B-2016-2932 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2932
20433 VIA SAN MARINO CUPERTINO,CA 95014-6332(316 01 204) RANDO AAA HVAC
INC
SAN JOSE,CA 95125
OWNER'S NAME: DEOL JASBIR DATE ISSUED:10/18/2016
OWNER'S PHONE:408-529-2446 PHONE NO:(408)293-4717
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C43&C20 Lie.#Z65-871
Contractor RANDO AAA HVAC INC Date 09/30/2017 X BLDG —ELECT _ PLUMB'
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: PLACE A/C UNIT,SAME LOCATION
i. I have and will maintain a certificate of consent to sclf-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
i. I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area Valuation $4500.00
APPLICANT CFRTMI ATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 316 01 204
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally,th ap licant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
sourcWre-
the Cu ertino Mu ' ' al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
SignaDate 10/18/2016 Issued by:ME
Date: 10/18/2016
OWNER-BUILDERDECLARATI N
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
i. I,as owner of the property,or my employees with wages'as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:10/18/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 1 have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupe ' o Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety UCod ,Sec ons 25505 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTMCATION Date: 10/18/2016
certify that I have readthis application and state that the above information is CON DING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Signature Date 10/18/2016 Licensed
Professional
GENERAL PERMIT APPLICATION MEEMP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CLIPERTIND
(408)777-3228•FAX(408)777-3333 buildin0(a)cuperEino oLq MISC
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OPLLMRING _ ❑IviECHANICAL ELECTRICAL QMiSCELLANEQUS
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CONTACT NAME BBgg � ® (�� per] �(� s/)
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❑OWNER. ❑ 0W-\TR-B1ALDER ❑ OWNER AGENT XCONTRACTOR ❑GO lTRACTOR.AGENT ❑ ARCHITECT ❑-ENGNEER ❑ llEVF.LOFER ❑TE.N'ANT
CONTRACTORNAME 11(y) LICENSENUNIBER�B �'j [LICENSE.'-S,'P1� c2-o Bi]S,L" ci:�
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STREET ADDRESS CITY,STATE;ZI� n P130yi
ARCHITECI§ENGINEERNAME LICENSENUNIBER Bus.LIC - -
COMPANY NAME E-'MAI1. FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF X SFD Or Duplex ❑ Multi-Family PROJECT IN XVILDLAND PROJECT IN
STRUCTURE: ❑ Commercial URBAN INTERFACE-AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ ISO
DESCRIPTION OF WORK
S`/fTi&777 GOGI U
TOTAL VALUATION:
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By my signature below,I certify to each of the following: I am the property owner of authorized agent to act on the property owner's behalf,I have read this
application and the infonliation I have provided is correct. I have read the Description ofNVorkandverify it is accurate. Iagree to comply w-ith all applicable local
ordinances and state laws relating g construction. I authorize representatives'of Cupertino to enter the above-id-Wi8$dproperty for inspection purposes.
Signature of ApplicandAgent:_ ��`�� Date:
SLIT'PLEME\TAI..INI'ORMATION REQUIRED or IC
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MEP,Wisc4plz_11.doc revised 03116111
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR--ALT-HVAC) (Page 1 of 3)
Project Name: JASBIR BEOL Date Prepared: 2016-10.05
A.General Information
CFIR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,
use one CFI11-ALT-02 document for each dwelling unit.
