B-2016-1905CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-1905
1070 COLONY HILLS LN CUPERTINO, CA 95014-5825 (359 28 012)
KEEP IT FLOWING
MECHANICAL
SAN JOSE, CA 95124
OWNER'S NAME: LIN SHIJER AND FONGMEI TRUSTEE
DATE ISSUED: 05/06/2016
OWNER'S PHONE: 408-242-8316
PHONE NO: (408) 821-9813
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class WARM -AIR HEATING, VENTILATING AND AIR-CONDITIONING
X BLDG —ELECT —PLUMB
Lic. #931421
Contractor KEEP IT FLOWING MECHANICAL Date 04/30/2017
X MECH 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
JOB DESCRIPTION:
license is in full force and effect.
RELOCATE FURNACE FROM CLOSET TO ATTIC; REPLACE
ASSOCIATED DUCT WORK
I hereby affirm under penalty of perjury one of the following two declarations:
i. 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.
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
Sq. Ft Floor Area:
Valuation: $5000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
359 28 012
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
PERMIT EXPIRES IF WORK IS NOT STARTED
City of Cupertino against Iia ' ' ' s, judgments, costs, and expenses which
'nst
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
may accrue g said n onsequence of the granting of this permit.
Additionally 'the pplican�und s ds and will comply with all non -point
180 DAYS D INSPECTION.
source re Iation pert e Cup o Municipal Code, Section 9.18.
Issued by: MELI,
Signature Date 05/06/2016
Date: 05/06/2016
RE -ROOFS:
TLDER DE LU l T
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
i. 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: 05/06/2016
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
i. 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. I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
Section 3700 of the Labor Code, for the performance of the work for which this
maintain compliance with the Cupertino Munic4pal.Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) shggQld I sto or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipmefit or devic which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by t Bay Area A' uality anagem -at District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance wit lie erti Muni de, Chapter 9.12 and
the Health & Safet Cod , etio W 2550and 25534.
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
Owner or authorized age
be deemed revoked.
Date: 05/06/2016
APPLICANT CERTIFICATION
CONSTRUCTTON LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
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 understands
ARCHITECT'S DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Professional
Signature Date 05/06/2016
m m
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 . FAX (408) 777-3333 • building(@cupertino.org MISC
CUPERTINO 14 S
❑ PLUMBING MECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS
PROJECT ADDRESS f.� -7 O � on 1 �U APN #Z-
OWNERNAME V =� L O r E-MAIL
r
STREET ADDRESS CITY, S TE, FAX
o�Z 0 o Y� lAan e ° vZIP r1i6 v Ch y S -0l
CONTAC NAME P O �J // E-MAIL
STREET ADD SS 1 '1 C FAX
l� GUJ a� I S � Y, STATE ZIP � JYI J C -h f
&WNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME-
/ � ` � LICENSE I�iJIv q2- BER / LICF�NSEZ EO BUS. LIC
COMPANY NAME - \_ _-e i _ _ . _ . E-MAIL . n �_ FAX
STREET ADD 'SS o /� lC' I-
lJ �i 1 l� i� u l
I U}; /11 A . ,
�C� _ S� ��
t iT-3
ARCHITECT/ENGINEF.R NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX
BUILDING:❑COMMERCIAL
® MULTI -FAMILY
PROJECT IN WH.DLAND ❑ YES
URBAN INTERFACE AREA NO
PROJECT IN ❑ YES
FLOOD ZONE ® NO
IS THE BLDG AN ❑ YES
EICHLER HOME? NO
DESCRIPTION OF WORK l� OCw �
� C
(,L'
"�Ov
TOTAL VALUATION:/ �� �^ EIVED By.
By my signature below, I certify to each of the following: I am the property owner of a6horized agent to act on th peity owners behalf. I have read this
application and the information I have provided is correct. I have read the Descriptiou-of-Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relaf to'1 m in�construc�tionI uthorize�n-T�tives�Cupertino�t enter the above-ide tified property for inspection purposes.
Signature of Applicant/A t: Date:
SUPPLEMENTAL INFORMATION REQUIRED oFFrr> Ilse oNI v
MEPMiscApp_2011.doc revised 06121111
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
1070 Colony Hills Lane I Date Prepared:
CF1R-ALT 02-E
(Page 1 of 3 )
2016-05-05
A. General Information
CF1R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
1070 Colony Hills Lane
02
Date Prepared
2016-05-05
03
Project Location
1070 Colony Hills Lane
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
1070 Colony Hills Lane
07
Zip Code
95014
08
Dwelling Unit Conditioned
1742
Installing
Installing
=
Floor Area (ft2)
Location or Area
by this SC
ducted
-
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, T 3'
01
02
:,03 r
04 d .
05 `° :
06
07
08
09
10 _
4
S the SC `
Installing a
?`
SC System
SC System „'
' fCFA 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
System 1
Location 1
1700
Yes
Yes
No
Yes
No
No
Altered space
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: 216-A0168991A-000000000-0000
Registration Date/Time: 2016-05-05 14:20:00
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-05 14:19:51
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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
Central gas
No heating
This field or
This field or
Central split
No cooling
This field or
This field or
Greater than
System 1
furnace
component
section is not
section is not
AC
component
section is not
section is not
Setback
40 feet
R-6
altered
applicable
applicable
altered
applicable
applicable
Required Documentation:
CF211-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' !red 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 <_ 10% leakage to outsideor seal all accessible leaks.
CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verlfication required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
MRCF313-MCH-23 & CF3R-MCH-23 Air Flow z 300;CF required;when.MCH-25 Is required.
