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15090115I CITY OF CUPERTINO BUILDING PERMIT BUILDING` ADDRESS: ; •10365 DEMPSTER AVE CONTRACTOR: CALIFORNIA DELTA PERMIT NO: 15090115 MECHANICAL INC OWNER'S NAME:.': KWOK;RYAN L AND ANGELA L 6056 E BASELINE RD STE 155 DATE ISSUED: 09/17/2015 OWNER'S PHONE:, 4687184455 ' : MESA, AZ 85206 PHONE NO: (866) 692-5273 LICENSED `CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] Lic., # License Class ®���� INSTALL (n) A/C UNIT IN REAR YEAR. �/ � REVISION #3 - ADD TO SCOPE OF WORK "REPLACE DUCTS" - ISSUED Conti torr.- :. ate J 11/5/15 I hereby affirm;'thia:tl I am licensed under the provisions of Chapter 9 (commencing witlt'-Sec ion 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,wi fnia n"tam" a'certificate'of consent to self -insure for Worker's Compensation m provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $15081 performance of the worlr�for which this'permit is'issued. Pave and'will+maintairi Work'er's Compensation Insurance, as provided for by s'_ , Section 37.60,6fthe'T aboi Code, for the performance of the work for which this perinit, is issued'. , APN Number: 32647078.00 Occupancy Type: " 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;irientioned'propertyfor inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify'and'keepiharmless the City of Cupertino against liabilities, judgments, costs 4hd,expenses wliieh may'accrue against said City in consequence of the ' Date: f / granting of •this permit: Additionally, the applicant understands and will comply Issued by:0 with all non-point,source'regulations per the Cupertino Municipal Code, Section 9.18.' RE -ROOFS: Signa, ' i Date J 7 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 fwo reasons: ,. •. ' :. ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as' ownet of the'property or'my employees with wages as their sole compensation, will do the.work; and,the`stiiicture is not intended or offered for sale (Sec.7044, Business & Profession's Code r � � ' ' ' I, as owner of the.property;' airi exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the ro`ect Sec.7044, Business & Professions Code . p J ( ) 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: ,;i °4yi'` Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will inaintain'a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation;las 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,tlie work for,'which this permit is issued. will maintain compliance with the Cupertino nicipal Code, Chapter 9.12 and I have "&will maintain' Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25 3, and 25534. Section 3700 `of the' : aboi Code, for the performance of the work for which this permit ,is issued Owner or authorized age Dat I certify that in the performance of the work for which this permit is issued, I shall not employ any!person iii 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 toitlie,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 complywith,such provisions or this permit shall be deemed revoked. works for which this permit is issued (Sec. 3097, Civ C.) Lender's Name :; ,, ".t. APPLICANT CERTIFICATION Lender's Address .. I certify:that I have rea&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 indernmify' 4nd;keep,harmless'th'e City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs; and:gxpenses ,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,sourcc regulations, per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signaturel'','iii`I.,I Date GENERAL PERMIT APPLICATION E" +c COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino(cDCUDeriino.org CUPERTWO I�m I ©&7()IIS ❑PLU]„ONC, ®'1MO-1-kNTICAL nELECTRICA.L nhi1SCELLAN! F-nT!R PROD: CT A.DDPESS I ,qPN O�NTcRl�p1J'r PHO p _ E -I✓ -IL 22 STREET: -II RESS CITY, ST. ZIP F.=.X CONTACT )\ 4IJ_E HH� � ' - (/U ST TADDRESS CITY STATE, ZIP FAX ❑ ORS?.=R ❑ ❑ OF t GTt I[I CO1, I?ACTOR ❑ CO FTRACTORAGD— �T ❑ AR�FZTTCT ❑ _NGi�==R ❑ ❑ DEVELOPER 1_?�t�� CO?NT1-,CT0 ,NA.1,,L/ j I LIC.,NSE?`Z�1 - I LICENSE TYPE I BUS, L C01JP Y NAb E-1✓AIL FAX 5yRE ET AD RESS � CITY, SgATE, ZIP -7-3 O P?