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14100076
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11897 WOODHILL CT CONTRACTOR: ALLIED AIRE SERVICE PERMIT NO: 14100076 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 C>� ✓ � License Classes z/o 3� Lic. # a7ea,O03�f WORK) Contractor 0/<' 1�d Aeel_4 � Date A �y 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 formance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $4500 ave and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36604069 00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITIHN 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 FRO LLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, i costs, and expenses which may accrue against said City in consequence of the Dare—// granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section with 9 18. RE -ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants 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 CupertiDwKunicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, 550 , 2553 , a 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 PERMHT APPLICATION ('fib COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION' V V 10300 T ORRE AVENUE • CUPERTINO, CA 95011-3255 (=:OB) 777-3228 • FAX (106) 777-3333 - buildino(.cuce ino.ora` m I S ❑PLUIri3TG I�h� rz.iC.4L ❑Z-j;t i -Car ❑I.ri.='—' ,&Ysou-S �AMPESS/g9�.S �� I F'N.r 3 4 b - o q - -� fJDDFss v t `X CO:ACP74 (' r:l P� Ej ADDR:..`S ,,/_� ( C1 r�, 51:Si.^., ZIP I FA - X o ,? ❑ OQ1I�-?..-B-M- DML L"7 os.'�=-, Aaz M1-6 1 ? hCOB m4C—? ❑ D� _ O?_�i ❑ �L�'I CGI`c� hC' O� � �u 1 I L-CE1QS8 ]hof% i1 D:S� O B 13 u5. LIC r STREET ADDRESS C iY, STAT£ Z P ,mss .• �,� i � a3� P 101 E �8��f�8��i� fi �CluisCT GITT P ]T F�� I LIC' SSE NLS ER. I BUTS. LIC z TY C01leiahTTAl I F.NATJ. FAX I S7R c 7 ADDR?SS I CRY, STATa ZI? I PH01M 'USE D? ❑ sm or DUPLr'i.' i❑ t +mn-FAUo .YI MD7tCT N W UMLA-ND ❑ YES I 111110M= JN, YESI Bu D^�•G: ❑colaeP.CLSL ';0 FLOOD?.0]1. ❑ ITO Is T _ BLDG klq ❑ 1 S FiC�'tHoll-'? ❑ NO DESCRIPTION Or FORK �e� TOTAL \% UXAT IION: By r:�y sig at+se be]o;a, I ce i.=y to e�c�, oT'ths fo11o;;�n:: I a:�, u,e grope_�y o;;•iter or av' ori�.d e�e�t to ect oa operty o�„�Ier`s bei;,lf. I ha;>e -ead tiTis application and the infozatiDn I ha`1'e.DL0vidtd is correct I have read the Description of %rk and'ver:iy it iS accTsate. i a_-ee to coTlply vrith all applicable local ordinances and sate ]g -,vs nlati7m esen'n'ves of Cupertino to eater r'ne above id-r_tired grope-, y for Lspection purposes. S i mature of AwDlicant A-.Qer:t: Date: /O / / ST- LNtORMATION RE-QUE ED MINE=^ MEEK 1� i� ti1i�cE �_2DII.doc revised 06121/11 CITY OF CUPERTINO 1PFF. 1Ti.CT FX4 A Tn]2 — RI TIT .SING DIVISION LA,ADDRESS: 11897 WOODHILL CT DATE: 10/14/2014 REVIEWED BY: MELISSA UNITS APN: 366 04 069 BP#: *VALUATION: 1$4,500 rPERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: p # PENTAMATION FURN/AC PERMIT TYPE: / WORK REPLACE E FURNACE SAME LOCATION NO DUCT WORK SCOPE S tr X71, 1ttti j ''e'e APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Furnace, Forced -Air 1MFR=<100 1 # $143 S tr X71, 1ttti j ''e'e PME Unit Fee: $143.00 PME Permit Fee: $48.00 C <}nsirltclion ""OX. T-1 Administrative Fee: 1ADMIN $45.00 Work Without Permit? ® Yes 0 No $0.00 TOTALS:. / Travel Documentation Fee: ITRAVDOC $143.00 Strong Motion Fee: 1BSEISMICR Mech. Plan Check I 0.0 I hrs $0.00 Plrwlbf loh (beck Mech. Permit Fee: IMPERMIT Plumb. Perm;t Fee. Other Mech. Insp. L.0 hrs $48.00 Other Plumb Insp. 1.1"(ch. fn'apI<<f: Plumb, hi i). Fee: Bile{, Phan Check NOTE: This estimate does not includefees aue to omervepartments y. e. rianning, ruouc rrurns, UIre, ouriaeuiy wci rowan the Dent fnr addn'l info. FEE ITEMS (Fee Resolution 11-053E . 7ff 11113) FEE QTY/FEE MISC ITEMS Plan Check /`tfe. Soppl' PC PME Plan Check: $0.00 S tr X71, 1ttti j ''e'e PME Unit Fee: $143.00 PME Permit Fee: $48.00 C <}nsirltclion ""OX. T-1 Administrative Fee: 1ADMIN $45.00 Work Without Permit? ® Yes 0 No $0.00 / Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: 1BSEISMICR $0.59 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $285.59 $0.00 ToL FEE: $285.59 Revised: 08/20/2014 o 1 M i C ur �^UrumsmA ALTERATIONS - HVAC CEC-CFIR-ALT-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations 7 HVAC CZ 1, 3 to 7 and 16 (formerly CF -1R -ALT -HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Dat Prep red: Permits*: � .'l �� l /'" i0 1t-( )N Iq(obo4-6 Equipment Type Equipment Efficiency New: 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 by system P Setback ❑ Split System ❑ Condensing Unit SEER ❑ R-8' (CZ 16) Ducts sq ft (If not already HSPF ❑ R-6 (all CZ's) Plenums present, must mace 11 Lineset EER ❑ R-5 or R7.5 Uneset3 be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form !, (lowed 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. Ellf HVAC Changeout/Repair{,fIPF Required Compliance Documents to be left on site for Final: Can include new ducting LL All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS Air Handl urnace CF3R: MECH-20-HERS Installer Regwrement: Duct leakage (<,15% or, < 10% to outside, or seal all accessible leaks) Exempte from duct leakage testing if: uct system registered with HERS provider as previously sealed, or . 