BNGINEERRNAMEV(x- LICENSE NUMBER iBUS.LIC# l COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD.,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 Q `Y PITSof' S r Ki TOTAL VALUATION: D BY � ,k By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on The property 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. I agree to comply with all applicable local ordinances and state laws relatin ��orize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: / / 2— ^6 SUPPLE AL INFORMATION REQUIRED _- f OFFICE�TSE W OAR=MI NTE ST�IVDARD y JQR MEPMiscApp_2011.doc revised 06/21/11 z, CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11129 CLARKSTON AVE DATE: 11/12/2013 REVIEWED BY: MELISSA APN: 326 52 049. I .BP#: *VALUATION: 1$6,581 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: FURN/A WORK REPLACE. E FURNACE &A/C UNIT SAME LOCATION ON ROOFTOP LIKE FOR LIKE SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $70 Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: fi:.,tx4! $209 -N, Mech.Plan Check "hrs Plumb.Plan Check Elec.Plan t.;heck Mech. Plumb.Permit Fee: Elec. Permit Fee: Other Mech.Insp. C11her Plr�mb Insp. ET Other Elec.Insp. LL1tlech.In}p..I'er: Plumb. bzsh.hee: 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). Theseees are based on the prdintina 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: suppl. PC Fee PME Plan Check: $0.00 Permit.Fee: .Slrppl. hasp Fee PME Unit Fee: $209.00 PME Permit Fee: $47.00 Construction Tax Administrative Fee: IADAffN $44.00 Work Without Permit? 0 Yes (E) No $0.00 A dvanced Plan ming Fees: Travel Documentation Fee: 1TRAVDOC $47.00 A Strong Motion Fee: IBSEISMICR $0.66 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $348.66 $0.00 , A Revised: 10/01/2013 COMMUNITY MANAGEMENT SERVICES November 11,2013 Zdena Pipkova 10413 Mary Ave. Cupertino, CA 95014 Re: Architectural Approval Dear Homeowner: I am writing in regards to your architectural change request. Your request to install a new furnace - air conditioning unit has been approved as specified. Please be aware any damage to the building as a result of the work will be your responsibility to repair. Thank you for contacting the board. If you have any questions, please contact me at (408)559-1977. Sincerely;, ,.d Dustin Mannina Community Management Services,Inc. Association Manager Casa de Anza Homeowners Association Cc: Board of Directors 1935 Dry Creek Road, Suite 203 Campbell, CA 9 95008-3631 •voice (408) 559-1977•fax(408) 559-1970 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINC! 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinaacuper#ino.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 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 £ .4. Simplified Prescriptive Certificate of Compliance.•2008 Resfdenthd i VACAIierations. CF-1R-ALT-HVAC Climate Zona I and 3-7 Aadressl _ for� erAgeDate 2`Jr#:,, Condoned Duct insulation Equipment Type' -I i 2 Nfinimiimsfscienyz Moor Awa" ,., : "I �rmosta# Over 40 8 of ducts .; r ®AIDE ]ly�i CUP Servedin Setbacl - 'by system a3orre de3 placed Indoor Coil [ _ ®RSPF ' (Ij ao7 al SEIILready present must be Condensing Unit EER Resistance sf unconditioned 1,space, nuicrlledJ 1.Equipment Type:Choose the equipment being installed;if mora than one system,use another CF-IR-ALT-HVAC for each system 2,Afinimum Equipment Mciencies: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 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 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 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 pan-nit applic4tion, Name: 1hAA VA Sim Company: , Address License: 3 City/StateJZip: '� Phoria: 4-7 2008 Residential Compliance Forms.doc revised 04110112