14080079 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 11590 UPLAND WAY CONTRACTOR:PELLE HEATING&AC PERMIT NO: 14080079
INC
OWNER'S NAME: YEE CHARLES L AND PEI L 3751 D CHARTER PARK DR DATE ISSUED:08/11/2014
OWNER'S PHONE: 4082577660 SAN JOSE,CA 95136 PHONE NO:(408)978-7060
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL [:]
1?V9 i�r�rZ REMOVE AND REPLACE FURNACE AND A/C UNIT
License Class Lie.#
Contractor C' ate
I hereby affirm that I am licensed under the provisions of hapter 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
Ve
ance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11505
nd will maintain Worker's Compensation Insurance,as provided for by
3700 of the Labor Code,for the performance of the work for which this APN Number:36651002.00 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 1 AYS 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 DA OM LAST CALLED 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
Issued by: Date:
granting of this permit. Additionally,the applicant understands and will comply /
with all non-point so rce regulations per the Cupertino Municipal Code,Section
9 18.
RE-ROOFS:
Signature DateV40 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 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 25 5,25533,and 25534.
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 APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinahap ertino.or MISC CUPERTINO cuD
❑PLUMBING MECHANICAL [:]ELECTRICAL ❑MISCELLANNEO,U�S�
PROJECT ADDRESS 1 {r 0j f') �/17t�.7I,, X11 APN#
OWNER NAME J v w• `/illi PHONE LY E`-JMAILI/�(�
(o(bo Ch o_s e e e Nwmst.
STREET ADDRESS 115010
15 `l J 'Wr IVPW
ITY,STATE,ZIP 5® FAX
CONTACT NAME f�I- Qnn, PHONE,� TQ(00
fQ � �pA�.�, ,��, ��� +0^L
STREET ADDRESS (�� � � �'f
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ) 'CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAM LIC SEB R LICENSE TYPE BU IC#
COMPANY NAME 1 /� E-MAIL FAX 44
o
STREET ADDRESS 1-� j•� C Y,STATE,ZI �`)' PHOe .1 t OG O
ARCHITECT/ENGINEER NAME LICENSE NUMBER S BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or DUPLEX ❑ MULTIFAMILYPROJECT IN WILDLAND ❑ YES PROJECT IN YES IS THE BLDG AN ❑YES
BUILDING ❑COMMERCIAL UFRBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO
DESCRIPTION OF WORK • O
1 � ani'111. L t rJ►1P.tt.-
TOTAL VALUATION: 1 RECEIVED BY:
r l S O VV ,,_._....... _ ...___.
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the propertya . I have read this
application and the information I have o ided is correct. I e re the escription of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b '1 Ing co ction. authori esentatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date:'SMPZZ i
LEMENTAL NF.,MMATIONREQUIRED o�FLCEusEOIVIY
w OVER-TItE COUNTER
D EXPRESS
STANDARD
U
LARGE
CI MAJOR'
MEPMiscApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 11590 upland way DATE: 08/11/2014 REVIEWED BY: Mendez
APN: BP#: *VALUATION: 1$11,505
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Du lex PENTAMATION FURN/AC
USE: p PERMIT TYPE:
WORK remove and replace furnace and a/c unit
SCOPE
's
Mech.Plan Check 0.0 hrs $0.00 Plurrrb. Plena("heeit 1 �>_'. f t arz C,neck
Mech.Permit Fee: 1MPERMIT Ph4mb. Permit Fee, &,r r r=f`e,
Other Mech.Insp. 0.0 hrs $48.00 odwr Plrrrnb Inylo 0/faer�F car. hgSP.
I hI11tb. Iris 1. F"e", Im"
2�Lj
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 onl an estimate. Contact the Dept-for addn'l info.
FEE ITEMS (Fee Resolution 11-053 FA.' 7/1/13) FEE QTY, MISC ITEMS
Plan Check Fee: $0.00 I I # Mechanical
Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $143.00 IMFR=<100 Furnace,Forced-Air
PME Plan Check: $0.00 1 # Mechanical
Permit Fee: $0.00 $72.00 IBREMAIR A/C Units(<=10K cfm)
Suppl. Insp. Fee:Q Reg. 0 OT0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $48.00
Administrative Fee: IADMIN $45.00 0
Work Without Permit? ® Yes (E) No $0.00 E)
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Documentation Fee: 1TRAVDOC $48.00 Building or Structure A
Strong Motion Fee: IBSEISMICR $1.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
As
$143.50 $215.00 r. TOTAL FEE: $358.50
Revised: 07/10/2014
t
A ,
� a
COMMUNITY MANAGEMENT SERVICES, INCORPORATED
August 6,2014
Charles Yee
Pei Yee
11590 Upland Way
Cupertino,CA 95014-5104
Re: SEVEN SPRINGS OWNERS ASSOCIATIONS
11590 Upland Way
Dear Homeowners:
Enclosed you will find a copy of your Architecture Application for the installation of a new air conditioner,
with the approval from the Board of Directors,as well as any restrictions or conditions that the Board
deemed necessary.As per your application you are placing the condenser in the exact same location as it
was previously.
