B-2016-2835CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2835
21721 GRANADAAVE CUPERTINO, CA 95014 (357 17 113) ON-TIME AIR
CONDITIONING &
HEATING INC
PLEASANTON,CA
94588
OWNER'S NAME: CIARDELLA CHRIS AAND DEBORAH A TRUSTEE I I DATE ISSUED: 09/29/2016 1
OWNER'S PHONE: 408-390-3100
LICENSED CONTRACTOR'S DECLARATION
License Class C_ -M Lic. #1317040
Contractor ON-TIME AIR CONDITIONING & HEATING INC Date 09/30/2017
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. I have and will maintain a certificate of consent to self -insure for Worker's
Co pensation, as provided for by Section 3700 of the Labor Code, for the
rfoimance of the work for which this permit is issued.
PIPhave 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 Cupertinp`Municipal Code, Section 9.18.
Date 9/29/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 1, 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)
z. 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. 1 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. 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.
PPI NT 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 9/29/2016
PHONE NO: (925) 444 4444
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
X MECH X RESIDENTIAL COMMERCIAL
JOB DESCRIPTION:
REPLACE HEAT PUMP AND AIR HANDLER (SAME LOCATION)
Ft Floor Area: I Valuation: $9195.00
"N Number: Occupancy Type:
357 17 113
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: AbbAyendg
Date: 09/29/2016
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: 9/29/201
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, hapter 9.12 and
the Health & Safety Code, Sections 25505, 2553 d 25534.
Owner or authorized agent:
Date: 9/29/2016
CONSTRUCTION LENDING 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
I understand my plans shall be used as public records.
Licensed
GENERAL PERMIT APPLICATIONMEP
CON/iMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
0300 TORRE AVENUE • CUPER T INO, CA 95014-3255
CUPITRT(Nf7 (408) 777-3228 • FAX (408) 777-3333 • building(E),cuoerino.org misc
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By any signature below, I certify to each of the follov t -ng: I -n-h- p ope: jy owner or authorized agent to act on the property ov tier's begalf. I have read this
application and the information I have provided is c -ect. I have r d the Description of ��'ork and v ii ' It Is accurate. I a_T ee'io comply with all applicable local
ordinances and tz ]F.ws relatmQ to build' _ 'c -4n. I auth rite representatives of Cupci ino to ezterthe above-idena-ied proper y for inspection purposes.
Signature of pphcanr' ,gent: Date:
SUPPtF?\1ENTA INFOR1\4 TION REQUIRED
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L_ CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
CHRIS CIARDELLA ( Date Prepared:
CF1R-ALT 02-E
(Page Iof3)
2016-09-28
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 CFIR-ALT-02 document for each dwelling unit.
01
Project Name
CHRIS CIARDELLA
02
Date Prepared
2016-09-28
03
Project Location
21721 GRANADA AVENUE
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
CHRIS CIARDELLA
OI
Zip Code
95014
08
Dwelling Unit Conditioned
.,
g a
tt���f
F-03 X * .14'x+.
� -"p
M10 '$.fi.,,+
Floor Area (M)1200
SCS stem
Y
SC System
Y
CFA served
" ��Osst m a I
nY
refraler ht i
g,
Number of space conditioning
k( I hst lling�
09
Climate Zone
4
10
(SC) systems in this dwelling
1
ducted
containing
tk.
system
more than 40
unit.
4
entirely new
B. Space Conditioning SCS stem Information swW �r��
W
01
02
03
04sn
rs`
t
06 ap
07` 3
dB
�� 09
10
X05
P , ��
��,
.. �s
the
.,
g a
tt���f
F-03 X * .14'x+.
� -"p
M10 '$.fi.,,+
SCS stem
Y
SC System
Y
CFA served
" ��Osst m a I
nY
refraler ht i
g,
Installing nevtS f
k( I hst lling�
�I�nstalli-'—
" fns to lli ng
Identification or
Location or Area
by this SC
ducted
containing
tk.
system
more than 40
z
entirely new
4
entirely new
Name
Served
System (ft2)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
System 1
Location 1
1200
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-A0357754A-000000000-0000
Registration Date/Time: 2016-09-28 12:14:52
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 12:14:53
Crhomo %1—;— n CCCCrNr%
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
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)
.. f�,�, .� 4 ti '�,{,�`u,�.,"'}.,'.. ��
� �ir�r e ��
...
01
02
03
04
05
06
07
08
09
10
11
12
Heating
Cooling
System
Heating
Altered
Heating
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
Central split
All new
Central split
All new
Less than or
System 1
HP
heating
AFUE
80
HP
cooling
SEER
14
Setback
equal to 40
R-6
components
components
feet
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%, or 510% leakage to outside, or seal all accessible leaks.
