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B-2016-2478 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-2478 22803 LONGDOWN RD CUPERTINO,CA 95014-2649(342 33 048) A-1 HEATINGAND COOLING INC SAN JOSE,CA 95710 OWNER'S NAME: MASEGIAN JOHN D AND KELLY A DATE ISSUED:08/09/2016 OWNER'S PHONE:408-649-9937 PHONE NO:(408)283-9915 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class WARM-AIR HEATING,VENTILATING AND AIR ONDITI NIN Lic.#966809 X BLDG _ELECT _PLUMB Contractor A-1 HEATING AND.QOOLING INCDate 07/31/2018 X_MECH X RESIDENTIAL_COMMERCLAL. 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 JOB DESCRIPTION: license is in full force and effect. REPLACE(E)FURNACE;ADD(N)A/C IN REAR YARD;INCLUDE I hereby affirm under penalty of perjury one of the following two declarations: ALL DUCTWORK 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. � ''/l�- 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:$12830.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county ordinances 342 33 048 and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities,judgments,costs,and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point 180 DAYS FRO PECTION. source regulations per the Cupertino Municipal Code,Section 9.18. Issu y:MELIS A Signature` Date 08/09/2016 Date:08/09/2016 R- l� 'R [2A I N PERE-ROOF. I hereby Arm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature ofApplicant: 2. I,as owner of the property,am exclusively contracting with licensed Dater 08/09/2016 contractors to construct the project(See.7044,Business&Professions Code). 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 HAZARDOUS'MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will Section 3700.of the Labor Code,for the performance of the work for which this 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 Quality Management District I will maintain_compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code, ections 25505,25533,and 25534. exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall Owner or authoriz:NMagent' be deemed revoked. Date:08/09/2016 APPLICANT CERTIFICATION N L NDIN A EN Y I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree 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 08/09/2016 Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION MEP 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 - C3 PERT1NO (408)777-3228•FAX(408)777-3333•building(a)cupertino.ora M I ��{ 2D1� 2 ❑PLUMBING ¢ECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS �S() -�' �� � e1 ��� iI APN# 7 q Z — 3 3 OWNER NAME PHONE �� �a �j .5 t,4k n f ^p E-MAIL STREET ADDRESS ® 8r�e a0 r3 �t�VA9J� lzcyk 10 e—r-,Zlp 8FCONTACT NAME PHONE \l ' E-MAIL$�B-400-)6) STREET ADDRESS CITY,STAT 1 f�,ZIP C� // Py' FAX OWNER D OWNER-BUILDER ❑ OWNER AGENT ❑' CONTRACTOR ,CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAMEpLICENSE NUMBER LICENSE TYPE BUS.LIC# i A '94 COMPANYNAME 'j , J E-MAIL FAX STREET ADDRESS// .-- S�1CITY,STATE,Z.3AA) J� ,1 a '? o Pro ' 71rj1. ARCHITECT/ENGINEER NAME 1 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 PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ No DESCRIPTION OF WORK y" C 1 0 <— �11 A /„ C'0'Lk_4.CA TOTAL VALUATION: f 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 rovided 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 to blding eoKtru�_ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent. alb _ Date: S PLEMENTAL INFORMATION REQUIRED oFFICE.I7SE ONLY .4 �. OVER-THE GOIINTER .7.i, r "❑ STANDARD ad LARGE Ft MEPMiscApp_2011.doc Devised 03116111 STATE OF CALIFORNIA ALTERATIONS - HVAC CEC-CF1R-ALT-03-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE GF111-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: OW - 1_®� Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditioned Required R-value Floor Area(sq ft) Thermostat 0 Packaged System 11 Evaporator Coil 3AFUE ❑R-6 (CZ Ducts COP ( ) Served by system 11 Setback 01'Split System ondensing Unit < •SE1?1R4 0 R-8' (CZ 16)Ducts sq ft (If not already 0 FurnaceHSPF 0 R-6(all CZ )Plenums's ' ineset . EER � present,must 0 R-5 or R7.5 Lineset' be installed) HERS VERIFICATION SUMMARY Installer determines � swork to be completed and matches to one of the options below. Atpermit application=this -. rm-is-allow—e tob`e-filled-out-by-hand For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. ;EIHI�IWAC Ghangeout/Repair Can-include new ducting Required Compliance Documents to be left on site for Final All Equipment, CF1R-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS Installer Requirement:Duct leakage(:5_15%or,: 10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: 0 1.Duct system registered'with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned space,or 0 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ) 02.New HVAC System Required Compliance Documents to be left on site for Fina l:All new equipment and All New Ducts' CF113-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) 0 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 