Please fill out pALgM the iiardpded$nal completion firm which will begin the completion process.
Please keep in mind that any deviation from your approved application will require you to resubmit your
application for review.If you utilize an unapproved material you will be required to remove and replace the
material with an approved selection.
The approval of your project's architectural compatibility with the Seven Springs Owners'Association's
complex does not constitute or imply,that the Architectural Committee and/or the Association Board of
Directors deem your project as meeting City of Cupertino/County of Santa Clara codes.The approval is
given contingent upon you and/or your contractor(s)obtaining the required construction permits and
meeting all code requirements,if any.
Sincerely,
Commun aa4gorn Services,Inc.
Luis Here ta,Senior Association Manager,CCAM
SEVEN SPRINGS OWNERS ASSOCIATIONS
LH/nm
cc Board of Directors
File 94
1935 Dry Creek Road,Suite 203• Campbell CA•95008-3631 .voice(408)559-1977 •fax(408)559-1970
Seven Springs Owners Association
Application for Approval of Architectural Change/Addition
CATEGORY C
Category C-Modifications that are exterior modifications with no changes to the original building structure or floor plan.All roofing,
siding,window material change,exterior paint color change,addition of a roof attic fan,or garage door,fall into this category.
Date: / / V YRequest for Approval of Proposed Change
PLEASE PRINT THE FOL;L. ,'tlk/IN INFORMATION
Name: Lt .S Address: -
i
Home Phone: A1,12 , Work Phone:
email: . _
Description of Proposed Change:
1)Paint Color Change:Please choose from"approved list"(Garage door outer trim should be diamond white or frost)
Fxferinr,S`/dlit�s Color&Guruire door(s)-,crew coli},,specified color
Trim color:diamond white—or frost Front door color:diamond white._.–..frost—natural oak or specified"approved
color"
2)Roofing Material Change(please check one choice)
a. Lightweight Concrete Tile from MonierLifetile-style"Cedarlite 5780",color"Muirwood"
b.GAF Laminated Fiberglass Asphalt-style"Grand Canyon",color"Mission Brown"
c.GAF Laminated Fiberglass Asphalt-style"Grand Canyon",color"'Stonewood"
d.Decra Stone Coated Steel Rood System-style"Decra Shake",color"Shadowood"
e.Class"A"Fire Retardant Roofing System using pressured treated cedar wood shingles with fire retardant fiberglass cap sheet
underlay.Need to have a City of Cupertino Permit accompanying this application for all wood shingle roots. -_-_
3)Siding Material Change(Please check one choice)
Siding Material:I lardiplank Cedarmill(wood grain finish) or Hardiplank Smooth Finish
Which sides are you are changing material?(front_back_left_right_)
4)Window Material and Design change:(Please check this box):Vinyl Windows-color White
*Must include manufacture also Include cut sheet for type and style of windows.Retrofit -New Constr.
5)Adding a roof attic fan,Tubular Skylight,Air Conditioner(location of Condenser),and Satellite Dish �''"
Please attach information regarding the proposed change Application must include dimension,color of the proposed fan and its
location on the roof.Please include detailed drawings,specifications,and product brochures if available.
Tubular skvlight up to 14"diameter, one roof attic fan up to 26"in width&height–paint to match roof
6)Garage doors:
a.Recessed wood panel,not raised in center same style for windows("PLAIN"–non decorative)
Style 84(8 panels across,64(6,panels across),44(4 panels across).Style_with windows or Style_no windows
b.Insulated wood,insulated metal w/wood facing or"Carriage House"style 303C windows,303 no window
7)Solar System:Adding solar panels to the roof of home.
