14060032CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11496 LINDY PL
CONTRACTOR: JIM'S AIR
PERMIT NO: 14060032
CONDITIONING
OWNER'S NAME: KASIK MARTIN A AND SHARON K TR
917 QUERCUS CT
DATE ISSUED: 06/06/2014
OWNER'S PHONE: 4088883066
SUNNYVALE, CA 94086
PHONE NO: (408)655 -0491
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
REMOVE & REPLACE (E) FURNACE, SAME LOCATION
�/ / f
C -A 0 �
License Class Li,. # N-� (R
Contractor �w.3 14 t��[f14d1�1`�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.
�.
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: $3500
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 35624007 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 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 Ts -P-EP SSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DAYS INSPEC O
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
said City in consequence of the
costs, and expenses which may accrue against
granting of this permit. Additionally, the applicant understands and will comply
y:
with all n n of urce regulations per the Cupertino Municipal Code, Sect"
9 18.
- ROOFS:
being installed. If a roof is
Signature Date �/
All roofs shall be inspected prio o any roofing material
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 r . Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sect' s 2 505 2 33, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Dater
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
G
CONSTRUCTION LENDIN 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
•
GENERAL PERMIT APPLICATION O IWEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 b
(408) 777 -3228 - FAX (408) 777 -3333 • buildinagouoertino.oro• � m I S
I— IDTI f rm- rTz Awnr .&7. 7F.TRrTRTCAL I— (MISCELLANEOUS
PROJECT ADDRESS // / f „�JI' �� I AP•N-#
PHONE
STREET ADDRESS / IC'�S (� 11 l �1' I CITY, STATE, ZIP ey l l �O SSD I FAX
CONTACT NfiA/t ^. 1 1 PHONE Fr1JiAIL �OII e ✓ ( �� Ci (. Calf,
� t Ll l S 7t'i 0- 4 66 r i� �E
ST REET 4DDRESS CITY. STAin, ZIP F•SX
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❑ 0"MEM El OW . -BUR DER ❑ OtL'1 •e�t. t AGENT Y CONTRACTOR ❑ COT'IRACTORAGE.'T ❑ ARMI1TECT ❑ ENGINEER ❑ DE«APrR ❑ TENANT
CONTPJ CrOi�j� *ANa� LJCENS NUIJBE LICENSETYPE
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BUS. LIC
COMYAIdY NA Ym — n
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STREETADDPESS G^I /�J NC�
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ARCH=JEINGINEER NAhM LICENSE NUMBER
I BUS. LIIC R
COMPANY NAI as
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I FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or DUPLEX ❑ MULTI-FAMILY I PROJECT IN WIIALAIM ❑ YES I PROJECT A* ❑ YES
BUILDING: ❑ COMMERCIAL tMAN NUERFACE AREA NO FLOOD ZONE 101"o
I IS THE BLDG AN ❑ YES
EICHLER H01, ME Z NO
DESCRIPTION Or' WORK
TOTALVP.LUATION'
By my signature below, I certify to each of the following: I am lie property ov, mer or authorized agent to act on the pro O'vner's a . I have rea
application and the information I hav r lffe ' orrect. I have read the Description of Work and verify it is accun . I comply vrith all applicable loci
ordinances and state laws relating to it i c 'on orize representatives of Cupertino to enter the above - //identified property for inspection purposes. Signature of Applicant/Agent: Date; ��p`
SUP LEMEAITAL INTFORMATION RE Q TJ=D
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MEPI✓iscApp 2011.doc revised 06 121111
CITY OF CUPERTINO
1PIRF. FCTIMATOR — RITII,DING DIVISION
APPLIANCE / EQUIP TYPE
ADDRESS: 11496 LINDY PL
DATE: 06/06/2014
REVIEWED BY: MELISSA
UNITS
APN: 356 24 007
BP #:
*VALUATION: $3,500
PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
p
#
PENTAMATION FURN /AC
USE:
Pcnlzil FCC'
PERMIT TYPE:
WORK
REMOVE & REPLACE E FURNACE SAME LOCATION
SCOPE
PME Unit Fee:
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
Furnace, Forced -Air
1MFR = <100
1
#
$139
Pcnlzil FCC'
PME Unit Fee:
$139.00
PME Permit Fee:
$47.00
Uofi_4lj1 vChOn Tax:
Administrative Fee: IADMIN
$44.00
Work Without Permit? ® Yes (F) No
$0.00
TOTALS:
Travel Documentation Fee: ITRAVDOC
$139.00
Strong Motion Fee: IBSEISMICR
Mech. Plan Check 0.0 hrs $0.00 Plumb. Plan C hed 1: 1ec' 1' /an Check
Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: l "W( Perirru F(e'
Other Mech. Insp. hrs $47.00 Otlae, Plumb Ins.n. �> '7'T 1 ='' <:' IFS 7.
