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14010104A44 44/ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10435 STERLING BLVD CONTRACTOR: WU ANDREW AND LU PERMIT NO: 14010104 MEI HUI OWNER'S NAME: WU ANDREW AND LU MEI HUI 10435 STERLING BLVD DATE ISSUED: 05/15/2014 OWNER'S PHONE: 4084102728 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL CONSTRUCT SINGLE STORE' SFDWL 2465 OF LIVING License Class Lic. # SPACE, ATTACHED GARAGE 485, PORCH 45 SQ AND DECD 108 Contractor Dale SQ- SUNNYVALE JURISDICTION 1 hereby affirm that I am licensed under the provisions of Chapter 9 EV # I REVISE INTERIOR LAYOUT - ISSUED 7/21/2014 (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 Sq. Ft Floor Area: Valuation: $350000 performance of the work for which this permit is issued. 1 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: 37526014.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES Ili' WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 D IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ISO D OM L LED INSPECTIO , 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 comp) Date: / with all non -point source regulations per the Cupertino Municipal Code, SeQtIMR 9.18. 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: 1 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 1, 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). 1 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 I 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: Date: 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 2 Or CONSTRUCTION PERMIT APPLICATION COMMLINITY DEVELOPMENT DEPARTMENT -BUILDING DIVISION 3. 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 PYA. (408) 777-3228 ^ FAX (408) 777-3333 ^ buildingancupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 9 REVISIO DEFERRED ORIGTNTAL PERMIT R"e % �O/D /0 l '• PROJECT ADDRESS C' APN 4 31P "" e% -p / OWNER NAME PHONE / /'/'7/m'/ I E-MAIL Ogn M.1. 1CBk STREET ADDRESS CITY, ST.A'TF, ZIP FAX CONTACT NAME PHONE fl 1-n Man E-MAIL Q,S�r e"n ;! STREET ADDRESSi 0 i'/C Cf CITY, STATE, ZIP I FAX 1' stoWIZER volArN'M-BUILDER ❑ OWNFER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARC-rinBCT ❑ EGGD.'EEji, ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENUMSER LICENSE 'PE I BUS. LIC 4 / O COMPANY NAME E-MAIL FAX (_"4vu 0 1®� STREET ADDRESS / SL CITY, STATE, ZIP PHONE 4RCHI7 ECT/ENGINEER NA1,4E LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP I PHONE DESCRIPTION OF WORK tk s-�'� IW rd&C to XIS G L'SE PROPOSED USE CONSTR TYPE '-STORIES USE TYPE OCC. SQ.FT. VALUATION (i) EXISTG NEW FLOOR DEMO TOTAL AREA AREA 7 AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE .AREA: DETACH ❑ ATTACH 9DA'KIINGUNITS: ISASECONDUNIT ❑YES SECONDSTORY [YES BEING ADDED? ❑NO ADDITION? ❑NO ILE� — ZS-P120YIDE-COEL' OF _IS THE BLD_G AN ___0 YES TOTAL V.4LU.4TION: PLA-N,gNGAPPL9 (]NO PLAAT'IIJGAPPROVAL LETTER EICHLERHOME?By my signature below, I certify to each of the following: 1 am the property owne or authorized agent to ac operty owner's behalf. 1 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 building co t Lion. I n rize re esentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: r Date: a '> SUPPLEMENTAORMATIONT REQUIRED i; c cxTiPE .Yr .'-_spa � * { ` �w-�ROVITI�G New SFD or Multifamily d-wellings: Apply for demolition permit for�� existing building(s). Demolition permit is required prior to issuance of building permit for new building.AM _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.," _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. 3t s -w'•. r. ..sn �© O\ERTHE-COUNTER, 3� g MOORE aR� RE ��'sTaS�D�i n I,°�R3 ��y tr'� :.r_'�^ `•� �: �..=Y?.�.�`�'tt ,�,^".x},-k '3�.,s+'-ei'4 qi.' `a -rn�z. ��s v ' �BUII:IDL\GPL4 REi�SEiV � a r gl- I Lz�Ei ,ter Rg PrusLlctYORI.s N. rn i �� fit AI2I SE{iBRT)ISTA1CTi �• ` �El�'VIRON114EAI'AI,HEADTFi _ .� ar* Bldg-App_201 1. doc revised 06/21/11 � O CITY OF c�UP Ell TENO FEE ESTIMATOR — IB�,TIIII.,Il�ENG DEVISIO T NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These_fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Efl..' 711!13) Plan Check Fee: Hourly Only? 0 Yes Q No ADDRESS: 10435 STERLING BLVD DATE: 07/21/2014 REVIEWED BY: MELISSA 71(,1'1 1'PPAtil Fcc- APN: 375 26 014 BP#: 14010104 "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p F'lurnh hqp 1..11, PENTAMATION PERMIT TYPE: 1GENRES� WORK REV # 1 REVISE INTERIOR LAYOUT - ISSUED 7/21/2014 SCOPE PME Unit 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_fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Efl..' 711!13) Plan Check Fee: Hourly Only? 0 Yes Q No Alec li Plar, Check QTY/FEE MISC ITEMS hours Plan Check, Hourly $286.00 1STPLNCK r*r"'. '%,;1„ 71(,1'1 1'PPAtil Fcc- IIP 't in t�f�'r, /"'rimf 1,jy Ch''x, i .11.:.' 1. /rr.�j� OIher I'ltrrriL layf� ED--I- 0!, r, i �__ �,r��. ll,�clr /rt�;��. l re F'lurnh hqp 1..11, hh' hP.V; Fr.' NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These_fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Efl..' 711!13) Plan Check Fee: Hourly Only? 0 Yes Q No FEE $0.00 QTY/FEE MISC ITEMS hours Plan Check, Hourly $286.00 1STPLNCK Suppl. PC Fee: ) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. OOT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: e'idli mi.wl"'2'tive Fee: G Work Without Permit? (0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure O A Travel Do, %w;7eyatat on Fees. Strong Motion Fee: $0.00 Select an Administrative Item Bldg* Stds Commission Fee: $0.00 SUBTOTALS: $0.001 $286.00 TOTAL ]FELE: $286.00 Revised: 0711012014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10435 STERLING BLVD CONTRACTOR: WU ANDREW AND LU PERMIT NO: 14010104 MEI HUI OWNER'S NAME: WU ANDREW AND LU MEI HUI 10435 STERLING BLVD DATE ISSUED: 05/15/2014 OWNER'S PHONE: 4084102728 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL CONSTRUCT SINGLE STORY SFDWL 2465 OF LIVING License Class Lic. # SPACE, ATTACHED GARAGE 485, PORCH 45 SQ AND DECK108 Contractor Date SQ - I hereby affirm that I am licensed under the provisions of Chapter 9 SUNNYVALE JURISDICTION (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. Sq. Ft Floor Area: Valuation: $350000 1 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: 37526014.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF FORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS ®F PERMIT ISSUANCE ®][8 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 DAYS F�tO}i 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: t 9 Date: '�� with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 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, l agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION %��' L Signature of Applicant: Date: 1 hereby affirm that 1 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) I, 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 of 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should 1 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 I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. }certify that in the performance of the work for which this permit is issued, l 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, l CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must l 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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. yy /,�'�/j� Signature Date 'Q / CUPERTINO NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 e building Wcupertino.org ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED U J ORIGINAL PERMIT # PROJECT ADDRESS APN #/� O l l fit: v J/ 1 OWNERNAME ,!n % PHONE E-MAIL STREET ADDRESS P CITY, STATE, ZIP FAX Ov / CONTACT NAMEONE E-MAIL STREET ADDRESS D ii CITY, STATE, ZIP Cv/ �Pd` fi.4 0 a FAX ❑ OWNER ❑ OWNER.BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITE NGINEERN E WIN � q {�� J� �T LICENSE NUMBER � � � BUS. LIC # COMPANY NAME . � E-MAIL �GJC O✓a t�� / ��k STREET ADDRESS 1LI/_ qc-t CITY, T,ATE, ZIP/ /S DESCRIPTION OF WORD I L . �,�uyl� ✓ c�`� C f4A tp Q -e / At, co n4wra?