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13110163CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10400 FARALLONE DR CONTRACTOR: VALLEY HEATING & PERMIT NO: 13110163 COOLING OWNER'S NAME: HUSSAIN JAVED AND'SHAKILA 1171 N 4TH ST DATE ISSUED: 11/25/2013 OWNER'S PHONE: 4087463081 SAN JOSE, CA 95112 PHONE NO: (408)294-6290 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL11 H LICENSED CONTRACTOR'S DECLARATION License Class C' �C9 Lic. # REMOVE AND REPLACE FURNACE, ADD A/C TO SIDE OF 1SFDWL Contractor V4 Ci �ec � _ Date _111,Z51,13 I hereby affirm that Imam 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: $5600 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36929013.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that 1 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 WIT 80 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 F OM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in consequence of the C �� �✓ costs, and expenses which may accrue against said 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. Signature Date RE -ROOFS: 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 1, 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 Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which thisOwner 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 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 \O� (408) 777-3228 - FAX (408) 777-3333 - building(&cupertino.org `n\ MEP MISC ❑ PLUMBING FVMECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS PROJECT ADDRESS D Q Q APN # _q b OWNER NAME 't,, PHONE o o-746- 30 7E -IL STREET ADDRESS Kwo o Fa.-- lloAc Dr. CITY, STATE, ZIP FAX CONTACT NAME PHONE E-MAII, STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER `` ,/�Q �5 S'7 LICENSE TYPE © BUS. LIC # i COMPANY NAME E-MAIL FAX yog-2 - 2'�T STREET ADDRESS 1171 � qA 5 f. CITY, STATE, ZIP _ �L Jbse s/! PHONE yob -Z y�f ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAII, FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or DUPLEX ❑ MULTI -FAMILY BUILDING: lb COMMERCIAL PROJECT M WILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLERHOME? ❑ NO DESCRIPTION OF WORK 1Z4 F r 4csmote 1 eJ,;w TOTAL VALUATION:4-5,615 a RECEit> D m By my signature below, I ^ertify to each of the following: I am the property owner or authorized agent to act on the o erty 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 accura . I agree to comply with all applicable local ordinances and state laws relating to building construction. I uthorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 1(1251.3 SUPPLEMENTAL INFORMATION REQUIRED o�tEus>e Oj, y y,' ... ';. " ONR VER-FiIE EXPRESS 0 STANDARD C3 LARGE: n MAJOR' MEPMiscApp_2011.doc revised 06/21/11 �� CITY OF CUPERTINO Ti'7`i Ti T`i C9'TM A WnD — RTTIT .TIIN(i' 111V1410N LaiADDRESS: 10400 Farallone DATE: 11/25/2013 REVIEWED BY: Mendez APN: BP#: 'VALUATION: $5,600 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex Suppl. PC Fee: Q Reg. 0 OT PENTAMATION FURN/AC PERMIT TYPE: USE: $0.00 PME Plan Check: $0.00 WORK remove and re place furnace add a/c to side of sfdwl Permit Fee: SCOPE Suppl. Insp. Fee -.(F) Reg. 0 OT Mech. Plan Check 0.0 1 hrs: $0.00 Phrrrrb. Plan ('heck Mech. Permit Fee: 7MPERMITPlremb. Permit Fee: Other Mech. Insp. 0.0 . hrs $47.00 Other Plumb Insp. _ifech. Insp. Fee: Plumb. lisp. Fee: Elec..Plan (.'hack Elec. Permit Fee: Other £tec. Insp. Etc(. Insx). Fee NOTE: This estimate does not include fees aue to otner vepartments (ie.rturtrttng, ruui•c .. �•n�, •• �, .•�•••••••y ��,•�• --•�•• �� -�� _. _ .... .. - . ___ .._ _-__r____e_t__..__t:._.�,...•,... ......;l..l.l......d ...., n.,lu ..., ncti•nnio !'nnlnrt>hv Hent for addn'I info. "1391 t' csa..