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B-2017-1091CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1091 10575 METEOR PL CUPERTINO, CA 95014-1326 (326 44 007) A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC MEMPHIS, TN 38120 OWNER'S NAME: HIRSCH PETER M TRUSTEE DATE ISSUED: 07/10/2017 OWNER'S PHONE: 916-668-8937 PHONE NO: (408) 286-8931 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Q-JQ Lic. #Z42039 Contractor A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC X BLDG —ELECT —PLUMB Date 10/31/2017 X MECH X RESIDENTIAL _ COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my JOB DESCRIPTION: license is in full force and effect. REPLACE AIR CONDITIONING UNIT -SAME LOCATION I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. z. 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 Sq Ft Floor Area: Valuation: $10067.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 32644 007 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 PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities, judgments, costs, and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all no -point 180 DAYS FROM LAST CALLED INSPECTION. source regulati per the Cupertino Municipal Code, Sectio /� ) ' 7 Issued by: Jasmine Archbold Signature Date V Date: 07/10/2017 OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Cade) Signature of Applicant: 2. I, as owner of the property, am exclusively contracting with licensed Date: contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance, as provided for by California Health & Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & Safety Code, Sections 25505, 25533, and 25534. exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall Owner or utho [zed agent: be deemed revoked. Date: 1% APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby ffir that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of wor for this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city ech Lend 's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildina(d)cupertino.ora '� (, C?Gi j M I S C' ❑PLUMBING MECHANICAL 2ELECTRICAL ❑MISCELLANEOUS PROSECT ADDRESS ?-J 4PN R -2- 6 - l� OWNER NAME + P � S 3 E-AZAIL STREET.4DDRESS � � /n/I l� I S / T FAX ' CONTACT NAME P N { E-A24II STREETADDRESS C ST. ✓ F.AX ❑ OWN17t ❑ OwN.'ER-BLMDER ❑ OVVNERAGEvT ❑ CONTRACTOR ❑ COMMA.CTOR AGENT ❑ ARCHITECTENGWEER ❑ DEVELOPER ❑ TENANT CONITRACTOR NAME LCF !n!!31LI� / ry V BUS. /k1 ( / COMPANY NAME E -WAIT, FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ FD or DUPLEY ❑ - NILZTI-FAMILY ( PR07EC7 LN WTLDTAND 'i'ES BUII DING: COA2ARCIAL URBAN RTERFACEAREA 1v0 PROSECT IN ❑ YES FLOOD ZONE El NO I IS TIE BLDG AN El 1iS EICHI IIt HOME? ❑ 0 DESCRIPTION OF WORK Vl TOTAL VALUATION: RECEIVTD BY: By my signature below, I certify to each o the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to uilding construction. uthorize representatives of Cupertino to enter the abov -/dented pro rty/fo ' pection pu poses. Signature of Applicanb'Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED i OFFICE USE ONLY t < OVER -TIE -CO UNTLR J E?.Pi.LSS Ej STANDARD ❑ L4RGE ❑ m-uOR A-fEPA,fisc,4pp_2011.doc remised 0 612 1/11 a 1 A i t- yr Ur,urUrciV in ALTERATIONS - HVAC Wo CEC-CFIR-ALT-03-E (Revised 01/16) CALIFORNIA ENERGY COMMISSION '" CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations - HVAC CZ 1, 3 to 7 and 16 (Page 1 of 1) Site Address: r� Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New: Ducting or Lineset Required R -value Conditioned Floor Area (ft Z) Thermostat ❑ Packaged System Evaporator Coil AFUE COP ❑ R-6 (CZ 1-10,12&13) Ducts Served by system back Split System .0 Condensing Unit SEER IJ R-8' (CZ 11,14-16) Ducts /��j� z l�—ft (!f not already 11 Furnace ff7Lineset EER HSPF 11 >_ R-2.8 Lineset' present must be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this for is allowed to be filled out by hand. For final inspection all forms are'to be registered (no hand filled forms allowed) and a copy left onsite. 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: (Can include new ducting) All Equipment, CF1R-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MCH -01, MCH -20-H Air Handler/Furnace CF3R: MCH -20-H Installer Requirement: Duct leakage (515% or, 510% to outside, or seal all accessible leaks) Exempted from duct leakage testing if: ❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building_ ❑ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1R-ALT-02-E CF2R-MCH-01-E, MCH -20-1-1, MCH -22-1-1, MCH -(23 or 24)-H CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24)-H' Installer Requirement: Duct leakage < 5%, Fan Efficacy (0.58W/CFM), Air Flow ? 350 CFM/ton (or Standards Table 150.0-13 / C alternative) ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CFIR-ALT-02-E Ducts' and one or more of the following: CF2R-MCH-01-E, MCH -20-H, MCH -(23 or 24)-H Condenser Unit, Evaporator Coil, Furnace CF3R-MCH-20-H, MCH -(23 or 24)-H Installer Requirement: Duct leakage < 5%, Air Flow >_ 350 CFM/ton (or Standards Table 150.0-13 / C alternative) ❑ Exempted from duct leakage testing if existing duct .systems are constructed, insulated or sealed with asbestos. ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing.ducts in unconditioned CF1R-ALT-02-E space but less than All New Ducts' CF2R-MCH-20-H CF311-MCH-20-1-1 Installer Required to: Duct leakage (< 15% or, < 10% to outside, or seal all accessible leaks) ❑ Exempted from duct leakage testing if existing duct systems are constructed, insulated or sealed with asbestos. 'All new ducting requires R-8 insulationwhen more than 40 ft installed in CZs 11 & 14-16 and R-6 in CZs 1-10, 12 & 13, and R-6 insulation when less than 40 ft installed. This includes in walls, between floors etc. ' A New Duct system is when the duct system is constructed of at least 75 %new duct material, and up to 25%may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, plenums, duct material. a R-2.8 (1" thick insulation) for linesets 1" and less. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on -this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of.Title 24, Parts 1 and 6 of the California Code of Regulations (CCR). 