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B-2016-1382 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR; PERMIT NO:B-2016-1382 1101 HOLLYHF,AD LN CUPERTINO,CA 95014-5041(362 26 012) (ALLIED AIRE SERVICE INC MILPITAS,CA 95035 OWNER'S NAME: GANESI3 J.SUNDARA AND GIRIJA S DATE ISSUED:02/17/2016 OWNER'S PHONE:408-394-4199 PHONE NO:408-934-8840 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-220 Lic.#2 DM Contractor(ALLIED AIRE SERVICE INC)Date 02/17/2016 X BLDG _ELECT _PLUMB X NIECII X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: REMOVE AND REPLACE_ FURNACE. I hereby affirm under penalty of perjury one of the following two declarations 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 performance of the work for which this permit is issued. z I have and will maintain Worker's Compensation Insurance,as provided for j by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3200.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building construction,and hereby 362 26 012 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will' comply with all n- s per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code Sectio 9. Issued by. W2l i Signature Date 02/17/2016 Date:02/17/2016 OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole- inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with licensed Date:02/17/2016 contractors to construct the project(See.7044,Business&Professions.Code). I I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. 1 have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. Iwill by Section 3700 of the Labor Code,for the performance of the work for which ,maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the this permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit i issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants defined the Bay Area Air Quality Management District I will maintain compliance iance with the C _e tiro Mu 'cipal Code,Chapter 9.12 and. i Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code a do s 25 5,25533,and 2.5.534. 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. Owner or authorized agent: / Date:02/17/2016 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirmi that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state Jaws of work's for which this permit is issued(Sec.3097,Civ C.} relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant ARCHITECT'S DECLARATION I understand My plans shall be used as public records. understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date 02/17/2016 GENERAL 'PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255! (408)777-3228-FAX(408)777-3333•building (a�cupertino.orq C tP R'TINO - 016.1 6 ,7-MISIC PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESSo e)k4k Q "� APN# - � s OWNERNAME n PHONE g 4} e t®fl E-MAIL STREET ADDRESS r s` /� CITY TATE,ZIP ��1` /+� 1 L[7 FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWA'ERAGENT CONTRACTOR El CONTRACTOR AGENT ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ® LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAILFAX STREET ADDRES j C Q CITY,STATE;ZIPJAW I L-P`` ._ PHONE ARCMTECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF 2BFD u DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND '.El YES PROJECT IN ❑YES IS THE BLDG AN' ❑YES BUILDING: COMMERCIAL URBAN INTERFACE AREA NO FLOOD ZONE tk�.NO EICHLERHOME? N0 DESCRIPTION OF WORK 14 2 \ TOTAL VALUATION: 3 RECEIVED BY z; k By my signature below,I certify to eac fthe Ilowin 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 hau pry vid is co ave read e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating b d ons on. I authorize re resentatives of Cupertino to enter the above-identifi property for inspection purposes. Signature of Applicant/Agent: Date: 1-7 C SUPPLEMENTAL INFORMATION REQUIRED '�`,... 'OF'F`ICE USE OALIY,., W OVER IAF COUI\TER a � ` r ©' STAAD�RD Www t, ❑ MAJOR;" � �� � MEPMiscApp_2011.doc revised 06/21/11 J I H I C yr wAwrum1,4IH ALTERATIONS -HVAC CALIFORNIA ENERGY COMMISSION CEC-CF1R-ALT-03-E Revised 03115 CF1R-ALT-03-E CERTIFICATE OF COMPLIANCE Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-1R-ALT-HVAC) {Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: 1-11 t New:Ducting;Plenums,Lineset Conditioned Thermostat Equipment Type kAsI4C Equipment Efficiency Required R-value Floor Area(sq ft) CZ 1,3-7)Ducts Served by system Setback 13 Packaged System ❑ Evaporator Coil �AFUE COP ❑R-6 ( (If not already ❑Split System ❑Condensing Unit SEER ❑R-8' lC )Ducts SCS sq ft HSPF ❑R-6(all l CZZ's)-Plenums present,.must Furnace ❑Lineset EER ❑ R-5 or R7.5 Lineset3 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. 01.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can include new ducting All Equipment, CF1R-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS Installer Requirement:Duct leakage(: 15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: 0 1.Duct system registered with HERS provider as previously sealed,or❑2.There is less than 40 linear feet of duct in unconditioned space,ory 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building I ❑2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts2 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)-HERS2 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 onsite for Final: Includes replacing or installing All New CFIR-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 Z 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: CF1R-ALT-02-E Adding or replacing ducts in unconditioned CF2R:MECH-20-HERS space but less than All New Ducts2 CF3R:MECH-20-HERS Installer Required to Duct leakage(<.