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14040153CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10973 WILKINSON AVE CONTRACTOR: AIR QUALITY HEATING PERMIT NO: 14040153 & AIR OWNER'S NAME: JAIN NITIN 720 NORTHRUP ST DATE ISSUED: 04/21/2014 OWNER'S PHONE: 3174176886 SAN JOSE, CA 95126 PHONE NO: (408)293-7138 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ADD (N) A/C UNIT IN SIDE YARD AREA & REPLACE (E) License Class �� Lic. # V& FURNACE, SAME LOCATION Contractor &I n P` — UAjJM !, Date '9 I hereby affirm that I am licensed under the provisions of Chapter (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: $13000 erformance of the work for which this permit is issued. 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: 35613031 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 P SSUANCE 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 F S D 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 Is with all non-point source regulations per the Cupertino Municipal Code, Sectio 9 18. 4 RE-ROOFS: Signature — DateAll P"i roofs shall be inspected prior to any roofing material being installed. If a roof is U- 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. 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 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, 25W3, 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 10 GENERAL PERMIT APPLICATION` E P COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1 (408) 777-3228 • FAX (408) 777-3333 • buildina(ftupertino.org MISC OUPIEATINO IACf-crA'KTTrAr T FrTPTr'AT. nMISCELLANEOUS MEPMiscApp_2011.doc revised 06/21/11 PROJECT ADDRESS Off / /®m APN # S / l / 2 .— 2 PHONE `3 / j O OWNER NAME Al I i� E-MAII, STREET ADDRESS a /� 4,Crry,STATE, ZIP, FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT C� ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME � LI ENUMBEp% Lj 'AIS LICENSETYPE BUS. LIC# COMPANY NAME r E-MAIL FAX STREET ADD—;I-.Z fir CITY, STATE ZIP t9 17 2-1 PHOT (� f ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI -FAMILY PROJECT IN WIIDLAND ❑ YES PROJECT IN YES IS THE BLDG AN [3 YES BUILDING: ❑ COMMERCIAL URBAN INTERFACE AREA O FLOOD ZONE O EICHLIIt HOME? NO DESCRIPTION OF WORK 011 TOTAL VALUATION: �� EIYEDB:.. `��?_�� rv#Y .... 5,x.2::' "e""_R..`' By my signature below, I cert4 tcrekh of the following: I am the property owner ora ized agent to act on the property ov< alf. I have read this application and the information I have provided is.correct. I have read the Description of VzTork and verify it is accurate. I agre o omply v ith all applicable local ordinances and state laws relating to buildin o tion. I authorize representatives of Cupertino to enter the abov -i entified operty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED ; T3ATER E L=TH)1CO75 M. 7CPRES�Sr•�s��=�: �- U-m s � STANII'ARD� �1- TWIN I aa ,..OR a MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO WN FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10973 WILKINSON AVE FEE ID DATE: 04/21/2014 REVIEWED BY: MELISSA APN: 35613031 BP#: *VALUATION: 1$13,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex # —j-PENTAMATION PERMIT TYPE: FURN/A C WORK ADD N A/C UNIT IN SIDE YARD AREA & REPLACE E FURNACE SAME LOCATION SCOPE 1 # APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES A/C Units (<=1 OK cfm) 113REMAIR 1 # $70 Furnace, Forced -Air 1MFR=<100 .`r L1Tpl' tt(:p!-'eu 1 # $139 PME Unit Fee: $209.00 PME Permit Fee: $47.00 Administrative Fee: 1ADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 TOTALS: Travel Documentation Fee: ITRAVDOC $209.00 Strong Motion Fee: 1BSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt otr 1 Thoco fooc aro hacod an tho nroliminary infarmatinn availahle and are anly an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Man Chcck Fee: sfppl. P Pee" PME Plan Check: $0.00 1L'Yil't1d �`c'L': .`r L1Tpl' tt(:p!-'eu PME Unit Fee: $209.00 PME Permit Fee: $47.00 Administrative Fee: 1ADMIN $44.00 Work Without Permit? ® Yes 0 No $0.00 ljdi 'U'mee'L / rC7773iZf?€% `i?YS: Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: 1BSEISMICR $1.30 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 Py- $349.30 $0.00 . TOTAL FEE: $349.30 Revised: 04/01/2014 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 -cuoertino.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 • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconfitioned 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 suspensionfrevocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24, Part 6) REQUIREMENTS INCLUDE: 1. Heating equipment muist 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. • FIex 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. The CF-6R-MECH-04!i'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 She Addresx Enforceine gerrcy: A i3rrf'.ti ,;= `� Permit. # "" 1(0/ 1 .. / . Yd Con itioned Duct insulation Egtiment Typei P8Clcaged'UmtE_U mace COP g ' Served by system er 40 bf dards ; 8 added or replaced in etback Indoor Cot? SEi;it� HSPF �' 1z sf unconditioned space {If not tdready present, must be onderising Unit °� EER_ Resistance ®R 6 (CZ 1, 3-5) Lnimer .. 1. Equipment Type: Choose the equipment being instal]4 if more than one _system, use anotltcr CF-I R-ALT EiVAC for each system. 2 Aflaimum Equipment Efficiencies: 13 SEER, 78% AFUE, VESPF for typical residential systems. Contractor (Documentation Author's /Responsible Defi„aner's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and coiiiplete: • I am eligible under Division 3 of the Califoruia Business and Professions Code to accept responsibility for the design identified, on this Certificate of Compliance. • I certify that the energy features and performance'speciffications for the design identffied on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 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 appro ai,with the permit application__ Name: Signature: Company: fil 17 411 ih Dater k Address. License: City/Stateaip: Phone; _ . 3 2008 Residential Compliance Forms.doc revised 04110112 0 Al, ® m y W y b4 c- �, am a m $ as 4V6 w a H Q � o A W y ` ON I F� 'RAM �� • . ' r -- IN M-wV.` r O{ as 4V6 w a H Q � o A