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15080085Ikx CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10364 STERLING BLVD CONTRACTOR: WELKIN PERMIT NO: 15080085 INTERNATIONAL IND INC OWNER'S NAME: HAPPY OCEAN LLC, ET AL 20731 HANFORD DR DATE ISSUED: 11/13/2015 OWNER'S PHONE: 5103645343 CUPERTINO, CA 95014 PHONE NO: (408) 888-9096 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL CONSTRUCT (1) 2 STORY SFD (2,036 S.F.) WITH # License Class1, ATTACHED GARAGE (438 S.F.) yLie. Contractor Ue�1\�� f 1 Date 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: 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 Sq. Ft Floor Area: Valuation: $375000 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 APN Number: 37524010.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITMN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. Signature Date (� 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address _ 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CCUPERTINO 1/I N/EW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(U-)cuaertino.org /50900&—s ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS / : 1"N# V $- O C OWNER NAME / /� PHONE � E-MAIL34A �%- ISI�ff STREET ADDRESS / / J •• %+ 1 rrY, STATE, Z'n FAX 7' �yyf v 1 CONTACT NAME / PHONED & - 3U, E-MAIL � ) ^ Q� v -2- STREET ADDRESS f 1 p� CITY, STATE, ZIP !A p FAX 121L ❑ OWNER ❑ OWNER -BUILDER I OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n . /�. (� v LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONF ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC# COMPANY NAME Gd/t/ % E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK + / L5 P"5i /J NO 8 S Fs !� a l� sFn s2 ;l- EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES �� ►^ J� -(/ USE TYPE OCC. SQ.FT. VALUATION ($) WO -S NEW FLOOR " �d REA 6 DEMO 7 q TOTAL NET AREA ` _. �6 BATHROOM KITCHEN ER REMODEL AREA o A REMODEL AREA 0 REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH LO-ATTAC. # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? 9 0 ADDITION? (.I O /"❑ PRE -APPLICATION YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES TO A ATION: PLANNING APPL # ❑ NO PJ C ENG ..f APPROV L ER EICHLER HOME? /• ;J,NO /' ) By my signature below, I certify to each of the following: I am the property owner or autho to act on th owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and v ' ccurate. I agree to comply with all applicable local ordinances and state laws relating t building construction. I authorize representatives of Cupertino to enter the above-identifid propelyfor inspection purposes. Signature of Applicant/Agent: I _ Date}C SUPPLEMENA1 INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for ' existing building(s). Demolition permit is required prior to issuance of building ` permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD El PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT —Copy of Planning Approval Letter or Meeting with Planning prior to ElMAJOR ❑ SANITARY SEWER DISTRIC-1 submittal of Building Permit application. ❑ I?n1'IRONMENTAL HEALTH B1dgApp_201 Ldoc revised 06/21/11 C--64 ."W FM_7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10364 STERLING BLVD DATE: 08/11/2015 REVIEWED BY: MELISSA PC FEE ID APN: 375 24 010 BP#: `VALUATION: $375,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: SFD or Duplex 2nd Unit? Yes No PENTAMATION PERMIT TYPE: 1 R3SFD A WORK CONSTRUCT N 2 STORY SFD (2,036 S.F. WITH ATTACHED GARAGE 438 S.F. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 2,474 $2,963.45 IR3PLNCK $2,774.65 1R31NSP $0.00 PME Plan Check: $0.00 Permit Fee: $2,774.65 Suppl. Insp. Fee.e Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 2,474 $2,963.45 Construction Tax: IBCONSTAXR $2,774.65 # ne unitws NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 EJf' 711.%131 h, I'lan Check Plrunb. Plus (7„ iec_ Plan Check .L/C.- I'lurr,h ' F,lae. Permit 1•,, Other Heck Insp - ?ricer 1'/umb Insp, Li other 1.1ec. Itisp. ET ;Vlach. Insp. Fee. Phanb. lisp. Fee: Elec. Insp. Fee. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the Dreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 EJf' 711.%131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,963.45 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. © OT F0,0 I hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,774.65 Suppl. Insp. Fee.e Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 # ne unitws $684.98 J: O O Work Without Permit? o Yes O No $0.00 Advanced Planning Fee: 1PLLONGR $346.36 Select a Non -Residential Building or Structure E) O i 1'ravel Docutnenlwiorr Fees: Strong Motion Fee: 1BSEISMICR $48.75 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $15.00 SUBTOTALS: $6,833.19 $0.00 TOTAL FEE: 1 $6,833.19 Revised: 07/02/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: p PERMIT # OWNER'S NAME: PHONE # 40e GENERAL CONTRACTOR: WA4 &7taj4a4j&j BUSINESS LICENSE `# -;2LtO k ADDRESS: CITY/ZIPCODE: Pdo h, *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature ,'l 17 b olG Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing rS4x-tyS 62ual,eu ox. . 1 Wfi Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper V Paving Cr,Sau�S Qua !� Lex v Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature ,'l 17 b olG Date CUPERTINO PURPOSE UTILITY RELEASE REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building(&cupertino.ora For residential single family or duplex construction, there are cases where gas and electric utilities are requested to be released prior to the issuance of the certificate of occupancy. Upon approval from the building inspector, the City of Cupertino is allowing both utilities to be released prior to the final sign -off of the building. INSTRUCTIONS 1. Download this form at: http://www.cupertino.org/index.aspx?page=297. 2. Complete the form and obtain signatures from both the owner of the property and the primary contractor. 3. Fax, E -Mail, Mail or hand deliver the original signed form to: City of Cupertino Building Division Attn: Utility Release Request Form 408-777-3228 office 10300 Torre Ave. 408-777-3333 fax Cupertino, CA 95014 building@cupertino.org 4. Schedule a Gas Meter Release inspection (#403) and/or Electric Meter Release inspection (#404). Please note, a Gas Test inspection (#506) is required prior to or at the same time of the Gas Meter Release inspection. BUILDING INFORMATION (Please complete the following information): APN BLDG PERMIT #: __7DAT E: D� 00 5 :7 -c SITE ADDRESS: �(i Lf r OWNER'S NAME: PHONE #: n:. FAX M MAILING ADDRESS (if different from site address): CONTRACTOR:PHONE #: ` ;;; C v�:>: , l L"ri'KI b FAX M CONTACT: '�,1 PHONE #: - ;- "'' . FAX I request the City to release my utilities prior to obtaining a final inspection approval for the building. I fully understand the occupants of the building cannot move into the residence until they receive all of the required final sign -offs and the City has issued a certificate of occupancv for the buildinq. J v� Sheng Dong/Happy Ocean LLC Date:.......07/20/2016 Owner: .........................../...................................Print:.......................................... Contractor:......:/!/ IL ..............................................Print:..... X�di ....t .......Date%.71}` k�L�l.. 1 UrilityReleaseForm_2011.doc revised 08/09/11 Project Name: Project Address: Project Description: / -5 o k)r", g�_� CALGREEN SIGNATURE DECLARATIONS Mr. Victor Donq Residence Rebuild 10364 Sterling Blvd., Cupertino, CA 95014-3867 To build a new 2 -story house 2,477 square footage SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 - "Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Mr. Victor Dong Owner's Name (Please Print) Design Professional's Signature Mr. Jack Lin Design Professional's Name (Please Print) Signature of License Professional responsible for CalGreen compliance Mr. Jack Lin Name of License Professional responsible for CalGreen compliance (Please Print) fu333@yahoo.com _ Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Date Date Date 408-218-0587' Phone Complete. sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed In accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. -- 09406T_ -- -- - 09-20-16_ Signature of License Professional responsible for CalGreen compliance nate Jack Lin 408-218-0587 Name of License Professional responsible for CalGreen compliance (Please Print) Phcnc jack@rcusa88.com Email Address for License Professional responsible for CalGreen compliance Parr 5 of 5 CalGreen 201 a.dw revised hl '15'14 CALGREEN RE5I1)ENIIAL CHECKLIST -MANDATORY ITEMS wRPoaE: TSI xolB CRWLwn CudW eppaasba8 r.yeman,Fra HIOYIE WOYb�blB�y IN„ �w. neaNy.. MatMbm. cRH10oHriNIAHr. Ylaaae �memyrAs, aeluyu eary.Ixna,Y p�M Iw,.]+W ue use. Es!N ara rtnY+Wq uwe.rmrSaYW ae,.. dNm.x.fs;..LN re Mauol�bN reRH+remalb a CAL— F,_ ALG,eot F„ Nen _ Mr. VICta Dong Retitlen a Rebuild PA Amrur 103645 g B.W Cupertiro, CA 95014-3887 FmeM DW,. To buBd a new 2 -story hams 2,477 sgLAB B footage Ne Oeme a N.e Ox]w'a qeM Md nnAby a lieennetl PObrbnN elma,latceU wAn Vle CNAtNnM �e,.Iue snnaNRe caer b yanN Am rwn mm a nau..o+n,p a..nW.a ne.n �. I.LWHN ylRl am ntala�RnWe F x >.ae,n ma syn rIb Bale aeceen 3 - LH.Frm.mWrm Ven FdrpMM b.mt ro e,! PuAWy �ym"� Ceasnn3 NIANDATONY FEATUREOR MEASURE A4.1 PLANNING AND DES�GN PHWk<a Vrdautlon .HIrlNrrr ' .B a..AWN— .,.,ac.eeew.ereuroa.w.ert A Prtr A43 WATE; E; AND CONSERVATION v,r ar.eloaea eW+•er,rmmsmN.rA wm ® ❑ —No P.,..PAW, o.aTNe Me vel HPb..a a,a.>awmrb PAW, w cmuis.nowW�w ®�.. lb.�� i.t aitlw.'Arlw ar bn baR. Ann Plea NdI1Pn WmIMrNm InWetnn urandR+i. A4.2 ENERGY EFFICIENCY -, RJIKIEARW,NbndIHt IImIIYYeuWYtrlAWeeeW POLYMER «aylraWae ® ❑ A43 WATE; E; AND CONSERVATION v,r b0`•,eans,r.Ma.rnMlwmmtw.R mM+o .c uv� ••.. .... ur.-o, l.Ya_1rNi ee_aity leve, v Nw�l ...a.. �. � e MleMNpuMrE+rl ler NW,R NNltlbnwa Pa]Ma NbW,yalnoONaJ (3wrWee.FRHo,..ema,n.Imbn NMAb,.-TNN:A.. ® ❑ �i.t aitlw.'Arlw ar bn baR. Ann Plea NdI1Pn WmIMrNm InWetnn urandR+i. ® ❑ ® - (3 ktlIm1AA11 ua3PA.,uIRaW.ea tMnW ae.a.d,M,mD eaapaB.R.r uro +�e..IwTaroe,,:r.nces..vMrb.lalM�+ Oatyaer WsaaOarN UaalPrBeYeRIWNMIAYaNebE ,ply OHa U4aIN maOla6'. I E.t.p4n_br ad M1eN qln HWlur rlyrBgr AUd YeyWle o, ® ❑ mlem. ®a.,R c rcu ao n1.ea D I P eo..Nmn J Shea Meoy ANmn49 rMRmrA audlybACG 865 NWHm S) Mepirebnl A4.4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY P.NL IQDLSIel1__�><ti RW'w4cY �tw a�rw -' f � rv. N,.NA1 Je10WWe AWWL AnWlraeecr erouN npr, Ntyc ® ❑ y.lI u.oswarvamnMrNcw�w�l.ry awr..alHyP dtrrerB PPIAaM bIN..Mewy.BWN] ❑ — nFrM Wa enAMFMPgrrbNMIN, ® ❑ tlHVAC eyNemA. 4450AA FRY W esRan a bP Ares nPMnO MMM NaanA4 Mw Donny Mai Tr Lural RebANOlN rramealAb Lary CALF aH•rtle,w ® ❑ ® r yeWr rb Nwreronree a,grtuFroasaplF aryFpd ® ❑ eM.A,A]. as bepea! is i,4�n fns sYNembi a,W ArlbbnrobN�VJ. ® ❑ pfywnO �sE n MSnfe o Oa ofanpaexr MN CALhas,nry m1N mar�m N. a..,.. gWiEcAwn.H W,cenXrnbn F _<.rq ay .aver mevb ® ❑ BatreuOmR,Mlerx alta Fpsr�nnabnd Nl yu en eW..Re.Iva TIMI nePePnan yRara. ® ❑ A4.2 ENERGY EFFICIENCY -, 7tCIE;CY n ❑ A43 WATE; E; AND CONSERVATION v,r b0`•,eans,r.Ma.rnMlwmmtw.R mM+o .c uv� ••.. .... ur.-o, l.Ya_1rNi ee_aity leve, v Nw�l ...a.. �. � e ❑ NbW,yalnoONaJ (3wrWee.FRHo,..ema,n.Imbn NMAb,.-TNN:A.. ® ❑ O ANFPannmbntFprMM v,ertwwilaanwmnmtl oa, TaYA30O a]D1n011 EMaLNm PNY ar Rao,IMP,al,otl nfPaa AOOa.I. Mipleatwlrrbau neawmEa tAw ® - (3 ktlIm1AA11 ua3PA.,uIRaW.ea tMnW ae.a.d,M,mD eaapaB.R.r uro +�e..IwTaroe,,:r.nces..vMrb.lalM�+ -._ _ ® ❑ kd)alaelt uaFs: vatb,N.F]Ma.ale,ma.n�rm INHneMEVAMa uMe rnNb n.F,n,ec.roNb,+]e.n.F.r.aua.Wl.arlabmrt u,W<rea ® ❑ A4.4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY P.NL IQDLSIel1__�><ti RW'w4cY �tw a�rw -' f � rv. N,.NA1 Je10WWe AWWL AnWlraeecr erouN npr, Ntyc ® ❑ y.lI u.oswarvamnMrNcw�w�l.ry awr..alHyP dtrrerB PPIAaM bIN..Mewy.BWN] ❑ N.LA aA DTwnnrtlen Nml4pawleUbwBy4rmr4MYgd aWl A. N, meYnNe lnn peen uwd .:� .• uuw.B. brd lubaAmA wlnnn. m,IMmltmm am a.IwEe. ...4 Pay., Tar aan awn amt rw�aowP.+ .D I ® ❑ 4450AA FRY W esRan a bP Ares nPMnO MMM NaanA4 Mw Donny ynaP..Am,wm.weHts,..d NHMIrnwraba. ® ❑ vMra.•. Alec+../a^.x/, i I N.Jaf CALOREEN SIGNATURE DECLARATIONS pnNen Ne,r Mr. Victor Dong Residence Rebuild P,PWa AeNer.. 10_364 Slang &W.. Cupertino. CA 95014-3867 Probn pPnIFOPI. To build a new 2 -atory house 2,477 Square footage SECTION 1 -DESIGN VERIFICATION -- f NWNAN=a6raa _ DAA,VwN l_.0o�MmevnmH60mWlmlcaunn.tnexlwntne PbrN pc,al.warywr n tta army DeaenmaN IrW_ uw Hie rtluW,LPuhan�,Wewvneoed-saWen __ w�raes I_,m_ onF ]rlmafineAHb WMxsaL rre,err. <m memAvel wNii.'