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B-2017-0169CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0169 11261 TERRA BELLA DR CUPERTINO, CA 95014-4805 (356 25 007) PELLE HEATING & AIR INC SAN JOSE, CA 95111 OWNER'S NAME: MENON AMITABH AND SENGUPTA SHALINI DATE ISSUED: 01/27/2017 OWNER'S PHONE: 214-2506251 PHONE NO: (408) 978-7060 LICENSED ONT TOR' DECLARATION BUILDING PERMIT INFO: License Class CQ Lic. #809887 Contractor PELLE HEATING & AIR_ INC,Date 10/31/2017 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: REPLACE FURNACE; REPLACE AC UNIT (SAME LOCATION) 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. r 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 Sq. Ft Floor Area: Valuation: $13930.00 permit is issued. 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 "N Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 356 25 007 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, cos and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence a ranting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the licant de ds co ly with all non-point source regulati ns per th 'Cu erti n' ' a1 Co e, section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ,Signature Date 01/27/2017 Issued by: Kim Dunbar All OWNER-BUILDER DECLARATION Date: 01/27/2017 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: 01/27/2017 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 a. 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 dons 't material. Additionally, should I use equipment or devices which h ardou 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 Man ement 'strict I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino n 'p _ o , Chapter .12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safe o eiT, S�U2 533, 25534 Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. ( Owner or authorized agent: APPLICANT CERTIFICATION _ Date: 01/27/2017 certify that I have read this application and state that the above information isY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that the struction 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, Lender's Address 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 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. Licensed Signature Date 01/27/2017 Professional COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300'TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(ftupertino.ora �7� Au o F-1 PLUMBING IIXMFC'NAMT(T F-1 VT U'( DTIC T i-1 PROJECT ADDRESS � IVI to% -1 3LLE'11Nr1U UJ APN # 3: OWNER AME YYI �-- 4'1 P 2I L 2 E-MAIL STREET ADDRESS ^ CONTACT NAME, ,p STREET ADDRESS CITY, TE, ZIP / FAX PHONE t \-cif E-MAIL CITY, STATE, ZIP FAX NER ❑ OWNER-BUIIAER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ACTOR NAME r LICENSENUMB R LICENSE T E BUS. LI # ME a j1iC, 1 E-MAILire Fly STR§f�k,ESSO lir CITY, STATE, ZIP p L ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ,,FD DUPLEX ElMULTI-FAMILY BUILDIIQG: CIAL PROJECT IN WILDLAND ElYES URBAN INTERFACE AREA ❑ NO PROJECT IN ElYES FLOOD ZONE ❑ NO IS THE BLDG A14 ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK 9� TOTAL VALUATION: C RECEIVED BY: By my signature below, certify to each of the fo wing: Jam the prop o or uthorized agent to act on the property owner's behalf. I have read this application and the information I have provi d is co have rea e e ripti of Work and verify itis accurate. 3 a ee to co ply with all applicable local ordinances and state laws relating to building ons fi autho ' e sen es of Cupertino to enter the above -id tified pr erty for inspection purposes. Signature of Applicant/Agent: Date: f Si SUPP TAI-, INFORMATION REQ tl) OFFICE USE ONLY © OVER-THE-COUNTER EXPRESS ❑ STANDARD - u © LARGE - - ❑ MAJOR MEPMiscApp_2011.doc revised 06121117 ALTERATIONS - HVAC MR CEC-CF1 R -ALT -03-E (Revised 01116) CALIFORNIA ENERGY COMMISSION —q4W— CERTIFICATE OF COMPLIANCE CF111-ALT-03-E Alterations - HVAC CZ 1, 3 to 7 and 16 (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: I I 2Je— Equipment Type Equipment Efficiency New: Ducting or Lineset Required R -value- Conditioned Floor Area (ft) Thermostat 0 Packaged System 13 Evaporator Coil I U&AFUE COP 0 R-6 (CZ 1-10,12&13) Ducts Served by system 11 Setback D19tSystem 0 Condensing Unit SEER &1_4CZ 11,14-16) Ducts ft2 (if not already 5 HSPF 0 2t R-2.8 Linesee present, must 171 Furnace 13 Lineset EER 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. I. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: (Can include new ducting) All Equipment, CF111-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MCH -01, MCH -20-H Air Handier/Furnace CF3R: MCH -20-H Installer Requirement: Duct leakage (:5 15% or, <10% to outside, or seal all accessible leaks) Exempted from duct leakage testing if: 15�­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 CF111-ALT-02-E CF2R-MC H -01-E, MCH -20-H, MCH -22-H, MCH -(23 or 24)-H CFBR-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H2 Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W/CFM), Air Flow 2: 350 CFM/ton (or Standards Table 150.0-B C alternative) Il NewDuctswith Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF111-ALT-02-E D UCtS2 and one or more of the following: CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H Condenser Unit, Evaporator Coil, Furnace CF3R-MCH-20-H, MCH -(23 or 