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151200891�1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1008 CRANBERRY DR CONTRACTOR: AIR AND PLUMBING PERMIT NO: 15120089 SYSTEMS OWNER'S NAME: TAN CHAO cp�� �� `S I'LL 14107 CAPRI DR DATE ISSUED: 12/09/2015 OWNER'S PHONE: 4082420440 LOS GATOS, CA 95032 PHONE NO: (408) 733-2000 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL REPLACE (E) FURNACE & DUCTWORK, SAME �} �A License Class'* �i 2� Lic. #JP _/ cqlz c 6 LOCATIONS Contractota l� dK %/L Date 7Z C7 [ �- I hereby affirm that I am licensed under he 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: $7000 performance of the work for which this permit is issued. 41 ave 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: 36202002.00 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 WITIIIN 180 DAYSOF SSUANCE 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 FRO S + D 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 Is 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. e� RE -ROOFS: Signatur D_ ate 0/ l 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 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 sale (Sec. 7044, Business & Professions Code) 1, 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 agea � �1% _ 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 constriction 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 constriction, 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 M rAN GENERAL PERMIT APPLICATION MEP A- COMMUNITY DEVELOPIdENT DEPARTMENT • BUILDING DIVISION 10300 T ORRE AVENUE • CUPERTINO, CA 55014-3255 (408) 777-3228 •FAX (408) 777-3333 • buildina(a cuoeriino.org ZD CUP ERTIN0. V ❑PLUvsD�I ''C' MECHANICAL ❑ELECTIUCA? ❑1,41ISCELLAH-'OUS PROJECT ADDPISS / QD� I 5��' 6 Z Q c) OZkTiRN-A.1J1E/ao-1 I PHOI�� L-IJ=IL �o' /e2�,2 - 0�`_� STREET ADDRESS CITY, STATE, ZIP FAX CONTACT 1\. JE PHOME .i 7�� STREETADDRESS r,, `O7 r ��jl CITY Tai �� / G�QOS ❑ Oti'1.R ❑ OWNER-BUiDER ❑ OFr ER AC•E] T ❑ Com?.ACTOR ❑ CONURACTOR AGENT ❑ ARC-=, CT ❑ = vGT_:R ❑ DE\rZ-LOP-.R ❑ 7E ANU CO?ITR4 CTOR X -A1-1 A n ply LICE ASE I\MMER C91 9 7'" I LICTSE TYPE I BUS. LIC 4 COMIPAT'Y KA -11E E -NAIL I F.SX STR=ETADDRESS q C'�� �_ 1 u 'C CITY, STATE, ZIP `^ � 6k b'q k � PHONE �mlr3 ARCIETECTrTGLT_ER NAME I LICD-�-SE 1\'UHBER BUS. LIC R CONPA-YI AIJE E-bLkm I FAY, STREET ADDRESS CITY, STATE, ZIP I PHONE USE OF ❑ SFD or DUPLEX ❑ h!ULTI-FA ,,ny PROTKT ZN WII DLF?\TD ❑ Y=S PROjHCT LN ❑ rS IS THE BLDG AN ❑ y -.S BUII*P.G: ❑COhn'=L bIRBAN'L-1EP AC'nAPt4 ❑ TO FLOOD ZONES ❑ NO 'FIC11ER&OIJ.E? ❑ NO I DESCPIPTIOI\' OF t% O.R?C - ke A n C -le q A „ / n / fe b ! ' c TOTAL VALUATION:L7 ®-2 4'� r r .By my signatnre below, I certify to each of the following: I am the prope o;vner 0r aU` ze zee zc prope.-y owner's behalf. I have read this application and the information I have provided is correct- I have read the Description of \',cork and fy it is accurate. I agree to comply;;-ith all applicable local ordinances a0d state laws relating to buildmQ caon. I zUuoriie representztives of Cope: ino t0 enter the zbove-identifiedopefor inspection purposes. Sigmahmre ofA.pplicanJ-".ge Date: ITAI INT 0-R- iATION REQUIRED kORFSCE LSE O>\L l h � �` ...... ti R z�--„n T�"*"D -H .- i i 5 - k 'f-. . F � A1J'EPM'7SC,4DP_2011.doc revised 06/21/11 x CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION' 9' 1 ADDRESS: 1008 CRANBERRY DR FEE DATE: 12/0912015 REVIEWED BY: MELISSA APN; 362 02 002 1 BP#: $0.00 *VALUATION: 1$7,000 *PERMIT TYPE: Mechanical Permit' PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: PME Plan Check: $0.00 PENTAMATION I PERMIT TYPE: FURN/AC WORK REPLACE (E) FURNACE & DUCTWORK, SAME LOCATIONS SCOPE L_ 111uw", ;, APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced -Air 1MFR=<100 1 # $143 $ TOTALS: 143.00 TOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Pire, Sanitary Newer District, 3;cnooj District, etc.). These.fees are based on the preliminary information available and are only an estimate. Contact the Dept for aaan-1 info. FEE ITEMS (Fee Resolution 11-053 Elf. 711113) FEE QTY/FEE MISC ITEMS plan ("heck.Fee: Mech. Plan Check"00 hrs $0.00 %iai; Phl"ib. P; F-7 PME Plan Check: $0.00 Feclh. Permit Fee: Mech. iMPERMIT 111uw", ;, � ,her Mech. Insp. FO, PNffi Permit Fee: hrs 081erl'itmil, !I,, Administrative Fee: (ADMIN $45.00 Work Without Permit? 