•4 xOIJCN4mu«.,e.n aAa+g euneen Lehr ewoHue W Rr uv a ca:w W. VMYDr Dant OL,IeyellWr lH�Frr BrL7,INerelNrn4+FR to Mr. Lill En glMwreneaFlYr aAf�hr Helm Mtrs�BNennW rrNwnb ONO,Ia. c'Wr AY.AeIh 408-21 -058 IswlNebrbrlrrrrYrrCdEwnrmdraiPHre w,m, m,e,r I—AWAAW P..rNo. sorN b unrr, araer SECTION 2 -IMPLEMENTATION VERFICAT10N EN MB,WgCepenma. vele,u6Ma n9 OFena.Na. irnprcHn eve�WM.NwbnH Lq�au.rmwu. Irn mgnRa n+rrara nA.e ,err..a sJmeen aowe+,A.m� •.0 wM e,n �N a,N'^s voile a.nn.a upew rranw.meR nnmManx d:, uH G,ree RdAy ClHrra ave m NwerVe rn M+nNrras a ar pt iCWHaMA 4'neI e,Wrq er'eNrm cane a Mbpne 4 ve CAy a Wpawb aver m .ra naBssl....s..M. r cal rv� mm•r Jack Lin 408_278-058 Jackltrcusa88.11 2 AAAAW THE JULY 13015 SUPPLEMENT TO ME 3013 E INST HAS NEW AND USE OF FOR ELECTRIC VEHICLE (EV) EE. 41 O .1 fACWTATE FUTURE INSTALLATION ANO Uff di EV CHARGERS. (PER CfESC SEC N.IOe.A.I) A INSTALL A LISTED RACEWAY TO ACCdYOMTE A DEDCATED 30a/N MDLT BRANCH ORCUIT. B. THE RACEWAY SHALL NOT BE LESS MAN NOWNAL 1" INSIDE PAMETER. C. THE RAfIWAY SHALL ORNAHATE AT THE MAN STRw OR SUBPANEL AND SHALL TERMINATE INTO A LISTED CASNET. BOA. OR OTTER ENCI.. N CLOSE PRO— TO E PROPOSED LOCATION OF AN EV WAN R. 0. THE RACEWAY TERrNATON LMATDN — BE PERMANENTLY AHD -1 MARKED AS 'Ev CAPABLE". E. THE SERMCE PANEL AND/OR SUBPANEL SHALL PROMDE CAPACITY TO INSTALL A NSTALUTIONMIOF AEBICATED RANCH ORCDORMIT AID L OWRCURRENT PMTE(CTKE0 MM. SERWD i0 PERMIT F ME SERM IE PANEL OR -PANEL CNCUT DIRECTORY SHALL IOENTFY THE RESERM:D OVERLURRENT PROTECPME DEMCE SPAC(S) AS EV CAPABLE HY SHEET N0. CAL( DRAWN BY: A m wmursrbasa6 ® ❑ emv wN ,, ll,yae eem,� -NA_ b0`•,eans,r.Ma.rnMlwmmtw.R mM+o ® ❑ a�ar�',..a ® ❑ AlA21 A1wMe. AeNn ana crMFAd rmmaiRMWP WLN r earybNe mnprM rr. uaFs: vatb,N.F]Ma.ale,ma.n�rm INHneMEVAMa uMe rnNb ® ❑ .M.iikmol JeYMA raoHe m.Ntp VV 4anNrNM vamHN Y.NLfWROCWdct,rbM:w,WPnb. ®-_. ❑ _ ® ❑ N.LA aA DTwnnrtlen Nml4pawleUbwBy4rmr4MYgd aWl A. N, meYnNe lnn peen uwd AIDE]CwNra vpN nPeuRN,aEraver+.EnwcW,r ..O_ ® 4450AA FRY W esRan a bP Ares nPMnO MMM NaanA4 Mw Donny vo::anNmbadeHe neM eaNeW.b.r Hg, PabrnMIs scl,o Y ® ❑ (cbvsl Le..wbm,g uvaia. Lvl o r amfiee r<. ne Reeloll Fm• CPwny bepMb (RCfI) FioaSene PDpmm as bepea! is i,4�n fns sYNembi a,W ArlbbnrobN�VJ. ® ❑ pfywnO �sE n MSnfe o ruaa� mw..NNNaaMn4WAb MaN.Na N+envee. ® ❑ uasalAWYroelQAaptaaWo mMM�as MAr Fwel WWaarmWab a.aw p.b.rmWm ® ❑ vMra.•. Alec+../a^.x/, i I N.Jaf CALOREEN SIGNATURE DECLARATIONS pnNen Ne,r Mr. Victor Dong Residence Rebuild P,PWa AeNer.. 10_364 Slang &W.. Cupertino. CA 95014-3867 Probn pPnIFOPI. To build a new 2 -atory house 2,477 Square footage SECTION 1 -DESIGN VERIFICATION -- f NWNAN=a6raa _ DAA,VwN l_.0o�MmevnmH60mWlmlcaunn.tnexlwntne PbrN pc,al.warywr n tta army DeaenmaN IrW_ uw Hie rtluW,LPuhan�,Wewvneoed-saWen __ w�raes I_,m_ onF ]rlmafineAHb WMxsaL rre,err. <m memAvel wNii.'•4 xOIJCN4mu«.,e.n aAa+g euneen Lehr ewoHue W Rr uv a ca:w W. VMYDr Dant OL,IeyellWr lH�Frr BrL7,INerelNrn4+FR to Mr. Lill En glMwreneaFlYr aAf�hr Helm Mtrs�BNennW rrNwnb ONO,Ia. c'Wr AY.AeIh 408-21 -058 IswlNebrbrlrrrrYrrCdEwnrmdraiPHre w,m, m,e,r I—AWAAW P..rNo. sorN b unrr, araer SECTION 2 -IMPLEMENTATION VERFICAT10N EN MB,WgCepenma. vele,u6Ma n9 OFena.Na. irnprcHn eve�WM.NwbnH Lq�au.rmwu. Irn mgnRa n+rrara nA.e ,err..a sJmeen aowe+,A.m� •.0 wM e,n �N a,N'^s voile a.nn.a upew rranw.meR nnmManx d:, uH G,ree RdAy ClHrra ave m NwerVe rn M+nNrras a ar pt iCWHaMA 4'neI e,Wrq er'eNrm cane a Mbpne 4 ve CAy a Wpawb aver m .ra naBssl....s..M. r cal rv� mm•r Jack Lin 408_278-058 Jackltrcusa88.11 2 AAAAW THE JULY 13015 SUPPLEMENT TO ME 3013 E INST HAS NEW AND USE OF FOR ELECTRIC VEHICLE (EV) EE. 41 O .1 fACWTATE FUTURE INSTALLATION ANO Uff di EV CHARGERS. (PER CfESC SEC N.IOe.A.I) A INSTALL A LISTED RACEWAY TO ACCdYOMTE A DEDCATED 30a/N MDLT BRANCH ORCUIT. B. THE RACEWAY SHALL NOT BE LESS MAN NOWNAL 1" INSIDE PAMETER. C. THE RAfIWAY SHALL ORNAHATE AT THE MAN STRw OR SUBPANEL AND SHALL TERMINATE INTO A LISTED CASNET. BOA. OR OTTER ENCI.. N CLOSE PRO— TO E PROPOSED LOCATION OF AN EV WAN R. 0. THE RACEWAY TERrNATON LMATDN — BE PERMANENTLY AHD -1 MARKED AS 'Ev CAPABLE". E. THE SERMCE PANEL AND/OR SUBPANEL SHALL PROMDE CAPACITY TO INSTALL A NSTALUTIONMIOF AEBICATED RANCH ORCDORMIT AID L OWRCURRENT PMTE(CTKE0 MM. SERWD i0 PERMIT F ME SERM IE PANEL OR -PANEL CNCUT DIRECTORY SHALL IOENTFY THE RESERM:D OVERLURRENT PROTECPME DEMCE SPAC(S) AS EV CAPABLE HY SHEET N0. CAL( DRAWN BY: A CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Pao 3. Project Name:Happy an LLC Enforcement Agency: Cupertino City of Permit Number: 15080085 Dwelling Address: 10364 Sterling Blvd 0y: Cupertino 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 New MCH -20a - Completely New Duct System B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 4 02 Heating Capacity (kBtu/h) 78 03 Conditioned Floor Area served by this HVAC system (ft2) 2036 04 Duct Leakage Test Condition Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.06 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Heating system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage (cfm) 102 10 Actual duct leakage rate from leakage test measurement (cfm) 93 11 Compliance Statement System passes leakage test Registration Number: 216-A0332170A-M2000002A-M20A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:31:16 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3 ) 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. 03 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. Visual Inspection at Final Construction Stage (applicable if system was tested at rough -in) After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following procedure must be performed 07 For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are properly sealed. 08 If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. 09 Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used. 10 Verification Status Pass 11 Correction Notes for this table 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. 01 Complies: All specified verification protocol requirements on this document are met. Registration Number: 216-A0332170A-M2000002A-M20A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:31:16 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: Liu Documentation Author Signature: �GX�sl�LX/�.4sli Minxuan Company: Date Signed: Bay Area Energy Consultants 2016-09-08 21:34:50 Address: CEA/ HERS Certification Identification (if applicable): 1181 Sundown Ln City/State/Zip: Phone: San Jose CA 95127 408-883-3865 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. 1 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 information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CFiR) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): WELKIN INTERNATIONAL INDUSTRIAL INC Responsible Builder or Installer Name: CSLB License: Xin Lu 812620 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Bay Area Energy Consultants Responsible Rater Name: Minxuan Liu Responsible Rater Signature: AGK""W10 !- Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006550 2016-09-08 21:34:50 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-A0332170A-M2000002A-M20A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:31:16 2013 Residential Compliance Schema Version: 2013.1.007 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 1 of 4 ) Project Name: Happy Ocean LLC Enforcement Agency: City of Cupertino Permit Number: 15080085 Dwelling Address: 10364 Sterling Blvd City: Cupertino Zip Code: 95014 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system 08 System Bypass Duct Status No Bypass Duct 09 Date of System Airflow Rate Measurement 2016-08-26 10 Airflow Rate Protocol Utilized RA3.3 procedures for airflow rate measurement B. Hole for the placement of a Static Pressure Probe (HSPP), and Permanently Installed Static Pressure Probe (PSPP) in the Supply Plenum. Procedures for installing HSPP or PSPP are specified in RA3.3.1.1. 01IMethod Used to Demonstrate Compliance with the I HSPP installed and labeled consistent with Figure RA3.3-1 HSPP/PSPP Requirement C. Airflow Rate Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1.1, and system airflow rate measurement apparatus information is given in RA3.3.2. Airflow Rate Measurement Type used for this airflow rate Traditional Flow Capture Hood according to procedure in 01 verification. RA3.3.3.1.4 02 Manufacturer of Airflow Measurement Apparatus Alnor 03 Model number of Airflow Measurement Apparatus 634-513-044 Certification Status of the Airflow Measurement Apparatus Certified by Manufacturer and listed on CEC Website at 04 Accuracy http://www.energy.ca.gov/title24/equipment_cert/ama_fas /index.html Registration Number: 216-A0332170A-M2300002A-M23A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-09 00:12:15 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 2 of 4 ) MCH -23a Forced Air System Airflow Rate Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor D. Forced Air System Airflow Rate Measurement The procedures for System Airflow Rate Verification are specified in Reference Residential Appendix RA3.3. 01 Required Minimum System Airflow Rate (cfm/ton) 350 02 Required Minimum System Airflow Target (cfm) 1400 03 Actual System Airflow Rate Measurement (cfm) 1450 04 Compliance Statement: System airflow rate complies E. Additional Requirements 01 Air filters that meet the applicable requirements of Standards Section 150.0(m)12 or 150.0(m)13 were properly installed in the system during system air flow rate measurement identified on this Certificate of Verification. The airflow rate measurement apparatus used to perform the airflow rate measurement identified on this Certificate of 02 Verification was calibrated in accordance with the apparatus manufacturer's specifications and conforms to the instrumentation specifications given in RA3.3.1. A visual inspection shall confirm that bypass ducts that deliver conditioned supply air directly to the space conditioning 03 system return duct airflow are not used on newly constructed zonally controlled systems unless the Performance Certificate of Compliance indicates an allowance for use of a bypass duct. When a bypass duct is accounted for on the Performance Certificate of Compliance, the airflow rate shall conform to the specifications listed on the Certificate of Compliance. 04 All registers were fully open during the diagnostic test. 05 System fan was set at maximum speed during the diagnostic test. 06 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 07 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan 08 efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. 09 Verification Status: Pass - all applicable requirements are met 10 Correction Notes: The responsible person's 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. Registration Number: 216-A0332170A-M2300002A-M23A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-09 00:12:15 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-22-H Space Conditioning System Fan Efficacy (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: Liu Documentation Author Signature: /�L�L�IIIZXili Minxuan Company: Date Signed: Bay Area Energy Consultants 2016-09-08 21:34:50 Address: CEA/ HERS Certification Identification (if applicable): 1181 Sundown Ln City/State/Zip: Phone: San Jose CA 95127 408-883-3865 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. 1 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 information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (MR) approved by the enforcement agency. S. I will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): WELKIN INTERNATIONAL INDUSTRIAL INC Responsible Builder or Installer Name: CSLB License: Xin Lu 812620 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Bay Area Energy Consultants Responsible Rater Name: Minxuan Liu Responsible Rater Signature: /%�l•IlsiSf"Vod L w Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006550 2016-09-08 21:34:50 Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 216-A0332170A-M2200002A-M22A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:34:22 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-22-H Space Conditioning System Fan Efficacy (Page 1 of 3 ) Project Name: Happy Ocean LLC Enforcement Agency: Cupertino City of Permit Number: 15080085 Dwelling Address: 10364 Sterling Blvd City: Cupertino Zip Code: 95014 A. Ducted Cooling System Information 01 System Identification or Name System 1 02 System Location or Area Served Whole House 03 System Installation Type New 04 Nominal Cooling Capacity (tons) of Condenser 4 05 Condenser Speed Type Single Speed 06 Cooling System Zonal Control Type Not Zonal 07 Central Fan Integrated (CFI) Ventilation System Status Not a CFI system O8 System Bypass Duct Status No Bypass Duct 09 Date of System Airflow Rate Measurement 2016-08-26 10 Airflow Rate Protocol utilized RA3.3 procedures for airflow rate measurement B. Fan Watt Measurement Apparatus and Procedure Information Instrument Specifications are given in RA3.3.1, and system fan watt measurement apparatus information is given in RA3.3.2.2. ( 01 ( Fan Watt Verification Device Used. ( Digital Utility Revenue Meter MCH -22a Forced Air System Fan Efficacy Measurement - Newly Installed Non -Zoned Systems or Zoned Multi -Speed Compressor C. Forced Air System Fan Efficacy Measurement The procedures for System Fan Watt Verification are specified in Reference Residential Appendix RA3.3. 01 Actual Tested Watts 818 02 Actual Tested Airflow from MCH -23 (cfm) 1450 03 Required Fan Efficacy (watts/cfm) 0.58 04 Actual Fan Efficacy (watts/cfm) 0.56 05 Compliance Statement: System fan efficacy complies Registration Number: 216-A0332170A-M2200002A-M22A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:34:22 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-22-H Space Conditioning System Fan Efficacy (Page 2 of 3 ) D. Additional Requirements 01 All registers were fully open during the diagnostic test. 02 System fan was set at maximum speed during the diagnostic test. 03 If fresh air duct is part of the HVAC system it was not closed during the diagnostic test. 04 Airflow rate and fan watt draw shall be simultaneous measurements when used to calculate the Fan Efficacy tested value. 