(Requires drawing indicating placement of panels and photo for type of panel to be installed)_
et ie�*�s**ie Rx9r is iriat**iexxA#fir ye+kirxk iek fr.*iYYs 'YIIf aY Lis'isEftat*9rk4e�nk4fkkirYi�ir-frkxle it 4fF F R$Yie<liyfrxix.F t*Ir ie ixii ie iir
Homeowner's Signature:.
The request is in compliance with Seven Springs HOArchitectur Guidelines:http://seven-springs.org/files/architectual-guidelines-pdf
Architectural Control CommitteeBoard: Approved end:i'ng_-
Denied Pending _ :r
Architectural Control Committee Board:3igua Date:
1.27.11 cat C
Attachment 1
Description of proposed changes:
Replace existing furnace and air conditioner with matched Bryant Preferred Series with
Certificate/Energy Star rated:
• Bryant 96.1% efficient 2-stage 5 ton 100KBTU gas furnace model
925TA60100E21,
• Bryant 5 ton 15 SEER Air Conditioner model, 126BNA060 with matched ADP
coil model, C60A2101-366.
New air conditioner condenser location is the same as the old condenser location (see
drawing on Page 2 below).
STATE OF CALIFORNIA
ALTERATIONS - HVAC -
CEC-CFIR-ALT-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-03-E
Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1)
Site Address: E forcement Agency: Date Prepared: Permit#:
t1590 M.Pl,-�Vo A14W tflIJAJ.YI U 9/76 11V
Type Equipment Equipment T e E ui fficienc Ne :Ducting,Plenums,Lineset Conditioned
q p y Required R-value Floor Area(sq ft) Thermostat
El Packaged System ❑Evaporator Coil AFUE COP 13R-6 (CZ 1,3-7)Ducts Served by system Setback
Nf R-8' (CZ 16)Ducts 124 1 q (If not already
JSplit System `f�Condensing Unit SEER sq ft
HSPF ❑R-6(all CZ's)Plenums present,must
Furnace 34 Lineset EER ❑R-5 or R7.5 LinesetaI be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
for is allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
T.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
Can include new ducting
All Equipment, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS
Air Handler/Furnace CF3R:MECH-20-HERS
Installer Requirement:Duct leakage(<15%or,<10%to outside,or seal all accessible leaks)
Exempted from duct leakage testing if:
❑1.Duct system registered with HERS provider as previously sealed,or❑2.There is less than 40 linear feet of duct in unconditioned
space,or ❑3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New DuctS2 CF1R-ALT-02-E
CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS
CF3R-MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS2
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow z 350 CFM/ton(or Standards Table 150.0-C/D alternative)
A 3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
Includes replacing or installing All New CF111-ALT-02-E
Ducts2 and one or more of the following: CF2R-MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS
Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS
Installer Requirement:Duct leakage<6%,Air Flow 2 350 CFM/ton(or Standards Table 150.0-C/D alternative)
❑Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos.
4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
Adding or replacing ducts in unconditioned CF1R-ALT-02-E
space but less than All New Ducts2 CF2R:MECH-20-HERS
CF3R:MECH-20-HERS
Installer Required to:Duct leakage(5_15%or,<10%to outside,or seal all accessible leaks)
❑ Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos.
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
2 A New Duct system is when the duct system is constructed of at least 75 percent 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,plenums,duct material.
3 R-5(1"thick insulation)for linesets 1"and less. 11-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%8',2.5-3T-2%",3.5 to 4T-2%",5T-4%"
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. 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(CCR).
4. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR.
S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Resppoonsiblle,Designer N e. Respo ible Designer Sign re: Date Signed: License:
PLtor
City/State/Zi3 v1�!� A lax l �assistarde or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300
� 1
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC) (Page 1 of 3)
Project Name: Yee,Charles Date Prepared: 2014-07-30
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 CFiR-ALT 02 document for each dwelling unit.:
01 Project Name: Yee,Charles 02 Date Prepared: 2014-07-30
03 Project Location: 11590 Upland Way 04 Building Type: Single family
05 CA City: Cupertino 06 Dwelling Unit Name: Yee,Charles
Dwelling Unit Conditioned
07 Zip Code: 95014 08 2494
Floor Area(ft2):
Number of space conditioning
09 Climate Zone: 4 10 (SC)systems being altered in 1
this dwelling unit.:
B.Space Conditioning(SC)System: i of mation
01 02 03 04` tib 07 ` 08 09 10
TI
tntat i) -new : is-the entire
components? duct system
(packaged unit,or accessible Are all of the
condensing unit, Installing for sealing, system's
is the,altered Altering or or more than 40 and is more components
or installed installing a cooling/heating linear feet of than 75%of and ducts new
SC System SC System CFA served system a refrigerant coil,or new or the duct or replaced?
