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15070023 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20560 RODRIGUES AVE CONTRACTOR:R&B HEATING AND A/C PERMIT NO: 15070023 OV1'NER'S N.4�IE: DUAN THOMAS AND WANG YUEH-CHEN TRUS 418 MENKER AVE DATF, ISSLIED:07/O6/2015 OWNER'S PFIONE: 4088285456 SAN JOSE,CA 95128 PHONE NO:(408)977-1401 ,�7� LICENSF.D CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL � COM11MERCIAL � 7" DUPLEX#20570-REMOVE WALL FURNACES& INSTALL License Class�� Z L' Lic.# ��;' �� (N� CENTRAL HEATING IN ATTIC AREA(TO MEET ALL 2013 Contractor Date �'--�� CA I hereby affirm that 1 am licensed under the provisions of Chapter 9 CODE ACCESS/LOCATION REQUIREMENTS) (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: 1 have and will maintain a certificate of consent to self-insure for Worker's ompensation,as provided for by Section 3700 of the Labor Code,for the '�rformance of the work for which this permit is issued. Sq.Ft Eloor Area: Valuation:$5000 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of[he work for which this APN Number:3�917017.00 Occupancy Type: permit is issued. APPLIC.4NT CERTIFICATION 1 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 D IT 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 R _ LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgment costs,and expenses which may accrue against said City in consequence o �s _- - �'�' ate- � t? �� granting of this per Additionally,the applicant understands and will comply with all non-point rce regulations per the Cupertino Municipal Code,Section 9.18. �-� / RE-ROOFS: Signature L�"�'"� Date 'lo � All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without tirst obtaining an inspection,I agree to remove all new materials for inspection. ❑ O��'NER-BUILDER DECL.4R.4TION Signature of Applicant: Date: I hereby affirm that 1 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) l,as owner of the property,am exclusively contracting with licensed contractors to HA'I,ARDOUS M1tA7'ERIALS DISCLOSURE construct the project(SecJ044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 2553A. 1 will I hereby aftirm 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 2_5532(a)should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should[use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of[he Labor Code,for the air contaminants as defined by the B Area Air Quality M11anagement District I performance of the work for which this permit is issued. will maintain compliance with the u ertino Ntunicipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by [he Health&Safety Code,Sectio s 505,25533 nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this � Z•�-- f permit is issued. Owner or authorized agent: Date:��+ � 1 certify that in the performance of[he work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of Califomia. If,after making this certificate of exemption,I CONSTRUCTION LENDING.4GENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must 1 hereby aftirm that there is a construction lending agency for the perfomiance of forthwith comply with such provisions or lhis permi[shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 1 certify that l 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 proper[y for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 wi[h all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date � CENEFZAL PER�I�[fT APPLlCAT[�N . .. COMNiUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 ' (408)777-3228 • FAX(408)777-3333 • buildina(a�cupertino.orq / �� UPERTtNU ❑ PLUMBING MECHANIC?,L ❑ELECTRICAL ❑AQISCELLANEOUS � ?ROJECT.ADDRESS �,r V_I �� • APN n � S � � l �" � V / � O�T��ER1�iA?�1E �M�/ PHONE E-M.AIL J �- — ►�I - C,cl ��.�- �-�L'� ��fS� STREET.4DDRESS �f'/� 8 / ��/ eYY-� - �� 'v C ST.4TE,7�P�� l � �/� F.AX e � « �i(J u �__i� COI�'IACT I�.AAJE PHONE E-?vI.AIL � ;� �� , �� c�-� J �� STREET ADDRESS CITY,STATE, ZIP FAX / �-�%z�� "L� 5�c�. ' � � `,/`�- �rs?� ❑ OP?T'ER ❑ OHT'ER-BUII.DIIt ❑ OW?��ER AGE'�'T L�7 C0�^,RACTOR ❑CO?�TRACTOR AGENT ❑ ARCHITECT ❑E�GL'�'EER ❑ DEVEIAPER ❑ TEN.41�'T CONTRACTOR 1�AAiE LICENSE I�'UT�ER LICENSE T'Y'PE BliS.LIC� � � '2 C-2� COMPAI�'Y r.AME ,, • ' E-MAIL FAX 2� �1}'T/rL/ �%�' I STREET ADDRESS CITY,STATE,ZIP PHO\'E �`� ' C,c-7� C� � � �'S 2�. � �� /S��/ ARCHITECT/ENGINEER NAME LICcI�SE NiJMBER BUS.LIC R COMPAtv'Y N.ANLE E-MALL FA}: STREET ADDRESS CITY,STATE,ZIP PHOI�TE USE OF ❑SFD or DLJPLEX ❑ MULTI-FP,TiII.,Y PROJECT PJ WILDLA2�TD ❑ YES PR07ECT IN ❑ 1'ES IS TI�E BLDG AN ❑ YES BUII.DL�G: �COMIvfERCL0.L URBAN A'TERFACE AAEA � NO FLOOD ZOI�t ❑ ?�'0 EICHLER HOME? ❑ NO DESCRIPTIOt�'OF WORK i 1_ 1 wtC c:'� ��,4 j� �w�t 4� c:�5 /iC.