B-2016-2432 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS. CONTRACTOR: PERMIT NO:B-2016-2432
10335 CALVERT DR CUPERTINO,CA 95014-3807(375 17 022) CALVEY HEATING&
AIR
MOUNTAIN VIEW,CA
94040
OWNER'S NAME: SRINIVASAN MAHESHWARANAND SUNDARESAKUMAR P DATE ISSUED:08/0,1/2016
OWNER'S PRONE:650-468-7121 PHONE NO:(650)265-2202
LICENSED CONTRACTOR'S 12ECLARATION BUILDING PERMIT INFO:
License Class C-2.Q Lic.#932199
Contractor CALVEY HEATING&AIR Date Q5/31/2Q17 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);(I)A/C-BACK YARD
I hereby affirm under penalty of perjury one of the following two declarations:
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
zperformance 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:$4715.00
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 375 17 022
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 standsconsequa ice of the granting all
this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands a c�will comply with all non-point
source regulaf ns per the Cupertino Mu 'opal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
.Signature Date 811/2.015 Issued by:Abby A ey nde
Date:08/01/2016
OWNER-BUII.DER 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 ofAppiicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:8/1/2016
1 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 ofthe 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. 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. 1 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 Area Air Quality Mnagement District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Co e,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Coe Sections 25505,25533, n 534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION Date:8/1/2016
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 /81/2016
Professional
GENERAL PERMIT APPLICATION M E F jqh
12 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 = = Isc
(408)777-3228 FAX(408)777-3333•buildingCcDeupertino.org
�UPER'i`INO
❑PLUMBING MECHANTICAL ❑ELECTRICAL ❑MISGELLANEOUS
PROJECT ADDRESS ®
� r �� APN I S' 3
- j T—M
OWNERNA E-NAIL[me �� 7 g
STREET ADDRESS TY, TATE ZIP
035 C.��,uu+ CiY' Ire x(561e'i FAX
CONTACT NAME ���ra�M PHONE E-MAIL
STREET ADDRESS CITY,STATE,ZIP pAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT X CONTRACTOR ❑CONTRAC'ORAGENT ❑ ARCHTTECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME &,y,, / I�. JJ tl
\ LIC EN E LICENSE TYPE BUS.LIC# �
COMPANY N n� � ` � iA y EeV FAX
STREET ADDRESS � G` TAT
ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑ SFD Or Duplex ❑ Multi-Family PROJECT IN WILDLAND I PROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ NO
DESCRIPTION OF WORK �(}��l-y�� � �,•.,�`.,(� LA'I l� �` �a T"'V�i�k�'�"�`'�.
TOTAL VALUATION: `S REGEIVEDBY, 1v
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 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating t uilding constructioN. Lauthorize representatives of Cupertino to enter the above-identified roperty for inspection purposes.
Signature of Applicant/Agent: Date: s —
SUPPLEMENTAL INFORMATION REQUIRED
„F OFFICE USB'OnI:Y .. .?:
ti OVER-THE COULTER
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MEPMiscApp_2011.doe revised 03116111
Gologle Maps 10335 Calvert Dr OFFICE
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changes or alterations on sa^ae, or to deviate
PLOT PLANS CHECKED BY therefrorn,witril approval from the Building Official.
The Stamping of tn,s plan and specifications SHALL NOT
SAT 3 /Mbe held to pe m,t or to be an approval of the violation
PIvANIIII DEPT of any roves or,s of any City Ordinance or State Law.
CUPERTINO DATE
PERMIT#
CERTIFICATE OF COMPLIANCE C17111-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVAC) (Page 1 of 3)
Project Name: CALVEY-Srinivashn Date Prepared: 2016-08-01
-------------
A.General Information
CFIR-ALT 02 is applicable to multiple space co1nditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,
use one CFIR-ALT-02 document for each dwelling unit.
1.
01 Projeci Name CALVEY-Srinivashn 02 Date Prepared 2016-08-01
03 Project,Location 10335 Calvert Drive 04 Building Tvpe Single family
05 CA Citi 06 Dwelling Unit Name Srinivashn
07 Zip Code 95014 08 Dwelling Unit Conditioned 1324
Floor Area(ft 2)
Number of space conditioning
09 Climat%Zone 4 10 (SC)systems pn this dwelling 1
unit.
B. Space Conditioning(SC)System Information
01 02 03 04 05 06 07 08 00 10
311
t � sta �
SCS ste 5C S st fA servem a refri
Y � y °c � E ���? ,- g�nt inst� sg new$�- �rlstalling Installing. Installing
identification or ocation o ea ed con �� tem rnr�r than 4p ent(rely new entirely new
Name Serve s'tt M a" comps��t moven
+1j p ucts? duct system? SC system? Alteration Type
a..^?a"`1...,
go
Al � Entirely new or
complete
System 1 entire home 1324 es Y -Na No Yes
R4w r replacement space
condition yng system
C.Extension of Existing Duct System,Greater Than 40 feet(Settion150.2(b)1Diib)
This section does not apply to this project.
Registiation Number:316-A1030395A-000000000-0000 Registration Date/Time:2016-68-01 12:44:26 HERS Provilder:USERA
CA Bulding Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.00 Report Generated:2016-08-01 12:44:28
Schema.Version:0.555SDD
b', t
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT HVA ) (Page 2 of 3)
D.Altered Space Conditioning System(Sections 150.2(b)1E anis F)
Thit section does not apply to this project.
