B-2016-2262 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR; PERMIT NO:B-2016-2262
11233 LA JOLLA CT CUPERTINO,CA 95014-4738(356 21 045) ALLIED AIRE
SERVICE INC
MILPITAS,CA 95035
OWNER'S NAME: PEDROTTI DONALD G AND MIRIAM P TRUSTEE DATE ISSUED:07/05/201
OWNER'S PHONE:408-253-5804 PHONE NO:(408)934.8844
LICENSED CONTRACTQRfS DECLARATION BUILDING PERMIT INFO:
License Class REFRIGERATION Lic.#260035
Contractor ALLIED AIRE SERVICE INC Date 07/31/2017 X BLDG _ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERC
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(N)A/C-SIDE YARD
i. 1 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:$6682.00
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 356 21 045
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 consand of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the p!can sta sand will comply with all non-point
source regula' n er t Cuperf o al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 715016 1 Issued by:Abby Ay
Date:07/05/2016
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 materia being installed.If a roof is
i. I,as owner of the properly,or my employees with wages as their sole installed without first obtaining an inspection,I agree to emove 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). Date:7/5/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS" "OR BETTER
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. HAZARDOUS MATERIALS DISC O UR
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, 5533,and 25534. Twill
permit is issued. maintain compliance with the Cupertino Municipal Code,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 st re 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 dei ices which emit hazardous
air contaminants as defined by the Bay Area Air Qua'ty Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cu ting Munici t, 255,34.
pter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code e n 25505, 5
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:7/512016
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 tender'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 ON
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 7/5/2016
Professional
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION MEP
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333-buildina(d)CUPERTINO -cupertino.org Isc
❑PLUMBING MECHANICAL []ELECTRICAL ❑MISCELLANEOUS
PROJECT ADD S ^ APN# 5�-ZI-05
OWNER NAME� f\� G ( PHONE
STREET ADDRESS CITY,STATE,ZIP FAX
CONTACT NAME
w.+ j,�. PHO -50 V 'lO V 7 E HI t ✓I.(j L'b. I9-F.C V44
STREET ADDRESS CIT STATE,ZIP F
�$� A I s a;t 88 S3 -88ya
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMEk. LIC ENSENUMBE LICENSETYP BUS LIC#
COMPANY NAME LAP-
9-f
Lit
STREET ADDRI%7X-Vi- 1A G�_ CITY,ST`AT�E 6 jZ, CA 937) PHO ^ `St
ARCHITECT/ENGINEER NAME I1lLlq
v, LICENSE NUMBER BUS.LIC# 7
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD Or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No
DESCRIPTION OF WORK
Fz
TOTAL VALUATION: 61
By my signature below,I certify to each e foil wing: I am the property owner or authorized agent to act on the property owner's behalf. I have re d this
application and the information I have ov' ed i orrect. I ve read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to Il g c ion. au orize entatves of Cupertino to enter the above-ide ifietd property for inspectior purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED oFVICE
USEJONLY
f N'�; Q OVER=TIiE- 011NT'�R
II-"EMPRESS `� <.
r-
<�' LARGE.
:,MAJOR
MEPMiscApp_2011.doe re ised 03/16111
J IF1I C ur IiHLIrumni im
ALTERATIONS -HVAC
CEC-CFIR-ALT-03-E Revised 03115 CALIFORNIA ENERG COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E.
Alterations-HVAC CZ 1,3't3 7 and 16(formerly CF-IR-ALT-HVAC) (Pagel of 1)
Site Address: Enforcement Agency:. Date Prepared Permit#:
0 33 L c L-,A 6oule
Equipment Type Equipment Efficient New:Ducting,Plenums,Lineset Conditioned
y Required R-value Floor Area(sq f) Thermostat
❑Packaged System *,Evaporator Coil AFUE CDP ❑ R-6 (CZ 1,3-7)Ducts Served by syst m Setback
❑ R-8' (CZ16)Ducts g Q (If not already
Split System Condensing Unit 14 J SEER E sq ft
HSPF ❑R-6(all CZ's):Plenums present,must
❑Furnace ❑Lineset 12.k EER ❑ R-5 or R7.5 Lineset3 be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand_ For final inspection all forms are to be registered(no hand filled forms allowed)and a dopy left on site.
1 1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
Can include new ducting
All Equipment, CFIR-ALT-02-E
Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS
Air Handier/Furnace CF3R:MECH-20-HERS
Installer Requirement:Duct leakage(:�_15%or,<10%to outside,or seal all accessible leaks)
Exempted from duct leakage testing if:
1.Duct system registered with HERS provider as previously sealed,or❑2.There is less than 40 linear feet of duct in uncor ditioned
space,or 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building
❑2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CFIR-ALT-02-E
CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS
CF3R-MECH-20-HERS,MECH-22-HERS;MECH-(23 or 24)-HERS'
Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alt rnative)
13 3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
Includes replacing or installing All New CF1R-ALT-02-E
Ducts'and one or more of the following: CF2R-MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS
Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS
Installer Requirement:Duct leakage<6%,Air Flow 2 350 CFM/ton(or Standards Table 150.0-C/D alternative)
❑Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos.
