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B-2016-2425
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2425 11838 UPLAND WAY CUPERTINO,CA 95014-5106(366 03 054) PELLE HEATING& AIR INC SAN JOSE,CA 95111 OWNER'S NAME: CUNNINGHAM JAMES GAND RENNAK KIM S TRUSTEE DATE ISSUED:08/01/2016 OWNER'S PHONE:408-255-3413 PHONE NO:(408)978-7060 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC-20 Lie.#8098117 Contractor PELLE HEATING&AIR INC Date 10/31/2017 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;ADD(N)A/C(BACK I hereby affirm under penalty of perjury one of the following two declarations: YARD)AND(I)HEAT PUMP(BALCONY) 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. lr 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:$9500.00 APPLICANT CERTIFICATION 1 c that I have read this application and state that the above PN information is correct.I agree to comply with all city and county ordinances 3660 66 Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 366 03 054 representatives of this city to enter upon the above mentioned properly 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 agains id City in consequenc of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the pPIG t nder nd a i comply with all non-point source regulation per th 'Cup: no u i ip I Code,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. S" ig nature Date /81/2016 Issued by:AbbyAyende Date:08/01/2016 OWNER-BUILD ECLARATION 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. 1,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 of Applicant: contractors to construct the project(See.7044,Business&Professions Code). Date:8/1/2016 i hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. 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 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 3. 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 Quali Lqgement District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Munici d ,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, C s 5, 55 3, nd 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. C Owner or authorized agent: APPLICANT CERTIFICATION Date: 18/ /2016 I certify that I have read this application and state that the above information is N s N LENDINAGENCY i correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there s a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city 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, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 8/1/2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(Wcupertino.org Zmisc J GIJ '�itT1NQ -Z`1 ❑PLUMBING MECHANICAL &hLECTRICAL ❑IVIISCELLANEOUS PROJECT ADDRESS '. APN# 16LeP -P OWNER NAME w �(V�re - PHO 4t)U - E-MAIL: STREET ADDRESS �g C4W vITY, STATE;ZIP /_. FAX ` I� '.i CONTACT NAME U PHONE E-M IL STREET ADDRESS . CI Y STATE,ZIP AX CA ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT oNrRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS LIC#., N� I IS COMPANY NAME 1 FAX _ O� CIN STREET ADDRESS CITY, TATE,ZIP PIJONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI777 PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING, dCOMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK C i!!7� s TOTAL VALUATION: REO7IY)D BY.` By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property o er's be alf. I have read this application and the information I have pro ided is co t. 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 buil Ig Fonsh cti n. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Dater 1. ttFPTEt_E7t7 INFORMATION REQUIRED cJRFzci,xJ o� D aVER CCQLl7ER -------------------- I STANAb CI >vJAro r> MEPMiscApp_201 Ldoc revised 06/21/11 1,' 7/29/2016 q 11838 Upland Way-Google Maps JOB COPY THIS PLAN SHALL REMAIN ON Google �a11838 Upland Way THE JOS AT ALL TIMES DURING ,T ,O h s, l k $� F ' Stamping of this plan and specifications SHALL NOT Map data©2016 Google ,held to permit or to be an approval of the violation PLPUNS E ED BY my pr visions o'any City Ordinance or State Law. Measure distance fiUMV& Total distance:40.12 ft(12.23 m) D�, `RM1T # hl� Z hu PLANNING . E UPERTI I SALES SERVICE INSTALLATION- t CA Lie.No.809887 J 29,2016 BBB.- ME Jim Cunningham 11838 Upland Way Cupertino, CA 95014 P. (408)255-3413 E.jimcjimcjimc@gmail.com e hereby propose to f the materials and perform the tabor necessary for the completion o . , Install (1) Fujitsu 15K ductless mini split indoor unit model#ASU15RLS3 Install (1)Fujitsu 15K heat pump outdoor unit, 1 zone model#AOU15RLS3 • Install (1) Lineset with line cap • Install (1) Electrical A/C circuit • Install(1) Condensate drain • 10 year warranty on compressor �• 10 years on all other parts f N" • 2 years on labor Price: $6,209.00 +Permit 6% Discount if paid by cash or check only and applies to price of job not permit This Proposal is valid for 30 days. Thank you for considering Pelle Heating and Air Conditioning for your heating and air conditioning needs. am confident that we offer the very best quality, service and installation available and we look forward to serving you. If you have any questions, please do not hesitate to call me at(408)878-5582 for clarification. Accepted by: Date: Regards, on Robert Shuper pgopie M us Comfort Co sultant ~°�V Y � W Pelle Heaf &Air Conditioning Pelle Heating &Air Conditioning, Inc. MALL BEST 3751-D Charter Park Court, San Jose,CA 95136 ' NSV2013 Phone(408)978-7060 Fax(408) 978-4780 'mLLoPAM�E www.pelleheatandairconditioning.com " Al FURNACES AIR PET ., CONDITIONING DUCTWORKa SALES INSTALLATION CA Lie.No.809887 1 June 29, 2016 Jim Cunningham 11838 Upland Way Cupertino, CA 951-"f 14 P. (408) 255-3413 or (408)891-0778 E.jimcjimcjimc@g_mail.com r We hereby propose to furnish the materials and perform the labor necessary for the completion of: • To install relocate per code: Install (1) Bryant 96%(AFUE) efficient, 80,000 BTU single stage furnace, model #925SA48080E17 • Install (1) Bryant 4 ton, up to 14 SEER condensing unit, model#105ANA048000 • Install (1) rr ant 4 ton evaporator cased coil, model#CNPVP4821ALA • Install (1) Bryant EZ Flex filter box • Install (1) -et n ducts with R-6 Flexduct .. o� 0 Install (1) 'ro705 single stage digital setback thermostat • Install(1) Nev� gas shut off and flex assembly • Install,(1) �e'-A., ABS furnace flue • Hook up tr '- ;sting furnace (circuit) • Install (1) e --ted circuit to A/C (30AMP 220) • Install (1) '^ sensate drain with drywell • Install (1) " .