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15120164CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120164 10216 AVOCADO PL CUPERTINO CA 95014 (369 09 014) BRIGHTON BUILDERS PO BOX 3104, LOS ALTOS, CA 94024 OWNER'S NAME: SESHADRI SRIDHAR AND POORNIMA DATE ISSUED: 03/16/2016 OWNER'S PHONE: 650-861-9007 PHONE NO: 650-787-6255 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Tic. #893522 Contractor BRIGHTON BUILDERS Date —BLDG —ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing _ MECH _ RESIDENTIAL _ COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIP'T'ION: ADD 248 S.F. TO (E) FRONT, 2ND STORY TO EXTEND (E) I hereby affirm under penalty of perjury one of the following two declarations: MASTER BEDROOM AREA & ADD 248 S.F. TO 1 ST FLR, 1. I have and will maintain a certificate of consent to iself-insure for Worker's SIDE YARD TO CREATE (N) 1/2 BATH & EXTEND (E) Compensation, as provided for by Section 3700 of the Labor Code, for the DINING RM performance of the work for which this permit is issued. **UPFRONT** 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. Sq. Ft Floor Area: Valuation: $115000.00 APPLICANT CERTIFICATION I ce ify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 369 09 014 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the Cityof Cupertino against liabilities, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Add, Tonally, the applicant understands and will comply with all non -point sour a regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Date 3/16/16 I her by affirm that I am exempt from the Contractor's License Law for one of the follo, ving two reasons: 1. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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 performance of the work for which this permit is issued. 2. 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. 3. 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 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. 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 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 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 3/16/16 Issued by: ABBY AYENDE RE -ROOFS: 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. Signature of A. Date: 3/16/16 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent'A&,4iar-d Date. 3/16/16 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender'sAddress ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professit CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120164 10216 AVOCADO PL CUPERTINO CA 95014 (369 09 014) BRIGHTON BUILDERS PO BOX 3104, LOS ALTOS, CA 94024 OWNER'S NAME: SESHADRI SRIDHAR AND POORNIMA DATE ISSUED: 03/16/2016 OWNER'S PHONE: 650-861-9007 PHONE NO: 650-787-6255 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class lI Lic. #893522 Contractor BRIGHTON BUILDERS Date 3/31/2017 —BLDG —ELECT _ PLUMB MACH RESIDENTIAL COMMERCL4L I hereby affirm that I aro 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: ADD 248 S.F. TO (E) FRONT, 2ND STORY TO EXTEND (E) MASTER I hereby affirm under penalty of perjury one of the following two declarations: BEDROOM AREA & ADD 248 S.F. TO 1 ST FLR, SIDE YARD TO 1. I have and will maintain a certificate of consent to self -insure for Worker's CREATE (N) 1/2 BATH & EXTEND (E)DINING RM. Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. REVISION #1: REVISE ROOF STRUCTURE ABOVE DINING/FAMILY ave and will maintain Worker's Compensation Insurance, as provided for by ROOMS TO VAULTED CEILING; AND ADD COFFERED CEILING TO ction 3700 of the Labor Code, for the performance of the work for which this cAtpermit MASTER BEDROOM. ISSUED 5/10/16 is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above Sq. Ft Floor Area: Valuation: $115000.00 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 APN Number: Occupancy Type: inspection purposes. (We) agree to save indemnify and keep harmless the 369 09 014 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 PERMIT EXPIRES IF WORK IS NOT STARTED source regulations per the Cupertino Municipal Code, Section 9.18. WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 5/10/2016 OWNER -BUILDER DECLARATION Issued by: ABBY AYENDE Date: 43/16/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole RE -ROOFS: compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: I hereby affirm under penalty of perjury one of the following three declarations: Date: 5/10/2016 t. 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER performance of the work for which this permit is issued. 2. 1 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 HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 3. I certify that in the performance of the work for which this permit is issued, I California Health & Safety Code, Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous exemption, I become subject to the Worker's Compensation provisions of the air contaminants as defined by the Bay Area Air Quality Management District I Labor Code, I must forthwith comply with such provisions or this permit shall will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and be deemed revoked. the Health & Safety Code, Se tions 25505, 25533, and 25534. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Owner or authorized agent: correct. I agree to comply with all city and county ordinances and state laws Date: 5/10/201 relating to building construction, and hereby authorize representatives of this city CONSTRUCTION LENDING AGENCY to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a construction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, of work's for which this permit is issued (Sec. 3097, Civ C.) judgments, costs, and expenses which may accrue against said City in Lender's Name consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 5/10/2016 Licensed J CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 JR&V**1 (408) 777-3228 •FAX (408) 777-3333 • building (a.cupertino.org n 2SEW CONSTRTICTION ❑ ADDITION ❑ ALTER.ATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS APN R OWNER NAME S I S i I PHONTE E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX - - O U CONTACT NA -%1E PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OR'NER ❑ OWT'ER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DE%LLOPER ❑ ?ENANT CONTRACTOR NAMF� , - �. f L� LICENSE NUMB S^ /J i LICENSE TY?E 1 I BUS. LIC R COMPA T NA),4E�I E-MAIL Fax — STREET ADDRESS /` f, CITY, STATE, ZIP 1 VJkAA0s' V ( PHONE LICENSE NUMBER BUS. LIC R COMPANY NAME -`� S I O E-NOUL FAX — --- -- STREET ADDRESS _ , n , CITY, STATE, ZIP ^ PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE 'STORIES USE I TYPE OCC. SQ.FT. VALUATION (S) E)aSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN -T OTHER REMODEL .AREA REMODEL AREA REMODELAREA PORCH AREA DECK.ARE.A TOTAL DECK,`PORCH AREA GARAGE.AREA: LJDETACH ❑ ATTACH DwELLTNG UNITS: IS A SECOND UNIT YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? [3"0 PRE-AP?L1CAT]ON ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN [:]PES RE �' T�� a a t' TOTAL VALUATION: PLANNING .APPL: ❑NO PLANNING APPROVAL LETTER I EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or auth iz agent t act on the property, owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of \ ork and verify it is accurate. I agee to comply With all applicable local ordinances and state laws relatin to wild' g nstruction. I authorize representatives of Cupertino to enter the above -id Iti-ri7roperty. for inspection purposes. Signature of Applicant/Agent: Date: / o SUPPLEN4ENTAL INFORN4ATION REQUIRED PLAN CliFClc TS PE ROUTING SLIP { New SFD or T4ultifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building 0\ -R-TEE-COUNT, }R RLILnING PLA\ RE\7E', permit for new building. ?