B-2017-1306CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1306
20261 REINELL PL CUPERTINO, CA 95014-2221 (316 42 014)
PELLE HEATING &
AIR INC
SAN JOSE, CA 95111
OWNER'S NAME: CHENG HENG-JU AND CHOU YI-CHIH TRUSTEE
DATE ISSUED: 08/08/2017
OWNER'S PHONE: 650-961-6911
PHONE NO: (408) 978-7060
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class CC=20 Lic. #80988
Contractor PELLE HEATING & AIR INC Date 10/31/2017
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 is full force and effect.
JOB DESCRIPTION:
REPLACE FURNACE (SAME LOCATION); INSTALL (N) AC UNIT -
I hereby affirm under penalty of perjury one of the following two declarations:
BACKYARD
1. .I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3100 of the Labor Code, for the
formance of the work for which this permit is issued.
oerve
and willmaintain Worker's Compensation Insurance, as provided for by
tion 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $6551.00
ermit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state thatthe 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
316 42 014
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 understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED'INSPECTION.
Date 8/8/2017
Issued by: Jasmine Archbold
OWNER BUIL ER DEC
Date: 08/08/2017
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
1. 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)
z. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 8/8/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR SETTER
r. 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.
HAZARDOUS MATERIALS DISCLOSURE
2. I 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.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
s. 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
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533ya 34.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
rorauthorized agen^
011.8
APPLICANT CERTIFICATION
0
I certify that I have read this application and state that the above information is
CONSTRUCTiO INGAGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a constfOction 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 inspdction purposes. (We) agree
Lender's Name
to save indemnify and keep harmless 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.
1 understand my plans shall be used as public records.
Licensed
Signature Date 8/8/2017
Professional
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 MISC(408) 777-3228 • FAX (408) 777-3333 • building5cuaertino.org
CUPERTINO
13--7-OL-7 -1306
❑ PLUMBING MECHANICAL ❑ ELECTRICAL [:]MISCELLANEOUS
MEPMiscApp_2011.doe revised 06/21/11
PROJECT ADDRESS (0 n e. Place
nell
APN#
OWNERNAME ^ � Chen
PHONE 0—q(QI_I_�il
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E-MAIL.
STREET ADDRESS 20 ' (0 �' ^ J I ��Q
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FAX
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V Peaina�'
CONTACT NAME
PHONE
E-MAIL
STREET ADDRESS
CTTY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER []'TENANT
CONTRACTOR NAME feVe I I
LTCENSE NUMBER
�� .y
LICENSE TYPE �'
1 LIC #
COMPANY NAME Pell HeG flr'5 fitr Ni r
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E-MAIL eSSi"L-PCjjf?huPSbccg1'1fI
FAX
STREET ADDRESS 5-I n py y,+er arl` ^l
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CITY,STAT� /; �,
7-nSf, CA (/I
PHONE L109-1-
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ARCHITECT/ENGINEER NAME
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OP ❑SFD or DUPLEX ❑ MULTI-FAMTLY
PROJECT TN VOLDLAND ❑ YES
PROJECT IN ❑ YES
IS THE BLDG AN ❑ YES
BUILDING: ❑ COMMERCIAL
URBAN INTERFACE AREA ❑ NO
FLOOD ZONE ❑ NO
EICHLER HOME? ❑ NO
DESCRIPTION OF wORP
placp IFLOnce Fur = '/2 -coo
Am C AC= 2,S Tvn
1z4 SEES
TOTAL VALUATION:it1� iY
By my signature below, l certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information 1 have provided is correct. 1 have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
ordinances and state laws relating to build' construction. I authorize representatives of Cupertino to enter the ab�o/ve 'den 6/f ed property for inspection purposes.
Signature of ApplicantiAgDate: J• �/
SUPPL TAL INFORMATIO UMD'
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$ �aix
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MEPMiscApp_2011.doe revised 06/21/11
CUP RTINO
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(@cupertino.org
PERMIT CANIVUT BE EINALED UNTIL LITS CERT CATE.AAS: BE 1V
CONI;E iI),
:�� A�TD I2FTUR_NiFD �Q THE-BUTDIl1�G IiI'4��IflN.