�F- A2,CHITECTrNGA"ELRNAA,E LICENSE IntiMIBER BUS. LIC r CO3,12A-YNAIJ,E E-1� II I Fey, STREET.4DDRESS I CITY, STATE, ZIP I PHONE USE of ❑ SFD ., DUPLE". ❑ brULTI-FA M -Y I . PROJECT LN WIT DL.A-ND ❑ YES PRO%CT LN ❑ YES IS TJ = BLDG AN ❑ )-ES B u -I DLN'G:❑COI J.FF.C1AJ— L'R3 N LNI�RFACE AREA ❑ NO FLOOD ZONE El NO EICIMEP HO1J.E? ❑ NO DESCRIPTION OF WORK TOTAL VA. LUATION: Q By my sigaaLue below, I certify to each of the follov,ine: I am the grope_ Ly ov,,ner cr ai-it orized zaent to act on Lhe p; operty o;; ner's b I hz� e read his application and the information I have provided is correct. I read the Description of Worl: and verify it is accurate. I agree to comply Vih all applicable local ordl_aaces tad state lax -vs relating to building co authorize representatives of Cupertino to enter the above -identified propei;y for inspection purposes. Sigmas ire of A -o licant/Agent: K)-2 E N T AL T -N r ORvI7,TION REQUIRED , ri a E. s �G OVER T,iIF COU''�TER, s Z7J S :i.. a - y . a �`z r. z1] ST4'tiDeD� -S Cf 17 ' kz- ? AJOR 1IF'P_Alisc%pp_2011.doc remised 06121/11 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF-lR-ALT-HVAC) (Page 1 of 3 ) Project Name: 10365 Dempster Ave I Date Prepared: 2015-09-17 A. General Information CF111-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 10365 Dempster Ave 02 Date Prepared 2015-09-17 03 Project Location 10365 Dempster Ave 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 10365 Dempster Ave 07 Zip Code 95014 08 Dwelling Unit Conditioned 2400 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;1 06;"; 07: ;.' 08 09 10 _Is the SC Installing a" SC System SC System CFA served `,''System a: refngeraht ' -'.Installing hew% 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 Entirely new or complete A/C Condenser & Whole Home 2400 Yes Yes Yes Yes Yes No replacement duct Coil system with or without equipment changeout C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A6328994A-000000000-0000 Registration Date/Time: 2015-09-17 09:15:31 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) This section does not apply to this project. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) 01 02 03 04 05 06 07 08 09 10 11 Heating Cooling System Heating Minimum Cooling Minimum Required Identification or Heating Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct Name System Type Component Type Value System Type Component Type Value Type R -Value No heating This field or This field or A/C Condenser & Central gas section is All new cooling SetbackTher Coil furnace component not section is not Central split AC components SEER 14 mostat R-6 altered applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. MR -MCH -20-11 & MR -MCH -20-11 Duct Leakage Verification required. -Leakage rate compliance: <_ 6%. CF2R-MCH-22 & CF3R-MCH-22 Fan Efficacy Verification CF2R-MCH-23 & CF3R-MCH-23 System Air Flow Rate Verification " -Compliance: Fan Efficacy <_ 0.58 W/cfm and System Airflow z 350 cfm/toh. - Alternative Compliance: CF2R-MCH-28 & CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH -22 and MCH -23 verification. CF211-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). Exceptions: Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. Note: An "entirely new or replacement duct system" means 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) if the reused parts are accessible and can be sealed to prevent leakage 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-A6328994A-000000000-0000 Registration Date/Time: 2015-09-17 09:15:31 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -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: ,_,/2&M1a Frederick, Alanna CjG�( Company: Signature Date: CALIFORNIA DELTA MECHANICAL INC 2015-09-17 09:15:31 Address: CEA/ HERS Certification Identification (if applicable): 1235 GRAND AVE City/State/Zip: Phone: SPRING VALLEY CA 91977 (480) 898-0007 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 consisterit with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approvdwi h this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall: be'made available with,the building permit(s) issued forthe.building, and made available to the;enforcement agency for all applicable inspections. I understand that a registered copy of this'tertificate 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: may( Frederick, Alanna Company: Date Signed: CALIFORNIA DELTA MECHANICAL INC 2015-09-17 09:15:31 Address: License: 1235 GRAND AVE 811114 City/State/Zip: Phone: SPRING VALLEY CA 91977 (480) 898-0007 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6328994A-000000000-0000 Registration Date/Time: 2015-09-17 09:15:31 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD /0, ('"`V� - ( V`,r\ , [) E 'v\ PsTEA AVE 10010115* i -X% NING DEP -ipuRTING ,30 L I N. E, 15n CEIVED OLCT 0 5 2015 1-1 Wi- Build��ing Department OCT 0 5 2015 VIEWED FOE CODE COMPLIANCE Reviewed �y: TAM�vw -%4 'OMMUNITY DE /E PMENT DEPARTMENT BUILDING E MON - CUPERTINO Aral'OROED I plans and s ecificat'lons MUST be kept at the I Juring-constrip,tinn J+isi UJ I QVIf U1 to make any Changes or alteral 'ons on same, or to daviate therefrom, without api')roval from the Building Official. The Stamping of this pl,-- n and specifications SHALL NOT be held to permit or tc be an qpproval of the violation of rovisions of a YCity Ordinance or State. Law. BY DATE PERMIT NO. A"16 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10365 DEMPSTER AVE CONTRACTOR: CALIFORNIA DELTA PERMIT NO: 15090115 MECHANICAL INC OWNER'S NAME: KWOK RYAN L AND ANGELA L 6056 E BASELINE RD STE 155 DATE ISSUED: 09/17/2015 OWNER'S PHONE: 4087184455 MESA, AZ 85206 PHONE NO: (866) 692-5273 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REPLACE A/C UNIT, SAME LOCATION. REPLACE ��/ f� y (E) DUCTWORK. License Class G -2,0 Lic.