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14020097 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 922 BROOKGROVE LN CONTRACTOR:KAVITA MAHTANEY PERMIT NO: 14020097 OWNER'S NAME: KAVITA MAHTANEY 922 BROOKGROVE LN DATE ISSUED: 10/09/2014 OWNER'S PHONE: 4083662003 CUPERTINO,CA 95014-4668 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ REAR ADDITION OF 85 S.F.TO EXTEND(E)FAMILY RM License Class Lic.# (EICHLER) Contractor Date 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: 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. Sq.Ft Floor Area: Valuation:$15000 1 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 APN Number:37539035.00 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.I agree to comply with all city and county ordinances and state laws relating WITH to building construction,and hereby authorize representatives of this city to enter F PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save 180 YS FROM LAST CALLED 'NSP CTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the �CS granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.l 8. RE-ROOFS: Signature Date 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. OWNER-BUILDER DECLARATION k1h eby 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 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) 1,as owner of the property,am exclusively contracting with licensed contractors to hIAZARDOUS MATERIALS DISCLOSURE nstruct 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 I 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 Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Section B 25505,25W3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater permit is issued. 1 ertify 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, l must I 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 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, 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-poin source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Datem(Jb4- b� CONSTRUCTION PERMIT APPLICATION n O COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION O V 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX(408)777-3333•build ing(a�cugertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN# -7 J U'eV � OWNER NAME 111J9M a , A nG PHONE _ E- STREET ADDRESS q 2,.Z �� Y �j 4 CITY,�l TE,ZIP )� CJ FAX CONTACT NAME �' 1 t ' t PC••NE E-MAIL � ' 6 f 6 � � STREET ADDRESS �J CITY,STATE,ZIP F � ❑ OWNER 13 OWNER-BUILDER El OWNER AGENT 13 CONTRACTOR 11 CONTRACTOR AGENT AR CT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITE /ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �® EXIS USE PROPOSED USE u _ COTR TYPE #STOI;IES USE TYPE OCC. SQ.FT. VALUATION($) EXIST FLOOR DEMO TOTAL AREA f , 'Z7 AREA 49 "� AREA NET AREA BATHROOM •/ KITCHEN OTHER v t/ REMODEL AREA t REMODEL AREA REMODEL AREA PORCH AREA DECK AREAAND TAL DECK/PORCH AREA GARAGE AREA. DETACH E]ATTACH K DWELLING UNITS: IS UNIT ❑YES SECOND STORY YES BEING ADDED? NO ADDITION? [:]NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES .„ o TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property o or authorized agent to act on th rope er'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 building construction. authonyp representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: f �.-' Date: G� SUPPLEMEN YALINFORMATION REQUIRED �LnivcP�cxxrrs � » iiozrnecL - New SFD or Multifamily dwellings: Apply for demolition Permit for ❑ ; - ` } ,0VER T1E&C LATER ❑ Evu DING PLAN RE IEG . existing building(s). Demolition permit is required prior to issuance of buildings permit for new building. ❑n�xrx�ss` � �� PLA crr.�VxEvtiEw �`�"� . Commercial Bldgs: Provide a completed Hazardous Materials Disclosure TnriDnxD PX7BLI oRKS form if any Hazardous Materials are being used as part of this project. ❑ Atici�� D�r . _Copy of Planning Approval Letter or Meeting with Planning prior tox f©�,��,JR submittal of Building Permit application. y a �; LENVIRONMENT "`liEALTE.ku x B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 91t2 BROOKGROVE LN DATE: 02/14/2014 REVIEWED BY: MELISSA APN: 375 39 035 BP#: "VALUATION: 1$15,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex 2nd Unit? 0 Yes : No PENTAMATION 1 R3SFDADD USE: OTC. C)Yes IG)No PERMIT TYPE: WORK REAR ADDITION OF 85 S.F. TO EXTEND E FAMILY RM 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,III-B,IV,V-B 85 $1,059.00 IADDPLCK $1,026.00 IADDINSP TOTALS: 85 $1,059.00 $1,026.00 MECH,HOURLY ® Yes (F) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No F-1 Ll NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District, etc. . Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 Fff 7/1,-13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,059.00 Select a Misc Bldg/Structure Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,026.00 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 AME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (j) No $0.00 G Advanced Planning_Fee: IPLLONGR $11.90 Select a Non-Residential E) Building or Structure 0 Strom-T Motion Fee: IBSEISMICR $1.50 Select an Administrative Item Bldg Stds Commission Fee; 1BCBSC I $1.00 SUBTOTALS: 1 $2,099.401 $0.00 TOTAL FEE: $2,099.40 Revised: 01/1512014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P ERI'I NO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: C(ewL G PERMIT# I40,� OWNER'S NAME: `}fit PHONE # - GENERAL CONTRACTOR: I 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 INSPECTION(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: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical CO C'. 2)S 0 Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass / Glazing Heating Insulation S P—,:E.rc�d t r j S 7 6o Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile L �& Owner/Contractor Sign ture Date Jeffrey Greef cg V From: Ignis Products [info@ignisproducts.com] Sent: Thursday, November 20, 2014 10:15 AM To: Jeffrey Greef Subject: RE: UL listing info Attachments: 4786640627_UL_Project_Plan_ECD.doc Hi Jeff, I apologize for the delay in getting back to you. I was trying to get in touch with our LIL engineer for more updated paperwork H=he is out of town so I am attaching the latest project plan. Also for your reference our UL file#is MH60552 Sincerely, Vladimir Brodsky ..........................._.............,. 