B-2016-2050 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2050
8147 HYANNISPORT DR CUPERTINO,CA 95014-4063(356 11 019) ATKINSON
CLDv ATROLLERS INC
SAN JOSE,CA 95112
OWNER'S NAME: ZHANG CHENGHUAN AND SHEN XUEMEI DATE ISSUED:05/31/2016
OWNER'S PHONE:408-826-9183 PHONE NO:(408)294-6290
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-20 Lic.#25854
Contractor ATKINSON CLIMATROLLERS INC Date 12/31/2016 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:
INSTALL(1)A/C UNIT-AT REAR
I hereby affirm under penalty of perjury one of the following two declarations:
r. I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
z. I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$6800.00
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 Number: Occupancy Type:
356 11 019
and state laws relating to building construction,and hereby authorize 356
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 regulatio s er a Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INS TION.
Signature Date 5/31/2016 Issued by:ALEX VALLELUNGA
Date:05/31/2016
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. I,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)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Scc.7044,Business&Professions Code). Date:5/31/2016
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
2. 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
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Are Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the u erti o Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Co , ecti ns 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized age
APPLICANT CERTIFICATION Date:5/31/2016
I 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 Professional
GENERAL PER 111 APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
I
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
-ll- (408)777-3228• FAX(408 777-3333• building aOcupertino.org misc
CUPERTINO
❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLAN///EOUS
PROJECT ADDRESS _Y41
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OWNER NAME PHONE Lr p`tG,J/Q� E-MAIL
STREET ADDRESS CITY STATE'
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IP FAX
CONTACT NAME ^ PHONE (�(1 r! 6�1f)_ E-MAIL�1 r���� / -� c
STREET ADDRESS ( r l�I r /t v'\ I I CITY,STATE,ZIP `G �� '6/ 4, FAX O� q('l
❑OWNER ❑ OWNER-BUILDER ❑ OVWNFRAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME (E� I11III LICENSE NUMBER 9 ,(�/O LICENSE TYPr BUS.LIC# C(
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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 c ` Pn,(-
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TOTAL VALUATION: o O v�U 1I IVERBY s �'
By my signature below,I certify toe hof the following: I am the property owner or authorized agentto act on the prope r owne's behalf. I have read this M
application and the information I ha e p ovide is correct. I have Icad the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to u ding n ction. I authorize representatives of Cupertino to enter the Ove entified property for inspection purposes.
Signature of Applicant/Agent: Date: (7
SUPPLEMENTAL INFORMATION REQUIRED
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CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC) (Page 1 of 3)
Project Name: 2015-0755 Charles Lu Date Prepared: 2016-05-26
A.General Information
MR-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 2015-0755 Charles Lu 02 Date Prepared 2016-05-26
03 Project Location 8147 Hyannisport Dr 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name 2015-0755 Charles Lu
07 Zip Code 95014 08 -Dwelling Unit Conditioned— 2397
Floor Area(ft2)
Number of space conditioning
09 Climate Zone 4 10 (SC)systems in this dwelling 1
unit.
B.Space Conditioning(SC)System'�Information ��� � �'
r.
.. 4
01 02 03`' 0 * !q ,U6 ti , U7 08 � y 09 10
o x
` Js the SC '11' failing a
�" # s '' r friger nt Jnstalli' ane ` SC I staling ns albs �Installin
SC System SC System CFA served s,�ystem a rig v► I g.+ g
04
Identification or Location or Area by this SC tlucted 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
Add AC Whole House 2397 Yes Yes Yes No No No Altered space
conditioning 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-A0196317A-000000000-0000 Registration Date/Time: 2016-05-26 13:56:54 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05-26 13:55:10
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-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
No heating This field or This field or All new This field or This field or
AC
Add AC Central gas component section is not section is not Central split cooling SEER 14 Setback section is not section is not
furnace altered applicable applicable components applicable applicable
Required Documentation:
MR-MCH-01-E-Space Conditioning Systems Ducts and Fan's
-Duct insulation requirement for new plenums:R6
CF2R-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:<_15%,or<_10%leakage to outside or seal all accessible leaks.
CF2R-MCH-25-H&CF3R-MCH-25-H Refrigerant Charge V.ification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
CF2RCF3R-MCH-23&CF3R-MCH-23 Air Flow>300 CFMAon regwred„y hen MGH-25 is required.
Exceptions:
Duct systems registered with HERS provider as p ewously sealed are exemptfrdm CH•.20 Duct Leakage Test ng re ulremen�ts,•; r
-Heating-only systems and Air Handler/Furnace changes do not require verificatki �of Air FloW MCH-Bi b�Refngerarit"`Charge IVIECH r z�
-Existing duct systems constructed,insulated or sealed with,# estos,are exemp from MCHC Duct Ledkage Test ttg e�gw emeClts. W, c '
a s',t E f, '•' 3 ? .i-'
E. Entirely New or Complete Replacement DuctSS,ystem,with or Tthout Equipment Ghangeout(Sections«150 2(b);Diia and ,50.2(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-A0196317A-000000000-0000 Registration Date/Time: 2016-05-26 13:56:54 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05=26 13:55:10
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-1R-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:
Faulkner,Cindy
Company: Signature Date:
ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-05-26 13:56:54
Address: CEA/HERS Certification Identification(if applicable):
1171 NORTH 4TH STREET
City/State/Zip: Phone:
-SAN-JOSE-CA 95-1-1-2 — --408=294=6290— — - --
Responsible Person's Declaration statement::.
I certify the following under penalty of perjury,under thetaws 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 Bus1ness`and Professions Code to accept:respon'sibilityfor the building design or system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and performance specifications materials\commponents,and manufactured devices for the building design orsystem design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part land Part&of the California-Code ofRegulations k, r `
4. The building design features or system design features identified on this Certifl&iii of Compliance are consistent w!tW1he mformatlon.provided on other,applrcab a compliance documents,worksheets,
calculations,plans and specifications submitted:to the enforcement`agency for''approval wItli this building permit application. ) :
5. I will ensure that a registered copy of this Certificate of Compliance shall he rnaO 9dttailtiple with.the bualdiitg permit(S)issuer!fonthg,budd�rig and t ale ava�IablL to thonforcement agency for all applicable
inspections.I understand that a registered copy of thisCertificate of Compliance is„required to be„Induded)nnth thedocumentation the.,builder provides tothe building owner at occupancy.
Responsible Designer Name: . .r Responsible Designer Signature. — .
Faulkner,Cindy cGy/j2P/t�
Company: Date Signed:
ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-05-26 13:56:54
Address: License:
1171 NORTH 4TH STREET 258540
City/State/Zip: Phone:
SAN JOSE CA 95112 408-294-6290
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document and in no way implies Registration Provider responsibility for the accuracy of the information.
Registration Number:216-A0196317A-000000000-0000 Registration Date/Time: 2016-05-26 13:56:54 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-05-26 13:55:10
Schema Version:0.555SDD