^ E>D KE Ss ❑ PLA-NN]Nc PLA -N IZEti ]E ' _ Commercial Bldgs: Provide a completed Hazardous ?`4aterials Disclosure _ ST-Xn�,-PD —i PI: F.LlC 60r. --s form if any Hazardous 1`4aterials are being used as part of this project. L -RGt PiI:EDKFI Copy of Planning Approval Letter or Meeting with Planning prior to _ submittal of Building Permit application. V ��JOR S tiNIT r ` FR 'r+,,, <e�'sY'." rt• -z >"',...' EN\-IRON-NIENT I - Bld&4pp_2011.doc revised 06/_%1/11 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-8 FAX (408) 777-3333 • building(aDcupertno.org1-4 LJ NEW CONSTRUCTION Z ADDITION ❑ ALTERATION / Ti 0 REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS r0 C- ® APN # OWNERNAME `� POro s 9 —Y06 -7E -MAIL STREET ADDRESS � C Y ` _ � � � CITY, STATE,, ZIP j`� FAX CONTACT NAME n, PHONEg / AIL z L " chisl19 �I( � ��A,>y STREET ADDRESS t) AJ CITY, STATE_ ZIP �( FAXaq .❑ OWNER ❑ OWNER -BUILDER ❑ OWNER:AGENT ❑CONTRACTOR CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC 15j0'f0*:kA LLA COMPANY NAME-MAIL� f f_rO 9 l 9U $1-,04 e_S 1-7' Ey P ' L ®% T i t (e FAX 9' STREET ADDRE CITY, STATE, ZIP P ONE 6C;f L-0�1 Acis_ C - 'f- 797 -G 5 E LICENSE NUMBER BUS. LIC # CONRANY.NAME E-MAIL FAX , 0-t fi STREET�SS CITY, STATE, ZIP PHONE # DWELLING UNITS: IS A SECOND UNIT ❑ S SECOND STORY RYES DESCRIPTION OF WORK BEING: ADDED? NO ADDITION? []NO y IS THE BLDG AN I --i PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? By my signature below, I certify to each of the following: I am the property owner iorize ent to act on the property owner's behalf. I have read ' application and the information I have provided is correct. I have read the Description of Work and verify it is accurate.. I agree to comply with all applicable�Iocaordin ances and state laws relating buil g construct'on. I authorize representatives of Cupertino to enter the above -identified property for inspection purpo Date: Signature ofApplicant/Agent: 1 SUPPLEMENTAL INFORMATION REQUIRED PT.AI)ICH CK7'. ,e-, YPE _ New SFD or Multifamily dwellings: Apply for demolition permit for fl a ER rHE COUNTS ❑ BUILPING PLANREVIEw existing building(s). Demolition permit is required prior to issuance of building pen -nit for new building. EeR> s PLAN Rvi� - r ; EXISTING USE l] STANbAiiD PROPOSED USE - CONSTR. TYPE I # STORIES ❑ - -' USE '� TYPE OCC, SQ.FT. VALUATION ($} EXISTAREAL' 1 � (y '. AREA' ® NEW Lt 8 AREA I® DEMO AREA submittal of Building Permit application. TOTAL NET AREA - - BATHROOM - KITCHEN OTHER - REMODEL AREA REMODEL AREA REMODEL AREA .. # DWELLING UNITS: IS A SECOND UNIT ❑ S SECOND STORY RYES BEING: ADDED? NO ADDITION? []NO PRE -APPLICATION ❑ YES IP YES, PROVIDE COPY OF IS THE BLDG AN -.Ej�7,ED. .'r ,_' „ �`;�,-: ' ' --" VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? By my signature below, I certify to each of the following: I am the property owner iorize ent to act on the property owner's behalf. I have read ' application and the information I have provided is correct. I have read the Description of Work and verify it is accurate.. I agree to comply with all applicable�Iocaordin ances and state laws relating buil g construct'on. I authorize representatives of Cupertino to enter the above -identified property for inspection purpo Date: Signature ofApplicant/Agent: 1 SUPPLEMENTAL INFORMATION REQUIRED PT.AI)ICH CK7'. ,e-, YPE _ New SFD or Multifamily dwellings: Apply for demolition permit for fl a ER rHE COUNTS ❑ BUILPING PLANREVIEw existing building(s). Demolition permit is required prior to issuance of