05 Multi -speed compressor space cooling systems or variable speed compressor systems shall verify air flow (cfm/ton) and fan efficacy (Watt/cfm) with system operating in cooling mode at the maximum compressor speed and the maximum air handler fan speed. 06 Zoned cooling air distribution systems with single speed compressors shall meet both the airflow (cfm/ton) and fan efficacy (Watt/cfm) criteria in every zonal control mode. 07 Verification Status Pass - all applicable requirements are met 08 Correction Notes 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. E. 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. 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: 216-A0332170A-M2200002A-M22A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-08 21:34:22 2013 Residential Compliance Schema Version: 0.51SDD CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 3 of 4 ) F. 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. low% .al HER 5 i P R 0 V1 D Registration Number: 216-A0332170A-M2300002A-M23A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CalCERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-09 00:12:15 2013 Residential Compliance Schema Version: 2013.1.008 CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 4 of 4 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Minxuan Liu Documentation Author Signature: �Gllst.�Ll�ffi�G�!!/ Company: Date Signed: Bay Area Energy Consultants 2016-09-08 21:34:50 Address: CEA/ HERS Certification Identification (if applicable): 1181 Sundown Ln CC2006550 City/State/Zip: Phone: San Jose CA 95127 408-883-3865 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. 1 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 information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CFSR) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): WELKIN INTERNATIONAL INDUSTRIAL INC Responsible Builder or Installer Name: CSLB License: Xin Lu 812620 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Bay Area Energy Consultants Responsible Rater Name: Responsible Rater Signature: Minxuan Liu«� Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006550 2016-09-08 21:34:50 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-A0332170A-M2300002A-M23A Registration Date/Time: 2016-09-08 21:34:50 HERS Provider: CaICERTS CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.008 Report Generated: 2016-09-09 00:12:15 2013 Residential Compliance Schema Version: 2013.1.008 CUPERTINO STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ingCa.cupertino. org SITE 10364 Sterling Blvd APN y�`-- O 'T O BP# AI' v � vv ADDRESS S4210 09/08/15 Registered Design Professional in Charge Si nature ..... ..................................... Owner............... MY........................................ ' ................................. Owner Name: Y,' mor y Contractor....................................................................................................... Address.......I..a'�.� �f�v!/.f�r!. ...../�I.�W.............................. Signature ....................................... Address........................................................................................................... ................................................................ Date:.. City/St....... fih{J......(/tl....Zip .................�....Phone...3b(f.r�� City/St ................................................. Zip ................... Phone ........................ Applicant......................................................................................................... CAPEX ENGINEERING INC. Engineer/Architect ............................................... Jing Chen Tsai.... Address........................................................................................................... Signature............... ................................................... Address............................................................................................. 2050 Concourse Dr. # 50 City/St............................................. Building Official or designee: Zip ........................... Phone ..................... City/St ....San Jose....................... 9513 Zip.. .1... Phone 408..892768C PROJECT DESCRIPTION: cs e -- I rL r G,L A-nate y 4 lin S F Date:.......................... This "STATEMENT OF SPECIAL INSPECTIONS" is submitted in fulfillment of the requirements of CBC Sections 1704 and 1705. This form is structured after and used by permission from the Structural Engineer Association of Northern California's (SEAONC) mode statement of Special Inspections. Also, included with th form is the following: ® "LIST OF SPECIAL INSPECTION AG (page 2). A list of testing agencies and other special inspectors that will be retained to conduct the tests and ins c ns this project ❑ "SCHEDULE OF SPECIAL INS P " (page 3 — 6). The Schedule of Special Inspections summarizes the Special Inspections and tests require . e I spectors will refer to the approved plans and specifications for detailed special inspection requirements. a al tests and inspections required by the approved plans and specifications shall also be performed. Special Inspections and T ,n i e performed in accordance with the approved plans and specifications, this statement and CBC Sections 1704, 1705, 7 , 1 nd 1708. Interim reports will be submitted to the Building f14Fi I and the Registered Design Professional in Re arge in accordance with CBC Section 1704.1.2. A Final Rep ial Inspections documenting required Special Inspectstesting and correction of any discrepancies noted in the inspeAft all be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). The Final Report will docume • fired special inspections. • Correction of discrepancies noted in inspections. The Owner recognizes his or her obligation to ensure that the construction complies with the approved permit documents and to implement this program of special inspections. In partial fulfillment of these obligations, the Owner will retain and directly pay for the Special Inspections as required in CBC Section 1704.1. This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special inspection activities on the job site to assure that the Special Inspectors are qualified and are performing their duties as called for in this Statement of Special Inspection. • Review submitted inspection reports. • Perform inspections as required by the local building code. I have read and agree to comply with the terms and conditions of this statement Prepared By: Project Ll Engineer ❑ Architect S4210 09/08/15 Registered Design Professional in Charge Si nature ..... ..................................... Lic.#....................................... Date:.......................... Owner Name: Y,' mor y Owner's Authorization Signature ....................................... ................................................................ Date:.. ......... .......... Inspection Agency / Inspector Name: CAPEX ENGINEERING INC. 09/08/15 Signature............... ................................................... Lie.# ....................................... Date:.......................... Building Official or designee: Signature.................................................................................................................... Date:.......................... SpecialnspectionForm_2012.doc revised 09/06/12 LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Each special inspection agency, testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency's listed on this form must be pre -approved and listed on Cupertino's approved Special Inspector's list. Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspection Agencies. No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order" and possible permit revocation. To be pre- approved by the City of Cupertino, refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process. The following are the testina and special inspection agencies that will be retained to conduct tests and inspection on this project: EXPERTISE FIRM / INSPECTOR INFORMATION 1. Special Inspection (except for Firm...... Capex Engineertng Inc. 5..Seville Place ...Addr..... .... . ................................................. geotechnical) City....... Fremont..... ......... ....................... ............ State .. CA...........Zip . 94539....... Telephone ..5.I.0-6.6.8.-.1.8.15 668-1815........ Fax...... 5.1.0.490-.809Q .......... Email......................................................... 2. Material Testing Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone.......................................Fax............................................ Email......................................................... 3. Geotechnical Inspections Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... 4. Other: Firm.....................................................................Addr......................................................................................... City.......................................................................................................... State .......................Zip ...................... Telephone...................................... Fax ............................................ Email......................................................... *All agencies specified on this form must be pre -approved and listed on the City of Cupertino's Approved Special Inspector's List. SEISMIC REQUIREMENTS (Section 1705.3.6) Description of seismic -force -resisting system and designated seismic systems subject to special inspections as per Section 1705.3: Holdown Epoxy Anchor Inspection The extent of the seismic -force -resisting system is defined in more detail in the construction documents. WIND REQUIREMENTS Section 1705.4.1 Description of main wind -force -resisting system and designated wind resisting components subject to special inspections in accordance with Section 1705.4.2: The extent of the main wind -force -resisting system and wind resisting components is defined in more detail in the construction documents. SpecialnspectionForm 2012.doc revised 09/06/12 SCHEDULE OF SPECIAL INSPECTION SITE APN BP# ADDRESS PROJECT DESCRIPTION: Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X Is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. --- Denotes an activity that is either a one-time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTIONC p REFERENCED IBC REFERENCE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control --- 1704.3 procedures. INSPECTION OF STEEL 1. Material verification of high-strength bolts, nuts and washers. ❑ Identification marking to conform to ASTM stds AISC 360, specified in the approved construction documents. --- X Section A3.3 and applicable ASTM material standards ❑ Inspect fabricator's fabrication and quality control procedures. 2. Inspection of high-strength bolting: ❑ Snug -tight joints. --- X ❑ Pretensioned and slip -critical joints using turn -of -nut with matchmarking, twist -off bolt or direct tension --- X AISC 360, indicator methods of installation. 1704.3.3 Section M2.5 ❑ Pretensioned and slip -critical joints using turn -of -nut without matchmarking or calibrated wrench methods X --- of installation. 3. Material verification of structural steel and cold -formed steel deck. ❑ For structural steel, identification markings to conform X AISC 360, to AISC 360. Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved --- X material standards construction documents. ❑ Manufacturer's certified test reports. --- X SpecinlnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE 4. Material verification of weld filler materials: ❑ Identification marking to conform to AWS specification in the approved construction documents. --- X AISC 360, Section A3.5 and applicable AWS A5 documents --- ❑ Manufacturer's certificate of compliance required. --- X --- --- 5. Inspection of welding: a. Structural steel and cold -formed steel deck: ❑ Complete and partial joint penetration groove welds. X --- AWS D1.1 1704.3.1 ❑ Multipass fillet welds. X --- ❑ Single -pass fillet welds > 5/16" X --- ❑ Plug and slot welds. X --- ❑ Single -pass fillet welds <= 5/16" --- X ❑ Floor and roof deck welds. --- X AWS D1.3 b. Reinforcing steel: ❑ Verification of weldability of reinforcing steel other than ASTM A 706. X AWS D1.4 ACI 318: Section 3.5.2 ❑ Reinforcing steel resisting flexural and axial forces in intermediate and special moment frames, and boundary elements of special structural walls of concrete and shear reinforcement. X --- ❑ Shear reinforcement. X --- ❑ Other reinforcing steel. --- X 6. Inspection of steel frame joints details for compliance: ❑ Details such as bracing and stiffening. --- X --- 1704.3.2 ❑ Member locations. --- X ❑ Application of joint details at each connection. --- X VERIFICATION AND INSPECTIONC P REFERENCED STANDARD IBC REFERENCE INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. --- X --- 1704.3 2. ❑ Welding of cold -formed steel framing members. --- X 3. ❑ Welding of stairs and railing systems. --- X SpecialnspectionForm_2012.doc revised 09/06112 VERIFICATION AND INSPECTION C p REFERENCED STANDARD IBC REFERENCE INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing --- X ACI 318: 3.5, 7.1-7.7 1913.4 tendons and placement. 