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B-2016-3273 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3273 10304 MINER PL CUPERTINO,CA 95014-2013(316 46 024) COMFORT ENERGY . INC MILPITAS,CA 95035 OWNER'S NAME: CHEN JULIE J TRUSTEE DATE ISSUED:12/14/2016 OWNER'S PHONE:408-255-8885 PHONE NO:(408)263-3100 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C20 Lic.#858776 Contractor COMFORT ENERGY INC Date 01/31/2018 X BLDG _ELECT _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: REPLACE FURNACE,SAME LOCATION(CLOSET) I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. /. I have and will maintain Worker's Compensation Insurance,as provided for by10 ''' Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area Valuation:$6390.00 . t_ 1 4 Is 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 46 024 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,the appiic. t under tands and will comply with all non-point source regulations p-• ai pe ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature re Date 12/14/2016 Issued b MELI ,e.3Vil fir( Date:12/14/2016 19h! t-: J1 1 . Li GiA s:. 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 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:12/14/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 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 • s. 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 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 : Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the .i•rtino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Co.e, • 'ons 2-,505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. 111 Owner or authorized agent ' 1 ai�i • T II •TI s Date:12/14/2016 I certify that I have read this application and state that the above information is CONSTRUC Ti' END u G AGENCY I hereby correct.I agree to comply with all city and county ordinances and state lawsaffirm 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 and DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 12/14/2016 Professional \ / GENERAL PERMIT APPLICATION MEP fr/411 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DI ISION .,4 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ,INO ' (408)777-3228•FAX(408)777-3333•buildinqcupertino:orq MISC CUPER lr - 2a/ ' - 32 3 PLUMBING ]�IECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS ?0 30 iyi ry2 OWNER NAME MA C.Y.C L I= PHONE . , 1,, /C7 E-MAIL ( (j (/ -C~4 STREET ADDRESS -ajd n ve CITY, STATE,ZIP c-t,,�C` `) 0 q o,if FAX el 1 4 CONTACT NAME e- PHONE STREET ADDRESS 1$,�.(,,,5- 14, 0,1,1 ,d/ i-ft -13 L CITY,STATE,ZIP GI t,g (• ,. q spo�r®" FAX Otf,F� '{,4Dif 1, ❑OWNER ❑ OWNER-BUILDER 0 OWNER AGENTICONTRACTOR ❑CONTRACTOR AGENT 0 -'CHITECT 0 ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME • Q i- E1 `�LICENSE NUMBER 'S- „NoLIC: SE TYPE C,2,0 BUS.LIC# - -33 st 3 COMPANY NAME Co E.0„,„vv ,a, E-MAIL c, ,edi4ra,r- q"t4 �' FAX *. y g 1 0"k f L194. STREET ADDRESS 1 4Gc 14 a "1 i )3,1,._\ CITY,STATE,ZIP ',H) I p i-l J , q.5-03& PHOIV .`°':('j8-1633/Oa 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 ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: 0 COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZO 0 NO EICHLER HOME? 0 NO DESCRIPTION OF WORK N O e-4-056-i--- CV-- LfLc — - 71111111111111111111.".- `4``IT, ...-," -,„-,-,. TOTAL VALUATION: - o U EI II , By my signature below,I certify to each of the f o I am the property owner or authorized agent to act o.the pro., • er's behalf. I have read this application and the information I have provide Is core.. I have read ,-Description of Work and verify it is.ccurate. I agree to om ly wi all applicable local ordinances and state laws relating to building c ns. tio,. I:utho '.. raprese fives of Cupertino to enter the above-idenrilie�}pr pt. fck ' peN ii.turposes. Signature of Applicant/Agent: - Date: i SUPPLEME , I P Ft)RM TION REQUIRED OFFICE GCSE ONLY _ — W 0 OYER :THE-COt•i TER..' g © STANDARD " D LARGE © v AJOR MEPMiscApp_2011.doc revised 06/21/11 STATE OF CALIFORNIA ALTERATIONS HVAC f- CEC-CF1R-ALT-03-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-1R-ALT-HVAC) (Page 1 of 1) Site Address: � '11.46-4_, A Enforcement Age-icy: Date Prepared: Permit#: E quipmenti e "6 Equipment Efficient New:Ducting,Plenums,Lineset Conditioned q P Ypy Required R-value Floor Area(sq ft) Thermostat ElPackaged System 0 Evaporator Coil AFUE COP 0 R-6 (CZ 1,3-7)Ducts Served b sy tem 0 Setback El Split System 0 Condensing Unit SEER 0 R-8' (CZ 16),Ducts 2-7- " q ft (if not already HSPF 0 R-6(all CZ's)Plenumspresent,must L urnace ❑Lineset EER 0 R-5 or R7.5 Lineset3 be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form is allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. 1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: `an-include new ducting All Equipment, CF1R-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS Installer Requirement:Duct leakage(5_15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: 0 1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned space,or 0 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ) 0 2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts2 CF1R-ALT-02-E CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS CF3R-MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS2 Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) 0 3.All New Ducts with Replacement Required Compliance Documents to be lef on site for Final: Includes replacing orinstalling All New CF1R-ALT-02-E Ducts2 and one or more of the following: CF2R-MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) Q Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. 0 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: • Adding or replacing ducts in unconditioned CF1R ALT 02 E space but less than All New Ducts2 CF2R:MECH 20 HERS CF3R:MECH-20-HERS Installer Required to:Duct leakage(5_15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. 'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc. 2 A New Duct system is when the duct system is constructed of at least 75 percent new duct material,and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material. 3 R-5(1"thick insulation)for linesets 1"and less: R-7.5(1.5"thick insulation)for linesets over 1 inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T-2%",2.5-3T-2'/",3.5 to 4T-2%",5T-41/8" Contractor(Documentation Author's/Responsible Designer'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. I am eligible under Division 3 of the California Business and Professions Code to accept -esponsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on th s Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations(CCR). 4. 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 CCR. 5. The building design features or system design features i. tified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, or shee,s, alculations,plans and specifications submitted to the enforcement agency for approval wit01,,,,,h this building permit applicati•n. r Responsible Designer Na Responsible Desig er Si_ ur.: Date i e c e,P R License• tc, C pa y: Address: 1.-. City/State/Zix Pone. 91r For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300