B-2016-2694CITY OF CUPERTINO $UI
DING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2694
7495 HEATHERWOOD DR CUPERTINO, CA 95014-5823 (359 26 050)
QU
S ELECTRICAL
CO
CUPE
TINO, CA 95014
OWNER'S NAME: NORDYKE WARREN T AND LYNN C TRUSTEE
DATE ISSUED: 09/12/2016
OWNER'S PHONE: 408-316-1474
PHONE NO: (408) 529-0854 '
LICENSED ONT A TOR' DECLARATION
BUILDING
PERNHT INFO:
License Class C-1 07C-20 Lie. #706512
Contractor C]UAN'S ELECTRICAL CO Date 05/31/2017
X BLI
IG _ ELECT _ PLUMB
I hereby affirm that I am licensed. under the provisions of Chapter 9 (commencing
X MEH
X RESIDENTIAL _ COMAJ ERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB
ESCRIPTION:
RELOATE
FURNACE TO ATTIC
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
%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.
Sq. Ft I
400,r Area:
Valuation: $8000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN N
umber:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
359 26
50
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
PE
T EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
THIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cupertino Municipal Code, Section 9.18.
180
DAYS FROM LAST CALLED INSPECTION.
Signature Date 12/2016
Issue
by: AbbyAyettde
OWNER -B M,D .R DE L RATION
Date:
9/12/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RF -ROOFS:
following two reasons:
All roofs
shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole
installed
without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work .and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature
of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code),
Date:
6
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance, as provided for by
I hai
a 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
Cal
forma Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
mainti
in compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. 1 certify that in the performance of the work for which this permit is issued, I
Hea
Ith & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
material.
Additionally, should I use equipment or devices which emit hazardous
air coi
taminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will in;
intain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25539.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
c6ner
or authorized agent:
APPLICANT CERTIFICATION
Date:
1 certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
1 hereby
affirm that there is a construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of wor
's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lende
's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lende
's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 undei
stand my pians shall be used as public records.
Licen
ed
Signature Date 9/12/2016
9
Profs
signal
GENERAL PERMIT APPLICATIONMEP
COMMUNITY DEVELOPMiENT DEPARTMENT BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
GUP;=RTfNC? (408) 777-3228 • FAX (408) 777=3333 buildingi1cupertino.org
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USE OF ❑ SFD O, DliPLEX ❑ I TIULT1-FAMILY PROJECT L\ \V I DLAI.'D ❑ AS
BLILDLIG: ❑CONi14ERCLAL URBANNT'ERFACEAREA ❑ -.N'o
PROJECT. LN ❑ YES
FLOOD ZONE ❑. NO
IS THE BLDG .AN ❑ vES
EICHLERHOME? ❑ NO
DESCRIPTION OFWORK
TOTAL VALUATION:
VED Bl x;
By my signature below, I cerify to each of the folloN ing: I am the property owner or autho
application and the information I have provided is colTTett. I have read the Description of «
ordinances and state laws relating to building construction. I authorize representatives of Cu
Signature of Applicant°.gent:
' ed agent to act on the property owner's behalf. I have read this
rk and verif}+ it is accurate. I agree to comply with all applicable local
ertLio to enter the above -identified grope, for spection purposes.
Date:
SUPPLE.MENTAL INFORAdATION REQUIRED::.
_.:: OFFiCE LSE'O1tL�....: F_? .._..•.._, ,:
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- EPA%isc,5pp_2011.doc revised 06/21/11
<41
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CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
I Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3 )
Project Name: Lynn Nordyke I Date Prepared:
2016-09-11 I
A. General Information
CFIR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one CFIR-ALT 02 document for each dwelling unit.
01 Project Name Lynn Nordyke 02 Date Prepared 2016-09-11
03 Project Location 7495 Heatherwood dr 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name Lynn Nordyke
07 Zip Code 95014 08 'Dwelling Unit Conditioned 2169
Floor Area (ft2)
Number of space conditioning
unit.
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
ME
%s
+^r'y"'„ s r
It4e
)ristallria`.