2. ❑ Inspection of reinforcing steel welding in accordance AWS D1.4 ACI 318: with Table 1704.3 Item 5b. __ 3.5.2 --- 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowable X --- ACI 318: 8.1.3, 1911.5, 1912.1 loads have been increased or where strength design 21.2.8 is used. 4. ❑ Inspection of anchors installed in hardened concrete. --- X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. --- X ACI 318: 1904.2.2,1913.2, 1913.3 6. ❑ At time fresh concrete is sampled to fabricate ASTM C 172 specimens for strength tests, perform slump and air X --- ASTM C 31 1913.10 content tests and determine the temperature of the concrete. ACI 318: 5.6, 5.8 7. ❑ Inspection of concrete and shotcrete placement for1913.6, X --- ACI 318: 5.9, 5.10 1913.7, proper application techniques. 1913.8 8. ❑ Inspection for maintenance of specified curing --- X ACI 318: 5.11-5.13 1913.9 temperature and techniques. 9. Inspection of prestressed concrete: ❑ Application of prestressing forces. X --- ACI 318:18.20 ❑ Grouting of bonded prestressing tendons in the X --- ACI 318: 18.18.4 seismic force -resisting system. 10. ❑ Erection of precast concrete members. --- X ACI 318: Ch. 16 --- 11. ❑ Verification of in-situ concrete strength, prior to stressing of tendons in posttensioned concrete and --- X ACI 318: 6.2 --- prior to removal of shores and forms from beams and structural slabs. 12. ❑ Inspect formwork for shape, location, and dimensions --- X ACI 318: 6.6.1 --- of the concrete member being formed. 13. ❑ Bolts Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. --- X See ICC ES Reports form special inspection requirements for proprietary ❑ Direct tension testing of new bolts. --- X ❑ Torque testing of new bolts. --- X products ❑ Prequalification test for bolts and other types of X anchors. 14. ❑ Other: SpecialnspectionForm_2012.doc revised 09/06/12 SpecialnspectionForm_2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/ASCE 6 INSPECTION OF LEVEL 1 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals shall be verified. 2. ❑ Verification of f'm and f'AA,c prior to construction --- X --- --- Art. 1.413 except where specifically exempted by this code. 3. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.513.1.b.3 the site for self consolidating grout. 4. As masonry construction begins, the following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar. --- X --- --- Art. 2.6A ❑ Construction of mortar joints. --- X --- --- Art.3.313 ❑ Location of reinforcement, connectors, --- X --- --- Art. 3.4, 3.6A prestressing tendons, and anchorages. ❑ Prestressing technique. --- X --- --- Art. 3.66 ❑ Grade and size of prestressing tendons and --- X --- --- Art. 2.413, 2AH anchorages. 5. During construction the inspection program shall verify: ❑ Size and location of structural elements. --- X --- --- Art. 3.3F ❑ Type, size, and location of anchors, including Sec. 1.2.2(e), other details of anchorage of masonry to --- X --- 1.16.1 structural members, frames or other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- --- --- ❑ Preparation, construction and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, --- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.66 force. 6. Prior to grouting the following shall be verified to ensure compliance: ❑ Grout space is clean. --- X --- --- Art. 3.2D ❑ Placement of reinforcement and connectors and --- X --- Sec. 1.3 Art. 3.4 prestressing tendons and anchorages. ❑ Proportions of site -prepared grout and --- X --- --- Art. 2.613 prestressing grout for bonded tendons. ❑ Construction of mortar joints. j --- j X j --- j --- j Art. 3.313 7. Grout placement: ❑ Grout placement shall be verified ensure X --- --- --- Art. 3.5 compliance. ❑ Observe grouting of prestressing bonded X --- --- --- Art 3.6C tendons. SpecialnspectionForm_2012.doc revised 09/06/12 SpecialnspeclionForm 2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TMS 402/ACI TMS 402/ACI SECTION 530/ASCE 5 530/ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be --- X 2105.2.2, --- Art. 1.4 observed. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved --- X --- --- Art. 1.5 submittals. 2. ❑ Verification of fm and fAAc prior to construction and for every 5,000 square feet during --- X --- --- Art. 1.4B construction. 3. ❑ Verification of proportions of materials in premixed or preblended mortar and grout as --- X --- --- Art. 1.513 delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X --- --- --- Art. 1.5B.1.b.3 the site for self consolidating rout. 5. The following shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar, grout, and --- X --- --- Art. 2.6A prestressing grout for bonded tendons. ❑ Placement of masonry units and construction of --- X --- --- Art. 3.36 mortar joints. ❑ Placement of reinforcement, connectors and --- X --- Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. ❑ Grout space prior to grouting. X --- --- --- Art. 3.2D ❑ Placement of grout. X --- --- --- Art. 3.5 ❑ Placement of prestressing grout. X --- --- --- Art. 3.6C ❑ Size and location of structural elements. --- X --- --- Art. 3.31F ❑ Type, size, and location of anchors, including other details of anchorage of masonry to X --- --- Sec.1.2.2(e) structural members, frames and other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and --- X --- Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X --- Sec. 2.1.9.7.2, --- 3.3.3.4 (b) ❑ Preparation, construction, and protection of masonry during cold weather (temperature below ___ X Sec. 2104.3, --- Art. 1.8C, 1.8D 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X --- --- --- Art. 3.66 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be X --- 2105.2.2, --- Art. 1.4 observed. 2105.3 SpecialnspeclionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C p REFERENCEDIBC STANDARD REFERENCE INSPECTION OF WOOD 1. ❑ Inspect prefabricated wood structural elements and assemblies in accordance with Section 1704.2. --- 1704.6 2. ❑ Inspect site built assemblies. --- --- 3. Inspect high -load diaphragms: ❑ Verify grade and thickness of sheathing. --- --- ❑ Verify nominal size of framing members at adjoining panel edges. --- 1704.6.1 ❑ Verify nail or staple diameter and length, --- --- ❑ Verify number of fastener lines, --- --- ❑ Verify spacing between fasteners in each line and at edge margins. 4. ❑ Metal -plate -connected wood trusses spanning 60 feet or greater: Verify temporary installation restraint/bracing and the permanent individual truss --- X --- 1704.6.2 member bracing are installed in accordance with the approved truss submittal package. REQUIRED VERIFICATION AND INSPECTION OF SOIL 1. ❑ Verify materials below footings are adequate to X achieve the desired bearing capacity. 2. ❑ Verify excavations are extended to proper depth and X have reached proper material. 3. ❑ Perform classification and testing of compacted fill X materials. --- Table 1704.7 4. ❑ Verify use of proper materials, densities and lift thicknesses during placement and compaction of X --- compacted fill. 5. ❑ Prior to placement of compacted fill, observe subgrade X and verify that site has been prepared properly. REQUIRED VERIFICATION AND INSPECTION OF DEEP DRIVEN FOUNDATION ELEMENTS 1. ❑ Verify element materials, sizes and lengths comply X --- with the requirements. 2. ❑ Determine capacities of test elements and conduct X additional load tests, as required. 3. ❑ Observe driving operations and maintain complete X and accurate records for each element. 4. ❑ Verify locations of piles and their plumbness, confirm type and size of hammer, record number of blows per --- Table 1704.8 foot of penetration, determine required penetrations to X --- achieve design capacity, record tip and butt elevations and document any damage to foundation element. 5. ❑ For steel elements, perform additional inspections in accordance with Section 1704.3. 6. ❑ For concrete elements and concrete filled elements, perform additional inspections in accordance with --- --- Section 1704.4. SpecialnspectionForm_2012.doc revised 09/06112 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in --- --- --- Table 1704.8 responsible charge. REQUIRED VERIFICATION AND INSPECTION OF CAST -IN-PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X --- --- Table 1704.9 adequate end -bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. HELICAL PILE FOUNDATIONS 1. ❑ Record installation equipment used, pile dimensions, X --- --- 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE-RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire - resistance design and the approved manufacturer's --- --- written instructions. ❑ Verify minimum ambient temperature before and after X application. 1704.12.1 ❑ Verify ventilation of area during and after application. --- X 2. ❑ Measure average thickness per ASTM E605 and Section 1704.12.4. --- --- --- 3. ❑ Verify density of material for conformance with the approved fire-resistant design and ASTM E605. (Ref. --- --- Section 1704.12.5) 4. ❑ Test cohesive/adhesive bond strength per Section 1704.12.6. 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire -Resistant Coating. --- --- --- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing --- --- --- 1704.14 substrate. 3. Special Cases --- --- --- 1704.15 4. Smoke Control System --- --- --- 1704.16 5. Seismic Resistance ❑ Suspended ceiling systems and their anchorage. --- --- --- 1705.3 [4.3] SpecialnspectionForm_2012.doc revised 09/06/12 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE 6. Wind Resistance ❑ Roof cladding and roof framing connections. --- --- --- ❑ Wall connections to roof and floor diaphragms and framing. ❑ Roof and floor diaphragm systems, including collectors, drag struts and boundary elements. ❑ Vertical wind -force -resisting systems, including braced frames, moment frames, and shear walls. ❑ Wind -force -resisting system connections to the foundation. ❑ Fabrication and installation of systems or components required to meet the impact resistance requirements --- --- --- of Section 1609.1.2. SPECIAL INSPECTION FOR WIND REQUIREMENTS 1. Structural Wood ❑ Inspect field gluing operations of elements of the main X wind -force -resisting system. --- 1706.2 ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the main windforce-resisting X system, including wood shear walls, wood diaphragms, drag struts, braces and hold-downs. 2. Cold -Formed Steel Framing ❑ Welding of elements of the main wind -force -resisting X system. ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the main --- 1706.3 wind -force -resisting system including shear walls, --- X braces, diaphragms, collectors (drag struts) and hold- downs. 3. Wind -resisting components ❑ Roof cladding. --- X --- 1706.4 ❑ Wall cladding. --- X SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE 1. ❑ Special inspection for welding in accordance with theX _ 1707.2 quality assurance plan requirements of AISC 341. 2. Structural Wood ❑ Inspect field gluing operations of elements of the X --- seismic-force-resisting system. ❑ Inspect nailing, bolting, anchoring, and other fastening of components within the seismic -force -resisting 1707.3 system, including wood shear walls, wood --- X diaphragms, drag struts, braces, shear panels and hold-downs. 3. Cold -Formed steel light -frame construction ❑ Welding of elements of the seismic -force -resisting _ X 1707.4 system. SpeciainspectionForm 2012.doc revised 09/06/12 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- _ X force -resisting system including shear walls, braces, diaphragms, collectors (drag struts) and hold-downs. 4. Storage racks and access floors ❑ Anchorage of storage racks 8 feet or greater in height X 1707.5 and access floors. 5. Architectural components ❑ Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet --- X above grade or walking surface. ❑ Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade --- X or walking surface. --- 1707.6 ❑ Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or --- X walking surface. ❑ Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher --- X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components ❑ Inspect anchorage of electrical equipment for X emergency or stand-by power systems. ❑ Inspect anchorage of non -emergency electrical X equipment. _ ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or --- X --- 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains X hazardous materials. _ ❑ Inspect installation of vibration isolation systems X where required by Section 1707.7. 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance --- 1707.8 when mechanical and electrical equipment must be seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation --- X --- 1707.9 system per ASCE 7 — Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, --- --- --- 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance 1708.3 requirements in AISC 341. --- 11. ❑ Obtain certificate that equipment has been seismically 1708.4 qualified. ___ 12. ❑ Obtain system tests as required by ASCE 7 Section--- --- --- 1708.5 17.8. SpecialnspectionForm_2012.doe revised 09/06/12 CUPERTINO RECOGNIZED SPECIAL INSPECTION AGENCY LIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingOa cupertino.org The following list of Special Inspection Agencies and their special inspectors are approved by the City of Cupertino to provide specific inspection in their respective field until the expiration date listed. Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM sw HB FP s w CG Achievement Engineering Corp. 434 Camille Cir. #13 San Jose, CA 95134 Tel: (800) 653-1397 Fax: (408) 852-0331 Expires: 07/22/2015 Firouz'aei, Arash FP = Spray -Applied Fire roofin CG = CalGreen Code X X X X Hooshdar, Sina X X X X Khodadadi, Mohammad X Safaian, Farshad Applied Materials &Engineering, Inc. 980 41 s` Street Oakland, CA 94608 Tel: (510) 420-8190 Fax: (510) 420-8186 Expires: 12/19/2014 Email: info(o)appmateng.com Aaron Hardy X X X AnthonyKlarich X X X X X Armen Tajirian, P.E. X Jackson X X —Bryan David Jackson X X X X X Diego Bertolino X X X Harold Walrath X X X X Ken Malone X X Michael Knowles X X X X Oswaldo Dominguez X X X X Sean Guches X X X Bagg Engineers 847 West Maude Ave. Sunnyvale, CA 94085-2911 Tel: (650) 852-9133 Fax: (650) 852-9138 Expires: 7/16/2015 www.baggengineers.com Brown, Christian X X X X X Cole, Michael Hepper, John X X X Knudsen, Steven J. McManus, Alvin X X X Norris, David L. X X X X O'Driscoll, Alan Salceda, Francisco Sciortino, Brandon Smith, Louis Steinbrueck, Bryan Thai, Minh Umeki, Takashi RC = Reinforced Concrete SW = Steel & Welding S = Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Secial Insectors pp S =Soils PC = Pre-stressed(Post-tensioned Concrete Special Inspection Field RC PC SM sw HB FP s w CG Biggs Cardosa Associates, Inc. 865 The Alameda San Jose, CA 95126 Tel: (408) 296-5515 Fax: (408) 296-8114 Expires: 7/11/2014 www.biggscardosa.com Castro, Roberto CG = Cal Green Code Chan, David X X Ghorbani, Behrooz Lazzarini, Dan Rivas, Ricardo Rosales, Adolfo Rosellini, Daniel Sanchez, Adam To an, Claudiu X X Wooley, Mark X X X X Yamane, Robert BSK Associates Engineers & Laboratories 324 Earhart Way Livermore, CA 94551 Tel: (925) 315-3151 Fax: (925) 315-3152 Expires: 9/06/2014 www.bskassociates.com Auser, Jim X X X Bos ue, Jeff X X X Clary, Mike X X X X Evans, Keven X Minerales, Gilbert Ness, Dennis X X X Olsten, Ken X X Reeves, Ben Rodriguez, Tim X X X Schurman, Peter X Capex Engineering Inc. 571 Seville Place Fremont, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Expires: 6/25/2014 Gary Hsu X X X X X Chow, Erwin 1105 Belmont Ave. Long Beach, CA 90804 Tel: (562) 449-7491 Expires: 4/24/2014 Erwin Chow X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed(Post-tensioned Concrete HB = High -Strength Bolding W = Wood SM = Structural Masonry FP = SpraymApplied Fireproofing CG = Cal Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field see sw HB FP S W CG Consolidated Engineering Laboratories 2001 Crow Canyon Road, Suite 100 San Ramon, CA 94583 Tel: (925) 341-7100 Fax: (925) 855-7140 Expires: 6/25/2014 www.ce-labs.com Ahmed, Badaruddin FP = Spray -Applied Fire roofin CG = CalGreen Code Alexander, David X X X Andersen, Calvin X X Bartlett, Dennis X X Bobrovitsk , Edward X X X Bolen, Michael X X X Brooks, Brendan X X X X X Brown, Ronald X X X X X Buchmiller, Kenn Cottingham, Paul Currier, James X X Eschliman, Duaine Eschliman, Kevin Fuller, Mark X X Halloran, James X X X X X Harrington, Wayne X X Hassebrock, Scott X X X X X Healy, Michael X Heilmann, Mark X X X Hornyak, John X X X X Hyslop, John X X X X King, Phillip X X X X Kmitt, Stanley X X Liebold, Jeffrey X X X X X Lozano, Alfonso Art Ma, Steven X Marlik, William X X McCutcheon, Thurmond X X McKenzie, Quinten McLaughlin, Lori X X Miner, Dwight X X Murphy, Don X Pastora, George X X X X Rodriguez, Sandra X X Si mon, Josephine Sisson, James X X X X Small, Michael X X Van Horn, Bradford X X X X Walters, Michael Zuerner, Robert X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code Speeiallnspectionbst.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM sw HB FP S W CG Construction Testing Services 2174 Rheem Dr., Ste. A Pleasanton, CA 94588 Tel: (925) 462-5151 Fax: (925) 462-5183 Expires: 6/26/2014 www.cts-1.com Brian Arnold X X X Edward Bindert X X X X X Jeremy Brown X X X James Brumley X Jared Byers X X Richard Collin X X X Robert Cortez X X X X X Robert Criswell X X X Mark Dornan X X X X Tom Edwards X X X X X Tim Farley X X X X X X Gary Fechner X X X Mike Gaunt X Ron Harr X X X X Neal Hoellwarth X Richard Jones X X X X Rick Mann X X Kevin McCurdyX X Kevin Meyers X Kevin Moore X X Craig Nagle David Puskarich X X X X William Radulovich Brian Ragan X X X X X John Rink X George Rockenstein X X Larry Rothey X Erin Salazar X X Robert Schulze X Donald ShirleyX X X Tom Shuster X X X X X Larry Slater X Daryl Spieker X X Gary Stapleton X X X Matt Swope X X Travis Taylor X X Vinny Vinavong X Shawn Vucenic X John White X X X X X Isidoro Zapien I X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC Pc Special Inspection Field See SW HB FP S w CG Earth Systems Pacific 446 S. Hillview Dr. Milpitas, CA 95035 Tel: (408) 934-9302 Fax: (831) 637-0510 Exp: 6/28/2014 www.earthsystems.com George Barnett FP = Spray -Applied Fire roofin X X Jeff Bryan X X Norman Engen X X X X Cal Hicks X X X X X Dennis Hurley X X rus Mejia ENGEO Incorporated 2010 Crow Canyon PI., Suite 250 San Ramon, CA 94583 Tel: (925) 866-9000 Fax: (888) 279-2698 Exp: 7/06/2014 www.engeo.com Tim Benton Greg Hudson X Mike Huener ardt X X X X Kevin Lecce James "Chip" Moore X X X Randy Mues X Jonathan Parker X X X X Rich Rose X X X H P Inspection, Inc. 690 Sunol ST, Building H San Jose, CA 95126 Tel: (408) 288-8460 Fax: (408) 271-0902 Expires: 11/15/2014 Larry Castrence Tony Cotta X X Mark Cotter Chuck Pinkham X X X X David Pinkham X X X X P. Scott Pinkham X X X Gary Stafford X X X X X Jason Waugh X X X X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W = Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpecialInspectionList.doc revised 02101/14 Agency Name, Address and expiration date Secial Insectors pp RC Pc Special Inspection Field SM SW HB FP S W CG Inspection Services, Inc. 1798 University Ave. Berkeley, CA 94703 Tel: (510) 900-2100 Fax: (510) 900-2101 Expires: 03/21/2015 www. inspection services. net Alakbarov, Ha dar CG = CalGreen Code X Amos III, Jessie X Baccus, Garrett X X Baek, Byung Gi X X X X X X Barone, Judith X X X Celik, Can X X X X X X X Colby, Paul X X Ehrsam, Gary X Falk, Andrew X X X X Flynn, Chris X X X X X X Gaut, Tobin X X X X Llames, Fernando X X X X Lon, Rand "Roy" X X X X X X Patterson, Rodger X X Putman, Edward X X X X X Sandoval, Carlos X X X X X X Shebesta, Todd X Simonton, Cy -Leon X Solis, Winnie X X Stafford, William X Stark, Douglas X X X X Toschi, Patrick X X X X X Wheeler, Steven X X X X X Kleinfelder 2601 Barrington Court Hayward, CA 94545 Tel: (925) 484-1700 Exp: 7/10/2014 www.kleinfelder.com Anderson, Tim X X X X X X Brewster, Steve X Burton, Nathan X X X Craig, Cliff X X X X X X Delabriandais, Gary X X X Eres, Mark X X X X X Foster, Stephen X X X X Hammon, Robert X X X X Johnson, Josh X Kesler, Timothy X Milla e, Leonard X X X X X Nicoletti, Johnathon X X Oandason, Jose X X X X X X Rommel, Daniel X X Saber, Sam X X X Swank, Phillip X I X X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed(Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code Speciallnspectionbst. doc revised 02101114 Agency Name, Address and expiration date Special Inspectors RC Pc Special Inspection Field SM SW HB FP S W CG Krazan &Associates, Inc. 6711 Sierra Court, Ste B Dublin, CA 94568 Tel: (925) 307-1160 Fax: (925) 307-1161 Exp: 2/6/2014 www.krazan.com James Allen X X X James Benefeito X X X Larry Borges X X X X Ron Chandler X Van DeMent X X Gregory Fernald Matthew Fernald Lewis Franklin X X X X X Ken Hafeli X X X Andy Morris X X X X Sidney Moss X X X X Matt Romero X Gregory Ruf MatriScope Engineering Laboratories, Inc. 4730 Contractors Common Livermore, CA 94551 Tel: (925) 606-7700 Fax: (925) 606-7702 Expires: 7/26/2014 www.matriscope.com D'Souza, Andrew Fannin, Dana X X X Ho elian, Joseph X X X X Keller, Don X X Kohls, Kristin Lake, Adam X X Mathis, Q. Shane X X X X X Nieser, Paul X Palmer, Scott Reese, Mark X Scoble, Kod Selvage, Kevin Shelton, James X X X X X X Sta ner, Jack X X X X X X Swartz, Jud Tadlock, K. Scott X X X X X X Tadlock, Robert X X X X X X Thomas, Chris X Varella, Joe RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = SprapApplied Fireproofing CG = CalGreen Code SpeciallnspectionList.doc revised 02101114 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW HB FP S W CG Neil O. Anderson & Associates, Inc. 902 Industrial Way Lodi, CA 95240 Tel: (209) 367-3701 Fax: (209) 333-8303 Expires: 2/1/2016 www.noanderson.com Allen, Eric FP = SpraywApplied Fireproofing CG = CalGreen Code Cozad, Mike X X X X X Dickey, David X Erickson, Rick Gray, Dave X X X X X X Hall, Rollin Johnson, Carl X X X X King, Ryan X Kort, Jason X X X X Landess, Frank X X X Lenehan, Gerry Me'orado, Aaron X Merrell, Ryan X Morgan, Daniel O as, George Oszut, Gregory X X X X Roberts, Jason Westfall, Kimmis X X X X X Whiting, John Williams, Roger X X X PacificlnterWest Bldg Consultants, Inc. 1600 South Main St, Suite 380 Walnut Creek, CA 94596 Tel: (925) 939-5500 Fax: (925) 939-9561 Expires: 9/6/2013 www.r)acificinterwest.com Cope,Doug X PSI, Inc. 365 Victor Street, Ste. C Salinas, CA 93907 Tel: (831) 757-3536 Fax: (831) 757-6265 Expires: 1/10/2015 www.psiusa.com Albert George X X X X X Deborah White X Michael Winter X X William Monger X X X X X Brand Burfield X Ezekiel Robles X Stephen Ramos X Darwin Zackary X El RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W = Wood SM = Structural Masonry FP = SpraywApplied Fireproofing CG = CalGreen Code SpecialInspectionList.doc revised 02/01114 Agency Name, Address and expiration date Secial Insectors pp S =Soils PC = Pre-stressed/Post-tensioned Concrete Special Inspection Field RC PC SM SW HB FP S W CG RMA Group of Northern California 6296 San Ignacio Ave., Suite A San Jose, CA 95119 Tel: (408) 362-4920 Fax: (408) 362-4926 Expires: 04/01/2012 www.rmacompanies.com Alley, Maurice X X Bosque, Jeff X X X Carr, Greg Cecconi, Joe X Chinn, Gordon X X X X Francis, Chris X X Geraghty, Rich X X X Gillespie, John X X X X X Gundersen, Al X X X Haff, Tiffany Hughes, Dottie X X X Sondrol, Jeff X X X X Stocke, Jacob X Swain, Pat X Tellesen, Mike X X Tonkovich, Bill X X X X Walters, Chris X X X X X X Zeiher, Adam X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W= Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code Speciallnspectionbst.doc revised 02/0//14 Agency Name, Address and expiration date Special Inspectors RC Pc Special Inspection Field SM sw HB FP s w CG Smith -Emery Company Corporate Office: 781 E. Washington Blvd. Los Angeles, CA 90021 Testing Facilities: 1940 Oakdale Ave. P.O. Box 880550 San Francisco, CA 94124 Tel: (415) 642-7326 Expires: 4/09/2015 www.smithemerysf.com Allder, Scott FP = Spray -Applied Fire roofin CG = Cal Green Code Brunett, John X X X Caraisco, Thomas X X X X X X Chuong, Jason X Contreras, Roberto X X X X X Cross, Len Cunningham, Jim Daniels, Jodie X X Daquinag, Bonafacio Docena, Bernard Drake, Barry X I X Joakimson, Robert X X X X X X lopson, Paul X X X K Mazuk, Ray X McCarron, Liam X X X Merino, Salvador X X X X X Miranda, Allen Murphy, Mike Nadler, Joel X X X Nickerson, Scott X X X X Ross, Jason X X Serrano, Ramon Sherwood, Tony X X X X X X Starkey, Raymond Stevenson, Wylie Viramontes, Keith X X X Stevens, Ferrone & Bailey 1600 Willow Pass Court Concord, CA 94520 Tel: (925) 688-1001 Fax: (925) 688-1005 Expires: 8/09/2014 www.sfandb.com Babione, Martin X X X Conner, Scott X X I X X X X Fletcher, Brett X X X X X X X Minor, Matt X X X Quinn, Tom X X X X Thielges, Jon RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W = Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = Cal Green Code SpeciallnspectionList.doc revised 02/01/14 Agency Name, Address and expiration date Special Inspectors RC PC Special Inspection Field SM SW HB FP s w CG Terracon Consultants, Inc. 3140 Gold Camp Drive, Suite 170 Rancho Cordova, CA 95670 Tel: (916) 858-1579 Fax: (916) 858-8277 Expires: 7/17/2015 www.terracon.com Houts, Walter X X X X X X Mears, Steven X X X X X X Testing Engineers, Inc. 2811 Teagarden Street San Leandro, CA 94577 Tel: (510) 835-3142 Fax: (510) 834-3777 Expires: 4/22/2015 testing-engineers.com Ardizonne, Mike X Dougherty, John X X X X Ganly, Jim Geraghty, Richard X X X X Grossman, Peter, P.E. X Gunderson, Al X X X X Hernandez, Frank X X X X X Mendosa, John X Muzika, Bruce X X Ronald, Seth X Souza, Jason X X Tellesen, Mike X X Thomas, Paul X X X X Watanabe, Dan X Williams, Brian X White, Walker X Yoka,John X X X Western Technologies, Inc. 3480 South Dodge Blvd. Tucson, AZ 85713 Tel: (520) 748-2262 Expires: 8/29/2014 www.wt-us.com Tiedemann, Thomas X RC = Reinforced Concrete SW = Steel & Welding S =Soils PC = Pre-stressed/Post-tensioned Concrete HB = High -Strength Bolding W = Wood SM = Structural Masonry FP = Spray -Applied Fire roofin CG = CalGreen Code SpeciallnspectionGist.doc revised 02/01//4 August 28, 2015 City of Cupertino Building Department 10300 Torre Avenue Cupertino, CA 95014-3255 Subject: 10364 Sterling Blvd., Cupertino, CA 95014 To Whom It May Concern: Please be advised that the proposed building as referenced above will not have any adverse impact on the City of Sunnyvale's sewer system. Please call me if you have any questions at (408) 730-7636. Very truly yours, Manuel Pineda Director of Public Works Bennett Chun, P.E. Civil Engineer CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence culation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis0 ame: 10364 Sterling Blvd new.xml 'Z "o., 117%A CF1 R -PRF -01 Pagel of 11 GENERAL INFORMATION 01 Building Complies with Computer Performance 01 Proame Mr. Dong Resid 03 This building incorporates one or more Special Features shown below 02 Calculation Description Title 24 Analysis Jk 08 Energy Use (kTDV/ft2-yr) 03 Project Location 4 Sterling Blvd 46 Compliance Margin Percent Improvement 04 City Cu rtino 05 Standards Version Compliance 2015 06 Zip Code 0 07 Compliance Manager Version BEMCmpMgr 2013-3c (710) 08 Climate Zone CZ4 09 Software Version EnergyPro 6.5 10 Building Type Single Family 11 Front Orientation (deg/Cardinal) 270 12 Project Scope Newly Constructed 13 Number of Dwelling Units 1 14 Total Cond. Floor Area (ft2) 2036 15 Number of Zones 2 16 Slab Area (ft2) 0 17 Number of Stories 2 18 Addition Cond. Floor Area N/A 19 Natural Gas Available Yes 20 Addition Slab Area (ft2) N/A 21 Glazing Percentage (%) 18.0% This compliance analysis is valid only for permit applications through July 31, 2015 COMPLIANCE RESULTS 01 Building Complies with Computer Performance 02 This building incorporates features that require field testing and/or verification by a certified HERS rater under the supervision of a CEC-approved HERS provider. 