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B-2017-1264
CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-1264 10401 TULA IN CUPERTINO, CA 95014-2935 (359 13 118) ON-TIME AIR CONDITIONING & HEATING INC PLEASANTON,CA 94588 OWNER'S NAME: LIU KELVIN SHIN-TAI AND WANG SHIO-CHUAN TRU DATE ISSUED: 08/01/2017 OWNER'S PHONE: 408-753-7555 PHONE NO: (925) 598-1911 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic. #817040 Contractor ON-TIME AIR CONDITIONING & HEATING INC Date 09/30/2017 X BLDG _ELECT _PLUMB 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 license is in full force and effect. JOB DESCRIPTION: the REPLACE FURNACE (SAME LOCATION); REPLACE AC UNIT I hereby affirm un r penalty of perjury one of following two declarations: (SAME LOCATION); REPLACE COIL r. I have d will maintain a certificate of consent to self-insure for Worker's Co pensation, as provided for by Section 3700 of the Labor Code, for the rformance 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 Sq. Ft Floor Area: Valuation: $22908.00 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 APN Number: Occupancy Type: and state laws relating to building construction; and hereby authorize 359 13 118 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 PERMIT EXPIRES IF WORK IS NOT STARTED ' may accrue against said City in consequence'of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understand and will comply with all non-point source regulations per the Cupe irfo Municipal Code, Section 9.18. .180 DAYS FROM LAST CALLED INSPECTION. Signatu; Date 08/01/2017 Issued by: KIM DUNBAR Date: 08/01 /2017 OWNER-BUILDER DECLARATION i I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is T. I, as owner of the property, or mY•employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the: structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am;exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business &Professions Cade). Date: 08/01/2017 I I hereby affirm under penalty of perjury one of the following three declarations: r. I have and will maintain a Certificate of'Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER Compensation, as provided for" ;by "Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700'of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. I will permit is issued. II maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I' certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the I Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management D* Cupertino will maintain compliance with the Municipal Code, Chaff 9.12 and exemption, Ibecome subject to the Worker's Compensation provisions of the the Health &Safety Code, Sec 25505, 25533, dZ 53, Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized age APPLICANT'CERTIFICATION Date: 08/01/2017 I certify that I have read this, application!and state that the above information is CONSTRUCTION LENDING AGENCV correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and;keepi6rmless the City of Cupertino against liabilities, '" judgments, costs, and�expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply, with all non'-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section;9.18: I understand my plans shall be used as public records. Signature Date 08/01/2017 Licensed GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildinga"cupertino.orq MISC & !-Z0, ( �4- -12_ l ? - ❑ PLUMBING MECHANICAL []ELECTRICAL ❑ MISCELLANEOUS PROJECT ADDRESS APN # — OWNER NAME C � � / ` , [ vL PHS' –n' STREET ADDRESS CITY, STATE, ZIPPfG�-f fJ� FAX J (% CONTACT NAME ^ PHG�j/ r( ((QQ-7� (�❑ FAX ❑ OWNER OWNER -BUILDER ❑ ,OVIT'ER AGENT ❑(CONTRACTORCONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER 11 DEVELOPER ❑ TENANT CONTRACTOR NAM LICENSE NUMBER y/ � LICENSE TYPE C 26 COMPANY NAME E-MAIL . FAX STREETADDRES ARCIRTECTIENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE 017FD or DUPLEX ❑ MULTT-FAMILY BUILDING: r[RCT BUILDING: ❑ OMMERCIAL PROJECT IN WILDLAND ❑ESY URBAN INTERFACE AREA ❑ NO PROJE CT IN INEl -i-Es FLOOD ZONE ❑ NO IS THE BLDG AN El YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK TOTAL VALUATION:2 RECEIVE By my signature' below, I certif}l to each of the following: i am the pro caner or authorized agent to ac on the property owner's behalf. I have read this application and the information I have provided is correct. I have the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin ction. I a orize representatives of Cupertino to enter the acb�'e-i entifie roperty for inspection purposes. Signature of Applicant/Agent: Date: !J SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ObLY a : ❑ OVER THE COUNTER .." ❑ EJTRE' M ❑ 'STANDARD , ❑ LARGE ❑ MAJOR MEPMiscApp_2011.doc revised 06/21/11 121 .,o CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF-IR-ALT=HVAC) CFiR-ALT 02-E (Page 1 of 3) Project Name: KELVIN LIU I Date Prepared: 2017-08-01 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 CF111-ALT-02 document for each dwelling unit. 01 Project Name KELVIN LIU 02 Date Prepared 2017-08-01 03 Project Location 10401 TULA LANE 04 Building Type Single family 05 CA City Cupertino = --06 - Dwelling Unit Name House Identification or 1it�;', ' 'Dwelling