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B-2017-1168CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1168 10311 LOCKWOOD DR CUPERTINO, CA 95014 (342 30 032) RELIABLE AIR MECHANICAL SAN JOSE, CA 95136 OWNER'S NAME: EVERARD WILLIAM A AND LECOMPTE BARBARA C TR OWNER'S PHONE: 808-388-6817 LICENSED CONTRACTOR'S DECLARATION License Class C-20 Lic. #2544QQ Contractor RELIABLE AIR MECHANICAL Date 11/30/2018 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 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. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature .1 Date 07/19/2017 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature ISSUED: 07/19/2017 PHONE NO: (408) 266-7267 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB X MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE (2) FURNACES- UNIT A & B (SAME LOCATION); INSTALL (N) AC UNIT AT UNIT A Sq. Ft Floor Area: I Valuation: $8000.00 APN Number: Occupancy Type: 34230 032 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Jasmine Archbold Date: 07/19/2017 RF ROOFS: All roofs shall be inspected prior to any roofmg material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 07/19/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 5533, and 25534. Owner or authorized agent: Date: 07/19/2017 CON TRU�WQN LENDINGY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Date 07/19/2017 Professional 1 3 GENERAL PERMIT APPLICATION E2, P COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a.cupertino.org CUPERTINO MISC ❑ PLUMBING MECHANICAL ❑ELECTRICAL MISCELLANEOUS PROJECT ADDRESS /L,)3/ ,k& Wc� 1 U d f� /T (JPHO APN # L JL OWNER NAME jC-) 60 I� � _ $g- !o � 1 � E-MAIL � ic.n e @ m':t4 1, cawt STREET ADDRESS10311 � ujondDr- U11r L 14 Y ! CITY, v TE, -I 7170 C jD/ Ll FAX 7 CONTACT NAME �0I L G O C� PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT dCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGII\'EER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEke(fa It, fIS 114( CLICENSE NUMBER LICENSE TNE BU LC # a('(501a 3'- COMPANY NAME E-MAIL 'CGtcl/t�S�t rc :afalea,� FAX o�- STREET ADDRESS sv' 366 Qa+- a yk- Or CITY, STA .ZIP cg • 5I/-� G PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD o UPLE ❑ MULTI -FAMILY PROJECT IN WILDLAND ❑ YES BUILDING: ❑ COMMtRttAL URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO 1S THE BLDG AN ❑ %-Fs EICHLER HOME? ❑ No DESCRIPTION OF WORK PZ q4j 4;�Va A) sa•tl < c '` TOTAL VALUATION: O [� V RECEIVED BY: By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil 'ng construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: - -7 PLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W ❑ OVER-THE-COUNTER a ❑ EXPRESS U w ❑ STANDARD U j LARGE ❑ MAJOR MEPA1iscApp_2011.doc revised 06121/11 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Pagel of 3) I Project Name: Jolene Goh I Date Prepared: 2017-07-18 A. General Information CF111-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name Jolene Goh 02 Date Prepared 2017-07-18 03 Project Location 10311 Lockwood Drive Unit A 04 Building Type Multi -family 05 CA City Cupertino 06 Dwelling Unit Name Jolene Goh 07 Zip Code 95014 08 Dwelling Unit Conditioned 1400 Installing Installing Installing Floor Area (ftZ) Location or Area by this SC ducted containing system Number of Space entirely new 09 Climate Zone 4 10 Conditioning (SC) Systems in 1 component? components? feet of ducts? duct system? this Dwelling Unit: Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Furnace and AC Whole House 1400 Yes Yes Yes No No No Altered space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 217-A020243975A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time Report Version: 2016.1.006 Schema Version: rev 10/16 2017-07-18 15:20:23 HERS Provider: CalCERTS Report Generated: 2017-07-18 15:20:15 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value Central gas All new Central split All new This field or This field or Furnace and AC furnace heating AFUE 80 AC cooling SEER 14 Setback section is not section is not components components applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16) CF2R and MR -MCH -20-H - Duct Leakage Test required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced -Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks. CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 