Identification or Location or Area by this SC ducted containing air-handling unit, replacement system new (entirely new
Name Served System(ft2) system? component? etc) ducts? or replaced? system) Alteration Type
Entirely new or
Yee,Charles Whole House 2494 Yes Yes Yes Yes Yes Yes complete replacement
space conditioning
system
Registration Number:214-A006505BA-000000000-0000 Registration Date/Time: 2014-07-30 09:35:49 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 09:34:44
a ,r
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 3)
C. Extension of Existing Duct System,Greater Than 40 Feet(Section 150.2(b)1Diib)
This section does not apply to this project.
D.Altered Space Conditioning System(Sections 150.2(b)1E and F)
This section does not apply to this project.
E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 150.2(b)1E, F)
This section does not apply to this project.
F.Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C)
01 02 03 � 04 05 Q6 `a 07 08 09 10 11
Heating Cooling
System HeatMinitnti Con ing Minimum Required
Identification or Heating System AlteredF3ng° ffficie Effrctency =�600litt - #iterecooit>tg Efficiency- Efficiency Thermostat New Duct
Name Type Component Type Value System Type Component Type Value Type R-Value
Central gas A(Irtevu heating Central split All new cooling SetbackTher
Yee,Charles furnace components AFUE .96 AC components SEER 16 mostat R-6
Required Documentation:
CF2R-MCH-03-E-Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums:R6.
CF2R&MR-MCH-20-H Duct Leakage Verification required.
-Leakage rate compliance:5 6%.
CF2R&CF3R-MCH-22 Fan Efficacy Verification
CF211&CF3R-MCH-23 System Air Flow Rate Verification
-Compliance:Fan Efficacy<_0.58 W/cfm and System Airflow 2_350 cfmAon.
-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:214-A0065058A-000000000-0000 Registration Date/Time: 2014-07-30 09:35:49 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 09:34:44
e f
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Sanchez,Rafael
Company: Signature Date:
PELLE HEATING&AIR INC 2014-07-30 09:35:49
Address: CEA/HERS Certification Identification(if applicable):
179 SAN RAMON DRIVE
City/State/Zip: Phone:
SAN JOSE CA 95111 (408)978-7060
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and;Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and performance specifications,materials,com0onents,and manufactured devices,f the building design or_systgm design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part 1 and Part:6 of the California.;Code of RQ Mations.
4. The building design features or system design features ide6t�ed on,,is Certificate of Compliance arecohsistent with the information py�yided'on other applicable compliance documents,worksheets,
calculations,plans and specificationssubmitted toahe enforcement a gncy for approval with this 4,ildmg permit application.
S. I will ensure that a registered copy of this CertifirreX.e of Cp t�liance sW0,11 be made av�lable withtiZtWildirrg ermitf s�iasued for he17w>ldirlgnand rnatie,available to the enforcement agency for all applicable
inspections.I understand that a registered copy ofthis Certificate ofCompliance is required to be inclutled with the documentation the Wilde provides to the building owner at occupancy.
Responsible Designer Name: Responsible Designer Signature: e�C E� ��Llll
Sanchez,Rafael
Company: Date Signed:
PELLE HEATING&AIR INC 2014-07-30 09:35:49
Address: License:
179 SAN RAMON DRIVE 809887
City/State/Zip: Phone:
SAN JOSE CA 95111 (408)978-7060
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document,and in noway implies Registration Provider responsibility for the accuracy of the
information.
Registration Number:214-A0065058A-000000000-0000 Registration Date/Time: 2014-07-30 09:35:49 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 09:34:44
C'an Iq�i{e s yee
t15g0 uniaM�l w�
PLOT PLANS
CHECKED BY
17 A91> I 1A
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VF-11
COMMUNITY DE LOPMEf4dT DEPARTNttoopy
BUILDING D f�RlUPERTINOttu�At�.
This set of plans anc specifications MUST be keptthe
job site during consiruction. It is unlawful to ma a any
changes or alterations on same, or to daviat � DePe�ellt.
therefrom, without pproval from the Buildi„� 0 cial. 1Bui�d�n9
The'Sta ' of this plan and specifications S!IALL NOT
e �
be hel mit of to be an approval cf :'-,- ,+iol tion
Aar, ron o any City Ordinur. 0Fpe\AeWGD�pLiP�O�
OK
ON
�. _:. ed gy.