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12080109CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10497 CHACE DR CONTRACTOR: SONRISE ENT INC PERMIT NO: 12080109 OWNER'S NAME: ROVEGNO BYRON P AND PATRICIA M TRUS 1750 GREENWOOD RD DATE ISSUED: 11/21/2012 OWNER'S PHONE: 4087351171 PLEASANTON, CA 94566 PHONE NO: (510) 305-9061 ❑ LICENSED NSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL License Class Lic. # 5 ZGl CONSTRUCT 427 SQ FT OF ADDITIONS TO RESIDENCE, �� r 2� ^ 12, CONSTRUCT A 162 SQ FT GARAGE ADDITION,A 25 SQ FT Contractor 1'N`Date COVERED PORCH, CONSTRUCT (2) PERGOLA'S (112 SQ I hereby affirm that I am licensed under the provisions of Chapter 9 (commenting 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: 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 Sq. Ft Floor Area: Valuation: $400000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32613077.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN J#0 DAYS OF PERMIT ISSUANCE O$ to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYOM LAST CALLED INSPECTION. 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 Issued by: Date: �� with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 2' RE -ROOFS: Signature Date 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: &A10 CDW Date: "12, 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT � BUILDING ADDRESS: 10497 CHACE DR [ CONTRACTOR: SONRISE ENT INC I PERMIT NO: 12080109 1 I OWNER'S NAME: ROVEGNO BYRON P AND PATRICIA M TRUS 1 1750 GREENWOOD RD II DATE ISSUED: 11/21/2012 1 OWNER'S PHONE: 4087351171 PLEASANTON, CA 94566 PHONE NO: (510) 305-9061 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class Lic. # Contractor. Date 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. 1 hereby affirm under penalty of perjury one of the following two declarations: 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 CERTIFICATION I certify that I have read this application and state that the above information is correct. l 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. Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for one of the following two reasons: 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) I, 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: 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 LaborCode, 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, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that 1 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 CONSTRUCT 427 SQ FT OF ADDITIONS TO RESIDENCE, CONSTRUCT A 162 SQ FT GARAGE ADDITION, A 25 SQ FT COVERED PORCH, CONSTRUCT (2) PERGOLA'S (112 SQ Sq. Ft Floor Area: Valuation: $400000 APN Number: 32613077.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: 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: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 1 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, and 25534. . Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I 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 7 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE a CUPERTINO, CA 95014-3255 LID CUPERTINO (408) 777-3228 ^ FAX ((5408) 777-3333 ^ buildingCakupertino.org NEW CONSTRT1CTTON � ADDITION 0 AT.TF.RATIC)N / TT 1 I RFVTRTCIN / DF.FF.RRF.D ORTC;TNAT. PERMIT ii PROJECT ADDRESS /0 ^�444:f e. r , APN'# /3 — 0�7 OWNER NAME! / rI Ic fit O V. PHONE �J ' !I I E-MAIL STREET ADDRESS CITY, STATE ZIP FAX r CONTACT NAME PHNE N0,4 Sz � �, MAIL ��F'� � sn .� STREET ADDRESS O ° E ^ CITY, STATE, ZIP 7�8 0 FAX b_ OWNER ❑ OWNER -BUILDER 11 OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT 13 ENGINEER ❑ DEVELOPER ❑ TENANT ^ CONTRACTOR NAME '17/ -7 LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/JiC ERN E i LICENSE NUMBER / –1 BUS. LIC# COMPANY-. �� A 1A E bCR�fl�N��^ICf��J/��JjY�/ DNaCA� FAX STREET ADDRESS �Z lJ �L CI Y, STATE, ZIP PHONE en 321-3? S - <,arb r CC DESCRIPTION OF WORK + � •- .