03 This building incorporates one or more Special Features shown below 06 Registration Number: 215-No217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 ENERGY USE SUMMARY 04 05 06 07 08 Energy Use (kTDV/ft2-yr) Standard Design Proposed Design Compliance Margin Percent Improvement Space Heating 21.33 21.12 0.21 1.0% Space Cooling 9.87 13.79 -3.92 -39.7% IAQ Ventilation 1.32 1.32 0.00 0.0% Water Heating 13.78w-d AF 4.63 33.6% Photovoltaic Offset --- F. 00 0.00 ---- Compliance Energy Total 46.30• 45.38 0.92 2.0% Registration Number: 215-No217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD CF1 R -PRF -01 Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Page 2 of 11 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml REQUIRED SPECIAL FEATURES The following are features that must be installed as condition for meeting the modeled energy performance for this computer analysis. • Window overhangs and/or fins HERS FEATURE SUMMARY The following is a summary of the features that must be field -verified by a certified HERS Rater as a condition for meeting the modeled energy performance for this computer analysis. Additional detail is provided in the building components tables below. Building -level Verifications: • IAQ mechanical ventilation Cooling System Verifications: • Minimum Airflow • Fan Efficacy Watts/CFM HVAC Distribution System Verifications: • Duct Sealing Domestic Hot Water System Verifications: • --None -- ENERGY DESIGN RATING This is the sum of the annual TDV energy consumption for energy use components included in the performance compliance approach for the Standard Design Building (Energy Budget) and the annual TDV energy consumption for lighting and components not regulated by Title 24, Part 6 (such as domestic appliances and consumer electronics) and accounting for the annual TDV energy offset by an on-site renewable energy system. Reference Energy Use Energy Design Rating Margin Percent Improvement Total Energy (kTDV/f2-yr)` 191.17 90.25 0.92 1.0% " includes calculated Appliances and Miscellaneous Energy Use (AMEU) BUILDING - FEATURES INFORMATION 01 02 03 04 05 06 07 Project Name Conditioned Floor Area (ft2) Number of Dwelling Units Number of Bedrooms Number of Zones Number of Ventilation Cooling Systems Number of Water Heating Systems Mr. Dong Residence 2036 1 4 2 0 1 ZONE INFORMATION 01 02 03 04 05 06 07 Zone Name Zone Type HVAC System Name Zone Floor Area (ft2) Avg. Ceiling Height Water Heating System 1 Water Heating System 2 First Floor Conditioned HVAC1 1218 9 DHW Sys 1 Second Floor Conditioned HVAC1 818 9 DHW Sys 1 Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Datefrime: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 3 of 11 OPAQUE SURFACES 01 02 03 04 05 06 07 08 Name Zone Construction Azimuth Orientation Gross Area (ft) Window & Door Area (ft2) Tilt (deg) Front Wall First Floor R-13 Wall 270 Front 201.7 100.4 90 Left Wall First Floor R-13 Wall 0 Left 421.5 12 90 Rear Wall First Floor R-13 Wall 90 Back 375.8 93.38 90 Right Wall First Floor R-13 Wall 180 Right 381 84 90 Lower Roof First Floor R-30 Roof Attic 622.3 First Front Wall First Floor»_Garage_ R-13 Wall1 210 First Right Wall First Floor»_Garage_ R-13 Wall1 210 Raised Floor First Floor R-19 Floor Crawlspace 1218 Front Wall 2 Second Floor R-13 Wall 270 Front 219.8 44.992 90 Left Wall 2 Second Floor R-13 Wall 0 Left 366.8 36.989 90 Rear Wall 2 Second Floor R-13 Wall 90 Back 219.8 62.985 90 Right Wall 2 Second Floor R-13 Wall 180 Right 366.8 25 90 Upper Roof Second Floor R-30 Roof Attic 818 Garage Front Wall Garage_ R-13 Wall 270 Front 210 112 90 Garage Left Wall Garage_ R-13 Wall 0 Left 210 36 90 Exterior Rear Wall Garage R-13 Wall 90 Back 10 90 Interior Right Surface _Garage_»First Floor R-13 Wall'! 210 Interior Rear Surface _Garage »First Floor R-13 Wall'! 215.8 Garage Roof _Garage_ R-30 Roof Attic 200 ATTIC 01 02 03 04 05 06 07 08 Name Construction Type Roof Rise Roof Reflectance Roof Emittance Radiant Barrier Cool Roof Attic Garage Attic Garage Roof Cons Ventilated 4 0.1 0.85 No No Attic First Floor Attic RoofFirst Floor Ventilated 4 0.1 0.85 No No Attic Second Floor Attic RoofSecond Floor Ventilated 4 0.1 0.85 No No Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF111-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Datefrime: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 4 of 11 WINDOWS 01 02 03 04 05 06 07 08 09 10 Name Type Surface (Orientation -Azimuth) Width (ft) Height (ft) Multipli er Area (ft) U -factor SHGC Exterior Shading Windows Window Front Wall (Front -270) 2.0 6.0 1 12.0 0.34 0.30 Insect Screen (default) Window2 Window Front Wall (Front -270) 6.0 6.0 1 36.0 0.34 0.30 Insect Screen (default) Window3 Window Front Wall (Front -270) 2.0 6.0 1 12.0 0.34 0.30 Insect Screen (default) Windowl 2 Window Left Wall (Left -0) 4.0 6.0 0.5 12.0 0.34 0.30 Insect Screen (default) Windowl 3 Window Rear Wall (Back -90) 5.0 4.0 1 20.0 0.34 0.30 Insect Screen (default) Window2 2 Window Rear Wall (Back -90) 8.0 6.7 0.375 20.0 0.34 0.30 Insect Screen (default) Windowl 4 Window Right Wall (Right -180) 4.0 3.0 2 24.0 0.34 0.30 Insect Screen (default) Window2 3 Window Right Wall (Right -180) 4.0 4.0 0.75 12.0 0.34 0.30 Insect Screen (default) Window3 2 Window Right Wall (Right -180) 4.0 4.0 2.25 36.0 0.34 0.30 Insect Screen (default) Window4 Window Right Wall (Right -180) 4.0 4.0 0.75 12.0 0.34 0.30 Insect Screen (default) Windowl 5 Window Front Wall 2 (Front -270) 4.0 4.0 1.562 25.0 0.34 0.30 Insect Screen (default) Window2 4 Window Front Wall 2 (Front -270) 2.0 5.0 1 10.0 0.34 0.30 Insect Screen (default) Window3 3 Window Front Wall 2 (Front -270) 5.0 5.0 0.4 10.0 0.34 0.30 Insect Screen (default) Windowl 6 Window Left Wall 2 (Left -0) 3.0 3.0 1.333 12.0 0.34 0.30 Insect Screen (default) Window2 5 Window Left Wall 2 (Left -0) 4.0 4.0 1.562 25.0 0.34 0.30 Insect Screen (default) Windowl 7 Window Rear Wall 2 (Back -90) 3.0 3.0 1.333 12.0 0.34 0.30 Insect Screen (default) Window2 6 Window Rear Wall 2 (Back -90) 2.0 6.0 2.5 30.0 0.34 0.30 Insect Screen (default) Window3 4 Window Rear Wall 2 (Back -90) 6.0 6.0 0.333 12.0 0.34 0.30 Insect Screen (default) Window4 2 Window Rear Wall 2 (Back -90) 2.0 6.0 0.75 9.0 0.34 0.30 Insect Screen (default) Windowl 8 Window Right Wall 2 (Right -180) 5.0 5.0 0.64 16.0 0.34 0.30 Insect Screen (default) Window2 7 Window Right Wall 2 (Right -180) 3.0 3.0 1 9.0 0.34 0.30 Insect Screen (default) Window Window Garage Left Wall (Left -0) 4.0 4.0 1 16.0 0.34 0.30 Insect Screen (default) Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation DatelTime: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 5 of 11 DOORS 01 02 03 04 Name Side of Building Area (ft2) U -factor Doors Front Wall 40.4 0.50 Door1 2 Rear Wall 53.4 0.50 GarageCarpoorFront Garage Front Wall 112.0 0.70 Door1 3 Garage Left Wall 20.0 0.50 Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-0603:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 6 of 11 Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 lost Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 7 of 11 OPAQUE SURFACE CONSTRUCTIONS 01 02 03 04 05 06 07 Total Cavity Winter Design Construction Name Surface Type Construction Type Framing R -value U -value Assembly Layers • Inside Finish: Gypsum Board • Cavity/Frame: R -13/2x4 • Exterior Finish: Wood R-13 Wall Exterior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.095 Siding/sheathing/decking Inside Finish: Gypsum Board Ceilings (below • Cavity/Frame: R-9.1 /2x4 R-30 Roof Attic attic) Wood Framed Ceiling 2x4 @ 24 in. O.C. R 30 0.032 • Over Floor Joists: R-20.9 insul. • Inside Finish: Gypsum Board • Cavity/Frame: R -13/2x4 R-13 Walll Interior Walls Wood Framed Wall 2x4 @ 16 in. O.C. R 13 0.092 • Other Side Finish: Gypsum Board • Cavity/ Frame: no insul. /2x4 Top Chrd • Roof Deck: Wood Siding/sheathing/decking 2x4 Top Chord of Roof Truss @ 24 • Tile Gap: present Attic Garage Roof Cons Attic Roofs Wood Framed Ceiling in. O.C. none 0.400 • Roofing: 10 PSF (RoofTile) • Cavity/Frame: no insul. /2x4 Top Chrd 2x4 Top Chord of Roof Truss @ 24 • Roof Deck: Wood Siding/sheathing/decking Attic RoofFirst Floor Attic Roofs Wood Framed Ceiling in. O.C. none 0.616 • Roofing: 10 PSF (RoofTile) • Floor Surface: Carpeted Floors Over • Floor Deck: Wood Siding/sheathing/decking R-19 Floor Crawlspace Crawlspace Wood Framed Floor 2x6 @ 16 in. O.C. R 19 0.049 • Cavity/ Frame: R -19/2x6 • Cavity/ Frame: no insul. /2x4 Top Chrd • Roof Deck: Wood Siding/sheathing/decking 2x4 Top Chord of Roof Truss @ 24 • Tile Gap: present Attic RoofSecond Floor Attic Roofs Wood Framed Ceiling in. O.C. none 0.400 • Roofing: 10 PSF (RoofTile) • Floor Surface: Carpeted • Floor Deck: Wood Siding/sheathing/decking • Cavity/Frame: R -19/2x6 R-19 Floor No Crawlspace Interior Floors Wood Framed Floor 2x6 @ 16 in. O.C. R 19 0.048 • Ceiling Below Finish: Gypsum Board BUILDING ENVELOPE - HERS VERIFICATION 01 02 03 04 Quality Insulation Installation (QII) Quality Installation of Spray Foam Insulation Building Envelope Air Leakage ACH @ 50 Pa Not Required Not Required Not Required --- Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 8 of 11 WATER HEATING SYSTEMS 01 02 03 04 05 06 Name System Type Distribution Type Water Heater Number of Heaters Solar Fraction (%) DHW Sys 1 - 1/1 DHW Pipe Insulation, All Lines DHW Heater 1 1 .0% WATER HEATERS 01 02 03 04 05 06 07 08 Name Heater Element Type Tank Type Tank Volume (gal) Energy Factor or Efficiency Input Rating Tank Exterior Insulation R -value Standby Loss (Fraction) DHW Heater 1 Natural Gas Small Instantaneous 0.2 0.84 199000-Btu/hr 0 0 WATER HEATING - HERS VERIFICATION 01 02 03 04 05 06 07 Name Pipe Insulation Parallel Piping Compact Distribution Point -of Use Recirculation Control Central DHW Distribution DHW Sys 1 - 1/1 --- --- --- SPACE CONDITIONING SYSTEMS 01 02 03 04 05 06 SC Sys Name System Type Heating Unit Name Cooling Unit Name Fan Name Distribution Name HVAC1 Other Heating and Cooling System Heating Component 1 Cooling Component 1 HVAC Fan 1 Air Distribution System 1 HVAC - HEATING UNIT TYPES 01 02 03 Name Type Efficiency Heating Component 1 CntrlFurnace - Fuel -fired central furnace 96.6 AFUE Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 9 of 11 HVAC - COOLING UNIT TYPES 01 02 03 04 05 06 07 Name Verified Airflow Efficiency Verified EER Multi -speed Verified Refrigerant Charge Name System Type EER SEER Zonally Controlled Compressor HERS Verification Cooling Component 1 SplitAirCond 11.3 13 Not Zonal Single Speed Cooling Component 1 -hers -cool HVAC COOLING - HERS VERIFICATION 01 02 03 04 05 06 Name Verified Airflow Airflow Target Verified EER Verified SEER Verified Refrigerant Charge Cooling Component 1 -hers -cool Required 350 Not Required Not Required Not Required HVAC - DISTRIBUTION SYSTEMS 01 02 03 04 05 06 07 Name Type Duct Leakage Insulation R -value Duct Location Bypass Duct HERS Verification Air Distribution System 1 DuctsAttic Sealed and tested 6 Attic None Air Distribution System 1 -hers -dist HVAC DISTRIBUTION - HERS VERIFICATION 01 02 03 04 05 06 07 08 Name Duct Leakage Verification Duct Leakage Target (%) Verified Duct Location Verified Duct Design Buried Ducts Deeply Buried Ducts Low -leakage Air Handler Air Distribution System 1 -hers -dist Required 6.0 Not Required Not Required Not Required Not Required --- HVAC-FAN SYSTEMS 01 02 03 04 Name Type Fan Power (Watts/CFM) HERS Verification HVAC Fan 1 Single Speed PSC Furnace Fan 0.58 HVAC Fan 1 -hers -fan HVAC FAN SYSTEMS - HERS VERIFICATION 01 02 03 Name Verified Fan Watt Draw Required Fan Efficiency (Watts/CFM) HVAC Fan 1 -hers -fan Required 0.58 Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 10 of 11 IAQ (Indoor Air Quality) FANS 01 02 03 04 05 06 Dwelling Unit IAQ CFM IAQ Watts/CFM IAQ Fan Type IAQ Recovery Effectiveness(%) HERS Verification SFam IAQVentRpt 57.86 0.25 Default 0 Required Registration Number: 215-N0217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 CERTIFICATE OF COMPLIANCE - RESIDENTIAL PERFORMANCE COMPLIANCE METHOD Project Name: Mr. Dong Residence Calculation Date/Time: 03:31, Thu, Aug 06, 2015 Calculation Description: Title 24 Analysis Input File Name: 10364 Sterling Blvd new.xml CF1 R -PRF -01 Page 11 of 11 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: fae-16 Jack Lin Company: Signature Date: W H Y CONSTRUCTION 2015-08-06 03:47:45 Address: CEA/HERS Certification Identification (If applicable): 6805 WESTMOOR WAY City/State/Zip: Phone: SAN JOSE, CA 95129 (408) 218-0587 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. 