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B-2017-0148CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0148 21174 LAURET L4, DR CUPERTINO, CA 95014-1657 (326 54 020) RANDO AAA HVAC INC SAN JOSE, CA 95125 OWNER'S NAME: WONG ROBERT C AND JUDY C TRUSTEE OWNER'S PHONE: 408-705-5035 r Tr T%TQ r% rANTD A f+9I'AD10 —1— ♦ r imr�n, License Class C43 C20 Lic. #768871 Contractor RANDO AAA HVAC INC Date 09/30/2017 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: 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 by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTHICATION 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, 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 gulatia s per the C pert! o Municipal Code, Section 9.18. f ,i �- Signature ; Date 01/26/2017 u I hereby affirm that I am exempt from the Contractor's License Law for one of the ISSUED: 01/26/2017 NO: (408) 293-4717 BUILDING PERMIT INFO: BLDG _ ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: ,ACE FURNACE - CLOSET Sq. Ft Floor Area: Valuation: $3076.00 APN Number: Occupancy Type: 326 54 020 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST 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 (See.7044, Business & Professions Code). Date: 01/26/2017 hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's j ( ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 by Section 3700 of the Labor Code, for the performance of the work for which this 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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, 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 Code, Section 9.18. Signature Date 01/26/2017 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & S ty-eod f ections 2 50 , 5533, and 25534. - Owner or authdfized agent:' Date: 01/26/2017 CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CdP cR i iE�i © (408) 777-3228 • FAX (408) 777-3333 - buildinci(o)cupertino.org ,- Z0Z �# I S C -- o/ nPLUMBING YjvIECI-IAMCAL nFI.FCTRICAL nmiscri.LaNrt�TIC PROJECT ADDRESS"] r -. �' %j7 AP?` if --5 OWNL;R NAT\^[£ )+ rt _ e g vu PIION(I V v �J E-hIAIL! STREET ADDRESS// `11 0. f ii I `� V CITY, Y, ST tn C) 1 CONTACT NAMERo `IA t� PIIONF�Ijy . --�g�.�m _ E-MAIL STREET ADDRESSD@J"LV�i Y v r I fl CITY, .ttV1��t y� f I t r•� ❑ ONNNER ❑ OWNER -BUILDER ❑OWNERAGENT CONTRACTOR ❑ CONTR4CTOR AGENT IJ ❑ ARcmrrECT M ENGINEF,R ❑ DEVELOPER ❑ TENANT CONTRACTORNAME ? D tt.,^ LiCENSENU\4BER-7 LICENSE '1; BUS, LIC.;: COMP.ANYNAMEjnffi roams/!.! )-MA]L �( /g `qC ' ��f'fy STREET ADDRESS t (fin d CITY, E ZIIP� �g t� PRO ' v' n' ARCHITECTIENGINEER T.?A?v4E LICE\S£NUMBER JUS. LIC.; COMPANY NAME E-MAIL rqA STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUC"I URF': ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN FLOOD ZONE ❑ Yes ❑ No DESCRIPTION OF WORK n l� TOTAL VALUATION: By my signature below, I certify to each the owing: 1 ann the property owner or authorized agent to act on the property owner's behalf'. T have read this' ` application and the infor7natioin 1 have $�rov red is onect. I hAve read the Deseript!on oi' Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bdildifi can ctiolr. I t epresentatives of Cupertino to enter the above -id nt Pied pr per fbr inspection purposes. Signature of Applicant/Agent: V Date: 6 SUPP ENTAL UNFORMATION REQUIRED ri ' EUSEDIN4Y.`-, £R-T-j-COtPYTLR , ❑ STANDARD ` LARGE.' •: .. MAJOR MEPMiscrlpp_2011.doc remised 03116111 . ra CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: ROBERT WONG I Date Prepared: r� CF1R-ALT 02-E (Page 1 of 3) 2017-01-06 A. General Information CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name ROBERT WONG 02 Date Prepared 2017-01-06 03 Project Location 21174 LAURETTA DRIVE 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name ROBERT WONG SC System SC System CFA served system a Dwelling Unit Conditioned Installing new SC 07 Zip Code 95014 08 Floor Area (ft) 2127 by this SC ducted containing system Number of Space entirely new 09 Climate Zone 4 10 Conditioning (SC) Systems in 1 component? components? feet of ducts? duct system? this Dwelling Unit: Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 06 07 . '.' 08 09 10 Is the'SC Installinga " SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft) system? component? components? feet of ducts? duct system? SC system? Alteration Type Altered space BRYANT WHOLE'HOUSE 2127 Yes No Yes No No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 217-A020024281A-000-000-0000000-0000 Registration Date/Time: 2017-01-06 11:26:03 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-01-06 11:26:23 Schema Version: rev 10/16 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 cooling This field or This field or This field or This field or BRYANT Central gas Gas furnace AFUE 81 Central split component section is not section is not Setback section is not section is not furnace AHU AC altered applicable applicable applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16) CF2R and CF311-MCH-20-H - Duct Leakage Test 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 and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2R and CF311-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements._„ Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH-23,,or Refrigerant Charge MC 25' -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH-20'Duet.Leakage Testing requirements. i r.. E. Entirely New or Complete Replacement Duct -Sy stem with or withoutE q u„ment C hangeout,(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) This section does not apply to this project. Registration Number: 217-A020024281A-000-000-0000000-0000 Registration Date/Time: 2017-01-06 11:26:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-01-06 11:26:23 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author, Signature: Rando, Eric C;4a-leuz�l Company: Signature Date: RANDO AAA HVAC INC 2017-01-06 11:26:03 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 for the building design orsystem 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 bemade.aJaiiable`with## buildi g,permit(s)_issue'd for the' building, and.made available toAhe,enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance isxequired to be included with the,documentation the,builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Rando, Eric Company: Date Signed: RANDO AAA HVAC INC 2017-01-06 11:26:03 Address: License: 1712 STONE AVENUE 768871 City/State/Zip: Phone: SAN,JOSE CA 95125 408-293-4717 Digitally signed by Ca10ERTS. 