B-2016-1949 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1949
10427 VISTA KNOLL BLVD CUPERTINO,CA 95014-1039(326 13 034) RANDO AAA HVAC
INC
SAN JOSE,CA 95125
OWNER'S NAME: DEFRANCO THOMAS JAND DORIS ATRUSTEE DATE ISSUED:05/16/2016
OWNER'S PHONE:408-739-0974 PHONE NO:(408)2934717
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-43.C-20 Lic.#76-0-71
Contractor RANDO AAA HVAC INC Date 09/30/2017 X BLDG _ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
(R)CONDENSER-BACK YARD
I hereby affirm under penalty of perjury one of the following two 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.
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:$4910.00
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 ordinances 26 Number: Occupancy Type:
3
and state laws relating to building construction,and hereby authorize 326 13 034
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 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
Additionally,the applicant understands and will comply with all non-point
source regulations pe he Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
L_
Signature � � Date 5/16/2016 Issued by:Abby Avende Gym
� n��'""�p�
Date:05/16/2016 Gym �Mwu1tJ�C
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS-
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/16/2016
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
performance of the work for which this permit is issued: HAZARDOUS MATERIALS DISCLOSURE
i. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
ermit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
p
Health&Safety Code,Section 25532(a)should I store or handle hazardous
a. I certify that in the performance of the work for which this permit is 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 as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code Sections 25505,25533,and
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:5116/2016
1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 5/16/2016 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(4008)777-3333^buildingCa�cupertino.org
❑NEW CONSTRUCTION ❑ ADDITION PI ALTERATION/TI)iLn wbo &OUW
❑ REVISION/DEFERRED ORIGINALPEERMIT#PROJECTADDRESS /] APN# 32(.p `� o
01
OWNERNAME PHONE E-MAIL /(n
STREET ADDRESS O I� CITY, STATE,ZIP I,n Ovl FAX
CONTACT NAME PHONE Y I E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME `^ /�j J� LICENSE NUMBER 1hiI LICENSE TYPE BUS.LIC#
so
COMPANY NAME h h, �( I�►/I� I(�(�`(�1 1 E-MAIL + I Q ^ �, FAX r M -01 I
STREET ADDRESS -1 t) 1/`��r��U�� L mv� ' CITY,STATE,ZIP on (�('+A M `^' PHONE`� y/I.�)`�JI I�
ARCHITECT/ENGINEER NAME `ll LICENSE NUMBER UJ ` BUS.LIC#UxJ (~VI sJi
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
►(01 Q(T f i ) 0 amt
EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: EIDETACH
ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? []NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN [I YES ;REG VED:By:` ,:' TOTAL VALUAT ON:
PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? E]NO
By my signature below,I certify to each of the following: I am the property owner or authorized agent to Act on A property owner's behalf. I have read this
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 local
ordinances and state laws relating to buildipgreonstruction. I authorize representatives of Cupertino to enter the above-' entifie p operty for inspection purposes.
Signature of Applicant/Agent: Date: �GJs
SUPPLEMENTAL INFORMATION REQUIRE 'PLAMCHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for �] ovER-T'sE•covNER " BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. EXPRESS ❑; PLANNING PLAN REVIEW'
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTArmARD ❑_'PUBLIC WORKS
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 �" MAaoii'. ❑ SANITARY SEWER nlsTxtcT
submittal of Building Permit application.
`ENVIRONMENTAL HEALTH
B1dgApp 201 Ldoc revised 06/21/11
CERTIFICATE OF COMPLIANCE � CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) v(lip, hofl f
Project Name: TOM DE FRANCO Date Prepared: w 2016-04-27
A.General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,
use one CF1R-ALT-02 document for each dwelling unit.
01 Project Name TOM DE FRANCO 02 Date Prepared 2016-04-27
03 Project Location 10427 VISTA KNOLL BLVD 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name TOM DE FRANCO
Dwelling Unit Conditioned
07 Zip Code 95014 08 Floor Area(ft2) 2443
Number of space conditioning
09 Climate Zone 4 10 (SC)systems in this dwelling 1
unit.
B.Space Conditioning(SC)System Information
YTS-" oX"im'� ti. }-
z
Ol 02 03 04t, ry ` 05 _ 06 r 07'p §Ty' 08 J 09 10
S ._. , v ..mesas...-,_z
05.20s the SC In"stalling a
SC System SC System CFA served system a refrigerant Installing new SCInstalling k Installing Installing
Identification or Location or Area by this SC ducted containing b system more than 40 entirely 01 new entirely new
Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
TRANE WHOLE HOUSE 2443 Yes Yes Yes No No No Altered spaceconditioning 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-A0157571A-000000000-0000 Registration Date/Time: 2016-04-27 13:46:56 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-04-27 13:46:51
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 2 of 3)
D.Altered Space Conditioning System (Sections 150.2(b)IE 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
No heating This field or This field or Outdoor This field or This field or
AC
TRANE Central gas component section is not section is not Central split condensing SEER 13 Setback section is not section is not
furnace altered applicable applicable unit applicable applicable
Rea ired Documentation:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums:R6.
CF2R-MCH-20-H&CF311-MCH-20-H—Duct Leakage testing required when heating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced.
-Leakage rate compliance:<_15%,or<_10%leakage to outside,or seal all accessible leaks.
CF211-MCH-25-H&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
CF2RCF3R-MCH-23&CF3R-MCH-23 Air Flow z 300 CFM/ton required when MCH-25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH720 Duct Leakage Testing requirements
4 14
-Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH 23,or"Refrigerant charge MECH 25
-Existing duct systems constructed,insulated or sealed with asbest.;are exempt from MCH 70,Duct Leakage Test ng requireements k4 MiRm M
E. Entirely New or Complete Replacement Duct System with or without,E uipment Chan eout Sections 150 2 b{1Dua and 150.2(b)1E F)
Y p p Y q p g ( ( )
s .
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)IC)
This section does not apply to this project.
Registration Number:216-A0157571A-000000000-0000 Registration Date/Time: 2016-04-27 13:46:56 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-04-27 13:46:51
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:
Rando, Eric
Company: Signature Date:
RANDO AAA HVAC INC 2016-04-27 13:46:56
Address: CEA/HERS Certification Identification(if applicable):
1712 STONE AVENUE N/A
City/State/Zip: Phone:
SAN JOSE CA 95125 408-293-4717
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations
€ j
M.
4. The building design features or system design features identified on�this Certificate of Compliance are consistent with the information provided on'other apolicable'compliance documents,worksheets,
calculations,plans and specifications submitted to the enforcement'agency for'approva)with this building permit application.
5. I will ensure that a registered copy of this Certificate of Compliance sfiall;be=made;aJailable v✓ith'the building per-timit`s)issuetl forthe building,ori&made available to the enforcement agency for all applicable
inspections.I understand that a registered copy of this Certificate of Compliance is required to be,included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: w w= Responsible Designer Signature.
Rando,Eric
Company: Date Signed:
RANDO AAA HVAC INC 2016-04-27 13:46:56
Address: License:
1712 STONE AVENUE 768871
City/State/Zip: Phone:
SAN JOSE CA 95125 408-293-4717
Digitally signed by CaICERTS" This digital signature is provided in order to secure the content of this registered document,and in noway implies Registration Provider responsibility for the accuracy of the information"
Registration Number:216-A0157571A-000000000-0000 Registration Date/Time: 2016-04-27 13:46:56 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-04-27 13:46:51
Schema Version:0.555SDD