building pen -nit for new building. EeR> s PLAN Rvi� - r ; Commercial Bldgs: Provide a completed Hazardous Materials Disclosure l] STANbAiiD ❑ POSLIC WOR" form if any Hazardous. Materials are being used as part of this project. LARGE ❑ ,FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to[YIV14sox ElSANITARY SEVI,MR DISTRICT submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ialADDRESS: 10216 AVOCADO PL 'DATE: 12/17/2015 REVIEWED BY: MELISSA APN; 369 09 014 BP# "VALUATION: 1$115,boo *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: . SFD or Duplex 2nd Unit? - Yes G No OTC? 0 Yes (j)No PENTAMATION PERMIT TYPE: 1 R3SFDADD' woRK ADD 248 S.F. TOE FRONT 2ND STORY TO EXTEND E MASTER BEDROOM AREA & ADD 248 SCOPE S.F. TO 1ST FLR, SIDE YARD TO CREATE (N) 1/2 BATH & EXTEND (E) DINING RM OCCUPANCY TYPE: TYPE OF FLR AREA CONSTR. (s.f.) PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B;III-13JV,V 13 496 $1,626.00 IADDPLCK $1,323.00IADDINSP TOTALS: 496 $1,626.00 $1,323.00 He,; !P. "I }n (3',it'f;7.; � Ku -.€,,b. 11..w Cheek 1..tec ?il„i c.,17t;. 1..1-.`.'f'. Fee: Y.Y. O'fhCr '1't<rt b llts'p. 0� fle ` NOTE: This estimate does not include -fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These -fees are based on the preliminary information available and`are only an estimate. uontact theyept.ror aaan't mfo. FEE ITEMS (Fee Resolution 11-053 E : 211113 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,626.00 - Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. 0 OT= hrs $0.00 PME Plan Check: $0.00' Permit Fee: $1,323.00 Suppl. Insp. Fee.6) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes .) No $0.00 Advanced Planning Feer IPLLONGR $69.44 Select a Non -Residential G Building or Structure 0 Strong Motion Fee: 1BSEISMICR $14.95 Select an Administrative Item Bld& Stds Commission Fee: IBCBSC $5.00 sUSTOTALs . $3,038.39 $0.00 Ta'TaL FEE: $3,038.39 Revised: 10/01/201 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: ( 0'2-) bJOG14170 C(' PERMIT # I Q) 6 �/ OWNER'S NAME: rOOPNiMP, -S A,i PHONE # 65 -0 -79,7 -62 -575 - 50 -7$%"62575 - GENERAL GENERAL CONTRACTOR: I I ToN 0IL L)p. BUSINESS LICENSE # Lf 0l ADDRESS:2. p , t/ )(Z LOS LT- CITY/ZIPCODE: f_ (_ os. C 9 (4aZ *Our municipal code requires all businesses working in thQ nota have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. P e 0 I am not using any subcontractors: S' ature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 10 � 1 f AYoc-A 9,0 P L PERMIT # 1 S I? a/ is If OWNER'S NAME:S'RIpHA4,C 4 foofpiM M SEsyoAR I PHONE # 5-0 - e% _ K,2 S GENERAL CONTRACTOR: M 1 G NTo.v BUSINESS LICENSE # � ! ADDRESS: Z) L,aX 71,01-r to f CA CITY/ZIPCODE: Lv S q LTo S *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing o.3 Electrical 7) L LD E L C C 7 ►f I C 4 L Excavation R cS 8 V! Fencing Flooring / Carpeting litJ E ff 0 USC 0I R ELT Linoleum / Wood Glass / Glazing Heating i/ Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing L L A 6 PL- Roofing Roofing lQ pS b v 1 L- 1'3 E Septic Tank Sheet Metal Sheet Rock L-'0 E S b Tile 7v /4-1 13 U/ L DL,:�k's d 3 3 Owner / Contractor Signature �17 17 17 I Date CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 10 Z I 6 JOGA- 0 PLA CC PERMIT # I 51 Lo) 6 4 OWNER'S NAME:- 0p A -V-9jkjb4j4P, SoSdAbf)PHONE # 66-0 - 78 7 -6 Z Sri GENERAL CONTRACTOR: 1 I TD tv ROILPERS 410- BUSINESS LICENSE # 0 ADDRESS: 2 MoKA- - N DK " Li C CITY/ZIPCODE: L19 q 4 OZ *Our municipal code requires all businesses w6rking in th# HON1 have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: oPW41�s-12-.3/zor -7 S' ature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 1 of 11 GENERAL INFORMATION 01 Project Name Seshadn Residence 02 Calculation Description Title 24 Analysis 03 Project Location 10216 Avocado Place 04 