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14040175 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1114 STEEPLECHASE LN CONTRACTOR:CALIFORNIA DELTA PERMIT NO: 14040175 MECHANICAL INC OWNER'S NAME: HAN SU KIM 6056 E BASELINE RD STE 155 DATE ISSUED:04/24/2014 OWNER'S PHONE: 8188075788 MESA,AZ 85206 PHONE NO:(866)692-5273 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL D �Illf y RELOCATE&REPLACE FURNACE TO ATTIC AREA, License Class �`2 Lic.# INSTALL (N)A/C UNIT IN SIDE YARD AREA Contractor� �D.-moi �Q��p���� / 2`'2, / 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:$12750 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:35931035 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 WITHIIN 18 F 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 FRO LED 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 Date: granting of this permit. Additionally,the applicant understands and will comply Lwith all non-point source regula' ns per the Cupertino Municipal Code,Section / RE-ROOFS: ature Date `2 0�// 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 Cupert' icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 533,and 25534. c� Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized a Date: l 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 918. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORR£AVENUE-CUPERTINO,CA 95094-3255 �O CUPERTINO (408)777-3228•FAX(408)777-3333•building cupertino.org ❑NEW CONSTRUCTIONS p ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS y r �! S f _ _ APN# 2 OWNER NAME •1 I.� r E(,U( /1PH� J -hrJ J E-MAiL J STREET ADDRESS ( j I �} � I�/ Cts,.,STA r FAX CONTACT NAMsJ�1 C P r �3�E1' Q r�U' / ,d��tni isC ! rehan t L/ 1 �Y STREET ADORES C. � CITX, zIP F S�;3266! O` 6_to fa X2175' 0 OWNER ❑OWNER-BUI D)ER ❑OWNERAGENT NF moil ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ° LICENSE NUMBER •,L LICENSETYPC3(rp BUS.LIC# 3�3�S QQ 3 f COMPANY NAMEMAtL FAX 1" Eawce,kou4tL&A-Llatvt, -8ar73 STREET ADDRESS / 064 I•GA6t:"Me-96-4 I55 CITY STATE,DPr3� a' � Q�w�r PHONE i0 �°l iG..'�Yr a dV•P `� ARCHrfECTIENOINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME - E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE f t DESCRIPTION OF WORK A frj!_ � I� �yi./� r �� ��L� r /7•�� 11 G ,- j� l t s EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES f } USE TYPE OCC, SQ.FT. VALUATION(S) E EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA - TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH OATTACH t #DWELLINGUNITS: ISASECOND UNrr OXEs SECONDSCORY DYES BEINGADDED? �'NO ADDrrION? O PRE-APPLICATION O YES IF YES,PROVIDE COPY/OF IS TBE BLDG AN ❑YES __. - Y;: ThT 1 T DATION: A!VA PLANNINGAPPL# ONO PLANNING APPROVAL LETfER EiCBLERHOME? ONO By ray signature below,I certify to each of the following: I am the property owner oriz eat to on th ro er's behalf-TUve read this application and the information I have ovided is correct. I have read the Description of Work and veri it is ur agree to comply with all applicable local ordinances and state Paws xela' ¢constrtr 1 attglgrize representatives of Cupertino to eater y identified property for inspection purposes. Signature of Applicant/Agent Date: SUPPLEMENTAL INFORMATION REQUIRED PLANCAECKTYPE ROUTING SLIP. _New SFD or Multifamily dwellings: Apply for demolition permit for © OYER-'FSE=COUN3'ER ❑ BtALDINGPLANREVIrsW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC woRKs To—nit if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to p M. roil ❑ SANITARY SEMR DISTRICT submittal of Building Permit application. t ❑ ENVIRONMENTAL-REALTH BldgApp_2011-doc revised 06/21111 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 1114 STEEPLECHASE LN DATE: 04/24/2014 REVIEWED BY: MELISSA APN: 359 31 035 BP#: *VALUATION: 1$12,750 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY PENTAMATIOIN FURN/AC USE: SFD or Duplex PERMIT TYPE: WORK RELOCATE & REPLACE FURNACE TO ATTIC AREA INSTALL N A/C UNIT SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) _dl 1BREMAiR 1 # $70 Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: $209.00 .�SMF 1 � 01 Mech.Plan Check0.0 hrs $0.00 phonb.Pleat Clk"ek Mech.PermitFee: IMPERMIT Plumb. Pct mit P�cr; f rr Yana,=�f�r�: Other Mech.Insp. 0.0 hrs $47.00 Other Plumb Ires` , El Ofhuu'Eic'( Inss). il(:c,. fp'v),f :r: flhanb. Insp. I1ee_ 1','/e( Ins") 1, ; " NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS Plan PME Plan Check: $0.00 SiffJljl. 77,4'/) '£' , PME Unit Fee: $209.00 PME Permit Fee: $47.00 (,YC)Pd:S{r'I.ICLion Tax: Administrative Fee: IADNIIN $44.00 Work Without Permit? ® Yes (E) No $0.00 /2c/V'UI: (At Planning Fees: Travel Documentation Fee: ITRAVDOC $47.00 i Strong Motion Fee: 1BSEISMICR $1.28 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 „o $349.28 $0.00 4e TOTAL FEE: $349.28 Revised: 04/01/2014 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CP-IR-ALT-HVAC \ Climate Zones 1,3-7 Site Address: Enforcement Agency: Date: Permit#: 1114 Steeplechase Lane Cupertino, CA 95014 City of Cupertino Apr 22, 2014 jgo yp Duct insulation Conditioned Floor i. Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ®Package Unit p Furnace ®AFUE 78% Q COPQ R 6(CZ 1 3-5) Served by system ®Setback p Indoor Coll ®SEER 13.0 Q HSPF If not already present,must be p Condensing Unit Q EER Q Resistance O R 4.2(CZ 6, 7) 13 0 sf installed) Q Other 1,Equipment Type:Choose the equipment being Installed,if more than one system,use another CF-1 R ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER,7801.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 features and performance specifications for the design Identified 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 approval with the permit application. Name: Brian Cannon Signature: Brion Connor Company: CALIFORNIA DELTA MECHANICAL INC Date: Apr 22, 2014 Address: 6056 E BASELINE ROAD#155 License: 811114 City/State/Zip: MESA/AZ J 85206 Phone: (619)229-6800 i i 's is ;. l+r} r '� s- a i a yi3 f 7 34 � h N ff `'17 .., ..; 7 Fti1�'.' �� yrM•:. P'�,,.,;.`y;n:Nm �{R'M}�a�Y �z,.:4 lv� : • t .. z:�• i i e i Reg: 214-A0028004A-000000000-0000 Registration Date/Time: 2014/04/22 17:41:50 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forms July 2020 Yo Oul CO II INF r np pnr i',i T DEPARTMENT W 41�`� APPROVED Thi-z�,^t of pians and specifications MUST be kept at the J ,Ct ;n cat ix a,construction. It is unlawful to make any c ic,q?,;ges of alterations on same,or to deviate A 7 thsre.from,without approval from the Building Official. .� T. 31 The st.irnping of this plan and specifications SHALL NOT � E ti lar.i lwl to pears' val of theviolation is ons nance or State Law. (� BLDG. DEPT. PER M- IT NO. '_' t1! �J Iola VN ' G �O RECEIVED Lth .APR 2 4 2 114 ey �Q BY 41,��c '2,, t