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14090183
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11771 SIERRA SPRING CT CONTRACTOR:ALLIED AIRE SERVICE PERMIT NO: 14090183 INC OWNER'S NAME: MILPITAS,CA 95035 PHONE NO:(408)934-8844 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ / .� REPLACE(E)FURNACE,SAME LOCATION.NO DUCT License Class�J,®?� Li_e.(#� ����`3S WORK Contractor/"'Z N G �'-abate 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4800 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:36653051 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 DAY T 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 DAY M ED 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 26 / granting of this permit. Additionally,the applicant understands and will com ss ate: with all non-point source regulat er the Cupertino Municipal Code,Section 9 18. �- RE-ROOFS: Signature Date 2� 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 the Health&Safety Code,. 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 RPFLICATION ' MEP :... COMMUNITY DEVELOPhfENT DEPAR 1 IdiEN i • BUILDING DIVISION V 110300 TORRE �O AVENUE P CUPERTINO, CA 95014-3255 - (408)777-3228� FAX(406)777-3333-buildinol�cuoenilno.ora misu ❑PLU-I+SaT-.CG jj:SE ra1,iC.4L ❑mL^-CTRiCa.L ❑Ay CELLA1��OtiS ( 5 O�� �r ort;ADDP ss / /elm c� lk-- I RST r ' S ti-i AJDRSS C'-Y,SLAT, IFP: co��Acr nAt,� ef ( P. �.� l�3! I =✓tn Y e-tc b O FAX 9.3 ems© OF' -❑ OR?vx-Bi�r_DEB L-7 Ov.T-'t-c t4GTZ o. acoR ❑CDAtFtiCTOP.AGhZ ❑ A.?•eTaer ❑ aCnL?. ❑ DEVMOPEP, ❑ :. T COAD :q:?Nk1J" --' -'sA°Uh� I LiCERSEBUS.LIC - CON°AhZ Ki�✓ I _-I✓LdT I FAX STPD'=I'A.DDI SS P � j �Civ::�ra�'GIlA�P.I�A1✓L ( LiCr'I:SEh'Lh�' I BUS.LIC COI�'/?QYTi� E Ma71, I FAX STR-.-T ADDP=- S I MY,STATE,ZIP I PiiO? L-S'c O Sri of DtJPL 1uJLTI-rAYPID Y I PRD�tCT ZR WII DLAA'D ❑ yBs I PROJECT INT LEI YES I IS T_^BLDG AN ❑ 1 S BL7ITJr T-K-0-. ❑CON tc'CLSL IMM A?N B,1=FACS APA .'TO FIMD ZA]� ❑NO FiG�uZ HOME?7 ❑ ]O DBSCP.IPTION OF—PORK V. TOTP_T.\%A_,JAi 110'\: y � �� �•,. .� �--Y-V-_- - � �'�__ ,:• ��y��=. By my signaz.ire below,I mrh:I'io each oI the folio\ing: I am use property owmer or authorized filen%to aCt on the propery read this application and the info . Dare: f-[/ est' -.. =z`-'_-�'- - sew _ SL�1�LE_ �r1\jTfi..L LNrO���-TION REQU�t`.D =y��z�=.sem-0 . �c�:�,�-r.Yc -;�= T- h1'—FP 1jLm pp-,201_1.docrevised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 11771 SIERRA SPRING CT DATE: 09/26/2014 REVIEWED BY: MELISSA APN: 366 53 051 BP#: *VALUATION: 1$4,800 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION FURN/A USE: pPERMIT TYPE: WORK REPLACE E FURNACE SAME LOCATION. NO DUCT WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $143 TOTALS: $143.00 Mech.Plan Check Fo.olhrs $0.00 Plwnh. Pkrn Chcck e _t',<ar%CJs_=e1: Mech.Permit Fee: IMPERMIT f'lunzh.Permit hec. like Other Mech.Insp. 10._01hrs $48.00 Ehler P7umh lnsn. Ll Off-cr f sl"'. i4c(''h. fngs' Phenth. Irish. Fee: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These _f fiees are based on the relimina information available and are onlyan estimate. Contact the Detor addn'1 info, FEE ITEMS (Fee Resolution 11=053 Eff' 7/1/132 FEE QTY/FEE MISC ITEMS Plan CCtec.1, F�e: Stippl, PC Fee PME Plan Check: $0.00 Fe"', PME Unit Fee: $143.00 PME Permit Fee: $48.00 Col"Sfr."'Ico'-Yz Tux., F Administrative Fee: ]ADMIN $45.00 Work Without Permit? ® Yes 0 No $0.00 1Cr1'Cdi2�f�U llti/()�tlr� Se�e:3. Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.62 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $285.62 $0.00 TOTALFEE: $285.62 Revised: 08/20/2014 STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CFIR-ALT-03-E Revised 06/14 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: E forcement Agency: Date Prepared: Permitil: l� ,e q- ,e��xs �0`" 7 i, 26 YG9o�S Equipment Type Equipment Efficiency 11 Ne :Ducting,Plenums,Lineset Conditioned Thermostat Required R-value Floor Area(sq ft) ❑Packaged System ❑Evaporator Coil AFUE COP ❑R-6 (CZ 1,3-7)Ducts Served b system Setback ❑Split System ❑Condensing Unit SEER ❑R-8' (CZ 16)Ducts VIS- ft (If not already HSPF ❑R-6(all CZ's)Plenums present must eFurnace ❑Lineset EER ❑R-5 or R7.5 Lineset; 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 odtbVh hd. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. 01.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can include new ducting All Equipment,t-� CF111-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace i-- CF3R:MECH-20-HERS Installer Requirement:Duct leakage(IS15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if.- 0 f:❑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 ..I ❑2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment a All New Ducts2 CF111-ALT-02-E CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS /�► t2I.0 f 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) ❑3.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 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 CFIR-ALT-02-E CF2R:MECH-20-HERS space but less than All New Ducts' 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%",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. 