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15070239
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11103 CANYON VISTA DR CONTRACTOR: CALVEY HEATING & PERMIT NO: 15070239 AIR OWNER'S NAME: MERGARD JAMES AND ANNETTE P O BOX 4146 DATE ISSUED: 07/31/2015 OWNER'S PHONE: MOUNTAIN VIEW, CA 94040 PHONE NO: (650) 669-3320 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL REPLACE (E) A/C UNIT WITH (N) 13 SEER A/C UNIT (5 License Class Li.. # �� Q Q TONS) Contractor C G CrDate44-2 I hereby affirm that tAL licensed order 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 Sq. Ft Floor Area: Valuation: $4000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 35628029.00 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 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 FROM LAST CALLED INSPE TION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the O C granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with ail non-point source regulations per the Cupertino Municipal Code, Section 9.18. RE-ROOFS: Signature Date7/:%1'S 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 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, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 3) 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 CUPERTINO GENERAL PERMIT APPLICATION 150ioO COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildingecuoertino.org ❑ PLUMBING MECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS PROJECT .ADDRESS APN n v `lJ oa1 . OWNtRNAM � STREETADDRE y. P"•,'z- ' �} qq � �� (, ] �F-MSIL 1 CITY, STATE, �( 1" 1r FAX CONTACT NAbf PHONE E-MAM 0, vie STREET ADDRESS CITY, STATE, ZIP 7FAX ❑ OWER ❑ ONR.'ER-BUIIAKt ❑ OWNFRAGEN'T ❑ CO\'MkCTOR ❑ COATRACTORAGENT ❑ ARCHITECT ❑ ENOWEER ❑ DEVELOPER ❑ TENAIvr CONT OR '? ASE LI ER LICENISETYYE _ BUS. LIC ONT O l"") "I. n - a F SIRE RE q) CI�jSeJ{sT , IP I�pt ARCHI7ECT/ENG1N7EER NAME LICENSE NUMBER BUS. LIC n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OFSFD or DUPLEX BUIIDING: ❑ COMMERCLAL ElMULTI-FAMILYPROJECT IN WILDLAND ❑ YES PROJECT IN ❑ YES URBAN INTERFACE AREA ❑ NO FLOOD TONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK �if cine TOTPL VA1.U-ATION: W-8, t By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons cti I authorize representatives of Cupertino to enter the above e--i entified mperty for inspection purposes. Signature ofApplicznt/Agent: Date: / SUPPL UM NTAL INFO TION REQUIRED oFFJc� rs ��Lr 0\� 1 () :NIL!, _l A _TOF MEPAfisa4pp_2011.doc remised 06/21/11 CITY OF CUPERTINO i 0 FEE ESTIMATOR — BUILDING DIVISION 1�Q APPLIANCE / EQUIP TYPE ADDRESS: 11103 CANYON VISTA DR. DATE: 07/31/2015 REVIEWED BY: PAUL UNITS APN: 356 28 029 BP#: "VALUATION: 1$4,000 °PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: # PENTAMATION FURN/AC PERMIT TYPE. WORK Replace E A/C Unit with N 13 SEER A/C Unit 5 TONS SCOPE I'crmit itppL Insp Fee APPLIANCE / EQUIP TYPE FEE ID �'hwib. Man Clieck QTY UNITS BP FEES Elec. Permit Pee: A/C Units (<=10K cfm) 1 BREMAIR Other Elec. hap Li I 1 # $72 F( -C3: I'crmit itppL Insp Fee PME Unit Fee: $72.00 PME Permit Fee: $48.00 onstruction Tax: Administrative Fee: 1ADMIN $45.00 Work Without Permit? © Yes (D No $0.00 TOTALS: A Travel Documentation Fee: ITRA VDOC $72.00 Strong Motion Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-033 UL.711113i Mech. Plan Check Rolhrs $0.00 �'hwib. Man Clieck Elec. Plan Check Mech. Permit Fee: IMPERMIT Plumh. I' Vee: Elec. Permit Pee: Other Mech. Insp. 0.0 hrs $48.00'Other Pluntb Irr p.Li I Other Elec. hap Li I liar) 1t. Plumb. Insp. F!_... 1',lec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-033 UL.711113i FEE QTY/FEE MISC ITEMS /Platt Check P'ee. �'uppl. 1'C Fee PME Plan Check: $0.00 F( -C3: I'crmit itppL Insp Fee PME Unit Fee: $72.00 PME Permit Fee: $48.00 onstruction Tax: Administrative Fee: 1ADMIN $45.00 Work Without Permit? © Yes (D No $0.00 Adv,oneed Pkinning 1--ees: A Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICR $0.52 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $214.52 $0.00 TOTAL FEE: $214.52 Revised: 07/02/2015 Rancho Deep Cliff Homeowners Association July 9, 2015 James Mergard REGARDING PROPERTY Annette Mergard 11103 Canyon Vista Drive 11103 Canyon Vista Drive Cupertino, CA 95014 Cupertino, CA 95014 Subject: V00054960 - Architectural Approval (Air Conditioner) Dear Homeowner(s), The Board of Directors reviewed your request for replacement of the Air Conditioner for your unit, located at 11103 Canyon Vista Drive. Please be advised that the Board of Directors has approved your application subject to the following conditions: • The unit owner assumes all responsibility for costs associated with this installation. • The unit owner assumes all responsibility, both legal and financial, for any and all damages to any exterior surfaces or damages of a structural or personal nature caused by the installation of such air conditioner. • The unit owner is responsible for all future maintenance, repair and replacement work associated with such installation. The obligation runs with the lot and must