217-A020243975A-000-000-0000000-0000 Registration Date/Time: 2017-07-18 15:20:23 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 15:20:15 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Dore, Phil ��� Company: Signature Date: RELIABLE AIR MECHANICAL 2017-07-18 15:20:23 Address: CEA/ HERS Certification Identification (if applicable): 3670 CHARTER PARK SUITE D City/State/Zip: Phone: SAN JOSE CA 95136 408-592-2708 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Dore, Phil (� Company: Date Signed: RELIABLE AIR MECHANICAL 2017-07-18 15:20:23 Address: License: 3670 CHARTER PARK SUITE D 954400 City/State/Zip: Phone: SAN JOSE CA 95136 408-592-2708 Easy to Verify R }r; r '� 1 at CaICERTS.com �r 16 Digitally signed b Ca10ERTS. This digital signature is providedin order to secure the content of this registered document, and in no wa im lies Registration Provider responsibility f 9 Y 9 Y 9 9 P 9 Y P 9 P Y the accuracy of the in Y Ll i Registration Number: 217-A020243975A-000-000-0000000-0000 Registration Date/Time 2017-07-18 15:20:23 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 15:20:15 Schema Version: rev 10/16 sr CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: Jolene Goh I Date Prepared: CF1R-ALT-02-E (Page 1 of 3) 2017-07-18 A. General Information CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name Jolene Goh 02 Date Prepared 2017-07-18 03 Project Location 10311 Lockwood Drive Unit B 04 Building Type Multi -family 05 CA City Cupertino 06 Dwelling Unit Name Jolene Goh 07 Zip Code 95014 081216 Dwelling Unit Conditioned Installing new SC Installing Installing Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of Space entirely new 09 Climate Zone 4 10 Conditioning (SC) Systems in 1 component? components? feet of ducts? I duct system? this Dwelling Unit: Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? I duct system? SC system? Alteration Type FurnaceAltered Re placement p Whole House 1216 Yes No Yes No No No space conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib) This section does not apply to this project. Registration Number: 217-A020243981A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time Report Version: 2016.1.006 Schema Version: rev 10/16 2017-07-18 15:22:56 HERS Provider: CalCERTS Report Generated: 2017-07-18 15:22:47 CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3) D. Altered Space Conditioning System (Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value Furnace Centralas g All new Central split No cooling This field or This field or This field or This field or Replacement furnace heating AFUE 80 AC component section is not section is not Setback section is not section is not components altered applicable applicable applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems - Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10, 12 and 13) and R8 (CZ 11 and 14-16) CF2R and CF3R-MCH-20-H - Duct Leakage Test required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced -Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks. CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2R and CF3R-MCH-23 Airflow Rate >= 300 CFM per ton required when MCH -25 is required. Exceptions: Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MCH -25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 217-A020243981A-000-000-0000000-0000 Registration Date/Time 2017-07-18 15:22:56 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-18 15:22:47 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CF111-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: �j5 Dore, Phil (f �� Company: Signature Date: RELIABLE AIR MECHANICAL 2017-07-18 15:22:56 Address: CEA/ HERS Certification Identification (if applicable): 3670 CHARTER PARK SUITE D City/State/Zip: Phone: SAN JOSE CA 95136 408-592-2708 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Dore, Phil Company: Date Signed: RELIABLE AIR MECHANICAL 2017-07-18 15:22:56 Address: License: 3670 CHARTER PARK SUITE D 954400 City/State/Zip: Phone: SAN JOSE CA 95136 408-592-2708 Easy to Verify at CaICERTS.com%.I Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility f the accuracy of the infor Registration Number: 217-A020243981A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time Report Version: 2016.1.006 Schema Version: rev 10/16 2017-07-18 15:22:56 HERS Provider: CaICERTS Report Generated: 2017-07-18 15:22:47