Ducts2 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,>_350 CFM/ton(or Standards Table 150.0-C/D alternative) 0 Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. _0 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in unconditioned CFIR-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,S.10%to outside,or seal all accessible leaks) 0 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 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. '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) 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 Nam e: Responsi Designer Signature: Date Signed: License: � y Comany: Addres. City/State/Zip: Phone: or assistance o questions regarding the Energy Standard ,contact the Energy Hotline at:1-906-772-3300 sco�� _ oo0ic ovum ` h 4 , CUPER,rINO Building De artment 6 3 0 VJ/k EVIEWED FOR CODE COM LIANCE Reviewed By.,114. - �( 1 0 CraN► � PLOT PLANS CHECKED BY DATE (A---- PLANNING DEPT OUPERTINC MUN SMOKE JC UN, WAVEA M6 I; COMMUNITY DEVELOPMENT�DEPARTMENT A BUUILDING,DIVISIONIANCE MNEWCE, M-A E"OF PIU, FILE ��7 t.1 10300 TO.RRE AVERUE CUPERTGNO.,CA 95014-3255 (408)777-3228*FAX—(408)777-8333b;u�ldin4 _c�perfiho,og C `T u Pti, S `II-iis affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for coi 1pliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access.for inspections are required. -NORAL INFORMATION Existing single4a•rnily and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide Aar ns Wien the valuation of additions, alterations,or repairs to existing dwelling units exceeds $1.0'0"agg,CR&C,Section IZ,314 and CBC Sections 907.2.11:.5 and 420.6 require that Smoke Alarms and/o�Carbon Monoxide Alarms be installed in the following locations: A\RtA SMO)iClr ALARM C,O,Alr Aft Outside of each,separate sleeping area in the irnatediafe vicinity of the - J �edli�oo�=s Oi�ewer le el of a dwelling i,nit nchid.in basernentsr X Within eacl't slee,irr+ roomn f f Carbon Moncs ade alarms.are not reclixir.ed iii dwellings which da ilot contain frlel burning appliances and tl al +a n i P ave°ani attaelied garage. Cart©n monoxide alarriis corrrbizte =with s f F cpke alarms sha1lI ccyim-piy with CB`C Sectlio�z 42'.0:6 az�d s11a11 be app'roved;by tle Office of the State l�'ire Marsh�I. Pu,wer Supply::lei ` vel{l+uzg units with no'c©ix,merci ; o}wer su l alarms,rna be solei h rttery operate;i,. P pPY � ) Y d ht existing,dw-e l ing;units;alarrms are perm,Ated tc b-e solely battery operatedi where repairs or a;Iteraftoxls d!o4 not resurl �T,a the removal of wall amid eePIi�:1g frrdslnes ozthere is nog access-by t F=e°��s otf attic;bfasernen�ox crawl space.,Refer to`CRC Sectiolrt R-3314 alr d CBIC Sections 90V.211.4 and 4201.6%2.Ant electric }=perm,-`t rs re goitre 4 I four alarms w tvklta mus:,be comiitected to the building wirk,% As owr-er ofthe above-referenced property.,I hereby certify fTiat the alann(s)referenced above has/ihavve been instal�le;d iii?accordance with.thein.+an�iufacturer's i7,s�E_,ctton�s;az�:d iris co}mtpl�ancewzt�..tlste CaI`iforn<a�B�utldilZg; and Ca,llfonua Residerohal.Codes.T he ala=rms have been,tested ail=`are operatio nal,a�a'of t date sighed, b:elow.. (Gave rread'and+_a .,e f.'a com („=w.th,the-Per.=msaad'corn.dIU0n,.s,of thifsstate•memf 1trel AA-A 1 i S(tlnalure . ...... Lac. ;, Date WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE F law COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ^_ CUPERTI!NO 10300TORRE AVENUE CUPERTINO,CA 95014-3285 (408)777-3228•FAX(408)777-3333 building0cupertino.org Owner Name To�A n 4 Y-C 4 ow 5 e a_ Permit Noel -20 Up I`kq Address ' v 1. Is your real property a registered historical site? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. D(No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. No Go to Question 3. 3. Is water service permanently disconnected for your building? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Lj .No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 0 No My real property is built and available for use or occupancy after January'l, 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 form.. 5. Please check ONE of the following: 7 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 1,20+17,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). 0My 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). 0 1VIy 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, 20,19, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless-of whether property undergoes alterations or improvements). 1,as the owner or owner's agent of this property,certify under penalty of per jury that non-compliant plumbing fixtures will be. replaced prior to.date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections.1104.1 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.a e. Owner or.Owner Agents Signature r .I D'4e.. l — r Upon completing and signing this Certificate,please return it V the Building Division in or=der to final your building permit.. SB40-72015.doc revised 08/26/15