1-855-MY-IGNIS 1-855-694-4647 www.ignisproducts.com Contemporary Ethanol Fireplaces, Ethanol Burners and Accessories From: Jeffrey Greef [mailto:JeffreyG(�bcupertino.org] Sent: Tuesday, November 18, 2014 7:25 PM To: info@ignisproducts.com Subject: UL listing info Hello- I'm a building inspector with the City of Cupertino in California. A local resident installed one of your fireplaces and we would like info on UL listing. I called your company today(11-18-14) and spoke with someone who told me that you have applied to UL for listing. Please send us evidence that you have filed with them, along with your standard info and installation instructions by email."rhe unit I saw is a Lata model. We will accept this particular installation if we know that you have filed with LIL and the installation meets the installation instructions. 'thanks. Jeff Greef Building Inspector City of Cupertino "Show me, don't tell me. I'm an inspector, not a believer." 1 UL November 7, 2014 IGNIS DEVELOPMENT INC 498 Columbia St Brooklyn, NY 11231 Subject: UL Project Number 4786640627 Dear Vladimir Brodsky, I have completed your project plan and this letter outlines important project information about the UL service(s)you requested. UL has received enough information to start the product evaluation, however additional items and/or samples may be needed to complete the evaluation. Details regarding the investigation items and/or samples required are included below under the heading of Required Investigation Items and Required Samples. Providing the items and samples requested below will avoid unnecessary delays in your project. Produot Service tecripts�xt Preliminary Investigation [LRBA/7] Ethanol Firebox (w/ burner in prototype) 1 Model Standad(s)Referenced fear thrs:8�ia uat on UL 1370 STANDARD FOR UNVENTED ALCOHOL FUEL BURNING DECORATIVE APPLIANCES - Edition 1 - Revision Date 2014/01/08 ULC/ORD C627.1 UNVENTED ETHYL ALCOHOL FUEL BURNING DECORATIVE APPLIANCES - Edition 1 - Issue Date 2008/03/01 Prods. Cafgor ' • LRBA7- UNVENTED ALCOHOL-FUEL-BURNING DECORATIVE APPLIANCES CERTIFIED FOR CANADA Required Invest g,ation 11 �m(s);for'eViIu'ation None Required Regiiulred Samples}for Evaluation No Samples Required Project Plan Estimated Completion Date Letter- Project Number 4786640627 Page 1 of 3 UL tSSt1lltti?1� s < a. 3� :� '.a,3 .; M. 1. • All safety critical components, enclosures and materials are UL Listed/Recognized and suitable for the intended application. • No Testing Anticipated. • Quotation does not include fees associated with travel, lodging, meals, etc. • Quotation does not include fees associated with Safety Certificates for other countries. • In accordance with UL's Data Acceptance Program (DAP), UL retains the right to request that a test or test program be repeated at UL or under UL witness after review of submitted data. Additional charges may apply. The engineer will travel to your location for preliminary investigation. Proposed Test Pura None N Trmel rid"Assessrrir�t Customer Requested Completion Date: Not Provided Estimated Project Completion Date: Dec 19, 2014 Project Phase Product Evaluation Process Quote Project Plan Initial Assessment and/or 6 eeks Construction Review Testing, Final Report Preparation,and Q Weeks 3 Technical Review Any proposed project plan and timeline included in this communication is based on the received information and on the above assumptions. The test program and other aspects of the project plan will be finalized following a comprehensive construction review of your specific product. A project handler from our engineering staff will begin the investigation shortly. The project handler will keep you informed of the progress of your project. If you have any questions or need additional information, you can contact me or customer service. Project Plan Estimated Completion Date Letter-Project Number 4786640627 Page 2 of 3 UL Regards, Shailesh Bulsara Project Engineer HVAC UL T: E: Shailesh.Bulsara@ul.com Any information and documentation involving UL Mark services are provided on behalf of UL LLC (UL)or any authorized licensee of UL. Project Plan Estimated Completion Date Letter-Project Number 4786640627 Page 3 of 3 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CU PERTINO (408)777-3228• FAX(408)777-3333- building(afcupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE= APt,F�5 v ��. BP# �✓f O ER NAM ,� � OWNER ADDRESS / DESCRIPTION OF WORK: on1J We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed,and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) 74ildI understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- er'building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my ins rance coverage for injuries to workers on my property. I understand building permits are not required to be signed by property owners unless they are responsible for �heconstruction and are not hiring a licensed Contractor to assume this responsibility. �. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her na a instead of my own. A. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. AI understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the tal alue of my construction is at least five hundred dollars ($500), including labor and materials, 1 may be cons' ered an "employer" under state and federal law. ddI understand if I am considered an "employer" under state and federal law, I must register with the state and eral government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. 1 understand under California Contractors' State License Law, an Owner-Builder who builds single-family rsidential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is erformed under contract with a licensed general building Contractor. 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for ny financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04/14/10 - I understand I may obtain more information regarding my obligations as an "employer"from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB)at 1-800-321-CSLB(2752)or www.cslb.ca.gov for more information about licensed c tractors. 10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I ivy the party legally and financially responsible for proposed construction activity at the site address listed above. 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide all applicable laws and requirements that govern Owner-Builders as well as employers. