B-2017-0698CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0698
10385 PLUM TREE LN CUPERTINO, CA 95014-2020 (316 33 023)
RANDO AAA HVAC
INC
SAN JOSE, CA 95125
OWNER'S NAME: AHERN JAMES M AND MARILYNN R TRUSTEE & ET A
DATE ISSUED: 05/02/2017
OWNER'S PHONE: 408-973-8519
PHONE NO: (408) 293-4717
LICENSED CO KLARATION.
BUILDING PERMIT INFO:
License Class C -e0 Lic. #768871
Contractor RANDO AAA HVAC INC Date 09/30/2017
X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
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 DUCT (70 FT)
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.
A4.z`.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: $3680.00
APPLICANT CERTIFICATION
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 33 023
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, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature (,/Date 05/02/2017
Issued by: Kim Dunbar
OWNER -BUILDER DECLARATION
Date: 05/02/2017
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)
z. I, as owner of the property, am exclusively contracting with licensed
Signature ofApplicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 05/02/2017
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
3. 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 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 f� (2
APPLICANT CERTIFICATION
Date: 05/02/2017
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
CONSTRUCTION LENDING AGENCY
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
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
SiSignature Date 05/02/2017
g
Professional
GENERAL PERMIT APPLICATION M
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE-AVENUE - CUPERTINO, CA 95014-3255 Awk
96 Ex Aff
CUPERTINb (408) 777-3228 - FAX (408) 777-3333 - building(a)-
cuperfing.org SRI
IV
13 20
r_1 PLUMBINCT F-ImprmAmyrAT F-1 1;T T7r-rDIPA 7 F__11ffTCfN T wren
PROJECT ADDRESSAFN`#
5 01 j W nc/
'3 -3 -3
OWNER NAME
J
I a o q-1-3
STREET ADDRESSJE�E
011 um 1�6 . . . ...... Ln� VITAM TpwfrnOft 4501 FAX
CONTACT NAME
AhanFAX
PHONE 'j 1/21
E-MAIL
STREET ADDRESS
1 5 P i u m -Frtn Un
qi5 o
11 OWNER ❑ OWNER -BUILDER 0 OWNER AGENT CONTRACTOR DCONTRACTOR AGENT 13 ARCHITECT 0 ENGINEER [I DEVELOPER ❑ TENANT
CONTRACTQRNAME
da. 7
LICENSE N111,111011 U Ig R
ICF,\'SEC� [�w
L 3
T
BUS. LIC4
COMPANIYNAME AA FUrnam
EC
ammiis
I
STREET ADDRESS12
&T�bm A/6.
PHONE
ARCHITECT/EI\TGINEER,NAME
LICENSE NUMBS
BUS. LIC-
TCCOMPANY
COMPANYNAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF `IT SFD or Duplex C3 M-ulti-Family
STRUCTURE: ❑ CornMerel al
PROJECT IN NVTLDLAND
URBAN INTERFACE AREA ❑ Yes El NO
PROJECT IN
FLOOD ZONE 0 Yes El NO
DESCRIPTION OF WORK
TOTALVALUATION:
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 behalf. I have read this
application and the information I h,ve provided correr I have read the Description of and verify it is accurate. I agree to oconlely with all applicable local
la �jg "
. t f, -poses,
ordinances -and state I o,�%,IdigcOnstructiO 1,, ize reprcsentatiVes of Cupertino to enter the above-ideltif 0 1 put
11SIff"clio jo-lb-01 Date:
Signature of Applicant/Agent: 1 V4
SUYPLEI\4ENTAL INFORMATION REQUIRED•
'OFFICE-USE ONLY.j
TER
EXPRESS"?
5
STANDARD-;
Z
MAJOR
MFPMiscApp_20 11. doe revised 03116111
a: ' o I:'
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC)
Project Name:
JIM AHERN I Date Prepared:
CF1R-ALT-02-E
(Page 1 of 3)
2017-04-27
A. General Information
CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one
CF111-ALT-02 document for each dwelling unit.
