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B-2016-2528CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2528 1077 MILKY WAY CUPERTINO, CA 95014-5008 (362 18 042) KUBRO CONSTRUCTION CUPERTINO, CA 95014 OWNER'S NAME: GUNTURU VAMSIDHAR AND RAVULA SUNAYANA DATE ISSUED: 08/16/2016 OWNER'S PHONE: 858-692-7296 PHgNE NO: (408) 839-5800 LICENSED CONIRACTOR'S DECLARATION License Class 5 Lic. #960307 , Contractor KUBRO CONSTRUCTION Date 04/30/2017 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. I hereby affirm under penalty of perjury one of the following two declarations: 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. 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. 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 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 City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ode, Section 9.18. Sign Date 08/18/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2, I, as owner of the property, am exclusively contracting with licensed contractors to construct the project.(Sec.7044, Business & Professions Code), I hereby affirm under penalty of perjury one of the following three 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 performance of the work for which this permit is issued. 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, s. 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of 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 be deemed revoked. 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 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 City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 08/18/2016 PERMIT INFO: X BLDG —ELECT -PLUMB X MECH X RESIDENTIAL _ COMMERCIAL' JOB DESCRIPTION: INSTALL (N) FURNACE IN ATTIC WITH (N) GAS LINE; INSTALL (N A/C UNIT SAME LOCATION Sq. Ft Floor Area: I Valuation: $10000.00 APN Number: Occupancy Type: 362 18 042 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature ofApplicant: Date: 08/18/2016 ALL ROOF COVERINGS TO BE CLASS "At° OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management Disfrict I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or auth a e Date: / TI N LENDIN A EN Y I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. GENERAL PERMIT APPLICATION. COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING IDIVI8JON 103007FORRE AVENUE • CUPERTIN'O, CA. 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • b lildina :cupertino.ora I— (ELECTRICAL -� '- - _ MISCELLANEOUS ► 14010 PROJECT ADDRESS APN # I M! a���a®r c:.� 2 �.` o2 OWNERATAME PHONE e�. t.(�. -7,)-9 4'p E-MAIL VCLrntJ � E? t2- STREET ADDRESS R9 C i�T3t g� yy�� y� ._ -.. � ti Iy 1 M I LV01 U-)Py CITY, STATE, ZIP l.ri� 1` %Z 1 a i�`L� f . � �L .fit - FAX CONTACT NAME PHONE E-MATL STREETADDRESS CITY, STATE, ZIP FAX "OWNM �❑ OWNER -BUILDER Q OWNERAGENT 0 CONTRACTOR 0CONTRACTOR .AGENT11 ARCHITECT 0 ENGINEER )] DEVELOPER Q TENANT CONTRACTOR NAME N CAE _ LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANYNAMF, MM n l �� i . L E -SIL r.-} , g E . i t 1Z r\& . rr-,a . t n CL's F" FAX STREET ADDRESS• ,. 102-16 1W- -1 CITY; STATE, ZIP d e N au It—K O CA q 1 PHONE C� }. $ (? O'© _ � i SP � -� � 1641 ARCHITECTIENGW EERNAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP' PHONE USE OF SFD or DUPLEX Q MULTI -FAMILY PROJECT IN WILDLAND 13 YES PROIECT IN Q YES. IS THE BLDG AN Q YES BUILDING: Q COMMERCIAL URBAN INTERLACE AREA ja. NO FLOOD ZONE, 19 NO . EICHLER HOME? Id NO DESCRIPTION OF WORK TOTAL VALUATION:#A aLD N�,,o Ll V t 13_� ������-By my signature below, I cern to each of the. following; I am the property owner ar authorized agent to act on theppro ner's Behalf. I have read this application and the information I have provided is correct. I have read the Description of Work anj Qverify it is accurate, I agree to comply with all applicable local ordinances and state laws relating to building construo ion_ I authorize Tepreseuta f CuD2 to er the above-ide ied a fo ' p . purposes. ',i ers p rt:j p p[/rty r mspe Signature of Applicant/Agent: MEPMisct4pp_2011.doc revised 06121/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2528 1077 MILKY WAY CUPERTINO, CA 95014-5008 (362 18 042) KUBRO OWNER'S NAME: GUNTURU VAMSIDHARAND RAVULA SUNAYANA OWNER'S PHONE: 858 - 692 7296 LICENSED ONTRA TOR'$ DECLARATION License Class B Lic. #960307 Contractor KUBRO CONSTRUCTION Date 04/30/2017 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. I hereby affirm under penalty of perjury one of the following two declarations: a. 