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14030170l! CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8129 PARK VILLA CIR CONTRACTOR: ATLAS - TRILLO HVAC PERMIT NO: 14030170 OWNER'S NAME: GOPAKUMAR PILLAI 1965 KYLE PARK CT DATE ISSUED: 03/28/2014 OWNER'S PHONE: 4088290695 SAN JOSE, CA 95125 PHONE NO: (408)286 -8931 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ /� �� REMOVE & REPLACE (E) FURNACE & A/C UNITS, SAME License Class— Lie. # `L � LOCATIONS Contract 1 1�t L `U Date 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 Sq. Ft Floor Area: Valuation: $5000 performance of the work for which this permit is issued. 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: 35610054 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 FR T37XELED 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 Z� granting of this permit. Additionally, the applicant understands and will comply Issu with all non -poin s urce re ulations per the Cupertino Municipal Code, Section 9 18. r RE- ROOFS: Signature Dat L /-' 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 Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Secti n 2 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 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 �gY.issJ GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildingQ)cupertino.org ❑ CHANICAL ❑ELECTRICAL ❑ MISCELLANEOUS MEP MISC PLUMBING PROJECT ADDRESS APN # 3S /0 U OWNTFR14AME PHO STREET ADDRESS CITY, ST TE, Z / I FAX �n L CONTACT NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER '❑ OWNER-BUILDER ❑ OWNER AGENT �-40= CTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT y— CONTRACTOR NAME at ' LICE LIC E BUS. LIC # I� COMPANY NAME \ n I I r , Y `�lll 111 v // �VV /t EMAIL q 4 � � � FAX STREET ADDRESS (q CITY, STATE, ZIP ! / '% G (VJ (J L ARCHrrECT/ENGINEERNAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI•FAMIT,.Y PROJECT IN WIIALAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ YES ❑ BUILDING: ❑ COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO PICHLER HOME? NO . DESCRIPTION OF WORK I �� G le a TOTAL VALUATION: s By my signature below, I certify to each of the fo owing I am the property owner or authorized agent to act on the property o er' alf. I have read this application and the information I have provided is er�ect. have read the Description of Work and verify it is accurate. I agree o comply with all applicable local ordinances and state laws relating to building c tructici. ze representatives of Cupertino to enter the above -i ntified pro Arty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQ = oicEUSEOn.. �„z� :�C�OVERTH1+iCOL33�TER XFRESSAW . MEMO ud f STAI�'DARD '-r- ra ev t3 l?3:AitGE MEPMiscApp_2011.doc revised 06121111 CITY OF CUPERTINO FFF. FCTIMATOR — BUILDING DIVISION im, ADDRESS: 8129 PARK VILLA CIR DATE: 03/28/2014 REVIEWED BY: MELISSA UNITS APN: 356 10 054 BP #: *VALUATION: 1$5,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Du lex USE: p # PENTAMATION FURN /AC PERMIT TYPE: i WORK REMOVE & REPLACE E FURNACE & A/C UNITS SAME LOCATIONS SCOPE Supp/, Ills/) P'ce APPLIANCE / EQUIP TYPE FEE ID QTY /FEE QTY UNITS BP FEES A/C Units ( < =10K cfm) 1BREMAIR 1 # $70 Furnace, Forced -Air 1MFR = <100 Supp/, Ills/) P'ce 1 # $139 PME Unit Fee: $209.00 PME Permit Fee: $47.00 C of i,,;tt'It <`ium 747:1': Administrative Fee: 1ADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 TOTALS: Travel Documentation Fee: 1TRAVDOC $209.00 Strang Motion Fee: IBSEISMICR 's_� Mech. Plan Check 0.0 I hrs $0.00 I1f7,ri.b. Plan Che'ct, Mech. Permit Fee: IMPERMIT phimh. F'e rtnil F'v: Other Mech. Insp. 0.0 hrs $47.00 C)ilic r Pl�,mb Insl >. Phmib Iii.sw.7ea: 01sar /"k "(. Inst�. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public worsts, rtre, 3anttary Sewer vtstrtct, moot ..:.:. TL,.... i _ b.. „d __ .G- .....,1:,.,:.,...., ;.,Fur ..Bn., nvnilnhlo and nro only nn adimatP_ Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY /FEE MISC ITEMS Plan Lill t.. ��t£'i'J�, l' ce. 52eppl, Iii h'ee PME Plan Check: $0.00 flerinit Fec": Supp/, Ills/) P'ce PME Unit Fee: $209.00 PME Permit Fee: $47.00 C of i,,;tt'It <`ium 747:1': Administrative Fee: 1ADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 �f�VCd71C't'Ll I1Jt7 {'FiIC1'14T /`'£'L'b': Travel Documentation Fee: 1TRAVDOC $47.00 Strang Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $1.00 w V ®hB.� may. $348.50 s ". $0.00 TOTAL FEE: $34 8.50 Revised: 01/15/2014 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 • building oupertino.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, bu 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 CO}E, 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. • OnIy 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 04110112 She a wis 42 Conditioned Duct insulation Equixnent n -Li'sf'Wmimiaz ,Ertcieri" Fioor:Aiea i °iinostsi t " PackagedtUfut Furnace EER COP �HSPP— i t Sered.by system Oyer 40 8 of dui, added orreplaced m Setback Indoor Coil E3 Resistance sf urcondrtnanedspace... ,iatalreadypremgirvsrbe IITU Condensing Unit EER ®R 6 (CZ I,'3 -S) Other 1. Equipment Type: Choose the equipment being installed; if more than one system, trse another CF -1 R- ALT -HVAC for each system 2. Armimurn Equipment mciencies: 13 SEER, 78 %AFUE, 7.7HS1F for typical residential systems. Contractor pl6annentation Author's /Responsible Designer's Declaration Statement) • I c ettify that this Cer#ificaft of Compliance documentation is accurate and corm fete. • 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 feattrres identified on this Certificate of Compliance are consistent whit the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the t agency for approvah, dth the permit application, Name: T (� Signature: Company: 7+111 a ID .. V ► l Date Address r _ t4 License: City /StawZip: G✓t Phone. U`t _ l3 2008 Residential Compliance Forms.doc revised 04110112 SMOTE / CARBON MONOXIDE ALARMS C1 OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CU PERTIN6 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408),777-3228 • FAX (408) 777 -3333 • build ingacuoertlao or4 Address '6114? PAI1 1� 044A Permit No. 140-301-70 7 % 44 ..R A f....�_ I'LJRPOSa This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420,6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFOIfMATION Existing single - family and multi - family, dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: nA r_ L I SMOKE ALARM CO ALARM. Outside of each separate:sleepng area in the immediate vicinity of the X I x On eve�vel of a Within each slee -oh Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burnang apphanc� and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal, Power Supply: In dwelling.units with no commercial power supply, alarms) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. J k Smoke and CO form.doc revised 03118114