-VA 4P EXISPNAPSE PROPOSE SE CONSTR. TYPP W STORIES g USE TYPE OCC. SaQ).FT. VALUATION (S) �f� AREA A ARE FL"OR%C/ -6 )EMO+y //P / TOTALn-, AREA.9�� VVV «` .J/ / s a - M BATHROOM REMODEL AREA / KITCHEN REMODEL AREA OTHER REMODEL AREA J n/� ♦ /o'�i PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH ❑ ATTACH #DWELLING UNITS: ISASECOND UNIT []YES SECOND STORY []YS BEING ADDED! ANO ADDITION? 4ffNO PLANNI G APPON ❑YDS IF YES, PROVIDE COPY E PLANNING APPL # PLANNING APPROVAL LETTER EI HL BLDG AN ❑YDS EICHLER HOME! RECE] VED BY: TOT`J� IZT Fo-'r_Fj0 s0�,.0 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 beha . application and the infonnation 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 bildi g con�structio�n I uthorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: �L''/_ / 6�c 6�^ Date: — �— SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLm ❑ OVER-THE-COUNTER BUILDING PLAN 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. ❑ ExPREss fPLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials DisclosureSTANDARD pUBU1C woRKS form if any Hazardous Materials are being used as part of this project, fff❑ LARGE FIRE WEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ submittal of Building Permit application. MAJOR' SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11 FM-7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION iaADDRESS: 10435 sterling blvd DATE: 01/16/2014 REVIEWED BY: Mendez PC FEE ID APN: RP#: ® 0/0 *VALUATION: 1$350,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY SFD or Duplex USE: 2nd Unit? Yes • No PENTAMATION 1R3SFDW PERMIT TYPE: WORK construct single story sfdwl 2465 of living space, attached garage 485 orch 45 sq and deck 108 s SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID RP FEES RP FELE IID R-3 (Custom) II-B,111-B,IV,V-B 3,103 $3,017.07 IR3PLNCK $3,016.68 IR3INSP $0.00 PME Plan Check: $0.00 Permit Fee: $3,016.68 Suppl. Insp. Fee:Q Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 3,103 $3,017.07 1 $3,016.68 $652.28 Administrative Fee: 0 ,Vfech. Plan Check ;Vfech. Perwit Fee: Other Alech. Insp. Alech. Insp. Fee: $0.00 Phunb. Plan Check Flimb. Permit Fee: Other Plumb Insp. Plumb. hisp. Fee: Elec. Plan Check Elec. Permit Fee: Other Elec. Insp. F-1 Elec. Insp. Fee: NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public 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 addh7 info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1713) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,017.07 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. () OT0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,016.68 Suppl. Insp. Fee:Q Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXR 1 units # new $652.28 Administrative Fee: 0 Work Without Permit?. 0 Yes Q No $0.00 Advanced Planning Fee: 1PLLONGR $434.42 Select a Non -Residential Building or Structure 0 Travel Documentation Fees: Strom Motion Fee: IBSEISMICR $35.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $14.00 SUBTOTALS: $7,169.451 $0.00 TOTAL FEE: $7,169.45 Revised: 01/15/2014 CUPERTINO 0&4��5 pe�A� CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 1043G, S eY ► . Q ✓ vf' PERMIT # (4 BUSINESS NATVIE OWNER'S NAME: M(/V PHONE # 4Ve 410--1 � GENERAL CONTRACTOR: MCr BUSINESS LICENSE # 5M190 ADDRESS: 11' W. AgQ1 CITY/ZIPCODE: R9 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signatu re Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NATVIE BUSINESS LICENSE # J Cabinets & Millwork (HAV, CHO W - I l 5260 J Cement Finishing CHAO CHUAN -N F10 505 260 J Electrical C �} ' MM - f `� 1 j dj� 260 �J Excavation CH C f DA�-MIA) 7,60 Fencing OD J Flooring / CarpetingCH� (H( �-HW 9D� Z6D Linoleum / Wood CHWI MAN %11 S -e X60 V Glass / Glazing HAM` CHUAb-MW ,'®T 26D V Heating C AO CH 0AA)-H t -e 260 V Insulation ACH OA"1 tv-2-6o Landscaping Nd V Lathing CHM67 CHQN -Hrr t4t"2-�D Masonry N V Painting / Wallpaper Ab( -1 CHU/��®�'111t9 S�®,�2(�� 1/ Paving C HAAA 0101U—NN ,-q,�s2-6o Plastering CH40 CHUM—MIM ,S ®x'2'68 Plumbing C H AN 1 CH OA O -M L-Z�k 2-6 D V Roofing CH 0 Uq ®Mf fi D Septic Tank v Sheet Metal CHAO (HVM- tf I o&2 o Sheet Rock CH AW, M% -" j � ��GD Tile CHAW CHOM-tjW r®-�2-6o Owner / Contractor S 411Af- Date STATE IIF� O�F CALIFORNIAFEMM \�pp pp pp nn \�pp tppvitm wmr) AMM C D �C� '�. ,./ /t'� /� I rni tGnaniin cnicor_v rnnnnnlcclnni CERTIFICATE OF INSTALLATION CF2R-ENV-01-E Fenestration Installation (Page 1 of 2) Project Name:�Q C Enforcement Agency: Permit N7 b. er: cv Dwelling Addre19 op �g �y/ City Zip Code .ILS If more than one person has responsibilitty for installation of the items on this certificate, each person shall prepare and sign a certificate applicable to,the portion of construction for which they are responsible. Alternatively, the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction. The signer agrees that all applicable Mandatory Measures were met. Temporary labels are not to be removed before verification by the building inspector. A. Fenestration/Glazing Includes all Windows, Skylights, Greenhouse/Bay Windows, and Glazed Doors. " 01 02 03 04 05 06 07 08 Ag "10"',11 ". Exterior Source of. Shading Manufacturer/ Fenestration LI -factor Fenestration' Devices Tag/ID Brand Area (FT2) Orientation Chromogenic U-factorSHGC and SHGC Type", (Describe) Comments/Special Features B. Fenestration Installation 01 For new construction, installed window U -factor and SHGC values -s `ould be equal to-ord"esa than listed on the'CF' iO: 02 For existing buildings the U -factor and SHGC values should 6e-t<h2`5arrte or better than,�he-required Energy;`COmmisslon prescriptive requirements. 03 Temporary labels should not be removed until verified by thi building inspector 04 The fenestration product manufacturer's installations ecificefions shal�be followed when inst�lin tFiese products. The space between the fenestration product and rough opening shall be completely filled with insulation. If batt insulatiorris used; it is cut to size and placed properly around the fenestration product. The responsible person's signature on this compliancedo`cument ms' re applicable,requirerrlents in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA FEMESTRATP01M MSTALLAMM CEC-CF2R-ENV-01-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF INSTALLATION CF2R-ENV-01-E Fenestration Installation (Page 2 of 2) Project Name:Enforcement Agency: IAL Per;it er: Vb Dwelling Addres?'. 5;ne w"... JVa - city nosp— -ey a, " lip Code ly DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: �X. Documentation Author Company Name: Date Signed: Address: CEA/HERS Certification lclentifi6tion (If applicable): City/State/Zip: Phone: 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable cl—assifica'iicinito accept respoMibifity for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on t&s'tertificate of lnsta-)Ia ion, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible' bu11'der/instaIIer. 