24)-H Installer Requirement: Duct leakage < 5%, Air Flow > 350 CFM/ton (or Standards Table 150.0-B / C alternative) 0 Exempted from duct leakage testing if existing duct systems are constructed, insulated or sealed with asbestos, b 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-MCH-20-H CF3R-MCH-20-H Installer Required to: Duct leakage (< 15% or, < 10% to outside, or seal all accessible leaks) 0 Exempted from duct leakage testing if existing duct systems are constructed, insulated or sealed with asbestos, All new ducting requires R-8 insulationwhen more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 & 13, and R-6 insulation 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 %new duct material, and up to 25%may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handier, plenums, duct material. 3 R-2.8 (1" thick insulation) for linesets 1" and less. 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. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this 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 s . ystem design identified on this Certificate of Compliance conform to the requirements of Title 24, Part I and Part 6 of the CCR. 5. The building design features or system design features identifiedon this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, cal ions, plans and specifications submitted to the enforcement agency for approyal with this building permiKati n. t"? I ResponsNle esignerNam Respons 1e atur Date S np ticens W/ak Aa&e %AO, ,/ -?-n I D 41-1 State/Zi p—;"- r 424 _f _2 Pon ly 6k_ 1 -Ur assistance or questions regarding the Energy Standards, c6—ntaft the—Energy HotWne at: f -80(T-772-3300 CUPERTtt+ O PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with. 2016 CRC Section R314, R315, 2016 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. -_ - GEX RAI. IN�OB-W-4IQ.N�. 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, R315, 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_I Outside of each separate sleeping area u1 the immediate vicinity of the bedroom(s) – (Smoke alarms shall not be located within 3 feet of bathroom door) X X On every level of a dwelling unit includirig basements and habitable attics X �X Within each sleeping, room X Carbon Monoxide alarms are not required in dwellings wluch 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: Irl 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 u1 the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl _l space. -Refer to -CIBC Sectio"i—R31�E-L— CBC-Sectioiis`907:2:11: 4 d zd 420.6:2 7 -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: Permit No. j3-ut- o � �p��, - a Specify Number of Alarms: Smoke Alarms: �� # Carbon Monoxide Detectors: I have read and agree tQ comply with the terms and conditions of this statement Owner (or Owner Agent's) N me: h �p� �"1 0� ,7 %' v Z`a(..� 1 Si nature .. ......... ... ....................................Date: ...� Contracttor Name: , �c'jt J V(Vt 4-('\- Signature.., 12 �-.-ia# .. j... �.. 1-........ Date:./!, . -13 Smote and COfonn.doc revised 01/1012017 Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino org s, Address \\ "Llo 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 171 No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. -�Teirceedl'�c�rti%h�slieenpr�vrded to the Buil-diriDiv3sroni - — - -- — Skip the rest of the form and sign bottom of form. 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. ANo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ 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 form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 110 1. 8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: ' 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). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. Ori and after January 1, 2014;specified building a t rations orimprofeinents-shall-require non- cornpharif - plumbing fixtures to be replaced with water-consenring plumbing fixtures. On or.before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ 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 be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or unprovements). I, as the owner or owner's agent of this property, ceitify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conseiving plumbing fixtures in accordance with Civil Code Sections 1101. l 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 fixtures comply with the requirements as indicated in the table on the following Dare. n Owner or Owner Agent's Signature: A_ JAxN u A&92L Date 3 0 31 9 Upon completing and signing this Certificate, pleas rpt to the Building Division in order to final your buildine permit. SB4072015.doc revised 08/26115 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. SB40 7 2015.doe revised 08126115 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture! (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage !Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 _ 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 Urinals Exceed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, 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 ppsi 60 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 temporarily 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 achieve 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. SB40 7 2015.doe revised 08126115