13120076 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1135 SCOTLAND DR CONTRACTOR:CALIFORNIA DELTA PERMIT NO: 13I20076
MECHANICAL INC
OWNER'S NAME: GUPTA RAJEEV AND ItEETA ET AL 6056 E BASELINE RD STE 155 DATE ISSUED: 12/09/2013
OWNER'S PHONE: 4085644511 MESA,AZ 85206 PHONE NO:(866)692-5273
❑ LICENSED CONTRACTOR'S'/DECLARAATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
License Class Lic.#CONTRACTOR'S'/
- REMOVE AND REPLACE FURNACE IN SAME LOCATION
Contractor Date
I hereby affi in 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 3700of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4958
�Ikave 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:36226056.00 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 18 AYS 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 S AST CALLED INSPE T ON.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the �'
granting of this permit. Additionally;the.applicant understands and will comply Issued by: Date:
with all non-point source regulati per the Cupertino Municipal Code,Section
9..18. / -
GRE-ROOFS:
Signature r Dat/2: 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 oroffered for sale(Sec.7044,
Business&Professions Code)
I,.as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUSMATERIALS 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 theCupertin icipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 3,and 25534. `p
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date;/ C
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 Compensationprovisions ofthe.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 cityand 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.
CITY OF Crr,P��^,� �J
CITY OF CUPERTINO
FURNACE/AC
C u P E RT i wo PERMIT APPLICATION FORM \�
APN# 'A� rl�
Bui ng, mess:
If residential,is house an Eichler? Yes ❑ No ❑ If yes,needs planning approval.
Ow Name: Phone#-
KA:1I5_
sKltl cn r-�A au PTPr 'qv$- ��4- 4611
C.2f trar.*or: q Phone#:
b�L-t�v S 1 A 8- 615:- &km t u L_._. Fax#: 5�77'
Contra Lice se#: Cupertino Business License#:
Con ct: Phone#: 84,G -/ag a- 5 "tom
/3C -rb .5 Fax/e-mail: taC.
Building Permh Info:
Elect❑ Plumb ❑ Mech [
Residential Commercial ❑
Job Description:
For Resid tial Installations:
Attic [{ IS,floor ❑ 2nd floor ❑
Adhere to minimum setback requirement ❑
For Commercial Installations:
Replacement same weight ❑ Additional weight(structural Gales) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required El
Cost of Proje: Type of Construction aJsage Class):
Strapped ❑ On Platform ❑ 1�onded U New Location❑ Replacement❑
Project Size: Counter❑ Express❑ Standard❑ Large❑ Major❑
Valuation:O,1�5s
Green Building:Please complete relevant portion of the Green Building Checklist&attach it to the
application or if applicable,include in plan set&the sheet index.
Revised 12/06/10
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1135 SCOTLAND DR DATE: 12/09/2013 REVIEWED BY: MENDEZ
APN: BP#: `VALUATION: $4,958
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair.
PRIMARY PENTAMATION
USE:
SFD or Duplex PERMIT TYPE: TURN/AC
�
wORK REMOVE AND REPLACE FURNACE IN SAME LOCATION
SCOPE
_
ON
Mech.Plan Check 0.0 hrs' $0.00 .Plzssrrb. Plau Clleck Flec.Plan{.;heck'
Mech.Permit Fee: IMPERMIT Plumb.Permit I<:e: Elec.Permit Fee:
Other Mech.Insp. 0.0 hrs $47.00 o he:r Plumb Insp. Lj Cather Elec.Insp. Lj
n3eeh.Insp.Fee: Pluraib. Insp.Fee: 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). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn 11 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: (E) Reg. OT: 0.0 hrs $0.00 $139.00 IMFR=<100 Furnace,Forced-Air
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Feer Reg. O:OT Q Q_ hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $47.00
Conswuction :7 tL :
Administrative Fee: 1ADMIN $44.00
Work Without Permit? 0.Yes (E) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure
i
Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
r
$139.50 $139.00
�_�_ $278.50
Revised: 10/01/2013
r
r
Simplified Prescriptive Ceriitirate ,
F �of Compliance:2008 Residential Hi�ACAlierations. CF-IR-ALT-AVAC
C#irnste Zones I and 3-7
She Addrers Enforcement Agency: Dail :> Permit
Conditioned Duct insulation
eat T ikyst niith '; Floor•Aiea l�temostat 1 "
Packaged Unrt .> "' Over 4413 nfdttds``
Furnace GOP Served by s}%item aided or neplar6d m Setbaclt
Indoor Coil HSPF �j (fjnoiuireadypresew mzwbe
Condensing Unit ®EER 13 gmistarice d-11L sf unconditioned space . iruta/ledj ;
Other.
i �R 6 (CZ I,3-S)
1.Equipment Type:Choose the equipment being installed,if more than one system,use ano&ff CF-1R-ALT-HVAC for each system.
2.Minimum Equipment Efficiencies:13 SEER;78%AFUE,7.7HSPF for typical residential systems.
Coatractor(Uocumentatiaq-Anthor'sl/Respondble 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 Bushiess and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance. j
• I certify that the energy features aad perfarmance-specrflcations 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 infomration documented on other applicable
compliance forms,worirsbeets,ca I culat ons,plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: f Gr �� SignattssE:
License*
ip:
Ci /StatelZ' �. �.: 2::; � C� - Phone:
i
I:
it
2008 Residential Compliance Forms.doc revised 04/10/12
IIII
I
HVAC ALTERATIONS ENERGY COMPLIANCE FORM
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTIN10 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building(d)cupertino.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 i>
• 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