❑4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
Adding or replacing ducts in unconditioned CF1R-ALT-02-E
space but less than All New Ducts' CF2R:MECH-20-HERS
CF3R:MECH-20-HERS
Installer Required to:Duct leakage(:<_15%or,<10%to outside,or seal all accessible leaks)
❑ Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos..
'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc.
2 A:New Duct system is when the duct system is constructedof at least 75.percent new duct material,and up to 25 percent may consist of reused
parts from the dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material.
3 R-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suc ion line Diameter
with insulation as the following 1.5-2T-2Ya",2.5-3T-2%",3.5 to 4T-2%",5T-4%8"
Contractor(Documentation Author's/Responsible Designer'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.. l am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts 1 and 6 of the California Code of Regulations(CCR).
4. 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 CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance docu ents,w rkshee calculations,plans and specifications submitted to the enforcement
agency for approval with this building perm' ap licati
R sponsible Designer Name: Re ons' a Desi r igna a Date Signed: Licen e:
Company: Address: City/State/Zip: Phone:
XwiC-6 A,lfi2 t 987 Xmes Au& . iM14tm CA
For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772.3300
CityCupertinoof
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CUPERTINO
Basemap'Labels
c Street Names
Secondary Address Labels
Primary Address Labels 's'`',y
Freeway
Basemap
a Street Centerline
- County Major Roads
County Freeways
Right-of-Way a
Parcels
Community Development
City Boundary ,
Aerials-April 2015
N
SCALE 1 261
20 0 20 40 60 COkA/',aUN Y Ckra-,/e7LOPMENT DEPA:R MENT
FEET
BUILDING DIVISON—CUPERTINO
r. ,"" V
Ns set of ratans and specifications MUST be kept at the_.
dunlig Construction, it is unlawful to Mai,
e any
or s iteral ions on same,or to deviate
vial Out ar.proval from the Buil Jing Official.
bng of this plan and specification SHALL NOT
t Q�d ta'Permit or to be an approval of the violation
la; �°'v okaieion5 of any City Ordinance o State Law.Y
FF11'0 (ff*E , BY
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1 C/� ryh cx J(�p
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http://gissvr/cupertinointranet/home/mapFile.aspx Tuesday, Ju y 05, 2016 11:26 AM
CERTIFICATE OF INSTALLATION ` 0. ) CF2R-MCH-01-E.
Space Conditioning Systems,Ducts,and Fans �! (Page 1 of 7)
Project Name: Donald Pedrotti Enforce ent Agent City of Cupertino,` Permit Number: B-2016-2261
Dwelling Address: 11233 La Jolla Ct City: Cupertino : Zip Code: 95014
A.General Information
01 Dwelling Unit Name Donald Pedrotti 02 Climate Zone 4
03 Dwelling Unit Total Conditioned Floor 1800 04 Number of Space Conditioning 1
Area(ft2) Systems in this Dwelling Unit.
05 Certificate of Compliance Type Prescriptive alterations(CF1R-ALT) 06 Method used to Calculate HVAC Loads NotApplicableEquipmentChangeout
Calculated Dwelling Unit Sensible Calculated Dwelling Unit Heating Load
07 Cooling Load(Btuh) This field or section is not applicable 08 (Btuh) This field or section is not applicable
09 Dwelling Unit Number of Bedrooms 3
MCH-01b Prescriptive Alterations-Space Conditioning Systemsx
,Ducts and Fans
B.Space Conditioning(SC)System Information
01 02 03 04 05 06 07 08 09 10
SC System SC System CFA served Is the SC Installing a Installing new SC Installing more Installing Installing
Identification or Location or Area by this SC ; systema refrigerant system than 40 feet of entirely new entirely new SC Alteration Type
Name Served System ft2 ducted containing components? ducts? duct system? system?
Y ( )` system? component?
