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14110128CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10411 TONITA WAY CONTRACTOR: AAA FURNACE & AIR PERMIT NO: 14110128 CONDITIONING OWNER'S NAME: SAN JOSE, CA 95125 PHONE NO: (408)293-4717 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIALE] REMOVE AND REPLACE FURNACE IN SAME LOC. License Class--- C- Lic. #� Contractor CNA Ce - Date Zapter I hereby affirm that I am licensed under the provisions of 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: $4674 1 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 35914008.00 Occupancy Type: 1 ection 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 WITII N 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 CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued b 1� 1 Y Date: Z granting of this permit. Additionally, the applicant understands and will comply withsource all non -point soue reg ati s per the Cupertino Municipal Code, Section 91 � RE -ROOFS: Signature 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 b the Bay Area Air Quality Management District I performance of the work for which this permit is issued. lia with the upertino M mcipal Code, Chapter 9.12 and will maintain com=horized I have and will maintain Worker's Compensation Insurance, as provided for by the Health e, �[ 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 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 • (YEN -15 -RAL PERMIT APPLICATION ME, COMMUNITY DEVELOPMENT 0EPARTMENT41ftJ..ILDING DIVISION • 103-00 TORRE AVENUE r CUPERTINO; CA 95014-3255 \"S c 28 - FAX 408 777.3333 , buiiding0cupertino.or4 \ (408) 777 32 ( ) \� i n fel —ur+dr r -A XMf)f rC r UTC3 tv(ECMANIQAL PROJECT ADDRESS ij' �(� I�G APN Mq �(, jyCO OWNERNAME`CV 1 � STREET AJJDF -4S �n i vJvV`FAX ONTACi NAIV(S E-MAIL 9TitEi"T ADD??'3S a. MY, STATE, ZIP FA's ❑ OWNER _n OWNI#R-BUILDER ❑ OWNIM AORfr ONTRACTOR ❑ CON-MACTORvAOSNT ❑ ARCHnTCT ❑ WQ NMr ❑ ()EVEIyorER ❑ TU4AKT CONTt.�' 70?. w'.:uE r' a, n ' n�� 1 LICENSE NUNuC �s 45 C20 ays. uc' CONG'ANY NAlya 'V Gf) a-MML FAX STREET ADDRESS tj PWI LO ATE JI ARG?'i =[�.� _'.::�RNANdl LICENS$NtlMBER aU3. uc C:'... ........ "MAIL FAX - -- - - =, STATE, ZI P PHONE VSE OF FD or Duplex ❑ Multi -Family PROJECT IN WILDLANO Yes � PROJECT IN n FLOOD' -ONE O Yes Commercial URBAN DnWACE AY -EA❑ .;o To -'AL YA.LUA'RON: $ t�C {` , A iow, T ecrt•ify teac o h of the following: I am the property owner or authorized agent to act on the prtip2Ttq comer s bcha!r f '° this on ac iniormadon T have i3 eorrec [ ha read the Description of Work and veniy r is acc,"r atc. I agree ro Cc au rize tt3entatives of Cupertino te. -!cr she ztiov -iden 4 prof" an.- ::e laws relating uIlding c1:1111:11111111 Date; SUP pf AL MORMA I"tON REQUIItED . ... CITY OF CUPERTINO TUU UQrrTl%4 A rr"ID — 72TTTT .1 1l%TP-nlVlClnN ADDRESS: 10411 tonita way DATE: 11/21/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$4,674 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY —1 or Duplex PENTAMATION FURN/AC 1SFD PERMIT TYPE: USE: $0.00 WORK remove and replace furnace in same loc. SCOPE PME Unit Fee: APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced -Air 1MFR=<100 1 # $143 TOTALS: $143.00 Mech. Plan Check 0.0 1 hrs $0.00 t'hwlb, Plan Check E ec.1 lun Chu'c'k Mech. Permit Fee: IMPERMIT Plumb. Permit let:. Permi T'`Lcz Other Mech. Insp. 0.0 hrs ] $48.00 Other Numb frtsv.ED E3tl'ea` �'?e<'. 1rs�"'. ED l7haaalbDazs p. Fee f ::e . I,�i 1� <%e: laa> t E: NOTE: This estimate does not include fees aue to otner departments (i.e. riunrnng, rnunc rr vrnu, a cr c, u......w.y �.• rnntart the Dent for addn'l info. Il/s'/rlc/, etc. . i//ene I G.. urc u—cw -1. .... I FEE ITEMS (Fee Resolution 11-053 off.' 711/13) .._---- ____ _-_ _ ____----- FEE QTY/FEE MISC ITEMS Plan (_7it,ck Fee: 7= PME Plan Check: $0.00 PME Unit Fee: $143.00 PME Permit Fee: $48.00 Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes 0 No $0.00 -'ldV6,11c c 1'Jc c r i t 1f"c e:i': i Travel Documentation Fee: ITRAVDOC $48.00 Strom Motion Fee: IBSEISMICR $0.61 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC — $1.00 _ $285.611 $0.00 _ TOTAL FEE: $285.61 Revised: 10/01/2014 STATE OF CALIFORNIA ALTERATIONS - HVAC [CO -5-3; 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 -1R -ALT -HVAC) (Page 1 of 1) Site Address:' ��A J 10 ( �Al,�� V� Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New: Ducting, Plenums, Lineset Conditioned Thermostat Required R -value Floor Area (sq ft) ❑ Packaged System ❑ Evaporator Coil MFUE COP ❑ R-6 (CZ 1,3-7) Ducts Served by system ❑ Setback ❑ Split System 13 Condensing Unit SEER 13q R-8' (CZ 16) Ducts ) p s ft (If not already HSPF IJ R-6 (all