0.0
i- hzt'/a. Ittslz 14sa: I'72arnL. lush. Fee: 1:ict. 15 sp lees::
NOTE: This estimate does not include fees due to other Departments (i.e. manning, rumac worKs, rare, aanarary newer uistncy Jc/LOVL
Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 Ef . 7f /1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
.`,'cfppl7 P ` l`c''
PME Plan Check:
$0.00
Pcnlzil FCC'
PME Unit Fee:
$139.00
PME Permit Fee:
$47.00
Uofi_4lj1 vChOn Tax:
Administrative Fee: IADMIN
$44.00
Work Without Permit? ® Yes (F) No
$0.00
A 0 , VUW"e!d l' urming =ties:
Travel Documentation Fee: ITRAVDOC
$47.00
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bide Stds Commission Fee: IBCBSC
$1.00
��
$278 50
$0.00 ; ' TOTAL FEE:
$278.50
Revised: 04/01/2014
i
t
r
Sim Baled Prescri tine Certificate of Compliance; 2008 Residential HVAC .Alterations CF- 1R- ALT -VAC
Climate Zones 1 and 3 -7
Manufacturer.
Model Number.
T
.� /A4 %d i J76 i
Site address:
Enforcement Agency:
Date:
Permit No- j
.
EquipmentT }pe'
List &-finimum Z
Conditioned
Duct Insulation
Thermostat
Ef &cicn
Floor area
requirement
• Packaged Unit
XkFUE
oCOP
Served by
Over 40 ft of ducts
ASethack
Furnace
oSEER
o14SPF
system
added or replaced
(f not already-
• Indoor Coil
oEER
oResistance
sf
in Unconditioned
present, mast
• Condensing. Unit
space
be installed)
• Other
o R 6 (CZ 1, 3 -5)
1. EquipmentType: Choose the equipment being installed; if more than one system, use another CF- IR -aI:r-
14VAC for each system. .
2. i%=iinimum Equipment Efficiencies: 13 SEER, M4 AFUE, 7.7 HSPF for typical residential systems.
Contractor (Docutnetitatioua author's /Responsible Designer's Declaration Statement)
e I certify that this Cera&cate of Compliance documentation is accurate and complete.
o I am eligible under Division 3 of the California Business and Professions Code to accept responsibility
I-or the design identified on this Certificate of Compliance
e I certify that the enetg}= features and performance specifications for the design identified on this
Certificate of Compliance confotrtt to the requirements of Title 24, Parris i and 6 of the California
Code of Regulations.
G The design features identified on this Certificate of Compliance are consistent 'With the information
documented on outer applicable compliance forms, -,norksheets, calculations, plans and specifications
submitted to the enforcement agency for approval frith the permit applica .
Name. a• e Signature:
Com an P Nl !`+� D4 J Date: -`
:address: 717 906ECO-5- License No.: �
Cit1- /State /Zi :
Phone No.: _
Planting rlpprot,91-
Setback from property:
311AAV /311,JAV
4 -Way Multipoise Induced Combustion Gas Furnace
Sizes 645 thru 15
Series F E:: :DJW
Product Data
downflow venting, 13 different venting options, and a door
designed for easy service access. An inner blower door is provided
for tighter sealing in sensitive applications. The 311AAV /JAV
furnace is approved for use with natural or propane gas, and the
311JAV is approved for use in Low NOx Air Quality Management
Districts.
STANDARD FEATURES
• Noise elimination combustion system
• SmartEvap'° can lower the humidity level in the home by
nearly 10%
• Four - position furnace: Upflow, Horizontal Right,
Horizontal Left, Downflow
Thirteen different vent options
PL�� • Compact design only 33 -113 in. (846 mm) tall
�" • Microprocessor based "smart" control center
Fan on Plus - - Continuous Fan speed adjustable from
thermostat
Al 0253
The Plus 80 Deluxe 4 -Way Multipoise Gas Furnace offers
outstanding features in an 80% AFUE furnace. Deluxe features
include: third fan relay for discrete continuous fan speed, the
ability to change continuous fan speeds from the thermostat (Fan
on Plus -), dehumidify mode, fault code storage, and more. The
Plus 80 is very quiet thanks to a new combustion design that
eliminates noise, rather than just muffle or box it in. Applications
are easy with 4 -way multipoise design, through- the -fumace
Adjustable heating air temperature rise
Dehumidify mode
Enhanced diagnostics with LED and reflective sight glass,
non - volatile fault code memory, and self -test feature
On -board fuse for transformer protection
• Certified to leak Z percent or less of its nominal air
conditioning CFM delivered when pressurized to 1 -In.
Water Gauge with all present air inlets and air outlets sealed.