Altered space
Donald Pedrotti 11233 La Jolla Ct 1800 i Yes Yes Yes No No No conditioning
system
L
9 �
Registration Number:216-A0248278A-1v10100002A-0000 Registration Date/Time: 2016-07-05 13:32A1 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:.2013 Rev 1.007 Report Generated:2016-07-05 13:32:32
Schema Version:2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems,Ducts,and Fans (Page 2 of 7)
C.Space Conditioning(SC)System Alterations Compliance Information
01 02 03 04 05 06 07 08 09 10 11 12 13
Central Fan
Integrated
Heating Cooling New or (CFI)
System Altered Heating Minimum Altered. Cooling Minimum Required ReplacedNew Ventilation
Identification Heating Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Duct Duct System
or Name System Type Component Type Value System Type Components Type Value Type Length R-Value Status
This field
or This field
No heating All new
Donald Central gas section is or section Central Not a CFI
Pedrotti furnace componen not is not split AC cooling :SEER 13 Setback LTE40Ft R6 system
t altered applicabl applicable components
e
D.Installed Heating Equipment Information
This section does not appp�
� apply to this'project. 4
t
E.installed Cooling Equipment information '
01 02 03 04 05 06 07 08
Condenser or Package Unit
Condenseror Condenser or Condenser or System Rated Cooling Condenser Rated
System Identification Cooling Efficiency Cooling Efficiency Package Unit Package Unit Package Unit Capacity at Design Nominal Capacity
or Name Type Value Manufacturer Model Number Serial Number Conditions(BTUH) (ton)
Donald Pedrotti SEER 13 Trane 4TTR4043LI00OAA 161534EA3F 42000 3.5
Notes:
Registration Number:216-A0248278A-M0100002A-000G Registration Date/Time: 2016-07-05 13:32:41 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:.2016-07-05 13:32:32
Schema Version:2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems,Ducts,and Fans (Page 3 of 7)
F. Extension of Existing Duct System,Greater Than 40 Feet
This section does not apply to this project.
G. Installed Duct System information
This section does not apply to this project.
H. Installed Air Filter Device Information
This section does not apply to this project.
I.Air Filter Device Requirements
This section does not apply to this project.
Registration Number:216-A0248278A-M0100002A-0000 Registration Date/Time: 2016-07-05 13:32:41 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-07-05 13:32:32
Schema Version:2013'.1.007
ntl x
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems,Ducts,and Fans (Page 4 of 7)
J. HERS Verification Requirements
01 02 03 04 05 06 07 08 09 10
MCH2O MCH21 MCH22 MCH23 MCH25 MCH28
Exemption
from
Minimum
Exemption R-Value for AHU
System SC System i From Duct Duct Ducts In Ducts Located AHU Fan Airflow
Identification or Location or Area Leakage, Leakage Conditioned In Cond Space Efficacy Rate Refrigerant Return Duct Design
Name Served Requirements Test Space Verification (WJcfm) (cfm/ton) Charge Table 150.0-C or D
Existing duct�
system is '
Donald Pedrotti 11233 to Jolla Ct insulated or. No No No No No No No
sealed with S Exemption
asbestos_..
Notes:
t- f
Registration Number:216-A0248278A-M0100002A-0000 Registration Date/Time: 2016-07-05 13:32:41 HERS Provider:CaI,CERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated;2016-07-05 13:32:32
Schema Version:2013.1.007
CERTIFICATE OF INSTALLATION. CF211-11VICH-014
Space Conditioning Systems,Ducts,and Fans (Page 5 of 7
K.Space Conditioning Systems,Ducts and Fans Mandatory Requirements and Additional Measures
Note:Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems.These requirements may be applicable to only newly installed equipment or portions of the
system that are altered.Existing equipment maybe exempt from these requirements.
Heating Equipment
01 Equipment Efficiency:All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a)and the Appliance Efficiency
Regulations.
02 Controls:All unitary heating systems,including heat pumps, must be controlled by a"setback thermostat.These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours.See Sections 150,0(i),110.2(b).
03 Sizing:.Heating load calculations must be done on portions of the building served by new heating•systems to prevent inadvertent undersizing or oversizing.See sections
150.0(h)1 and 2).
04 Furnace Temperature Rise:Central forced-air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet-to-outlet temperature rise specification.See Section 150.0(h)4.
05 Standby Losses and Pilot Lights: Fan-type central furnaces may not have a continuously burning pilot hght'Section 110.5and Section 110.2(4).
Cooling Equipment
Equipment Efficiency:All cooling equipment must meet the:.minimurn efficiency- 'requirements of.Section 110.1,and Section 110.2(a)and the Appliance Efficiency
06 ".
Regulations.
07 Refrigerant Line Insulation:All refrigerant line insulation in split system air conditioners and heat pumps must meet the R-value and protection requirements of Section
150.0(j)2 and 3,and Section 150..0(m)9.
08 Condensing Unit Location:Condensing units shall not be placed within five(5)feet of a dryer vent outlet.See Section 150.0(h)3A..
09 Sizing:Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing.See Section
150.0(h)1 and 2.
Air Distribution System Ducts,Plenums and fans
10 Insulation: In all cases,unless ducts are enclosed entirely in directly conditioned space,the minimum duct insulation value is R-6.Note that higher values may be
required by the prescriptive or performance requirements.See Section 150.0(m)l..
Registration Number:216-A0248278A-M0100002A-0000 Registration_Date/Time: 2016-07-05 13:32:41 HERS Provider.CaICERTS
CA Building Energy Efficiency Standards-2013 ResidentialCompliance Report Version:2013 Rev 1.007 Report Generated:2016-07-05 13:32:32
Schema Version:2013.1.007'