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 jt Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 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 City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Cofie, Section 9.18. Signat rem_ Date 08/16/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: i. I, as owner of the proper(} or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 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. 3. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of 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 be deemed revoked. 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 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 City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 08/16/2016 CONSTRUCTION CUPERTINO, CA 95014 ISSUED: 08/16/2016 NO: (408) 839-5800 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE FURNACE, SAME LOCATION; INSTALL (N) A/C UNIT Sq. Ft Floor Area: l Valuation: $10000.00 APN Number: Occupancy Type. 362 18 042 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: PAUL O'SULLIVAN Date: 08/16/2016 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 08/16/2016 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25 33. Owner or authorized a Date: 08/16/2)16 co"N NDING AGENCY I hereby affirm that there is a construction.lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Licensed COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, GA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 . building(okupertino.= PROJECT ADDRESS APN # �� 2- 4 ILLI! ° y r c�Pea-ii\i®P c. i$ 042 PHONEe OWNER NAME $ E-MAIL VL-L,'n-s( r1 -ht:. sA VAMISID+iAj la,L l� i®ia V68 Cq� -7.)-91-U 0-koo � STREET ADDRESS �y4�y ILY{� CITY, STATE, ZIP pFAX -Y tAilY AQP(FXi iNOi(A?911��bij CONTACT NAME f' I PHONE I E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX 'OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME_ p y LICENSE NUMBER t� p LICENSE TYPE BUS. LIC # 303 t>' t"w i Ea c� COMPANY NAME, E-MAIL ...m— FAX �+"C�l"� STREET ADDRESS. 0 110 J L y CITY, STATE, ZIP clu A R:rt No CA ct So i i i PHONE 4 O a J�55 �� 16'a 1 I r � ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI -FAMILY PROJECT IN WH DLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ YES BUILDING: ❑ COMMERCIAL URBAN INTERFACE AREA NO FLOOD ZONE. TXI NO EICHLER HOME? �. NO DESCRIPTION OF WORK TOTAL VAEUATION; KECFEDr 'z^ y <• By my signature below, I certi to each of the following: I am the property owner or authorized agent to act on the pi'6- erty ow.ner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work anj verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representaiwT Af Cunerti 10Iger the above-ide'fied p petty for inspection purposes. Signature of Applicant/Agent: -Date: _ - FL� V�lENTAL INFORMATION REQ IRED' MEPMiscApp_2011.doe revised 06/21/11 ALTERATIONS - HVAC :3 CEC-CF1R-ALT-03-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ALT-03-E Alterations - HVAC CZ 1, 3 to 7 and 16 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: t , Enforcement Agency: e Prepared: Permit#: Equipment Type Equipment Efficiency New: Ducting, Plenums, Li et ditioned FFlobr Required R -value fes. Area (sq ft)Thermostat 0 Packaged System m.Evaporator Coil i AFUE COP ❑ R-6 (CZ1,3-7) Ducts ed by system Setback 0 Split System l�ondensing Unit J 4 SEER &(R-8' (CZ 16) Ducts 1 sq ft (if not already %furnace 0 Lineset( c x`s�r+, EER HSPF 13R-6 (all CZ's) Plenums present must 0 R-5 or R7.5 Lineset' be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit -application this ,for is -allowed to be filled out by handy Torfinal inspection all forms are to be registered (no hand filled forms allowed) and atopy left on site. 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can -include new ducting All Equipment, CF1R-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: 01. 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 1 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts CF1R-ALT-02-E CF2R-MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS 4CF3R-MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS' Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow 2! 