2. 1 certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 3. 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: Responsible Designer Signature: Jack Lin Company: Date Signed: W H Y CONSTRUCTION 2015-08-06 03:47:45 Address: License: 6805 WESTMOOR WAY CSLB# 964820 City/State/Zip: Phone: SAN JOSE, CA 95129 (408) 218-0587 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: 215-No217724A-000000000-0000 Registration Date/Time: 2015-08-06 03:47:45 HERS Provider: CaICERTS inc. CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version - CF1R-07082015-710 Report Generated at: 2015-08-06 03:32:26 2013 Low -Rise Residential Mandatory Measures Summary NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the comvliance avoroach used. Exceptions may aDDly. Review the respective code section for more information. Building Envelope Measures: §I10.6(a)1: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. § 110.6(a)5: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of § 10-111 (a). § 110.7: Exterior doors and windows are weatherstripped; all joints and penetrations are caulked and sealed. § 110.8(a): Insulation specified or installed meets Standards for Insulating Material. Indicate type and include on the CF2R. § 110.8(1): The thermal emittance and aged solar reflectance values of the cool roofing material meets the requirements of § 110.8(i) when the installation of a cool roof is specified on the CFIR. § 110.80): A radiant barrier shall have an emittance of 0.05 or less when the installation of a radiant barrier is specified on the CFI R. Minimum R-30 insulation in wood -frame ceiling; or the weighted average U -factor shall not exceed 0.031. Minimum R-19 in a § 150.0(a): rafter roof alteration. Attic access doors shall have permanently attached insulation using adhesive or mechanical fasteners. The attic access shall be gasketed to prevent air leakage. § I50.0(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -value. § 150.0(c): Minimum R-13 insulation in 2x4 inch wood framing wall or have a U -factor of 0.102 or less (R-19 in 2x6 or 0.074 maximum U - factor). § 150.0(d): Minimum R-19 insulation in raised wood -frame floor or 0.037 maximum U -factor. In Climate Zones 14 and 16 a Class 11 vapor retarder shall be installed on the conditioned space side of all insulation in all exterior §150.0(g)l: walls, vented attics and unvented attics with air -permeable insulation. In Climate Zones 1-16 with unvented crawl spaces the earth floor of the crawl space shall be covered with a Class I or Class II § 150.0(g)2: vapor retarder. In a building having a controlled ventilation crawl space, a Class I or Class Il vapor retarder shall be placed over the earth floor of § 150.0(g)3: the crawl space to reduce moisture entry and protect insulation from condensation, as specified in the exception to Section 150.0(d). § 150.0(1): Slab edge insulation shall: have a water absorption rate, for the insulation material alone without facings, no greater than 0.3%; have water vapor permeance rate is no greater than 2.0 perm/inch, be protected from physical damage and UV light deterioration; and when installed as part of a heated slab floor meets the requirements of § 110.8 150.0 § (q)' Fenestration, including skylights, separating conditioned space from unconditioned space or outdoors shall have a maximum U- factor of 0.58; or the weighted average U -factor of all fenestration shall not exceed 0.58. Fireplaces, Decorative Gas Appliances and Gas Log Measures: § 150.0(e)IA: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox. § 150.0(e)1B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a readily accessible, operable, and tight -fitting damper or a combustion -air control device. §150.0(e)IC: Masonry or factory -built fireplaces have a flue damper with a readily accessible control. § 150.0(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket. when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: § 110.0-§ 110.3: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified to the Energy Commission. §110.3(c)5: Water heating recirculation loops serving multiple dwelling units meet the air release valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of § 110.3(c)5. Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances (appli- § 110.5: ances without an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool ands a heaters. §150.0(h)l: Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA using design conditions specified in § 150.0(h)2. § 150.0(h)3A: Installed air conditioner and heat pump outdoor condensing units shall have a clearance of at least five feet from the outlet of any dryer vent. § 150.0(i): Heating systems are equipped with thermostats that meet the setback requirements of § 110.2(c). §150.00)IA: Storage gas water heaters with an energy factor equal to or less than the federal minimum standards shall be externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §150.00)1B: Unfired hot water tanks, such as storage tanks and backup storage tanks for solar water -heating systems, have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. For domestic hot water system piping, whether buried or unburied: the first 5 feet of hot and cold water pipes from the storage tank, all piping with a nominal diameter of 3/4 inch or larger, all piping associated with a domestic hot water recirculation system § 150.00)2A: regardless of the pipe diameter, piping from the heating source to storage tank or between tanks, piping buried below grade, and all hot water pipes from the heating source to kitchen fixtures must be insulated according to the requirements of TABLE 120.3- A. § 150.00)2B: All domestic hot water pipes that are buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. 2013 Low -Rise Residential Mandatory Measures Summary §150.00)2C: Pipe for cooling system lines shall be insulated as specified in §150.00)2A. Piping insulation for steam and hydronic heating systems or hot waters stems with pressure > 15 psig shall meet the requirements in TABLE 120.3 -A. § 150.00)3: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Insulation exposed to weather shall either be rated for outdoor use or installed with a cover suitable for outdoor service. For § 150.00)3A: example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation protected as specified or painted with coating that is water retardant and provides shielding from solar radiation that degrades the material. Insulation covering chilled water piping and refrigerant suction piping located outside the conditioned space shall have a Class I § 150.00)3B: or Class Il vapor retarding facing, or the insulation shall be installed at the thickness that qualifies as a Class I or Class II vapor retarder. Systems using gas or propane water heaters to serve individual dwelling units shall include: a 120V electrical receptacle within 3 feet of the water heater; a Category III or IV vent, or a Type B vent with straight pipe between the outside termination and the §150.0(n)l: space where the water heater is installed; a condensate drain that is no more than 2 inches higher than the base of the installed water heater, and allows natural draining without pump assistance; and a gas supply line with a capacity of at least 200,000 Btu/hr. § I50.0(n)2: Recirculating loops serving multiple dwelling units shall meet the requirements of § 110.3(c)5. § 150.0(n)3: Solar water -heating systems and collectors shall be certified and rated by the Solar Rating and Certification Corporation (SRCC) or by a testing enc approved by the Executive Director. Ducts and Fans Measures: All air -distribution system ducts and plenums installed are sealed and insulated to meet the requirements of CMC §601.0, §602.0, §603.0, §604.0, §605.0 and ANSI/SMACNA-006-2006 HVAC Duct Construction Standards Metal and Flexible 3rd Edition. Supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-6.0 (or higher if required by CMC §605.0) or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing (RA3.1.4.3.8). Connections of metal ducts and inner core of flexible ducts are mechanically fastened. Openings shall be sealed §150.0(m)l: with mastic, tape, or other duct -closure system that meets the applicable requirements of UL 181, UL 181A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than '/4 inch, the combination of mastic and either mesh or tape shall be used. Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. Factory -Fabricated Duct Systems shall comply with specified requirements for duct construction, connections, and closures; joints §150.0(m)2: and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. §150.0(m)3-6: Field -Fabricated Duct Systems shall comply with requirements for: pressure -sensitive tapes, mastics, sealants, and other requirements specified for duct construction; duct insulation R -value ratings; duct insulation thickness; and duct labelmi . § 150.0(m)7: All fan systems that exchange air between the conditioned space and the outside of the building must have backdraft or automatic dampers. §150.0(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers except combustion inlet and outlet air openings and elevator shaft vents. Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind but not § 150.0(m)9: limited to the following: insulation exposed to weather shall be suitable for outdoor service. For example, protected by aluminum, sheet metal, painted canvas, or plastic cover. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation. §150.0(m)10: Flexible ducts cannot have porous inner cores. When space conditioning systems use forced air duct systems to supply conditioned air to an occupiable space, the ducts shall be § 150.0(m)11: sealed and duct leakage tested, as confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Mechanical systems that supply air to an occupiable space through ductwork exceeding 10 feet in length and through a thermal §150.0(m)12: conditioning component, except evaporative coolers, shall be provided with air filter devices that meet the requirements of §150.0(m)12. Space conditioning systems that utilize forced air ducts to supply cooling to an occupiable space shall have a hole for the placement of a static pressure probe (HSPP), or a permanently installed static pressure probe (PSPP) in the supply plenum. The §150.0(m)13: space conditioning system must also demonstrate airflow > 350 CFM per ton of nominal cooling capacity through the return grilles, and an air -handling unit fan efficacy:S 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Zonally controlled central forced air cooling systems shall be capable of simultaneously delivering, in every zonal control mode, §150.0(m)15: an airflow from the dwelling, through the air handler fan and delivered to the dwelling, of > 350 CFM per ton of nominal cooling capacity, and operating at an air -handling unit fan efficacy of _< 0.58 W/CFM as confirmed by field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. All dwelling units shall meet the requirements of ASHRAE Standard 62.2. Neither window operation nor continuous operation of § 150.0(0): central forced air system air handlers used in central fan integrated ventilation systems are permissible methods of providing the Whole Building Ventilation. §150.0(o)IA: Whole Building Ventilation airflow shall be confirmed through field verification and diagnostic testing, in accordance with Reference Residential Appendix RA3. Pool and Spa Heating Systems and Equipment Measures: Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency § 110.4(a): Regulations; an on-off switch mounted outside of the heater that allows shutting off the heater without adjusting the thermostat setting; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating. 