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14080009
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 948 FERNGROVE DR CONTRACTOR:PELLE HEATING&AC PERMIT NO: 14080009 INC OWNER'S NAME: GUINN LISA A AND STEPHEN H 3751 D CHARTER PARK DR DATE ISSUED:08/01/2014 OWNER'S PHONE: 9564231773 SAN JOSE,CA 95136 PHONE NO:(408)978-7060 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL � _ � k_/ INSTALL 2 INSIDE & 1 OUTSIDE SPLIT SYSTEMS(HVAC) License Class �y /T Lic.#/ ► Jf Contractorpa//f �} �—Rk�-t Date I hereby affirm that I am licensed under the provisions of C apter 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:$9000 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:37538024 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 FROM ALLED 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 granting of this permit. Additionally,the applicant understands and will co ssue a e: with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. RE-ROOFS: SignatDate C 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 505,25533,and 5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agen : 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 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 000 MEP ELI] COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPER'TINO (408)777-3228• FAX(408)777-3333•buildinga-cupertino.orq \� MISC PLUMBING LJ,MF ELECTRICAL MISCELLANEOUS PROJECT ADDRESS 014i�,Y V0 y. � APN# OWNER NAME �r '; � PHONE ��, Ij�� E-MAIL �../ STREET ADDRESSqqfiCITY, STS TE,ZIP FAX r+ vw pwy N:oi CONTACT NAME PHONE E-M IL " _ . fot a. zj STREET ADDRESS & CI STA ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ,CONTRACTOR ❑CONTRACTOR AGENT ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICE E NUMBER LIC NSE TYPE BUS.LIC# . C�,20 COMPANY NAMEek 40 y'( E- AIL � .n FAX ssh4obd Cd STREET ADDRESST TE, P PHONE` T S 64K 0115 IS(D 40% ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN W ILDLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO EICHLER HOME? ❑NO DESCRIPTION OF WORK t o i».tkdd Vn Q. Fu; +I} Z y41e--SS 5124- S + + 7ilSlSD �f1�R� t�IS�e crr��e. F� t�sv Si 1 2u,�,e. v Ips vi► TOTAL VALUATION: j�}11 v��M w By my signature below,l certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. 1 have rea application and the information I have provide is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b nstruction. 1 authorize re entatives of Cupertino to enter the above-i enti ed property for inspection purposes. Signature of Applicant/Agent: SUPPLEME AL INFORMAlEOVIZEQUIRED btcp�Jy w ❑ ovER c© N�te LARGE a ❑ MAJOR MEPMiscApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 948 FERNGROVE DR DATE: 08/01/2014 REVIEWED BY: MELISSA APN: 375 38 024 BP#: *VALUATION: 1$9,000 TPERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: A WORK INSTALL 2 INSIDE & 1 OUTSIDE SPLIT SYSTEMS HVAC SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $72 Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: 1 $211.00 Mech.Plan Check 0.0 hrs $0.00 Phunh. Pl on C7x<r(; Mech.Permit Fee: IMPERMIT f'Iwmh P mir I,ee' i Lter Mech.Insp. 0.0 hrs $48.00 {?;het•mum!)7ns.p of/wr'U""c'. h"Sil" '� 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'l info. FEE ITEMS (Fee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 C' r PME Unit Fee: $211.00 PME Permit Fee: $48.00 Administrative Fee: ]ADMIN $45.00 Work Without Permit? 0 Yes 0 No $0.00 Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $1.17 Select an Administrative Item Blda Stds Commission Fee: IBCBSC $1.00 A> k $354.17 $0.00 TOTAL FEE: $354.17 Revised: 07/10/2014 STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CF1R-ALT-03-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1) Site Address: Enforcement_Agency: Date Prep red: Permit#: DV A'Y v -- 2�i 14 Equipment Type Equipment Efficiency New.Ducting,Plenums,Lineset Conditioned Thermostat Required R-value Floor Area(sq ft) ❑Packaged System ❑Evaporator Coil VIIA_AFUE COP ❑R-6 (CZ 1,3-7)Ducts Served by system WSetback Split System Condensing Unit ,SEER [3R-8' (CZ 16)Ducts �sq ft (If not already HSPF 13R-6(all CZ's)Plenums present,must ❑Furnace X Lineset EER ❑R-5 or R7.5 Lineset3 be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form 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. ❑1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can include new ducting All Equipment, CFIR-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 113.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ....... S$2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts2 CF111-ALT-02-E CF211-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>_350 CFM/ton(or Standards Table 150.0-C/D alternative) 113.All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF1R-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>_350 CFM/ton(or Standards Table 150.0-C/D alternative) ❑Exempted from duct leakage testing 1 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(:.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. R-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%s",2.5-3T-2%",3.5 to 4T-2ye",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. 5. 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 permik application. Res ns'ble Designer Respo ible signer Signatu Date Signed: License: company: City/State/Zip: LPhone:. 