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the i formation I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signafiuw. Property Owner's Signature: Date: ------------------------------------------------------------------- -- ---------------------------------------------------------------------- (NOTE: The following Authorization Form is required to b completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForni 2010.doc revised 04/14/10 CALGREEN RESIDENTIAL CHECKLIST - MANDAT . (J ITEMS EIVED COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION O 16 2014 CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333- buildinq(7a.cupertino.org DY PURPOSE: The 2013 CalGreen Code 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. Project Name: e" V ttr: (IC Project Address: (1))- 9(ai�( ier ' f Laoc� Project Description: lkco i (C In G Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 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-th 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 licensee) profe4sional shall ' 9I `"CT � n 3 and sign and date Section 2 - Implementation Verification at=tae encs of this checklisfan9� rthe completed form to the Building Inspector. to COMPLIANCE Column n 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements A4.1 PLANNING AND DESIGN Planning and Design -Site Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during ❑X ❑ construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ® ❑ site grading or a drainage system will manage all surface water flows. OFFICE COPY Page I of 5 CalGreen_2014.doc revised 01/15/14 A4.2 ENERGY EFFICIENCY 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 AN� CONSERVATION Indoor Water Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads)shall comply with the following: ❑ 4.303.1.3.2 Water Closets.The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank-type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank-type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall beLai designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units) in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 01/15/14 Outdoor Water Use 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather-based. ❑ 4.304.1.1 Controllers shall be weather-or soil moisture-based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ 4.304.1.2 Weather-based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture-based controllers are not required to have rain sensor input. A4.4 MATERIAL CONSERVATION AND RESOURCE EFFICIENCY Enhanced Durability and Reduced Maintenance 4.406.1 Rodent proofing. Annular spaces around pipes, electric cables, conduits, or other openings in plates at exterior walls shall be protected a 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 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall be submitted for approval to the enforcing agency. Building Maintenance and Operation 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building occupant or owner. A4.6 - Fireplaces 4.503.1 General. Install only a direct-vent sealed-combustion gas or sealed wood-burning fireplace, or a sealed woodstove. Pollutant Control - 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air OX ❑ distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic ❑X compounds. Page 3 of 5 CalGreen_2014.doc revised 01!15114 4.504.2.4 Verification. Documentation shall be provided to verify that compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) 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 QX Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall ❑X comply with low formaldehyde emission standards. Interior Moisture Control 4.505.2 Concrete slab foundation. Required vapor retarders and capillary breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building materials used in wall and floor framing is checked before enclosure. Indoor Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building are provided in every bathroom. Environmental Comfort 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. INSTALLER AND SPECIAL INSPECTOR QUALIFICATIONS Qualifications 702.1 Installer training. HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the ❑X discipline they inspect and verify. Verifications 703.1 Documentation. 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_2014.doc revised 01115/14 CALGREEN SIGNATURE DECLARATIONS Project Name: J( " i-rA r C5 i-0L--,-j cL Project Address: 922 13rocfka-rove- Lc,ne i OT`s" Cil 9,501 (1 Project Description: Acl&J,- SECTION (,J ,oSECTION 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 the requirements set forth in the 2013 California Green Building Standards Code as adopted by e ity of Cupertino. 7-f 2- !4 Owner's Signature Date Owner' Name (Please Print) �1 D sign Professional's Signature Date �T Design Professional's Name (Please Print) Signature of qqense Professional responsible for CalGreen compliance Date MAALA:� c SCA Name of L ense Professional responsible for CalGreen compliance(Please Print) Phone Qv c+Q Email Address for License Professional, i le for CalGreen compliance -K-jr02KVv\eq I 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 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2014.doc revised 01/15/14 CALGREEN RESIDENTIAL CHECKLIST — MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL RECEIVED 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408) 777-3228- FAX(408)777-3333- buildingCcDcupertino.g SEP 1 2014 PURPOSE: The 2013 CalGreen Code applies to all newly constructed hotels, motels, lodging ho%Yesf ellings, 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. f � Project Name: G' `� Project Address: LaoLJ 'f'f1 Project Description: mei Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. mo�_O? - -- ,, 2. The licensed professional, in collaboration with the owner argn profesYs�hal'i�1f�f�r4 Column Ul- 2 of this checklist, sign and date Section 1 - Design Verifice end of't ��ch�t'�Ntf have the checklist printed on the approved plans for the project. F�;g . �� 3. Prior to final inspection by the Building Department, the lice rt t' rofessi i Adil 49�plete Column 3 and sign and date Section 2 - Implementation Verification;_ of this checklist and submit the completed form to the Building Inspector. t Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements A4.1 PLANNING AND DESIGN Planning and,Desrgrr Site`Development 4.106.2 Storm water drainage and retention during construction. A plan is developed and implemented to manage storm water drainage during ❑X ❑ construction. 