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B-2071-1253CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1253 19639 MERRITT DR CUPERTINQ, CA 95014-2437 (316 35 002) MUSIAL HEATING & AIR NEWARK, CA 94560 OWNER'S NAME: LAKSHAM NARAYAN AND MALLESWARI NARAYAN TRUS OWNER'S PHONE: 408-595-0205 LICENSED CONTRACTOR'S DECLARATION License Class C-2-20 Lic. # 48 4028 Contractor MUSIAL HEATING & AIR Date 08/31/2018 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. 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. 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 siQd will comply with all non -point source regulation, per the Cupertinu Scipal Code, Section 9.18. � Date 7/31/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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. 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. z. 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. s. I certify that in the performance of the work for which this permit is issued, I shall not employ anyperson'm 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,. PPLICANT CERTIFICATI I certify that I have read this application and state that the above information is correct. I agree to comply with alll 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 iyhich may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 7/31/2017 DATE ISSUED: 07/31/2017 NO: (510) 579-3075 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL JOB DESCRIPTION: REPLACE FURNACE(SAME LOCATION); INSTALL (N) AC UNIT ( PER PLANNING A/C TO MEET NOISE REQUIREMENTS OF CITY AND HAVE MINIMUM 3 -FOOT SETBACK FROM SIDES OR REAR OF PROPERTY LINE Sq. Ft Floor Area: I Valuation: $0.00 APN Number: Occupancy Type: 316 35 002 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: 07/31/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 7/31/2017 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 2/55505,, 25533 nd 25534. Ow _ ei thorized agent: V " V TR LE D AEN 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 jy: GENERAL PERMIT PP' ICATIOMEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildina(a�cupertino.org MISC ❑PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS I ^ q �� /� APh# OWNERNANIE p �Ct \ , PHONF,,©g -+"I�r©�� 1 ' E r\ aS►IqW ltJ STREET ADDRESS 1 q U � yq/� } Z CITY, STATE, ZIP C. �\ ;� FAX CONTACT NAME �Y v ACV V r I PHONE,-,,, _ 2 ©! 7 EMAIL /%G \C. (OAS (T7- ADDRESS STREET�PL(S Scmv krose Air.�C4 CITY, STATE, ZIP �S00Syo- © ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER n TENANT CONTRACTOR NAME�\` LICENSE NUMBER Ql j LICENSE TYPE/�^�7 f� (- LV BUS. LIC # �y COMPANY NAMEEMAIL/ VQ -Q V (`� iAN� C o_+n�� IM vs i� p NnC, AXf W. STREET ADDRESS �►� CITY, STATE, ZIPPHONE; 1. far ARCFIITECT/ENGINEER NAME LICENSE NUMBER BUS : LIC O J ,J COMPANY NAME r E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI-FAMTLY BUILDING: ❑ COMMERCIAL PROJECT TN WILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT TN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES . EICHLER HOME? ❑ NO DESCRIPTION OF WORK 1 ao� >MAJ TOTAL VALUATION: RECENED BY.. By my signature below, I certify -to each of the following: I am the property owner or authorized agenvto act on the property owner's behalf.I have -read This I; application and the informanoal have providedds correct. I have d the Description of Work and verify itis accurate. I agree to comply with all applicable local ordinances andistate laws relahi g to build' g c instruction. I a o ze representatives of Cupertino to enter the above -i nt ifi d property for inspection purposes. Signature of Apphcant/A'gent, i±`i I � �; Date: ' � �i S ENTAL INF RMATION REQUIRED 6 OFFICE USE O1vZi , rw. � J.',, ❑ OVER THE COUNTER EXPRESS ❑ STAIQDARD ! ', '.❑ LARGE: ❑ MAJOR +i ' 1 t A.\M�=�• cc-,l0—vl n MEPMiscslpp_2011.doc,revised 06/21/11 �-ii >ef rw-t ALTERATIONS - HVAC ral CEC-CF1R-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: Enforcement Agency: Date Prepared: Permit#: 101103 C-Perre Equipment Type Equipment Efficiency New: Ducting or Lineset Conditioned Thermostat Required R -value Floor Area (ftZ) ❑ Packaged System ❑ Evaporator Coil AFUE COP ❑ R-6 (CZ 1-10,12&13) Ducts Served by system Ksetback ❑ Split System iCondensing Unit SEER El R-8' (CZ 11,14-16) Ducts z Ito 0 ft, (if not already HSPF ❑ >_ R-2.8 Lineset' present, must Furnace ❑ Lineset EER be installed) HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form 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 on site. ❑ 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 1:13. 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 DuctS2 CF111-ALT-02-E CF2R-iMCH-01-E, MCH -20=H, MCH -22-H, MCH -(23 or 24)-H CF3R-MCH-20-H, MCH -22-H, MCH -(23 or 24) -HZ Installer Requirement: Duct leakage <5%, Fan Efficacy (0.58W/CFM), Air Flow >_350 CFM/ton (or Standards Table 150.0-6 / C alternative) ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left.on site for Final: Includes replacing or'installing All New CF1R-ALT-02-E DuctS2 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-B / 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-ALT702-E space but less than All New'Ducts7 CF2R-MCH-20-H CFBR-MCH-20-H 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. 2A 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. 3 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 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. Responsible Des' er Name:' men Responsible Designer Signature: Date Signed: / License: `� a �-ff L Company: \ 1 t S � Address: S'g�-t5 S 01) Ave � ity/State/Zip: 12i" 946 Phone: S7-1-327 kysi r©e v�L For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300