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 Duc : CFIR-ALT-02-E f /!x N CF2R-MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS RV --r CF3R-MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2 Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow 2 350 CFM/ton (or Standards Table 150.0-C / D alternative) ❑ 3. All New Ducts with Replacement eP Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CFIR-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. b ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in uncondit)oned CFIR-ALT-02-E CF2R: MECH-20-HERS space but less than All New Ducts= YLo s CF3R: MECH-20-HERS Installer Required to: Duct leakage (e 15% or, < 10% to outside, or seal all accessible leaks) ,/ l [I Exempted from duct leakage testing 1 existing duct systems are constructed, insulated or sealed with asbestos. /V ' 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. z 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 -2y.'', 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. ReSpOnSible Desi ege r Name: 5V Dest Date Sign: L� se: Compan , 1 �� Address: City/State/Zip: Phone: �!g 933<e rvQ .moi✓ yes .40e �5 ln�e For assistance or questions regarding the Energy Standards, contact the En@fgy Hotline at: 1-800-772-3300 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE log F 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 every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. h d and a rem to comply with the terms and conditions of this statement ave rea Owner (or Owner Agent's) Name: � �/ �' V /✓C,/►'' tDate: Si nature ........................ ...................................................... ............................... Contractor Name: /) • �/�f� �f , Lic.# �6 oa3� Date �3i � . `! /PsO /(Jr�v /�O,�i/✓�i . Si nature...... .. . .................. Smoke and CO form.doc revised 03118114 5 i CUPE Name U/A-) WATER- CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION __1030=77-3228 FAb • CUPERTINO, CA 95014 -3255 (408) •FAX (408) 7 -3333 • buildinca (D-cupertino.org. -7- &%©,6�„ 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: Date: %o /3 ///,�z Lit' No Go to Question 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. j Owner' Signature:'�M, _ Date: / 6�131�� E2( No Go to Question 3. 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: Date: 4�slll_ r' lid' No Go to Question 4.,1��"^'7 /' 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 1 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: /r�=anavailable Date: es My real property is built for use or occupancy on or before January 1, 1994. / Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. C" My property 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). ❑ My property is a multifamily residential real properly. 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.doc revised 03118114 On or before January x,';2019, all non- compliant plumbing fixtures shall be replaced with water - conserving plumbrn lJoures throughout the, building (regardless of whether property undergoes alterations or improvements). IfWe, 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 with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water - conserving plumbing fixtureslomply wit1whe requirements as indicated in the table below. 3/ Owner's (or Owner Agent's) Signature: _i PWao , Date: _ia� 1 115f- Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 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.doe revised 03118114 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 @160 psi the above are unavailable, Where faucets meeting aerators orother means the above are maybe 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.doe revised 03118114 FILE CERTIFICATE OF INSTALLATION CF2R- MCH -20 -H Duct Leakage Diagnostic Test Vincent Fung Project Name: Vincent F-uftg, Enforcement Agency: pertino City of Permit Number: 14100076 Dwelling Address: 11897 Woodhill Court City: Cupertino Zip Code: 95014 A. System Informatio 01 Space Conditioning System Identification or Name Vincent Fung 02 Space Conditioning System Location or Area Served 11897 Woodhill Court 03 Building Type from CF -1R Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category Alteration MCH -20d - Complete Replacement or Altered Duct System B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 0 02 Heating Capacity (kBtu /h) 100 03 Conditioned Floor Area served by this HVAC system (ft2) 2263 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Heating system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage (cfm) 326 10 Actual duct leakage rate from leakage test measurement (cfm) 160 11 Compliance Statement: System passes leakage test Registration Number: 214- A0116514A- M2000002A -0000 Registration Date rime: 2014 -10 -29 11:02:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2014 -05 -08 Report Generated: 2014 -10 -23 21:59:43 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF INSTALLATION CF2R- MCH -20-H Duct Leakage Diagnostic Test (Page 2 of 3 ) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) ducts for Central Fan Integrated (CFI) ventilation systems, shall not be sealed /taped off during duct leakage 02 testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may be configured to the closed position during duct leakage testing. 