3. The constructed or installed features, materials, components or manufactured devices (the installa�tl6ir,))id"tifiecl on th1s' 'Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given orl-the plans and specific atio.ns approved by -the -enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the-erif6rcement agencyth4t.1clentifies the�gpecific"teqUirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements ikai apply to the,co'nstrtiction or installwon,have been met. —�\ V_ 5. 1 will ensure that a registered copy of this Certificate of Installation shall be postecT. ormade available,with'the'building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I unclers�and that a registered ,oP` of this Certed ifica',te of Installation is required to be included with the documentation the builder provides y to the building owner at occupancy. 4 Responsible Builder/installer Name- Re , spuilder/Instal ler Signature: Company Name: (installing Subcontractor or I /-,� Genera 1,gootrktoror-guilder/ ner) Positidn I With Company (Title), -/ –, h eg Address:11) U (C CSLB License: S-6 6 ows -c- C i—ty/State/Zip: * Phone "IV atesigned: —TM, Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA INSULATION INSTALLATION CFC-CF9R-FNV-03-F /Revised 03/1Iril CAI IFORNIA FNFRr,Y Cr)MMIRRION 11W CERTIFICATE OF INSTALLATION CF2R-ENV-03-E Insulation Installation (Page 1 of 5) Project Name: 1A Id �Vi 11 Enforcement Agency: Permit Number: /A/tLo Dwelling Address: ® City /�®� ,�y� Zip Code.,5�r60/ Medium and light density SPF manufacturers claim various R -values per inch. In California the maximum R -value that can be claimed for ccSPF is on R -value of 5.8 per inch and for ocSPF is on R -value of 3.6 per inch unless documentation is provided showing that the product and/or manufacturer has a current ICC Evaluation Service Report (ESR) that shows compliance with Acceptance Criteria for Spray -Applied Foam Plastic Insulation--AC377. MOTE. The Energy Efficiency Standards Section 110.7 requires that 'all joints, penetrations and other openings in the building envelope that are potential sources of air leakage shall be caulked, gasketed, weather stripped, or otherwise sealed to limit infiltration and exfiltration". In areas where spray foam (SPF) insulation is used, the SPF can be considered the air barrier. Other than rigid board insulation, all other forms of insulation are not considered as an air barrier. s , A. ROOF/CEILING INSULATION '. 01 02 03 04 05 06 07 S08 \ '' 09 10 L. \`, r \..rh;' ' Mass,. Ickness Framing Framing Size Insulation ESR Cavit 1nSiilatidri Above Deck Below Deck 1. D. Manufacturer & Brand Framing Framing Size I.nsulatlon , \. ESR ' Insu ation, Depth Insulation Insulation R -value R -value Material & Spacing Type Number R-tialluye.' (inches) -: R;value R -value R -value inches) —77 R -value R -value B. WALL INSULATION 01 02 03 04 05 ` , 0& %' " 07, 08 09 10 L. \`, r \..rh;' ' Mass,. Ickness Furring3frip\ � Framing'Size & Spacing c Interior Cavity` Insulation Exterior Interior I.D. Manufacturer & Brand Framing Framing Size I.nsulatlon , \. ESR ' � Insulation Depth Wall Wall R -value R -value Material & Spacing ,, ,'-Type Number, ( Insulation Insulation R -value inches) R -value R -value C. MASS INSULATION 01 02 �,A�03 (04 ��;�� 05 �` 06 07 08 09 10 L. \`, r \..rh;' ' Mass,. Ickness Furring3frip\ � Framing'Size & Spacing Exterior Interior 1. D. r,; Manufacturer & Brand ...` - ,�_- Location\ inches �' ( ) Jype/,Depth Insulation Type Insulation Insulation r; (inches) R -value R -value D. RAISED,, ' FLO'01ONSULATION 0102 --` �,A�03 (04 ��;�� ` 05 06 07 08 09 10 L. \`, \n \ �� Manufacturer`�BcBrand" \j Framing Material � Framing'Size & Spacing Insulation Type ESR Number Cavity Insulation R -value Insulation Depth (inches) Exterior Floor Insulation R -value Interior Floor Insulation R -value E. SLAB FLOOR/PERIMETER INSULATION (SEE F. FOR INSULATION REQUIREMENTS FOR HEATED SLABS) di—) 02 03 04 05 06 07 08 I.D. Manufacturer & Brand Floor Type Insulation Type Insulation Depth (inches) Insulation R -Value Vertical insulation Length (inches) Horizontal Insulation Length (feet) Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA INSULATION INSTALLA"rm CEC-CF2R-ENV-03-E Revised 03/15 CALIFORNIA ENERGY COMMISSION r. CERTIFICATE OF INSTALLATION CF2R-ENV-03-E Insulation Installation (Page 2 of 5) Project Name: �, Enforcement Agency: Permit Number: eo /0 Ape Dwelling Address::/®S[ -cI_e C� q city p V �1/ til Zip Code y F. HEATED SLAB INSULATION 01 All heated slabs shall be insulated as required by Section 110.8(g). Footings must meet required insulation levels. 02 Insulation shall be installed from the top of the slab, down 16 inches or to the frost line, whichever is greater. Climate zones 1-15 requires 02 R-5, climate zone 16 requires R-10. 03 Alternatively, vertical insulation from top of slab at inside edge of outside wall down to the top of the horizontal insulation. Horizontal 03 insulation from the outside edge of the vertical insulation extending 4 feet toward the center of the slab in a direction normal to the outside of the building in plain view. Climate zones 1-15 require R-5, climate zone 16 requires R-10 vertical and R-7 horizontal. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. G. MINIMUM MANDATORY MEASURES % ;- , .'; Insulation - 110.8(a): All installed insulation is certified and listed with the Department of Consumer Affairs, "Standards for Insulating 01 Material." t 02 Insulation - 110.8(b): Urea formaldehyde foam insulation is protected by 4 mil polyethylene vapor retarder. 03 Insulation - 110.8(c): Flame spread and smoke density requirements of CBC are met. 04 Raised Floor - 150.0(d): All raised wood -frame floor have a minimum R-19 insulation or equivalent LI -factor Slab Floor/Perimeter - 150.0(1): Water absorption rate for the insulation material alone without facings is r` `greater than 0.3%; water 05 vapor permeance rate is no greater than 2.0 perm/inch, and perimeter insulation is,protected from physical damage and UV light deterioration. 06 Above Grade Exterior Wall - 150.0(c)1: All 2x4 wood -frame walls have -a minimum R-13 insulation or equivalent U -factor. 07 Above Grade Exterior Wall - 150.0(c)2: All 2x6 wood -frame walls' }ade,a minimum R-19 insulation or equivalent U -factor. 08 Ceiling/Rafter Roof - 150.0(a)1: All wood -framed ceilings have a' minimum R-30 insulation or equivalent U -factor. Vapor Retarder—150.0(g)1: In Climate Zones 14 and 16, Class II vapor retarder installed on conditioned space side of insulation in exterior 09 walls, vented attics, and unvented attics with air -permeable insulation.., - 10 Vapor Retarder—150.0(g)2: Class I or II vapor retarder in`stalled on the earth floor of unvented crawlspaces in Climate Zones 1-16. 11 Vapor Retarder—150.0(g)3: Class I or II vapor retar'd`er'installed on the edrth floor of controlled ventilation crawlspaces. Heated Slabs - 110.8(g): All heated slabs shall be insulated as fequired:. 0 Insulation shall be installed frgm,fhe'top of the slab; 'down 16 inches or to the frost line, whichever is greater. Climate zones 1-15 require R-5, climate zone 16`reAdires R-10. , 12 r 0 Alternatively, vertical,tnsulation from top ofsfab•at'inside edge of outside wall down to the top of the horizontal insulation. Horizontal insulation.from the outside a ge,ofthe vertical insolation extending 4 feet toward the center of the slab in a direction normal to the -6 4si"cl'of the build.ing,in plain view. Climate.'Zones 1-15 require R-5, climate zone 16 requires R-10 vertical and R-7 horizontal ,l-`.�: , c;.��.