Unit Conditioned containing 07 Zip Code 95014 _ 08 Floor Area (ft) 2932 Served System (W) system? component? components? feet of ducts? duct system? SC system? r} SYSTEM 1 Number of Space 2932 09 Climate Zone 4 1'�0' Conditioning (SC) Systems in 1 Altered space ,, this Dwelling Unit: - - B. Space Conditioning (SC) System Information s:,s i1._ pi ;rte fff� ri—i) � 01 02 03 04 05 N;;- t j U6'' 07 08 09 10 SC System SC System CFA served Is the SC_ _. �_�nn system a _ :Installin, aLUnid .,La vj refrigerant -c-, 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 (W) system? component? components? feet of ducts? duct system? SC system? Alteration Type SYSTEM 1 LOCATION 1 2932 Yes Yes Yes - - No No No Altered space - -- - - - conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)Mib) This section does not apply to this project. Registration Number: 417-A020106769A-000-000-0000000-0000 CA Building Energy Efficiency Standards - 2016 Residential Compliance Registration Date/Time: 2017-08-01 10:02:11 Report Version: 2016.1.006 Schema Version: rev 10/16 .HERS Provider: CHEERS Report Generated: 2017-08-01 10:02:11 CERTIFICATE OF COMPLIANCE CF111-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -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 SYSTEM 1 furnace heating AFUE 0.96 AC cooling SEER 16 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 duds or plenums R6 (CZ 1 10 12 and 13) and R8 (CZ 11 and 14-16) CF2R and CFBR-MCH-20-H - Dud Leakage Test required when heating or cooling components are installed m ducted systems, or when more than 40 ft of dud length is replaced t -Leakage rate compliance: <= 15% or <= 10% leakage to outside, or seal all accessible leaks..F _ir- CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing compo nts arel it t "fed 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. 4 Exceptions:, F i Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leaka' 7 esting requirements. Heating -only systems and Air Handler Furnace changes do not require verification of Air Flow MCH -23, or`Refrigerant Charge MCH -25. -Existing dud 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 l•�-=ri:,Js��h'�?�:lI.�t'il=';; section does�r;�not apply to th€s-�;aproject. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C) This section does not apply to this project. Registration Number: 417-A020106769A-000-000-0000000-0000 Registration Date/Time: 2017-08-01 10:02:11 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-01 10:02:11 Schema Version: rev 10/16 CERTIFICATE OF COMPLIANCE CFiR-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: April Rodriguez APraRodrLguek Company: Signature Date: I Permit E Raters 2017-08-01 Address: CEA/ HERS Certification Identification (if applicable): 31225 La Baya Drive City/State/Zip: ` Phone: '-jr� Westlake Village CA 91362 735-7876 ,J;`, Y818 Responsible Persons Declaration statement 1_-- h __-J. .I I certify the following under penalty of perjury, under the laws of the State of California: � , ;- k 1. The information provided on this Certificate of Compliance is true and correct. i* i`• i�.'...' 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsitiil(ty,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 man fact&6d 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. � 114 - f )l it J5 • CJ,. 5. [will ensure that a registered copy of this Certificate of Compliance shall be made available -with the builcling.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: tResponsible .Ji'ili d: li `_, r"b'iL �Designer Signature: - LY 'lzdse%r='11Ls Lyndy Rose Company: Date Signed: On -Time Air Conditioning & Heating Inc dba Service Champions- 2017-08-01 Address: License: 7020 Commerce Drive 817040 City/State/Zip: Phone: Pleasanton CA 94588 925-444-4444 Digitally signed by CHEERS"". This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 417-A020106769A-000-000-0000000-0000 Registration Date/Time: 2017-08-01 10:02:11 HERS Provider: CHEERS CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-08-01 10:02:11 Schema Version: rev 10/16 \\.° . SMOKE / CARBON MONOXIDE ALARMS 474 OWNER CERTIFICATE OF COMPLIANCE A�© Tq COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildinq(7a cupertino.orq r✓., 5 .e. u a ti � 7 - w r C '*' bi, y ii r " '� F .''k is Y 'a t 3 get .,e' 'yxad` e1. 4 't s$'�'N�k s r �# J ft , ERM T ECANNO3 BE P ALED'UNTIL THIS CERTIFI ATE ITA BEEN "' Sid z �" s� - �`✓,� ., ��"' �'�k iCOMPLETEI ,ISI NED,A RETUR DTTO E KILD 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 X X the bedroom(s) 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 CBC 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 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. As owner of the above-referenced property,I hereby certify that the alarm(s) referenced above has/have 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: / 4-o/ T,,4 24)11, /if . Specify Number of Alarms: #Smoke Alarms: 111111 #Carbon Monoxide Detectors: 71 1 I have read and agree to comply with the terms and conditions of this statement Owner( r Owner Agents)Name: �� /� 3�1 C"'�� l , Signature.... ! ........ .w`�. � Date:/u,p, , F ntractor Name: Signature Lic.# Date: Smoke and CO form.doc revised 12/15/16