03 All supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements 07 of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification compliance. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: 214- A0116514A- M2000002A -0000 Registration Date/Time: 2014 -10 -29 11:02:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2014 -05 -08 Report Generated: 2014 -10 -23 21:59:43 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF INSTALLATION CF2R- MCH -20 -H Duct Leakage Diagnostic Test (Page 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: x_ /1 iTj Trent H. Hugill Company: Signature Date: 2014 -10 -23 22:03:20 Nor Cal Duct Testing Address: CEA/ HERS Certification Identification (if applicable): 260 Woodfield Lane CC2006333 City /State /Zip: 1408-761-2041 Phone: Brentwood CA 94513 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations In this statement (responsible builder /installer), otherwise I am an authorized representative of the responsible builder /installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 understand that a HERS rater will check the installation to verify compliance, and that if such checking identifies defects; I am required to take corrective action at my expense. l understand that Energy Commission and HERS Provider representatives will also perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS rater, and if those installations fail to meet the requirements of such quality assurance checking, the required corrective action and additional checking /testing of other installations in that HERS sample group will be performed at my expense. 5. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permits) 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder /Installer Name: Responsible Builder /Installer Signature: ARNIE STEINER Position With Company (Title): Company Name: (Installing Subcontractor or General Contractor or Builder /Owner) Owner ALLIED AIRE SERVICE INC Address: CSLB License: 887 AMES AVENUE 260035 City /State /Zip: Phone: Date Signed: MILPITAS CA 95035 (408) 934 -8844 2014 -10 -29 11:02:57 Third Party Quality Control Program (TPQCP) Status: Name of TPQCP (if applicable): 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- A0116514A- M2000002A -0000 Registration Date/Time: 2014 -10 -29 11:02:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2014 -05 -08 Report Generated: 2014 -10 -23 21:59:43 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans Project Name: Vinc Fung Enforcement Agency: City of Cupertino Permit Number: 14100076 Dwelling Address: 11897 Woodhill Court ty: Cupertino Zip Code: 95014 iiiW A. General Information 01 Dwelling Unit Name Vincent Fung 02 Climate Zone 4 07 Dwelling Unit Conditioned Floor Area 09 10 Number of space conditioning (SC) 03 (ft2) 2263 04 systems being altered in this dwelling 1 Are AU of the unit. 05 Certificate of Compliance Type Prescriptive alterations (CF1R -ALT) 06 Method used to calculate HVAC loads Not applicable - equipment changeout, like- for -like 07 Calculated dwelling unit Sensible This field or section is not applicable 08 Calculated Dwelling Unit Heating Load This field or section is not applicable Cooling Load (Btuh) (gtuh) MCH -01b Prescriptive Alterations - Space Conditioning Systems Ducts and Fans B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Are AU of the system's components and ducts CFA served Is the SC Installing a Installing new or SC System SC System by this SC system a refrigerant Installing new SC Installing more entirely replaced? Identification or Location or Area System ducted containing system than 40 feet of new duct (entirely new Name Served (ft2) system? component? components? ducts? system? system) Alteration Type 11897 Woodhill Altered space Vincent Fung Court 2263 Yes No Yes No No No conditioning system Registration Number: 214- A0116514A- M0100002A -0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2014 -10-29 11:02:37 Report Version: 2014 -05 -13 Schema Version: 0.551SDD HERS Provider: CalCERTS Report Generated: 2014 -10 -14 13:28:53 CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 ) C. Space Conditioning (SC) System Alterations Compliance Information 01 02 03 04 05 06 07 08 09 10 11 12 Heating Unit serial number Rated Heating Capacity, Output (BTUH) Vincent Fung AFUE Heating Trane TUHMC1B00ACV4V 14242KJ27G Cooling Notes: New or New System Altered Heating Minimum Altered Cooling Minimum Required Replaced Duct Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct R- or Name System Type Component Type Value System Type Component Type Value Type Length Value This field This field Central gas All new No cooling or section or section Less than Vincent Fung furnace heating AFUE 0.78 No cooling component is not is not Setback or equal R6 components altered applicabl applicable to 40 feet e D. Installed Heating Equipment information 01 02 03 04 05 06 07 System Identification or Name Heating Efficiency Type Heating Efficiency Value Heating Unit Manufacturer Heating Unit Model Number Heating Unit serial number Rated Heating Capacity, Output (BTUH) Vincent