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15090141CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11260 BUBB RD CONTRACTOR: CALIFORNIA DELTA PERMIT NO: 15090141 MECHANICAL INC OWNER'S NAME: TANEJA ABHINAV 6056 E BASELINE RD STE 155 DATE ISSUED: 09/22/2015 OWNER'S PHONE: 6506699501 MESA, AZ 85206 PHONE NO: (866) 692-5273 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ NEW A/C UNIT IN REAR YARD & (N) DEDICATED CIRCUIT License Class tfZ0 Li, Contractor D�lf 17e- ell &'0v/Date 1 hereby affirm that l 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. Sq. Ft Floor Area: Valuation: $725() I hereby affirm under penalty of perjury one of the following two declarations: APN Number: 36206048.00 Occupancy Type: r. 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 erformance 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 EXPIRES IF WORK IS NOT STARTED permit is issued. WITHIN180 YS OF PE 111JISSUANCE OR APPLICANT CERTIFICATION AST C INSPECTION. 1 certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws ZL S to building construction, and hereby authorize representatives of this city to ente Issued Date: 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 ROOFS: granting of this permit. A ' ionally, the applicant understands and will comply with ' All roofs shall inspected prior to anyy roofing material being installed. If a roof is all non -point source r a s per the Cupertino Municipal Code, Section 9.18. Q installed withouutt first obtaining an inspection, [agree to remove all new materials for Signature Date / - 2 2 inspection. Signature of Applicant: Date: ❑ OWNER -BUILDER DECLARATION ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: t 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE compensation, will do the work, and the structure is not intended or offered for 1 have read the hazardous materials requirements under Chapter 6.95 of the sale (Sec.7044, Business & Professions Code) California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain 2. I, as owner of the property, am exclusively contracting with licensed contractors to compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & construct the project (Sec.7044, Business & Professions Code). Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air I hereby affirm under penalty of perjury one of the following three declarations: contaminants as defined by the Bay Area Air Quality Management District I will i. I have and will maintain a Certificate of Consent to self -insure for Worker's maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Compensation, as provided for by Section 3700 of the Labor Code, for the health & Safety Code, Sections 25505, 25533, and 25534. performance of the work for which this permit is issued. Owner or e�a. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by Date: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. CONSTRUCTION LENDING AGENCY 3. I certify that in the performance of the work for which this permit is issued, [shall not employ any person in any manner so as to become subject to the Worker's I hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If, after making this certificate of exemption, 1 for which this permit is issued (Sec. 3097, Civ C.) become subject to the Worker's Compensation provisions of the Labor Code, I Lender's Name must forthwith comply with such provisions or this permit shall be deemed Lender's Address revoked. ARCIIITECT'S DECLARATION APPLICANT CERTIFICATION I understand my plans shall be used as public records. I certify that 1 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 Licensed Professional 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 GENERAL PERMIT APPLICATION MEPLiz COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 Amok Alak CUPERiINO (408) 777-3228 • FAX (408) 777-3333 • buildincecuoertino.org I /'5-0'?a/ C PL1L7,sING l,-Ci-LANICAL ELECmCAZ. ❑1,111SCELLA? =( PiLorcTADDF-ESS / / OW1 ERNAME T n �7 /fiQ PHO�(� / 6Y - 9SQ/ J 4 STF.FETADDRESS CITY, S A.TE,'T /� no F.eJ CONTACT N.a>viE timoo'�� STREETPDURESS /J �C / e 1W CITY, STATE, �P e?fdD Si FAX ❑ O)Alh- t ❑ 01ANER-BUDMER ❑ O'ANTERAGE'.'T ❑ CONTRACTOR ❑ CO',TRACTORAGENT ❑ ARCFSECT ❑ ENGAE:ER ❑ D=vELOPER ❑ T=' ART CONTRACTOR N? / LICENSE NUl• R /W -+i cn 4//// LICENSE TYPE y C'- ZD BUS. LIC r COMP. YNAJ✓.F CL EMAIL — FAX ST FET ADD FSS CITY, STATE, ZIP(y\' _ Y ARCIUTECTiENGMHR NA.I`M LICENSE NUMBER BUS. LIC n C OM?ANY NAME E-MAIL FAX STREET ADDPESS CITY, STATE, ZIP PHONE USE OF ❑ SFD., DUPLEX ❑ MULTI-F.A.)MY I PROJECT IN WILDLA ND El YES I PROTECT IN El 1iS EL ILDLNG! [� COMMERCLAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO IS THE BIAG.AN ❑ ' r$ EICMM HOME1 ❑ NO DESCPn TIC": OF W&RK TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property owner cr au razed ag to e property owner's behalf. I have read this application and the information I have provided is correct. 