14080243I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 20509 CEDARBROOK TER CONTRACTOR: CALIFORNIA DELTA PERMIT NO: 14080243
MECHANICAL INC
OWNER'S NAME: WONG HIU YUNG AND LEE Al PING 6056 E BASELINE RD STE 155 DATE ISSUED: 08/25/2014
OWNER'S PHONE: 6502487495 MESA, AZ 85206 PHONE NO: (866) 692 -5273
❑ LICENSED CONTRACTOR'S DECLAcR/ATION
License Class C Lie. #
Contractor DateC
I hereby affhr. � . t 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
performance of the work for which this permit is issued.
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
permit is issued.
APPLICANT CERTIFICATION
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
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 comply
with all non -point source re lations per the Cupertino Municipal Code, Section
918.
Signature Date 13
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
construct the project (Sec 7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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.
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
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
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
REMOVE AND REPLACE FURNACE IN SAME LOCATION
Sq. Ft Floor Area: I Valuation: $2252
APN Number: 32345007 00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 18 PERMIT ISSUANCE OR
180 DAYS F M LAST CALLED INSP CT ON.
Issued by: Date: �2�
RE- ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent: Date: 2
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must I 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. S 3097 C' C
APPLICANT CERTIFICATION
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
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 comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9 18
Signature
Date
work s for which this permit is issued ( ec. , iv .)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
e[J� =�i tt�t0
GENERAL PERMIT ,tPPL[CA T [QN mmEP
IVI
CON /iMUNIlY DEVELOPMENT DEPARTMENT - BUILDING DIVISION' (/ tt11�`��
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(403) 777 -3228 - F,1-X (403) 777 -3333 - building. 5 uDe fino.ora m (�vV
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1�!t ?Illisc_ta�_20I_1.doc revised 06121111
CITY OF CUPERTINO
FF.F F.STIMATOR - BUILDING DIVISION
ia* ADDRESS: 20509 cedarbrook terrace
DATE: 08/25/2014
REVIEWED BY: Mendez
APN:
BP #:
"VALUATION: 1$2,252
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE:
PENTAMATION FURN /A
PERMIT TYPE:
WORK
remove and replace furnace in same location
SCOPE
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
Furnace, Gravity -Type
1MFR = <100
1
#
$143
PME Unit Fee:
$143.00
PME Permit Fee:
$48.00
Con,strl%i 'tion / f v: '
T-F
Administrative Fee: 1ADMIN
$45.00
Work Without Permit? ® Yes 0 No
$0.00
TOTALS:
Travel Documentation Fee: ITRAVDOC
1 $143.00
Strong Motion Fee: 1BSEISMICR
Mech. Plan Check 0.0 hrs $0.00 Nnwb. t'/an Check ). l'wc°. Y/<ai, 01'eck
Mech. Permit Fee: IMPERMIT Numb. t't; °mfg Fec 7�t`zrc- t'Eur,rrr i'rr<
Other Mech. Insp. 0.0 hrs $48.00 (lilrer 1',x n1� 7rrs;n. fJrim,= Liac.i';t : >. Li
1'llw1b, bisp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Nire, Sanitary sewer District, school
n. *- :,.s .. 1 77.,...,. ! ,. .. t........t __ fl.., .,Ii.....- -n..,, nsrit nro hi nn octim"to ('nntart tho Dow fnr addn'I infa-
FEE ITEMS (Fee Resolution 11 -053 Eff. 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Chec.'. ,', ;
PME Plan Check:
$0.00
PME Unit Fee:
$143.00
PME Permit Fee:
$48.00
Con,strl%i 'tion / f v: '
T-F
Administrative Fee: 1ADMIN
$45.00
Work Without Permit? ® Yes 0 No
$0.00
fIil1'r.Txict'ci pfC?Ydn�Ytg cues:
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: 1BSEISMICR
$0.50
Select an Administrative Item
i'.o
Bldy- Stds Commission .Fee: IBCBSC
$1.00
$285.50
$0.00 TO>f`AL FEE:
$ 285.50
Revised: 07/10/2014
CERTIFICATE OF COMPLIANCE CFIR- ALT -02 -E
Alterations to Space Conditioning Systems (formerly CF -lR -ALT HVAC) (Page 1 of 4 )
Project Name: 20509 Cedarbrook Terrace Date Prepared: 2014 -08 -20
A. General Information
CF1R- 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:
20509 Cedarbrook Terrace
02
Date Prepared:
2014-08 -20
03
Project Location:
20509 Cedarbrook Terrace
04
Building Type:
Single family
05
CA W.
Cupertino
06
Dwelling Unit Name:
20509 Cedarbrook Terrace
07
Zip Code:
95014
08
Dwelling Unit Conditioned
1000
components?
duct system
Floor Area (ft2):
Number of space conditioning
09
Climate Zone:
3
10
(SC) systems being altered in
1
condensing unit,
Installing
this dwelling unit.:
system's
B. Space Conditioning (SC) System.;lformation? ':
01
02
03
tA..
QS�� :
06
07
- 08
09
10
:.
I�Is` theen
,tire
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
Furnace
Whole Home
1000
Yes
No
Yes
No
No
No
Altered space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Dlib)
This section does not apply to this project.