� The responsible person's signature on this co`mplian`ce document affirmsthat all applicable requirements in this table have been met. H. INSTALLED INSULATION 01 Instal(eo.insulation R -values are the same or gceater,than listed on the CF1R. 02 "No gaps or voids between the insulation andframi'ng. 03 `No gaps betweehihesides or ends of batt insulation. Loose -fill insulation must be installed to the minimum installed weight per square foot (density) of the manufacturer's cut sheet for the �.04 proposed R -value. 05 Baf0nsulation is not compressed (no stuffing of the insulation into the cavity) and is installed to its full thickness. 06 rinsulati6n is cut around obstructions such as electrical boxes, 07,--,-',Bait'insulation is delaminated around all plumbing and electrical lines in ceilings, walls, and floors. 08�-� % Band joists are insulated to the same R -value as the wall. 09 In all narrow cavities the insulation shall be cut to fit or filled with expanding foam. 10 1 Insulation was installed per manufacturer instructions. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA INSULATION INSTALLATION CEC-CF2R-ENV-03-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION CF2R-ENV-03-E Insulation Installation (Page 3 of 5) Project Name: Enforcement Agency: Permit Number: �f Dwelling Addressd : o rf City o V Zip Code 9 I. WALL INSULATION 01 When allowed by the manufacturer, low expanding foam shall be used to fill gaps and voids around windows and doors. If not, the cavity 02 must be airtight and filled completely with insulation. Batt insulation must be cut to width. No stuffing allowed. 02 Install wall insulation before installing tubs, showers, and fireplaces. 03 Electric panels on walls separating conditioned and unconditioned space are sealed and insulated behind the panel with rigid insulation or 05 expanding foam. 04 All walls of interior closets vented to the outside for HVAC or water heating equipment have the same R -value and air barrier as the 07 exterior walls and ceiling. Doors are insulated and weather stripped. 08 Ducting is not allowed in exterior walls unless it is insulated to R-6 or greater, and the insulation and ducting are not,crushed. Ducting is not 05 allowed in 2x4 wall assemblies. 06 Corner channels, wall intersections, and double sided shear walls are insulated to the required R -value before enclosing the wall: 07 Insulation that does not fill the cavity is placed against the exterior air barrier. 08 Band joists are insulated to the same R -value as the walls. The responsible person's signature on this compliance document affirms that all applicable requirements in this tablehave been met. J. CEILING/ROOF INSULATION 01 Insulation extends to the outside edge of the exterior top plates and is flush against'any ventilation dams/baffles. 02 Insulation is in direct contact with ceiling, so there are no gaps between the ceiling and the insulation.: - 03 For chimneys and flues, the insulation is in contact with the sheet metal;collar.-% 04 Can lights are covered with insulation to the same depth as required`by the CF1R for ceiling jin�ulation. If not, an area weighted calculation is required to be turned in with this form (Form CF1R-ENV;02-E): 05 Walkways and mechanical platforms are insulated to the same R value as required forthe ceiling. If not, an area weighted calculation is required to be turned in with this form (Form CF1R-ENV-02-E). • % '' 1 06 Insulate soffits by adding an air barrier and covering`with,insulation, or insulate the entire soffit including floor and walls. 07 Knee walls and skylight shafts are insulated to the-(yall'R-value and in full contact with the interior air barrier. If framing on these surfaces is laid flat batt insulation is cut to fit around,th� framing. Batt insulation is not allowed,tq lie:draped over the framing. 08 Attic access doors are insulated to,the-same R` --value as the ceiling. The insulation ispernianently attached using adhesive or mechanical fasteners. c {,, t ,. �V1. 09 Attic access must be surround4w' ith`a dam at least the same depth as the insulation to prevent loss of ceiling insulation. 10 Batt insulation is cut to fit .around cross bracings and'truss webs in the attic.- The responsible person's signat'uri,o' this compliance,document affirms`that'alfapplicable requirements in this table have been met. K. RAISED FLOOR,INSULATION !; "N- 01 Insulation' is.in'fuil contact with subfloor. X/ 02 Intulafidr hangers are spaced at'�g inches or less; insulation hangers must not compress insulation. 03 ,If netting or mesh is used; the cavity under the 006r'-Isfilledand in contact with the subfloor. If the'basement,isconditioned, the walls adjacent to the crawlspace must meet minimum wall R -value requirements. This includes framed stem walls, and vertical concrete retaining walls. -\45- If access to the crawl space is from the conditioned area, the raised floor must have an airtight insulated access hatch. "9 he responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. XV" � L. FLOOR -AIJVE'dARAGE INSULATION Ql� '1I6sulation must be in full contact with the subfloor if the air barrier is at the band joist at the garage/house wall. 02 Insulation hangers spaced at 18 inches or less; insulation hangers must not compress insulation. 03 If netting or mesh is used, the cavity under the floor is filled and in contact with the subfloor. 04 If the air barrier is at the perimeter of the garage, below the conditioned subfloor, the insulation is placed on the garage ceiling. The perimeter of the subfloor is also insulated. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA MULATION INSTALLA,nom CFC-('.F2R-FNV-01-F /Revised 03l1S) t CALIFORNIA FNFRr.Y COMMISSION ' CERTIFICATE OF INSTALLATION CF2R-ENV-03-E Insulation Installation (Page 4 of 5) Project Name:Enforcement Agency: Permit Number: Dwelling Address:�V 1911 City®� I Zip Code W v M. CANTILEVERED FLOOR INSULATION 01 Insulation is in full contact with the cantilevered subfloor. Insulation hangers are spaced at 18 inches or less; insulation hangers do not compress insulation. 02 If netting or mesh is used, the cavity under the floor is filled and in contact with the subfloor. 03 Sealed blocking is installed between joists where a wall rim joist would be located in the absence of a cantilever. Insulation is placed on both sides of this block. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. N. ATTACHED PORCH ROOF INSULATION 1 01 The exterior insulated wall at the intersection with the porch roof is fully insulated above, below, and behind the roof line. 02 Where truss framing is used, airtight blocking is installed at the top and bottom of each wall/roof section and insulated. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been meta. {J V < . i �\ J <�`` Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA INSULATION INSTALLATION CEC-CF2R-ENV-03-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION CF2R-ENV-03-E Insulation Installation (Page 5 of 5) Project Name:r^ Enforcement Agency: Permit Number: /o/®W Dwelling Address:.0 ��® City ie rr� Zip Code A DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: Date Signed: Address: CEA/HERS Certification Identification (If applicable): City/State/Zip: Phone: RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: C. 