4.106.3 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ® ❑ site grading or a drainage sy " m ce water flows. THIS PLAN SHALL REMAIN ON THE JOB AT ALL TIMES DURING CONSTRUCTION Page 1 of 5 CalGreen_2014.doc revised 01/15/14 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 CONSERVATION u Indoor Wates Use 4.303.1 Water conserving plumbing fixtures and fittings. Plumbing fixtures (water closets and urinals) and fittings (faucets and showerheads) shall comply with the following: ❑ 4.303.1.3.2 Water Closets. The effective flush volume of all water closets shall not exceed 1.28 gallons per flush. Tank-type water closets shall be certified to the performance criteria of the U.S. EPA WaterSense Specifications for Tank-type Toilets. ❑ 4.303.1.3.2 Urinals. The effective flush volume of urinals shall not exceed 0.5 gallons per flush. ❑ 4.303.1.3.1 Single Showerheads. Showerheads shall have a maximum flow rate of not more than 2.0 gallons per minute at 80 psi. Showerheads shall be certified to the performance criteria of the U.S. EPA WaterSense Specification for showerheads. ❑ 4.303.1.3.2 Multiple Showerheads serving one shower. When a shower is served by more than one showerhead, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute at 80 psi, or the shower shall be ® ❑ designed to allow only one shower outlet to be in operation at a time. ❑ 4.303.1.4.1 Residential lavatory faucets. The maximum flow rate of residential lavatory faucets shall not exceed 1.5 gallons per minute at 60 psi. The minimum flow rate of residential lavatory faucets shall not be less than 0.8 gallons per minute at 20 psi. ❑ 4.303.1.3.2 Lavatory faucets in common and public use areas. The maximum flow rate of lavatory faucets installed in common and public use areas (outside of dwellings or sleeping units)in residential buildings shall not exceed 0.5 gallons per minute at 60 psi. ❑ 4.303.1.4.3 Metering faucets. Metering faucets when installed in residential buildings shall not deliver more than 0.25 gallons per cycle. ❑ 4.303.1.4.4 Kitchen Faucets. The maximum flow rate of kitchen faucets shall not exceed 1.8 gallons per minute at 60 psi. Kitchen faucets may temporarily increase the flow above the maximum rate, but not to exceed 2.2 gallons per minute at 60 psi, and must default to a maximum flow rate of 1.8 gallons per minute at 60 psi. 4.303.2 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code, and shall meet the applicable standards referenced in Table 1401.1 of the California Plumbing Code. Page 2 of 5 CalGreen_2014.doc revised 01/15/14 Outdoor`Water Use; 4.304.1 Irrigation controllers. Automatic irrigation systems installed at the time of final inspection shall be weather-based. ❑ 4.304.1.1 Controllers shall be weather-or soil moisture-based controllers that automatically adjust irrigation in response to changes in plants' needs as weather conditions change. ❑ ❑ 4.304.1.2 Weather-based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicated with the controller(s). Soil moisture-based controllers are not required to have rain sensor input. A4.4 MATERIAL CONSERVATIONRESOURCE Erihanced'Durabilityapd Reduced Maintenance � 4.406.1 Rodent proofing. 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 Redu`c'tion, Disposal"an dRecycling, 4.408.2 Construction waste management plan. Where a local jurisdiction does not have a construction and demolition waste management ordinance, a construction waste management plan shall be submitted for approval to the N El enforcing agency. Building Maintenance and,Operat1on 4.410.1 Operation and maintenance manual. At the time of final inspection, an operation and maintenance manual shall be provided to the building �X occupant or owner. ENVIRONMENTALQUALITY Fireplaces 5 m a 4.503.1 General. Install only a direct-vent sealed-combustion gas or sealed wood-burning fireplace, or a sealed woodstove. El Pollutant Cont"rol 4.504.1 Covering of duct openings and protection of mechanical equipment during construction. Duct openings and other related air X❑ ❑ distribution component openings shall be covered during construction. 4.504.2.1 Adhesives, sealants and caulks. Adhesives, sealants and caulks 0 shall be compliant with VOC and other toxic compound limits. 4.504.2.2 Paints and coatings. Paints, stains and other coatings shall be compliant with VOC limits. 4.504.2.3 Aerosol paints and coatings. Aerosol paints and other coatings shall be compliant with product weighted MIR Limits for ROC and other toxic QX compounds. Page 3 of 5 CalGreen_1014.doc revised 01/15/14 4.504.2.4 Verification. Documentation shall be provided to verify that compliant VOC limit finish materials have been used. 4.504.3 Carpet Systems. Carpet and carpet systems shall be compliant with VOC limits. 4.504.4 Resilient flooring systems. Eighty (80) percent of floor area receiving resilient flooring shall comply with the VOC-emission limits defined in the Collaborative for High Performance Schools (CHIPS) Low-emitting OX Materials List or be certified under the Resilient Floor Covering Institute (RCFI) FloorScore program. 4.504.5 Composite wood products. Particleboard, medium density fiberboard (MDF), and hardwood plywood used in interior finish systems shall OX comply with low formaldehyde emission standards. Interior.Moisture Control'., ":0_ 4.505.2 Concrete slab foundation. Required vapor retarders and capillary breaks are also required to comply with CalGreen Section 4.505.2.1. 4.505.3 Moisture content of building materials. Moisture content of building materials used in wall and floor framing is checked before enclosure. Indoor Air Quality and Exhaust 4.506.1 Bathroom exhaust fans. Exhaust fans which terminate outside the building are provided in every bathroom. 4 Environmental,Comfort , 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. INSTALLER AND SPECIAL INSPECTOR QUALIFICATIONS QualificatIons< " 702.1 Installer training. HVAC system installers are trained and certified in the proper installation of HVAC systems. 702.2 Special inspection. The Licensed Professional responsible to verify CALGreen compliance is qualified and able to demonstrate competence in the ❑X discipline they inspect and verify. Verifications 703.1 Documentation. 