be disclosed to any potential purchaser of the unit. The unit will be no higher than the parapet wall. The unit will be under 40 inches tall and will not be visible from the common area. The installation must be coordinated with the associations roofing contractor to insure the integrity and warranty of the existing flat roof. There will be no penetration of the roof surface. The unit will be mounted on the existing platform. If you have any questions regarding this approval please call me at (408) 226-3300. Sincerely, RANCHO DEEP CLIFF HOMEOWNERS ASSOCIATION Jason Overhulse Association Manager RECET VTED Cc: Board of Directors Unit File "JUL 312015 BY Compass Management Group, Inc. 77 Las Colinas Lane, San Jose, CA 95119 Business (408) 226-3300 Fax (408) 226-3406 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS APPLICATION FOR ARCHITECTURAL MODIFICATION Name of Owner(s): Jim Mergard Unit Address: 11103 Canyon Vista Drive, Cupertino, CA 95014 If rented, Owner's Address: Home Phone: 512-922-1642 Work Phone: Email: imergard@me.Com There are two broad types of Architectural Modifications: 1.) Standard modifications which have a previous request history that has resulted in a set of architectural standards leading to an expedited approval process. 2.) Non -Standard modifications requiring a more thorough review process prior to any approval. Both types of architectural modification require formal application and approval. This application form and its respective attachments will serve for both types of modification requests. Applicant understands and agrees that failure to conform to the requirements stated in the approved architectural modifications (both Standard and Non -Standard) will be automatic authorization by the applicant to have the work brought into conformance with the approved requirements at owner's expense. Applicant understands that the Association maintains the right of approval of the stated addition, change, or alteration and may require its removal, should it become necessary for safety, maintenance of surrounding structures, or lack of proper maintenance. Applicant further understands and agrees that all costs incurred by the Association as a result of bringing said work into compliance would be a charge against the owner and the owner's condominium, to the full extent authorized by the law. Such costs shall include: construction, reconstruction, administration fees, attorney fees and reasonable court costs, if incurred. It is also agreed that no work will be initiated which will be in violation of any of the provisions of the Association's Declarations of Covenants, Conditions and Restrictions or any applicable building code; be an annoyance to the residents; or increase the cost of insurance. Applicant agrees to be responsible for damage to the exterior of the building that may arise as a result of the requested addition, change or alteration and will be responsible for maintenance of same. It is also agreed that any necessary insurance coverage for the protection of these additions will be the sole responsibility of the owner(s). Applicant understands that all necessary permits and approvals from municipalities or other jurisdiction are the sole responsibility of the applicant and that Committee/Board approval of the application is subject to the applicant receiving all such necessary permits and approvals. Applicant agrees to indemnify the Association against any and all acts or claims arising in connection with the improvements, including but not limited to, any and all omissions, or claims arising in connection with the approval, construction, operational maintenance, repair, use or removal of the improvement, including attorney fees and costs of litigation in connections therewith. Applicant agrees to hold the Association, its Board of Directors, members, employees and agents harmless for any liability, injury, damage, or costs that may be incurred as a result of the stated addition, change or alteration. October 2012 1of6 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS Applicant agrees that, upon approval, all maintenance, repair or replacement of the approved item will be the sole responsibility of the unit owner and further that any expense incurred by the Association that is the direct or indirect result of the approved change shall also be the sole responsibility of the unit owner. This Application for Architectural Modification is for the following type(s) of application: ❑ Standard Architectural Modification as selected in the attached table of Architectural Standards. ❑✓ Non -Standard Architectural Modification as specified per the attached Architectural Standards, Project Details, description and drawings. Applicant agrees to the foregoing conditions and accepts these conditions as evidenced by the owner's signature. Signature: Date: 6-18-15 Signa te: Rancho Deep Cliff Homeowners Association Use Only: Approved: Denie Conditions of Approval: Signature: tk) � Ulq L � b�_ -N i Date: q I 1� I �Zl►go{ 0V'' 1? Cl,T(-r Allo\I_l lrC1ULo-Ik-►- �Ti Jr