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification'to accept responsibility for'the system design, construction, or installation of features, materials, components, or manufactureclAevices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible-builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured'r�evices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency#hat identifies the specific requirements for the scope of construction or installation identified on this Certificate; of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. ' :;- 5. 1 will ensure that a registered copy of this Certificate'of Installation shall bg,post'ed, or 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 i .. Certificate of Installation is required to be included with the docuna,entation t e builder provides to the buildingoWner at occupancy. Responsible Builder/Installer Na ;\ . Respo i Builder/dnstallerSi n,ture: Company Name: Installing Sub con actor df GenerqI,QpntFactor or Builder/Owner) \ ; Posif5ofi With tornpany"(Title): r Z7 N Oi14;"l�DP \ Address:Ar '/y i�►/( ; CSLB'License:-' A y 3 City/State/Zip: {J,' V, phone Date Signed: Cl <" V 4 �r. V r t ni Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA CEC-CF2R-PLEF02-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF INSTALLATION CF2R-PIB-02-E Single Dwelling Unit Hot Water System Distribution (Page 1 of 6) Project Name:s, ¢� p IJ V! / W_4 C Enforcement Agency: Permit Number:' ®/o /0 Dwelling Address: City Zlp Code Sa/ 4Z y A. General Information 01 1 Dwelling Unit Name B. Design Dwelling Unit Water Heating Systems Information This table reports the water heating system features that were specified on the registered CFSR compliance document for this project. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 # of Water Water Heating Water Water Water Heater Fuel Rated Rated Heating Heating Standby Exterior Central DHW System Dwelling Unit DHW System System ID or Heating Heater Heaters Storage Type Input Input Efficiency Efficiency Loss (%) Insul. Distribution Type Distribution Type Name System Type Type in Volume Efficiency Type Value Type Value Name R -Value Type system (gal) Type Type system (gal) Value Loss (%) R -Value Distribution Type Distribution Type LO o C. Installed Dwelling Unit Water Heating Systems Information 01 02 03 04 05 06 07 08 09 10 11 12 13 14 # of Water Water Heater Water Heating Water Water Heaters Storage Rated Rated Heating Heating Exterior System ID or Heating Heater in Volume Fuel Input Input Efficiency Efficiency Standby Insul. Central DHW System Dwelling Unit DHW System Name System Type Type system (gal) Type Type Value Type Value Loss (%) R -Value Distribution Type Distribution Type LO o D. Installed Water Heater Manufacturer Information 01 02 03 Water Heating System ID or Name Manufacturer Model Number o d i9 Registration Number: Registration DateMme: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 I STATE OF CALIFORNIA SINGLE DWELLING UNIT HOT WATER SYSTEM DISTRIBUTION CEC-CF2R-PLB-02-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION CF2R-PLB-02-E Single Dwelling Unit Hot Water System Distribution (Page 2 of 6) Project Name: u 2QSi�2 2 Enforcement Agency: Permit Number: / /a/v Dwelling Address: 0' ` S� /` l / city�� r 21p CodeJPO! E. Mandatory Measures for All Domestic Hot Water Distribution Systems 01 Equipment shall meet the applicable requirements of the Appliance Efficiency Regulations (Section 110.3(b)1). 02 Unfired Storage Tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. (Section 110.3(c)4). The following pipes are insulated, to the thicknesses required by Table 120.3A, except for those sections of pipe that are subject to one of the exceptions below: (RA4.4.1) • The first 5 feet (1.5 meters) of hot and cold water pipes from the storage tank. • All piping with a nominal diameter of 3/4 inch (19 millimeter) or larger. • All piping associated with a domestic hot water recirculation system regardless of the pipe diameter, except when cold water return is used in a demand system. • Piping from the heating source to storage tank or between tanks. 03 a Piping buried below grade. • All hot water pipes from the heating source to the kitchen fixtures. The following sections of pipe do not have to be insulated: (RA4.4.1) • Piping installed in interior or exterior walls that is surrounded on all sides by at least 1 inch of insulation. • Piping installed in attics with a minimum of 4 inches (10 cm) of attic insulation on top • Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Metal piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members. 04 Piping buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. (Section 150.00)) 05 All elbows and tees shall be fully insulated. (RA4.4.1) 06 Where insulation is required, no piping shall be visible due to insulation voids, and all insulation shall fit tightly to the pipe. (RA4.4.1) For Gas or Propane Water Heaters: Ensure the following are installed (Section 150.0(n)) 1. A 120V electrical receptacle is within 3 feet from the water heater and accessible with no obstructions 07 2. A Category III or IV vent, or a Type B vent with straight pipe between outside and water heater 3. A condensate drain no more than 2 inches higher than the base on water heater for natural draining 4. A gas supply line with capacity of at least 200,000 Btu/Hr The responsible person's signature on this compliance document affirms that all applicable requirements In this table have been met. F. Standard Distribution System Requirements(trunk and branch systems only) Systems that utilize this distribution type shall comply with these requirements 01 1 Verification of measures D1 through D8 shows compliance for standard distribution system The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA SMIGLE DWELLING UMT HOT WATER SYSTEM MSTMBUTM CEC-CF2R-PLB-02-E (Revised 03115) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF INSTALLATION CF2R-PLB-02-E Single Dwelling Unit Hot Water System Distribution (Page 3 of 6) Project Name: omc Enforcement Agency: Permit Number: is�e�/�/J 1 03 Hot water distribution system piping from the manifold to the fixtures and appliances must take the most direct path. For instance, piping from a second story manifold Dwelling Address: -6/v / City /'� � r�0 ug Zip Cod kV / G. Pipe Insulation Credit Requirements(For trunk and branch Hot Water system) Systems that utilize this distribution type shall comply with these requirements 01 All hot water piping shall comply with the insulation requirements in Table 120.3-A. (RA 4.4.14) The responsible person's signature on this compliance document affirms that all applicable requirements In this table have been met. H. Parallel Piping Requirements Systems that utilize this distribution type shall comply with these requirements 01 Each central manifold has 15 feet or less of pipe between manifold and water heater (RA 4.4.15) 02 For manifolds that include valves, the manifold must be readily accessible in accordance with the plumbing code. (RA 4.4.4) 03 Hot water distribution system piping from the manifold to the fixtures and appliances must take the most direct path. For instance, piping from a second story manifold The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. cannot supply the first floor. (RA 4.4.4) 04 The hot water distribution piping must be separated by at least two inches from any other hot water supply piping, and at least six inches from any cold water supply piping. Alternatively, the hot water supply piping must be insulated to the thicknesses shown in TABLE 120.3-A. (RA 4.4.4) The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. 