Fung AFUE 0.78 Trane TUHMC1B00ACV4V 14242KJ27G 95000 Notes: E. Installed Cooling Equipment information: This section does not apply to this project. F. Extension of Existing Duct System, Greater Than 40 Feet This section does not apply to this project. Registration Number: 214- A0116514A- M0100002A -0000 Registration Date/Time: 2014 -10-29 11:02:37 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 ) G. Installed Duct System information This section does not apply to this project. H. Installed Air Filter Device Information This section does not apply to this project. I. Air Filter Device Requirements This section does not apply to this project. Registration Number: 214- A0116514A- M0100002A -0000 Registration Date /Time 2014 -10-29 11:02:37 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 4 of 7 ) J. HERS Verification Requirements 01 02 03 04 05 06 07 08 09 10 MCH2O MCH21 MCH22 MCH23 MCH25 MCH28 Exemption from Minimum Exemption R -Value for AHU Fan AHU SC System SC System From Duct Duct Ducts In Ducts Located Efficacy Airflow Identification or Location or Area Leakage Leakage Conditioned In Cond Space (W per Rate (cfm Refrigerant Return Duct Design Name Served Requirements Test Space Verification dm) per ton) Charge Table 150.0 -C or D Vincent Fung 11897 Woodhill No Yes Not No No No No No Court exemptions applicable Registration Number: 214- A0116514A- M0100002A -0000 Registration Date/Time: HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 5 of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements. Heating Equipment 01 Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency Regulations. 02 Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(1), 110.2(b). 03 Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections 150.0(h)1 and 2). 04 Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum inlet -to- outlet temperature rise specification. See Section 150.0(h)4. OS Standby Losses and Pilot Lights: Fan -type central furnaces may not have a continuously burning pilot light. Section 110.5 and Section 110.2(d). Cooling Equipment 06 Equipment Efficiency: All cooling equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency Regulations. 07 Refrigerant Line Insulation: All refrigerant line insulation in split system air conditioners and heat pumps must meet the R -value and protection requirements of Section 150.0(j)2 and 3, and Section 150.0(m)9. O8 Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A. 09 Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section 150.0(h)1 and 2. Air Distribution System Ducts, Plenums and Fans 10 Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R -6. Note that higher values may be required by the prescriptive or performance requirements. See Section 150.0(m)1. Registration Number: 214- A0116514A- M0100002A -0000 Registration Date/Time: 2014 -10-29 11:02:37 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 6 of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the system that are altered. Existing equipment may be exempt from these requirements. 11 Connections and Closures: All installed air - distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CIVIC Sections 601.0, 602.0, 603.0, 604.0, 605.0 and ANSI /SMACNA- 006 -2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R -6.0 or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.8. Heat Pump Thermostat 12 A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c). 13 The thermostat shall be installed in accordance with the manufacturers published installation specifications 14 First stage of heating shall be assigned to heat pump heating. 15 Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: 214- A0116514A- M0100002A -0000 Registration Date/Time: 2014 -10-29 11:02:37 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD CERTIFICATE OF INSTALLATION CF2R- MCH -01 -E Space Conditioning Systems, Ducts, and Fans (Page 7 of 7 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: STEINER, ARNIE Company: Signature Date: ALLIED AIRE SERVICE INC Address: E rfi a I tification (if applicable): 887 AMES AVENUE CC2006333 City /State /Zi p: 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder /installer), otherwise I am an authorized representative of the responsible builder /installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate. of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that Identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. S. I will ensure that a registered copy of this Certificate of Installation shall be posted, or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder /Installer Name: Responsible Builder /Installer Signature: STEINER, ARNIE Company Name: (Installing Subcontractor or General Contractor or Builder /Owner) Position With Company (Title): ALLIED AIRE SERVICE INC President C�� ✓/G7i��IrG,\ Address: CSLB License: 887 AMU) AVENUE 260035 City /State/Ap: Phone: 1(408) Date Signed: MILPITAS CA 95035 934 -8844 2014 -10 -29 11:02:37 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- A0116514A- M0100002A -0000 Registration Date /Time: 2014 -10-29 11:02:37 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -05 -13 Report Generated: 2014 -10 -14 13:28:53 Schema Version: 0.551SDD