�G� � 1 ��%� � � ` �L �(ZI�Ty�,� �D �d'J Zit �{. � L% G�ro�� a 1 3-e&rt96-M,11 , a`\ EXISTINOPOSED U CONS TYPE STORIES J USE n USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA.3Z NEW FLOOR AREA JW DEMO AREA TOTAL NET AREA $[� 1 v COO COOBATHROOM KITCHEN OTHER REMODEL AREA j /470 ! REMODEL AREA Z.,-7,0 REMODEL AREA .may y� PORCH AREA DECK AREA TOTAL DECK/PORCH AREA C iEA: DETACH r:p I ;& ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND ND STO ❑ YES BEING ADDED? WO ADDITION? �0 PRE -APPLICATION [I YES IF YES, PROVIDE COPY OFYY�3 IS THE BLDG AN ❑ YES RECEIVED BY `� ``�' �+ TOT VALUATION: PLANNINGAPPL# ®NO PLANNING APPROVAL LETTER EICHLERHOME? rz3 N0 "'1n'a �,,��,�+r `.•�rY v� 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 have provided 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 relating to ding constr4tieI authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION RE IRED�'� PLiN,i: KTYPE .,' p ROUTING SLI' ID OVER THE COUNTER LDINGPLAN`REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. � ExPxEss 1�-�nr NG PIAN REVIEW " f Commercial Bldgs: Provide a completed Hazardous Materials Disclosure1 pnRn s"vusLTCwoRres - _ form if anHazardous Materials are being used as art of this project. y g p p Fg :.� LARGERE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to" ❑ _ submittal of Building Permit application. MAJOR ;, 8A1V ARY SEWER DISTRICT "❑ ENVIRONMENTALHEAITH BldgApp 2011.doc revised 06/21/11 a CITY OF CUPERTINO IM -0 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10497 chace dr. TYPE OF CONSTR. DATE: 08/09/2012 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$400,000 *PERMIT TYPE: Building Permit 614 PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex ;l]ech. bzsp. Fee: 2nd Unit? Yes '. No OTC? 0Yes �No PENTAMATION PERMIT TYPE: 1R3SFDADD WORK Sfd add to bedroom #2 garage, family/kitchen, porch, 614 s.f. minor remodel of baths bedrooms SCOPE dining , hall, living non structural, only electrical, lighting , plumbing. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 614 $2,468.00 1R3PLNCK $1,549.00 1R3INSP ;l]ech. bzsp. Fee: Plulab. hrap. Fee: F.iec. Insp. Fete: $0.00 PME Plan Check: $0.00 =# $13.00 Plumbing IPRREPIPE I Re -Pipe Interior Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT F-01hrs $0.00 1 # Plumbing $67.00 IBPGAS Piping, Gas >4 Outlets TOTALS: 614 $2,468.00 $1,549.00 $90.00 MECH, HOURLY 0 Yes G No PLUMB, HOURLY Q Yes (j) No ELEC, HOURLY Q Yes (D No iWech. [Ion, (.'heck Plumb. Plan Check 0.0 1 hrs $0.00 Elec. Plan Check 1 0.0 1 hrs $0.00 `ie,_,. fermi! Fee: Plumb. Permit Fee: IPPERMIT Elec. Permit Fee: IEPERMIT Jrl,,er A e ch. Insp.ET-1- Other Plumb Insp. EThrs $45.00 Other Elea Insp. 0.0 hrs $45.00 ;l]ech. bzsp. Fee: Plulab. hrap. Fee: F.iec. Insp. Fete: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Puhlic Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,468.00 =# $23.00 Plumbing IPRSEWER Sewer, Sanitary Suppl. PC Fee: Q Reg. OT 0 .0 hrs $0.00 PME Plan Check: $0.00 =# $13.00 Plumbing IPRREPIPE I Re -Pipe Interior Permit Fee: $1,549.00 Suppl. Insp. Fee:Q Reg. Q OT F-01hrs $0.00 1 # Plumbing $67.00 IBPGAS Piping, Gas >4 Outlets PME Unit Fee: $0.00 PME Permit Fee: $90.00 17 # $170.00 Plumbing 1BPFIXTURE Fixture or Trap Construction arra: ticleniriistrrxtivc�c��: 122 # $453.00 Eleytrical ]BRE /Switch/Outlets Work Without Permit? C) Yes iS No $0.0 Advanced Planning Fee: IPLLONGR $79.82 Select a Non -Residential Building or Structure E) d Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: IBSEISMICR $40.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $16.00 SUBTOTALS: $4,287.82 $726.00 TOTAL FEE: $5,013.82 Revised: 07/01/2012 CITY OF CUPERTINO Fm_§ FEE ESTIMATOR - BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: Insp.1'ee: PENTAMATION 1 REAP10 PERMIT TYPE: WORK $0.00C.0REMRECEP SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These lees are based on the preliminary information available and are only an estimgte. Contact the Dept_for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) Mech. Plan Check F0.0 Thrs $0.00 Plumb. Pion Cl;ec,A Elec. Plan Check 0.0 hrs $0 0 Mech. Permit Fee: 1MPERMIT Phimn. Permit Fee: Elec. Permit Fee: lE EMIT LOt,her Mech. Insp.ET�L$45.00 Orbe r 1%Jr<mb Insp. Other Elec. Insp. 0.0 hrs $4 .00 Insp.1'ee: I'lurnb. Insp. Fee-, Else. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These lees are based on the preliminary information available and are only an estimgte. Contact the Dept_for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE ISC ITEMS Plan Check Fee: $0.00 1 Electrical ecep/Switch/Outlets Suppl. PC Fee: (j) Reg. () OT L.0 hrs $0.00C.0REMRECEP PME Plan Check: $0.00 chanical Furnace, Forced -Air Permit Fee: Hourly Only? � Yes C) No $0.00FR=<100 Suppl. Insp. Fee:Q Reg. Q OT LEhrs $0.00 0 # Mechanical $201.00 1BAPPLOT Other Appliance/Equip PME Unit Fee: $0.00 PME Permit Fee: $90.00 Coni—action Tax: Administrative Fee: $42.09 0 E) Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee: $0.00 hours $931.00 Inspections 1STINSP Inspection, Hourly E) d Travel Documentation Fee: Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $177.00 $1,678.00 TOTAL FEE: $1,855.00 Revised: 07/01/2012 I Il u lding (Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C M P E R7 0 H® Fax: 408-777-3333 CONTRACTOR SUBCONTRACTOR ILESU JOBADDRESS: U�P,U19 PERMIT# x-00 OWNER'S NAME: fwo PHONE # 50 `- 2,@� "qPM GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: VO 964, VIM * hO ,' et ? CITY/ZIPCODE: "Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL O1R ]FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL TILL GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINIEID A CITY OF CU]P1ERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature ]Please check appReable subcontraetors anal compRete the ffo llc wIlng nnfform2flon: (Date d 1- 13 (Date SUBCONTRACTOR BUSINESS NAME BURIN ESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting �f Linoleum / Wood ®Tet, M*%* fj Glass / Glazing Heating U Insulation Landscaping Lathing Masonry Painting / Wallpaper �� la�� s ► ��os�� Paving Plastering. Plumbing Roofing `r� �;`�' ,.' !, ��a�9� `��'-' I/ Septic Tank Sheet Metal Sheet Rock svK� *-ts 0- Tile 1- 13 (Date BUILDING ENERGY ANALYSIS REPORT PROJECT: Addition and Alterations 10497 Chace Drive Cupertino, CA 95014 Project Designer: Richard Morrison, AIA, ASID 570 EI Camino Real, #150-242 Redwood City, CA 94063 650.321-3729 Report Prepared by: Richard Morrison, AIA, ASID 570 EI Camino Real, #150-242 Redwood City, CA 94063 650-321-3729 CUPERYINO r .- Builciia3g Department � Nod 2 0 7012 Job Number: EVIEWEG FOR CfiiJMPLMCE 11022 owed By: P Date: 8/4/2012 h•. The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySofl, LLC—www.energysoft.com. I EneroyPro5.1bvEnemv5off UserNumber.'4162 Run Code:2012-08-04747:21:51 1D: 11022 1 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R Project Name Addition and Alterations Building Type m Single Family ❑ Addition Alone Date ❑ Multi Family ❑ Existing+ Addition/Alteration $/4/2012 Project Address 10497 Chace Drive Cupertino California Energy Climate Zono CA Climate Zone 04 Total Cond. Floor Area 3,177 Addition n/a 8 of Stories 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ❑ No HERS Measures -- If Yes, A CF-4R must be provided per Part 2 of 5 of this form. ❑ Yes El No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity (flz} Features (see Part 2 of 5) Status Floor Wood Framed w/Craw! Space R-19 3,177 New wall Wood Framed R-15 1,863 New Door Opaque Door None 36 New Roof Wood Framed Attic R-38 2,613 New wall Wood Framed R-13 456 New Roof Woad Framed Attic R-19 286 New FENESTRATION U- Exterior Orientation Area(ft) Factor SHGC Overhang Sidefins Shades Status Front (NE) 139.0 0.360 0.37 none none Bug Screen New Right (NVO 30.9 0.360 0.37 none none Bug Screen New Rear (SK9 204.1 0.360 0.37 none none Bug Screen New Lett (SE) 94.4 0.360 0,37 none none Bug Screen New Skylight 68.2 0.390 0.29 none none None New Skylight 10.0 0.390 0.29 none none None New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status I Central Fumace 785a AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R-Value Status HVAC System Ducted Ducted Crawlspace 8.0 New WATER HEATING Qty. Type Gallons Min. Eff Distribution Status 1 Small Gas 50 0.58 Kitchen Pipe Ins New ErrergyPro 5.1 by EnergySoft User Number. 