01
Project Name
JIM AHERN
02
Date Prepared
2017-04-27
03
Project Location
10385 PLUM TREE LN
04
Building Type
Single family
05
CA City
Cupertino
06
Dwelling Unit Name
JIM AHERN
SC System
SC System
CFA served
system a
Dwelling Unit Conditioned
Installing new SC
07
Zip Code
95014
08
Floor Area (ft2)
1296
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
05
06
07
08
09
10
Is the SC
Installing a
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
System 1
WHOLE HOUSE
1296
Yes
No
No
Yes
No
No
Extension of existing
duct system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
01
02
System Identification or
Name
New Duct R -Value
System 1
R-6
Registration Number: 217-A020138460A-000-000-0000000-0000
Registration Date/Time: 2017-04-27 13:40:19
HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-27 13:40:23
Schema Version: rev 10/16
G� e"
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 3)
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 CF3R-MCH-20-H Duct Leakage Test
- Leakage rate compliance: <=15 percent, or <=10 percentleakage to outside, or seal all accessible leaks
Exceptions:
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 duct leakage testing requirements
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)
This section: does not apply to this project.,
Registration Number: 217-A020138460A-000-000-0000000-0000 Registration Date/Time: 2017-04-27 13:40:19 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04=27 13:40:23
Schema Version: rev 10/16
�e , n V,
CERTIFICATE OF COMPLIANCE CF111-ALT 02-E
Alterations to Space Conditioning Systems (formerly CF -1R -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: �/ ILLGO
Rando, Eric
Company:
Signature Date:
RANDO AAA HVAC INC
2017-04-27 13:40:19
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 or system 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 be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable
inspections. I understand that a registered copy of this Certificate of Compliance is required 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
2017-04-27 13:40:19
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-A020138460A-000-000-0000000-0000
Registration Date/Time
2017-04-27 13:40:19
HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-04-27 13:40:23
Schema Version: rev 10/16
•c' I
IDE
ALARMS
SMOKE I CARBONM OE DO COMPLIANCE
OWNER CERTIF
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
CUPERTINO, CA 95014-3255
10300 TORRE AVENUE h,,,IdmQ(cDcupertmo oL
CUPERTINO
(408) 777-3221 FAX (408) 777-3333
r I11�TTIL TFII F'ICAT.E
g CER .
i1tAdii
d .. m'ak"L..�s,wk^iY.MC• H :4;SyxTtl'F . •.-
£0.VMlm srea yptt�tM ��'
PURPOSE the installation of all required Smoke andCarbon
Whre no interaor access
This affidavit is a self -certification for R315,2016 CBC Sections 420.6 and 117.2-11.2
compliance with 2016 CRC Section 8314;
for inspections are required.
ms and GENAlar
ERAL INFORMATION Q is exceeds
'-famil dwellings shall be provided witl`s tooexisting dwellinb Carbon
sin le -family and multi y alterations, or repair
Exishnb ° When the valuation of additions,
Monoxide alarms. � C Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or
M and CB
$1000.00, CRC Section 8314, 8315,
SMOKE ALARM CO ALARi1 '-
Carbon Monoxide Alarms be installed in the following locations: X
AREA X I
of the
Outside of each separate sleepnlg area in the immediate vicinity X
'et of bathroomX
s _ (Smoke alarms shall not be locatedrwithin nd habitable atti S door X
bedroom() Q mut ineludinv bas
On every level of a dwellin
Within each Slee ina room g appliances and that
s are not required in dwellings which do not
withcontain
nmke ala ms shall comply with
Carbon Monoxide alarm garage. Carbon monoxide alarms comb
do not have a 7 attacheddll be approved by the Office of the State Fire Marshal.
CBC Section 4_0• 1 alarms) may be solely battery operated.
units with no commercial power supply,
0
Power Supply In dwelling operated where repairs or alterations
or there is no ameans of attic, basement or crawl
n existing dwelling units, alarms are per to be solely battery p electrical Permit's
required for
I
ccess
not result
in the removal of wall and ceiling filushee 907-2-11.4 and 420.6.2. An ele P
space. Refer to CRCSection e ted to the building wiring-
alarms whic14 and
h must
s referenced above has/have been
ctions and in compliance With the California Building
As owner
of the above -referenced property, I herebyWlertify that the alarm(s) operational, as of the
installed in accordance with the manufacturer's ins
Residential Codes. The alarms specified below have been tested and are
and California Permit N —O 19
date signed below.
t Smoke Alarm
Specify Number of Alarms:
Smoke and CO form. doc revised 01/10,=01; I
CUPERTINO
Owner Name
Address
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(alcupertino.org
"I ly./2q/,,AM_Permit Nn. -- tel/
q,wl
00
Is your real property a registered historical site?
❑Jf"es Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
V No Go to Question 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.
L� No Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Ves 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?
❑ 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.
2111y,es 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..
FPie e 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 irmprovements).
❑ 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 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 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 NA water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current Californi lu Zbing Code and California Green Puilding Standards Code, and manufacturer's
installation requirements, and thatt wat r-consery lum na lxtures c m ' ply with the requirements as ind' ated the
table on the following ua2e.p //� /
Owner or Owner Agent's Signature: 7x /4 1K] "v /, pix VVY\ l Date: 11 /GT / I
Upon completing and signing tlu Cert' rcate, please return it to the Building Division in order to final your bur ding ermit.
SB407 2015. doc revised 01,105117
SB407 20I5.doc revised 01/05/17
Non -Compliant
Water -Conserving Plumbing Fixture
PlumbingFixture
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2016 CPC Ch. 4
2016 CPC Ch. 4
2016 CPC Ch. 4
/Flow Rate
2016 CALGreen Div. 4.3
2016 CALGreen Div. 4.3
2016 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
0.5 gallons/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 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 onlyone 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 si .
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 rnaximum
60 psi
1.8 gallons per minute
Wher`e 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
SB407 20I5.doc revised 01/05/17