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14120134CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20157 SUISUN DR CONTRACTOR: DE ANZA BUILDERS PERMIT NO: 14120134 OWNER'S NAME: SIEVERT GLENN F AND ANN A TRUS 1129 LITTLE JOHN WAY DATE ISSUED: 11/10/2015 OWNER'S PHONE: 4088050065 SAN JOSE, CA 95129 PHONE NO: (408) 865-0222 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL CONSTRUCT ONE STORY ADDITON (336 SQ FT); KITCHEN License Class_?7 Lic. # 3 ZZ,�I REMODEL (180 SQ FT); RE-ROOF (2600 SQ FT). ``6(1i Contractor U G J b.ZU \J V,, clot S 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 ompensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $115000 rformance 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: 36928011.00 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mention property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnifyand keep ss the City of Cupertino against liabilities, judgments, costs, and expenses whi tay accrue against said City in consequence of the / Issued by: ��%/ ✓ ��.gfGt Date: //-/0 granting of this permit. d itionally, the applicant understands and will comply l withall non- int sours r ulations per the Cupertino Municipal Code, Section 9.18. i L t { RE-ROOFS: 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(a) sho 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 equip_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 Are it Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cuperti o unicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5505,#5133, and 25534. Section 3700 of the Labor Code, for fie performance of the work for which this Owner or authorized agent: Date: jtLDi, 5 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 I 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 CONSTRUCTION PERMIT APPLICATION 2U�3 CON COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISI is 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (W-cupertino.org CUPERTINO r*2r rl r --I m�wi /r vvvDDvn C)PTCUNAL PRRMIT # L NEW CONSTRUCTION En�L ADDITION LJ AL1bRAlIVIN / 11 LJ -- PROJECT ADDRESS ;?C) I G APN # I y2 -0/1 OWNERNAME ' A PHON� E-MAIL STREET ADDRESS CITY, STATE, ZIP �`FAX / AJC CONTACT NAME PHONE E-MAIL �-- -?Z; -/C)95 Sc0 / STREET ADDRESS �GJ Y/x CITY, STATE, ZIP �^ /'„ yn, FAX ,l ❑ OWNER ❑ OWNER -BUILDER ❑J OWNER(AGENT ❑ CONTRACTOR ❑ CONTRACTOR/A^GENT 1f ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME ( /it /Y LICENSE NUMBER BUS. LIC # COMPANY NAME�i ^, E-MAIL FAX STREET ADDRES7.5i� CITY, STATE, ZIP �/., /' /I PHONE `��/���,/ DESCRIPTTON OF WORK // LN EXISTING USE PROPOSED USE CONSTRTYPE #STORIES Z USE TYPE OCC. SQ. PT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA 1 Q Z -D AREA 2. �L / _ AREA N A NEI' AREA:eZ5;Cf BATHROOM RN OTHER _/� REMODEL AREA � REMODEL AREA rs REMODEL AREA /� � C O PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH AATTACH IVIA ` # DWELLING UNITS: IS A SECOND UNIT❑ YES SECOND STORY LJ YES BEING ADDED? i�6lNO ADDITION? RNO PRE APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # OkNO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME' JANO RECEIV BY: TOTAL VALUATIOa LJ /!5 lorAot7— By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this it is I agree to comply with all applicable local application and the information I have provided is correct. I have read the Description of Work and verify accurate. I representatives of Cupertino to enter the above -identified property for inspection purposes. ordinances and state laws relating to building construction. authorize S i gnature of Appl icant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW _ existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXP SS PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ❑ PUBLIC WORKS _ form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FI DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION kADDRESS: 20157 Suisun dr DATE: 12/23/2014 REVIEWED BY: Mendez PC FEE ID APN: BP#: 'VALUATION: j$115,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex 2nd Unit? Yes • No 0Yes ONO PENTAMATION 1 R3SFDREM PERMIT TYPE: USE: OTC? i WORK a_ddito_n_of 336 sq ft to rear of sfdwl to include (bath bedroom); kitchen remodel 180 sq ft; re -roof 26 sq SCOPE $1,323.