1. Recirculation Non -Demand controls Requirements Systems that utilize this distribution type shall comply with these requirements 01 If more than one loop installed each loop shall have its own pump and controls 02 The active control shall be either: timer, temperature, or time and temperature. Timers shall be set to less than 24 hours. The temperature sensor shall be connected to the piping and to the controls for the pump. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA SINGLE DWELLING UNIT HOT WATER SYSTEM DISTRIBUTION r.Fr._CF9R-PI FL09-F rRevisad 031151 t CAI IFnRNIA FNFRr,V MMMISSICIN CERTIFICATE OF INSTALLATION CF2R-PLB-02-E Single Dwelling Unit Hot Water System Distribution (Page 4 of 6) Project Name: r 6k Enforcement Agency: Permit Number: ! SLarO /vf� Dwelling Address: S city Zip Code 4�e i O( tY K 02 J. Demand Recirculation Manual Control Requirements Systems that utilize this distribution type shall comply with these requirements 01 The system operates "on -demand", meaning that the pump begins to operate shortly before or immediately after hot water draw begins, and stops when the return water temperature reaches a certain threshold value. (RA4.4.13) After the pump has been activated, the controls shall allow the pump to operate until the water temperature at the thermo-sensor rises to one of the following values: (RA4.4.13) 02 • Not more than 10 degrees Fahrenheit ( 5.6 degrees Celsius ) above the initial temperature of the water in the pipe • Not more than 102 degrees Fahrenheit (38.9 degrees Celsius). 03 The controls shall limit pump operation to a maximum of 10 minutes following any activation. This is provided in the event that the normal means of shutting offthe pump have failed. (RA4.4.13) Pump and control placement shall meet one of the following criteria: (RA4.4.13) • When a dedicated return line has been installed the pump, controls and thermo-sensor are installed at the end of the supply portion of the recirculation loop; or 04 • The pump and controls are installed on the dedicated return line near the water heater and the thermo-sensor is installed in an accessible location as close to the end of the supply portion of the recirculation loop as possible; or • When the cold water line is used as the return, the pump, demand controls and thermo-sensor shall be installed in an accessible location at the end of supply portion of the hot water distribution line (typically under a sink). 05 Insulation is not required on the cold water line when it is used as the return. (RA4.4.13) 06 Each control shall have standby power of 1 Watt or less. Controls may be located in individual units or on the loop. Controls may be activated by wired or wireless mechanisms, including buttons, motion sensors, door switches and flow switches. (RA4.4.13) 07 If more than one loop installed each loop shall have its own pump and controls 08 Automatic Air release valve is installed on the inlet side of the recirculation pump per Section 110.3(c)5A. 09 A check valve is located between the recirculation pump and the water heater per Section 110.3(c)5B. Hose bibb is installed between the pump and the water heating equipment with an isolation valve between the hose bibb and the water heating equipment per Section 10 110.3(c)5C. 11 Isolation valves are installed on both sides of the pump. One of the isolation valves may be the same isolation valve as in item 10 above per Section 110.3(c)5D. 12 The cold water supply piping and the recirculation loop piping is not connected to the hot water storage tank drain port per Section 110.3(c)5E. 13 A check valve is installed on the cold water supply line between the hot water system and the next closest tee on the cold water supply per Section 110.3(c)5F. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA SINGLE DWELLING UNIT HOT WATER SYSTEM MSTRIBILMON CEC-CF2R-PL&02-E (Revised 03115) CALIFORNIA ENERGY COMMISSION 0 CERTIFICATE OF INSTALLATION CF2R-PLB-02-E Single Dwelling Unit Hot Water System Distribution (Page 5 of 6) Project Name:i ///� Enforcement Agenry: Permit Numbe Dwelling d I Os� Y i �l u l f 'P C' `' `�' �D�Y® ZIP Code K. Demand Recirculation Sensor Control Requirements Systems that utilize this distribution type shall comply with these requirements 01 The system operates "on -demand", meaning that the pump begins to operate shortly before or immediately after hot water draw begins, and stops when the return water temperature reaches a certain threshold value. (RA4.4.13) After the pump has been activated, the controls shall allow the pump to operate until the water temperature at the thermo-sensor rises to one of the following values: (`4.4.13) 02 o Not more than 10 degrees Fahrenheit ( 5.6 degrees Celsius ) above the initial temperature of the water in the pipe o Not more than 102 degrees Fahrenheit (38.9 degrees Celsius). 03 The controls shall limit pump operation to a maximum of 10 minutes following any activation. This is provided in the event that the normal means of shutting off the pump have failed. (RA4.4.13) Pump and control placement shall meet one of the following criteria: (RA4.4.13) o When a dedicated return line has been installed the pump, controls and thermo-sensor are installed at the end of the supply portion of the recirculation loop; or 04 ° The pump and controls are installed on the dedicated return line near the water heater and the thermo-sensor is installed in an accessible location as close to the end of the supply portion of the recirculation loop as possible; or o When the cold water line is used as the return, the pump, demand controls and thermo-sensor shall be installed in an accessible location at the end of supply portion of the hot water distribution line (typically under a sink). 05 Insulation is not required on the cold water line when it is used as the return. (RA4.4.13) 06 Each control shall have standby power of 1 Watt or less. Controls may be located in individual units or on the loop. Controls may be activated by wired or wireless mechanisms, including buttons, motion sensors, door switches and flow switches. (RA4.4.13) 07 If more than one loop installed each loop shall have its own pump and controls 08 Automatic Air release valve is installed on the inlet side of the recirculation pump per Section 110.3(c)5A. 09 A check valve is located between the recirculation pump and the water heater per Section 110.3(c)58. 10 Hose bibb is installed between the pump and the water heating equipment with an isolation valve between the hose bibb and the water heating equipment per Section 110.3(c)SC. 11 Isolation valves are installed on both sides of the pump. One of the isolation valves may be the same isolation valve as in item 8 above per Section 110.3(c)5D. 12 The cold water supply piping and the recirculation loop piping is not connected to the hot water storage tank drain port per Section 110.3(c)5E. 13 A check valve is installed on the cold water supply line between the hot water system and the next closest tee on the cold water supply per Section 110.3(c)5F. The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 STATE OF CALIFORNIA CEC-CF2R-PLB-02-E (Revised 03/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION CF2R-PLB-02-E Single Dwelling Unit Hot Water System Distribution (Page 6 of 6) Project Name: Enforcement Agency: Permit Number: Dwelling Address: Ctty Zip Code DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Documentation Author Company Name: Date Signed: Address: CEA/HERS Certification Identification (If applicable): City/State/Zip: Phone: 