14070056 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19978 RODRIGUES AVE CONTRACTOR:ATLAS-TRILLO HVAC PERMIT NO: 14070056
OWNER'S NAME: KUMAR SUBRAMANI 1965 KYLE PARK CT DATE ISSUED:07/14/2014
OWNER'S PHONE: 6509066869 SAN JOSE,CA 95125 PHONE NO:(408)286-8931
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
/� —7 �3 REMOVE&REPLACE(E)FURNACE &A/C UNITS,NO
License Class Lic.# e I-:C 2 DUCT
Contractor
�,t �=A T ( U Date FORK INCLUDED
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
rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$5000
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:36904047 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 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 F LLED 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 `
ate:
granting of this permit. Additionally,the applicant understands and will comply a by:
with all non-poi t source egulations per the Cupertino Municipal Code,Section
9 18. `)
LRE-ROOFS:
&a,e,
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)
1,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 asdefined by t e Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with t rtino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec25534. 1
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
GENERAL PERMIT APPL[GATEON � ME P
4 COMMUNITY DEVELOPMENT DEPARTMENT•BU1LDlNG DIVISION ryO
10300 T ORRE AVENUE• CUPERTINO, CA 95014-3255
e u ryfft;rC t•%Q
(408) 777-3228• FAX(408)777-3333-buiidinoecuoe tino.ora MISU
❑PLUMBING - ❑RMMA'NICAL ❑ELECTRICA-L ❑MISCELLAAT.OUS
- 1'0 qPROirCrADDRESS �A I APN R y O(/ O J( �i
`i e ( T
O�".TNER NAS � PH .�C V (� r„ _ E-IJ 4II.
I-O&A
ST?_7tIfDDPBSS Vl/^►✓ I CTiY, S �f c �/ I FAX
COh'rACT NArr : ( PHONE I E-]JikT�
ST?.=c.1.SDDPsSS (� CITY,STATF,,ZIP I FAX
❑ OA%-a ❑ O(-W1,M-BUU_1)ML ❑ OVTMAGENT ❑ hTR4CTOR ❑COI.TfL1,CTORA AT ❑ A?,=7 CT ❑ NG�J L—R ❑ DEIN LO? ❑ .c iTI
COI�PACTORN LIC' rR`� O I LJCDT t E I BUS.LIC.
COIOAN1 NAIS" L FAX
l r r I .CITY,STATE,ZIP S/�(� I °!�
STP----.T ADDP.ESS IKD > ( J V
ARCh7Br_T/ENGII,7.�.RNAhf I LICrT'SENUI/3ER. I LIC.
CON,PANyNANM_ B-WATT- I FAX
STREET ADDRESS cay,STATE,ZIP PHONE
USE OF ❑SFD or DUPLEX ❑ MULTI-FAI,ffi.Y I PROJECT LN WILDL ND ❑ YFS I PRO=It1 ❑YES I IS Thr BLDG AN ❑YES
svuDrHc ❑CDMI.ERCLAL URBAN D. AREA p NO FLOOD ZONE ❑NO EICR=_ Hoi,�=? ❑ t"o
DESCRIPTION OF WORK
TOTAL VALUATIO SL y
By ny signature blow,I certi�y to each of the 12-M dhe property o-%;,?er.or authorized agent to u:, pe, ov en's behalf. I have read this
application and the info oration I have prov' ed T or,ec. I have read the Description of Work and verify it is accu-ste. I a�*ee to comply v ith all zpplicable local
ordinances and state laws relating to buil ng cons I authorize representatives of Cupertino to enter the above-id e Iii, d t for inspection purposes.
Si--natureof AppticanJAgent: Date: ✓�
SUPPLEMEI\TTAL LNFORNLkTION REQTJ=D V
o —
_ � T
kiEP)t isc.�pp 2011.doc revised 06/21 1
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
W�PERMIT
DDRESS: 19978 RODRIGUES AVE DATE: 07/14/2014 REVIEWED BY: MELISSA
PN: 369 04 043 BP#: "VALUATION: $5,000
PE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition / Repair
PRIMARY SFD or Duplex PENTAMATION FURN/AC
USE: p PERMIT TYPE:
WORK REMOVE & REPLACE E FURNACE &A/C UNITS NO DUCT WORK INCLUDED
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
A/C Units (<=1 OK cfm) 1BREMAIR 1 # $72
Furnace, Forced-Air 1MFR=<100 1 # $139
TOTALS: $211.00
Mech.Plan Check 0.0 hrs $0.00 Pfrrmh. Plum C hech kiec_Piz"
Mech.Permit Fee: 1MPERMIT Plumb, I'E rmif 1'ee. 1 "f r i<<�
Other Mech.Insp. 0.0 hrs $48.00Other Plumb 7nsp oihet'1:1cc h'sg::
SMOKE / CARBON MONOXIDE ALARMS FAS
7�10300TORRE
ERTIFICATE OF COMPLIANCEEV PMENT DEPARTMENT•BUILDING DIVISION
AVENUE• UPERTINO, CA95014-3255
CUPERT1 0 •FAX(408)7 -3333•building(a)cupertino.orgo Permit No.