4162 RunCode: 2012-08.04777:21:51 0: 11022 Page 3 of 10 PERFORMANCE CERTIFICATE: Residential (Part 2 of 5) CF-1 R Project Name Addition and Alterations Building Type m Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 8/4/2412 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist. These items require special written justification and documentation, and special verification to be used with the performance approach. The enforcement agency determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-4R form for each of the measures listed below for final to be given. The HVAC System HVAC System Incorporates MFRS Verified Refrigerant Charge or a Charge Indicator Display. The HVAC System HVAC System Incorporates HERS verified Duct Leakage. HERS held verification and diagnostic testing is required to verify that duct leakage meets the specified criteria. EnemyPro 5.1 by EnemySoft User Number. 4162 Run Code: 2012-08-04T17:21:51 ID: 11022 Pa e 4 of 10 PERFORMANCE CERTIFICATE: Residential (Part 3 of 5) CF-1 R Project Name Building Type m Single Family ❑ Addition Alone Date Addition and Alterations ❑ Multi Family ❑ Existing+ Addition/Alteration $/4/2012 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2 r Space Heating 22.72 16.17 6.55 Space Cooling 6.42 9.00 -2.58 Fans 4.61 4.66 -0.04 Domestic Hot Water 13.24 13.24 0.00 Pumps 0.00 0.00 0.00 Totals 47.00 43.07 3,93 Percent Better Than Standard: 8.4% BUILDING COMPLIES - HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (NE) 45 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (NE) 1,054 139 Fuel Available at Site: Natural Gas (SE) 485 94 Raised Floor Area: 3,177 (SW 803 204 Slab on Grade Area: 0 (NW) 485 31 Average Ceiling Height: 8.5 Roof 3,177 78 Fenestration Average U-Factor: 0.36 TOTAL: 547 Average SHGC: 0.37 Fenestration/CFA Ratio: 17.2% REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts t the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documentation author hereby certifies that the documentation is accurate and complete. Documentation Author Company 8/4/2012 Address 370 El Camino Real. #150-242 Name Richard Momson, AIA, ASID City/StalelZip Redwood City. CA 94063 Phone 650-321-3729 Signed Date _ The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company Richard Morrison, AIA, ASID Address 570 El Camino Real, #150-242 Name Richard Morrison, AIA, ASID CitylState/Zlp Redwood City, CA 94063 Phone 650-321-3729 Signed license # Date EneravPro 5.1 by EnerqySaft User Number- 4162 Run Code: 2012-08-041-17:21:51 ID: 11022 Pa e 5 of 10 CERTIFICATE OF COMPLIANCE: Residential (Part 4 of 5) CF -1 R Project Name Addition and Alterations Building Type O Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 8/4/2012 OPAQUE SURFACE DETAILS Surface U- Insulation Type Area Factor Cavity Exterior I Frame Interiorl Frame Axm Tilt Status Joint Appendix 4 Location/Comments Floor Zest 0.037 R-19 0 180 New 9,4,1-A4 Zone i Wall 324 0.095 R-15 45 90 New 4,3,1-A4 Zone 1 Door 20 0.500 None 45 90 New 4.5.1-A4 Zone f Wal! 310 0.095 R-15 315 90 New 4.3. i -A4 Zone f Wall 469 0.095 R-15 225 90 New 4.3.i -A4 Zone 1 Wall 391 0.095 R-15 135 90 New 4.3. i -A4 Zone 1 Roof 2813 0.025 R-38 180 18 New 4.2.1-A21 Zone 1 Wall 458 0.102 R-13 45 90 New 4.3.1-A3 Zone 1 Door 18 0.500 None 45 90 New 4.5.1-A4 Zone 1 Floor 296 0.037.R-19 0 180 New 4.4, i -A4 Zone i Wall 95 0.095 R-15 45 90 New 4.3.1-A4 Zone 1 Wall 144 0.095 R-15 315 90 New 4.3.1-A4 Zone 1 Wall 130 0.095 R-15 225 90 New 4.3.1-A4 Zone 1 Roof 266 0.048 R-19 1801 16 New 4.2.1-A 16 Zone 1 FENESTRATION SURFACE DETAILS ID Tvpe Area U -Factor SHGC Azm Status GlazingType Location/Comments 1 Wndow 132.0 0.360 NFRC 0.37 NFRC 45 New Eagle Low -E Zone 1 2 Wndow 30.9 0.360 NFRC 0.37 NFRC 315 New Eagle Low -E Zone 1 3 Window 190.1 0.360 NFRC 0.37 NFRC 225 New Eagle Low -E Zone 1 4 Window 94.4 0.360 NFRC 0.37 NFRC 135 New Eagle Low -E Zone 1 5 Skylight 68.2 0.390 NFRC 0.29 NFRC 180 New Velux Comfort+f74j Lowe2/Arg Zone 1 fi Wndow 7.0 0.360 NFRC 0.37 NFRC 45 New Eagle Lcw-E Zone 1 7 Window 14.0 0.360 NFRC 0.37 NFRC 225 New Eagle Low -E Zone 1 8 Skylight 10.0 0.390 NFRC 0.29 NFRC 180 New Velux Comfort+(74) Lowe2/Arg Zone i (1) U -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value (2) SHGC Type: 116-B = Default Table from Standards. NFRC = Labeled Value EXTERIOR SHADING DETAILS ID Window Exterior Shade Type SHGC Hglt Wd Ove hang Left Fin Right Fin Len H t LExt RExt Dist Len tit Dist Len