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B-2016-2237 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2237 22684 LIBERTY OAK LN CUPERTINO,CA 95014-5612(342 32 042) ATKINSON CLIMATROLLERS INC SAN JOSE,CA 95112 OWNER'S NAME: GREENE JULIANE R TRUSTEE&ET AL DATE ISSUED:06/29/2016 OWNER'S PHONE:408-489-4141 PHONE NO:(408)294-6290 LICENSED CONTRACTQR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#258540 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: REPLACE FURNACE(SAME LOCATION ANE ADD A/C(REAR I hereby affirm under penalty of perjury one of the following two declarations: YARD) 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. 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. Sq.Ft Floor Area: Valuation:$8917.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 342 32 042 Deferred Submittal(R-3) 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 per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLS INSPECTION. YA�Signature Date /26 9/2016 Issued by:Abby Ayende Date:06/29/2016 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 r move 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(Sec.7044,Business&Professions Code). Dates 6/29/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS" "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 DIS L URE 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 25505,2: 533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal C de,Chapter 9.12 and the a. 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 dev ces which emit hazardous air contaminants as defined by the Bay Area Air Qual ty Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municip d 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 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:6/29/2016 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 ag ancy 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,Giv 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 DE LARATI N Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 6129/201-6 professional GENERAL PERMIT APPLICATION s- COMMUNITY DEVELOPMENT DEPARTMENT :BUILDING DIVISION MEP 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinCUPERTINOgQcupertino.ora DIsc-7a(,r— [:]PLUMBING ❑MECHANICAL ❑ELECTRICAL MISCELLANEOUS PROJECT ADDRESS APN# OWNER NAME t t/7G PHONE W� l `( �( 1 E-MAIL STREET ADDRESSCITY, STATE,ZIP& FAX CONTACT NAME PHONE f /1lJ (�(�i EL f C� — STREET ADDRESS a a /1iJ CITY,STATE-4;,,,, ©1 !SI C A �g� F -G- l ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT VIONTRACTOR ❑'CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEV LOPER ❑TENANT CONTRACTOR NAME +3rvve f _ vLICENSE NUMBER q�r S'( LICENSE TYPE JJJ BUS.LIC# Pi COMPANYNAME �`C yf iE-MAIL J �" FAX _( STREET ADDRESS `tl� f a CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE;ZIP PHONE USE OF ❑.SID or DUPLEX ❑ MULTI-FAMILY PROJECT IN WB,DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG ❑YES. BUILDING: COMMERCIAL URBAN INTERFACE AREA NO FLOOD ZONE ❑NO EICHLER HO E? ❑NO DESCRIPTION OF WORK L TOTAL VALUATION: l ® ir ItECELVEDI` 3� By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's b half I hav read this application and the information I have pr vi d is orrect. I have read the Description of Work and verify it is accurate. I agr.e to comply with all ipplicable local ordinances and state laws relating to bui i g co #ruction. I authorize representatives of Cupertino to enter the above enti e roperty for inspec tion purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED ! z �XPRS....... .....' a "IM� ��.. M -MAJOR MEPMiscApp_2011.do revised 06/21/11 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION UPER I „ ko 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(a)cupertino.org Permit Nox—.7ale'lo- AddressZ � f�� ` �`.� /` #o Alarms Smoke: � Carbon Monoxide: PERMIT CANNOT BI1�„INALED ANU�CO�IY�pLETED TNT�;�THIS GERT�FIrCATE;; ��� � �=1x� Yss,� i��r,��r�' Y YY✓YY?s �BU1C��U GD V1CS� PURPOSE 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. r GENERAL INFORMATION Existing single-family and multi-family dwellings 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 SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room 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 commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement'or crawl space.Refer-to CRC Section 8314 and CSC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarm(s)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes.The alarms have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Si g nature..".�;�... ........ - .: . ....................Dater Contractor Name: Signature.......... ........................................................Lic.#......................................Date: ................... Smoke and COform.doe revised 03/18/14 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTtNO 10300 TORRE AVENUE.CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)1777-3333 building(6cupertino,org Owner Name G/.�d .,i/ Permit No. � � Addressi� � �'� f� t. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110 1.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 2. 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 1101.1.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? ❑l 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 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? El 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. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 11.01.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. _Pjease check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is'a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real properly. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant--_ plumbing fixtures to be replaced with water-conserving plumbing fixtures. 