# v Contractor Dater I hereby affirm t rat `Iam 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. Sq. Ft Floor Area: Valuation: $15081 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 APN Number: 32647078.00 Occupancy Type: Compensation, as provided for by Section 3700 of the Labor Code, for the 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 permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR I certify that I have read this application and state that the above information is 180 DAYS FROM LAST CALLED INSPECTION. 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 , / ?6PL051 UL upon the above mentioned property for inspection purposes. (We) agree to save -Ll Issued by: Date: 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 regudwiog per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature Date - l%'%f installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 1 1, 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 HAZARDOUS MATERIALS DISCLOSURE sale (Sec.7044, Business & Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the z. I, as owner of the property, am exclusively contracting with licensed contractors to California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain construct the project (Sec.7044, Business & Professions Code). compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. 1 hereby affirm under penalty of perjury one of the following three declarations: Additionally, should I use equipment or devices which emit hazardous air 1 I have and will maintain a Certificate of Consent to self -insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation, as provided for by Section 3700 of the Labor Code, for the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the performance of the work for which this permit is issued. Health & Safety Code, Sections 25505, 25533, and 25534. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by Owner or gent: 3700 of the Labor Code, for the performance of the work for which this Section Date: C l permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code, I for which this permit is issued (Sec. 3097, Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION ARCHITECT'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 GENERAL PERMIT APPLICATION jjC-'0g0tj'5 - COMMUNITY DEVELOPMiiENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildina(d)CUDertino.org Lf PLUI,,EBING LeNECHANTICAL IL ELECTRICAL L Aa-ISCELLANEOUS PROJECT ADDRESS`� - i .42? %`v D J� f :f tr O WNER NAMZ PHONE E-1,CAIL STREETA.DDRESSCITY STATE ZIP „ FAX -4 k- � so CONTACT NAME P E-MAIL STBZFTADPRESS CITY, STATE, ZIP FAX ' D . /� rr 2 f^ ❑ OWI.E.R ❑ OWN'ER-BUIIDER ❑ CAVN'ERAGENT ❑ CON-MACTOR ❑ CONTRACTORAGENT ❑ ARCF1TFCT ❑ ENGL' ER ❑ DEVELOPER ❑ TENAIvf CONT ACTO N CE LIC E N 'I, ER . LICEN,S,TYP BUS. LIC 24) CON AIT I E-MAIL I F.AX TOTAL VALUATION;00 / / }/ RECEIVEDBl i/bs�, By my signature bel- 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. e read the Description of Work and verify itis a��t-�-. I agree to comply Nvith all applicable local ordinances and state laws relating to building e representatives of Cu e enter the above -identified property for inspection purposes. Signature of Applicaut/Agent: Date: ENT PT ATION REQUIRED A1fEPMisc,4pp_2011.doc revised 06121/11 ST ET ADD FSS zz CITY STATE, ZIP C7 P NE a ARCHITECTIENGLN°EER NAI\M i LICENSE NUMBER BUS. LIC n COMPANY NAME E-MAII, FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD.,DUPL.FX ❑ MULTI-F.Aa,,jLY PROJECT IN WILDLAND ❑ YES PROTECT IN ❑ YES B=N''G: ❑ CO1'-Y ERCLAL URBA>`' LN'TERFACE AREA ❑ 2"0 FLOOD ZONE ❑ NO IS THE BLDG AW ❑ YES EICHLER HOME? ❑ 1.'0 DESCRIPTION OF WORK nfC TOTAL VALUATION;00 / / }/ RECEIVEDBl i/bs�, By my signature bel- 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. e read the Description of Work and verify itis a��t-�-. I agree to comply Nvith all applicable local ordinances and state laws relating to building e representatives of Cu e enter the above -identified property for inspection purposes. Signature of Applicaut/Agent: Date: ENT PT ATION REQUIRED A1fEPMisc,4pp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 10365 Dempster Ave DATE: 09/17/2015 REVIEWED BY: PAUL UNITS APN: 326 47 078 BP#: *VALUATION: 1$15,081 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: # PENTAMATION FURN/A PERMIT TYPE. WORK Re lace E A/C unit Same Location. Replace Ductwork. SCOPE SuppL Insp F'ec APPLIANCE / EQUIP TYPE FEE ID Plumb. flan C "hec/. QTY UNITS BP FEES l lec. Permit Fee.