H t 1 Bug Screen 0.76 2 Bug Screen 0.76 3 Bug Screen 0.76 4 Bug Screen 0.76 5 None 1.00 6 Bug Screen 0.76 7 Bug Screen 0.76 6 None 1.00 EnergyPro 5.1 by EnergySoft User Number.4162 RunCode: 2012-08-04T17:21:51 ID: 11022 Page 6 of 10 CERTIFICATE OF COMPLIANCE: Residential (Part 5 of 5) CF -1 R Project Name Addition and Alterations Building Type ❑ Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date W412012 BUILDING ZONE INFORMATION System Name Zone Name Floor Area ft New Existing Altered Removed Volume Year Built HVAC System Main Nouse 2,861 24,489 Dressing Area/Master Closet 296 2,368 Totals 3,177 0 01 0 HVAC SYSTEMS System Name of . Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC System 1 Central Fu mace 78% AFUE Split Air Conditioner 13.0 SEER Setback New HVAC DISTRIBUTION System Name Heating Duct Cooling Duct Location R -Value Ducts Tested? Status HVAC System Ducted Ducted Crawlspace 6.0 Q1 New ❑ WATER HEATING SYSTEMS S stem Name City. Type Distribution Rated Input Btuh Tank Cap. al Energy Factor or RE Standby Loss or Pilot Ext. Tank Insul. R- Value Status Standard Gas 50 gal or Le 1 Small Gas Kitchen Pipe Ins 40,000 50 0.58 n/a n/a New MULTI -FAMILY WATER HEATING DETAILS HYDRONIC HEATING SYSTEM PIPING Control Hot Water Piping Length ft o i� -0 y ¢ System Name Pipe Length Pipe Diameter Insul. Thick. QtV. HP Plenum Outside Buried EnergyPro 5.1 by Erre Soft User Number: 4162 Run Code: 2012-08-04T17:21:51 ID: 11022 Pacre 7 of 10 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R Project Name Addition and Alterations Date 8/4/2012 NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF - 1 R -ALT Form) shall supersede the items marked with an asterisk (") below. This Mandatory Measures Summary shall be incorporated Into the permit documents, and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R Form with plans. Buildinct Envelope Measures: 116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified U -Factor, certified Solar Heat Gain Coefficient SHGC , and infiltration that meets the requirements of 10-111 (a). 117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed. 118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form. §118(i): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the Installation of a Cool Roof is specified on the CF -1 R Form. *§150(a): Minimum R-19 insulation in wood -frame ceiling orequivalent 1 -11 -factor. §150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value. *§1 50 c : Minimum R-13 insulation in wood -frame wall orequivalent U -factor. *§150(d): Minimum R-13 insulation in raised wood -frame floor orequivalent U -factor. §150(f): Air retarding wrap is tested, labeled, and installed according to ASTM El677-95 2000 when specified on the CF -1 R Form. 150 : Mandatory Vapor barrier Installed in Climate Zones 14 or 16. §150(1): Water absorption rate for slab edge insulation material alone without facings Is no greater than 0.3%; water vapor permeance rate is no areater than 2.0Perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 a 1A: Masonry or factory -built fireplaces have a closable metal or q lass door covering the entire opening of the firebox. §150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is equipped with a with a readily accessible, operable. and tight -fitting damper and or a combustion -air control device. §150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the outside of the building, are prohibited. Space Conditioning, Water Heating and Plumbing System Measures: §110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release valve, backflow prevention, pump isolation valve and recirculation loop connection requirements of §113(c)5. §115: Continuously burning pilot lights are prohibited for natural gas: ian-type central furnaces, household conking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and spa heaters. §150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACOA. §11500): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §1500)1B: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the tank. §1500)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculafing sections of hot water pipes are insulated per Standards Table 150-B. §1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §150(1)2: Pipe insulation for steam hydropic heating systems or hot water systems X15 psi, meets the requirements of Standards Table 123-A. 150(i)3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. §1 500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. §150@4: 4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 byEnergYSoff User Number. 