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15090038CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1066 COLONY HILLS LN CONTRACTOR: ECO SYSTEMS HEATING PERMIT NO: 15090038 & AIR OWNER'S NAME: CHANG CHAO-YUAN AND YASYWE HU OWNER'S PHONE: 4082528765 ❑ LICENSED CONTRACTOR'S DECLARATION License Class CZ C Lic. # D L\,NG9 d A�f Contractor V --c<'. 'SNr4ecv—'3 Date 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: t. I have and will maintain a certificate of consent to self -insure for Worker's pensation, as provided for by Section 3700 of the Labor Code, for the Trmance of the work for which this permit is issued. e and willmaintain Woer's Compensation Insurance, as provided for by on 3700ofthe Labor Code,for the performance of the work for which this it is issued. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Addition applicant understands and will comply with all non -point source rf gulatiok per the Obpertino Municipal Code, Section 9.18. Date 9 U - �� ❑E I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: t. 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. 2. 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 permit is issued. 3. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date I I I DEERWOOD RD STE 200 1 DATE ISSUED: 09/04/2015 SAN RAMON, CA 94583 1 PHONE NO: (925) 415-5240 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REMOVE AND REPLACE A/C UNIT. Sq. Ft Floor Area: I Valuation: $3705 APN Number: 35928013.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSGP�E�C/TION. Issued by: ` Date: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & S ety C ons 25505, 25533, and 25534. Owner or tho Date : -9 RUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 Vh— (408) 777-3228 • FAX (408) 777-3333 • buildina(G cuoertino.org M10I�D���� ❑PLUMBING �11MCHAATICAL 7ELECTRICAL F7T\/TSCELLANPCITiR PROJECT ADDRESS I APN OWNER NAME PHONE &I✓L4IL STREET ADDRESS EY, STATE, ZIP FAX �� C A CONTACT NAME PHONE E•MAII ���c,.��-vr A\ c.•!e2 �Y'2.. -355- 9�-tlo STREET ADDRESSCITY, M y�eer�,.�c5o� ae_ 'LOG'' ST.,kTF �ct�.o a A g4Sc`3 FAX . ❑ OWNER. ❑ OV,R.'ER-BUJLDER ❑ OWNER AGENT L1CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINMER ❑ DEVELOPER ❑ T�ANT CONTRACTOR N?.ME LIC 'S NumBER LIC 'SE TYPE I-1 a 9 c BUS. LIC COMPANY NAME ";�_ e-_ S h A LY E-MAIL I FAX STREET ADDRESS 9TY, STATE, p ARCHITECTIENGINTER NAME LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL I FAY, STREET ADDRESS CITY, STATE, ZIP PHONE USE OF W4FD. DUPLEX ❑ MULTI-FA7 ULY I . PROJECT LN WILDLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ } tS BUILDING: ❑ COMMERCIAL URBAN JNTERFACE AREA ❑ NO FLOOD ZONE ❑ NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK TOTAL VALUATION: O I V R. C =i , ED F i By my signature below, I certify to each of the following: I e prop owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is rrec ave read Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con cti utho ' representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: " 4 - SUPPLEMVITAL D FORMATIO REQUIRED k MEPAriSC-4pp_2011.doc remised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 1066 COLONY HILLS CIR DATE: 09/04/2015 REVIEWED BY: SEAN UNITS APN: BP#:Q��j -VALUATION: 1$3,705 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: # PENTAMATION FURN/AC PERMIT TYPE. WORK REMOVE AND REPLACE A/C UNIT. SCOPE '),uppl. Insp 1 e c APPLIANCE / EQUIP TYPE FEE ID i'liimb. Plan Check QTY UNITS BP FEES flee. Permit Fee: A/C Units (<=10K cfm) 1 BREMAIR 01her Elec. hisp LLI L 1 # $72 Permit '),uppl. Insp 1 e c PME Unit Fee: $72.00 PME Permit Fee: $48.00 ( `f�rt.titt�uctinn Mx: Administrative Fee: 1ADMIN $45.00 Work Without Permit? © Yes E) No $0.00 TOTALS: 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 fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7f /1/13) Mech. Plan Check 0.0 1 hrs $0.00 i'liimb. Plan Check L7ec. Plan Cheek Mech. Permit Fee: IMPERMIT flee. Permit Fee: Other Mech. Insp. 0.0 hrs $48.00 r )then Plumb lasp.Li 01her Elec. hisp LLI L A/111 /I / ,r [''c Phimb, "'Vp. Fee: glee. Insp lee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7f /1/13) FEE QTY/FEE MISC ITEMS 'lixn Check Fc, uppl. P(' Fee PME Plan Check: $0.00 Permit '),uppl. Insp 1 e c PME Unit Fee: $72.00 PME Permit Fee: $48.00 ( `f�rt.titt�uctinn Mx: Administrative Fee: 1ADMIN $45.00 Work Without Permit? © Yes E) No $0.00 4/((meed PlanninP, l'ecs: Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $214.50 :$0:0±0 TOTAL FEE: 1 $214.50 Revised: 07/02/2015 "-- . ALTERATIONS - HVAC Print clear Form CEC-CHR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: 1066 COLONY HILLS LANE Enforcement Agency: Date Prepared: Permit#: City ofil v\t7 9-2-15 Equipment Type Equipment Efficiency New Ducting, Plenums, Lineset. Required R -value Conditioned Floor Area (sq ft) Thermostat ❑ Packaged System 10 Evaporator Coil 78 AFUE N/A cop ❑ R-6 (CZZ 8-13) Ducting Served by system 19 Setback 10 Split System ® Condensing Unit ❑ R-8' (CZ 11, 14, 15) Ducting sgft (if not already ❑ Mini Split ❑ Compressor 14 SEER 7-7 HSPF ❑ R-6 (all CZ's) Plenums present must ❑ Furnace ❑ Lineset 11 ❑ R-5 or R7.5) Lineset° be installed) ❑ TXV EER 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: All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)' -HERS, MECH-25-HERS' Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' Air Handler/Furnace' (Can include new ducting) Installer Requirement: Duct leakage (< 15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge. 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 building ❑ 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 including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New Ducts3 and one or more of the following CFIR-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: ❑ 1. 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: New ducting but less than All New Ducts3 CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems 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. ' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 ' All New Ducts is when at least 75 percent of the duct system is 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, coil, 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 1.5-2T-2%", 2.5-3T-2%", 3.5 to 4T-2ya", 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 identifienonCert ificate of Compliance are consistent with the information provided on other applicable compliance documents, workshetions, plans and specifications submitted to the enforcement agency for approval with this building permit appliyation. Responsible Designer Name: Responsible D 'gner Si ture: Date Signed: License: ABRAHAM ALVAREZ 924909 Company: Eco Systems Heating & Air Address: 111 Deerwood Rd. Ste. 200 City/State/Zip: CONCORD, CA 94520 Phone: 925-0W3-, For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300