- 'ee-Other A/C Units (<=10K cfm) 1 BREMAIR ' )ther I Jec. lush. 1 # $72 Heating System 1 MRRAA SuppL Insp F'ec 1 # $72 PME Unit Fee: $144.00 PME Permit Fee: $48.00 Construction Tax.- ax:Administrative AdministrativeFee: (ADMIN $45.00 Work Without Permit? Yes (F) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $144.00 Strom? 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.). Thesefees 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 a.' 711113) Mech. Plan Check 0.0 hrs $0.00 Plumb. flan C "hec/. !�Jec. Plan Check Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: l lec. Permit Fee.- 'ee-Other OtherMech. Insp.0.0 hrs $48.00 hherPlumb lasp. ' )ther I Jec. lush. /nmb. Insp. 1 << hup, Fct' NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees 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 a.' 711113) FEE QTY/FEE MISC ITEMS i � h m Check Fee.- ee:PC' PC'Fee PME Plan Check: $0.00 "c,rmil Fee: SuppL Insp F'ec PME Unit Fee: $144.00 PME Permit Fee: $48.00 Construction Tax.- ax:Administrative AdministrativeFee: (ADMIN $45.00 Work Without Permit? Yes (F) No $0.00 Athurnced Planning Fees: Travel Documentation Fee: ITRA VDOC $48.00 Strom? Motion Fee: IBSEISMICR $1.96 Select an Administrative Item , Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: 1 $287.96 $0.00 TOTAL FEE: $287.96 Revised: 07/02/2015 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: 10365 Dempster Ave I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2015-09-17 A. General Information MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name 10365 Dempster Ave 02 Date Prepared 2015-09-17 03 Project Location 10365 Dempster Ave 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 10365 Dempster Ave 07 Zip Code 95014 08 Dwelling Unit Conditioned 2400 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 Entirely new or complete A/C Condenser & Coil Whole Home 2400 Yes Yes Yes Yes Yes No replacement duct system with COV $thout,dquipn M changeout� C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) ry ~ o This section does not apply to this project. Registration Number: 215-A6328994A-000000000-0000 Registration Date/Time: 2015-09-17 09:15:31 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT-024 Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)IE and F) This section does not apply to this project. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)lE, F) 01 02 03 04 05 06 07 08 09 10 11 Heating Cooling System Heating Minimum Cooling Minimum Required Identification or Heating Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct Name System Type Component Type Value System Type Component Type Value Type R -Value No heating This field or This field or A/C Condenser & Central gas component section is section is not Central split AC All new cooling SEER 14 SetbackTher R-6 Coil furnace altered not applicable components mostat 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 Verification required. -Leakage rate compliance: <_ 6%. CF2R-MCH-22 & CF3R-MCH-22 Fan Efficacy Verification CF2R-MCH-23 & CF3R-MCH-23 System Air Flow Rate Verification -Compliance: Fan Efficacy <_ 0.58 W/cfm and System Airflow 2 350 cfm/ton. - Alternative Compliance: CF2R-MCH-28 & CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH -22 and MCH -23 verification. CF2R-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). Exceptions: Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. Note: An "entirely new or replacement duct system" means 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) if the reused parts are accessible and can be sealed to prevent leakage 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-A6328994A-000000000-0000 Registration Date/Time 2015-09-17 09:15:31 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -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: Frederick, Alanna C�LILI?C1iP�Ptc� Company Signature Date. CALIFORNIA DELTA MECHANICAL INC 2015-09-17 09:15:31 Address: CEA/ HERS Certification Identification (if applicable): 1235 GRAND AVE City/State/Zip: Phone: SPRING VALLEY CA 91977 (480) 898-0007 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. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permits) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Q Frederick, Alanna Cctcnl2lL cl 2P��"u( Company . Date Signed: CALIFORNIA DELTA MECHANICAL INC 2015-09-17 09:15:31 Address: License: 1235 GRAND AVE 811114 City/State/Zip: Phone: SPRING VALLEY CA 91977 (480) 898-0007 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the udorn)allon Registration Number: 215-A6328994A-000000000-0000 Registration Date/Time: 2015-09-17 09:15:31 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-17 09:15:26 Schema Version: 0.555SDD