B-2016-2236 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2236
11331 BUBB RD CUPERTINO,CA 95014-4941(356 23 045) ATKINSON
CLIMATROLLERS INC
SAN JOSE,CA 95112
OWNER'S NAME: GOTTUMUKKALA RAJU K AND MADHUMATI R DATE ISSUED:06/29/2016
OWNER'S PHONE:408-420-9232 PHONE NO:(408)294-6290
LICENSED CONTRACTOR'S DE T RATION BUILDING PERMIT INFO:
License Class rFNERAL BUILDING CONTRACTOR Lic.#258540
Contractor ATKINSON CLIM6MQLLERS INC Date 12M12016 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: ,
I hereby affirm under penalty of perjury one of the following two declarations: ADD(1)A/C -REAR OF HOUSE;REPLACE DU T WORK
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.
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 FIoor Area: Valuation:$22365.00
APPIICANT CERUEICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 356 23 045
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 ll 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 CALLED INSPECTION.
Signature - '��,,
9 Date 6/29/2016 Issued by.AAbbv A,e—nde
Date:06/29/2016
OWNER-B Iii D R 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 beng 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 rem Ove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(See.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). Date:6/2.9 0.16
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 Cod ,Chapter 9.12 and the
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I store r handle hazardous
material. Additionally,should I use equipment or device which emit hazardous
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If,after making this certificate of air contaminants pl defined h the Bay Area Air Quality de,Chapter
District I
will maintain compliance with the Cupertino Municipal ode,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,2553 3,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:6/2912016
1 certify that 1 have read this application and state that the above information is CONSTRUCTION LENDING Y
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 ARCHITECT'S DELTI
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Sectio 9 18. I understand my plans shall be used as public records.
Signatur Date 6/29/2016 Licensed
Professional
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPME E
NT DEPARTMENT• BUILDING DIVISION
MP
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPIEItTM'N (408)777-3228• FAX(408)777-3333•building(Qcupertino.orgIsc
❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
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❑OWNER ❑ OWNER-BUILDER V ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑: ARCHITECT ❑:ENGINEER ❑. DEVELOPER ❑f.TENANT
CONTRACTOR NAME LICENSE NUMBER �1}
LICENSE TYPE BUS.LIC# I I f
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USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PR07ECT RV WII,DLAND ❑ YES PROJECT IN ❑.YES IS TIM BLDG kN ❑YES
BUILDING:. - ®.COMMERCIAL .,.URBAN INTERFACE AREA. ❑ NO FLOOD ZONE ❑.NO EICHLER HO ? ❑NO
DESCRIPTION OF WORK
A-
TOTAL VALVATION: GV v RECEIVItIY ,. .:'
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property ow°ner's behllf. I hav read this
application and the information I have ro ided i 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 b J Ing c struction. I authorize representatives of Cupertino to enter the above enfi d property for inspec ion purposes.
Signature of Applicant/Agent: Date: _
SUPPLEMENTAL INFORMATION REQUIREFor
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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: 2015-0802 Raju Gottumukkala 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 CF1R-ALT 02 document for each dwelling unit.
01 Project Name 2015-0802 Raju Gottumukkala 02 Date Prepared 2016-06-16
03 Project Location 11331 Bubb Road 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name 2015-0802 Raju Gottumukkala
07 Zip Code 95014 08 Dwelling Unit Conditioned 2700
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 0203 04 X05 ' . X06 07 ; CIA
09 10
-o.. �
Is the SC Installing a
SC System SC System CFA served5ystem a refngefat s ulnstallirg new SC Istalhng 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
Furnace and Duct Altered space
replacement with whole house 2700 Yes Yes Yes Yes No No
conditioning system
A/C add
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-AO22370OA-000000000-0000 Registration Date/Time: 2016-06-16 14:58:08 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:58:30
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)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 and All new All new
Duct Central gas Central split Greater than
heating AFUE 96 cooling SEER 16 Setback R-6
replacement furnace AC 40 feet
with A/C add components components
Required Documentation:
CF2R-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:55.15%,or15 10%leakage to outside,or seal all accessible leaks.
CF2R-MCH-25-H&CF3R-MCH-25-H Refrigerant Charge.Verification tequired when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
CF2RCF3R-MCH-23&CF3R-MCH-23 Air Flow 2�300 CFM/ton required when MCH-25 is required.
Exceptions: Oft a AM. n ..
-Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Duct Leakage"testing regwrem nts N
Heating-only systems and Air Handler/Furnace changes do:not,require verrfication of Air FIo MCI 231vor Refrige00t;:Char�e
Existing duct systems constructed,insulated or sealed with'as esto re exempt�from Mq libu t°Leakage Test g requirr menu. 1 ,
E. Entirely New or Complete Replacement Duct System,with lar withob Fqu(pment I lsangenut(Se tioril 150 2(_)"',,ancl' 0.2(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-AO22370OA-000000000-0000 Registration Date/Time: 2016-06-16 14:58:08 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:58:30
Schema Version:0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-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 2016-06-16 14:58:08
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 thelaws>of the State of California:
1. The information provided on this,Certificate of Compliance is true and correct.
2. Lam eligible under Division 3 ofthe 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 rr anufactured devices for t e building design or,system design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part 1 and Part 6M the California Code of POP ations
4.. The building design features or system design features dentified orihis Certificatof 66m 'fiance arelonsistentwitthe itf)orma{D rovided on tither applicable compliance documents,worksheets,
calculations,plans and specifications submitted o the enforcement agency for4apr�roval'=with this built yng permit application. €"
y;,
5. J will ensure that a registered copy of this Gertificateaf Cpmpliance shalfbe made available vriti the bufldiCr p mit(s,,issued for the building an ;;ode avai ab(e tm b nforcement agency for all applicable
Inspections.I understand that a registered copy of this4€;rtlficate of Compliance i required to be,ancluded with the documenation the bitllder pr„ou des tQ the building owner at occupancy.
x
Responsible Designer Name: U � �” Responsible Designer Siknature. � _ -
Faulkner,Cindy c� q/yLPJL
Company: Date Signed:
ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-06-16 14:58:08
Address: License:
1171 NORTH 4TH STREET 258540
City/State/Zip: Phone:
SAN JOSE CA 95112 408-294-6290
DigildflysignedbyCaICERn. This digitalsignaiureispiovidedh7 orderto secure the contentof Mis registereddocument,andhi no way hrrpties Registration Movidei iespum;ffiffity t6i Me accuracy ufthe hifonnation.
Registration Number:216-AO22370OA-000000000-0000 Registration Date/Time: 2016-06-16 14:58:08 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-06-16 14:58:30
Schema Version:0.555SDD
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERT11140 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•_buildingC@cupertino.org
Owner Name � .� -; ,, s Permit No e) 2.01 2116
Address 11331 13"b SW
I. 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 fonn.
No Go to Question 2.
f 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its
j plumbing,installation of water-conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
El The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
kNo Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
Qq'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.
G(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. Please 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 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).
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 1101.1
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
table on the following page.
Owner or Owner Agent's Signature: Date: l
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB40 7 2015.doc revised 08126115
i
ITILDINPEI I'I'C NST I3E EI TA.LED
CE�LTIF S SEE ASD COMPLETED UNTIL THIS
. NES�ND.�.2ETURNED TO THE-BUILDING DIVI:STON-;
� bion-Compita�t
1 Water-Conserving Plumbing Fixture
Plumbi
ng Fixture (Fixture Complying with Current Code Applicable:to New Construction)
Fixture Type Maximum Water Usa a/Flow Rate
Water Usage 2013 CPC Ch.4 2013 CPC Ch.4 201'3 CPC Ch.4
/f=low Rate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3
Single-Family Multi-Family Commercial
Water Closets Fxceed1.6 Residential Residential
Toilets Single flush toilets: 1.28 gallons/flush
( ) Gallons flush Dual flush toilets: 1.28 gallons/flush effective flush volume(the composite,
Urinals average flush volume of two reduced flushes and one full flush
l=xceed 1.t1
Gallons/flush 0.5 gallons/flush
Showerheads
txcee 2.5 .0 gallons per
aligns g pv minute @ 80 psi. Also certified to the performance criteria of
g per minute U.S. FPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
II Por multiple showerheads serving one shower, the combined flow rate of a l
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 I 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 Pse minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi -
i 1.8 gallons per minute
psi
Faucets— Fxceed 2.2 gallans 1.8 gallons per mi'ru#e @ 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
red
uction.
I. If the existing Plumbingixtuye water usage/flow rite is equal to or lower than the figure shown,it is not required to be upgraded.
SB407 2015.doc revised 08126115
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333 building(aDcupertino.org.
Permit No. ��d i�"`����'
Address 6 ►`� � '' GA #of Alarms Smoke: 7 Carbon Monoxide: �-
PERMITBE FI A EWAND COlM,PLETE TIL THIS CERTIFICATE
HSS BEEN
TURN
r+T
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.
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 8314 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 R314 and CBC 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:
Signature......... ................................................. ......... .............................Date .........
Contractor Name:
Sinature...................................................................Lic.#......................................Date: ...................
Smoke and COform.doc revised 03/18/14