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B-2017-0993CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0993 7863 LILY CT CUPERTINO, CA 95014-4212 (359 03 012) RANDO AAA HVAC INC SAN JOSE, CA 95125 OWNER'S NAME: MACALLISTER ALICE J DATE ISSUED: 06/23/2017 OWNER'S PHONE: 408-390-4164 PHONE NO: (408) 2931717 LICENSED ONT TOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic. #768871 Contractor RANDO AAA HVAC INC Date 09/30/2017 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 (E) FURNACE AND EXTERIOR CONDENSER IN SAME I hereby affirm under penalty of perjury one of the following two declarations: LOCATIONS. 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 Sq. Ft Floor Area: Valuation: $9950.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 359 03 012 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 6.23.17 Issued by: SEAN HATCH OWNER -BUILDER DECLARATION Date: 06/23/2017 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. 1, 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 of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6.23.17 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 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: APPLICANT CERTIFICATION Date: 6.23.17 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws 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 Signature Date 6.23.17 Professional ;5- 9-/V 1.09g3 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buil dino(d)-cupertino.ora MISC 1 IAT.T IMRTNr I-1 MFCT-IAATT(`AT. I PrTRif m I 1Mlq(`FI T ANF(IT IQ PROJECT ADDRESS' APN # 35 G� D3 _D/ JJMAIL OWNER NAME I cod kc PHONNQ- STREET ADDRESS Q� q CITY TATET FAX CONTACT NAM i t PHO ` EMAIL STREET ADDRES ' C , ST ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR NAME 0 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT LICENSE NUNUMN LI ' F� BUS.LIC# (, COMPANY NAME E-MAIL n FA , rte, I — STREET ADDRESS �`' J crn" ST TE,,IZIPPHON \4111 ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 1KSFD or Duplex ❑ Multi -Family STRUCTURE: ElCo PROJECT M WILDLAND URBAN INTERFACE AREA ❑ Yes No PROJECT IN FLOOD ZONE El Yes NO yyymmercial ���'''� DESCRIPTION OF WORK � r S i TOTAL VALUATION: RECEIVED $Y, 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 informati n I have rovided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatuig to u ' constructi . I authorize representatives of Cupertino to enter the above -i entj�i property for inspection purposes. Signature of Applicant/Agent: Date: rJL SUPP MENTAL INFORMATION REQUIRED u�FiCE usE Q1VLY` ""ENTER U ' © STANDARI? � i Z. a : i ❑ LARGE w: ❑ MAJOR MEPMiscApp_2011.doe revised 03116111 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: ALICE MCALISTER I Date Prepared: CF1R-ALT-02-E (Page 1 of 3) 2017-06-13 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 ALICE MCALISTER 02 Date Prepared 2017-06-13 03 Project Location 7863 LILY CT 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name ALICE MCALISTER SC System SC System CFA served system a Dwelling Unit Conditioned Installing new SC 07 Zip Code 95014 08 Floor Area (ft2) 1917 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 CARRIER WHOLE HOUSE 1917 Yes Yes Yes No No No Altered space 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-A020198297A-000-000-0000000-0000 Registration Date/Time: 2017-06-13 09:18:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-06-13 09:19:31 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) CF1R-ALT-02- (Page 2 of 3 D. Altered Space Conditioning System (Sections 150.2(b)lE 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 Central gas Gas furnace Central split Outdoor This field or This field o CARRIER furnace AHU AFUE 81 AC condensing SEER 14 Setback section is not section is nc unit 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 CF3R-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 CF3R-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 MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. 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) Registration Number: 217-A020198297A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance This section does not apply to this project. Registration Date/Time Report Version: 2016.1.005 Schema Version: rev 10/16 2017-06-13 09:18:57 HERS Provider: CaICERT Report Generated: 2017-06-13 09:19:3 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 I Company: Signature Date: RANDO AAA HVAC INC 2017-06-13 09:18:57 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 permits) 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 two the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: rjC'�[�GLGa" Rando, Eric C Company: Date Signed: RANDO AAA HVAC INC 2017-06-13 09:18:57 Address: License: 1712 STONE AVENUE 768871 City/State/Zip: Phone: SAN JOSE CA 95125 408-293-4717 Easy to Verify FEE Fil at CaICERTS.com S v 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 fc r the accuracy of the inforrpmj Registration Number: 217-A020198297A-000-000-0000000-0000 Registration Date/Time: 2017-06-13 09:18:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-06-13 09:19:31 Schema Version: rev 10/16 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 I10M 777-3228 • FAX (408) 777-3333 • buildina(d)cmertino.org 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. 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 'CO ALARM Out of each separate sleeping area in the immediate vicinity of the bedrooms) —.(Smoke alarms shall not be located within 3 feet of bathroom door) X X On ever, level of a dwelling unit including basements and habitable attics X X Within each ,slee in 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 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 wall 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: Specify Number of Alarms: Permit No ex —6' 3 I lingo rnnrl nnr1 arrraa to nmmnly with tha fp=g.and conditions of this statement Ca:'�r�o'OwnerAge;t�� ame;: "............... .......................................................................... Co tractor Nam I, `1�-=df) Lic:� [J.:!..�. DateQ...!-!l'..1.. Signature.....I I. ..... U Smoke and COforni. doe revised 01/10/2017 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CtlPRTtN4 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777p-322FAX (408) 777-3333 : building(a_cupertino.org AOw`rier aim I ((,& 1--s'�yVx� . I I Pennit N o] °)-241:1— 0 .4 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. 2 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 ofthe form and sign bottom of form. �d No Go to Question 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. X No 'Go to Question.4. Is your real property built and: available for use or occupancy on or before January 1, 19949 ❑ No My real property is; built and available for use or occupancy after January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. My real property is built and available for use or occupancy on or before January 1, 1994. Civil'C.ode�Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign . bottoii'of form.. Please check ONE; of the following: I� My propertyis,a'S ngle , dnzily residential real property. See Civil Code Section 1101.4. On.and: after, 7anuary 1,'. 20.14,';building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced ivitli'water-6nserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- compliant I pluinbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or unprovements). ❑' My property is 41.niultifaniily 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- conserv9ngplumbing fixture's throughout the building (regardless of whether property undergoes alterations or improvements)! r ❑ My property is ai 667nnz6vial 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-coinpliant 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 with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101;8, the;cuirentCalifornia 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 indicatedin the table on the followinzi)aRe. Upon completing and signing this Ccxtificate, please return it to the Building Division in order to final your building permit. SB407 2015. doe revised. 01105117 1. If the existing plumbing fixture water usage/flour rate is equal to or Iower than the figure shown, it is not required to be upgraded. SB4071015.doc revised 08126/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4' Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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 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 1.5gallons 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 psi 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/flour rate is equal to or Iower than the figure shown, it is not required to be upgraded. SB4071015.doc revised 08126/15