A dress #of Alarms Smoke: Carbon Monoxide:
i°
PU POSE
This a idavit is a self-certifica ' for the installation of all required Smoke and Carbon Monoxide Alarms for
complian ith 20 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 X X
bedroom(s)
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
e-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.
l have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
Sinature...........................................................................:......................................Date: ..................
Contractor Name:
Signature...................................................................Lic.#......................................Date: ...................
Smoke and CO form.doc revised 03/18/14
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
CEC-CFIR-ALT-02-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CFIR-ALT-HVAC) (Page 3 of 6)
Project Name: f Date Prepared:
D. Altered Space Conditioning System(Sections 150.2(b)lE and F)
01 02 03 04 05 06 07 08 09 10 11 12
Heating Cooling New or
System Altered Heating Minimum Altered Cooling Minimum Required Replaced New
Identification or Heating System Heating Efficiency Efficiency Cooling System Cooling Efficiency Efficiency Thermostat Duct Dud
Name Type !N Component Type Value Type �C,o/mponents I
y Type
Value Type j Length �Rt-Value
1D
WO
Required Documentation:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums:R6.
CF211&CF3R-MCH-20-H—Duct Leakage testing required when heating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced.
-Leakage rate compliance: 515%,or 510%leakage to outside,or seal all accessible leaks.
CF2R&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in C22,8-15).
CF2R&CF3R-MCH-23 Air Flow 2:300 CFM/ton required when MCH-25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Dud Leakage Testing requirements.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH-23,or Refrigerant Charge MCH-25.
Existing duct systems constructed,insulated or sealed with asbestos are exempt from MCH-20 Duct Leakage Testing requirements.
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards-2013 Residential Compliance lune 2014
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
CEC-CFIR-ALT-02-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF1R-ALT-HVAC) (Page 4 of 6)
Proje Name: Dale Prepared:
E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)IE,F)
01 02 03 04 05 06 07 08 09 10 11
Heating Cooling
System Altered Heating Minimum Cooling Minimum Required
Identification or Heating System Heating Efficiency Efficiency Altered Efficiency Efficiency Thermostat New Duct
Name Type Component Type Value Cooling System Type Cooling Components Type value Type R-Value
Required Documentation:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums:R6.
CF2R&CF3R-MCH-20-H Duct Leakage Verification required.
-Leakage rate compliance:5 6%.
CF2R&CF311-MCH-22 Fan Efficacy Verification
CF2R&CF3R-MCH-23 System Air Flow Rate Verification
-Compliance:Fan Efficacy15 0.58 W/cfm and System Airflow 2 350 cfm/ton.
-Alternative Compliance: CF2R&CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH-22 and MCH-23 verification.
CF2R&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
Exceptions:
Heating-only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
Note:
An"entirely new or replacement duct system"means at least 75 percent of the duct system is new duct material,and up to 25 percent may consist of reused parts from the dwelling unit's existing
duct system(e.g.,registers,grilles,boots,air handler,coil,plenums,duct material)if the reused parts are accessible and can be sealed to prevent leakage
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards-2013 Residential Compliance June 2014
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
CEC-CFI R-ALT-02-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF1R-ALT-HVAC) (Page 1 of 6)
Preje Name: Dale Prepare0: 1 J/�
A.GENERAL INFORMATION
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,use one CF1R-ALT-02 document for
each dwelling unit.
01 Project Name: 02 Date Prepared: 4-11
03 Project Location: za ve s- 04 Building Type: CC�
05 CA City: 06 Dwelling Unit Name:
07 Zip Code: 05W 1 08 Dwelling Unit CFA(ft2):
09 Climate Zone: 10 Number of space conditioning(SC)systems
IL
In this dwelling unit:
B. Space Conditioning(SC)System Information
01 02 03 04 05 06 07 08 09 10
CFA served Is the SC Installing a
SC System SC System by this SC system a refrigerant Installing new SC Installing more Installing Installing
Identification or Location or Area System ducted containing System than 40 feet of entirely new entirely new
Name Served (ft2): system? component? components? ducts? duct system? SC system? Alteration Type:
(^-C I Q-e5 AID 0 NO NO baw,
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards-2013 Residential Compliance June 2014
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
CEC-CFI R-ALT-02-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF1R-ALT-HVAC) (Page 2 of 6)
P,.IM Name: Date Prepared:
C. Extension of Existing Duct System,Greater Than 40 Feet(Section 150.2(b)1Diib)
01 02
System
Identification New Duct
oName R-Value
« N
Firs «
t system of calculated
Type C in Section field:if A09=CZ
8 above>> 1-10,12,13,then
"R-6.";else if -
A09=CZ i1,14.16
then"R-8."
Required Documentation:
CF211-MCH-01-E-Space Conditioning Systems Ducts and Fans
-Dud insulation requirement for new plenums:R6.
CF211&CF3R-MCH-20-H—Duct Leakage Verification
-Leakage rate compliance: 515%,or 5 10%leakage to outside,or seal all accessible leaks
Exceptions:
Existing duct systems constructed,insulated or sealed with asbestos are exempt from MCH-20 duct leakage testing requirements
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards-2013 Residential Compliance June 2014