City Cupertino 05 Standards Version Compliance 2015 06 Zip Code 95014 07 Compliance Manager Version BEMCmpMgr 2013-4 (744) 08 Climate Zone CZ4 09 Software Version EnergyPro 6.6 10 Building Type Single Family 11 Front Orientation (deg/Cardinal) 330 12 Project Scope Addition and/or Alteration 13 Number of Dwelling Units 1 14 Total Cond. Floor Area (ft2) 2801 15 Number of Zones 4- 16 Slab Area (ft2) 706 17 Number of Stories- 2 70 18 Addition Cond. Floor Area 496 19 Natural Gas Available Yes "?f 20 Addition Slab Area (ft) 0 21 Glazing Percentage (%) 12.6% COMPLIANCE RESULTS 01 Building Complies with Computer Performance rig 02 This building DOES NOT require HERS Verification ._ V- G..S r. 03 This building incorporates one or more Special Features shown belowL e Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 ENERGY USE SUMMARY 04 05 06 07 08 Energy Use (kTDV/ft2-y r) Standard Design Proposed Design Compliance Margin Percent Improvement Space Heating 47 81 44.12 3.69 7.7% Space Cooling 37.78 3889 i9 Pryx;,;r- -2.9% IAQ Ventilation 0.00 0.00 0.00 ItZ4 0.0% Water Heating 11.37 11.37 0.00 0.0% Photovoltaic Offset ---- 0.00 0.00 ---- Compliance Energy Total 96.96 94.38 2.58 2.7% Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml REQUIRED SPECIAL FEATURES The following are features that must be installed as condition for meeting the modeled energy performance for this computer analysis. • New ductwork added is less than 40 ft. in length HERS FEATURE SUMMARY CF1 R -PRF -01 Page 2 of 11 The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting the modeled energy performance for this computer analysis. Additional detail is provided in the building components tables below. Building -level Verifications: • --None -- Cooling System Verifications: • --None -- HVAC Distribution System Verifications: • -- None -- Domestic Hot Water System Verifications: • -- None -- ENERGY DESIGN RATING This is the sum of the annual TDV energy consumption for energy use components included in the performance compliance approach for the Standard Design Building (Energy Budget) and the annual TDV energy consumption for lighting and components not regulated by Title 24, Part 6 (such as domestic appliances and consumer electronics) and accounting for the annual TDV energy offset by an on-site renewable energy system. 02 Reference Energy Use Energy Design Rating Margin Percent Improvement Total Energy (kTDV/f2-yr)* 141.06 138.48 2.58 1.8% * includes calculated Appliances and Miscellaneous Energy Use (AMEU) BUILDING - FEATURES INFORMATION 01 02 03 04 05 06 07 Project Name Conditioned Floor Area (ft2) Number of Dwelling Units Number of Bedrooms Number of Zones Number of Ventilation Cooling Systems Number of Water Heating Systems Seshadri Residence 2801 1 4 4 0 1 Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CFiR-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 3 of 11 ZONE INFORMATION 01 02 03 04 05 06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ft2) Avg. Ceiling Height Water Heating System 1 Water Heating System 2 Main Floor Conditioned HVAC Systeml 1445 8 DHW Sys 1 Main Floor Addition Conditioned HVAC System 248 8 DHW Sys 1 Upper Floor Conditioned HVAC System 860 8 DHW Sys 1 Upper Floor Addition Conditioned HVAC System 248 8 DHW Sys 1 Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CFI R -PRF -01 Page 4 of 11 OPAQUE SURFACES 01 02 03 04 05 06 07 08 09 10 Name Zone Construction Azimuth Orientation Gross Area (ft2) Window & Door Area (ft) Tilt (deg) Status Verified Existing Condition Front Wall Main Floor R-0 Wall 330 Front 224 73.3 90 Existing No Left Wall Main Floor R-0 Wall 60 Left 287 18 90 Existing No Rear Wall Main Floor R-0 Wall 150 Back 401 102.7 90 Existing No Right Wall Main Floor R-0 Wall 240 Right 93 9 90 Existing