4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR. 5. The building design features or system design features identified onthis Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency fora proval with this building permit application. Responsible Designe m Responsible esigner Signature: e¢':,^ / G(/ Li ey G� y Company: r$ /� 5LAI i /State/I Phon ! 2�ls ) . For assistance or questions regargyg the Energy Standards, contact the Energy Hotline at -71-800-772-3300 CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION_ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building crDcupertino.orq MOO CANNOT MFINALED INT MS CE 2TIFiCATE HAS: BEEla C011�LETED, 1�I�, �'gETL1REI3 �'(i SIE' SUiilf��fi DIYI�I�1tI, f PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314, 2016 CBC Sections 420 6 and 907.2 11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000 00, CRC Section R314 and CBC Sections 907.2.11.5 and 420 6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CSC Section 420 6 and shall be approved by the Office of the State Fire Marshal. Power Supply In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CSC Sections 907.2.114 and 420 6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above hasihave been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below Address - cc,[ i Specify Number of Alarms: -- # Smoke Alarms. 77-1 l # Carbon Monoxide Detectors: E l have read and agree to comoiv with the terms and rnnn'ifinn.,� of this .ctafamanf g Name: Owner (or o�er Agent's) )Afe.Vh f'"n' � / Signature .1. ".. ....... Date: S�/R! Contractor Name: Signature Lic.# Date: Smoke and CO fonn.doc revised 12/1.5/16 \\,,,,,I // 1. SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE j4"�,'ss COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 'CU-PER, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 O (408)777-3228•FAX(408)777-3333•buildinct(a cupertino orq Onlit .�, v 4 cc IDs` z I seas' '#a d • y a r��.'r ', PERMIT CA*,T'0 FIlITALED 1;1-THIS •� GA E 1 £•S BEEN CO , IG1ED, TC) C�` N �. BUILDII� 4Q a' Vie., t Jr; i i -- ,. . ,'' ''''' �' . 41 l' S mac..... PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314,R315,2016 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions,alterations,or repairs to existing dwelling units exceeds '$1000.00,CRC Section R314 R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or i ,Carbon Monoxide Alarms be installed in the following locations: 1AREA I SMOKE ALARM CO ALARM Oiitside!of each separate sleeping area in the,immediate vicinity of the , X X i,I `bedroom(s)—(Smoke alarms shall not be:located within 3 feet of bathroom door) On every level of a dwelling unit including basements and habitable attics: X X Within each sleeping room X ' ; Carbon;Monoxide alarms are not required;'in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined'with smoke alarms shall comply with i CBC Section 420.6 and shall,be approved by the Office of the State Fire Marshal. I ii Power Supply:In dwelling units with no commercial power supply,alarm(s)may be solely battery operated. 1 ilk In existing dwelling units,alarms are permitted'to be solely battery operated where repairs or alterations do ,'not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl 11, : , space.Refer to CRC SectionR314 and CBC;Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building,wiring. I As owner of the above-referenced property,I hereby certify that the alarm(s) referenced above has%liave been installed in accordance with the manufacturer's instructions and incompliance with the California'Building and California Residential Codes. The alarms specified below have'been tested and are operational, as of the l'' date signed below. Address: 1 as-7c /41/4.0 ,r- 1` Permit No. �,- /2 /0 9/' i Specify Number of Alarms:4 IC i � #;Smoke Alarms: I #Carbon Monoxide Detectors: 7-7 I have read and agree to .co I ply with the terms,, and conditions of this statement , Owner.(or Owner Agent's)Name: l; , i �'.i� A-0 GGl Si•gnature�i k ` Date: (.17.-17#�7 ontractor Name: i Signature' i Lic.# Date: Smoke and CO form.doc revised 01/10/2017 , Li. i i \------ �{ �, // WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE �yt.ryss COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUP,EiafT�lNC? 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(c�cupertino.orq Owner Name f(- v ` 4 421.54_ Permit No. —26 i? - /dg( Address i I' (WI 1" [ Z.,i f ; ANNO BE FINALEJ1"AND�fJI II'LETEA CER IEI�ATE 0��� __£ y »:,�, of gBUIEDIMOY- h �i:' �..ca Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? CIYes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: 1 No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. CI The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: Date: A No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: 5-.f7No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? CI No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: Eit Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). CI My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. SB407 2014.doc revised 03/18/14 • 2 " ur •D3[ G RM I• •.'D SGA LETED T E'��iIS *CEA :Wit°' S EE b 33VEI AWT� zslysmf . t Non-Compliant • Water-Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 2013 CPC Ch.4' Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 /Flow Rate Single-Family Multi-Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush) Urinals Exceed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for.Showerheads (A hand-held shower is considered a showerhead,.) For multiple showerheads serving one shower,the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets-- Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory . per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute© per minute @ 60 psi; 20 psi - minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 05 gallons per minute @ 60 psi 1.8 gallons per minute @ 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per.minute ' 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum . 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting; aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. SB407 2015.doc revised 08/26/15