14040170 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10740 BROOKWELL DR CONTRACTOR:RESCUE AIR SERVICE PERMIT NO: 14040170
OWNER'S NAME: ERIC AND ANGELA LEUNG 6007 MAJORCA CT DATE ISSUED:04/24/2014
OWNER'S PHONE: 4085685628 SAN JOSE,CA 95120 PHONE NO:(408)655-9916
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
REPLACE&RELOCATE FURNACE TO ATTIC AREA&
License Class C Lic.# 2Q ' ADD(N)
41 ��` �4 A/C UNIT IN SIDE YARD AREA
Contractor ��SCV� IV(- 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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$9280
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Laboir Code,for the performance of the work for which this APN Number:36921040 00 Occupancy Type:
rmit is issued. G,�v,(�
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 WITfIIN 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 FRO ED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ,A
costs,and expenses which may accrue against said City in consequence of the Z
Date:
granting of this permit. Additionally,the applicant understands and will comply Is Y
with all non-point source regulations per the Cupertino Municipal Code,Section
9 18.
1-2.. t RE-ROOFS:
Signature c xr `��C- Date 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. 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 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this / f L�
Owner or authorized agent:����G4 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
r
i
re
GENERAL PERMIT APPLICATION b�
` MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ` 1r
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CLIPERTINb (408)777-3228•FAX(408)777-3333•building a�cupertino.oro misc
❑PLUMBING LJMECHANICAL []ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS 1 d_AL�O 1 I
7APN# 5 - 2 ( / 0 ,(0
OWNER NAME M'2�s, a PHONE ,^ E-MAIL
STREETADDRESS I"Lkr CITY, STATE,ZIP „-R FAX
CONTACT NAME. PHONE ''\ ` CA
STREETADDRESS(,Oti-, '_^�\ r� CITY,STATE,ZIP
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT U CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMEV.; LICENSE NUMBER , LICENSE TYPE(:� BUS.LIC# Lq
COMPANY NAME QeSCWe N\-(- E- GL� , FAX
`OM1YAj�
STREET ADDRESS � �\ CITY,STATE,ZI C4 AS\Zv P"!T I$
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OFSFU.,DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES
BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA �DNO FLOOD ZONE 'Q-l1Q0 EICHLER HOME? VAO
DESCRIPTION OF WORK 1
n-ev"j M
TOTAL VALUATION:
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the properly owner's behalf. I have rcadAink
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agr a applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: 2-4
SUPPLEMENTAL INFORMATION REQUIRED
;,DT FICE;IISE QN,i✓X�,'
" EYKSS, '
� STANDARD
MEPMiscApp_2011.doc revised 06121/11
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
all ADDRESS: 10740 BROOKWELL DR DATE: 04/24/2014 REVIEWED BY: MELISSA
APN: 369 21 040 BP#: *VALUATION: 1$9,280
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition / Repair
PRIMARY SFD or Duplex PENTAMATION
USE:
p PERMIT TYPE: FURN/A
WORK REPLACE & RELOCATE FURNACE TO ATTIC AREA&ADD N A/C UNIT IN SIDE YARD AREA
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
A/C Units (<=1 OK cfm) 1BREMAIR 1 # $70
Furnace, Forced-Air 1MFR=<100 1 # $139
TOTALS: $209.00
Meeh.Plan Check0,0 hrs $0.00 .Plxrrrrh. Pfurr C'hc:c� E7ec. f'1<zr Check
Mech.Permit Fee: IMPERMIT Phnnb. Pe:rrust Fee: GI<:r PE-rau!,, ,
rj'j"1her Mech.Insp. 0.0hrs $47.00 0iher�Phimb'In>p. el-lee Invr'< fta.=�.f��:e: Plttrariz tus��. 7'ez� 1 icf.I zs, i°C(
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Theseees are based on the prelimina information available and are only an estimate. Contact the Dept./or addn7 info.
FEE ITEMS (Fee Resolution 11-053 E f L 13) FEE QTY/FEE MISC ITEMS
Plan Check k r'°'CC.