No Interior Surface Main Floon>_Garage_ R-0 Walll 199 16.7 Existing No Roof Main Floor R-0 Roof Attic 739 Existing No Raised Floor 2 Main Floor R-0 Floor Crawlspace 739 Existing No Front Wall 2 Main Floor Addition R-13 Wall 330 Front 94 90 New N/A Rear Wall 2 Main Floor Addition R-13 Wall 150 Back 94 20 90 New N/A Right Wall 2 Main Floor Addition R-13 Wall 240 Right 226 25 90 New N/A Roof 2 Main Floor Addition R-30 Roof Attic 248 New N/A Raised Floor 3 Main Floor Addition R-19 Floor Crawlspace 248 New N/A Left Wall 2 Upper Floor R-0 Wall 60 Left 305 24.7 90 Existing No Rear Wall 3 Upper Floor R-0 Wall 150 Back 177 36 90 Existing No Right Wall 3 Upper Floor R-0 Wall 240 Right 174 90 Existing No Interior Surface 3 Upper Floor»Attic Upper Floor R-0 Walll 90 Existing No Roof 3 Upper Floor R-0 Roof Attic 860 Existing No Raised Floor Upper Floor R-0 Floor No Crawlspace 67 Existing No Interior Surface 5 Upper Floon>_Garage_ R-0 Floor No Crawlspacel 84 Existing No Front Wall 3 Upper Floor Addition R-13 Wall 330 Front 177 54 90 New N/A Left Wall 3 Upper Floor Addition R-13 Wall 60 Left 91 10.7 90 New N/A Right Wall 4 Upper Floor Addition R-13 Wall 240 Right 91 90 New N/A Roof 4 Upper Floor Addition R-30 Roof Attic 248 New N/A Interior Surface 7 Upper Floor Add ition»_Garage_ R-19 Floor No Crawlspace 248 New N/A Front Wall 4 _Garage_ R-0 Wall 330 Front 177 112 90 Existing No Left Wall 4 _Garage_ R-0 Wall 60 Left 181 17.8 90 Existing No Right Wall 5 _Garage_ R-0 Wall 240 Right 160 90 Existing No Roof 5 _Garage_ R-0 Roof Attic 133 Existing No Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 5 of 11 ATTIC 01 02 03 04 05 06 07 08 09 10 11 Name Surface (Orientation -Azimuth) Width(ft) Height (ft) Multiplie r Radiant U -factor Statu Verified Existing Name Construction Type Roof Rise Roof Reflectance Roof Emittance Barrier Cool Roof s Condition Attic Attic Garage Roof Cons Ventilated 0 0.1 0.85 No No Exgti No _Garage_ Insect Screen (default) New N/A Window 3 Front Wall (Front -330) ---- ---- 1 13.3 Attic Main Floor Attic RoofMain Floor Ventilated 4 0.1 0.85 No No Existi No 18.0 0.55 0.67 Insect Screen (default) Existing No Window 5 Rear Wall (Back -150) ng ---- Attic Main Floor Addition Attic RoofMain Floor Addition Ventilated 4 0.1 0.85 No No New No Attic Upper Floor Attic RoofUpper Floor Ventilated 4 0.1 0.85 No No Eng ti No ---- ---- 1 9.0 0.55 0.67 Insect Screen (default) Existing No Window 8 Attic Upper Floor Addition Attic RoofUpper Floor Addition Ventilated 1 4 1 0.1 0.85 No No New No WINDOWS 01 02 03 04 05 06 07 08 09 10 11 Name Surface (Orientation -Azimuth) Width(ft) Height (ft) Multiplie r Area (ft2) U -factor SHGC Exterior Shading Status Verified Existing Condition Window Front Wall (Front -330) ---- ---- 1 32.0 0.34 0.30 Insect Screen (default) Altered N/A Window 2 Front Wall (Front -330) ---- ---- 1 8.0 0.34 0.30 Insect Screen (default) New N/A Window 3 Front Wall (Front -330) ---- ---- 1 13.3 0.55 0.67 Insect Screen (default) Existing No Window 4 Left Wall (Left -60) ---- ---- 1 18.0 0.55 0.67 Insect Screen (default) Existing No Window 5 Rear Wall (Back -150) ---- ---- 1 90.7 0.55 0.67 Insect Screen (default) Existing No Window 6 Rear Wall (Back -150) ---- ---- 1 12.0 0.34 0.30 Insect Screen (default) Altered N/A Window 7 Right Wall (Right -240) ---- ---- 1 9.0 0.55 0.67 Insect Screen (default) Existing No Window 8 Rear Wall 2 (Back -150) ---- ---- 1 20.0 0.34 0.30 Insect Screen (default) New N/A Window 9 Right Wall 2 (Right -240) ---- ---- 1 25.0 0.34 0.30 Insect Screen (default) New N/A Window 10 Left Wall 2 (Left -60) ---- ---- 1 6.0 0.55 0.67 Insect Screen (default) Existing No Window 11 Left Wall 2 (Left -60) ---- ---- 1 18.7 0.34 0.30 Insect Screen (default) New N/A Window 12 Rear Wall 3 (Back -150) ---- ---- 