SC System
� SC Sys " 6
�,:fA server
►stem a
refrigerht
Instalig n
talling
Installing
Installing
Identification o
ocation E" ea
�` ' t �,
ducted =
contai# iri
rstem
more,than 40
entirely new
entirely new
Name
Sery
Sy
system?"; '
° compone
ccmponentspt{of
ducts?
duct system?
SC system?
Alteration Type
Entirely new or
S
complete
System 1
whole house
2169
Ye
Eb
r'
Y
t ;rs Asso(
Y s
)f
Yes
Yes
replacement space
u u
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: 316-A1033404A-000000000-0000Registration Date/Time: 2016-09-11 18:43:38 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-09-11 18:43:42
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -111 -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
10
11
Heating
Cooling
Efficiency
Required
Thermostat
New Duct
System
Identification or
Heating System
Altered Heating
--Heating—
Efficiency
Minimum
Efficiency
Cooling
Altered Cooling
Efficiency
Name
Type
Component
Type
Value
System Type
Component
Type
Value
Type
R -Value
Central gas
All new heating
No cooling
SetbackTher
System 1
AFUE
78
No cooling
SEER
14
R-6
furnace
components
component altered
mostat
Required Documentation:�.
'{d R �'3� A
CF2R-MCH-01 E Spa4 ndM-111ng S tns Du
-Duct insulation requi' ntfor new p ms:
Cf2R & CF3R-MCH 20 ; cation
�ctLeakage
-Leakage rate complia
gjF
�'
CF2R & CF3R-MCH-22 . fficacy Ver i n
y '�
CF2R&CF3R-MCH-23 AirflowVerif' ions
-Compliance: Fan Effic` d Sys
°)•
- Alternative Compliance: C MCH -28 Retur - esign Verl
4"ve'toih&-22 and t kk vekia"tion.
CF2R & CF311-MCH-25-11 Refrigerant Charge Verification required when
refrilge t cei
N
Exceotions:6
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-A1033404A-000000000-0000 I Registration Date/Time: 2016-09-11 15:43:38 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version:, 2013 Rev 1.007 Report Generated: 2016-09-11 18:43:42
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:yl
Hien Truong
w
}-
tAl
Company:
}
Signature Date:
Quan's Electrical
2016-09-11
Address:
CEA/ HERS Certification Identification (if applicable):
10628. Randy Lane
706512
City/State/Zip:
Phone:
Cupertino CA 95014
408-529-0854
Responsible Person's Declaration statement
certify the following under penalty ot 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 agency for approval with this building permit application.
S. i will ensu(,. t a registered copy of this Celt e,.of Complianees(tallibe Inaditi avarlable wJtPubhe-4uilding permits) isst d for the building, and made available to the enforcement agency for all applicable
N' P,� `,4+
Al 1 4 f ,,, , a
inspection nderstand tl at regis r t) copy of t erbfi ate of Obiti pllarlee is regi aped to beirtcliit(e` with the doculnr�tatation the builder provides to the building owner at occupancy.
Responsible Designer ? .
Respoll:�ible Des iprSi'gnt4lre:
F
Hien Truong , �,
, J { /�Nie�lOti
-„i
Hi Truono e 'I I 01
Company :
Company
Signed
Qu Eb
2Ci 09
„,E.. .
AddressrLicense:
10628 Randy Lane U.S. nen a
ssiocia io
City/State/Zip:
phone:
Cupertino CA 95014
408-529-0854
US” '",?Tris da�il P su0-no' Ns prcrvadeel #rl ow er fa seceia
t tied content aftrris rey,s#ei`Cli�curaaeat area %no
W.
impiids i�epistratiarr 'rbvider rssparasr`br"arty for
tf1e accura::cy ofthe Jnalonaraticrn."
Y t AW001011013
Registration Number: 316-A1033404A-000000000-0000 Registration Date/Time: 2016-09-11 18:43:38 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version. 2013 Rev 1.007 Report Generated'. 2016-09-11 18:43:42
Schema Version: 0.555SDD