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_2014.doc revised 01115114 CALGREEN SIGNATURE DECLARATIONS Project Name: k7 A-V f'rA 10 C'S (DcL Project Address: 922 13rook-grow t. L zne CA 9601 Project Description: NA cc 1-L0 n 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 the requirements set forth in the 2013 California Green Building Standards Code as adopted by e ity of Cupertino. —f Z- I4 Owner's Signature� �.� �� 7 A-7i Date Owner's Name (Please Print) , D sign Professional's Signature Date Design Professional's Name (Please Print) Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen 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 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 5 of 5 CalGreen_2014.doc revised 01/15/14 BUILDING ENERGY ANALYSIS REPORT RECEIVED ECEIVED Kavita Residence Addition SEF 6 2014 922 Brookgrove lane Cupertino, CA 95242 '----- Project Designer: Williams Designs 715 N First Street - Suite 34 San Jose, CA 408 971 2116 SUBMITTAL 2 Report Prepared by: Tailored Energy Services, Title 24 Calculations, Kevin Laughton www.TailoredEnergyOnline.com 1640 W. Longview Avenue, Stockton, CA 95207, Email: Kevin@TailoredEnergyOnline.com OFFICE COP'S' Job NumbEr; CUPERTINO 4067 `11Jj1dine Department 4 Date: ..P yAr.Cr is`<. t;` ;I C�C�iv��'�_sfiNCk 16-Sep-14 1'wec Ey The EnergyPro computer program has been used to perforin the calculations summarized in this compliance report.This program has approval and is authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards. This program developed by EnergySoft,LLC—www.energysoft.com. Ene w 5.1 by Ene Soft User Number.5308 RunCode:2014-09-16709:26:41 10.4067 TABLE OF CONTENTS Cover Page 1 Table of Contents 2 Form CF-1 R Certificate of Compliance 3 Form MF-1R Mandatory Measures Summary 8 HVAC System Heating and Cooling Loads Summary 11 Room Load Summary 12 Room Heating Peak Loads 13 Room Cooling Peak Loads 14 I i EnergyPro 5.1 by EnergySoft Job Number ID:4067 User Number:5308 PERFORMANCE CERTIFICATE: Residential Part 1 of 5 CF-1 R Project Name Building Type ® Single Family ®Addition Alone Date Kavita Residence Addition ❑ Multi Family ❑ Existing+Addition/Alteration 16-Sep-14 Project Address California Energy Climate Zone Total Cond.Floor Area Addition #of Stories 922 Brookgrove lane Cupertino CA Climate Zone 04 85 85 1 FIELD INSPECTION ENERGY CHECKLIST ❑ Yes ® No HERS Measures -- If Yes, A CF-413 must be provided per Part 2 of 5 of this form. ❑ Yes ® No Special Features -- If Yes, see Part 2 of 5 of this form for details. INSULATION Area Special Construction Type Cavity (ft) Features (see Part 2 of 5) Status Wall Wood Framed R-15 190 New Slab Unheated Slab-on-Grade None 85 Perim=20' New Roof Wood Framed Rafter R-13 85 New FENESTRATION U- Exterior Orientation Area ft) Factor SHGC Overhang Sidefins Shades Status Front(E) 110.0 0.370 0.36 none none Bug Screen New HVAC SYSTEMS Qty. Heating Min. Eff Cooling Min. Eff Thermostat Status 0 Central Fumace 81%AFUE Packaged Air Condition 11.0 SEER Setback Existing HVAC DISTRIBUTION Duct Location Heating Cooling Duct Location R-Value Status hvac Ducted Ducted Attic,Ceiling Ins,vented 4.2 Existing WATER HEATING Qty. Type Gallons Min. Eff Distribution Status EnergyPro 5.1 by Ene ySoft User Number. 5308 RunCode:2014-09-16T09.26:41 ID:4067 Page 3 of 14 PERFORMANCE CERTIFICATE: Residential Part 2 of 5 CF-1R Project Name Building Type ® Single Family m Addition Alone Date Kavita Residence Addition 1 ❑ Multi Family ❑ Existing+Addition/Alteration 16-Sep-14 SPECIAL FEATURES INSPECTION CHECKLIST The enforcement agency should pay special attention to the items specified in this checklist.These items require special written justification and documentation,and special verification to be used with the performance approach.The enforcement agency determines the adequacy of the justification,and may reject a building or design that otherwise complies based on the adequacy of the special justification and documentation submitted. HERS REQUIRED VERIFICATION Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a completed CF-4R form for each of the measures listed below for final to be given. EneroyPro 5.1 by EnergySoft User Number.5308 RunCode:2014-09-16T09:26:41 ID:4067 Page 4 of 14 PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF-1 R Project Name Building Type m Single Family m Addition Alone Date Kavita Residence Addition ❑ Multi Family ❑Existing+Addition/Alteration 16-Sep-14 ANNUAL ENERGY USE SUMMARY Standard Proposed Margin TDV kBtu/ftz- r Space Heating 68.72 16.58 52.14 Space Cooling 34.20 81.04 -46.84 Fans 20.23 25.31 -5.08 Domestic Hot Water 0.00 0.00 0.00 Pumps 0.00 0.00 0.00 Totals 123.15 122.94 0.21 Percent Better Than Standard: 0.2% BUILDING COMPLIES - NO HERS VERIFICATION REQUIRED Fenestration Building Front Orientation: (E)90 deg Ext. Walls/Roof Wall Area Area Number of Dwelling Units: 0.30 (E) 200 110 Fuel Available at Site: Natural Gas (S) 50 0 Raised Floor Area: 0 Im 0 0 Slab on Grade Area: 85 (N) 50 0 Average Ceiling Height: 9.0 Roof 85 0 Fenestration Average U-Factor: 0.37 TOTAL: 110 Average SHGC: 0.36 Fenestration/CFA Ratio: 129.4% REMARKS STATEMENT OF COMPLIANCE This certificate of compliance lists the building features and specifications needed to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the Efficiency Standards of the California Code of Regulations. The documendation author hereby certifies that the documentation is accurate and complete. Documentation Author Company Kevin Laughton Address www.TailorL-dEnergy0niine.com com Name Tailored Energy Services, Tithe 2, 16-Selo-14 w. Cit /State/Zi 1640 W.Longview Avenue,Stockton,CA 9E Phone Email: Kevin@TailoredEnergyOr Signed Date The individual with overall design responsibility hereby certifies that the proposed building design represented in this set of construction documents is consistent with the other compliance forms and worksheets,with the specifications, and with any other calculations submitted with this permit application, and recognizes that compliance using duct design, duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require installer testing and certification and field verification by an approved HERS rater. Designer or Owner (per Business & Professions Code) Company Williams Designs �/;A r T Address 715 N First