:5'z ppl. PC];'C '
PME Plan Check: $0.00
PME Unit Fee: $209.00
PME Permit Fee: $47.00
6,on:stt ucrIir)rr f"a:
Administrative Fee: 1ADMIN $44.00
Work Without Permit? 0 Yes (E) No $0.00
A'dvance'i Plarmh111;'Fifes:
Travel Documentation Fee: ITRAVDOC $47.00
Strong-Motion Fee: IBSEISMICR $0.93 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
q �IUT 'hfi $348.93 $0.00 ' TOTAL FEE: $348.93
s :
Revised: 04/01/2014
HVAC ALTERATIONS ENERGY COMPLIANCE FORM
L` COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
CUPERTIN0 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building ancupertino.org
WHEN IS A PERMIT REQVIRED
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 Boardworkingin conjunction with the local building department. This action may
consist of fines up,to $5,000 -per violation or suspension/revocation of a contractor's license.
2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS
INCLUDE:
L Heating equipment must have a minimum 78%AFUE (Exception: Wall &floor furnaces; room
heaters).
2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2.
4. A setback type thermostat(24 hr clock with four set points) is required for all alterations.
5. New or replacement ducts must meet the mandatory requirement of Section 150(m).
• All joints and openings in the HVAC system must be sealed.
• Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct
openings.
• Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened.
Flex ducts must be connected using a metal sleeve/coupling.
• FIex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no
more than 2"of sag between supports and 6 ft. max for vertical runs.
6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector
will collect this form and verify that the model numbers are the same as the installed equipment.
2008 Residential Compliance Forms.doc revised 04/10/12
:
X.
ShppIified Proscriptive Certificate of Compliance 2008 Residential., AC Alterations CR-IR-ALT=AVAC
Climate Tones 1 and 3-?
S;teAddrerr Enfj cerrrent.4rcy: fffe±,x Perrrrif.#
40.1 Lir 0 �'U01C�.ie�
Consfitioned Duct insulation
Eq
. ... 3 ''.Ir$tivlmineien �^ 'Floors s -F
d U r r�' over 40:ft of dacas
Furnace �AFL1E Q Setback
Served by system added orrepho d to
Indoor Cod [ SR ECOP
IiSPF t (Ifrrotarrreadyprrsart auslbe
Condensing Unit ®EER LI Resistance �sf rttoned spans -
Other. ,
R 6 (CZ 1,3-5) ,
1.Equipment Type:Choose the equipment being installed,if more than one-system,use another CF-1 R-ALT HVAC.for each system.
2.Afinimnru Equipment Efficiencies:13 SEER,78%AFUF,7.7HSIIF for typical residential:systems.
Contractor(b6ttirdentatiou Author's/Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and cotimlete:
• I am eligible under Division 3 of the California Business and Professions Code to acogpt responsibility for the design identified,on this
Certificate of Compliance.
• I certify that the energy features and performance.specifica ions 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 areconsistent with the information documented on other applicable
compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement.agency for aper( al.zvith the permit
application. _
Name: C Un Vj tr Signature:
Company: sqf\i<e t. 1�, Date ; fit
Address- �OON- Q t C License: Z 20
City/State/Zip: So"n S vZ; Phone: LkO_(CSS- M
,,.
2008 Residential Compliance Forms.doc revised 04110112
DEPARTMENT
BUILDiNu-Di"fiSION
CUPERTINO
TH2,-sc-t ay,py
MmS and sps-c2
ifications MUST be k(-Pt at the FAV-cO�
ig cOl-is"TUction. It is unlawful-0 make any
4
01,Ce,or to QC— (Neu"
;'ndeviate
"Q' Wit
LhOUt approval froni the Building Official.
P,�
Th'StqMpinq of this plan and specifications SHALL NOT -2:-2
held to permit or to b-A LO
be
ation
of any prov 0
e or State Law. CHECKED .By
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DATE DA
up,
PERMIT NO. PLAINNIATG DEPT.
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