Submit applications to the Association by Fax or Mail to: Rancho Deep Cliff Board of Directors c/o Compass Management Group at 77 Las Colinas Lane, San Jose CA 95119. Fax (408) 226-3406 or by email to helpdesk(@gocompass.com October 2012 2 of 6 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS STANDARD ARCHITECTURAL MODIFICATIONS — EXPEDITED APPLICATION The standard exterior modifications below are approved for Rancho Deep Cliff homeowners. If you wish to make a standard modification, please initial the modifications and attach this checklist to the standard Architectural application available on the Compass Management web site or in the table in the club house. Both sides of the applications must be signed and dated by all owners of the unit. ITEM REQUIREMENTS Initials Front Door Side Clear or frosted (not colored) tempered glass installed in the existing Lights framework; frosted glass may have a pattern of homeowner's choice. Light Fixtures — Entrance & Front Patio ❑ Required fixture on front entryway or front facing location is Melissa light fixture #2032 in "Old Iron" finish with ripple glass ❑ Required fixture between side-by-side garages is Melissa light fixture # 2036 in "Old Iron" with ripple glass. Light Fixtures — ❑ Required fixture on patio locations observable from the street or Side & Back Patios common area walkways is Melissa light fixture #2032 in "Old Iron" finish with ripple glass. ❑ Other patio locations can be fixtures in owner's choice of style with height up to 14" (including decorative elements) and 7" in width. Required finish is matte black, dark grey or bronze shin / olished brass finish no longer allowed). Door Hardware Door handle and lock surround in owner's choice of style in original height and width (12" and 3" respectively). Required finish is matte black, dark grey or bronze (shiny/polished brass finish no longer allowed). Front Door The removal of the three medallions is an approved modification. The Modification large three panel trim molding must remain in place. Front Door — ❑ House paint color in Baja White (light), Breakfast Biscuit Paint Color (medium) or Travertine (dark) (contact Compass Management for unit color) ❑ Ruddy Oak Door paint must be Dunn -Edwards W901 Permasheen formulation. Exterior Front All new and replacement front screen doors shall be of the "Disappearing" Screen Doors style in a color matching the trim paint, e.g., "Sandalwood" from Phantom or "Champagne" from Clearview. Patio Heater Free standing, portable patio heaters are to be operated in accordance with the manufacturer's instruction and may not be operated under the eaves of the house. Fixed installation patio heaters are not permitted. I wish to make the standard architectural modification(s) initialed above for my unit at and will adhere to requirements stated above. If I or my contractor deviates from these standards, I authorize the Board of the Association to require me to correct the modification to meet the required standard at my expense. (Name) (Signature) (Date) (Name) (Signature) (Date) October 2012 3of6 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS NON-STANDARD MODIFICATIONS — DETAILED APPLICATION REQUIRED The architectural modifications listed below or any other non-standard external modifications ALWAYS require a regular application detailing the modification, product specifications including brand and color (samples may be required), contractor information and required permits. To expedite requests which require permits, the following pages provide information on window and door replacements. A completed application with all required attachments must be submitted to Compass Management. To expedite processing, please alert the Architectural Chairperson at the same time. Your application must be signed and dated by all owners of the unit. ITEM DESCRIPTION Window or Door Replacement with existing configuration requires approval of manufacturer brand, style and Replacement exterior frame color. Opening sizes may not be changed. See page 5 for allowed kitchen window configuration. Use attached spec sheet to identify brand, color and style. Window or Door Replacement with existing configuration requires with a modification (e.g., sliders replaced Modification with French doors) requires approval of modification, manufacturer brand, style and exterior frame color. Opening sizes may not be changed (i.e., a 5' door opening may not be expanded. Use attached spec sheet to identify brand, color and style. Front Entry Door Front entry door replacement in other than the original style may be approved with the Replacement or alternative of Style 2132 in the Classical Standard Series manufactured by T. M. Cobb in Reconfiguration paint grade finish. Front Entry Tile Front step entry ceramic tile may be approved if supplied by Cerdomus Ceramics, ROK series in colors of Anthracite or Tofu. The size shall be 6x6 or larger. Skylights Installation or removal of skylights, solar tubes and/or roof vents require an application and Solar Tubes must be installed to DuroLast