15110145lL�
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1630 ASTER LN
CONTRACTOR: DELUXE AIR PERMIT NO: 15110145
OWNER'S NAME: CHANG NEIL AND VERA TRUSTEE
10 N EAST ST STE 210 DATE ISSUED: 11/20/2015
OWNER'S PHONE: 4084068271
WOODLAND, CA 95776 PHONE NO: (530) 662-5008
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
REPLACE CENTRAL HEATING SYSTEM AT SAME
_
License Class- C 0 Lie. #�� �1�� ,�
LOCATION
Contractor Date
I hereby irm tb t 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:
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
r "
Sq. Ft Floor Area:
Valuation: $3500
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: 33
16i �'j�
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIYEXPIRES 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 INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
�+��w '1 Date:
granting of this permit. Additionally, the applicant understands and will comply
Issued by: 1
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
RE-ROOFS:
Signature Date
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 33, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
- r
Owner or authorized agent: Date:
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
___ GENERAL PERMIT APPLICATIONMEP
Ag COhfAhUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 T ORRE AVENUE • CUPERTINO, CA °5014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildina(a)Cuoerino.org
CUPERTINO- M, I_
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TOT.ALVALUATION: , 3V70
By ny signature below, I certify to each of the follo;ving:
Ian the propefty owrier or authorized went to act on the property owner's beh.f. have read this
appl_icztioa and he izfonna ion 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
Grdiranres and state laws relating to bT dma Gpa ct' s
nthorze representatives of Cupertino to enter the zbove-identifieed property for inspection purposes.
SignztnreOf—ppi-ic212t' eat:
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Date:
SUP r.?\ EIS ! AI. Nr ORvIATION REQ U L.ED
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11"EP-4!iscflpp=2011.doc remised 06/21/11
W-M,
CITY OF CUPERTINO
FEE ESTIMATOR —BUILDING DIVISION
lalADDRESS:
1630 Aster Lane
DATE: 11/20/2015
REVIEWED BY: Phuong
Plan ("fleck Eee:
APN: 366-16-037
BP#:
*VALUATION:
1$3,500
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex
USE:
$0.00
PENTAMATION FURN/AC
PERMIT TYPE:
WORK
Re lace central heating s sem at same location
SCOPE
Mech. Plan Check 10.0 1 hrs $0.00 '1-ss7%r:. i'lan Check: li
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) (Page 1 of 3 )
Project Name: Neil Chang Date Prepared: 2015-11-20
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 CF111-ALT 02 document for each dwelling unit.
01
Project Name
Neil Chang
02
Date Prepared
2015-11-20
03
Project Location
1630 Aster Ln
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
Neil Chang
07
Zip Code
95014
08
Dwelling Unit Conditioned
Floor Area (ft2)
1200
Installing
Installing
Identification or
Number of space conditioning
by this SC
09
Climate Zone
4
10
(SC) systems in this dwelling
1
Name
Served
System (ft2)
unit.
component?
B. Space Conditioning (SC) System Information
01
02
03
,.
s 04 ;,
, , 05 s
06
07" i
08
09
_.
10
`:Is the SC
Installing a
SC System
SC System
CFA served
systema
refrigerant
Installing new;SC
,Installing f
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
Location 1
1200
Yes
No
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 215-A6401115A-000000000-0000 Registration Date/Time: 2015-11-20 05:20:51 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-20 05:20:56
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)
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
All new
Centrals lit
No cooling
This field or
This field or
Less than or
System 1
Central gas
heating
AFUE
0.78
AC p
component
section is not
section is not
Setback
equal to 40
R-6
furnace
components
altered
applicable
applicable
feet
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF211-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: 515%, or 510% 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 & MR -MCH -23 Air Flow' z300;CFM%fon reg9Ired.;When MCH -25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH720 Duct Leakage Testing requirements..,.
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH'23, or Refrigerant Charge IVIECH 25
Existing duct systems constructed, insulated or sealed with asbestos are exern from MC)i""=20 Duct Leakage Testing ;requirements F »_,
E. Entirely New or Complete Replacement
ent
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-A6401115A-000000000-0000
Registration Date/Time:
2015-11-20 05:20:51 .
)1E, F)
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-20 05:20:56
Schema Version: 0.5555DD
CERTIFICATE OF COMPLIANCE CF111-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:(���
oC VLc�C� cJC c YcTL
GARCIA, LUIS
Company:
Signature Date:
DELUXE AIR
2015-11-20 05:20:51
Address:
CEA/ HERS Certification Identification (if applicable):
10 N EAST STREET SUITE 210
City/State/Zip:
Phone:
WOODLAND CA 95776
530-662-5008
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 Part6 of the California Code of Regulations. ;
p applicable compliance documents, worksheets,
4. The building design features or stem design features identified on this Certificate of Compliance are consistent with the information rovided on other a plica
g g y g t p
enc fora rovCompli this building ermit application. :
calculations, plans and specifications submitted to the enforcement ag y , pp g p ,
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, trade availableto th6 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 p[oyides to.the building owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature: ^-•
�URCiLq
GARCIA, LUIS
"
Company:
Date Signed:
DELUXE AIR
2015-11-20 05:20:51
Address:
License:
10 N EAST STREET SUITE 210
994539
City/State/Zip:
Phone:
WOODLAND CA 95776
530-662-5008
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-A6401115A-000000000-0000 Registration Date/Time: 2015-11-20 05:20:51 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-11-20 05:20:56
Schema Version: 0.555SDD