1 have read th eripl1cn ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building con 7�I zu a representatives of Cupertino to enter the above -identified property for inspection purposes. Si of ApplicanUAgent: Date: AL II\'FOR-MATION REQUIRED oFF:cE rsE o�Lv ON ER-THE-COL:—F_ft = EXPRESS _ STAND!,KI) 7_ LARGE Ll MIAJOR ATEPMisc.4pp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Puhlic Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminarl information available and are onl j, an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution /1-053 tk. 7/1%131 ADDRESS: 11260 BUBB RD DATE: 09/2212015 REVIEWED BY: MELISSA Mech. Permit Fee: IMPERMIT APN: 362 06 048 BP#: *VALUATION: 1$7,250 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex hrs PENTAMATI ON PERMIT TYPE: FURN/A WORK NEW A/C UNIT IN REAR YARD & N DEDICATED CIRCUIT SCOPE Electrical 18REMMISC Special Circuits NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Puhlic Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminarl information available and are onl j, an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution /1-053 tk. 7/1%131 Mech. Plan Check 0.0 hrs $0.00 lnnih. Nan i ��� Elec. Plan Check 0.0 hrs $0.00 Mech. Permit Fee: IMPERMIT Plan Check Fee: Elec. Permit Fee: 1EPERMIT Other Mech. Insp. 0.0 $48.00 Mechanical IBREMAIR I A/C Units (<=10K cf n) Other Elec. Insp.0 0.0 ��s$48.0hrs Suppl. PC Fee: 12) Reg. Q OT 0.0 hrs NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Puhlic Works, Fire, Sanitary Sewer District, School District, etc.. These fees are based on the preliminarl information available and are onl j, an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution /1-053 tk. 7/1%131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1� # $72.00 Mechanical IBREMAIR I A/C Units (<=10K cf n) Suppl. PC Fee: 12) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 1 $143.00 Electrical 18REMMISC Special Circuits Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $96.00 _r_T Lstl'Uclioll /(tv Administrative Fee: (ADMIN $45.00 O 0 Work Without Permit? O Yes 19 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.94 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 F_ SUBTOTALS: F $190.94 $215.00 TOTAL FEE: $405.94 Revised: 07/02/2015 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: 11260 Bubb Rd I Date Prepared: CF111-ALT-02-E (Page 1 of 3 ) 2015-09-16 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 CHR -ALT -02 document for each dwelling unit. 01 Project Name 11260 Bubb Rd 02 Date Prepared 2015-09-16 03 Project Location 11260 Bubb Rd 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 11260 Bubb Rd SC System SC System CFA served system a Dwelling Unit Conditioned Installing new SC 07 Zip Code 95014 08 Floor Area (ft2) 2700 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 O1 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 5.0 Ton A/C Altered space Condenser & Coil Whole Home 2700 Yes Yes Yes No No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 1S0.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A6327494A-000000000-0000 Registration Date/Time 2015-09-16 09:38:18 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-16 09:38:15 Schema Version: O.SSSSDD CERTIFICATE OF COMPLIANCE CF1R-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) 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 5.0 Ton A/C No heating This field or This field or All new This field or This field or Condenser & Central gas furnace component section is not section is riot Central split AC cooling 5rEk 1 Setback section is not section is not Coil 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. CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air 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)1Diia and 150.2(b)lE, 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-A6327494A-000000000-0000 Registration Date/Time 2015-09-16 09:38:18 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-16 09:38:15 Schema Version: O.SSSSDD CERTIFICATE OF COMPLIANCE CFIR-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:rG L az Frederick, Alanna ��Ca(ClL ' e& Company: Signature Date: CALIFORNIA DELTA MECHANICAL INC 2015-09-16 09:38:18 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 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: ^ n�� �;� C Frederick, Alanna Company: Date Signed: CALIFORNIA DELTA MECHANICAL INC 2015-09-16 09:38:18 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 noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6327494A-000000000-0000 Registration Date/Time: 2015-09-16 09:38:18 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-09-16 09:38:15 Schema Version: 0.555SDD Building Departmen? t b �U SEP 2 2 2015 t Gjele-c _V� fl_ � IEWED FOR CODE COMPLIANCE Reviewed By Dx_ ( C IEG`KED BY E �z fS PLANNING DEPT CUPERTINO OFFICE OA COMMUNITY DEVELOPMtkrr pEP BUILDARTMENT ING DIVISION = CUPERTINO This plans artd.§pecifications.M! 1ST be kept at the j0:isae ��r.�9_FonstruCtion..Jt`is unlawfu(to ch: pss CT al!©ratbris make.any on same; or to deviate . . thFr^Wm �ut a from, from the BUildirg t✓ (;cial, --- th "n "31' 6. L — p.m