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B-2016-3158 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3158 11450 CANYON VIEW CIR CUPERTINO,CA 95014-4831(356 27 023) RESCUE AIR SERVICE INC SAN JOSE,CA 95120 OWNER'S NAME: CHANG CHIAO-FU AND SUE-FAY DATE ISSUED:11/23/2016 OWNER'S PHONE:408-688-6377 PHONE NO:(408)[655-9916 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: i License Class C-20 Lie.#826201 Contractor RESCUE AIR SERVICE INC Date 11/30/201.7 X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: Ypenalty perjury gNEW EXTEND 3/4"GALVANIZE GASCLI E-INSTALL(N)AC UNIT; RELOCATE FURNACE(CRAWL SPA I hereby affirm under enal ofone of the following two. declarations: LINE-FURNACE;.(N). 1. I have and will maintain a certificate of consent to self-insure for Worker's ELECTRICAL CIRCUITS Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. CV-�A 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:$13150.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 35627 023 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. WITHIN 180 DAYS„OF PERMIT ISSUANCE OR Additionally,theapplicant understands andwill comply with all non-point source regulations per the Cupertino Municipal Code,Spection 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature .� � Date 11/23/2016 Issued by:AbbyAyendo Date: 11/23/2016 OWNER-BUILDER DECLARATION 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 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for ms ect compensation,will do the work,and the structure is not intended or offered for p yon. 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:11/23/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A”OR BETTER s. I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I 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&SafeCode,Section 25532 a should I store or handle hazardous ( ) shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air 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 Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. `' Owner or authorized agent: APPLICANT CERTIFICATION C%Date:11/23/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws 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 'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Si nature Date 11/23/2016 Licensed Sig Professional I t ,, etCp-31:SI s GENERAL PERMIT APPLICATION r,..V ' M P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION t<ry 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 41' (408)777-3228• FAX(408)777-3333•buildinggcupertino.orq MISC CUPERTINO PLUMBING NZIIMICHANICAL DIPECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS % APN# "551p ?1 ~ 02. OWNER NAMEPHONE E-MAIL it..... Vii® (C3 'Y _ STREET ADDRESS 11450 �'��, CITY, STAA.TEE,ZIP FAX. CONTACT NAME 'HONE , E-MATE STREET ADDRESS � \`,u x,`rci pppp cv. UTTY.TATE, Zip . ..`.. � (....} 11111111111.111 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT INTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE.. i BUS,LIG# 2O SCS COMPANY NAME (^`tve / n( E- AIL - FAX STREET ADDRES - CITY.STATE,ZIP __ ' PT •NE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF 0 SFD or DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND 0 YES PROJECT TN 0 YES � IS TILE BLDG AN 0 YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA 0 NO FLOOD ZONE Q NO EICHLER HOME? 0 NO DESCRIPTION OF WORK 1 mac` lib ; . � _ _--F--- s _ � — TOTAL VALUATION: 1� A...T'S 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'be alf. I h ve read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. T authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent:_ s" Date: 1 SUPPLEMENTAL INFORMATION REQUIRED :_= ' j pmSt o t Y ` 0 OVER THItCQITNTT'R I 0 EXPRESS TANUfRt7 { it 'O MAJOR _ ME.PMiscAp'p_2011.cdoc revised 06/21/11 Go qe Maps Furnace relocate and A/C add on. 11450 Canyon View Cir. Cupertino Ae'c' e4sr-e \--.),:eN _ c '4-.?' '".--..,-- , (,:::, NI ' 00 V7* ''-------'\ -------- !. ----- \ . -r---P-- 1 itt° I 1 4,k) i ,.. - /i_k 2:1,,,L I /2_2" 'i IIIIMIFAIIIIIIIIIIMIMIIIIIIIklillilliguoik n '0 u\ -- . etw_cf: cc et_ 0 ce-- 1 0 0),."\-C, \-0 C.,c-13‘-v•A o _tp,__, k-a ° • •------ \2—‘-ikom \--N-eA,3 e_.\-e0--k-----,-,u,KA c- cu-k --I-c. - +'qC, lily — V2.-,\Jom flc,‘,,J c—o --1SO \A-e, — \ co, no,,,,...) --..,_.), \ .p•ki — e'"),.11\ A I, * 1----•'.>(.,-A---QiNdi OLNI\-- 'N1N-S_,, isn-e,. 0\ni-- , CCN' • CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: Alice Chang Date Prepared: 2016-11-23: A.General Information CFIR-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented, use one CFIR-ALT-02 document for each dwelling unit. 01 Project Name Alice Chang 02 Date Prepared 2016-11-22 03 Project Location 11450 Canyon View Cir 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name Alice Chang 07 Zip Code 95014 OB Dwelling Unit Conditioned 2755 Floor Area(ft2) Number of space conditioning 09 Climate Zone 4 10 (SC)systems in this dwelling 1 unit. B.Space Conditioning(SC)System Information + - 01 02 03 04 X05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served --system a; refrigerant Installing new SC Installing Insfalhpg Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Entirely new or System 1 Location 1 2755 Yes Yes Yes Yes Yes Yes complete replacement 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-A0431999A-000000000-0000 Registration Date/Time: 2016-11-23 01:05:53 ' HERS Provider:CaiCERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008 ` Report Generated:2016-11-23 00:34:16 Schema Version:0.555SDD l CERTIFICATE OF COMPLIANCE CF1R-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) This section does not apply to this project. E.Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 150.2(b)1E,F) This section does not apply to this project. F.Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C) 01 02 03 04 05 06 07 08 09 10 11 Heating Cooling, System Heating Minimum Cooling Minimum Required Identification or Heating System Altered Heating Efficiency Efficiency Cooling Altered Cooling Efficiency 1 Efficiency Thermostat New Duct Name Type Component Type Value System Type Component Type Value Type R-Value Central gas All new heating Central split Ali new cooling SetbackTher System 1 furnace components , AF4E 78• AC `I components SEER Iy13 mostat R-6 Required Documentation: ., CF2R-MCH-01-E•Space Conditioning Systems Ducts and Fans - "' "'- -Duct insulation requirement for new plenums:Rel CF2R&CF3R-MCH-20-H Duct Leakage Verification required. ` -Leakage rate compliance:5 6%. CF2R&CF3R-MCH-22 Fan Efficacy Verification CF2R&CF3R-MCH-23 System Air Flow Rate Verification -Compliance:Fan Efficacy 5 0.58 W/cfm and System Airflow S 350 cfm/ton. -Alternative Compliance;CF2R&CF3R-MCH-28.Return Duct Design Verification is an alternative to MCH-22 and MCH-23 verification. CF2R&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15). Exceptions: Heating-only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements. Note: An"entirely new or replacement duct system"means at least 75 percent of the duct system is new duct material,and up.to 25 percent may consistof reused parts fromthedwelling unit's existing duct.system(e.g., registers,grilles,boots,air handler,coil,plenums,duct material)if the reused parts are accessible and can be sealed to prevent leakage. Registration Number:216-A0431999A-000000000-0000 Registration Date/Time: 2016-11-23 01;05:53. f HERS Provider:CaICERTS. CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008 1 Report Generated:2016-11-23 00:34:16 Schema Version;0.555SDD 1 1 1 { 1 r CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-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: Liu,Minxuan Me&WON./a,[�r/ Company;... . Signature Date: - t Bay Area Energy Consultants 2016-11-23 00:39:11 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 taws of the State of California: 1. The information provided on this.Certificate of Compliance is true and correct, it 2. I 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 buil ding design or system design.identified on this Certificate of Compliance conform to the requirements of Title 24,Pan 1 and Part 6;of the California Code of Regulations. 4. The building design features or system design features id entified on this Certificeteof Compliance areconsistent with the idiormatfon provided onbthlY"appjwab tarnpliance documents,worksheets, calculations,plans and specifications submitted to the enforcement agency forapproval with this building permit application 5. I will ensure that a registered copy of this Certificat%9f comliance s tatr,be rnaleavaileble with;,the biflldtng poymit(s)issued for the building and made avaitabletotheenforcement agency for all applicable inspections.]understand that a registered copy of this,Certificate of Compliance ..required to,be included with the documeptation the5booilder pfpgpdes to the bulldog owner at occupancy. Responsible Designer Name: ..._. y Responsible Designer Signature: r t. Kim,James �aea Company: _ Date Signed: _ - RESCUE AIR SERVICE 2016-11-23 01:05:53 Address: License: 6007 MAJORCA COURT 826201 City/State/Zip:. Phone: { _. SAN JOSE CA 95120 408-655-9916 Digitally signed by CaICERTS.This digital signature is provided in order to secure the content of this registered document,and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number:216-A0431999A-000000000-0000 Registration Date/Time: 2016-11-23 01:05:53 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.008 Report Generated:2016-11-23 00:34:16 Schema Version:0.5555DD ) ' , WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE 4x4.1,4 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPi11N[€ " 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 ,, jw (408)77228•F (408)777-3333•buildinq(a cupertino.orq �,� -1t yr( Owner Name '1 T(A Permit No. Address ..L�^0 Ci DVl VGA C r 6-E &4i 4.0CA /S) /If 1. Is your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. .117 No Go to Question 2. 2. oes your real property have a licensed plumber certifying that,due to the age'or configuration of the property or its dumbing,installation of water-conserving plumbing fixtures is not technically feasible? Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of fonn. 0 No Go to Question 3. 3. Is water service permanently disconnected for your building? . Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 0 No My real property is built and available for use or occupancy after January 1, 1994. ° Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the fonn and sign bottom of fonn. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. ‘Phase check ONE of the following: 'CZ My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014,building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). D My property is a multifamily residential real property.. See Civil Code Section 1101.5. On and after January 1, 2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be rep aced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). 0 My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall he replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations.;or improvements). I,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-conserving plumbing fix -es comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: � -4k1.-fir ' Date: Upon completing and signing this Certificate,please return it to the 3 ilding Division in order to final your building permit. SB4072015.doc revised 08/26/15 . • Z- , BTaILDING PERMIT CANNOT BE EINALED AND COMPLETED UNTIL THIS "A:CERT CASE H.A BEEN SIGNEDe .mow -H �,_`ice " tr. * �� P �'- -x4 Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 2013 CPC Ch.4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate Single-Family Multi-Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets)_ Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush) Ufinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria sof gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one slower,the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets— Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute© per minute @ 60 psi; 20 psi minimum 0 8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute @ 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May tempo-arily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to acl-ieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. SB4072015.doc revised 08/26/15 . 1 SMOKE i CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 4 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildinq a(�cupertino.orq PERMIT C OT SE FINALEI)ITNTIL THISy CERTIFICATE.HAS BEEN ? 7 D 'i RET ' -..3.O TJEJAUILIING Dt SI ' PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided,with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of X X the bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X' • Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supply,alarm(s) may be solely battery.operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl • space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the 'date signed below. Address:- I I LAS O C.0\1NxJbn v Permit No. P)-2-0140-:115P3 Specify Number of Alarms: `# Smoke Alarms: #Carbon Monoxide Detectors: 2 I have read and agree to co .! � . e terms and ditions of this statement Owner(or Owner Agent's)Name: ' Nr,ov . Signature. Date:1 �/1, Contractor Name: �SewB Signature Lic.# .. bz�..\-....._...Date:1f Smoke and CO.form.doc revised 09/27/16