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,III-B,IV,V-B 336 $1,626.00 IADDPLCK $1,323.00 IADDINSP PME Plan Check: $0.00 5,600 s.£ $442.00 Re -roof IREROOFRES Permit Fee: $1,323.00 Suppl. Insp. Fee.e Reg. Q OT O,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 336 $1,626.00 $1,323.00 MECH, HOURLY O l es 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No T MISC ITEMS Plan Check Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School n -In otr ► Diese foot are based an the nreliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. �...._., - --- --- are ----- - --------- --- FEE ITEMS (Fee Resolution 11-053 E -f .f 1 '13) FEE QTY/FEE T MISC ITEMS Plan Check Fee: $1,626.00 = s.f. $645.00 Remodel, Kitchen (<=300 sf) IREMRESKIT Suppl. PC Fee: Q Reg. Q OT 0.0 lirs $0.00 PME Plan Check: $0.00 5,600 s.£ $442.00 Re -roof IREROOFRES Permit Fee: $1,323.00 Suppl. Insp. Fee.e Reg. Q OT O,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? © Yes O No 0 0 $0.00 Advanced Planning Fee. IPLLONGR $47.04 Select a Non -Residential Building or Structure 0 7,:;I r°l 1)r,rcni��:; I/�.uir4n F( "S Strong Motion Fee: IBSEISMICR $14.95 Select an Administrative Item WdL, Stds Commission Fee: 1BCBSC $5.00 SUBTOTALS: $3,015.99 $1,087.00 TOTAL FEE: $4,102.99 Revised: 10/01/2014 n XiIt5,P llic� bnfi:-, I )- Al c- _ (fit il„►tc�1� `C�t S G sem' = ►sa i� Ae---vu At Kray �G�.- ko Y// — ���� a�, 4-� �Sn►�c� ►�c`�k�csz 31qoFFICE COP LO -1 ,VroptisQ, C-plS 1 ixw . R E EIVEY �uCCx �?oiu or �,, �7e,mctu I oea l 1adl�, -..�. - -ono L.;7 blT j LIAR 0 0 2010 E -WIEVVED FOR CODE COMPLIANCE R@bIQ'l�� By. , I STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-05-E (Revised 06114) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 1 of 9) P,.j-t Names SIEVERT RESIDENCE Date Prepared: 12/4/13 This compliance document is only applicable to additions 300 ft° or less, or additions that do not require HERS field verification for compliance. When HERS verification is required, a CF1R-ADD-07 shall first be registered with a HERS Provider Data Registry. Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CFIR-ADD-02 and CF2R- ADD -02 Compliance Documents. Possible exemptions from duct leakage testing include: less than 40 ft of ducts were added or replaced, • or the existing duct system was insulated with asbestos; or the existing duct system was previously tested and passed by a HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification, then a CF1R-ADD-01 must be completed and registered with a HERS Provider Data Registry. Additions or alterations that utilize close Cell Spray Polyurethane Foam (ccSPF) with a density of 1.5 to less than 2.5 pounds per cubic foot having an R -value other than 5.8 per inch, or Open Cell Spray Polyurethane Foam (ocSPF) with a density of 0.4 to less than 1.5 pounds per cubic foot having an R -value of 3.6 per inch, shall complete and register a CF1R ADD -01 with a HERS Provider Data Registry. If more than one person has responsibility for installation of the items on this certificate, each person shall prepare responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this certificate Temporary labels shall not be removed before verification by the building inspector. portion of construction for which they are 51e Mandatory Measures shall be met. A. GENERAL INFORMATION �- 01 Project Name: SIEVERT RESIDENCE 02 Date prepared: 12/4/13 03 Project Location: 20157 SUISUN DRIVE 04 Building Front Orientation (deg): SOUTH 05 CA City: CUPERTINO 06 Number of Dwelling Units with Additions: 1 07 Zip Code: 95014 08 Futyp • NATURAL GAS 09 Climate Zone: 4 4e 30 Tot itioned Floor Area (ftz) (Addition): J 4 336 11 Building Type SINGLE FAMILY Cr 0 12 Slat&Area (ft): 13 Project Scope: ADDITION EL � LU CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 CID U! LawI t-r�- ) CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification 401 CEC-CFIR-ADD-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 2 of 9) P`°'e`t"d`"e' SIEVERT RESIDENCE °ate P`epared; 12/4/13 B. OPAQUE SURFACE DETAILS — Framed (Section 150.2(a)) 01 02 03 04 05 06 07 08 09 10 11 Tag/ID Assembly