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. z 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%8",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. Thatthe 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 4Address: Date signed: License: Res onsibleDesign rName Pona sig Signature; A6�D't M2�.►IrG �t ll•1�` - City/State/Zip: Phone: �� Company: 8 93q— XtuL� Alas �Iwlu= Am CS AuF. rl/11 , �- Forassistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300 OWNER GERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT m BUILDING DIVISION IL 10300 TORRE AVENUE►CUPERTINO,CA 95014-3255 ' (408)777-3228 a FAX:(408)777-3333•buildin4Ca cupertino.org Q _ _ � � of��• �3� Ir PERMIT C NYNOT BE FINNIXI)AND CO PIXTE3)UNTIL TffIS CE RTIFICATt PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GEN,ERAL IN,FORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA S11VC0'ICE All AIZM CO ALARM-, Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning,appliances and that do not have an attached garage: Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply In dwelling units,with no commercial power supply,alarms)may be solely battery operated. In existing dwellrtlg,unitsi alarms are permitted to be safely battery operated where repairs or alterations,do not result in,the removal of wall and ceiling finishes:or there is no access by means.of attic,basement or crawl. space.Refer to CRC`Section 8314 and CBC Sections 907.2.11.4 and 420j.6.2.An electrical permit is required for alarms which must be,connected to the building wiring. As owner: of the above-referericed pro=petty,I hereby certify t11at the alarm(s)referenced above has/haue,Beer installed m ace or;{'once°with the nnanufacturer:'s instracl3ions and in, compliianee wilti the Cailifornia Buildlkt ands Calfflunrdiat Residential Codes.The alairrns have leen tested and are operational,as of the date sigTiedl b Allo>w.. U hiave,road_aured a pec too)com=G v*k tUn&terms,and somd32fans>of thhs�stato e rnr t' nature...... ......... �.. � ba a Cot�tPacfotYlrJarr, :, e � A Snioke,aazdlCQ fb micdbc revised-103/18%1;4} WATER-CONSERVING PLUM13ING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITYDEVELOPMENT DEPARTMENT•Bl:llt_blNG;DIVISION CUPERTINO 10300 TORREAVENUE a CUPERT;LN0,CA 950'14--3255 , + `('408)777-3228-FAX�(�408)777-3333®bui(dirra0n DS—ertino org Owner Nam (n Permit No �G- l a'�F 2 Address e. ` C - nA; 0% tSj 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. P No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and.sign bottom of form. C] No Go to Question 3. 3. Is water service perrnanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the fonn and sign bottom of form. ® No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Ep,Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form., 5. Please check ONE of the following: ® Mypropertyis asingle farreily residential.real property. See Civil Code Section 1101.4. Onn and after January 1, 2'014,.building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced,with water-conserving pluinbing fixtures throughout the building.On or:before January 1,.2017,all.non- compliant plumbing fixtures shall be replaced with water-conservingplurribimg fixtures (regardless of whether property undergoes alterations or umprovetnents). ❑ Mypropertyis amult family residential real property. See Civil Code Section 1101.5, On and after January 1,2014,,specified building alterations or improvements shall re ; :ire non-compliant plumbing,fixtures to be replaced with water conserving plumbing.fixtures. On or before January 1,2019,.all`.non compl'antplumbir g fixtures shall be,replaced with water- conserving,plumbing fixtures throughout the building,(regardless of whether property undergoes;alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after,January 1,2014,,specified building alterations or improvements shall require non compliant plumbing fixtures.to be replaced with water-conserving plumbing fixtures. On or, before, January 1.,, 2019,; all non-compliant plumbing fixtures shall be replaced with water conserving plumbkrgfixtares,thraughoutthebuildmg(regardless ofwhether property undergoes altbra'tions or,impro-vernents)� I,as,the owner or owner's agent of this pr•.operty,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with.Civil Code Rections.110)1.1 tluough 1101.8,the current California Plumbing Code and California Green.Building Standards Code,and manufacturer's, rrrstallahon requirements,.and that the.watez-conservingplumbing fixtures comply with the requirements as indicated in the table on the followin page,., e Owner orOwrioPAgeWsSig 'atuxe '.? a Daus,= t la Upon comp-leting and signing this Certlfrcate,. `eas etura it e Bixitdin-g IIrvis on in order to final your•,buildingpermit. S '� 0497 20.15.doc revised 08126/1'5