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14070020 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10091 BYRNE AVE CONTRACTOR:R.J.PEREZ CONST INC PERMIT NO: 14070020 OWNER'S NAME: RICHARD J PEREZ 10091 BYRNE AVE DATE ISSUED:07/21/2014 OWNER'S PHONE: 4083139323 CUPERTINO,CA 95014 PHONE NO:(408)252-2797 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ CONSTRUCT ONE STORY ADDITION(123 SQ FT); License ClassLic.# DETACHED TRELLIS(360 SQ FT). Contractor �.,� ,�'�•`�Z Date � �1.� �`'' 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. 1 hereby affirm under penalty of perjury one of the following two declarations: 1 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 rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$12000 have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:35711005.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct, l agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: with all non-point source regulations per the Cupertino Municipal Code,Section ii 1 RE-ROOFS: Signature — _____Date Z't y All roofs shall be inspected prior to any roofing material being installed. if a roof is I installed without first obtaining an inspection,l agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Arca Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cu ertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code, 11r0ns 2 _05,25 and 25534. Section 3700 of the Labor Code,for the performance of the work for which this R 1 permit is issued. Owner or authorized agent: �—Dater Z� 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must l hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that l have read this application and state that the above information is correct. l 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, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERT[hl0 (408) 777-3228• FAX(408)777-3333• buildino aQcuoertino.oro r'A ❑1\EW CONSTRUCTION ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT n PROIF,Cr.ADDRESS �©b� � y'�� r r APN OWNER NAME � � PHO? �� )?>0 3 E-MAIL STREET ADDRESS \c �- CI Y, STATE,ZIP' W��yA A� ►`\ FAX CO?17ACT N",E \ 41 `SICPHONE Z�PF -2721_L{ 3 E-MAIL STREET ADDRESS /(� j��/A- I� 1•J) I� ��/( - CITY,STATE, ZIP ° � \ FAX � I 2 u 13 OWNER 13 OWNER-BBU[LDER ❑ OO%WTRAGE>`°T ❑ CO?'-RACTOR ❑CON7R4CTORAAGEXr J CHrr..CT ❑ENGNTEER 11 DEVELOPER TENA.NT CONrIMACTORNAME I LICENSENU1TaiER LICENSE TYPE BUS.LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP I PH0117E, ARCI-irrECT/EUGINEER NA%1E LICENSE NUMBER BUS.LIC COMPANYNAME E-MAIL I FAX STREET ADDRESS CITY,STATE,ZIP' I PHONE DESCR]PT10N OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE I RSTORIES 5 5 v USE TYPE C. T. VALUATION(5) EXISTG NEW FLOOR DEMO TOTAL AREA �03( AREA 23 AREA I � NET AREA '/R BATHROOM J/ KITCHEN EN OTHER REMODEL AREA 10 0 RFA70DEL AREA REMODEL AREA PORCH ARE DECK AREA TOTAL DEC ORCH.AREA GARAGE A A: I DETACH 7 V ❑.4_TACH 9D G U?.'ITS: IS A SECOND UNtT YES SECOND TORY ❑)-ES BETNGADDED? NO ADDITION? ❑No --- ..� S-PROVIDE-COPY-01__�S�'HE BLDG.4N L]YES CFtl' BY, ,_ -` '� s.� = >- TOT. VALUATION: PLA\TINGA?PL.i ❑NO PLA>`?-INGAPPROVAL LETTER EICHLERHOME? i = - 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 46ve 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 ding construction. ize representatives of Cupertino to enter the above-identified property for inspection purposes. SignatureofApp)icant/Aeent: Date: Z— 7 SUPPLEMENTAL INFOR. t REQ -IRED -,Pl rL1 C73ECIC TYPE,` = t.ROUTE\G SLIP New SFD or Multifamily dvvellings: Apply for demolition permit for k "� €r © OVERTFCOUl\TER BIIIIDItGPLA�REi1E<Fs� existing building(s). Demolition permit is required prior to issuance of building _ �� - 'x Nam- permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STAT )APD�� x PusLle oRl s form if any Hazardous Materials are being used as parr of this project. '� } "� DEBT-..............., _Copy of Planning Approval Letter or Meeting with Planning prior to � z ,4470R � `SEIIRDISTFICT x submittal of Building Permit application. �,����"���£� � �-��ANT�IRI Bldogpp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10091 Byrne Ave DATE: 07/21/2014 REVIEWED BY: Sean APN: BP#: 061 `VALUATION: 1$13,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex 2nd Unit? 0 Yes No PENTAMATION 1 R3SFDREM USE: OTC. Yes No PERMIT TYPE: WORK One story first floor addition 123 sq ft); Detached trellis 360 sq ft). SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 123 $1,091.00 IADDPLCK $1,057.00 IADDINSP