Type Frame Type Frame Depth (inches) Frame Spacing (inches) Proposed Required Comments Cavity R -value Continuous Insulation R -value LI -Factor AppendixJA4 Reference U Factor Table Cell WALL WOOD 2X4 16 OC R-13 0.102 4.3.1 A3 0.102 ROOF WOOD 2X4 24 OC R-30 0.031 4.2.1 A20 0.031 FLOOR WOOD 2X6 16 OC R-19 0.037 4.4.1 A4 0.037 CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verificationi 0) CEC-CFIR-ADD-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 3 of 9) Project Name: SIEVERT RESIDENCE I°"°`"°"°° 12/4/13 C. OPAQUE SURFACE DETAILS — Non -framed (Section 150.1(c)1) 01 02 03 04 05 06 07 08 09 10 11 Tag/ID Assembly Type Assembly Materials Thickness (inches) Proposed Required Comments Core Insulation R -value Continuous Insulation R -value LI -Factor Appendix JA4 Reference U -Factor from Package A Table Cell LI -factor N/A Ll -factor Table Cell R -value LI -factor R -value Ll -factor N/A D. OPAQUE SURFACE DETAILS — Mass Walls (Section 150.1(c)1) 01 02 03 04 05 06 07 08 09 10 11 Tag/ID Walls Above Grade Mass Type Mass Thickness (inches) Furring Strip Thickness (inches) Proposed Required Interior Insulation Exterior Insulation Appendix JA4 Reference Interior Insulation Exterior Insulation R -value LI -factor R -value Ll -factor Table Cell R -value LI -factor R -value Ll -factor N/A CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification it CEC-CFIR-ADD-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 4 of 9) Project Name SIEVERT RESIDENCE Date Prepared: 12/4/13 E. SLAB INSULATION (Table 150.1-A) 01 02 03 04 05 06 Floor Type Proposed Required Comments Insulation R -value Insulation Ll -factor Insulation R -value Insulation U -factor N/A • Heated slab floors require mandatory slab insulation (see Table 110.8-A). F. RADIANT BARRIER (Section 150.1(c)2 01 02 Radiant Barrier installed below the roof deck and on all gable end walls Comments YES A radiant barrier is required (for Climate Zones 2-15) • Radiant barriers shall meet specific eligibility and installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards for low-rise residential buildings. Refer to RA4.2.1 • The emittance of the radiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. For Prescriptive Compliance the attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic floor area with no less than 30 percent upper vents. Ridge vents or gable end vents are recommended to achieve the best performance. The material should be cut to allow for full airflow to the venting. CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification ii CEC-CFIR-ADD-05-E (ReviSed OU14) GALIFUHNIA ENERGY CUMMISSIUN CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 5 of 9) Project Name SIEVERT RESIDENCE Date Prepared: 12/4/13 G. ROOFING PRODUCTS (COOL ROOF) (Section 150.1(c)11) 01 02 03 04 05 06 07 08 09 10 11 12 Mass Roof 25lb/ft2or Greater Roof Pitch Method of Compliance Product Type CRRC Product ID Number Proposed Required Initial Solar Reflectance Aged Solar Reflectance Thermal Emittance SRI (Optional) Aged Solar Reflectance Thermal Emittance SRI (Optional) Maximum N/A Addition Type ft2 Allowed Allowed Comments Maximum Maximum Calculated Maximum Calculated Maximum U -factor SHGC Calculated Calculated based on based on Allowed ft2 Allowed ft2 Allowed % Allowed 336 100.8 60 0.32 0.25 NOTES: • Any roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. H. FENESTRATION/GLAZING AREAS ALLOWED (Section 150.2(a)1) 01 02 03 04 05 06 07 08 Maximum Allowed Maximum Allowed Fenestration Area For All Orientations ft2 West -Facing Fenestration Area Only ft2 The Greater The Greater Maximum Maximum Addition Type ft2 Allowed Allowed Comments Maximum Maximum Calculated Maximum Calculated Maximum U -factor SHGC Calculated Calculated based on based on Allowed ft2 Allowed ft2 Allowed % Allowed 336 100.8 60 0.32 0.25 CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification 401 CEC-CFIR-ADD-05-E (Revised 06114) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 6 of 9) Pmfe`t Name: SIEVERT RESIDENCE Date Prepared: 12/4/13 I. FENESTRATION PROPOSED AREAS AND EFFICIENCIES 01 02 03 04 05 06 07 08 09 10 11 12 13 Tag/ID Fenestration Type Frame Type Dynamic Glazing Orientation