& i••w cw u•c o.wr. .............. I FEE, ITEMS /Fee Resolution 11-053 E . 7fj /1113) ..' ..._________ --' ------- FEE -- --- QTY/FEE MISC ITEMS Plan Check Fee: $0.00 I ' # $139.00 Mechanical 1MFR=<100 I Furnace, Forced -Air Suppl. PC Fee: Q Reg. 0 OT 0:0 hrs $0.00 PME Plan Check: $0.00 1 # $70.00 Mechanical IBREMAIR A/C Units (<=10K cfin) Permit Fee: $0.00 Suppl. Insp. Fee -.(F) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 u Mech. Plan Check 0.0 1 hrs: $0.00 Phrrrrb. Plan ('heck Mech. Permit Fee: 7MPERMITPlremb. Permit Fee: Other Mech. Insp. 0.0 . hrs $47.00 Other Plumb Insp. _ifech. Insp. Fee: Plumb. lisp. Fee: Elec..Plan (.'hack Elec. Permit Fee: Other £tec. Insp. Etc(. Insx). Fee NOTE: This estimate does not include fees aue to otner vepartments (ie.rturtrttng, ruui•c .. �•n�, •• �, .•�•••••••y ��,•�• --•�•• �� -�� _. _ .... .. - . ___ .._ _-__r____e_t__..__t:._.�,...•,... ......;l..l.l......d ...., n.,lu ..., ncti•nnio !'nnlnrt>hv Hent for addn'I info. "1391 t' csa..& i••w cw u•c o.wr. .............. I FEE, ITEMS /Fee Resolution 11-053 E . 7fj /1113) ..' ..._________ --' ------- FEE -- --- QTY/FEE MISC ITEMS Plan Check Fee: $0.00 I ' # $139.00 Mechanical 1MFR=<100 I Furnace, Forced -Air Suppl. PC Fee: Q Reg. 0 OT 0:0 hrs $0.00 PME Plan Check: $0.00 1 # $70.00 Mechanical IBREMAIR A/C Units (<=10K cfin) Permit Fee: $0.00 Suppl. Insp. Fee -.(F) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 (Amsh-rction 7 ax: Administrative Fee: IADMIN $44.00 0 E) Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 ®� Travel Documentation Fee: 1TRAVDOC $47.00 Strong Motion Fee: 1BSEISMICR $0.56 Select an Administrative Item Bldg Stds Commission_ Fee: 1BCBSC $1.00 ir$139.56 $209.00 .' 4 ANWM $348.56 Revised: 10/01/2013 CUPERTINO HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinaacupertino.oro l+i�/ ;19I ►i f.`l ���'.7�1 I I il-:i 9T�1 it t�� 1, 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 McAddrm // DrlFI25 EnforcementAjmcy. IJate >:;s /01tOO rur'al&e i Conditioned Duct insulation EQuil)[roentTypeii rst Afmamnm'£cKKen Hoar Area IC Th'rmostat . 13imPackagbd Unit AFUE-� COP J t Over 46 -ft of duct§ Setback indoor Coil S�R� � FISPF _ Servedty system added or replaced im {If riof�4; vdy present, must be Condensing Unit ® EER E3 Resistance sf unconditioned space ®R6 (CZ113S) 1. Equipment Type: Choose the equipment being installed; if more than one_system, use another CF -IR -ALT -HVAC for each system. 2_ iKmimnm 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 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 feahffes and performance specifications for the design identified on this Certificate of Compliant 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 permit application. Name: Signature: (jrra Company / Date: Adams: S7z - License: 2 5 5,Y6 CirylStatelZip: 5 yr// Phone: jlb : 2 2008 Residential Compliance Forms.doc revised 04/10112 CUPERTINO h Building Department REVIEWD-.1 AOR CODE COMPLIANCE Reviewed By: d -' "IT D7PR .Ml ENT y _ i 0, fi s 7 ST he k of at the any or to Offlal. T!, nc:i flOrls S-FIALL NOT vL �I �h. ..d d', f '.Uula..y10n _ 1 1,3,E CUPERTINO h Building Department REVIEWD-.1 AOR CODE COMPLIANCE Reviewed By: d -' IE /3 y _ i 0, fi Scope - Fr,,rzace . JA AJJ nem A16 ( 3oL)etl y�cssa .L �a q0 t, ` fiy Dill CHECKED: By PLANN G DEPT. DATE �� �' 'sFFICE COP BLDG. DEPT. Stree � L ENNI X PRODUCT CATALOG FEATURES Refrigerant System Scroll Compressor Non -chlorine, ozone friendly, R -410A refrigerant. Units applicable to expansion valve systems or RFC systems when matched with specific indoor coils Copper tube construction with enhanced ripple -edged aluminum fins. Fully serviceable brass service valves. Liquid line drier shipped with unit High Pressure Switch Totally