E. Entirely New or Complete Replacement Duct System,with or without Equiprhent Changeout(Sections 1S0.2(b)1Diia and 1S0.2(�)1E,F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning ystem (Section t50.2(b)1C)
01 02 03 04 05 06 07 08 09 10 11
Heating Cooling
System Heating (Minimum Cooling Minimum. Required
Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency Efficiency Thermostat New Duct
Name Type Component Type Value System Type Component 'Type Value Type R-Value
System 1
Central gas All new heating Central All hew cooling SetbackTher R-6
AFUE .80
furnace components packaged AC components SEER 14 mostat
Required Documl ntatian:
CF2R MCH-o1-E,S a ditionin 5 s DurK.
-Duct insulation'tequi t for new p >. .s � ¢,� tr r a ;, �, ; ai'
CF211&CF3R-MCH-20 ct Leakage cats
Leakage rate cornplia 6%. 1 � �ngd
CF2R&CF3R-MCH-22 fficacy Veri n510
� a �
CF211&CF3R MCH-23 Air Flow Venffi ion
Compliance:Farb Effic clSys s x S 2
Alternative Corrlpliance: k(ICH-28 Retu eign Veri�it`'��ibh�s analtfafroe'fa III-22 and 1tG1- +}e"iition.
CF2R'&EBR-MCH-25-H Refrigerant Charge Verification required when ri a tc . I' 8-15).
EXcePtlans: .S. SIL.Hff AVOW ft � �
Heating-only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
Note:
An"entirely new or replacement duct system"means at least 75 percent of the duct system is new duct material,and up to 25percent(may consist of reused ports from the dwelling unit's existing duct system(e.g.,
registers,grilles,lboots,air handler,coil,plenums,duct material)if the reused parts are 4ccessible and can be sealed to prevent leakage
Registiation Number:316-A1030395A-000000000-0000 Registration Date/Time:2016-68-01 12:44:26 HERS Provider:USERA
CA Bulding Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.0017 Report generated:2016-08-02 12:44:28
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)
Documentotion Author's Declaration Statement
1. 1 certify that this Certificato of Compliance Oocumentation'is accurate and complete.
Documentation Author Name: Documentation Author signature:
JosephCalveyl � '
Compary: Signature Date: "
Calvey Heating&Air X016-08-01
Address CEA/HERS Certification Identification(if applicable):
P 0 Bra 4146 .932199
City/stake/Zip Phone:
650-265-2202 CA 94040 6502652202
Responsible Person's Declaration statement
I certifythe following under penalty of perjury,under the laws o�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 Business and Professions Code to accept responsibility for the b1pilding design or system design identified on this Certificate of Compliahce(responsible designer),
3. That the energy features and!performance specifications,materials,components,and manufacturer devices for the building design or system desiOn identified on this Certificate of compliance conform to the
requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design featuros identified on this Certificate of Compliance a¢e consistent with the information provided on other applicable compliance documents,worksheets,
calculations,plans and specl�ications submitted to the enforcement agency tor approval with this building permit application.
S. I will ensa t a register,. y of th' of Com ija f 11,b ova aniitblkr t(aur mg permit(s)vi sk or the building,and made available to the enforcement agency for all applicable
inspdctio ° nderstand t regis ertifrplirs re e, dtd° r ( with the doffs fition the builderproyides to the building owner at occupancy.
MIR
Responsible Designer �` ADM ible Desi
Joseph Calve , a � d5e 1...Gt Lve
p >I ,f gin.
Compary: t Signed � w
Calvey Heating& 41 g Rf�AB (�F
o
Address
Bo(4146 U.S., Energy � License:
P0
City/Stake/Zip: Rhone:
650-265-2202 CA 94040 6502652202
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Registiation Number:316-A1030395A-000000000-0000 Registration Date/Time:2016-i)8-01 12:44:26 HERS Provljder:USERA
CA Building Energy Efficiency Stanclords-2013 Residential Compliance Report Version:2013 Rev 1°00"i Report Generated:2016-D8-0;2 12:44:28
Schema Version:0.555SDD
SMOKE I CARBON MONOXIDE ALARMSFILE
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
10300 TORRE AVENUE=CUPERTINO,CA 95014-3255
{408)777-3228-FAX(40$)777-3333�buildingC�euaertino.ora
Permit No.
g ess j Ka��� m U #of Alarms Smoke: Carbon Monoxide:
PERNII �CANi OT BE ANAUb AND GpMPLETEI)UNTIE FHLB CERTIFICATE
h
O_
fo
-
PURPOSE
This affidavit is a self-certification err-th-e i tsta;Iattan""cif-allrequixed Smoke and Carbon Mon_axic1e-A1am1-_f_a_r-
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) X
On eve level of a dwellin unit includingbasements 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. Cae-ryonmonoxide alarms-combined with smoke-alarms--sha"-comply t^&tb-
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 CSC""Sections-9-07.Z.11.4 and 40:6.2.An ej ctt cal permit 1s required"fear
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 a ree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)game: ' b
l ILL �t7rtpA�tS�+ I :i� btt. : Date:
Si nature................
Contractor Name:
Si nature.......................................................
Lic.#......................................Rate: ...................
Smoke and W form.doc revised 03118114