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 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 >_ 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. 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 L15% 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 -2y.', 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: Responsib Dei erSignature: Date Signed: 'u License: q b 6 & V s r nriv ru-) ( � Company: Address: V City/State/Zip: Phone: For assistance or gbestions regarding the Energy Standards, contact the Energy'Flotline at: 1-800-772-3300 �-N5 11 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space- C-o.ndi.tioning-S-ystems,-Ducts,, and Fans- - (Page 1 of 8 Project Name: Kubro Gunturu Enforcement,Agency: Cupertino Building Permit Number: B-2016-2528 Dwelling Unit Total Conditioned Floor Department than 40 feet of Number of Space Conditioning Dwelling Address: 1077 Milky Way City: Zip Code: 95014 A. General Information 01 Dwelling Unit Name Kubro Gunturu 02 Climate Zone 4 03 Dwelling Unit Total Conditioned Floor 2300 than 40 feet of Number of Space Conditioning Name Served Area (ft2) ducted 04 Systems in this Dwelling Unit. 05 Certificate of Compliance Type Prescriptive alterations (CFIR-ALT) 06 Method used to Calculate HVAC Loads NotApplicableEquipmentChangeout 07 Calculated Dwelling Unit Sensible 0 complete Calculated Dwelling Unit Heating Load Yes Yes Cooling Load (Btuh) replacement space 08 (Stuh) 0 LO9 Dwelling Unit Number of BedroomsT2 I I MCH -01b B. Space Condit" Ming (SC) 01 06 SC S * y SC System CFA served = 1, *1 , r, Z, rill! trCsV%ng _fte Ideritifi2telomn or Location or Are a I by this SC I 1 than 40 feet of system Name Served System (ft2p) ducted containing components? system? component? Entirely new or System I I Whole House 1 2300 1 Yes I yes Yes 1,j: 07 08 09 10 A.@qllinore Installing Installing than 40 feet of entirely new entirely new SC Alteration Type ducts? duct system? system? Entirely new or complete Yes Yes Yes replacement space conditioning system Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (P -age 2 of 8 ) C. Space Conditioning (SC) System Alterations Compliance Information 01 02 03 04 05 06 07 08 09 10 11 12 13 Heating Unit serial Rated Heating Capacity, r Name Heating Efficiency Type Value Manufacturer Model Number number Output (BTUH) Systemi A I4, Central Fan .; f � . ,31.Ojwpv036070 2516a24206 Integrated Condenser Rated System Identification Cooling Efficiency Cooling Heating Package Unit Package Unit Package Unit Cooling Nominal Capacity New or Type (CFI) System Manufacturer Altered Heating Minimum (ton) Altered Cooling Minimum Required Replaced New 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 All new System 1 Central gas furnace heating AFUE 780 Central All new cooling SEER 14000 Setback c GT40Ft R6 Not a CFI componen split p . system is components ID. Installed Heating Equipment Information I Notes: e F><a E. Installed Cooling €gW0066nt inforr93 VL us 3 ®4 05 06 07 System Identification or Heating Efficiency Heating Unit Heating Unit Heating Unit serial Rated Heating Capacity, r Name Heating Efficiency Type Value Manufacturer Model Number number Output (BTUH) Systemi A I4, R; . _- ,UE „ ,,780l .; f � . ,31.Ojwpv036070 2516a24206 51000 I Notes: e F><a E. Installed Cooling €gW0066nt inforr93 3 ®_.. 01 02 3 4- tat .. 0 07' 08 Condenser or Package Unit Condenser or 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) System 1 SEER 14.000 bryant 124ans036-a 2416x89851 36000 3.0 Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09=16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated 2016-09-16 14:02:29 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CFZR-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 3 of 8)_ E. Installed Cooling Equipment information 01 02 03 04 0-5----T 06 07 08 04 Condenser or Package Unit 06 System Identification or Name Cooling Efficiency Type Cooling Efficiency Value Condenser or Package Unit Manufacturer Condenser or Package Unit Model Number Condenser or Package Unit Serial Number System Rated Cooling Capacity at Design Conditions (BTUH) Condenser Rated Nominal Capacity (ton) Notes: _ F. Extension of Existing Duct System, Greater Than 40 Feet This section does not apply to this project. G. Installed Duct System information 01 02 03 04 05 06 07 08 09 t �` Method of Can RA3.3 SC i _. M.