01 Project Name JASBIR BEOL 02 Date Prepared 2016-10-05
03 Project Location 20433 VIA SAN MARINO 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name JASBIR BEOL
07 Zip Code 95014 08 Dwelling Unit Conditioned 2110
Floor Area(ft2)
Number of space conditioning
09 Climate Zone 4 10 (SC)systems in this dwelling 1
KIB.Space Conditioning(SC)System Information
01 02 03 04— 0S 06 07 °, 0$ 09 10
hr# Is the SC Installing a
SC System SC System CFA served system av � refrigerant Installs sew SC F;installing {; Installing T' Installing
Identification or Location or Area by this SC ducted containing system more than 401 entirely new entirely new
Name Served System°(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type
TRANE WHOLE HOUSE 2110 Yes Yes Yes No No No Altered space
conditioning system
C. Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number:216-A0374622A-000000000-0000 Registration Date/Time: 2016-10-05 15:34:52 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008 Report Generated:2016-10-05 15:34:53
Schema Version:0.5555DD
1
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 3)
D.Altered Space Conditioning System(Sections 150.2(b)1E and F)
01 02 03 04 05 06 07 08 09 10 11 12
Heating Cooling
System Heating Altered Heating Minimum Altered Cooling Minimum Required New or
Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct
or.Name Type Components Type Value System Type Components Type Value Type Duct Length R-Value
No heating This field or This field or Outdoor This field or This field or
AC
TRANE Central gas component section is not section is not Central split condensing SEER 13 Setback section is not section is not
furnace altered applicable applicable unit applicable applicable
Required Documentation:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and fans
-Duct insulation requirement for new plenums:R6.
CF2R-MCH-20-H&CF3R-MCH-20-H—Duct Leakage testing required when heating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced.
Leakage rate compliance:<_15%,or<_10%leakage to outside,or seal all accessible leaks.
CF2R-MCH-25-H&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in C2 2,8-15).
CF2RCF3R-MCH-23&CF3R-MCH-23 Air Flow>_300 CFM/ton required when MCH-25 is required.
Exceptions:
-Duct systems registered with HERS provider as previously sealed are exempt fro m,MCH-20 Duct Leakage Testing te,qi,ements
Heating-only systems and Air Handler/Furnace changes do not require venficatiofn of Air Flow MCH 23„or Refn'gerant Chatge MECH`2 ” `ry
Existing- duct systems constructed,insulated or sealed with asbestos;are exempt from M0 D
CN-2ucf,Lea.',kage Testing re ulren7ettts.
vl b
4 �
'a
E.Entirely New or Complete Replacement Duct System,with or without;Equipment Changeout(Sections 15 2(b) Dua and 150 2(b)1E,F)
,
This section does not apply to this project.
F.Entirely New or Complete Replacement Space Conditioning System(Section 1S0.2(b)1C)
This section does not apply to this project.
Registration Number:216-A0374622A-000000000-0000 Registration Date/Time: 2016-10-05 15:34:52 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008 Report Generated:2016-10-05 15:34:53
Schema Version:0.555SDD
1
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: TCS ILff.O�
Rando,Eric
Company: Signature Date;
RANDO AAA HVAC INC 2016-10-05 15:34:52
Address: CEA/HERS Certification Identification(if applicable):
1712 STONE AVENUE N/A
City/State/Zip: Phone:
SAN JOSE CA 95125 408-293-4717
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and performance specifications,materials,components,and manufactured devices forthe building design or,system design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part1 and Part 6 of the California Code of
l;oguiations %x �
4. The building design features or system design features identified on this Certrficate of Complriance are cansisteratwiththe informaCion,,provided on other apptjca:btexcompliance documents,worksheets,
v
calculations,plans and specifications submitted to the eiClforcement dgency for`apprpval with this build/ng perrrfit appl
S. I will ensure that a registered copy of this Certificafa of Cd0,,pliance sha,,, made ayailAj e waththe b, ding^pprmit(s)rissued for'tltepuildirt'g,and;,tnade available Yo the enforcement agency for all applicable
inspections.I understand that a registered copy oft' iSCer'fificate of Compliance,is required to beJncluded with the documeptation the bu�lc)er provides to,>he building owner at occupancy.
u �„ �sr. �. a ,,. .,.
A p g^s, g a 0'r7 «,
Responsible Designer Name: � r x _ ,,,
'i �-- ��� Res onsible Desi nerSi�nature.
Rando,Eric '.
Company: Date Signed:
RANDO AAA HVAC INC 2016-10-05 15:34:52
Address: License:
1712 STONE AVENUE 768871
City/State/Zip: Phone:
SAN JOSE CA 95125 408-293-4717
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-A0374622A-000000000-0000 Registration Date/Time: 2016-10-05 15:34:52 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008Report Generated:2016-10-05 15:34:53
Schema Version:0.555SDD