CF2R-MCH-25-H & CF311-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.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt from MCH, 20 Duct Leakage Testing requirements 4 m
of 'Cha
-Heating-only systems and Air Handler/Furnace changes do not require verificatlb;n Air Flow MCH 23 <<br Refnge an ge IV( CH 25 ,4
-Existing duct systems constructed, insulated or sealed with asbestos,are exemoffrom MCH-20tDuct Leakage Test rig,requirerpgnts
x)",I+ w; ".�y 39 urs '� 4,5`I + ` a1s ."+' „ iai '§1M. a<7t+1�a, ;.� P G6 k 4 hk4 a t' T�tS�v'
E. Entirely New or Complete Replacement Duc 1,ystem, with or vinthout Equipment Ghangeout (Sections 150 2(b)1Dua and,, 50.2(b)1E, F)
r n. tra<wm. gg J;�,
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-A0357754A-000000000-0000 Registration Date/Time: 2016-09-28 12:14:52 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008 Report Generated: 2016-09-28 12:14:53
Crhemn verci- n E�rScnn
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. l certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: �-77��
W Q000P/%?i
Queen, Drew
oUW
Company:
Signature Date:
i PERMIT E RATERS
2016-09-28 12:14:52
Address:
CEA/ HERS Certification Identification (if applicable):
31225 La Baya Drive #213
City/State/Zip:
Phone:
West Lake Village CA 91362
818-735-7876
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 ppnufacctu ed 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 Re ulaii ns. `fi " rn N' + `
w^ � b`po
4. The building design features or system design features identified on this Certificate of Cr mpfiance are Cn s steh kith the i formatLongprovided orlgw othe w'ap�hcab�le Compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement" for approval W+tha EN
this bmldmg perr�rt ap{licatiol. +r
5. 1 will ensure that a registered copy of this Certific�ate;bfCpm fiance di 11 be ma a �1ail` ble witkl the b it ,ri ermit s issued fonlh buil i and maa available o3fih enforcement agency for all applicable
p U, g P (:) drg g PP
inspections. i understand that a registered copy of th+sCrtficate of Compltanceis required toe�induded wh the,documer�tation �the�bCidder pkv des tome building owner at occupancy,
Responsible Designer Name: �;¢. t `�R _5
Al
Respon5iiiile Designer Signature.1�y 1' '111a
Queen, Drew
oLJW8w
Company:
Date Signed:
ON-TIME AIR CONDITIONING & HEATING INC dba SERVICE CHAMPIONS
2016-09-28 12:14:52
Address:
License:
7020 COMMERCE DR
817040
City/State/Zip:
Phone:
PLEASANTON CA 94588
925-598-1911
Digitally signed by CaICERTS. 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-A0357754A-000000000-0000 Registration Date/Time: 2016-09-28 12:14:52 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.008
Crhoma Vorcinn- 0 rgrrnn
Report Generated: 2016-09-28 12:14:53
1
- . � Gl1P�Ei,TINQ
COMMUNITY DEVELOPMENT DEPARTMENT ♦ BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building ancuperHno.orq
E
W
. . t'a'r �t✓t.y' ,: -
PERMIfi.CANI OT I3E;FIl�IALED ANIi COWLETED <UNM THIS.0 TI `I ATE
HAS BEEj�,�' l AI' D ItF THI'; 33 3NO STON
AMC
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 wher no interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon
Monoxide alarms. When the valuation of additions, alterations, or repairs to existing c welling units exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smokelarms and/or Carbon
Monoxide Alarms be installed in the following locations:
AREA
SMOKE ALA
M
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each sleeping room
X
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-buriiing appliances and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with
CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated.
Ili existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result h -i the removal of wall and ceiling finishes or there is no access by means of ttic, basement or crawl
space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for
alarms which must be connected to the building wiring.
As owner of the above -referenced property,. I hereby certify that the alarm(s) referenced above has/have been
installed in accordance with the manufacturer's instructions and in compliance with the California
BlilldlLlg
and California Residential Codes. The alarms -have been tested and are operational, as: of the date signed
below.
I have read and agree to comply with the terms and
of this
Smoke qnd CO form.doc revised 03/18/14
its
CUPERTINO
OwnerNamef �IY-Rk
Address
[417,74,111 ]AZINIA :A C11114-I.Al 1:001aliel 1,, 1101 INN YA-1-1
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - bui(dingCa)-cupertino.oM
=I I
1. Is your real property a registered historical site?
n Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sin bottom of form.
Id 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?
11 Yes Civil Code Sections 1101.1 through 1101.8 donot apply.
0 The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of fonn.
No Go to Question 3.
V9
3. Is water service permanently disconnected for your building?
F! Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
El No My real property is built and available for use or occupancy after January 1, 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 1,1.994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. P ease check ONE of the following:
My property is a sing-le-farnity residential real property. See Civil Code Section, 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-compli�nt plumbing fixtures
to be replaced with, water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
't
propeny undergoes alterations or improvements).
0 My 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- co�plia-nt
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January t, 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).
D Myproperty 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- c�mpliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures. I
On or before- January 1, 2019', all non-compliant plumbing fixtures shall• be replaced with water- conserving
plumbing fixturesr throughout the building (regardless of whether property undergoes alterations or improvements).
i
1, as. the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.9, the current California Plumbing Code and California Green Building Standard's Cod-
nts as indicated in the
, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirein
table on the following. page. A,-
OwrTer or Owner. Agenfs. Signature:, . V�,- 0f,-
Uipon- completing and signing this Certificate, please return it to the Building Division in order to finall your building permit.
i
S�407 2015.doc revised 08126115