Exceptions: "
-Duct systems registered with HERS provider as°previously sealed are exempt from MCH -20 Duct Leakage Testing regwrements
r,
-Heating-onlyor Refrigerant Charge MEC H 25 „_.
systems and Air Handler Furnace changes do not require'verificat!on of Air Flow MCH-,23,-
-Existing duct systems constructed, insulated or sealed with asbdsfos;,are exempt.;from MCH 20 Duct'Leakage Testing requiremenfs
Y
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections;150.2(b)1Dih and 150.2(b)1E, 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: 216-A0168991A-000000000-0000
Registration Date/Time: 2016-05-05 14:20:00
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 20116-05-05 14:19:51
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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:
Bocanegra, Matthew
L���
AVL
Company:
Signature Date:
KEEP IT FLOWING MECHANICAL
2016-05-05 14:20:00
Address:
CEA/ HERS Certification Identification (if applicable):
P O BOX 54390
CC2005756
City/State/Zip:
Phone:
SAN JOSE CA 95124 a
408-821-9813
Responsible Person's Declaration statement; .
I certify the following under penalty of perjury, under thellaws":of the State of California:
1. The information provided o_n this Certificate of Compliance !s true and correct.
2. 1 am eligible under Division 3- of thdBusmess 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 orsystem design identified on this Certificate of Compliance conform to the
requirements of Title 24; Part 1 and Pa'r ,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_uifththis building permit application. z
S. I will ensure that a registered copy of this Certificate of Compliance shall' be made available with ft building permit(s) Issued for the_.building, and,"made available to the`;enforcement agency for all applicable
inspections. I understand that a re iste ecopy of this°Certifcate of Compliance,is required to be -included with the.documentationthe builder provides to the building owner at occupancy.
Responsible Designer Name: % �-Z=
Bocanegra,
Responsible Designer Signature.
CI�LG�f22U7 UJ
Matthew
Company:
Date Signed:
KEEP IT FLOWING MECHANICAL
2016-05-05 14:20:00
Address:
License:
P 0 BOX 54390
931421
City/State/Zip:
Phone:
SAN JOSE CA 95124
408-821-9813
Digitally signed by Ca10ERTS. 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: 216-A0168991A-000000000-0000 Registration Date/Time: 2016-05-05 14:20:00 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-05 14:19:51
Schema Version: 0.555SDD
CUPERTINO
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300' AVEN E • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAXi (408) 777-3333 • buildingCaD-cupertino.or4 Z l —I 10 f
Owner Name 5'1-x, 11;n e-ld I Permit No.' CO
Address f 7 Ca %'•ti H', l(f L.L Cl)
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.
( No Go to Question 2. j
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 110 1. 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.
No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
W 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.
Bek', 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..
5.1 Please check ONE of the following:
( My property is a single-family residential rez
On and after January 1, 2014, building alter
to be replaced with water -conserving plumbi
compliant plumbing fixtures shall be rep]
property undergoes alterations or improveme
❑ My property is a multifamily residential real
On and after January 1, 2014, specified build
plumbing fixtures to be replaced with water -
On or before January 1, 2019, all non-compli
conserving plumbing fixtures throughout the
improvements).
❑ My property is a commercial real property.
On and after January 1, 2014, specified build
plumbing fixtures to be replaced with water -
On or before January 1, 2019, all non -co:
plumbing fixtures throughout the building (rf
property. See Civil Code Section 1101.4.
ions or improvements shall require all non-compliant plumbing fixtures
fixtures throughout the building. On or before January 1, 2017, all non-
-ed with water -conserving plumbing fixtures (regardless of whether
�perty. See Civil Code Section 1101.5.
alterations or improvements shall require non- compliant
serving plumbing fixtures.
plumbing fixtures shall be replaced with water-
ilding (regardless of whether property undergoes alterations or
Civil Code Section 1101.5.
alterations or improvements shall require non- compliant
serving plumbing fixtures.
iant plumbing fixtures shall be replaced with water- conserving
dless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property,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 Sections 110 1. 1
through 1101.8, the current California Plumbing (Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
pa
table on the following te.
I Owner or Owner Agent's Signature:' Date: .-/ u/r G I
Upon completing and signing this CertifiCate, please return it to the Building Division in order to final your building permit.
SB407 2015. doc revised 08/26/15
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015.doc revised 08/26/15
Non -Compliant
Water -Conserving Plumbing Fixture
PlumbingFixture
(Fixture Complying with Current Code Applicable to New Construction)
I., . Maximum Water Usage/Flow Rate
Fixture Type
yp
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
/Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets —
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015.doc revised 08/26/15
iCvpr:KTIINQ
wJ ±59 %r ltd," El 10 70
PURPOSE
SMOKE / CAkBON WONOXBDE ALARMS
0WRER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVEN I E - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX 1(408) 777-3333 - build! n4Ca.cupertino.org
F;°
�F �Ct�rla�z�4dno�.i�de:s i
Z✓
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERA, INFORMATION
Existing single-family and multi -family dwellii ngs 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 j
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
I
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 co;
In existing dwelling units, alarms are permi
not result in the removal of wall and ceiling
space. Refer to CRC Section R314 and CBC
alarms which must be connected to the buil
As owner of the above -referenced property, I
installed in accordance with the manufacture:
and California Residential Codes. The alarms
below.
t have read and
z „✓ - I
.�---
�rcial power supply, alarm(s) may be solely battery operated.
to be solely battery operated where repairs or alterations do
3hes or there is no access by means of attic, basement or crawl
ons 907.2.11.4 and 420.6.2. An electrical permit is required for
Wirinbc,.
reby certify that the alarm(s) referenced above has/have been
instructions and in compliance with the California Building
ve been tested and are operational, as of the date signed
with the terms and conditions of this statement
Dale:
2 /
........... .. Lic:#:.:.. J �G�ZL.............