0 Yes (F) No $0.00, Adi;awcetl fllanningff'ees: I Travel Documentation Fee: ITRAVDOC I Ir TOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Pire, Sanitary Newer District, 3;cnooj District, etc.). These.fees are based on the preliminary information available and are only an estimate. Contact the Dept for aaan-1 info. FEE ITEMS (Fee Resolution 11-053 Elf. 711113) FEE QTY/FEE MISC ITEMS plan ("heck.Fee: Suj�pl, PCTIC"(11 F-7 PME Plan Check: $0.00 PME Unit Fee: $143.00 PNffi Permit Fee: $48.00 ("OnsiTuction M'x; _F7 Administrative Fee: (ADMIN $45.00 Work Without Permit? 0 Yes (F) No $0.00, Adi;awcetl fllanningff'ees: Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.91 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $1.00 SVBTO ALS.$285.91 $0.00 TOTAL FEE: $285.91 Revised: 10/01/201; STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CFIR-ALT-03-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ALT-03-E Alterations - HVAC CZ 1, 3 to 7 and 16 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address:Enforcement /009 C�pa Agen : X Date Prepared: Permit#: e'ee pe CSI .e_ A.0 2g Equipment Type 11 Equipment Efficiency New: Duc ing, Plenums, Lineset Required R -value Co itioned Floor Area (sq ft) Thermostat El Packaged System EJ Evaporator Coil �AFUE COP �R-6 (CZ 1,3-7) Ducts Served by system 11 Setback [I Split System El Condensing Unit SEER El R-81 (CZ 16) Ducts sq ft not already HSPF EI R-6 (all CZ's) Plenums t pr present, must Furnace ❑ Lineset EER El R-5 or R7.5 Lineset' be installed) 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: an -include new ducting All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS Air Handler/Furnace CF3R: ME CH -20 -HERS Installer Requirement: Duct leakage (< 15% or, < 10% to outside, or seal all accessible leaks) 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 113. 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' CF1R-ALT-02-E CF2R-MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS CF3R-MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS' Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >: 350 CFM/ton (or Standards Table 150.0-C / D alternative) ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF1R-ALT-02-E Ducts' and one or more of the following: CF2R-MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS Condenser Unit, Evaporator Coil, Furnace CF3R-MECH-20-HERS, MECH-(23 or 24) -HERS Installer Requirement: Duct leakage < 6%, Air Flow_ 350 CFM/ton (or Standards Table 150.0-C/ D alternative) ❑ Exempted from duct leakage testing I 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: Adding or replacing ducts in unconditioned CF1R-ALT-02-E space but less than All New Ducts' CF2R: MECH-20-HERS CF3R: MECH-20-HERS Installer Required to: Duct leakage (:S_15% or, < 10% to outside, or seal all accessible leaks) ❑ Exempted from duct leakage testing I existing duct systems are 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. ' A New Duct system is when the duct system is constructed of at least 75 percent 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, plenums, duct material. 3 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-2%", 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. S. 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. Responsible Designer Name: Responsible Designer Signature: Date Signed: License:©`� q� 1Z � /s'� Company: �j2� Address: n� City/State/Zip: Phone: For assistance or quesfibn's regarding the Energy Stay(dards, contact the Energy Hotline at: 1-800-772-3300