roof specifications which can be obtained from Compass Management. Skylights, solar tubes and roof vents may not be installed through the rile Roof Vents portion of the roof. If the proposed installation is on a home with a DuroLast roof, coordination with the Association's roofing contractor at the homeowner's expense is required to maintain roof integrity and warranty. Replacement of Air All air conditioner and/or other roof mounted items must have a height profile no higher than Conditioners or Any the surrounding parapet wall. These items require a specific application. If the proposed Roof Mounted Items installation is on a home with a DuroLast roof, coordination with the Association's roofing contractor at the homeowner's expense is required to maintain roof integrity and warranty. Garage Door Garage doors require a specific application and must match the adjoining unit for duet Replacements homes. Contact the Architectural Committee to discuss updating garage doors on duet units with original configurations. Sousa Garage Doors in Santa Clara at (408) 248-0782 and Campbell Overhead Door at (408) 980-1270 are Association approved contractors. Patio Wall Gate Installation of a gate in patio walls requires an application and Association approval. Walkway Walkway replacement always requires a detailed application and Association approval. Replacement October 2012 4 of 6 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS ALL WINDOW MODIFICATIONS REQUIRE FULL APPLICATION & ASSOCIATION APPROVAL Replacement of the window or door frames always requires an approved Architectural Application. Replacing broken glass in the existing window or sliding glass door frames does not require an application. SINGLE PANE CONFIGURATION I DUAL PANE ORIGINAL CONFIGURATION ❑ KITCHEN WINDOW - SINGLE PANE CONFIGURATION: This is the current standard for replacement. A single pane center window with single pane side windows that open with a crank out mechanism for ventilation. The dual pane original configuration will be phased out as replacements occur. ❑ OTHER WINDOW OR DOOR CONFIGURATIONS: Replacement or modification of any window or door frame, including a conversion of sliders to French doors, requires a completed application and approval of the Association prior to beginning the work. Doors may open only on to owner's exclusive use property in existing patios (generally from living room, dining room or master bedroom). To replace windows or doors other than a kitchen configuration above, either in the existing configuration or a modification, note brand, style and color below and provide configuration details on additional sheets. NOTE: Frame color may be either original bronze/brown or a light brown/taupe shade matching window's wood trim color; frame color must match on all three windows. Window Manufacturer: Manufacturer's Style or Line: Exterior Window Frame Color: October 2012 5 of 6 RANCHO DEEP CLIFF ARCHITECTURAL STANDARDS NON-STANDARD APPLICATION PROJECT DETAILS Name of Owner(s): Jim Mergard Unit Address: 11103 Canyon Vista Drive, Cupertino, CA 95014 Applicant understands and agrees that submission of this form does not necessarily fulfill all of the conditions and requirements for an approval. In addition to a completed Architectural Application form, the applicant must submit to the Architectural Review Committee (Committee) and/or the Board of Directors (Board) a set of plans and specifications showing the nature, kind, shape, size, materials and locations of the proposed architectural alteration. The Committee/Board will review application on a case-by-case basis. There may be additional information required as deemed necessary to make a decision. Until all information is submitted to the Committee/Board, the application will be deemed to be incomplete and the application will stand unapproved. Applicant understands and agrees that the Committee/Board may impose "Special Conditions", as a condition of approval. Any special conditions shall be attached and be a part of the approval. Applicant agrees and understands that failure to conform to these requirements will be automatic authorization by the applicant to have the work brought into conformance with the approved plans, specifications and special conditions. Applicant agrees to the foregoing conditions and accepts these conditions as evidenced by the owner's sig tur . Signature: Date: 6-18-15 Signature: Date: Description of Proposed Work (or attachment if more space needed): Replace air-conditioning unit The following information is required for consideration of the application. Contractor's Name: Calvey Heating and Air License Number: 932199 Xj Copy of Contractors License X Copy of Contractors Insurance C Copy of estimate C Copy of plans, drawings and specifications X Is building permit required? Yes M Nod X Copy of any required city building permits October 2012 6 of 6 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: Mergard, Annette I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2015-07-15 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 