Registration Number: 214- A0079283A- 000000000-0000 Registration Date/nme: 201408-20 09:50:14 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03 -31 Report Generated: 2014-08 -20 09:49:41
CERTIFICATE OF COMPLIANCE: CFIR- ALT -02 -E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 4 )
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
New or
Identification
System
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Replaced
New Duct
or Name
Type
Components
Type
Value
System Type
Components
Type ype
Value
Type
Duct Length
R -Value
Furnace
Central gas
furnace
All new
heating
AFUE
0.78
No cooling
No cooling
component
This field or
section is not
This field or
section is not
Setback
This field or
section Is not
This field or
section is not
components
altered
applicable
applicable
applicable
applicable
Reauined Documentation:
CF211- MCH -01 -E - Space Conditioning Systems Ducts and Fens
-Duct insulation requirement for new plenums: R6.
CF2R- MCH -20-H & MR- MCH -20-14 — 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'X, leakage to outside, or seal all accessible teaks.
CF2R- MCH -25 -H & CF3R- MCH -25-14 Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
CF2RCF3R- MCH -23 & CF311- MCH -23 Air Flow k 300 CFM/ton required when MCH -25 is; squired.
e
''F': ,: .
-Duct stems registered with HERS provide as `ky
sy egi p p iriously sealed are. m ffq . MCkf -20 Duct L e,Testing require ants.
- Heating -only systems and Air Handler/Fumactcrianges do not require verfftcatioh`iif Air Flow M - 3; dr Refripp"ppY'm�fit:Cha'/rge MECH -25. >.
- Existing duct systems constructed, insulated a ed with as6estcsre eiiemptfrom MCH, 20 Duct Leakage TESiing regtireme o';:<
E. Entirely New or Complete Replacement Duct Systern, with or without Equipment Changeout (Sections 1S0.2(b)1Diia and 150.2(b)1E, F)
This section does not apply to this project.
Registration Number: 214- A0079283A- 000000000 -0000
Registration Date/Time:
201408 -20 08:50:14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03 -31 Report Generated: 2014 -08 -20 09:49:41
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF-1R-AU-HVAC) (Page 3 of 4)
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
Registration Number: 214-A0079283A-000000000-0000
Registration Date/71me. 2014-08-20 09M14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-08-20 09:49:41
Ste' d
Registration Date/71me. 2014-08-20 09M14
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2014-08-20 09:49:41
CERTIFICATE OF COMPLIANCE CF111- 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:
Frederick, Alanna
Documentation Author Signatures C�GL7�%7/lT.CL �2E�(x�%uClyi
Company:
Signature Date:
CALIFORNIA DELTA MECHANICAL INC
2014 -08 -20 09:50:14
Address:
CEA/ HERS Certification Identification (If applicable):
1235 GRAND AVE
Uty /State /Zip:
Phone:
SPRING VALLEY CA 91977
(480) 898 -0007
Responsible Person's Declaration statement
I certify the following under penalty of perjury, underthe laws of the State of Caliifomia:
1. The information provided on this Certificate of Compliance Is true ind correct.
2. tam eligible under Divisbn 3 of the Business. and Professbns Code to accept responsibility for the buIIding,design or system ,design identified on this Certificate of Compliance (responsible designer).
3. That the features
energy and performaiSce spectflcatlons ,materials; components; 'and devices f8T the building desigWbr system design Identified on this Certificate of Compliance conform to the
,@Anufactured
requirements of Title 24, Part 1 and Aij 6 of the Cailfomla,Code` . Regialallons. V
4. The building design features or ig
8 8 systf -Wdes n feature�ide lffeil o Ts Certificate of i iYipffance ark e7ii sisteht with tie lidormatfa9 �i`rovidedIn other applicable compliance documents, worksheets,
'
calculations, plans and specifiwtioris' submitted to .4 e . gency for approvall4ith this building permft a,�,,,F{{icacion.
S. I will ensure that a registered copy cr 4.Cend6cat` fof,CompiIaiice.sKall;be.made vAlI&Ia AM;tt .`building permk(�}`issued fo�die,building san�m dd'avatEable to the enforcement agency for all applicable
. >... : : : :�� :. B cY pp icable
..:...;..
inspections. I understand that a copy p y ''
registered co of this Ceitiflwte'of Com dance ts're ui'ied to'tie included with the doiumentatloii tfie builder provides to the building owner atoccQupancy.
Responsible Designer Name:
Frederick, Alanna
, -
Responsible Designer Signature: CGL7�77/!?,Ui
Company:
Date Signed:
CALIFORNIA DELTA MECHANICAL INC
2014.08-20 09:50:14
Address:
license:
1235 GRAND AVE
811114
City /State/Zip:
Phone:
SPRING VALLEY CA 91977
(480) 998 -0007
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- A0079283A -000000000 -0000 Registration Date/Time: 2014 -08 -20 09:50:14 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014-08 -20 09:49:41
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(alcupertino.org
RSoI D ---
,o5Uq (Ja6ra-OK Te. -raCe 0 rfi'oi C'# of Alarms Smoke:
o. 1,e+690 2_ -3
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 ever level of a dwellin unit includin basements
X
X
Within each slee in 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 -Kith the manufacturer's instructions and in compliance wit the California B i inw
and California Residential Codes. The alarms have been tested and are operational, s of t g�
below. `,YIS
_.._ .. ..,,I ,....r .. ,. +., .. rh..,ifh fhn forme and ennrlifinn.c of this em
I I/aVC I6au
allua Ice iv VW. .. . ........... ......... .... ... __.._._. _.._ __ ___._
Owner (or Owner Agent's) Name:
—
�a....�.....
A;P% Lele
....... ........... .................. �.
Si nture..... . ..................... .. s.
Contractor Name:
Signature.................................... ............................... Lic.# ....... ............................... Date: ...................
Smoke and COform.doc revised 03118114