� �� ,� w ;� �� compliance with Airflow System br` SC tSys#errl "41duct �' , `� ��: and filter Number of Air Protocols be Identification 3: Locatidih or Ahga '. ;wgPR Duct Sppp�ly DuctReturn°Duct Return Duot grille sizing Req's Filter Devices on used to test Name i Served L°ocaion, "R'=Value Location f2Yelue in 150.0(m)13 System this system? Y 4 p ,.41, .� „�, �,.r a �3. r.r, "Y New or Unconditior ll• f7 Ene 1� ' " Un n '1' ara �' replacement System 1 Whole House R_6 1�' R 6'���' system requires 0 No attic attic HERS verified fan efficacy and airflow rate I Notes: Registration Number:316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09.16 14:02:29 Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 4 of 8 H. Installed Air Filter Device Information This section does not apply to this project. 1. Air Filter Device Requirements 01 The system shall be designed to ensure that all recirculated air and all outdoor air supplied to the occupiable space is filtered before passing through the system's thermal conditioning components. The system shall be designed to accommodate the clean -filter pressure drop imposed by the system air filter device(s). The design airflow rate and maximum allowable clean -filter pressure drop at the design airflow rate applicable to each air filter device shall be determined, and all system air filter device locations shall be 02 labeled to disclose the applicable design airflow rate and the maximum allowable clean -filter pressure drop. The labels shall be permanently affixed to the air filter device, readily legible, and visible to a person replacing the air filter media, and the air filter devices shall be provided with air filter media that conforms to these determined or labeled maximum allowable clean -filter pressure drop values as ratedusing AHRI Standard 680. 03 All system air filter devices shall be located and installed in such a manner as to allow access and regular service by the system owner. 04 The system shall be provided with air filter media having a designated efficiency equal to or greater than ME'RV 6 when tested in accordance with ASHRAE Standard 52.2, or a particle size efficiency rating equal to or greater than 50 percent in the 3.0 to10 micron range when tested in accordance with AHRi Standard 680. 05 The syst o?` }I" all be pravid'ed withfir filtel,m dia`i hat�las !been I bel d Icy the mahitifacturer to "di' se the efficiency and pressure drop ratings that conform to the required'f(iciency and pressurer'op requir�mer�tsfor the air fi'l`er dvlcr': "'� ,�q i. . e � The responsible e`rsons signatur6 on this." onr►phnce ddc0rrtientfF(rms thai ' m all appicab le requirements th�s,table have been met. i , U.S.Energy Raters Association Registration Number; 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1.007 4 t CERTIFICATE OF INSTALLATION CFZR-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 5 of 8 ) J. HERS Verification Requirements 01 02 03 04 05 06 07 08 09 10 4 MCH2O MCH21 MCH22 MCH23 MCH25 MCH28 U.S. Eneirgy Raters Association Exemption from Minimum Exemption R -Value for AHU System SC System 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 (W/cfm) (dm/ton) Charge Table 150.0-C or D System 1 Whole House No exemptions. Yes No Exemption No Yes Yes No No Notes: Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1:007 fii j x yN rk� Ori 4 U.S. Eneirgy Raters Association Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1:007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 6 of 8 ) 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 may be exempt from these requirements. Heating Equipment Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency 01 Regulations. Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant 02 to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(i), 110.2(b). 