-)per refrigerant lineset • Install (1) - Pad • Install (1) ; -uid line filter • Isolation r • Seal up k - and plenums • Removal "s.,osal of the old system • Lifetime v my on the heat exchanger 0 10 years <. all other Bryant parts °-` • 2 years c., bor - Price: $8,651.00+° 6%o Discount if ; s, cash or check only and applies to price of job.;not permit or HERS test people us on P E � Pelle Heating & Air Conditioning, Inc. e Mew. . BES= 3751-D Ch rt 5,HALL Charter Park Court San Jose CA 95136 V2 moPAME Phone(408) 978-7060 Fax(408) 978-4780 � zYeaRs www.pelleheatandairconditioning.com k. CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 1 of 3) Project Name: Cunningham,Jim Date Prepared: 2016-07-28 A.General Information MR-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 Cunningham,Jim 02 Date Prepared 2016-07-28 03 Project Location 11838 Upland Way 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name Cunningham,Jim Dwelling Unit Conditioned 07 Zip Code 95014 08 2740 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 ,ux 01 02 0304 '4 M 5 06, 0 �. ! %H%� ro fav Mh GQW SCS stem SCS stem CFA served stem m a�% refrails the S i Installing t Anstallir rie ¢5C Irsta�llin nsalh ' aalnsta Y Y Y g i g g .; �g (ling 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? feetofducts? duct system? SC system? Alteration Type Cunningham,Jim Whole house 2740 Yes Yes Yes' No No No Altered space 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-A0282583A-000000000-0000 Registration Date/Time: 2016-07-2811:54:09 HERS Provider:CalCERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-07-28 11:53:52 c e Vers ma ion: CERTIFICATE OF COMPLIANCE C17111-ALT02-E U 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 AlteredHeating 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 All new All new This field or This field or Cunningham, Central gas Central split heating AfUE 80 cooling SEER 14 Setback section is not section is not Jim furnace com onents AC com onents A p applicable applicable 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:<_15%,ors 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>300 CFM/ton required when-MCH-25 is required. Excentions: Duct systems registered with HERS provider as previously sealed are exempt from MCJ I;20 Duct Leakage Testrpg r qu'r mets -Heating-only ' ' fe g y systems and Air Handler/Furnace changes do not require verification of Air FIowMCH 23r Refrrgeant��ai e NYC15 %/ 5i /' s Existing duct systems constructed,insulated or sealed with asbestosare exem rom MCHr20��uet,Leaage Testing, qui erasSO E.Entirely New or Complete Replacement Duch i m with r withol#tXquipment Chianpout Sections//, .2(b)1Dna�and 150.2(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-A0282583A-000000000-0000 Registration Date/Time: 2016-07-2811:54:09 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-07-28 11:53:52` Schema Version:0.555SDD i T 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: Sanchez,Rafael Company: Signature Date: PELLE HEATING&AIR INC 2016-07-28 11:54:09 Address: CEA/HERS Certification Identification(if applicable): 179 SAN RAMONDRIVE City/State/Zip. Phone: SAN JOSE CA 95111 408-978-7060 Responsible Person's Declaration statement:: 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 Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of compliance(responsible designer). B. That the energy features and performance specifications,materials com onents,and manufa ted devices for the buildin esgn5o system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part land Part 6 of the California-Code of R, Fez0111111W V1 y, 4. The building design features or system design features identified ort this Certincat 4 f G,m{i't ance are�ostent wit thein ormatEon provided oti oth is cake ompliance documents worksheets Gr calculations,plans and specifications submitted to the e�iforcementgency forappiov $wits this building permit at icatiiri 5. I will ensure that a registered copy of"this Certific to Compliance steal{>,,,b„ inado auaila,le witth bslttblhg°permit(issued forthe,b'"ild ttg,and7ma, av /blete=enforcement agency for all applicable inspections.I understand that a registered copy of this "r�i icate of Compltanc S tequtr to bg included w th th h prpv(des to the being owner at occupancy. P 4�� o,d, cume tationthe it er Responsible Designer Name: $ ., tea, Responsible Designer Signature: �1>✓f Sanchez,Rafael Company: Date Signed: PELLE HEATING&AIR INC 2016-07-28 11:54:09 Address: License: 179 SAN RAMON DRIVE 809887 City/State/Zip: Phone: SAN JOSE CA 95111 408-978-7060 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document,and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number:216-A0282583A-000000000-0000 Registration Date/Time: 2016-07-28 11:54:09 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-07-28 11:53:52 Schema Version:0.555SDD