Street-Suite 34 Name City/Stateop San Jose,CA Phone 408 9712116 //4signed License# Date ILI EnergyPro 5.1 by EnerpySoft User Number.5308 RunCode:201409-16T097.31 1D.4067 Pace 5 of 14 CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF-1 R Project Name Building Type m Single Family m Addition Alone Date Kavita Residence Addition ❑ Multi Family ❑Existing+Addition/Alteration �16-Sep-14 OPAQUE SURFACE DETAILS Surface U- Insulation Joint Appendix T e Area Factor Cavi Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments Wall 50 0.091 R-15 0 90 New 4.3.1-A22 addition Slab 85 0.730 None 0 180 New 4.4.7-A1 addition Roof 85 0.075 R-13 0 0 New 4.2.2-A3 addition Wall 90 0.091.R-t5 90 90 New 4.3.1-A22 addition Wa# 50 0.091 R-15 160 90 New 4.3.1-A22 addRrcn FENESTRATION SURFACE DETAILS ID T Area U-Factor SHGC Azm Status GlazingType Location/Comments 1 Window 35.0 0.370 NFRC 0.36 NFRC 90 New new addition 2 Window 35.0 0.370 NFRC 0.36 NFRC 90 New new addition 3 Window 40.0 0.370 NFRC 0.36 NFRC 90 New new addition (1) U-Factor Type: 116-A=Default Table from Standards,NFRC=Labeled Value 2 SHGC T 116-B=Default Table from Standards,NFRC=Labeled Value EXTERIOR SHADING DETAILS Window Overhang Left Fin Ri ht Fin ID Exterior Shade Tvpe SHGC H t Wd Len H t LExt RExt Dist Len Hot Dist Len H t 1 Bug Screen 0.76 2 Bug Screen 0.76 3 Bug Screen 0.76 EnergyPro 5.1 by EnergySoff User Number.5308 RunCode:2014-09-16T09:26:41 ID:4067 Page 6 of 14 CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5 CF-1 R Project Name Building Type m Single Family ®Addition Alone Date Kavita Residence Addition ❑ Multi Family ❑ Existing+Addition/Alteration 116-Sep-14 BUILDING ZONE INFORMATION Floor Area System Name Zone Name New I Existing Altered Removed Volume Year Built hvac added area 85 765 Totals 851 0 0 0 HVAC SYSTEMS System Name Oty. HeatingT e Min.Eff. Cooling Type Min.Eff. Thermostat Type Status hvac 0 Cenh-al Fumace 81%AFUE Packaged Air Conddione 11.0 SEER Setback Existing HVAC DISTRIBUTION Duct Ducts System Name Heating Cooling Duct Location R-Value Tested? Status hvac Ducted Ducted Al6c,Ceiling Ins,vented 4.2 ❑ Existing WATER HEATING SYSTEMS Ext. Rated Tank Energy Standby Tank Input Cap. Factor Loss or Insul. R- S stem Name Qty. Type Distribution Btuh al or RE Pilot Value Status CEC Standard MULTI-FAMILY WATER HEAPING DETAILS HYDRONIC HEATING SYSTEM PIPING Hot Water Piping Length ft 2 Pipe Pipe Insul. Control 70ty. HP Plenum Outside Buried .2 System Name Len th Diameter Thick, EnergyPro 5.1 by EnergySoft User Number.5308 RunCode:2014-09-16709.26:41 ID:4067 Page 7 of 14 MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF-1 R Project Name Date Kavita Residence Addition 16-Sep-14 NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed,regardless of the compliance approach used. More stringent energy measures listed on the Certificate of Compliance(CF-1 R,CF-1 R-ADD,or CF- 1 R-ALT Form)shall supersede the items marked with an asterisk(*)below.This Mandatory Measures Summary shall be incorporated into the permit documents,and the applicable features shall be considered by all parties as minimum component performance specifications whether they are shown elsewhere in the documents or in this summary.Submit all applicable sections of the MF-1 R Form with plans. Building Envelope Measures: 116(a)l:Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage. §116(a)4:Fenestration products(except field-fabricated windows)have a label listing the certified U-Factor,certified Solar Heat Gain Coefficient SHGC ,and infiltration that meets the requirements of 10-111(a). 117:Exterior doors and windows are weather-stripped;all joints and penetrations are caulked and sealed. 118(a): Insulation specified or installed meets Standards for Insulating Material.Indicate type and include on CF-6R Form. §118(1):The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of§118(1)when the installation of a Cool Roof is specified on the CF-1 R Form. _*§1 50 a : Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor. 150(b): Loose fill insulation shall conform with manufacturers installed design labeled R-Value. * 150(c): Minimum R-13 insulation in wood-frame wall or equivalent U-factor. _*§1 50 d : Minimum R-13 insulation in raised wood-frame floor or equivalent U-factor. 150 :Air retarding wrap is tested,labeled,and installed according to ASTM El677-95 2000 when specified on the CF-1 R Form. 150 :Mandatory Vapor barrier installed in Climate Zones 14 or 16. §150(1):Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%;water vapor permeance rate is no areater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration. -Fireplaces, Decorative Gas Appliances and Gas Log Measures: 150 e 1 A: Masonry or factory-built fireplaces have a closable metal or glass door covering the entire opening of the firebox. §150(e)l B:Masonry or factory-built fireplaces have a combustion outside air intake,which is at least six square inches in area and is equipped with a with a readily accessible,operable,and tight-fining damper and or a combustion-air control device. §150(e)2:Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket,when that indoor air is vented to the outside of the building,are prohibited. -Space Conditioning,Water Heating and Plumbing System Measures: §110-§113: HVAC equipment,water heaters,showerheads,faucets and all other regulated appliances are certified by the Energy Commission. §113(c)5:Water heating recirculation bops serving multiple dwelling units and High-Rise residential occupancies meet the air release valve,backflow prevention,pump isolation valve,and recirculation loop connection requirements of§113(c)5. §115:Continuously burning pilot lights are prohibited for natural gas:fan-type central furnaces, household cooking appliances (appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt),and pool and spa heaters. 