TOTALS: 123 $1,091.00 $1,057.00 MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY 0 Yes 0 No ELEC,HOURLY 0 Yes 0 No El ET "I", p, NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District etc.). These _f -fees are based on the relimina information available and are on an estimate. Contact the De tor addn'l in o. FEE ITEMS (Fee Resolulion 11-0S3 E. 7iU13J FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,091.00 = # Covered Porch Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $1,003.00 1COVPORCH PME Plan Check: $0.00 Permit Fee: $1,057.00 Suppl. Insp. Fee-0 Reg. 0 OT F0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 O Work Without Permit? O Yes 0 No $0.00 0 Advanced Planning Fee: 1PLLONGR $17.22 Select a Non-Residential 0 Building or Structure 0 Strong Motion Fee: IBSEISMICR $1.69 Select an Administrative Item Blds,Stds Commission Fee: IBCBSC $1.001 1 SUBTOTALS: $2,167.911$1,003.00 TOTAL FEE: 1 $3,170.91 Revised: 07/10/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 1,W y/,�/✓� PERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR: / BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY 1NSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: -- - / j Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile 0; ner/Contractor Signature Date ry SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE --jFlLa COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333 •building(1cupertino org `� Permit lea y��Oo 2� Address �� r,�G X� �5 #of Alarms Smoke: Carbon Monoxide: CI PERMIT CANNOT BE FINALED AND COMPLETED_UNTIL THIS CERTIFICATE HAS BEEN ST('•11�,�AND R T RN b TO TIDE�UiLDING DTVISION PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314, 2013 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 X X 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 8314 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 have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Si nature.......... ..... .............Date: Contractor Name: Signae......... ........ ...........I.......... ...............Lic.# ......................................Date: ../.......... Smoke and CO form.doc revised 03/18114 Atvhiteet 61gIc ofCalifomia;bieense No.(28285 480l?ovale Palk Drive, ban,lose, CA 95136 CndiFed Green Building Proiessional Tel(408)229-8683 Tgx(408)226-9110 Medtber.- The Amefican Institute oFArchitects wVw.dtbugay.com Email.-DTBugay.A/A@dtbugay.com OCT. 9, 2014RF."'�`L VED CITY of Cupertino OC . 10 2014 Building Department BY PROJECT AD17RE55: 10081 3Y'F E AVENUE RE: INSULATION To Whom it may concern: This letter certifies that the roof/celing insulation we will use for the addition at the above mentioned project will be the " SPRAY FOAM INSULATION; MD-C200" by Icynene or equal. There will be no vents required per Section R806.5 of the 2013 California Residential Code. If you have any questions, please feel free to contact me at (408) 229-8683. O Sincerely, � ARCINO �j T. a '828c R n 1 -311 OF CA DIONY T.- GAY,AIA Architect OFFICE COPY CO) t5i� W�- A i ��►��su ��,�, `- R�`' 0- C, Doc- . IF CJ sl /r{.t 1\ ��[._V 1 P 1 . .•' {i.� ,KSf is : L ® _ 2 ftc> 4 OF ADDITION AND REMODEL FOR: RICHARD & GRACE PEREZ r��� : AVC-- 10091 BYRNE AVENUE,CUPERTINO,CA 95014 D. T. DUGAYAichlrecam Inc. DIONY T. RUGA Y ALA Ll A�rGiteet �ltate of(:nlifvr�iie:Liee�iarc Na C?,8285 480 kvynlc Anrk Drivc, ckiu Jcwc, C'A 95136 Member of the American Institute of Architects 2010 CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS 7 ITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERL lA SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO, CA 95014-325 JUL 1 4(4%,k77"3228•FAX(408)777-3333•buildin cu e ' oC Aak Py PURPOSE: we FICE U The 2010 Caffl&BaprGad applies to all newly constructed hotels, motels, lodging houses, dwellings, dormitories, condominiums, shelters, congregate residences, employee housing, factory-built housing and other types of swellings with sleeping accommodations and new accessory buildings associated with such uses. Existing site and landscaping improvements that are not otherwise disturbed are not subject to the requirements of CALGreen. CUPERTINO Huildinq Department C Y S1 61 Project Name: Project Address: 'IES �G , „ - ��+� •� Project Description: 2_ — iccviewed oy �%<•v„ ftT� Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2010 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2- Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements A4.1 PLANNING AND DESIGN Planning`and Design '-Site Preservation. 