1-_ On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). . 1,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 1101.1 through 110 1.8,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 table on the following page. el , P Owner or Owner Agent's Signature: Date: - i Upon completing and signing this Vertificate,please return it to the Building Division in order to final your building permit. SB40 7 2015.doc revised 08126115 BUILDING PERMiT'C.AI�INOT BE TTNN 'ETD '0 VETHy THIS cExT TA I $ '' �ILII� UII+IN Non-Compliant Water-Conserving PlumbingFixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate 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, Urinals Exceed 1.0 average flush volume of two reduced flushes and one full flush Gallons/flush 0.5 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 onlyone 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 201 S.doc revised 08126115 PLS LANE CH CKEC7 DATA -PLANNI G DEPS ;. GUPERTIN I✓OMMUt-ITY DEVEd OPMIENT DEPARTMENT . BUI DING DIVISION-CUPERTINO I r i t a i , PRMI D F I This set of plans and specification f�iilT tie kept a the t } I E 1 job site,dUrineg ,ons�ruct on. !t is uniaWful to mak any cl;c nt s CyP's C a i e o V11 S:�i i�=�t'a i�r7€3 wAi ffic 01 ; therefrom,witi�aat Opprovai frorn'the�3urld�,ng O i n and specifications'SHALL OT The stamping of :his�a , { t � c i� id to perp lit or to an approval!of the�sesiatsn i of any,provisioi s any Cityiordlnanoe or Stat L W i a !" BY ! 2 t i W { DATE , PERMIT NO. } �� =---- , MV ..-.... . .; t + — a a r i t { i f , e r t , F - � t e i : 4 1 ' t ISL SHS IRE AIS C�' ! `?. THE J T �4LL TSMt—S r 6c NSTRUOFFROP"'"fCOPY t t S j i CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems(formerly CF-111-ALT-HVAC) (Page 1 of 3) Project Name: 2015-0834 Rose Greene Date Prepared: 2016-06-16 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 CHR-ALT-02 document for each dwelling unit. 01 Project Name 2015-0834 Rose Greene 02 Date Prepared 2016-06-16 03 Project Location 22684 Liberty Oak Lane 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 2015-0834 Rose Greene 07 Zip Code 95014 08 Dwelling Unit Conditioned 1500 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 . 01 02 03 Ai 04y 0S qi 06 07l: 0 s 09 10 Js the SC ,a 5 "Installing a ; SC System SC System CFA served 'Tlystem refuge ant ;nstallirjg tteuy Srr r stalliryg instalhngc Installing Identification or Location or Area by this SC ductecontaining system more than 4dd ent ely new entirely new Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Furnace whole house 1500 Yes Yes Yes No No No Altered space replacement 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-A0223608A-000000000-0000 Registration Date/Time: 2016-06-16 14:04:49 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:04:26 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 Furnace Central gas All new Central split All new This field or This field or heating AFUE 78 AC cooling SEER 14 Setback section is not section isnot replacement furnace components components 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-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 5 10%leakage to outside,or seal all accessible leaks. CF2R-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�M5b720 Duct Leakage Testing requirements,, y -Heating-only systems and Air Handler/Furnace changes do not require venficat of Air Flow MCH`23t or Refrigerant Charge MELC n W25 Existing duct systems constructed,insulated or sealed with as est -are exemia-from MCN 201)uct'L,akage Testrr<grequiremeJtts. Al ; ., r. r E.Entirely New or Complete Replacement Duct NStem,with or withopt,,Equipment Changeout(Sections.>1 0 2(b)Wila and 150.2(b)1E,i=) 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-A0223608A-000000000-0000 Registration Date/Time: 2016-06-16 14:04:49 HERS Provider:CalCERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:04:26 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: (?� l/ CJ GLfGCf/lLP/li Faulkner,Cindy Company; Signature Date: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-06-16 14:04:49 Address: CEA/HERS Certification Identification(if applicable): 1171 NORTH 4TH STREET City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 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. lam eligible under Division 3 of•the'Busihes5 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 Part 6 of the California•Code of g cations 4. The building design features or system design features identified on,;his Certifrcat3abf CQmj%l ance are faps!Steii Nath the iff orm o rovided on nth cabie compliance documents,worksheets, calculations, laps ands specifications submitted`to the enforcements enc far rova'wt this buildtn ermit a icatio�n'. p p g ypp . g p 5. I will ensure that a registered copy of this Certificafie zzf CtamPliance shall be inaz,p.4,aiWble uv�it(tgthp b,0il"d trp permit ;issu ;ti forthe,building,an c nacle available to the nforcement agency for all applicable inspections.I understand that a registered copy of thi ry "ificate'of Cotnpl ance�5„regglred to be,included.with thg"documentation the,bijhcler prof/jdes to the build ng owner at occupancy. ., - r. �- , 9 e. 3" Responsible Designer Name: ' w Responsible Designer Signature: .r �p Faulkner,CindyGZLlCly/I2P/l� Company: Date Signed: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-06-16 14:04:49 Address: License: 1171 NORTH 4TH STREET 258540 City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 Digitafly signed by GaIGERT-9. This digital signatw;e is provided in order to seewe the content of this registered doeument and in no ivay hnpfies Registfation Provider responsibft for Me occur-acy of the Womiatioii. Registration Number:216-AO22360SA-000000000-0000 Registration Date/Time: 2016-06-16 14:04:49 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:04:26 Schema Version:0.555SDD