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 03 150.0(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 light. Section 110.5 and Section 110.2(d). Cooling Equipment Eur mens Eff it .' cienc All olingequipmentmust meet the min y q q �p � y Im` m efl`icrenc re urreFnents of Se i"tic�q{ 1101 and Section 110.2(a) and the Appliance Efficiency 06 �, Regulations l w w RefrigerantLiriYe Insulation 'All refrigerant line rlisul�tion m split systemhair conclklpjrr�rs and hxeat pit,mp meet the R -value and protection requirements of Section 07 ,must 150.0(1)2 and 3, dl Sectirbn 15>j Q(rti)9 `+ iii' 08 Condensing Unit Location: Condensing units shall n b ala c� fi iri if ipe � t f , d hh 1 ;'" rd' ction 150.0(h)3A. 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 09 150.0(h)1 and 2. Air Distribution System Ducts, Plenums and Fans 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 10 required by the prescriptive or performance requirements. See Section 150.0(m)1. Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1.007 r CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 7 of 8 ) 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 installedequipment or portions of the system that are altered. Existing equipment may be exempt from these requirements. 11 Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0, 602.0, 603.0, 604.0, 605.0 and ANSIJSMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference Residential Appendix RA3.1.4.3,8. Heat Pump Thermostat 12 A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c). 13 The thermostat shall be installed in accordance with the manufacturers published installation specifications 14 First stage of heating shall be assigned to heat pump heating. 15 Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met. The responsible person signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 . Schema Version: 2013.1.007 ! : l: {s YG I r\r \ 'f 4"k .S., Energy Raters Association Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 . Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 8 of 8 Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature M evj Terrence Kurns Company: Kubro 77 qm Signature Date: z e Construction 2016-09-16 -J * ,. °..' Address: CEA/ HERS Certification Identification (if applicable): 658 Arbutus Ave Apt 3 960307 City/State/Zip: Phones Sunnyvale CA 94086 4088395800 Responsible Person'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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer); otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewgd-a• cgpy of the fwertifjr�-ate of Compliance approved,by-the..enforcementr agency-that,ldentifie$ the specific requirements for the scope of construction or installation identified on this Certificate of Instaliatian apd I have ensures) that the repulrgrp00ts,,hat 4pplyto tho cortsYruction or rns>a1lat�ph iave'been met 5. I will ensure t( at a registe #e4,41) oftfals Certificate f Instellatt n shall be posted, os made available,wit�i{the buildirSg,pe' mit(s)issued for the building, and made available to the enforcement agency for all apphcabl m pections. I uraderstanc that Yegistered copy of this CertificatgQ of Install)ativ ,is regwrsdta kie included with the documentation the builder provides to the building owner occupancy, at Responsible Builder/Iame: I I i Responsible Budder/InstaII0r$Ignature: Terrence Kurns Company Name: (Installlnli5p d tfa taF'"orGelierai olttrdctviadf Builderji wnerj PosifiioCl Wttfll om an T,YIe Kubro Construction Address: U.S. - - Terrence Kurns (Sep 16, 2016) �Ba�ie'i5se i. V, ' ci a ' ' 11 658 Arbutus Ave Apt 3 960307 City/State/Zip: Phone: Date Signed: Sunnyvale CA 94086 14088395800 2016-09-16 T °'Tills d%itai signONro !s provided id otdor "cu tib doPaterlf rsf afaf� rear"sa�r^pd a�taotrltaerlt, arlrJari rtv , wayiaaallds le1stafr,r#videra esp6nsfbijyrU !za . Ulsls MMM al r Ats '' f, , , the accuracy aff#ta Prl oatilatiorl.' Registration Number: 316-A1033397A-M0124534A-0000 Registration Date/Time: 2016-09-16 14:02:04 HERS Provider: USERA CA Building Energy Efficiency Standards 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-16 14:02:29 Schema Version: 2013.1.007 41 FIL 'PAu� .W6hb . CERTIFICATE OF VERIFICATION CF R -M H-2 -H Duct Leakage Diagnostic Test (Page 1 of 3 ) Project Name; K'ubro Gunturu Enforcement Agency:. Cupertino Permit Number: B-2016-2528 Building Type from CF -111 Building Department Verified Low Leakage Ducts in Conditioned Space Dwelling Address: 1077 Milky Way City: (VLLDCS) Credit from CF1R? Zip Code: 95014 