4.104.1 A site plan and inventory of the site is developed and used to minimize site disturbance in order preserve desirable existing natural resources and ❑X ❑ minimize future adverse effects on the proposed structure. Planning and Design Site Development 4.106.2 A plan is developed and implemented to manage storm water ❑ El during construction. 4.106.3 The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how site grading or a drainage ❑X ❑ system will manage all surface water flows. Page 1 of 5 CalGreen_2010.doc revised 08127111 A4.2 General 4.201.1 Low-rise residential buildings shall meet or exceed the minimum ❑ standard design required by the California Energy Standards. A4.3 WATER EFFICIENCY AND • • indoor Water Use 4.303.1 Indoor water use shall be reduced by at least 20 percent using one of the follow methods. ❑ Water saving fixtures or flow restrictors shall be used per Table 4.303.2. 0 ❑ ElA 20 percent reduction in baseline water use shall be demonstrated per As of 7/01/2011 Table 4.303.1. 4.303.2 When using the calculation method specified in Section 4.303.1, multiple showerheads shall not exceed maximum flow rates. As of 7/01/2011 4.303.3 Plumbing fixtures(water closets and urinals)and fittings (faucets and showerheads)shall comply with specified performance requirements. As of 7/01/2011 Outsioor Water Use" 4.304.1 Automatic irrigation systems installed at the time of final inspection shall be weather-based. A4.4 MATERIAL CONSERVATION AND RESOURCE Enhanced Durability and Reduced Maintenance 4.406.1 Joints and openings. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected against the passage of rodents by closing such openings with cement mortar, concrete masonry or similar method acceptable to the enforcing agency. Construction Waste Reduction, Disposal and Recycling 4.408.2 Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall X❑ be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 An operation and maintenance manual shall be provided to the building occupant or owner. Page 2 of 5 CalGreen 2010.doe revised 08/27/11 A4.5 ENVIRONMENTAL QUALITY fireplaces. 4.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- ❑ ❑ burning fireplace, or a sealed woodstove. Frollu#ant Control 4.504.1 Duct openings and other related air distribution component openings ❑ ❑ shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks shall be compliant with VOC and ❑ ❑ other toxic compound limits. 4.504.2.2 Paints, stains and other coatings shall be compliant with VOC limits. ❑X ❑ 4.504.2.3 Aerosol paints and other coatings shall be compliant with product ❑X ❑ weighted MIR Limits for ROC and other toxic compounds. 4.504.2.4 Documentation shall be provided to verify that compliant VOC limit ❑ ❑ finish materials have been used. 4.504.3 Carpet and carpet systems shall be compliant with VOC limits. ❑X ❑ 4.504.4 Fifty (50)percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance ❑ ❑ Schools (CHPS) Low-emitting Materials List or be certified under the Resilient Floor Covering Institute(RCFI) FloorScore program. 4.504.5 Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall comply with low formaldehyde ❑X ❑ emission standards. Interior Moisture Control 4.505.2 Vapor retarder and capillary break is installed at slab on grade foundations. X❑ ❑ 4.505.3 Moisture content of building materials used in wall and floor framing is ❑ ❑ checked before enclosure. Page 3 of 5 Ca]Green_2010.doc revised 08127111 Indoor Air Quality and Exhaust 4.506.1 Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 4.507.1 Whole house exhaust fans shall have insulated louvers or covers which close when the fan is off. Covers or louvers shall have a minimum XD insulation value of R-4.2. 4.507.2. Duct systems are sized and designed and equipment is selected using the following methods: 1. Establish heat loss and heat gain values according to ACCA Manual J or equivalent. 2. Size duct systems according to ACCA 29-D (Manual D)or equivalent. 