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B-2016-2311 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2311 10253 MINER PL CUPERTINO,CA 95014-2012(316 46 036) AIR&PLUMBING SYSTEMS INC LOS GATOS,CA 95032 OWNER'S NAME: BASKIND ALEX O AND HANA A TRUSTEE DATE ISSUED:07/13/2016 OWNER'S PHONE:408-896-9723 PHONE NO:(408)733-2000 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#901246 Contractor AIR&PLUMBING SYSTEMS INC Date 07/31/2017 X BLDG _ELECT _PLUMB 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 license is in full force and effect. JOB DESCRIPTION: REPLACE FURNACE-GARAGE;REPLACE A/C-OUTSIDE I hereby affirm under penalty of perjury one of the following two declarations: GARAGE 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. 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:$13000.00 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 16 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 316 46 036 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 ww 1-cemplyVh all non-point source regulations per the Cupe 'ne-M n>c pal ,section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur Date 7/13/2016 Issued by:AbbyAvende Ow 9- Date:07/13/2016 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) z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sce.7044,Business&Professions Code). Date: /137 /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 z. 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous a. 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 Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2 ,and 2553 Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:7/1312016 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 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 properly 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. I understand my plans shall be used as public records. Licensed Signature Date 7/13/2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 Ist; (408)777-3228•FAX(408)777-3333•building(acupertino.org CUPERTlh90 M rl [:1 PLUMBING ❑MECHANICAL ❑ELECTRICAL [:]MISCELLANEOUS �z0kX _ 2N 1 PROJECT ADDRESS (� �jj ,� APN# t 314 - 14 ^ 4U-03(p U-O 2/„ OWNER NAME ,�/ � PHONE �,5& O � �+��7 E-MAIL , STREET ADDRESS /.y7CITY, STATE,ZIP e-1 A-0`[`�� FAX CONTACT NAME �/�n ,p_/ !y � PHONE 6���z �� E-MAIL STREET ADDRESS/�(/Io7 / / ( CITY,STATE,ZIP / f. FAX ❑OWNER ❑ OWNER-BuiLDER ❑ OWNERAGENT VrCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME/ �� �I /�n ICENSE NUMBER� LICENSE TYPE/v BUS.LIC# COMPANY NAME ,7(, (�1 E-MAIL (� FAX J STREET ADDRESS /�1,Qt / ` r/� ^ CITY,STATE,ZIP 6 �© PHON rep ARCHITECT/ENGINEER NAME ( J LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CI'T'Y,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 41 (<"AQ(-e_ DCAe a V 61oXi� TOTAL VALUATION: O m�� RECEIVEDBY:a Ili 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 behalf. I have read this application and the information I have provided is correct. I e-Desc. tion of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building Ion. I tliori � a i es of Cupertino to enter the above-identified/property for in ection purposes. Signature of Applicant/Agent: Date: / SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W OVER-TIIE=COUNTER " ❑ EaPRESS STANDARD U,- El"❑ liARGE MAJOR MEPMiscApp_2011.doc revised 03/16/11 STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CF1R-ALT-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF--IR-ALT-HVAC) (Page 1 of 1) Site Address: PL Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditioned Thermostat Required R-value Floor Area(sq ft) ❑ Packaged System ? Evaporator Coil AFUE COP ❑ R-6 (CZ1,3-7)Ducts Served by system 13 Setback E3 Split System Condensing Unit SEER '§a:R8' (CZ 16)Ducts sq ft (If not already HSPF /❑R-6(all CZ's)Plenums present,must Furnace Lineset EER ❑ R-5 or R7.5 Lineset3 be installed) HERS VERIFICATION ru I aller 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 copy left on site. 'Er1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can-include niew ducting All Equipment, CF111-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF311: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 40.1inear feet of duct in unconditioned 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 alternative) ❑3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF111-ALT-02-E Ducts'and one or more of the following: CF2R7MECH-01,MECH-20-HERS;MECH-(23 or 24)-HERS Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS InstallerRequirement:Duct leakage<6%,Air Flow z 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. 'A New Duct system is when the duct system is constructed of 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 Suction line Diameter with insulation as the following 1.5-2T-2%",2.5-3T-2%",3.5 to 4T-2%",5T-4%" 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. 1 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 documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. Responsible Designer Name: Responsible Designer Signature: Date Signed: License: Compan Address: City/State/Zip: Phone: i yob � ���/��— Z� F assistance or questlori&4dgai ding the Energy Stan rds,contact the Energy Hotline at:1-800-772-3300 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUP RTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228^ FAX(408)777-3333 building(a)cupertino.org tr7wne' r arise- L.�'' _ AS�,f JV I) (F-ennrt N o m lc2 j 1. Is your real property a registered historical site? ❑�'es 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 2. .2. Does your real property have a licensed plumber certifying that,due to the ageor 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 fora and sign bottom of form. M,!,T-No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑des Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. r3o Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ Vo 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 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of fora.. 5. Please check ONE of the following: EN�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 properly is a niultifatnily 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 cull ent California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements, and that the water-conserving lurnbing fixtures comply with the requirements as.indicated in the liable on the following page. Owner or Owner Ag-ent's-Signature:—-. Date: 1 Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26115