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Whole House 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space No, credit is not'taken (VLLDCS) Credit from CF1R? 05 Verified Low Leakage Air Handling Unit Credit from No, credit is not taken CF1R? 06 Duct System Compliance Category Replacement .: MCH -20d - B. Duct Lea 01 ` Condenser Nominal Cooling Capacity (ton)4 Q 02 Heating Capacity (kBtu/h) 03 Conditioned Floor Area served by this HVAC system (ft2) 04 Duct Leakage Test Condition 05 1 Duct Leakage Test Method 06 1 Leakage Factor 07IAir Handling Unit Airflow (AHUAirflow) Determination Method Energy Raters Association 51 2300 Test final Total leakage .06 Cooling system method 08 Measured AHUAirflow 0 09 Calculated Target Allowable Duct Leakage Rate (cfm) 72 10 Actual duct leakage rate from leakage test measurement 47 ;(cfm) 11 Compliance Statement: System passes leakage test Registration Number: 316-A1033397A-M2014783A-M20A Registration Date/Time: 2016-09-19 21:58:26 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 21:58:43 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF VERIFICATION - CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3 ) System was tested in its normal operation condition. No temporary taping allowed. B. Duct Leakage Diagnostic Test 12 Notes; C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage 02 testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed "position during duct leakage testing. 43 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supplyand return plenums are completely sealed. If the syst complies 11 7 th °"_ e s ethod, e s�iake fest wa on uc d n "ccordang tt�the requirements " 07 of Referen esidential ' en 3.6. Sysi rim ha omply USJ moke test ail not l e incl d in sample for S groups verifica >' , com' Verificatio` as ill app fable reu menu re met .. " 08 09 Correction Notes for this table Association r ar The responsible persons signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. D. Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 101 I Complies: All specified verification protocol requirements on this document are met. Registration Number: 316-A1033397A-M2014783A-M20A Registration Date/Time: 2016-09-19 21:58:26 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 21:58:43 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 :of 3 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Joe Novelo Date Signed: Company; California Air Duct Testers 2016-09-19 Address: CEA/ HERS Certification Identification (if applicable): 1630 Oakland Rd, Suite A205-3 410231432 City/State/Zip: Phone: San Jose CA 95131 408-824-0740 Responsible Person'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 Verification is true and correct. 2. I am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification<(responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The info, n reporte plicabi e CerYtfltat ti T Sian(C }slid Ott bmitted by tho pRoii(s) responsible for the construe it r installatro for it ., is sicledan"the�tertifrcat ufC€sm ran CSR a ( ) pprovecl�tl)e enforcement agency. S. I will ens , „ hat a regrste - py ertificate f Veri b tcatton shall posted a made available the bund ng errr€(s) issued for the building, made availab the cy forjallBz rblfls ectron�Er P q ata registere�S o bfiCCertificate of Verificati r required to .. duded vdd tate nt e b ride, rovides t h ilrld�" " �; , ner at occu�� - _ .. E Builder Or Instal I n A e �tca�� 1 � sta lion � Company Name (Installing Subcontractor, General Contractor,, or BuilderU.S. Energy Raters Association Kubro Construction Responsible Builder or Installer Name: CSLB License: Terrence Kurns 960307 HERS Provider Data Registry Information Sample Group Number (if applicable); Dwelling Test'Status in Sample Group (if applicable) 316-25746 Tested HERS Rater Information HERS Rater Company Name: California Air Duct Testers Responsible Rater Name: Joe Novelo Responsible Rater Signature: /n Q AD Responsible Rater Certification Number w/this HERS Provider: Date Signed; OE NOV[ LO (Sep t9, 2096 410231432 2016-09-19 z. "Th' s ciigr#aisi raatcsra is fare"verCed'In artier fia sec`cats t#a cdiiiont of df s regiadere aacurare tt, and in iac% fh vaJr itaapitis'ieisirafrcrn wader r€asransitsllifj� fts m� ,: �A ' t�. e:�cducacyaP.