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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or 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 Installation is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: /� r i Re le Builder/Installer Si abure: A AA OSv% — /F/ r � �Y Area Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) 61Pos tion ith Company (Title): /'-V"as R Address: rp / CSLB License: City/State/Zip: CA ?k' Phone ®� Date Signed: ® s Registration Number: Registration Date/Time: HERS Provider: CA Building Energy Efficiency Standards - 2013 Residential Compliance March 2015 W, L r. CANNEINBUiLDBR DISCLOSURE FORM COMMUN7 Y DEVELOPMIEN i DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINa (408) 777-3228 - FAX (40B) 777-3333 - build! no(a)cuDer tino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specifad at: SITE ADDRESS APN BPj :rr C' R(o/ I Ol IER` E V J O%IVNERIDDRESS 1_ b) o c —DESCRIPTION OF WORK: We are providing you with an 0\vner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder, VVe will not issue a building permit until you have read, initiated your understanding of each provision, signed, and returned this form to us at our OiilCial address indicated. An agent Of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below fo signiy you understand or verity this inTormation.) /1/2_fI. I understand a frequent practice of unlicensed persons is to have the property owner obtain an 'Owner - Builder" building permit that erroneously impiks; that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. �. 1 understand building permits are not required to be signed by property.owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. /41a3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that 1 may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ,1ILL4. I understand Contractors are required by law to be licensed and bonded in California and to list their license 'K6 -m' on permits and contracts. ,L�c-f6. [understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the Total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal Ia\,✓, /L�6. 1 understand if I am considered an "employer' under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide v✓crkers' compensation disability insurance, and contribute to unemployment compensation for each "empicyee." I also understand my failure to abide by these laws may subject me to serious financial risk. /*7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family resid,ential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general buliding Contractor. nu. I understand as an Owner -Builder if I sell the -property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. O7+.nei•BvilderFar 7� 2010.doc remised 04114110 I understand I may obtain more information regarding my obligations as an "employer" from the Internal Rue Service, the United States Small Business Administration, the California Department of Benefit Payments, and tie California Division of Industrial Accidents. I also understand I may contact the Califomia Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or v,N,w.cslb.ca.gov for more information about licensed contractors. / / 10. 1 am aware of and consent to an Owner -Builder building. permit applied for in my name, and understand that l am the party legally and financially responsible for proposed construction activity at the site address listed above. � i 1. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable lavvs and requirements that govern Ovvner-Builders as well as employers. , '' (LL. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil tour. it is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Con actors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of thlBir workers' compensation insurance coverage. th CGNSTRUCTION LENDINGAGENCY (DIRECTIONS: Pie ase complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verrication acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature, Property Owner's Signature: Date: 1 --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE. The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF „GENT TO ACT ON PROPERTY OWNERS BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following persons) to act as my aoent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or tA,coress: Name of 11-1.uthorized Agent: Tel No ,^-ddress of,';uthorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be raquired to be presented when the permit is issued to verify the property owner's sicnature. Property Owner's Signature: Date: Or;;erBui!derFonn 2010.doc revised 04114110 BUHILDIING ENERGY ANA .YS E * T _ Suildin' "° vU 9 DePartmen= S40 � 3 20% REVIEWED FOR CODE COMPLIANCE Reviewed By. Wu Residence 10435 Sterling Blvd Cupertino, CA 95014 Project Designer: G.S. Engineering 41076 Davila Ct Fremont, CA 94539 510-304-9812 Report Prepared by: G.S Engineering Jolt Number: 1308 Date. 4/11/2014 The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This pr gram 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 EnergySoft, LLC —www.energysoft.com. I EnergyPro 5.1 by EnergySoft User Number. 9571 ID: 1308 R N N TABLE E OF CONTENTS I Cover Page Table of Contents Form CF -1 R Certificate of Compliance Form MFA R Mandatory Measures Summary EnergyPro 5.1 by EnergySoft Job Number: ID: 1308 User Number: 9571 2 3 8 CER T01FiCATE. ResidentW Part 1 of 5 CIS -1 R .PERFORMANCE Project Name Wu Residence Building Type 0 Single Family ❑ Addition Alone ❑ Multi Family ❑ Existing+ Addition/Alteration Date 4/11/2014 Project Address 10435 Sterling Blvd Cupertino California Energy Climate Zone CA Climate Zone 04 Total Cond. Floor Area 2465 Addition n/a # of Stories 1 REL® Of SPECTMN ENERGY CHIECI UST ❑ Yes El No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form. ❑ Yes EI No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Type Cavity ftp Features see [dart 2 of 5 Status .Construction Floor Wood Framed w/Crawl Space R-19 2,465 New Wall Wood Framed R-13 7,862 New Door Opaque Door None 40 New Roof Wood Framed Attic R-30 2,699 New FENESTRATION U- IEiderior Area ft`) Factor SHGC Overhang Sidlefins Shades Status .Orientation Front (N) 38.0 0.390 0.37 none none Bug Screen New Left (E) 108.0 0.390 0.37 none none Bug Screen New Rear (S) 116.0 0.390 0.37 none none Bug Screen New Right (W) 56.0 0.390 0.37 none none Bug Screen New Skylight 16.0 0.390 0.29 none none None New HVAC SYSTEMS Ot . Heating Min. Eff Cooling lain. Eff Thermostat Status 1 Central Furnace 90% AFUE Split Air Conditioner 13.0 SEER Setback New MVAC IDIS7TRIS4. TION ®acct Location Heating Cooling Duct Location R -Value Status HVAC System Ducted Ducted Garage 6.0 New WATER HEATING Q$ . Type Gallons Min. Eff Distribution Status 1 Small Gas 50 0.58 Kitchen Pipe Ins New Energ Pro 5. 