3. Select heating and cooling equipment according to ACCA 36-S(Manual S) or equivalent. SPECIALINSTALLER AND - - QUALIFICATIONS Qualifications 702.1 HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the discipline they inspect Lai and verify. Verifications 703.1 Verification of compliance with CALGreen may include construction documents, plans, specifications, builder or installer certification, inspection reports, or other methods acceptable to the enforcing agency which show substantial conformance. Implementation verification shall be submitted to the Building Department after implementation of all required measures and prior to final inspection approval. Page 4 of 5 CalGreen_2010.doc revised 08/27/11 CALGREEN SIGNATURE DECLARATIONS Project Name: `p��Z_ t I Project Address: Project Description: -2- SECTION SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 –"Design Verification" and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with quirements set forth in the 2010 California Green Building Standards Code as ad he o uperti 7-- � - 1 Ow Signature li—,:)- Date Owner's Name (Please Print) 7iDP�l I r? ^� Design Professional's Si9ndure Date Design Professional's Name (Ple seT�= Signature of License Professional respodsible for CalGreen compliance Date Name of License Professional responsible for C Green Pl compliance( ease Print) hone P r v w W Email Address for Li nse Professional responsible for al en compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3,together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green B 'Iding Standards Code as adopted by the City of Cupertino. 7- 1 Signature of License Profe conal ksponsible for CalGreen compliance Date Name of Lic nse Professional responsible for Cal n co A�ce ase Print) `Rhone Is Cr)►M Email Address for License rofe sional responsible for CalGreen co n Page 5 of 5 CalGreen_2010.doc revised 08/27/11 STATE OF CALIFORNIA ADDITIONS 1000 FT 2 OR LESS - CEC-CFIR-ADD-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION ' J CERTIFICATE OF COMPLIANCE CFIR-ADD-01-E Prescriptive Residential Additions 1,000 ft or less (Page 1 of 6) Date —7 Prepared: �� Project Name: _` A.GENERAL INFORMATION of Project Name: 2.ej' 02 Date Prepared: �_ 03 Project Location: 04 Building Front Orientation(deg): p 05 CA City D 06 Number of Dwelling Units with Additions: 07 Zip Code: ( 08 fuel Type: 413project limate Zone: a 10 Total Conditioned Floor Area(ft2)(Addition): 2 uildingpe rJ( V� ► it 12 Slab Area(W): Scope: B.OPAQUE SURFACE DETAILS—Framed (Section 150.2(a)) L�T,gll�D 02 03 04 05 06 07 08 09 10 11 Proposed Required Frame Frame Continuous AppendixJA4 Reference Depth Spacing Cavity Insulation U- Assembly Type Frame Type (inches) (inches) R-value R-value Factor Table Cell U-Factor Comments ZNMD tn% p Ge C.OPAQUE SURFACE DETAILS—Non-framed (Section 150.1(c)1) 01 02 03 04 05 06 08 09 10 11 C P Required AppendixJA4 Core Cos_tinus """ 5� Reference Thickness Insulation In uIatign LI-Factor from Tag/ID Assembly Type Assembly Materials (inches) R-value Rsyaluer. LI-Factor Table Celt I Package A Comments E) RgZEIVE C' SUB ITT AL 41a 4 2014 #1j� 4z rr Registration Number: Registration Date/Time: HERS Pro ider: 2008 Residential Compliance Forms / STATE OF CALIFORNIA ADDITIONS 1000 FTZ OR LESS CEC-CFIR-ADD-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION Y, CERTIFICATE OF COMPLIANCE CFIR-ADD-01-E Prescriptive Residential Additions 1,000 ft or less (Page 2 of 6) Project Name: �j T� PFi\/,� Date Prepared: — D. OPAQUE SURFACE DETAILS—Mass Walls(Section 150.1(c)1) 01 02 03 04 05 06 07 08 1 09 10 11 Proposed Required Interior Insulation Exterior Insulation Appendix 1A4 Interior Insulation Exterior Insulation Walls Mass Furring Strip Reference Above Thickness Thickness Tag/ID Grade Mass Type (inches) (inches) R-value U-factor R-value U-factor Table Cell R-value U-factor R-value Fu-factor E.SLAB INSULATION(Table 150.1-A) 01 02 03 04 05 06 Proposed Required Insulation Insulation Floor Type R-value U-factor R-value U-factor Comments • Heated slab floors require mandatory slab insulation(see Table 110.8-A). F. RADIANT BARRIER(Section 150.1(c)2 01 02 Radiant Barrier installed below the roof deck and on all gable end walls Comment E5 A radiant barrier is required(for Climate Zones 2-15) • Radiant barriers shall meet specific eligibility and installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards for low-rise residential buildings. Refer to RA4.2.1 • The emittance of the radiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. For Prescriptive Compliance the attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic floor area with no less than 30 percent upper vents. Ridge vents or gable end vents are recommended to achieve the best performance.The material should be cut to allow for full airflow to the venting. N Registration Number: Registration Date/Time: HEKS Provider: 2008 Residential Compliance Forms June 2014 STATE OF CALIFORNIA ADDITIONS 1000 FT' OR LESS � CEC-CFIR-ADD-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION r CERTIFICATE OF COMPLIANCE CFiR-ADD-OI-E Prescriptive Residential Additions 1,000 ft or less (Page 3 of 6) Project Name: Date Prepared: G. ROOFING PRODUCTS(COOL ROOF) (Section 150.1(c)11) 01 02 03 04 05 06 07 08 09 10 11 12 Mass Roof Proposed Minimum Required 25 Ib/ft2 or Method Of Product CRRC Product ID Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI greater Roof Pitch compliance Type Number Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) NOTES: • Any roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. H. FENESTRATION/GLAZING AREAS ALLOWED(Section 150.2(a)1) 01 02 1 03 04 05 06 07 Gg Maximum Allowed Maximum Allowed Fenestration Area For All Orientations ft2 West-Facing Fenestration Area Only ft2 The Greater The Greater Maximum Maximum Addition Type ft2 Maximum Maximum Maximum Maximum Allowed Allowed Comments Calculated Calculated LI-factor SHGC based on Calculated based on Calculated Allowed% Allowed ft2 Allowed% Allowed ft2 sr�'►� S izms 4-s 'toe Cx�sti►J� Registration Number: Registration Date/Time: HERS P vider: 2008 Residential Compliance Forms June 2014 STATE OF CALIFORNIA ADDITIONS 1000 FT Z OR LESS CEC-CFIR-ADD-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CHR-ADD-014 Prescriptive Residential Additions 1,000 ftZ or less (Page 4 of 6) Project Name: r1 1� Date Prepared: I. FENESTRATION PROPOSED AREAS AND EFFICIENCIES 01 02 03 04 05 06 07 08 09 10 11 12 13 Proposed Dynamic Number of Orientation Proposed West Facing Proposed Proposed Combined Panes Tag/ID Fenestration Type Frame Type N,S,W,E FenestratiExterior on Source Shading SHGC from Glazing or Roof Area ft2 Fenestration U-factor SHGC CFIR-ENV- Area ft2 Device 03 14 Total Proposed Fenestration Area 15 Maximum Allowed Fenestration Area 16 Compliance Statement 17 Total Propose West-Facing Fenestration Area 18 Maximum Allowed West-Facing Fenestration Area 19 Compliance Statement 20 Proposed Fenestration U-factor j2 r22 Required Fenestration U-factorCompliance Statement Proposed Fenestration SHGC Required Fenestration SHGC 25 Compliance Statement Registration Number: Registration DateMme: HE S Provider: 2008 Residential Compliance Forms Jur, STATE OF CALIFORNIA ADDITIONS 1000 FT 2 OR LESS CEC-CFIR-ADD-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION , CERTIFICATE OF COMPLIANCE CF111-ADD-01-E Prescriptive Residential Additions 1,000 ft2 or less (Page S of 6) Date Prepared: 0—k �, SPACE CONDITIONING(SC)SYSTEMS-HEATING/COOLING—SINGLE FAMILY DWELLING (Prescriptive section 150.2(b)or(Section 150.1(c)7). 01 02 03 Dwelling Unit Total CFA= Dwelling Unit Name Sum of Existing+Addition(ft2) Comments K. WATER HEATING SYSTEMS(Section 150.1(c)8) List water heaters and boilers for both domestic hot water(DHW)heaters and hydronic space heating. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 q of Water Water Heater Back-Up Nater Heating Water Water Heaters Storage Rated Rated Heating Heating Exterior Solar Dwelling Unit DHW system ID or Heating Heater in Volume Fuel Input Input Efficiency Efficiency Standby Insul. Savings Central DHW System System Name System Type Type system (gal) Type Type Value Type Value Loss(%) R-Value Fraction Distribution Type Distribution Type f� LAK �D AiPi sTr� ( L SPACE CONDITIONING SYSTEMS AND WATER HEATING SYSTEMS IN MULTIFAMILY DWELLING UNITS 01 02 03 04 05 06 Dwelling Unit Total CFA= Central Water Heating Dwelling Unit Dwelling Unit: Sum of Existing+Addition System Identification or Water Heating System Installing a New Space Dwelling Unit Name (ft2) Name Identification or Name Conditioning System? Cogiments 2 pOCUMENTATION AUTHOR'S DECLARATION STATEMENT Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms June 2' STATE OF CALIFORNIA ADDITIONS 1000 FTS OR LESS ` fill � CEG-CFIR-ADD-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-01-E Prescriptive Residential Additions 1,000 ftor less (Page 6 of 6) Project Name: � �\^]-� Date Prepared: O 1. I certify that this Certificate of Compliance documentation is accurate and complete. Documen atjon Author Name: Documentation Author Signature: �1 ClJ Company: V � Signature Date: 7-1 O Address: CEA/HERS Certification Identification(if rapplicable j` City/State/Zilllp:r�' \ � ^,s Phone: � `1 `✓V 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: !r>1C*) e Company: ( Date Signed: Address: (� ^ -,` License: Z'Z -*S City/State/Zip: �^, \ Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. 4 Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms June 2014