enclosed, direct drive outdoor fan motor with sleeve bearings. Louvered steel top fan guard. Cabinet Heavy -gauge galvanized steel cabinet with powder paint finish. Steel louvered panels provide complete coil protection Corner patch plate allows access to compressor. Compressor - five years All covered components - five years Refer to Lennox Equipment Limited Warranty certificate included with equipment for details Model No. A B 13ACX-018 25-1/4 m 13ACX-024 1y . (D 13ACX-030 29-1/4 � "rr �j 13ACX-036 (743) CU 13ACX-042 29-1/4 28-1/4 (743) rrl a i C a. o -7y (718) 13ACX-060 (� 28-1/4 Z C) fn CD Q Compressor - five years All covered components - five years Refer to Lennox Equipment Limited Warranty certificate included with equipment for details Model No. A B 13ACX-018 25-1/4 24-1/4 13ACX-024 (616) (616) 13ACX-030 29-1/4 24-1/4 13ACX-036 (743) (616) 13ACX-042 29-1/4 28-1/4 (743) (718) 13ACX-048 33-1/4 28-1/4 (845) (718) 13ACX-060 29-1/4 28-1/4 (743) (718) R-41 OA SEER - Up to 14.0 1.5 to 5 Tons Page 13 January 2013 Supersedes July 2012 `AHaRI R/�,TINGS See AHRI Ratings Supplement See page 16 Cabinet • Mounting Base • Unit Stand -Off Kit Compressor • Compressor Crankcase Heater • Compressor Hard Start Kit • Compressor Low Ambient Cut -Off • Compressor Sound Cover • Compressor Time -Off Control Controls • Freezestat • Indoor Blower Off Delay Relay • Low Ambient Kit • Loss of Charge Switch Kit • Thermostat Refrigerant System • Expansion Valve Kits • Refrigerant Line Kits NOTE — Due to Lennox' ongoing commitment to quality, Specifications, Ratings and Dimensions subject to change without notice and without incurring liability. Improper installation, adjustment, alteration, service or maintenance can cause property damage or personal injury. Installation and service must be performed by a qualified installer and servicing agency. ©2013 Lennox Industries Inc. General Data Model No. Nominal Tonnage ' Sound Rating Number (dB) Connections Liquid line o.d. - in. (sweat) Suction line o.d. - in. 2 Refrigerant (R -410A) furnished Outdoor Diameter - in. Fan Number of blades Motor hp Shipping Data lbs. -1 package 13ACX- 018 13ACX- 024 13ACX- 030 1.5 2 2.5 76 76 76 3/8 3/8 3/8 3/4 3/4 3/4 3 lbs. 13 oz. 4 lbs. 6 oz. 4 lbs. 4 oz 18 18 18 3 3 4 1/10 1/10 1/5 138 138 144 Product Catalog -Air Conditioners Page 14 January 2013 Supersedes July 2012 13ACX- 036 13ACX- 042 3 3.5 76 80 3/8 3/8 7/8 7/8 5 lbs. 4 oz. 6 lbs. 6 oz. 18 22 4 4 1/5 1/4 151 188 13ACX- 048 13ACX- 060 4 5 80 80 3/8 3/8 7/8 7/8 lbs. 12 oz. 9 lbs. 0 oz. 22 22 4 4 1/4 1/4 195 218 Line voltage data - 60 hz - 1 ph 2081230V 208/230V 208/230V 208/230V 208/230V 208/230V 208/230V 20 30 30 35 40 50 50 3 Maximum overcurrent protection (amps) "Minimum circuit ampacity 12 17.5 18.7 20.1 25.3 31.9 29.4 Compressor - Rated load amps 9.0 13.4 14.1 15.2 28.8 24.1 22.1 Condenser Fan Motor - Full load amps 0.7` 0.7 1.1 1.1 1.7 1.7 1.7 NOTE - Extremes of operating range are plus 10% and minus 5% of line voltage. Sound Rating Number rated in accordance with test conditions included in AHRI Standard.270. P Refrigerant charge sufficient for 157ft. length of refrigerant lines. 3 HACR type circuit breaker or fuse. - 4 Refer to National or Canadian Electrical Code manual to determine wire, fuse and disconnect size requirements V C) D O ®O®npI" ® /MEMBER COMPANY cus OTID Intertek NOTE - Due to Lennox' ongoing commitment to quality, Specifications, Ratings and Dimensions subject to change without notice and without incurring liability. Improper installation, adjustment, alteration, service or maintenance can cause property damage or personal injury. Installation and service must be performed by a qualified installer and servicing agency. ©2013 Lennox Industries Inc.