150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE,SMACNA or ACCA. 150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c). §1500)1 A:Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped with insulation having an installed thermal resistance of R-12 or greater. §1500)1 B: Unfired storage tanks,such as storage tanks or backup tanks for solar water-heating system,or other indirect hot water tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R-value is indicated on the exterior of the tank. §1500)2: First 5 feet of hot and cold water pipes closest to water heater tank,non-recirculating systems,and entire length of -recirculating sections of hot water pipes are insulated per Standards Table 150-B. §1500)2:Cooling system piping(suction,chilled water,or brine lines),and piping insulated between heating source and indirect hot water tank shall be insulated to Table 150-B and Equation 150-A. §1500)2: Pipe insulation for steam hydronic heating systems or hot water systems>15 psi,meets the requirements of Standards Table 123-A. 150 50@3A: Insulation is protected from damage,including that due to sunlight,moisture,equipment maintenance,and wind. §1500)3A:Insulation for chilled water piping and refrigerant suction lines incudes a vapor retardant or is enclosed entirely in conditioned space. 150 50@4:Solar water-heating systems and/or collectors are certified by the Solar Rating and Certification Corporation. EnergyPro5.1 byEnergySoR User Number.5308 RunCode:201409-16T09:26:41 ID.4067 Page 8 of 14 MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF-1 R Project Name Date Kavita Residence Addition 16-Sep-14 §I50(m)1:All air-distribution system ducts and plenums installed,are sealed and insulated to meet the requirements of CMC Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R- 4.2 or enclosed entirely in conditioned space.Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable requirements of UL 181,UL 181 A,or UL 181 B or aerosol sealant that meets the requirements of UL 723.If mastic or tape is used to seal openings reater than 1/4 inch the combination of mastic and either mesh or tape shall be used §150(m)1:Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other than sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned air.Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. §150(m)2D:Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. -4150(m)7: Exhaust fans stems have back draft or automatic dampers. §150(m)8:Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. §150(m)9:Insulation shall be protected from damage,including that due to sunlight,moisture,equipment maintenance,and wind. Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. 150 m 10:Flexible ducts cannot have porous inner cores. §150(o):All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air Quality in Low-Rise Residential Buildings.Window operation is not a permissible method of providing the Whole Building Ventilation required in Section 4 of that Standard. Pool and Spa Heating Systems and Equipment Measures: §114(a):Any pool or spa heating system shall be certified to have:a thermal efficiency that complies with the Appliance Efficiency Regulations;an on-off switch mounted outside of the heater;a permanent weatherproof plate or card with operating instructions;and shall not use electric resistance heating ora pilot light. §114(b)1:Any pool or spa heating equipment shall be installed with at least 36"of pipe between filter and heater,or dedicated suction and return lines,or built-up connections for future solar heating. 114(b)2:Outdoor pools or spas that have a heat pump or gas heater shall have a cover. §114(b)3:Pools shall have directional inlets that adequately mix the pod water,and a time switch that will allow all pumps to be set or -programmed to run only during off-peak electric demand pehods. . 15Q : Residential pool systems or equipment meet the pump sizing,flow rate,piping,filters,and valve requirements of§150 . Residential Lighting Measures: §I 50(k)1:High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies contained in Table 150-C and is not a low efficacy luminaire as specified by§150(k)2. 1 50 k 3:The wattage of permanently installed luminaires shall be determined as specified by§130(d). §150(k)4:Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than 20 kHz. §150(k)5:Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line-voltage socket or line- voltage lamp holder;OR shall be rated to consume no more than five watts of power as determined by§130(d),and shall not contain a medium screw-base socket. 1 50 k 6:Lighting integral to exhaust fans,in rooms other than kitchens,shall meet the applicable requirements of§150(k). 1 50 k 7:All switching devices and controls shall meet the requirements of 5150(k)7. §150(k)8:A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy. EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 11:2 or 100 watts for dwelling units larger than 2,500 ft2 may be exempt from the 50%high efficacy requirement when:all low efficacy luminaires in the kitchen are controlled by a manual on occupant sensor,dimmer,energy management system(EMCS),or a multi-scene programmable control system;and all permanently installed luminaries in garages,laundry rooms,closets greater than 70 square feet,and utility rooms are high efficacy and controlled by a manual-on occupant sensor. §150(k)9:Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of illuminated cabinet. EnergyPro 5.1 by EnergySoR User Number.5306 RunCode:2 01 4-09-1 6 709:28:41 1U 4067 Page 9 of 14 MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF-1 R Project Name Date Kavita Residence Addition 16-Sep-14 §150(k)10: Permanently installed luminaires in bathrooms,attached and detached garages,laundry rooms,closets and utility rooms shall be high efficacy. EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual-on occupant sensor certified to comply with the applicable requirements of§119. EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a manual-on occupancy sensor. §150(k)l 1: Permanently installed luminaires located in rooms or areas other than in kitchens,bathrooms,garages,laundry rooms, closets,and utility rooms shall be high efficacy luimnaires.EXCEPTION 1:Permanently installed low efficacy luminaires shall be allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of§119,or by a manual- on occupant sensor that complies with the applicable requirements of§119.EXCEPTION 2:Lighting in detached storage building less than 1000 square feet located on a residential site is not required to comply with 150 k 11. §150(k)l2:Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact(IC)by Underwriters Laboratories or other nationally recognized testing/rating laboratory;and have a label that certifies the lumiunaire is airtight with air leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283;and