#itain�omrai`ror3:�. Registration Number: 316-A1033397A-M2014783A-M20A Registration Date/Time: 2016-09-19 21:58:26 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 21:58:43 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: Kubro Gunturu I Date Prepared: CFIR-ALT-02-E (Page 1 of 3 ) 2016-09-14 A. General Information CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF111-ALT-02 document for each dwelling unit. 01 Project Name Kubro Gunturu 02 Date Prepared 2016-09-14 03 Project Location 1077 Milky Way 04 Building Type Single family 05 CA City IstheSG; � 06 Dwelling Unit Name Gunturu Home 07 Zip Code 95014 08 Dwelling Unit Conditioned 2300 CFA served system a refrigerant Floor Area (ft2) Installing Installing Installing Number of space conditioning Location or 4'rea 09 Climate Zone 4 10 (SC) systems in this dwelling 1 entirely new entirely new unit. Seryers;' B. Space Conditioning (SC) System information 01 02 03 04 05 06 07 09 09 10 IstheSG; � lnstalling�' SC System i, SC Systems CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or 4'rea hy.tbigsc 9 ducted ;_ � , contammg , - stem more than 40 entirely new entirely new Name Seryers;' Systm(ft2 <}� sy3tem?� a components _ component#7 "- f e of,ducts7 duct system? SC system? Alteration Type \ Entirely new or System 1 Whole House 2300 a ��_ Yes Y Yes Yes Yes complete j RI Asst j j n replacement space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section1S0.2(b)1Diib) This section does not apply to this project. Registration Number: 316-A1033397A-000000000-0000 Registration Date/Time: 2016-09-14 14:47:46 HERS Provider: USERA CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-14 14:48:02 Schema Version: 0.555SDD Fes, CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) This section does not apply to this project. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia 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) 01 02 03 04 05 06 07 08 09 30 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 AFUE Central sP ht All new cooling g Setbas furnace components P .80 AC components SEER 14 motat tat R-6 Required Documentation: - CF2R-MCH-01-E-5 acgCgoditioning ystems Ducts dDd'fdn"",3 - -Duct insulation requaemept for new pIL*Dums R6 a CF2R & CF311-1VICH-20 1 Duct Leakage �4Ygicatidn required k -Leakage rate compliakit 56%.V3.,gr =r mss)' , CF2R & CF3R-MCH-22E an Efficacy Venfic Lon CF2R & CF3R-MCH-23stem Air Flow Verdiq on - -Compliance: Fan Efficacy50 awl"'and Systerlirf(pxv 5tim/ton:_ --,� -� '�, -Alternative Compliance CF�&-CFR-N1CH-28 Returh-Duct b'esign Venfication is an alternative #o MCH -22 and NCH -23 verification. Y - w, CF2R & CF3R-MCH-25-H Refrigerant Charge Verification required. when r' e t c ' iipg a �jUed ed Ica a 8-15). Exceptions: s. da� 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 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage Registration Number: 316-A1033397A-000000000-0000 Registration Date/Time: 2016-09-14 14:47:46 HERS Provider: USERA CA Building. Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-14 14:48:02 Schema Version: 0.555SDD u - CERTIFICATE OF COMPLIANCE CFiR-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -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: Joe Novelo r Signature Date: Company: California Air Duct Testers 2016-09-14 Address: CEA/ HERS Certification Identification (if applicable): 1630 Oakland Rd, Suite A205-3 410231432 City/State/Zip: Phone: San Jose CA 95131 408-824-0740 Responsible Person'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 Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. 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 California Code of Regulations. 4. 