4162 Run Code: 2012-08-04Ti7:21:51 ID., 11022 Page 8 of 10 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R Project Name Date Addition and Alterations 8/4/2012 §150(m)1: All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum Installed level of 8- 4.2 or enclosed entirely In conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the applicable requirements of UL 181, UL 181 A, or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 114 inch, the combination of mastic and either mesh or tape shall be used §150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. i 50(m)7: Exhaust fans stems have back draft or automatic dampers. §150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. §150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. Cellular foam insular€on shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150 m i 0: Flexible ducts cannot have porous inner cores, §150(0): All dwelling units shall meet the requirements of ANSIMSHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and shall not use electric resistance heating ora pilot light. §114(b)l : Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction and return lines, or built-up connections for future solar heating. 114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover. §114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be sot or programmed to run only during off-peak electric demand periods. §150(p): Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150(p). Residential Lighting Measures: §150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-C and Is not a low efficacy luminalre asspecified by §150(k)2. §150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d). §150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line - voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a medium screw -base socket. 150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k). 150 k 7: All switching devices and controls shall meet the requirements of §150(k)7. §150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a manual -on occupant sensor. §150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by ErnergySoR User Number. 4162 RunCode: 2012-06-04117:21:51 !D: 11022 Pega 9 of 10 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R Project Name Date Addition and Alterations 8/4/2012 §150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms shall be high efficacy. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on occupant sensor certified to comply with the applicable requirements of §119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual -on occupancy sensor. §150(k)l 1: Permanently installed luminaires located In rooms or areas other than in kitchens, bathrooms, garages, laundry rooms, closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual - on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with 150 k 11. §150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters Laboratories or other nationally recognized testingfrating laboratory; and have a label that certifies the lumiunaire Is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)13: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management control system (FMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptionl to §150(k)l3 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not be high efficacy luminaires. §150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no more than five watts of power as determined according to §130(d). §150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable requirements of Sections 130, 131, 134 and 146. §150(k)l6: Permanently Installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119. EnergyPrn 5.1 by EnergySoft User Number. 4162 RunCode: 2012-08-04r17:21:51 !D: 11022 Page f0 of l p