CZ's) Plenums present, must Furnace ❑ 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 (:5_15% or,: .10% to outside, or seal all accessible leaks) Exempted from duct leakage testing if: ❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building1 ❑ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CFIR-ALT-02-E CF2R-MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS CF3R-MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS' Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 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 CF111-ALT-02-E Ducts' and one or more of the following: CF2R-MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS Condenser Unit, Evaporator Coil, Furnace CF311-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 space but less than All New Ducts' CF2R: MECH-20-HERS CF3R: MECH-20-HERS Installer Required to: Duct leakage (:L15% 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. ' 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. ' 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.S -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. Re onsible Designer Na e: espon igner Sign r Date Signed Licens Company: Address: City/S Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 CUPERTINO 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 • build ing(a)cupertino.org I "-k 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: hi 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. I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: Sinature ....... ....................................................................... ............................... Date: ................... Contractor Name: 'Ot Si natur :... ............. .... ..... ............................... v .... Date: U Smoke and COform.doc revised 03118114 11/24/2014 Alteration MR- MCH -01 -H 13fT 01 System Name 02 Heating System Type 03 Altered Heating Component 04 Heating Efficiency Type 05 Heating Minimum Efficiency Value 06 Cooling System Type 07 Altered Cooling Component m..._�.._._._...._.�_ g ponent 08 Cooling Efficiency Type 09 Cooling Minimum Efficiency Value 10 Required Thermostat Type 11 New or Replaced Duct Length 12 New Duct R -Value No Cooling Components Altered All New Cooling Components Compressor Fancoil AHU IndoorCoil D. Installed Heating Equipment Information 01 System Name TRANE 02 Heating Efficiency Type AFUE 03 Heating Efficiency Value 0.78 1 Must be a valid number hftps://www.calcerts.com/alterations-2013—cf2r—mechOl.php 1/3 11/24/2014 Alteration MR- MCH -01 -H 04 Heating Unit Manufacturer TRANE 05 Heating Unit Model Number TDD2B080A9V3 06 Heating Serial Number N/A w _ . 07 Rated Heating Capacity, Output (BTUH) [80 Must be a valid integer E. Installed Cooling Equipment Information 01 System Name N/A - No Cooling Components Altered 02 Cooling Efficiency Type N/A - No Cooling Components Altered 03 Cooling Efficiency Value N/A - No Cooling Components Altered 04 Condenser or Package Unit Manufacturer N/A - No Cooling Components Altered 05 Condenser or Package Unit Model Number N/A - No Cooling Components Altered 06 Condenser or Package Serial Number N/A - No Cooling Components Altered .. x._ .._ .. ........ _. . 07 System Rated Cooling Capacity at Design Conditions (BTUH) N/A - No Cooling Components Altered 08 Condenser Rated Nominal Capacity (ton) N/A - No Cooling Components Altered J. HERS Verification Requirements 01 System Name TRANE 02 System Location WHOLE HOUSE 03 Exemption From Duct Leakage Requirements i Has Asbestos 04 MCH20 - Duct Leakage Test No - Exempt 05 Exemption from Minimum R -Value N/A for Ducts In Conditioned Space 06 MCH21 - Ducts Located In Cond Space Verification No 07 MCH22 - AHU Fan Efficacy (W per cfm) No 08 MCH23 - AHU Airflow Rate (cfm per ton) No 09 MCH25 - Refrigerant Charge No 10 MCH28 - Return Duct Design Table 150.0 -C or D No INSTALLATION DATE Date of System Installation 1014 I?_ may not be greater than today DOCUMENTATION AUTHOR Documentation Author Name: Eric Rando Documentation Author Company Name: RANDO AAA HVAC INC CEA /HERS Certification Identification (If applicable): N/A RESPONSIBLE PERSON https:/ANv,iw.calcerts.com/alterations-2013—cf2r—mechOl.php 2/3 11/24/2014 Alteration MR- MCH -01 -H Responsible Builder /Installer Name Rando, Eric _. Company Name RANDO AAA HVAC INC • Position With Company: OWNER * ** ALERT * ** The registration of this document will require payment before printing. SAVE BACK SUBMIT .; Copyright © 2004 -2014 CaICERTS, Inc. All rights reserved. hftps:/Avww.calcerts.com/alterabons-2013—cf2r—mechOl.php 3/3 � FILE [Koo-5 CERTIFICATE OF COMPLIANCE CF1R- ALT -02 -E Alterations to Space Conditioning Systems (formerly CF -1R- ALT -HVAC) (Page 1 of 4 ) Project Name: EMMY GLUMAC Date Prepared: 2014 -11 -14 A. General Information CF1R- ALT -02 is applicable to multiple spa nditioning s tems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF1R -ALT ocument o ch dwell g unit. 01 Project Name EMMY GLUMAC 02 Date Prepared 2014 -11 -14 03 Project Location 10411 TONITA WAY 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name EMMY GLUMAC 07 Zip Code 014 OB Dwelling Unit Conditioned 1532 Installing new SC Installing Installing Installing Floor Area (ft2) Identification or Location or Area by this'SC ducted containing Number of space conditioning more than 40 09 Climate Zone 4 30 (SC) systems in this dwelling 1 system? component? components? feet of ducts? unit. SC system? B. Space Conditioning (SC) Systemjpiormation 1 01 02 03, 04 f5 s;. O6._ 07 OS 09 10 xx. °fsthezSC Ipstallinga 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 TRANE WHOLE HOUSE 1532 Yes No Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 214- A0140230A- 000000000 -0000 Registration Date/Time: 2014 -11 -14 14:30:00 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -11 -14 14:31:11 Schema Version: 0.551SDD CERTIFICATE OF COMPLIANCE CF111- 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 Central large No cooling This field or This field or Less than or TRANE furnace AHU AFUE 0.78 packaged AC component section is not section is not Setback equal to 40 R -6 altered applicable applicable feet Required Documentation: CFZR- MCH -01 -E -Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R- MCH -20 -H & CF3R- 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: 5 15 %, or 5 10% leakage to outside, or seal all accessible leaks. CF2R- 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 Fiow 2 300 CFM /ton;required when MCH -25 isy required. Exceptions: _! , -. A :�"�' -Duct systems registered with HERS provider as pre Iously sealed are exempC�' from MCH -20 Duct Leakage Testing requirements. - Heating -only systems and Air Handler /Furnacetc anges do not re Air Flow MCH-23,br Refrigerant:Charge MECH -25. - Existing duct systems constructed, insulated or�*ied with be Cempt 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)1E, F) This section does not apply to this project. Registration Number: 214- A0140230A- 000000000 -0000 Registration Date/Time: 2014 -11 -14 14:30:00 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -11 -14 14:31:11 Schema Version: 0.5515DD 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 15O.2(b)1C) This section does not apply to this project. AK Registration Number: 214- A0140210A- 000000000 -0000 Registration Date/Time: 2014 -11 -14 14:30:00 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -11 -14 14:31:11 Schema Version: 0.551SDD 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: �j r Rando, Eric G /itRSlZ- Company: Signature Date: RANDO AAA HVAC INC 2014 -11 -14 14:30:00 Address: CEA/ HERS Certification Identification (if applicable): 1712 STONE AVENUE NSA City /State /Zip: Phone: SAN JOSE CA 95125 (408) 293 -4717 Responsible Person's Declaration statement I certify the following under penalty of perjury, underthe laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. lam eligible under Division 3 of the Business,and.Professions Code to accept responsibility for the building design ocsystem design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performs tespei:ifioations n mateals componentsand 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 QW16f the Callfomla Code of Regulations 4. The building design features or systa`�esign features�'idE,fnbRedi on'thlrCertrficate of Compliance are consistent with the- information provided on other applicable compliance documents, worksheets, calculations, plans and specification 6,, dbmitted.to4,t�heg� tte enY agency for approvafwith this bulldin :permit application. S. I will ensure that a registered copy A s,Certificate -of compliance sIhafl be mSde 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 Ceitifita #e3of Cornphance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: - Responsible Designer Signature: Rando, Eric �/ Company: Date Signed: RANDO AAA HVAC INC 2014 -11 -14 14:30:00 Address: License: 1712 STONE AVENUE 768871 City /State /Zip: Phone: SAN JOSE CA 95125 (408) 293 -4717 Digitally signed by CaICERTS. This digitaf signature is provided in order to secure the content ofthis registered document and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 214- A0140230A- 000000000 -0000 Registration Date/Time: 2014 -11- 1414:30:00 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -03 -31 Report Generated: 2014 -11 -14 14:31:11 Schema Version: 0.551SDD