B-2016-1918 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1918
22740 ALCALDE RD CUPERTINO,CA 95014-3905(342 44 003) RESCUE AIR SERVICE
INC
SAN JOSE,CA 95120
OWNER'S NAME: DATTAARUN KAND NEETA DATE ISSUED:05/10/2016
OWNER'S PHONE:408-257-2655 PHONE NO:(408)655-9916
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class WARM-AIR HEATING VENTILATING AND AIR-CONDITIONING
X BLDG _ELECT _PLUMB
Lic.#826201 .
Contractor RESCUE AIR SERVICE INC Date 11/30/2017 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. REPLACE FURNACE(GARAGE ATTIC);ADD(N)A/C(REAR YARD)
I hereby affirm under penalty of perjury one of the following two declarations:
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
LLperformance of the work for which this permit is issued.
z. 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 Sq.Ft Floor Area: Valuation:$7290.00
permit is issued.
APPLICANT CERTIFICATION APN
I certify that I have read this application and state that the above Number: Occupancy Type:
342
information is correct.I agree to comply with all city and county ordinances 342 44 003
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 liabilities,judgments,costs,and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR
may accrue against said City in consequence of the granting of this permit.
Additionally,the applicant understands and will comply with all non-point 180 DAYS FRO SPECTION.
source regulations per the Cupertino Municipal Code,Section 9.18.
Issued by:MELI 'NAMaf
Signature 6� Date 05/10/2016 Date:05/10/2016
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
r. 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(See.7044,Business&Professions Code) Signature of Applicant:
z. I,as owner of the property,am exclusively contracting with licensed Date:05/10/2016
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
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. 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 Municipal Code,Chapter 9.12 and the
permit is issued. Health&Safety Code,Section 25532(x)should I store 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 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
will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25505,25533,and 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 agent: 4 �s
be deemed revoked. Date:05/10/2016
APPLICANT CERTIFICATION CONSTRUCTION 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 exp6nses 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 05/10/2016
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
MIS
(408)777-3228• FAX(408)777-3333•building(cDcuoertino.ora
IC
G11F�EiTINt
[_1 PLUMBING X544ECHANICAL LECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS �� O 1�` �� T18APN# Y - 00
3
OWNER NAME PHON E-MAIL
STREET ADDRESSZ;2:,1 O ^ ` r2—�—{1 CITY, STATE,ZIP � �� ` FAX
CONTACT NAME rF--� PH N } — ` E-MATE %60A
`
STREET ADDRESt,OO_, ^, r CITY,STATE IPFAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ONTRACTOR ttbSQNTPACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME C., ..r (1 �t LICENSE N BER LICENSE TYPE BUS.LIC# 1
COMPANY NAME `\ \A� E-MAIL FAX
STREET ADDRESS ��O r`� �� CITY,STATFrZiP� �� ��1� ^ PHONE GS�_q
ARCHITECT/ENGINE`EER NAME ,` LICENSE NUMBER a `iJ BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES
BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO
DESCRIPTION OF WORK �w n
.. �c
TOTAL VALUATION::W �3
O
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on thepro r 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 building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: �C Date: R:E;/ 0
SUPPLEMENTAL INFORMATION REQUIRED
' bVGIt TTtE LOCIf ESR ,
B 1 J EXPRESS
'If f
MEPMiscApp_2011.doc revised 06/21/11„
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-111-ALT-HVAC) (Page 1 of 3)
Project Name: Neeta Datta Date Prepared: 2016-05-09
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 Neeta Datta 02 Date Prepared 2016-05-09
03 Project Location 22740 Alcalde Rd. 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name Neeta Datta
Dwelling Unit Conditioned
07 Zip Code 95014 08 Floor Area(ft2) 1703
Number of space conditioning
09 Climate Zone 4 10 (SC)systems in this dwelling 1
W s v,• unit.