4 6451-0M3 O HIOW) For assistang or questions regarding the Energy Standard,contact the Energy Hotline at:1-800-772-3300 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC) (Page 1 of 4) Project Name: Guinn,Steve 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 CF111-ALT 02 document for each dwelling unit.: 01 Project Name: Guinn,Steve 02 Date Prepared: 2014-07-30 03 Project Location: 948 Ferngrove Drive 04 Building Type: Single family 05 CA City: Cupertino 06 Dwelling Unit Name: Guinn,Steve elling Unit Conditioned 07 Zip Code: 95014 087 Floor Area(ft2): 1432 ;. Number of space conditioning 09 Climate Zone: 40 (SC)systems being altered in 1 this dwelling unit.: B.Space Conditioning(SC)System i►irormation 01 02 03 04 {!6 07 D8 09 10 `V., , gine %> is#h entire Olt components? duct system (packaged unit,or accessible Are all of the condensing unit, Installing for sealing, system's Is then, d Altering or or more than 40 and is more components Itt al ed installing a cooling/heating linear feet of than 75%of and ducts new SC System SC System CFA servedm a refrigerant coil,or new or the duct or replaced? Identification or Location or Area by this SCed containing air-handling unit, replacement system new (entirely new Name Served System(ft2) stem? component? etc) ducts? or replaced? system) Alteration Type Entirely new or complete replacement Guinn,Steve Whole House 14 = No Yes Yes No No Yes � space conditioning system Registration Number: „= Registration Date/Time: 2014-07-30 08:16:57 HERS Provider:CalCERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 08:17:49 CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 4) C.Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib) This section does not apply to this project. D.Altered Space Conditioning System(Sections 150.2(1b)1E and F) This section does not apply to this project. E.Entirely New or Complete Replacement Duct System,with or without Equipm"ft- angeout(Sections 150.2(b)1Dtia and 150.2(b)1E,F) This section does no `a �)y to this project. F.Entirely New or Complete Replacement Space Conditioning System(Si „ on 150.2(b)1C) 01 02 03"� -04 06 0� , 08 09 10 11 i ' Cooling System feag 7imvm Coming Minimum Required Identification or Heating System Altered tieeji g';°;E#ticlency fc P1e}f Coolrng Iter6iMpofinge Efficiency Efficiency Thermostat New Duct Name Type Component Type Value System Type Component Type Value Type R-Value 10 Aph 11 This field All new heating4 SEER 16 Ductless split All new cooling SetbackTher or section Guinn,Steve Ductless split HP components ; NA HP components mostat is not applicable Reouired Documentation: CF2R-MCH-01-E-Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums:R6. CF2R&CF311-MCH-20-H Duct Leakage Verification required. -Leakage rate compliance::5 6%. CF2R&CF3R-MCH-22 Fan Efficacy Verification CF2R&CF311-MCH-23 System Air Flow Rate Verification Compliance:Fan Efficaty 5 0.58 W/cfm and System Ai 350 cfm/ton. -Alternative Compliance:CF211&CF3R-MCH-28 Return t Design Verification is an alternative to MCH-22 and MCH-23 verification. CF2R&CF3R-MCH-25-H Refrigerant Charge Verifidn required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15). Exceptions: Heating-only systems are exempt from the 0 S8 ttifm and 350 cfm/ton requirements. Registration Number: Registration Date/Time: 2014-07-30 08:16:57 HERS Provider:CalCERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 08:17:49 e CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT HVAC) (Page 3 of 4) F. Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C) O1 02 03 04 05 06 07 08 09 10 11 Heating Cooling System Heating Minimum Cooling Minimum Required Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct Name Type Component Type Value System Type Component Type Value Type R-Value Note: An"entirely new or replacement dud 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 s v ; ,LT / r Registration Number: Registration Date/Time: 2014-07-30 08:16:57 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 08:17:49 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 4 of 4) 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 08:16:57 Address: CEA/HERS Certification Identification(if applicable): 179 SAN RAMON DRIVE City/State/Zip: Phon 111P SAN JOSE CA 95111 (4J978-7060 Responsible Person's Declaration statement ` I certify the following under penalty of perjury,under the laws of the State of California: c, 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 responsibil' ;ar the building design or system design identified on this Certificate of Compliance(responsible designer). 3. That the energy features and performa �e specifications,mater ,conents and � acturzd deifices for the buiCtling deSi sir sysetn design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Raft S of the California.Code of Rei�'ulations. 4. The building design features or systiQ-design features idbNtif 4 on his Certificat�Compliance are cots intent withthe information p ovided on other applicable compliance documents,worksheets, calculations,plans and specificationsubmitted to the epforcementncy ford [:with this buldmgpermrt application. S. 1 will ensure that a registered copy of tfa Cert`fica#e of Coni iartce sNali,� vait bie wttht{to%I� �tdi g ermit�sp,CSSued foi the bwrt4rOg artd�rnade:awai}able to the enforcement agency for all applicable inspections.I understand that a registered copy of this Cerdiicateof Con pli is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Sanchez,Rafael Company: Date Signed: PELLE HEATING&AIR INC 2014-07-30 08:16:57 Address: License: 179 SAN RAMON DRIVE 809887 City/State/Zip: Phone: SAN JOSE CA 95111 (408)978-7060 O Digitally signed b CaICERTS. This digital si natu�is provided in order to secure the content of this registered document,and in no way implies Registration Provider responsibility for the accuracy of the 9 Y 9 Y 9 P 9 Y P 9 P Y Y information. Registration Number: Registration Date/Time: 2014-07-30 08:16:57 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2014-03-31 Report Generated:2014-07-30 08:17:49 c 1 t �e, CUPERTINO BUildinq Department _ N*0 M g1xV Dw " ve, ; ° 3 r, REVIEWED FOF CODE COMPLIANCE Reviewed 13 lam � 5 COJE1 EVELOPMENT DEPARTMENT a, " DIVISION-CUPERTINO PROVED Thi s=t of d pecifications MUST he kept at the d� cons ruction. It is unlawful to mike any 3 ' c°,u, Vio tions on same,or'to deviate the rcfromwithout pproval from the Building Official. Tho _:tnrnPinIan and s . ifications SHALL NOT b.- h"i tc; rovalof the violation Of an amance or State Law. ;a BY PERP,ilT NO. UG 01 014 fi Y*J PLOT PLAINS CHECKED BY MATE 1 q OATE nFnT.