2013 Low -Rise Residential Mandatory Measures Summary § 110.4(b)1: Any pool or spa heating equipment shall be installed with at least 36 inches of pipe between filter and heater or dedicated suction and return lines, or built-up connections for future solar heating. § 110.4(b)2: Outdoor pools or spas that have a heat pump or gas heater shall have a cover. § 110.4(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or pro- grammed to run only during off-peak electric demand periods. § 110.5: Natural gas pool and spa heaters shall not have a continuous burning pilot light. § 150.0(p): Residential pool systems or equipment shall meet specified pump sizing, flow rate, piping, filters, and valve requirements. Lighting Measures: § 110.9: All lighting control devices and systems, ballasts, and luminaires shall meet the applicable requirements of § 110.9. §150.0(k)IA: Installed luminaires shall be classified as high -efficacy or low -efficacy for compliance with §I50.0(k) in accordance with TABLE 150.0-A or TABLE 150.0-B, as applicable. § 150.0(k)1B: When a high efficacy and low efficacy lighting system are combined in a single luminaire, each system shall separately comply with the applicable provisions of § 150.0(k). The wattage and classification of permanently installed luminaires in residential kitchens shall be determined in accordance with §150.0(k)IC: § 130.0(c). In residential kitchens, the wattage of electrical boxes finished with a blank cover or where no electrical equipment has been installed, and where the electrical box can be used for a luminaire or a surface mounted ceiling fan, shall be calculated as 180 watts of low efficacy lighting er electrical box. §150.0(k)1D: Ballasts for fluorescent lamps rated 13 watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. Permanently installed night lights and night lights integral to installed luminaires or exhaust fans shall be rated to consume no §150.0(k)IE: more than 5 watts of power per luminaire or exhaust fan as determined in accordance with §I30.0(c). Night lights do not need to be controlled by vacancy sensors. §150.0(k)IF: Lighting integral to exhaust fans (except when installed by the manufacturer in kitchen exhaust hoods) shall meet the applicable requirements of § 150.0(k). § 150.0(k)2A: High efficacy luminaires must be switched separately from low efficacy luminaires. § 150.0(k)2B: Exhaust fans shall be switched separately from lighting systems. § 150.0(k)2C: Luminaires shall be switched with readily accessible controls that permit the luminaires to be manually switched ON and OFF. § 150.0(k)2D: Controls and equipment are installed in accordance with manufacturer's instructions. § 150.0(k)2E: No control shall bypass a dimmer or vacancy sensor function if the control is installed to comply with § 150.0(k). § 150.0(k)2F: Lighting controls comply with applicable requirements of § 110.9. An Energy Management Control System (EMCS) may be used to comply with dimmer requirements if: it functions as a dimmer § 150.0(k)2G: according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in § 150.0(k)2. An Energy Management Control System (EMCS) may be used to comply with vacancy sensor requirements of § I50.0(k) if. it § 150.0(k)2H: functions as a vacancy sensor according to § 110.9; meets Installation Certificate requirements of § 130.4; the EMCS requirements of § 130.5; and all other requirements in § 150.0(k)2. §150.0(k)21: A multiscene programmable controller may be used to comply with dimmer requirements of this section if it provides the functionality of a dimmer according to § 110.9, and complies with all other applicable requirements in § 150.0(k)2. § 150.0(k)3A: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. Kitchen lighting includes all permanently installed lighting in the kitchen except internal lighting in cabinets that illuminate only § 150.0(k)3B: the inside of the cabinets. Lighting in areas adjacent to the kitchen, including but not limited to dining and nook areas, are considered kitchen lighting if they are not separately switched from kitchen lighting. § 150.0(k)4: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. § I50.0(k)5: A minimum of one high efficacy luminaire shall be installed in each bathroom; and all other lighting installed in each bathroom shall be high efficacy or controlled by vacancy sensors. §150.0(k)6: Lighting installed in attached and detached garages, laundry rooms, and utility rooms shall be high efficacy luminaires and controlled by vacancy sensors. §150.0(k)7: Lighting installed in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, and utility rooms shall be high efficacy, or shall be controlled by either dimmers or vacancy sensors. Luminaires recessed into ceilings shall: be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testing/rating laboratory; have a label that certifies that the luminaire is airtight with air leakage less than 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; be sealed with a gasket or caulk between the luminaire housing §150.0(k)8: and ceiling, and shall have all air leak paths between conditioned and unconditioned spaces sealed with a gasket or caulk; and allow ballast maintenance and replacement without requiring cutting holes in the ceiling. For recessed compact fluorescent luminaries with ballasts to qualify as high efficacy for compliance with § 150.0(k), the ballasts shall be certified to the Energy Commission to comply with the applicable requirements in § 110.9. For single-family residential buildings, outdoor lighting permanently mounted to a residential building or other buildings on the same lot shall be high efficacy, or may be low efficacy if it meets all of the following requirements: i. Controlled by a manual ON and OFF switch that does not override to ON the automatic actions of Items ii or iii below; and § 150.0(k)9A: ii. Controlled by a motion sensor not having an override or bypass switch that disables the motion sensor, or controlled by a motion sensor having a temporary override switch which temporarily bypasses the motion sensing function and automatically reactivates the motion sensor within 6 hours; and iii. Controlled by one of the following methods: 2013 Low -Rise Residential Mandatory Measures Summary a. Photocontrol not having an override or bypass switch that disables the photocontrol; or b. Astronomical time clock not having an override or bypass switch that disables the astronomical time clock, and which is programmed to automatically turn the outdoor lighting OFF during daylight hours; or c. Energy management control system which meets all of the following requirements: At a minimum provides the functionality of an astronomical time clock in accordance with § 110.9; meets the Installation Certification requirements in § 130.4; meets the requirements for an EMCS in §130.5; does not have an override or bypass switch that allows the luminaire to be always ON; and. is programmed to automatically turn the outdoor lighting OFF during daylight hours. For low-rise multifamily residential buildings, outdoor lighting for private patios, entrances, balconies, and porches; and outdoor lighting for residential parking lots and residential carports with less than eight vehicles per site shall comply with one of the §150.0(k)9B: following requirements: i. Shall comply with § 150.0(k)9A; or ii. Shall comply with the applicable requirements in 110.9, §130.0, § 130.2, §130.4, §140.7 and §141.0. § I50.0(k)9C: For low-rise residential buildings with four or more dwelling units, outdoor lighting not regulated by § I50.0(k)9B or 150.0(k)9D shall comply with the applicable requirements in § 110.9, § 130.0, § 130.2, § 130.4, § 140.7 and § 141.0. Outdoor lighting for residential parking lots and residential carports with a total of eight or more vehicles per site shall comply § I50.0(k)9D: with the applicable requirements in § 110.9, § 130.0, § 13 0.2, § 130.4, § 140.7 and § 141.0. §150.0(k)10: Internally illuminated address signs shall comply with § 140.8; or shall consume no more than 5 watts of power as determined according to § 13 0. 0 c . § 150.0(k)11: Lighting for residential parking garages for eight or more vehicles shall comply with the applicable requirements for nonresidential garages in § 110.9, § 130.0, § 130. 1, § 130.4, § 140.6, and § 141.0. In a low-rise multifamily residential building where the total interior common area in a single building equals 20 percent or less of § 150.0(k)12A: the floor area, permanently installed lighting for the interior common areas in that building shall be high efficacy luminaires or controlled by an occupant sensor. In a low-rise multifamily residential building where the total interior common area in a single building equals more than 20 percent of the floor area, permanently installed lighting in that building shall: §150.0(k)12B: i. Comply with the applicable requirements in §110.9, §130.0, §130.1, §140.6 and §141.0; and ii. Lighting installed in corridors and stairwells shall be controlled by occupant sensors that reduce the lighting power in each space by at least 50 percent. The occupant sensors shall be capable of turning the light fully On and Off from all designed paths of ingress and egress. Solar Ready Buildings: Single family residences located in subdivisions with ten or more single family residences and where the application for a §I10.10(a)1: tentative subdivision map for the residences has been deemed complete, by the enforcement agency, on or after January I, 2014, shall comply with the requirements of § 110.10 b through § 110.10 e . § 110.10(a)2: Low-rise multi -family buildings shall comply with the requirements of § 110.10(b) through § 110.10(d). The solar zone shall have a minimum total area as described below. The solar zone shall comply with access, pathway, smoke ventilation, and spacing requirements as specified in Title 24, Part 9 or other Parts of Title 24 or in any requirements adopted by a local jurisdiction. The solar zone total area shall be comprised of areas that have no dimension less than 5 feet and are no less than 80 square feet each for buildings with roof areas less than or equal to 10,000 square feet or no less than 160 square feet each for §1 10.10(b)l: buildings with roof areas greater than 10,000 square feet. For single family residences the solar zone shall be located on the roof or overhang of the building and have a total area no less than 250 square feet. For low-rise multi -family buildings the solar zone shall be located on the roof or overhang of the building or on the roof or overhang of another structure located within 250 feet of the building or on covered parking installed with the building project and have a total area no less than 15 percent of the total roof area of the building excluding any skylight area. § 110.10(b)2: All sections of the solar zone located on steep -sloped roofs shall be oriented between 110 degrees and 270 degrees of true north. § 110.10(b)3A: No obstructions, including but not limited to, vents, chimneys, architectural features, and roof mounted equipment, shall be located in the solar zone. Any obstruction, located on the roof or any other part of the building that projects above a solar zone shall be located at least twice § 110.10(b)3B: the distance, measured in the horizontal plane, of the height difference between the highest point of the obstruction and the horizontal projection of the nearest point of the solar zone, measured in the vertical plane. § 110.10(b)4: For areas of the roof designated as solar zone, the structural design loads for roof dead load and roof live load shall be clearly indicated on the construction documents. The construction documents shall indicate: a location for inverters and metering equipment and a pathway for routing of conduit § 110.10(c): from the solar zone to the point of interconnection with the electrical service (for single family residences the point of interconnection will be the main service panel); a pathway for routing of plumbing from the solar zone to the water -heating system. § 110.10(d): A copy of the construction documents or a comparable document indicating the information from § 110.10(b) through § 110.10(c) shall be provided to the occupant. § 110.10(e)l : The main electrical service panel shall have a minimum busbar rating of 200 amps. The main electrical service panel shall have a reserved space to allow for the installation of a double pole circuit breaker for a § 110.10(e)2: future solar electric installation. The reserved space shall be: positioned at the opposite (load) end from the input feeder location or main circuit location, and permanently marked as "For Future Solar Electric". HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Mr. Dong Residence Date 8/6/2015 System Name HVAC Floor Area 2,036 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 1 COIL CFM Total Room Loads 626 Return Vented Lighting Return Air Ducts Return Fan Ventilation 0 Supply Fan Supply Air Ducts TOTAL SYSTEM LOAD COOLING PEAK COIL HTG. PEAK Heating System Sensible Latent CFM Sensible Output per System 38,000 15,108 1,340 516 24,342 Total Output (Btuh) 38,000 0 Output (Btuh/s ft) 18.7 685 1,352 Cooling System 0 0 Output per System 33,600 0 0 0 0 Total Output (Btuh) 33,600 0 1,340 0 Total Output (Tons) 2.8 685 1,352 Total Output (Btuh/sqft) 16.5 Total Output (s ft/Ton) 727.1 1 16,479 27,046 Air System CFM per System 1,050 HVAC EQUIPMENT SELECTION Airflow (cfm) 1,050 Carrier 58MVB40-14 CNP 38HD 3 T 31,550 849 38,000 Airflow (cfm/sqft) 0.52 Airflow (cfm/Ton) 375.0 Outside Air (%) 0.0% Total Adjusted System Output (Adjusted for Peak Design conditions) TIME OF SYSTEM PEAK 31,550 849 38,000 Jan 1 AM Outside Air (cfm/sqft) 0.00 Note: values above given at ARI conditions Aug 3 PM HEATING SYSTEM PSYCHROMETRICS (Airstream Temperatures at Time of Heating Peak) 28 OF Outside Air 0 cfm 69 IF 69 OF 115'F 115 OF f rJ Heating Coil Supply Fan 1,050 cfm 114 OF ROOM]n 70 OF COOLING SYSTEM PSYCHROMETICS (Airstream Temperatures at Time of Cooling Peak) 88/68°F Outside Air Ar 0 cfm 79/63°F 79/63°F 55/54°F 55/54°F f CA Cooling Coil Supply Fan 56 / 54 OF 1,050 cfm 41.8 % ROOM 78/62°F i EnergyPro 6.5 by EnergySoft User Number. 20692 Run Code: 2015-08-06703:35:38 ID: WHY14-1201 Page 5 of 5