14060157J
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1272 POPPY WAY
CONTRACTOR: ONE HOUR HEATING
PERMIT NO: 14060157
AND AIR
OWNER'S NAME: KANCHANA SANTHANAM
1400 PETALUMA HILL RD
DATE ISSUED: 06/25/2014
OWNER'S PHONE: 4085284807
SANTA ROSA, CA 95404
PHONE NO: (707) 545 -1800
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E]
ADD (N) A/C UNIT IN REAR YARD AREA
License Clas �C(/ J Z Lic. # 7 y qQ 7
Contractor Date
I hereby aff that I am licensed under the provisions of Chapter 9
(comme ng 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: $7500
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 36619043 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 DA H3 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
S LAST C 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 Ithe,
ued by: Date:
granting of this permit. Additionally, the applicant understands and
with all non -point source regulations per the Cupertino Municipal Code, S n
9 18.
RE- ROOFS:
Signature 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
Section 3700 the Labor Code, for the of the work for which this
the Health & Safety Code, Sections 25505, 25533, and 25534. ^�
of performance
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
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
9 18.
Signature Date
GENERAL PERMIT APPLICATION O\ A E P
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • buildin0(a7CUDettno.orq M I S (;
. — ISCLOtS �nT Tn inr y/-- n 1,=ru e T.TTreT —M.F.CTRMAT- IMI
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PROJECT ADDRESS 2 7 /� P P Y CA,-
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STREET ADDRESS CITY, STATE, ZIP
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❑ CIAWEM Q 0"ANUM -B=ML ❑ OWN� ACE2'S ZCOATRACTOR ❑ CON- MIXTOR AGEMr
❑ ARCei cT ❑ ENGlln ,-R ❑ DLIIELO ?ER ❑ TENAlTI
CONTPJ CI OR KAI✓E I LICzT'SE NM44 O /��j /�
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FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SM., DUPLEX ❑ MULTI - FAMILY I PROJECT 7N WILDLAND ❑ YES I PROJECT IN ❑ YES
BiJ1I-DING: ❑ COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ 1Q0
I IS THE BLDG AN ❑ YES
EICHLER HMM? ❑ NO
DESCRIPTION OF WORK /—/ /^ ac "t 0 k
TOTAL VALUATION: 2 _ nom- .� .ta-.. _- z,�-�� �� --�.•
By my sign-re below, I certify to each of the following: I am the property o,%Nmer or authorize o act on the prope vn is behalf. I have read tEs
application and the information I have provided ect. I have read the Description of Wori and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to buildi _ ns tion. I authorize representatives of Cupertino to enter the abov ° ° -i ''entified roper ty for inspection purposes.
2
Signature of Applicant/Agent: Date: C� � 1'y
S I 14TAL INFO P- MATION REQUIRED
OBFICESETaZ
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1vtEP1v isc1pp_2011.doc revised 06121111
CITY OF CUPERTINO
1 1PIPIPi. F.CTTMATnR — RITTI,DINf MVISION
APPLIANCE / EQUIP TYPE
ADDRESS: 1272 POPPY LN
DATE: 06/25/2014
REVIEWED BY: MELISSA
UNITS
APN: 36619 043
BP #:
*VALUATION: 1$7,500
rEERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE: p
#
PENTAMATION FURN /AC
PERMIT TYPE:
WORK
A/C UNIT IN REAR YARD AREA
SCOPE
��)
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
A/C Units ( < =10K cfm)
1BREMAIR
1
#
$70
PME Unit Fee:
$70.00
PME Permit Fee:
$47.00
T-T-
Administrative Fee: IADMIN
$44.00
Work Without Permit? 0 Yes Q No
$0.00
TOTALS:
Travel Documentation Fee: ITRAVDOC
$70.00
Strom; Motion Fee: 1BSEISMICR
Mech. Plan Check 10.0 1 hrs $0.00 1 Phunh. Plan t:' /tcc.�k
FMech. Permit Fee: 1 MPERMIT 1 lure >. Perm,"', fee
Other Mech. Insp. 1 0.0 1 hrs 1 $47.001 orht,r Plunib Irisp.
1',=WnL fl2sp. Fee:
ofbu, - 1>k:- .