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 permit application. RReessJposoleressii6gnnnernN,ame: /©�y� wu Re bre Designer Sig Date Signed: Licensees 2 ComFa"y /: Address: City/State/Zip: Phone: �r �/•t��.J�,c�/ r For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300 CUPERTINO Owner Name Address WATER- CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ( (408) 777 -3333 • building okupertino.ora ,010183 Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: XNo Go to Question 2. Date: 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water- conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has, been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: No Go to Question 3. Date: 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: No Go to Question 4. Date: 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. ❑ Myproperty is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non - compliant plumbing fixtures to be replaced with water- conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non - compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ Myproperty is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water - conserving plumbing fixtures. On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water - conserving plumbing fixtures. SB407 2014. doe revised 03118114 On or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I/We, the owner(s) of this property, certify under penalty of perjury that non - compliant plumbing fixtures have been replaced with water - conserving plumbing fixtures in accordance ith Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Gr n uildin tandards Code, and manufacturer's installation requirements, and that the water - conserving plumbing fixtures in the table below. Owner's (or Owner Agent's) Signature: Date: d — /v — 1 Upon completing and signing this Certificat , please return it to Bui ' g Division in order to final your permit. Non - Compliant Water - Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single - Family Multi - Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons /flush (Toilets) Gallons /flush Dual flush toilets: 1.28 gallons /flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons /flush Gallons /flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand -held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and /or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage /flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4072014.doc revised 03118114 Ab CERTIFICATE OF COMPLIANCE CF1R -ALT 02 -E Alterations to Space Conditioning Systems (formerly CF - 1R - ALT - HVAC) (Page 1 of 4) Project Name: Diane Mately Date Prepared: 2014 -09 -26 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 CF111-ALT 02 document for each dwelling unit. 01 Project Name 02 Date Prepared 2014 -09 -26 03 Project Location 11771 Sierra Spring Court 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name Diane Mately 07 Zip Code 95014 08 Dwelling Unit Conditioned 1745 Installing Installing Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 4 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Diana Mately 11771 Sierra Spring Court 1745 Yes No Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 214- AO10183SA- 000000000 -0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Fla, Registration Date/Time: 2014 -09 -26 07:43:3 HERS Provider: CaICERTS Report Version: 2014 -03 -31 Report Generated: 2014 -09 -26 07:44:01 Schema Version: 0.551SDD 0 d CERTIFICATE OF COMPLIANCE CKR -ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -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 Value Type Duct Length R -Value Central gas Gas furnace No cooling This field or This field or Less than or Diana Mately furnace AHU AFUE 0.78 No cooling component section is not section is not Setback equal to 40 R -6 altered applicable applicable feet Required Documentation: CF2R- MCH -01 -E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. MR- MCH -20-11 & MR- 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. MR- MCH -25 -H & CF3R- MCH -25 -H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8 -15). CF2RCF3R- MCH -23 & 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 Duct Leakage Testing requirements. - Heating -only systems and Air Handier /Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH -25. - Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)lE, F) This section does not apply to this project. Registration Number: 214- A0101835A- 000000000 -0000 Registration Date/Time: 2014 -09 -26 07:43:38 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -09 -26 07:44:01 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R -ALT 02 -E Alterations to Space Conditioning Systems (formerly CF -iR -ALT 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- A010183SA- 000000000 -0000 Registration Date/Time 2014 -09 -26 07:43:38 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -09 -26 07:44:01 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF1R -ALT 02 -E Alterations to Space Conditioning Systems (formerly CF -1R -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: STEINER, ARNIE C��� ✓/!✓r /� Company: Signature Date: ALLIED AIRE SERVICE INC 2014 -09 -26 07:43:38 Address: CEA/ HERS Certification Identification (if applicable): 887 AMES AVENUE CC200633 City /State/Zip: Phone: MILPITAS CA 95035 (408) 934 -8844 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, 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 California Code of Regulations. 4. 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. S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature:/ STEINER, ARNIE Company: Date Signed: ALLIED AIRE SERVICE INC 2014 -09 -26 07:43:38 Address: License: 887 AMES AVENUE 260035 City /State/Zip: Phone: MILPITAS CA 95035 (408) 934 -8844 Digitally signed by CaICERTS. 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- A010183SA- 000000000 -0000 Registration Date/Time: 2014 -09 -26 07:43:38 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -09 -26 07:44:01 Schema Version: 0.551SDD