N, S, W, E or Roof Number of panes Proposed Fenestration Area ft Proposed West Facing Fenestration Area ft2 Proposed U factor Proposed SHGC Source Exterior Shading Device Combined SHGC from CF1R ENV - 03 GLASS DOOR VINYL WEST 2 53.36 53.36 0.32 0.25 DEFAULT WINDOWS VINYL NORTH 2 36 0.32 0.25 DEFUALT 14 Total Proposed Fenestration Area 89.36 15 Maximum Allowed Fenestration Area 100.8 16 Compliance Statement Total Proposed Fenestration Area 5 Maximum Allowed Fenestration Area ® Yes ❑ No 17 Total Proposed West -Facing Fenestration Area 53.36 18 Maximum Allowed West -Facing Fenestration Area 60 19 Compliance Statement Total Proposed West -Facing Fenestration Area 5 Maximum Allowed West -Facing Fenestration Area ® Yes ❑ No 20 Proposed Fenestration LI -factor 0.32 21 Required Fenestration U -factor 0.32 22 Compliance Statement Proposed Fenestration U -factor 5 Required Fenestration U -factor ® Yes ❑ No 23 Proposed Fenestration SHGC 0.25 24 Required Fenestration SHGC 0.25 25 Compliance Statement Proposed Fenestration SHGC <_ Required Fenestration SHGC ® Yes ❑ No CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification CEC-CFIR-ADD-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 7 of 9) Project Name: SIEVERT RESIDENCE Date Prepared: 12/4/13 J. SPACE CONDITIONING(SC) SYSTEMS - HEATING/COOLING (Prescriptive section 150.2(b). Alterations to Space Conditioning Systems shall be exempt from HERS verification requirements as prerequisite for use ofthe CFIR-ADD-02 and CF2R-ADD-02 Compliance Documents. If new space conditioning systems are installed or existing systems are altered and are not exempt from HERS verification, then a CF1R-ADD-01 shall be completed and registered with a HERS Provider Data Registry. In each row below for each dwelling unit in the building, check the box that indicates the exemption from HERS verification compliance: ❑ a: space conditioning system was not altered; ❑ b: less than 40 ft of ducts were added or replaced; ❑ c: (exempt from duct leakage testing) if: the existing duct system was insulated with asbestos; ❑ d: (exempt from duct leakage testing) if: the existing duct system was previously tested and passed by a HERS Rater. 01 02 03 04 Dwelling Unit Name SC System Identification or Name SC System Location or Area Served Exemption from HERS Verification EXISTING ® a ® b ❑ c ❑ d 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 13 13 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 13 13 0 0 0 0 0 13 13 0 13 0 CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification it CEC-CFIR-ADQ05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 8 of 9) Project Name: SIEVERT RESIDENCE °"e Prepfd: 12/4/13 K. WATER HEATING SYSTEMS (Section 150.1(c)8) List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Dwelling Unit Name Water Heating System Identification or Name Water Heating System Location or Area Served Water Heating System Type Water Heater Type # of Water Heaters in System Water Heater Storage Volume (gal) Fuel Type Rated Input Type Rated Input Value I Heating Efficiency Type Heating Efficiency Value Standby Loss I%) Exterior Insulation R -Value Back -Up Solar Savings Fraction EXISTING CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014 STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification (1 CEC-CFIR-ADD-05-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft or Less, or Additions That Do Not Require HERS Field Verification (Page 9 of 9) Project Name: SIEVERT RESIDENCE °ate Pre Pared: 12/4/13 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: NICHOLAS L. BIGNARDI Company: Signature Date: FRI ENERGY CONSULTANTS, LLC 12/4/13 Address: CEA/ HERS Certification Identification (if applicable): 21 N. HARRISON AVE, SUITE 210 City/State/Zip: Phone: CAMPBELL, CA 95008 408-866-1620 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included wit documentation the builder provides to the building owner at occupancy. z 111 Responsible Designer Name: Responsibl e r Signatur SCOTT CUNNINGHAM Company : e Sig d: SCOTT DESIGN ASSOCIATES / Address: License: PO BOX 3485 City/State/Zip: Phone: SARATOGA, CA 95070 1408-378-5799 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014