• Patented blocked -vent safeguard to ensure proper furnace
venting
• Insulated blower compartment
• HYBRID HEAT® Dual Fuel System compatible
• All models are chimney friendly when used with accessory
vent kit
• Twinning in Upflow, Downflow, and Horizontal
• Perfect Light'" Igniter
• Residential installations eligible for consumer financing
through the Comfort Credit Program
SPECIFICATIONS
1111E 1 p�
RATINGS AND PERFORMANCE
Input Btuh* 311JAV Upflow; all 311AAV
Nonweatherized ICS 311JAV Downflow /Horizontal
44,000
04 YO
44,000 65,000 66,000 66,000
042090
88,000
1748086
88,000
42,000
42,000 63,000 63,000 63,000
84,000
84,000
Output Capacity (Btuh)t 311JAV Upflow; all 311AAV
Nonweatherized ICS 311JAV Downflow/Horizontal
35,000
36,000 53,000 54,000 53,000
71,000
71.000
34,000
34,000 51,000 51,000 51,000
68,000
68,000
AFUEt
80.0
80.0 1
80.0 80.0 80.0
1 80.0
80.0
Certified Temperature Rise Range - ° F (° C)
30-60
(17 -33)
20-50
(11 -28)
40 -70 30 -60 25-55
(22 -39) (17 -33) (14 -30)
40 -70
(22 -39)
30 -60
(17 -33)
Certified External Static Pressure Heat/Cool
0.10 /0.50
0.10/0.50
0.12/0.50 0.12/0.50 0.12/0.50
0.15/0.50
0.15/0.50
Heating
Airflow CFM#
Cooling
ELECTRICAL
Unit Volts -Hertz -Phase
865
1250 720 1195 1450
1375
1505
835 1160 870 1200 1530 1385 1720
115 -60 -1
Operating Voltage Range Min -Max
104 -127
Maximum Unit Amps
5.2
7.0
5.1
6.8
9.5
8.2
10.0
Maximum Wire Length (Measure one way in Ft (M)
49 (14.9)
39 (11.8)
51 (15.5)
40 (12.1)
29 (8.8)
34 (10.3)
28 (8.5)
Minimum Wire Size
14
Maximum Fuse or Ckt Bkr Size (Amps) **
15
Transformer (24v)
40va
External Control Heating
12va
Power Available Cooling
35va
Air Conditioning Blower Relay
• ••
Limit Control
Standard
SPST
Heating Blower Control
Solid -State Time Operation
Burners (Monoport)
2
2
3
1 3
3
4
4
Gas Connection Size
GAS CONTROLS
Gas Valve (Redundant) Mfr.
Min. inlet pressure (In. W.C.)
Max. inlet pressure (In. W.C.)
1/2-in. NPT
White- Rodgers
4.5 (Natural Gas)
13.6 (Natural Gas)
Ignition Device
Hot Surface
Factory- installed orifice
BLOWER DATA
Direct -Drive Motor HP (PSC)
Size 43
1/5 1/3 1/5 1/3 1/2 1/3 1/2
Motor Full Load Amps
2.8
5.2
2.8
5.2
5.2
5.2
7.9
RPM (Nominal)- Speeds
1075 -3
1075 -4
1075 -3
1075 -4
1075 -4
1075 -4
1075 -4
Blower Wheel Diameter x Width - In. (mm)
10 x 6
(254 x
152)
10 x 6
(254 x
152)
10 x 6
(254 x
152)
10 x 6
(254 x
1 152)
11 X8
(279 x
1 203)
10 x 8
(254 x
203)
10 x 10
(254 x
254)
* Gas input ratings are certified for elevations to 2000 ft. (610 M). In USA, for elevations above 2000 ft. (610 M), reduce ratings 4 percent for each 1000 ft. (305
M) above sea level. Refer to National Fuel Gas Code NFPA 54 /ANSI 2223.1 -2012 Table F.4 or furnace installation instructions.
t Capacity in accordance with U.S. Government DOE test procedures.
# Airflow shown is for bottom only return -air supply for the as- shipped speed tap. For air delivery above 1800 CFM, see Air Delivery table for other options. A
filter is required for each return -air supply. An airflow reduction of up to 7 percent may occur when using the factory- specified 4 -5/16 in. wide, high efficiency
media filter.
** Time -delay type is recommended.
ICS Isolated Combustion System
Address
M
•
SMOKE I CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • buildinga- cupertino.org
— - - - i L/ /) / /-) /1 Z ?__
PURPOSE
This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section 8314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORMATION
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:
AREA .
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances 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, alarm(s) 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.
t haye read and agree to comp Vith the terms and conditions of this statement
Owner or Owne Na
J
lAg)ent
. i
.. .. .............. .... .................. Date Si nature . .................4f..... ...... ..`...
Cont actor Name:
Signature............................... .......... ..... .... ................. Lic.# ....... ............................... Date: ...................
Smoke and CO form.doc revised 03118114
J