be sealed with a gasket or caulk between the luminaire housing and ceiling. §150(k)l3: Luminaires providing outdoor lighting,including lighting for private patios in low-rise residential buildings with four or more dwelling units,entrances,balconies,and porches,which are permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy.EXCEPTION 1:Permanently installed outdoor low efficacy luminaires shall be allowed provided that they are controlled by a manual on/off switch,a motion sensor not having an override or bypass switch that disables the motion sensor, and one of the following controls:a photocontrol not having an override or bypass switch that disables the photocontrol;OR an astronomical time dock not having an override or bypass switch that disables the astronomical time clock;OR an energy management control system(EMCS)not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2:Outdoor luminaires used to comply with Exceptionl to§150(k)13 may be controlled by a temporary override switch which bypasses the motion sensing function provided that the motion sensor is automatically reactivated within six hours.EXCEPTION 3: Permanently installed luminaires in or around swimming pool,water features,or other location subject to Article 680 of the California Electric Code need not be hiah efficacy luminaires. §150(k)l4: Internally illuminated address signs shall comply with Section 148;OR not contain a screw-base socket,and consume no more than five watts of power as determined according to§130(d). §150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable requirements in Sections 130, 132,134,and 147.Lighting for parking garages for 8 or more vehicles shall comply with the applicable -requirements of Sections 130,131,134,and 146. §150(k)l 6: Permanently installed lighting in the enclosed,non-dwelling spaces of low-rise residential buildings with four or more dwelling units shall be high efficacy luminaires.EXCEPTION:Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119. EnergyPro 5.1 byEnergySoR User Number.5308 RunCode:2014-09-16T09:26:41 ID: 067 Page 10 of 14 HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY Project Name Date Kavita Residence Addition 16-Sep-14 System Name Floor Area hvac 85 ENGINEERING CHECKS SYSTEM LOAD Number of Systems 0 COIL COOLING PEAK COIL HTG. PEAK -Heating System CFM Sensible Latent CFM Sensible Output per System 60.800 Total Room Loads 292 6,775 -2 70 3,539 Total Output(Btuh) 18.240 Return Vented Lighting 0 Output Btuh/ 214.6 Return Air Ducts 375 242 -Cooling System Return Fan 0 0 Output Per System 36,000 Ventilation F o 0 01 0 0 Total Output Btuh 10,800 Supply Fan 345 -345 Total Output(Tons) 0.9 Supply Air Ducts 375 242 Total Output(Btuh! ) 127.1 Total Output on 94.4 TOTAL SYSTEM LOAD 1 7,868 -2 1 3,678 Air System CFM per System 1.200 HVAC EQUIPMENT SELECTION Airflow cfrn 360 current 9,447 878 18,240 Airflow(cfm/ ft) 4.24 Airflow cfm/Ton 400.0 Outside Air(%) 0.0% Total Adjusted System Output 1 9,4471 878 18,240 Outside Air(cfm/ ) 1 0.00 (Adjusted for Peak Design conditions) Note:values above given at ARI conditions I TIME OF SYSTEM PEAK Aug 3 PM F Jan 1 AM HEATING SYSTEM PSYCHROMETRICS Airstream Temperatures at Time of Heating Peak 6 F 3;' Outside Air 0 elm HeatingCoil Supply Fan E;,-vc- 360 cfm ROOM COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak 88 1 68 OF Outside Air Ar oil 11 0 cfm Goofing Coil Supply Fan 360 drn 39.6% ROOM 78 6,�of 99!62 IF �� LJ EnergyPro 5.1 by EnergySoft User Number.5308 RunCode:2 01409-1 6 709:26:41 ID:4067 Page 11 of 14 ROOM LOAD SUMMARY Project Name Date Kavita Residence Addition 16-Sep-14 System Name Floor Area hvac 85 ROOM LOAD SUMMARY ROOM COOLING PEAK COIL COOLING PEAK COIL HTG. PEAK Zone Name Room Name Mult. CFM Sensible Latent CFM Sensible Latent CFM Sensible addition added area 1 292 6,775 -2 292 6,775 -2 70 3,539 PAGE TOTAL 292 6,775 1 -2 70 3,539 TOTAL 1 292 6,775 -2 70 3,539 Total includes ventilation load for zonal systems. EnemyPro 5.1 by Erre oft User Number.5308 RunCode:2014-09-16T09:26:41 1D:4067 Pae 12 of 14 ROOM HEATING PEAK LOADS Project Name Date Kavita Residence Addition 16-Sep-14 ROOM INFORMATION DESIGN CONDITIONS Room Name added area Time of Peak Jan 1 AM Floor Area 85.0 ft2 Outdoor Dry Bulb Temperature 28 OF Indoor Dry Bulb Temperature 70 OF Conduction Area U-Value AT OF Btu/hr R-15 Wall 190.0 X 0.0910 X 42 = 726 Slab-On-Grade perim=20.0 X 0.7300 X 42 = 613 RoofAltic 85.0 X 0.0750 X 42 c 268 new 110.0 X 0.3700 X 42 = 1,709 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Items shown with an asterisk(`)denote conduction through an interior surface to another room Page Total 3,317 Infiltration:[ 1.00 X 1.077 X X 9.00 X 0.386 /60 1 X 42 = 223 Schedule Air Sensible Area Ceiling Height ACH AT Fraction TOTAL HOURLY HEAT LOSS FOR ROOM 3,539 EnergyPro 5.1 by Ene ySoft UserNurnber 5308 RunCode.2014-09-16709:26:41 Q 4067 Pae 13 of 14 'RESIDENTIAL ROOM COOLING LOAD SUMMARY Project Name Date Kavita Residence Addition I 16-Sep-14 ROOM INFORMATION DESIGN CONDITIONS Room Name added area Outdoor Dry Bulb Temperature 88 OF Floor Area 85.0 ft2 Outdoor Wet Bulb Temperature 68 OF Indoor Dry Bulb Temperature 78 OFI Outdoor Daily Range: 30 OF Opaque Surfaces Orientation Area U-Factor CLTD' Btu/hr R-15 Wall (N) 50.0 X 0.0910 X 11.0 = 50 Roof Attic (N) 85.0 X 0.0750 X 55.0 = 351 R-15 Wall (E) 90.0 X 0.0910 X 24.0 = 197 R-15 Wall (S) 50.0 X 0.0910 X 18.0 = 82 X X X X X X = X X = X X I = Page Total 679 Items shown with an asterisk(`)denote conduction through an interior surface to another room. 1. Cooling Load Temperature Difference(CLTD) Shaded Unshaded Fenestration Orientation Area GLF Area GLF Btu/hr Window (E) 0.0 X 17.9 + 35.0 X 55.1 = 1,928 Window (E) 0.0 X 17.9 + 35.0 X 55.1 = 1,928 Window (E) 0.0 X 17.9 + 40.0 X 55.1 = 2,204 X + X - X + X - X + X - X + X - X + X - X + X - Page Total 6,061 Internal Gain Btu/hr Occupants 0.0 upants X 230 Btuh/occ. = �-Ao Equipment 0.0 Dwelling Unit X 1,200 Btu = Infiltration: 1.077 X 0.61 X 5.26 X f0 = 35 Air Sensible CFM ELA AT TOTAL HOURLY SENSIBLE HEAT GAIN FOR ROOM 6,775 Latent Gain Btu/hr Occupants o•o Occupants X 200 Btuh/occ. = 0 Infiltration: 4,830 X 0.61 X 5.26 X -0.00015 = -2 Air Sensible CFM ELA AW TOTAL HOURLY LATENT HEAT GAIN FOR ROOM -2 EneravPm 5.1 by EneraySoff User Number.5308 RunCode:2014-09-16T09:26:41 ID:4067 Pae 14 of 14