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: 217-A020024281A-000-000-0000000-0000 Registration Date/Time: 2017-01-06 11:26:03 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-01-06 11:26:23 Schema Version: rev 10/16 0 PURPOSE C I U SMOKE / CARBON MONOXIDE ALARMS OWNER, OF COIL OLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.or-a This affidavit is a self -certification for the installation of all required Smi compliance with. 2016 CRC Section R314, R315, 2016 CBC Sections 420.6 for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided wi Monoxide alarms. When the valuation of additions, alterations, or rept $1000.00, CRC Section 8314, R315, and CBC Sections 907.2.11.5 and 420 Carbon Monoxide Alarms be installed.in the following locations: and Carbon Monoxide Alarms for 1 907.2.11;2 where no interior access Smoke Alarms and Carbon s to existing dwelling units exceeds require that Smoke Alarms and/or —�— AREA I SMOKE ALARM CO ALARM _ Outside of each separate sleeping area in 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 including basements and habitable attics Signature .......:............ Lic.# ...(...�...........Date:�..�.�� _ 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 Yl arshal. Power Supply: In dwelling units with no commercial power supply, ala In existing dwelliiag units, alarms are permitted to be solely battery ope: not result in the removal of wall and ceiling firdshes or there is no acces space. Refer to CRC Section R314 and CSC Sections 907.2.11.4 and 420.6 alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alai installed in accordance with the manufacturer's instructions and in corn and California Residential Codes. The alarms specified below have beer date signed below. Address: Specify 1lTumber of Alarms: - 4 _n(s) may be solely battery operated, ited where repairs or alterations do by means of attic, basement or crawl '.. An electrical perinit is required for n(s) referenced above has/have been diance with the California Building tested and are operational, as of the Permit No. ) 2 0 1-1 - 0142 # Carbon Monoxide Detectors !_have read and agree to comply with the terms and co6ditions of this statement Owner (or Owner Agent's) Name: ��V� Signature.. .............f/ .. Date2��l.' Contractor Name: U I Signature .......:............ Lic.# ...(...�...........Date:�..�.�� Smoke m7d CO fon7r.doc 7-erised 0111012017 CUPER,TINO Owner Name � Address 9-W1 } I 1 L WATER -CONSERVING PLUMBING .FIXTURES OWNER CERTIFICATE, OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDI 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (41W77-3228 • FAX (408) 777-3333 • buildina(akuoertii DIVISION ILI 1: 1 7-1 F I I F 7 1. Is your real property a registered historical site? 11 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. V6�' 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. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. V 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. +l� No Go to Question 4. 4.. Is your real property built and available for use or occupancy on or before January i, 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 properly 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 t ee 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 Sectic On -and after January 1, 2014, building alterations or improvements shall reqs to be replaced with water -conserving plumbing fixtures throughout the buildin compliant plumbing fixtures shall be replaced with water -conserving plu property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section On and after January 1, 2014, specified building alterations or improvements s. plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be rep conserving plumbing fixtures throughout the building (regardless of whether p: 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 s: plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall plumbing fixtures throughout the building (regardless of whether property and 1101.4. e all non-compliant plumbing fixtures On or before January 1, 2017, all non- :)ing fixtures (regardless of whether 01.5. l require non- compliant with water- y undergoes alterations or require non- compliant replaced with water- conserving )es alterations or improvements). Las 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 inaccordance -through 1101.8, the current California Plumbing Code and California Green Buildi�g with Civil Code Sections 1101.1 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 page. r, 4., Owner or Owner Agent's Signature: t Date: Upon completing and signing this Certificate, please retuit'to the Building Division in order to final your building permit. �// SB40 7 2015.doc revised 08/26/15 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. SB407 2015.doc revised 08/26/15 .Non -Compliant Water-Conseryin Plumbing Fixture PlumbingFixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usa a/Flow Rate 2013 CPC Ch. 4 2013 C C 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-ramily 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 0.5 gall ns/flush 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 shoY✓erhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlet controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow onlyone shower outlet to be in operration.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 iand public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallonsper minute @60Psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons :)er 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 minute @ 60 increase up�II to 2.2 psi, and must gallons per minute @ default to maximum 60 psi, and Tust 1.8 gallons per minute @ default toaximum 60 psi 1.8 gallons er minute Where faucets meeting @ 60 psi the above are unavailable, Where fauc is meeting aerators or other means the above lire may be used to achieve unavailabl% aerators or reduction. other mean's 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. SB407 2015.doc revised 08/26/15