NOTE: This estimate does not include fees due to other Departments (t.e. Flanntng, ruot)c worKs, rtre, aanuary newer uturtcc, ocnooc
_ art _ _ r - -- ,. _ L,. ,..J ,.,. 11.,... ..n.,.. .:......... :..£n...,nhns. n ..ilnRlo nad nro nrrly nn actimnta_ t"nntart the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 Eff. 711113)
FEE
QTY/FEE
MISC ITEMS
Stlppl PC F—
PME Plan Check:
$0.00
PME Unit Fee:
$70.00
PME Permit Fee:
$47.00
T-T-
Administrative Fee: IADMIN
$44.00
Work Without Permit? 0 Yes Q No
$0.00
Pc: %L`td12C't'Cf t'IC1Pli1ing Fees:
Travel Documentation Fee: ITRAVDOC
$47.00
Strom; Motion Fee: 1BSEISMICR
$0.75
Select an Administrative Item
Bldy- Stds Commission Fee: IBCBSC
$1.00
YS' TS'
$209.75
$0.00 TOTAL FEE: '
$209.75
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 - buildina tupertino.ora
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 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 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.
• 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.
• 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 ddras:
Z a
Enforcement Agency:
Dazr-, - P
6 "
I
Conditioned
Duct insulation
Equipment Type,
-Li sfWmijunim Effi cien��2
-Floor
Packaged Unit .:
OF
M Coil
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system
I
Over 40 8 of dn�s
added or fe'l' ijdc6a in
Setback
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Condensing Unit
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EER
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sf
uncandition ed space
07
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MR6 1, 3-5)
(CZ
6
Other
1. Equipment Type; Choose the equipment being installed-, if more than one_system, use another CF-1R-ALT-HVA.0 for each system.
2. Alinimum Equipment Efficiencies: 13 SEER, 78% 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 a=pt responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance, speicifications 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 an this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, plans and specifications submitted to the enfi t agericy for approval with the pen-nit
application.
Name:
Company:
'4�
Date:
- (�. 2
Address
License: 0
civlslwzlzip-' ro'�'i
Poe:
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2008 Residential Compliance Forms.doc revised 04110112
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RECEIVED
,JUN 2 5 2014
BY
4-
N. =
RM,
CUPERTINO
Address
SMOKE / 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 • building(a-cupertino.orq
FILE
IN�EC��S 7
PURPOSE
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 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.
w ., .a ,14 . oo f., nn h, with iha icrm_c and nnnrlitinns of this statement
Owner (or Owner Agent's) Name:
(/►V //�\`' // �,pyc) {(�1�i t +��
Sinature ........ ....... .... ......•....... G�J•:•••••�•:•••••••••••••••. ..........................Date: ."g... ..).1..
Contractor Name:
Signature.................................... ............................... Lic.# ....... ............................... Date: ...................
Smoke and CO form.doc revised 03118114
r�
S' rescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF -iR- ALT -HVAC
Climate 1nes 1, 3-
Site Address:
Enforcement Agency:
Date:
Permit #:
1272 POPPY WAY CUPER INO, CA 95014
City of Cupertino
Jun 16, 2014
Duct insulation
Conditioned Floor
Equipment Type1
/St Minimum Eficiency2
requirement
Area
Thermostat
❑ Package Unit
® Indoor Coil
❑ AFUE
® SEER
p COP
[3 HSPF
E3 R 6 (CZ 1, 3 -5)
Served by system
® Setback
If not already esent must be
y P
® Condensing Unit
[3 EER -
[3 Resistance
E3 4.2 (CZ 6, 7)
1500 sf
installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -1R- ALT -HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% 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: Kevin Schaff
I Signature: Kevin Schaff
Company: BIGHAM SERVICES INC dba ONE HOUR HEATING & A/C
Date: Jun 16, 2014
Address: 1400 PETALUMA HILL RD
License: 740999
City/State /Zip: SANTA ROSA / CA/ 95404
Phone: (707) 545 -1800
FILE
.,
t06 Dids-7
Reg: 214- A0043651A- 000000000 -0000 Registration Date /Time: 2014/06/16 11:40:52 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010