1 36.0 0.55 0.67 Insect Screen (default) Existing No Window 13 Front Wall 3 (Front -330) 1 54.0 0.34 0.30 Insect Screen (default) New N/A Window 14 Left Wall 3 (Left -60) ---- 1 10.7 0.34 1 0.30 1 Insect Screen (default) New N/A Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 6 of 11 DOORS 01 02 03 04 05 06 Name Side of Building Area (ft2) U -factor Status Verified Existing Condition Door Front Wall 20.0 0.50 Existing No Door 2 Interior Surface 16.7 0.50 Existing No Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CFIR-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 7 of 11 OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 Total Cavity Winter Design Construction Name Surface Type Construction Type Framing R -value U -value Assembly Layers • Inside Finish: Gypsum Board • Cavity/ Frame: no insul. / 2x4 • Exterior Finish: Wood R-0 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. none 0.302 Siding/sheathing/decking Ceilings (below Inside Finish: Gypsum Board R-0 Roof Attic attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. none 0.481 Cavity/ Frame: no insul. /2x4 • Cavity/ Frame: no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic Garage Roof Cons Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Cavity/ Frame: no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofMain Floor Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Floor Surface: Carpeted Floors Over Floor Deck: Wood Siding/sheathing/decking R-0 Floor Crawlspace Crawlspace Wood Framed Floor 2x12 @ 16 in. O.C. none 0.216 Cavity/Frame: no insul. /2x12 • Inside Finish: Gypsum Board • Cavity/ Frame: no insul. / 2x4 R-0 Walll Interior Walls Wood Framed Wall 2x4 @ 16 in. O.C. none 0.277 Other Side Finish: Gypsum Board • Cavity/ Frame. no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofMain Floor Addition Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Floor Surface: Carpeted Floors Over Floor Deck: Wood Siding/sheathing/decking R-19 Floor Crawlspace Crawlspace Wood Framed Floor 2x6 @ 16 in. O.C. R19 0.049 Cavity/ Frame: R -19/2x6 • Inside Finish: Gypsum Board • Cavity / Frame: R-13 / 2x4 • Exterior Finish: Wood R-13 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.095 Siding/sheathing/decking • Inside Finish: Gypsum Board Ceilings (below Cavity/Frame: R-9.1 /2x4 R-30 Roof Attic attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. R 30 0.032 Over Floor Joists: R-20.9 insul. • Cavity/ Frame: no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofUpper Floor Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Floor Surface: Carpeted • Floor Deck: Wood Siding/sheathing/decking R-0 Floor No Crawlspace Exterior Floor=Wood med Floor 2x12 @ 16 in. O.C. none 0.240 Cavity/Frame: no insul. /2x12 Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801 EA.xml CF1 R -PRF -01 Page 8 of 11 SLAB FLOORS 01 02 03 04 05 • Floor Surface: Carpeted 07 08 09 Name Zone Area (ft2) • Floor Deck: Wood Siding/sheathing/decking Edge Insul. R -value Carpeted Fraction Heated Status Verified Existing Condition Slab -on -Grade • Cavity / Frame: no insul. / 2x 12 R-0 Floor No Crawlspacel Interior Floors Wood Framed Floor 2x12 @ 16 in. O.C. none 0.196 Ceiling Below Finish: Gypsum Board • Cavity/ Frame: no insul. / 2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 Roof Deck: Wood Siding/sheathing/decking Attic RoofUpper Floor Addition Attic Roofs Wood Framed Ceiling in. O.C. none 0.644 Roofing: Light Roof (Asphalt Shingle) • Floor Surface: Carpeted • Floor Deck: Wood Siding/sheathing/decking • Cavity/Frame: R -19/2x6 R-19 Floor No Crawlspace Interior Floors Wood Framed Floor 2x6 @ 16 in. O.C. R 19 0.048 Ceiling Below Finish: Gypsum Board SLAB FLOORS 01 02 03 04 05 06 07 08 09 Name Zone Area (ft2) Perimeter (ft) Edge Insul. R -value Carpeted Fraction Heated Status Verified Existing Condition Slab -on -Grade Main Floor 706 52 None 0.8 No Existing No BUILDING ENVELOPE - HERS VERIFICATION 01 02 03 04 Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage CFM50 Not Required Not Required Not Required --- WATER HEATING SYSTEMS 01 02 03 04 05 06 07 08 Name System Type Distribution Type Water Heater Number of Heaters Solar Fraction M Status Verified Existing Condition DHW Sys 1 DHW Standard DHW Heater 1 1 Annual Existing I No WATER HEATERS 01 02 03 04 05 06 07 08 Name Heater Element Type Tank Type Tank Volume (gal) Energy Factor or Efficiency Input Rating Tank Exterior Insulation R -value Standby Loss (Fraction) DHW Heater 1 Natural Gas Small Storage 50 0.575 EF 40000-Btu/hr 0 0 Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Input File Name: Seshadri RR2801EA.xml CF1R-PRF-01 Page 9 of 11 WATER HEATING - HERS VERIFICATION 01 02 03 04 05 06 07 Name Pipe Insulation Parallel Piping Compact Distribution Point -of Use Recirculation with Manual Control Recirculation with Sensor Control DHW Sys 1 n/a n/a n/a n/a n/a n/a SPACE CONDITIONING SYSTEMS 01 02 03 04 05 06 07 08 09 Zonally Controlled Multi -speed Compressor Heating System Cooling System NoCooling - No cooling equipment N/A N/A No No N/A Verified Existing HERS Name Type Distribution Fan Floor Area Location Verified Existing Name System Type Name Ducted Name Ducted System System Served Status Condition HVAC SystemlOther Heating and Heating Yes Cooling No Air Distribution HVAC Fan 2801 Existing No Cooling System Component 1 Component 1 System 1 1 HVAC - HEATING SYSTEMS 01 02 03 Name Type Efficiency Heating Component 1 CntrlFurnace - Fuel -fired central furnace 80 AFUE HVAC - COOLING SYSTEMS 01 02 03 04 05 06 07 Name System Type Efficiency EER SEER Zonally Controlled Multi -speed Compressor HERS Verification Cooling Component 1 NoCooling - No cooling equipment N/A N/A No No N/A HVAC - DISTRIBUTION SYSTEMS 01 02 03 04 05 06 07 08 09 10 Insulation Supply Duct Return Duct Verified Existing HERS Name Type Duct Leakage R -value Location Location Bypass Duct Status Condition Verification Air Distribution Ducts located in attic Existing (not 6.0 Attic Attic None Existing + New No N/A System 1 specified) IAQ (Indoor Air Quality) FANS 01 02 03 04 05 Name IAQ CFM IAQ Fan Type IAQ Recovery Effectiveness(%) HERS Verification SFam IAQVentRpt 0 Default 0 Not Required Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Calculation Description: Title 24 Analysis Registration Number: CA Building Energy Efficiency Standards - 2013 Residential Compliance Input File Name: Seshadri RR2801 EA.xml Registration Date/Time: Report Version - CF1R-08252015-744 CF1 R -PRF -01 Page 10 of 11 HERS Provider: Report Generated at: 2015-12-14 06:36:02 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Seshadri Residence Calculation Description: Title 24 Analysis Calculation Date/Time: 06:33, Mon, Dec 14, 2015 Input File Name: Seshadri RR2801EA.xml CF1R-PRF-01 Page 11 of 11 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Miles Hancock 41 &aLv �-14�- C Company: Signature Date: Energy Design Group 12/14/2015 Address: CEA/HERS Certification Identification (If applicable): 2149 Dartmouth Street R13-14-10047 City/State ip: Palo Alto, CA 94306 Phone: (650) 804-9063 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. 2. 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 3. 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: Rick Reynolds Company: Date Signed: Rick Reynolds Address: License: City/State/Zip: Phone: Boulder Creek, CA 95006 (408) 320-3616 Registration Number: Registration Date/Time: CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CFiR-08252015-744 HERS Provider: Report Generated at: 2015-12-14 06:36:02