�" / �Z`., GP:�'7`� 'V2� �yc C� I iVv ��—, � __ - _ __ �___�_..,__ -- TOTAL VALUATION: Z�� CEI�"ED �'- �;,m By my signature below,I certify to each the following: I asn tt;e property o��ner or authorued a�ent to act on the-pm�erty`�ncr's behalf. I have read this application and the inforu�ation I have ��ided is conect. � � read the Description of\TJork and verify it is accurate. I a�ee to comply with all applicable]ocal ordinances and state la��s relatin�to ildin�construction. tborize representatives of Cupertino to enter the above-identified propeiTy for inspection purposes. Signaiure of ApplicandA�ent: y Date: ��cc-% ` �� SUPPLE��ENTAL Ii� ATION RE D orFlc��;sE o�:L�� -�.3z rTrF-co�;�rr.3: _ J F�PI:I'.SS _ �'c`I'A\I�ARD � � l.:�hcr:� � ❑� ��aJOEz R7FPA7iscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO � FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20570 RODRIGUES AVE DATE: 07/06/2015 REVIEWED BY: MELISSA � APN: 359 17 017 BP#: �j �v� 'VALUATION: $5,000 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: FURN/A� WORK REMOVE WALL FURNACES & INSTALL N CENTRAL HEATING IN ATTIC AREA TO MEET ALL SCOPE 2013 CA CODE ACCESS/LOCATION REQUIREMENTS) APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $143 TOTALS: $143.00 Mech.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT Other Mech. Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to ot/:er Departments(t.e. Planning,Pubfic Works, Fire,Sanitary Sewer District,School District,etc. . These ees are based on tl:e reliminar in ormation available and are onl nn estimate. Contact the De t or addn'l in o. FEE ITEMS (1-'ee Resolu�ioj� 11-0�3 I j'/' ?��1��13J FEE QTY/FEE MISC ITEMS :� PME Plan Check: $0.00 PME Unit Fee: $143.00 PME Permit Fee: $48.00 Administrative Fee: �AON1�N $45.00 Work Without Permit? � Yes � No $0.00 Travel Documentation Fee: �T2AVDOC $48.00 � Strons� Motion Fee: IBSEISti11CR $0.65 Select an Administrative Item E31d<� Std� Commission I�ee: 1/3CBSC $1.00 SUBTOTALS: $285.65 $0.00 TOTAL FEE: $285.65 Revised: 07/02/2015 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: Enf cement gency: Date P epa ed: Permit#: . � ,,, � 6 Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditio ed Thermostat Required R-value Floor Area(sq ft) ❑ Packaged System ❑ Evaporator Coil �FUE COP �R-6 (CZ 1,3-7)Ducts Served by system �'Setback ❑ Split System ❑Condensing Unit SEER � R-8' (CZ 16J Ducts Sq ft (!f not already HSPF f'9 R-6(al!Q's)Plenums ` present must C�'jFurnace ❑ Lineset EER ❑ R-5 or R7.5 Lineset3 be insto/ledJ 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 ou nd. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. ❑i.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can include new ducting All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coii, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS Installer Requirement:Duct leakage(<15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: ❑ 1.Duct system registered with HERS provider as previously sealed,or O 2.There is less than 401inear 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 Ducts2 CF1R-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)-HERSZ Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) ❑3.Ail New Ducts witt�Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF1R-ALT-02-E DuctsZ and one or more of the following: CF2R-MECH-Ol,MECH-20-HERS,MECH-(23 or 24)-HERS Condenser Unit, Evaporator Coil,Furnace CF3R-MECH-20-HFRS,MECH-(23 or 24)-HERS Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) ❑ Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. ❑4.New Duding over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in unconditioned CF1R-ALT-02-E space but less than All New Ducts2 CF2R:MECH-20-HERS CF3R:MECH-20-HERS Installer Required to:Duct leakage 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. 'Ali 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-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: l. The information provided on this Cer-tificate of Compliance is true znd correct. 2. I 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 ofTitle 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 compiiance docum ts,worksheets,calculations,plans and specifications submitted to the enforcement cy for approval with this building permit p cation. Respo le Designer Name: Respo i Designer Signatu . Date Signed: License: yH,�� i��'�— c,.��- � �—��S �-�i S Z ��- Company: A dress: ty/State/Zip: Phone: �.�� '��►`7i �c-.��' ,� �/(`� i,� F>�''� /a f.L� �� S� ��- rj�`�� I��`� ��'� For zssistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300