1 by EnergySoft User Number: 9571 /D: 1308 Page 3 of 10 MANCE C ER IT11MC A Ea Resiiden M (Part 2 of 5) CF -IR. -PERFORMANCE Project Name Wu Residence Building Type m Single Family ❑ Addition Alone 1 0 Multi Family 0 Existing+ Addition/Alteration Date 4/11/2014 SPEML FEATURES I]IMSPEC`il M C HIECKLMT 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 s ecial justification and documentation submitted. HERS RCOURED VERMC xnoom Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a CF -4R form for each of the measures listed below for final to be given. -completed Ener Pro 5.1 b Ene Soft User Number: 9571 ID: 1308 Pa e 4 of 10 PERFORMANCE E C ERTIIRCATE:' ResWentiall (Part 3 of 5) CSF-`i] G�3 Project Name Building Type D Single Family D Addition Alone Date Wu Residence D Multi Family D Existing+ Addition/Alteration 4/11/2014 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ft2- r Space Heating 57.35 46.81 10.54 Space Cooling 15.52 19.86 -4.34 Fans 10.43 11.27 -0.84 Domestic Hot Water 16.93 16.93 0.00 Pumps 0.00 0.00 0.00 Totals 100.24 94.87 5.36 Percent Better Than Standard: 5.3% o UOLDOM0 CORIPLUES [�IOO [;�Cf3� MLL3�G��C�LQ`��OO Cil G�3C�QU�G�3�D Fenestration Building Front Orientation: (N) 0 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 1.00 (N) 645 38 Fuel Available at Site: Natural Gas (E) 630 108 Raised Floor Area: 2,465 (S) 645 116 Slab on Grade Area: 0 (tM 6,300 56 Average Ceiling Height: 9.0 Roof 2,715 16 Fenestration Average U-Factor: 0.39 TOTAL: 334 Average SHGC: 0.37 Fenestration/CFA Ratio: 13.5% REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 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 Autihov Company G.S Engineering 4/11/2014 Address Name City/State/ZipCity/State/Zip Phone 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. Designev olr Ownelr (per Business & Professions Code) Company G.S. Engineering Address 41076 Davila Ct Name Guangsheng Wang City/State/Zip Fremont, CA 94539 Phone 510-304-9812 Signed License # Date Ener Pro 5.1 6 Ener Soft User Number: 9571 ID: 1308 Pae 5 of 10 CCG TIFOCATE OF COMPLOAMC E- ResWenftllPart 4 of 5 C F4 R Project Name Building Type @ Single Family ❑ Addition Alone Date Wu Residence ❑ Multi Family ❑ Existing+ Addition/Alteration 4/11/2014 OPAQUE SURFACE DETAI Surface Type Area U- Factor Cavity Insulation Exterior Frame Interior Frame Azm Tilt Status Joint Appendix 4 LocationiComments Floor 2,465 0.037 R-19 0 180 New 4.4.1-A4 Zone 1 Wall 607 0.102 R-13 0 90 New 4.3.1-A3 Zone 1 Wall 482 0.102 R-13 90 90 New 4.3.1-A3 Zone 1 Door 40 0.500 None 90 90 New 4.5.1-A4 Zone 1 Well 529 0.102 R-13 180 90 New 4.3.1-A3 Zone 1 Wall 6,244 0.102 R-13 270 90 New 4.3.1-A3 Zone 1 Roof 2,699 0.031 R-30 0 18 New 4.2.1-A20 Zone 1 Milgard Classic Low -E Vinyl Zone 1 4 Window 56.0 0.390 NFRC 0.37 NFRC 270 New Milgard Classic Low -E Vinyl Zone 1 5 Skylight 16.0 0.390 NFRC 0.29 NFRC 0 New Velux Comfort+(74) Lowe2fArg Zone 1 FENESTRATION SURFACE DETAILS ID Type Area U -Factor' GC2 Azm Status Glazing Type Location/Comments- 1 Window 38.0 0.390 NFRC 0.37 NFRC 0 New Milgard Classic Low -E Vinyl Zone 1 2 Window 108.0 0.390 NFRC 0.37 NFRC 90 New Milgard Classic Low -E Vinyl Zone 1 3 Window 116.0 0.390 NFRC 0.37 NFRC 180 New Milgard Classic Low -E Vinyl Zone 1 4 Window 56.0 0.390 NFRC 0.37 NFRC 270 New Milgard Classic Low -E Vinyl Zone 1 5 Skylight 16.0 0.390 NFRC 0.29 NFRC 0 New Velux Comfort+(74) Lowe2fArg Zone 1 (1) U -Factor Type: 2 SHGC Type: i i 6-A = Default Table from Standards, NFRC = Labeled Value 116-B = Default Table from Standards NFRC = Labeled Value EXTERIOR SHADING DETAILS Exterior Shade Type SHGC H t Wd Ove hang Len Hat LEA REA Left Fin Ri ht Fin Dist Len H t Dist Len H t F42Window Bug Screen 0.76 Bug Screen 0.76 Bug Screen 0.76 Bug Screen 0.76 5 None 1.00 Ener Pro 5.1 bZ Ener Soft User Number: 9571 ID: 1308 Pa e 6 of 10 cER`[r'llmcA u E OF C®MPUAN1C E- ResWc nftll (Pari 5 of 5) CSF -1 R Project Name Wu Residence Building Type © Single Family ❑ Addition Alone ❑.Multi Family ElExisting+ Addition/Alteration Date 4/11/2014 BUILDING ZONE INFORMATION System Name Zone Name Floor Area New Existinq Altered Removed Volume Year Built HVAC System Room 1 2,465 22,185 Totals 2,465 0 0 0 HVAC SYSTEMS System Name Qty. Heating Type Min. Eff. Cooling Type Min. Eff. Thermostat Type Status HVAC System 1 Central Furnace 90% 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 Garage 6.0 ❑ New El El WATER IDEATING SYSTEMS S stem Name Qty. 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 HYDRONOC HEATING SYSTEM PIPING Control Hot Water Piping Length ft o i� n ¢ c System Name Pipe Length Pipe Diameter Insul. Thick. Qty. HP Plenum Outside Buried Ener Pro 5.1 6i Ener Soft User Number: 9571 ID: 1308 Page 7 of 10 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MFA R Project Name Wu Residence Date 4/11/2014 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. Building 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(i) when the installation of a Cool Roof is specified on the CF -1 R Form. *§1 50 a : Minimum R-19 insulation in wood -frame ceiling orequivalent U -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. *§1 50 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 E1677-95 2000 when specified on the CF -1 R Form. 1 50 : Man datory 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 qreater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass 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: fan -type central furnaces, household cooking 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 ACCA. §150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §150(j)1 A: 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. §150(j)1 B: 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. §150(j)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of recirculating sections of hot water pipes are insulated per Standards Table 150-13. §150(j)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. §1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table 123-A. 150(1)3A: Insulation is protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind. §1500)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in conditioned space. 150(j)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro 5.1 by EnergySoft User Number: 9571 ID: 1308 Page 8 of 10 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF_1I R Project Name Date Wu Residence 4/11/2014 §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 R- 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 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings reater than 1/4 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. 150(m)7: Exhaust fans stems have back draft or automatic dampers. §I50(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 insulation 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 10: Flexible ducts cannot have orous inner cores. §150(0): All dwelling units shall meet the requirements of ANSI/ASHRAE 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; anon -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)1: 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 set or programmed to run only during off-peak electric demand periods. 150 : Residential pool systems orequipment meet the eume sizing, flow rate, piping, filters, and valve requirements of §159 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 luminaire 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: Liqhtinq 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(1<)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 ft2 or 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 EnergySoft User Number: 9571 ID: 1308 Page 9 of 10 I� MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 WIF-1 R Project Name Date Wu Residence 4/11/2014 §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)11: 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 testing/rating 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 (ENCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor luminaires used to comply with Exceptions to §150(k)13 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)16: 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. EnergyPro 5.1 by EnergySoft User Number: 9571 ID: 1308 Page 10 of 10