CF1R-ALT-02 document for each dwelling unit. 01 Project Name Mergard, Annette 02 Date Prepared 2015-07-15 03 Project Location 11103 Canyon Vista Drive 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name Mergard, Annette 07 Zip Code 95014 08 Dwelling Unit Conditioned 2097 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 Altered space System 1 entire house 2097 Yes Yes Yes No No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)INb) This section does not apply to this project. Registration Number: 215-A0194166A-000000000-0000 Registration Date/Time: 2015-07-15 11:39:51 JUL 3 12015 BY HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-15 11:40:12 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 2 of 3 ) 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 No heating This field or This field or Central All new This field or This field or System 1 furnace component section is not section is not packaged AC cooling SEER 13 Setback section is not section is not altered applicable applicable components applicable applicable Required Documentation: CF2R-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%, or15 10% leakage to outside, or seal all accessible leaks. CF211-MCH-25-14 & 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 >_ 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 Handler/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)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 215-A0194166A-000000000-0000 Registration Date/Time: 2015-07-15 11:39:51 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-15 11:40:12 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 3 of 3 ) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Ca Calvey, Joe doe vy Company: Signature Date: CALVEY HEATING AND AIR 2015-07-15 11:39:51 Address: CEA/ HERS Certification Identification (if applicable): PO Box 4146 City/State/Zip: Phone: MOUNTAIN VIEW CA 94040 6502652202 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: Calt, Calvey, Joe cloe y Company: Date Signed: CALVEY HEATING AND AIR 2015-07-15 11:39:51 Address: License: PO Box 4146 932199 City/State/Zip: Phone: MOUNTAIN VIEW CA 94040 6502652202 Digitally signed by CalCERTS. 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: 215-A0194166A-000000000-0000 Registration Date/Time: 2015-07-15 11:39:51 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-07-15 11:40:12 Schema Version: 0.555SDD ner A r� n��lte r r a r OFFICE CQP, , CUPERTINO Ulding Deparlmeni- w REVIEWED FOR CODE C "Reviewed By: 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 • building Ca.cupertino.org I 1 103 C�,i U,Sk Dr c)'13 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 8314 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 8314 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 ac7re&4TcbvP1y with the terms and conditions of this statement Owner (or Owner Agent's) Name: Nl-.j YA Jca>Z cS 0 r ! U' k► Signature ............... 'p................................... �. ......................................... Date:............... Contractor Name: 11 Signature...................................................................Lic.#...................................... Date:................... Smoke and CO form.doc revised 03/18114 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • building0cupertino.org Owner Name J,� s '• ANKEnc )1424A/46 Permit No. 15-0702-59 Address 11103 (,A-? Y4N VISTit bZ. e"P£K-17r-1 0 PEWMIT CANTNTOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE d' HAS BEEN SI(.NFI) AND RE'I URNIA) TO THE 13tJTt-DING DIVISION z t; 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 Section 101.1 through 1101.8 do nota ply. Sign below and skip the rest of the form Owner' Signature:,d Date: I No Go to Question 2. lJ 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 rest of the form Owner' Signature:_ b Date: No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections01.1 through 1101.8 do Uot apply. Rign below and skip the rest of the form. Owner' Signature: OJAAO 6"YV uke Date: y I I� No Go to Question 4. Q I C v 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 Sectio 101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: k#V " G Date: �Yes My real property is b ilt and available for use or oc panty on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. 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 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. SB4072015.doc revised 02/04115 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 will be replaced prior to date specified above 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-consCzvis4g plumbing fixtures„cpmply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signaturd, 0,k,_ -L0 t) I 1 V:! � Date:- j—_. L Upon completing and signing this Certificate, please return it to tM Building Division in order to final your pen -nit. 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. SB407 2015.doc revised 02/04/15 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. SB407 2015.doc revised 02/04/15