B.Space Conditioning(SC)System Information E ,�
01 02 X03 04 : 07 0$ 09 10
'E•Is the SC 4 "Install n a y, .. "N"" _4
�;
SC System SC System CFA served System a' refrige aft Installutg.new& Irtstalh g nst311� g 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 1703 Yes Yes Yes No No No Altered spaceconditioning system
C. Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number:216-A0173236A-000000000-0000 Registration Date/Time: 2016-05-09 22:46:13 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05-09 22:11:13
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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)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
All new All new Less than or
AC
System 1 Central gas heating AFUE 0.78 Central split cooling SEER 13 Setback equal to 40 R-6
furnace components components feet
Required Documentation:
CF211-MCH-01-E-Space Conditioning Systems Ducts and Faris
-Duct insulation requirement for new plenums:R6.
CF211-MCH-20-H&CF3R-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::5 15%,or<_10%leakage to outside-;fly seal all accessible leaks.
MR-MCH-25-H&MR-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>_'300 G,FNl ton regUliesi when MCH-25 is required
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from;MCH 20 Duct Lea age Testing regy gments
'n +e�fi d' osp t9
Heating-only systems and Air Handler/Furnace changes do not require venficatiiir of Air F ow MCH 3,, r Refrigerin Chaise MEQ H-25
-Existing duct systems constructed,insulated or sealed with asbestWre exempt from MCH`2 Du Vage Testartg re w mems. a ,i w`
�5
o
4 0
E. Entirely New or Complete Replacement Duct, stem,with or withou Equipment Changeout(Sections 150 2(b)1Dua and]150 2(b)1E,F)
This section does not apply to this project. µ
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-A0173236A-000000000-0000 Registration Date/Time: 2016-05-09 22:46:13 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05-09 22:11:13
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CFiR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-111-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: �J
Liu,Minxuan �GfltL�lfalt/e �!!/
Company: Signature Date:
Bay Area Energy Consultants 2016-05-09 22:10:37
Address: CEA/HERS Certification Identification(if applicable):
1181 Sundown Ln CC2006550
City/State/Zip: Phone:
San Jose CA 95127 408-883-3865
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under thelaw`&f the state of California:
1. The information provided on this Certifica a of Co jshance js true and correct.
� �� e ;
2. 1 am eligible under Division 3'of the Business and Professions Code to acc-ept resj 6iig'i ility for the building design or system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and perf6rtiiance specifications,tzater als components,and manufactured devices fo a bulldmg design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part 1 and Part of the California Code of Relations ; ffOF
'
4. The building design features or system design fetue,IHs identified on this Certificateof C mIiance are cons5te�tw he iformatiUn provided on other appltcabte�tonpliance documents,worksheets,
calculations,plans and specifications subinrtted to the enforcement gen forapp7ovawi' this buildtng per a icati '
5. 1 will ensure that a registered co ofithis Certificatie Qf otYh Bance shaltbe made i .Ale h th2
R A ci t
g" copy ,4 0p w buddrrig p mrt issued forth Jsuildi g and made avallabre hforcement agency for all applicable
inspections.I understand that a registered copy of MAC'rtiticate of compliance;is requ,!C� to Wncluded with th cumept�ationjhe Milder provides t10 die b 'I ng owner at occupancy.
Responsible Designer Name: Responsible Designer Signature. "
Kim,James � ' 6OW-1
Company: Date Signed:
RESCUE AIR SERVICE 2016-05-09 22:46:13
Address: License:
6007 MAJORCA COURT 826201
City/State/Zip: Phone:
SAN JOSE CA 95120 408-655-9916
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-A0173236A-000000000-0000 Registration Date/Time: 2016-05-09 22:46:13 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05-09 22:11:13
Schema Version:0.555SDD
Google Maps Page 1 of 1
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This set of plans and specifications MUST be kept at the
job slto c\Rl;fd.V,_;J'rzstruction. It is unlawful to make any
changes or alterations on same,or to deviate
i1 � w therefrom,without approval from the Building Official,
Th°stamping of this plan and specifications SHALL NOT
be held to per lo 0
of an n approval of the violation
3,. ons of^ City Ordinance or State Law.
BY _
DATE
PERMIT NO. E'
httns-//www.unnale.rnm/mane/(n717 15707 _177 (1779d77 717