PURPOSE
F 2 21's 7 '' .+
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
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 buildmg 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: Permit No. E--,.� n —k_34,1
Specify Number of Alarms: 4 Smoke Alanns. # Carbon Monoxide Detectors �1
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
Signature ... .t.'��.r�.r'� Date: ,tr/«.1�
-
Contractor Name:
Signatur�- ..... Lic.# Date:
Smoke and CO form.doc revised 12/15/16
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CERTIFICATE OF COMPLIANCE
G _2-0 ( "I -- (
CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 1 of 3) 1
Project Name:
Cheng Hengju I Date Prepared: 2017-07-25
A. General Information
MR -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
Cheng Hengju
02
Date Prepared
2017-07-25
03
Project Location
2026 Reinell Place
04
Building Type
Single family
05
CA City
Cupertino• w
06
Dwelling Unit Name
Hengju Cheng
Identification or
Location or Area
'3
ducted
containing
system
more than 40
entirely new
entirely new
Dwelling Unit Conditioned
Name
07
Zip Code
95014
08
2
Floor Area (ft }
1349
duct system?
SC system?
Alteration Type
Number of Space
09
Climate Zone
4=x,10`
1349
Conditioning (SC) Systems in
1
Yes
No
No
No
this Dwelling Unit:
B. Space Conditioning (SC) System Information
01
02
03
04
_', i 05
°. s`
07
09
09
10
SC System
SC System
CFA served
Is theS
system
Insta :ing
"'"refrigerant'(
`Irnsf&ni g iiia 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
Altered space
Cheng Hengju
Whole House
1349
Yes
Yes
Yes
No
No
No
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 417-A020105381A-000-000-0000000-0000
Registration Date/Time: 2017-07-25 14:01:39
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-25 14:41:39
Schema Version: rev 10/16
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
Cheng Hen&
furnace
heating
AFUF
S0
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 CF3R-MCH-20-H -Duct Leakage Test required when heating or cooling components are instaued do' uqt� 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 CF311-MCH-25-H Refrigerant Charge verification required when refrigerant containing comprnents az 164alled or altered (applicable in CZ 2, 8-15).
CF2R and CF3R-MCH-23 Airflow Rate >= 3130 CFM per ton required when MCH -25 is required
Exceptf ons:
Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Lea 64C.r4 sting 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, virlti or vlri out E'quip'ment hangea"Olt (Sections 150.2(b)1Diia and 150.2(b)1E, F)
ir,= si'
'hls iktr6h does ndt'apl31V t Wrb'*Ct.
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--A020105381A-000-000-0000000-0000
Registration Date/-Fime: 2017-07-2S 14:01:39
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-25 14:01:39
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:
Jessica Valencia
jesstca'Va.ie,,c+'.a.
Company:
Signature Date:
Pelle Heating and Air, Inc.
2017-07-25
Address:
CEA/ HERS Certification Identification (if -applicable):
3751-D Charter Park Court
City/state/Zip:
Piaone.
San Jose CA 95136
4�g-8-7060
Responsible Person's Declaration statement 3E
I certify the following under penalty of perjury, under the laws of the State of California
L 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'bullding design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and mar ufa�ture devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part land Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of! Comp] lance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement icy fo p oval itis this building perp it application.
S. I will ensure that a registered copy of this Certificate of Compliance E all be mde vailal{e unth tuildir 1 10 pmGt(s} isued 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 incfuded with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: g
'moi 3 1 .&'.g I ¢'ffit �` 3 :3
RespQsibe De�lgpgr Signature:
1: t g E: "e5jg er
f%d�,y
Jessica Valencia
Company:
Date Signed:
Pelle Heating and Air, Inc.
2017-07-25
Address:
License:
3751-D Charter Park Court
809887
City/State/Zip:
Phone:
San Jose CA 951.36
408-978-7060
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-A020105381A-000-000-00000000000
Registration Date/Time: 2017-07-25 14:01:39
HERS Provider: CHEERS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.006 Report Generated: 2017-07-25 14:01:39
Schema Version: rev 10/16