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 agencyfor approval with this building permit application. S. I will ensurethet a registered copy of this Certificate; of Compliance shall -be -made available -with the building permit(s)-issued for the building, and made available to the enforcement agency for all applicable inspecCioruc. i understand thati a 'edificar of-C9mptiaric registeredxopy ofthfis' ,is requiraio'be: ndudedwith the documeittation the builder provides to the building owner at occupancy. Responsible Designer dame: - _ Resppnsible Designer Signature: Terrence Kurns-:_ -. Torrence Ku Se 14 .201 B Company:s "' Date Signed: ,... Kubro Construction ....,,. - 201& 09-14 . Address: 658 Arbutus Ave Apt 3U.S. !,Energy License: City/State/Zip: Phone: Sunnyvale CA 94086 4088395800 BNM, TNI r U.S, Encr FS, dissoci01'sfa[3. Registration Number: 316-A1033397A-000000000-0000 CA Building Energy Efficiency Standards -2013 Residential Compliance "This digital slgnalarc is provided in order to secure tho content of thas ro9wered document and to no stay implies Registration Provider responsibflityF for the accuracy of the information:" Registration Date/Time: 2016-09-14 14:47:46 Report Version: 2013 Rev 1.007 Schema Version: 0.555SDD HERS Provider: USERA Report Generated: 2016-09-14 14:48:02 { CERTIFICATE OF INSTALLATION CF211-MCH-20-1-11 Duct Leakage Diagnostic Test (Page 1 of 3 ) Project Name: Kubro Gunturu Enforcement Agency: Cupertino Building Department Permit Number: B-2016-2528 Dwelling Address: 1077 Milky Way City: Zip Code: 95014 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Whole House 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No credit is not taken 05 Verified Low Leakage Air Handling Unit (VLLAHU) Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category Replacement 77 MCH -20d Coe Replacement gtAltered Duct System= K } r 5 B. Duct Leakagelaianst z e, "'"�,_.,,.,��'_.:� �'c'g-`'- -a'4 .:,, a-wx° f-•-- F Z,4r . a. .[-„ �, s �Y = 01 Condenser Nominal Cooling Capacity (ton) U.S.Energy Raters Association 02 Heating Capacity (kBtu/h) 51.00 03 Conditioned Floor Area served by this HVAC system (ft2) 2300 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor .06 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow 0 09 Calculated Target Allowable Duct Leakage (cfm) 72 10 Actual duct leakage rate from leakage test measurement (cfm) 47 11 Compliance Statement System passes leakage test Registration Number: 316-A1033397A-M201763BA-0000 Registration Date/Time: 2016-09-19 11:35:11 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 11:35:20 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF INSTALLATION CF2R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3 C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage 02 testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 if cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. A, If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the 07 requirements of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification compliance. The responsible persons signature on this ccmnpl[ance document arms that attapp)Icaile iequirementsln this table have been met. i r I 9111111111111!1111111l �. Registration Number:316-A1033397A-M2017638A-0000 Registration Date/Time: 2016-09-19 11:35:11 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 11:35:20 2013 Residential Compliance Schema Version: 2013.1.007 A, I 9111111111111!1111111l �. Registration Number:316-A1033397A-M2017638A-0000 Registration Date/Time: 2016-09-19 11:35:11 HERS Provider: USERA CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-09-19 11:35:20 2013 Residential Compliance Schema Version: 2013.1.007 Sint: 1974 -FTR4'0'NTY INSUUTION Acoustical Contractors A DWIsion of StateMde Insulation. Inc. * Uc. No. 632052 Post Office 2176 - Santa Cruz, CA 95OSS StatMide; 1-800-2-INSIA8 0 (830475-2205 -Fax, (8Z475-8243 RP.4tiOnM6i IVSIIIATION PrUTICIPATIC ,NUMBER & STREET 10500 Castine Ave - CITY Cupertino, CA 95014 COUNTY Santa Clara County CUSTOMER/CONTRACTOR. Timeline Design TCI JOB # 5120522 DATE OF COMPLETION: July 2016 0 AREA Attic MATERIAL Fiberglass Batts THICKNESS -INCHES- 9.5 BRAND NAME . Owens Coming THERMAL RESISTANCE ...... . R -VALUE (FINAL) R30 SQFT . ..... (FINAL) 668 Exterior Walls Fiberglass Batts 3.5 Owens Corning R13 646 Entire Sub Floor Open Coll Spray Foam 5.5 SVID R19 2377 FOAM CAULKING COMPLETED: YES DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations saffina Fnprnit rnmanimfinn General Contractor (guilder) 'Ila v0111jullltd murninisirau code L;oae Signature and Title License # Date Sub -Contractor (insulation AppFlc_,000ig�nature-�Stephen�K.Gies�ekeJr.���— License —# Date Trl-.County Insulation -7(4�Z 632052 9-13-2016 Title:sti�ator THIS CERTIFICATE S14ALI r A" .. .-..V. I cm IN A (_V1VW'1E;UUUS PLACE WITHIN THE BUILDING BEFORE FINAL BUILDING INSPECTION WILL BE MADE.