B-2017-0114CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0114
MARY AVE UNIT 10365 CUPERTINO, CA 95014-1341 (326 52 025) SILICON VALLEY
SHEETMETAL
SAN JOSE, CA 95127
OWNER'S NAME: MERTOLATILAAND NILGUN TRUSTEE
OWNER'S PHONE: 408-529-5246
LICENSED CONIRACTORIS DECLARATION
ARATION
License Class = Lic. #990708
Contractor SILICON VALLEY SHEETMFTAL Date 02/28/2018
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
DATE ISSUED: 01/23/2017
PHONE NO: (408) 971-7246
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
DESCRIPTION:
.,ACE FURNACE (SAME LOCATION
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
F
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: $5145.00
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
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 understanAs and will comply with all non -point
source regulations per the Cupert} o Municipal Code, Section 9.18.
Date 01/23/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
t. 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)
2. 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I 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
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 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 01/23/2017
APN Number: Occupancy Type:
326 52 025
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
Date: 01/23/2017
RE -ROOFS:
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.
Signature of Applicant:
Date: 01/23/2017
COVERINGS TO BE CLASS "A"
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 I 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 & Safety Code, Sections 25505, 25533-.anr125534.
2
Owner or authorized agentr .�
Date: 01/23/2017 �l
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency fort a 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
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
[ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(akupertino.m M I S Cook
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❑ OWNER ❑ OWNER-BUMDER ❑ OWNER AGENT
CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAP IE Pp
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CITY, STATE, ZIP
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ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC 11
COMPANY NAME
STREET ADDRESS
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CITY, STATE, ZIP Y
FAX
PHONE
USE OF D -or DUPLEX [MULTI -FAMILY
BUILDING: COMMERCIAL
PROJECT IN WILDLAIVD El ES
URBAN INTERFACE AREA NO
PROJECT IN ❑ YES
FLOOD ZONE NO
IS THE BLDG AN I] YES
EICHLER HOME? 079. NO
DESCRIPTION OF WORK 'L
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TOTAL. VALUATION:
By my signature below, I certify to each of the following: I the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is orrect, aver;the scnption of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b true ' . I a thoriz presentafives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Age Bate: //17// 7
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SUPPLETAT INFO A ON REQUIRED
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OMCE USE ONLY
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MEPA11iscApp 2011.doc revised 06121111
STATE OF CALIFORNIA
ALTERATIONS - HVAC
CEC-CF1 R -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 -IR -ALT -HVAC) (Page 1 of 1)
Site Address:
AVSMT
Enforcement Agency:
Date Preared-
Permit#:
Equipment Type
Equipment Efficiency
New: Ducting, Plenums, Lineset
Conditioned
Thermostat
Required R -value,
Floor Area (sq ft)
�-Packaged System
13 Evaporator Coll
AFUE
COP
171 R-6 (CZ 1,3-7) Ducts
Served by system
0 Setback
r7l Split System
I:] Condensing Unit
IL -k SEER
13 R-81 (CZ 16) Ducts
1 sq ft
(if not already
HSPF
0 R-6 (all Q's) Plenums
t
present, must
17-1 Furnace
0 Uneset Ilk
-5- EER
13 R-5 or R7.5 Linesets
be installed)
HERS VERIFICATION SUMMARY Installer determines workto 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.
M-1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
Can -include new ducting
All Equipment,
CF1RALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS
Air Handier/Furnace
CF3R: MECH-20-HERS
Installer Requirement: Duct leakage C<_15% or, :S_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 fig 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 Ducts'
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) -HERS'
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.SSW/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 left on site for Final.,
Includes replacing or installing All New CKR-ALT-02-E
DUCtS2 and one or more of the followl I g: CF2R-MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS
Condenser Unit, Evaporator Coil, Fur; CF3R-MECH-20-HERS, MECH-(23 or 24) -HERS
Installer Requirement: Duct leakage < �%, Air Flow? 350 CFM/ton (or Standards Table 150.0-C / D alternative)
171 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:
45
CFIR-ALT-02-E
Adding or replacing ducts in unconditioned
space but less than All New Ducts' I
CF2R: MECH-20-HERS
CF3R: MECH-20-HERS
Installer Required to: Duct leakage (<J,59/. 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.
I
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 handier, plenums, duct material.
I R-5 (1' thick insulation) for linesets 1"I 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%", 15-3T-2%," 3.5 to 4T -2Y0, 5T -4y."
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. Thatthe energyfeatures and performance specifications forthe design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts I 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.
S. 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.
Responsible Designer Name:
i Desi r Sign
Respons,
,�l Des!
Dat Signed,
License:
Company:
Address-
city/state/zip:
Phone:
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--- ---
For assistance of questions regarding the Energy Standards, contact tne Energy r1QUIM2 dL; L-OVU-1 f4-��VU
COMMUNITY MANAGEMENT SERVICES, INCORPORATED
January 20, 2017
Atila Mertol
17780 Holiday Drive
Morgan Hill, CA 95037-6305
Re: Furnace at 10365 Mary Avenue
Dear Atila,
Please let this letter confirm that on'fanuary 18, 2017, the Casa De Anza. Board of
Directors approved the replacement of your furnace at 10365 Mary, Avenue, Your
contractor, Silicon Valley Sheetmetal, may proceed with the work.
If you have any questions or concerns, please call me at 408-559-1977.
Sincerely,
CCarn zutizt M-cmagement'Services, Inc.
Rob Woods, Association Manager
Casa De Anza. Association
cc: Board of Directors
1935 Dr
y Creek Road, Suite 203 * Campbell CA * 95008-3631 9 voice (408) 559-1977 * fax (408) 559-1970
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 • building0cum 'no.ora
E "I-0k!3-•i�
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.
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, 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
CQ 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 mduding basements and habitable attics
X
X
Within each slee m 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 Fiore 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 wail 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 o.345 Mf}2y &e. 60 P &0-7 t P10 . 00V 9 SO f c f Permit 1!70.,
Specify Number 0f Alarms: # Smoke Ala=as: #Carbon Monoxide Detectors: F771
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
197'IL4 1;7&17--"o4— Signature. .Date:
contractor Name:
Signature . 1-10A .Date:
Smoke and CO form.doc revised 01110/2017
I -"?-