B-2017-1579 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1579
10202 MANN DR CUPERTINO,CA 95014-1153(326 19 011) GLOBAL HEATING
AND COOLING •
SERVICES INC
SAN JOSE,CA 95118
OWNER'S NAME: SITYAMSUKHA SANDEEP AND AMIDHA DATE ISSUED:09/14/2017
OWNER'S PHONE:408-242-5209 PHONE NO:(408)514-7112
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=20 Lic.#1025424
Contractor GLOBAL HEATING AND COOLING SERVICES INC Date 04/30/2019 X BLDG _ELECT _PLUMB
X MECH X RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
REPLACE FURNACE(ATTIC);INSTALL(N)A/C
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
?r Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$9550.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 326 19 011
representatives of this city to enter upon the above mentioned property for ,
inspection purposes. (We)agree,to'save indemnify and keep harmless the '
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,t -.p scant un.-rstands and will comply with all non-point
source regul=tion)er th-,'upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
" -t - Date 9/14/2017 Issued by:Abby Ayende
Date:09/14/2017
• ./�' ..-: ._ IERDE _ a II
I hereby affirm that I am exempt from the Contractor's License Law for one of the . RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any:roofing"material being installed.If a roof is
t. 'I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I:agree to remove all new materials.for
compensation,will do the work,and the structure is not intended or offered for inspection:,, ,
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,_am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:9/14/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the '
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials!requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I'store or handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the 'upertino Mun 'ipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, • do i - 05;25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall 1
be deemed revoked.
d3rNv er or authorized a.e 100i
, APPLICANT CERTIFICATION Date:9/14/2017 '
I certify that I have read this application and state that the above information is CONST'UCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction Fending'agency for the performance
relating to building construction,and hereby authorize representatives of this city. of work's for which this permit is issued'(Sec;3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities, '
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as•public records.
Licensed
Signature Date 9/14/2017 Professional
CONSTRUCTION PERMIT APPLICATION
\\ // COMMUNITY DEVELOPMENT DEPARTMENT •
( BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
41.1.,„.\\ 213 q Y4, (408) 777-3228 • building@cupertino.org PEMIT#B-
CUPERTINO REV# DEF#
❑NEW CONSTRUCTION ❑ADDITION 0 ALTERATION ❑T.I. 0 MEP ❑RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS APN# !,_O I
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DECRIPTON (CC ` `'(1-- / 7
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INGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
REMODEL REMODEL KITCHEN REMODEL OTHR ' GARAGE 0 ATTACHED
BATHROOM SF SF SF SF 0 DETACHED
EXISING ❑YES EICHLER ❑YES SECOND STORY ADDITION 1:1YES
FIRE SPRINKLERS 0 NO ❑ NO 0 NO
DWELLING SECOND DWELLING DYES 0 ATTACHED 0 DETACHED OTHER
UNITS# UNIT ADDITON: 0 NO S F
POOLSI 0 FIBERGLASS 0 VINYL-LINED ❑GUNITE ❑PREFABRICATED
POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO I TOTAL-SF
RECEIVED Bm.Y: ,.•A) T �yUOATION:
Commercial or Multi-Pandit/Buildings with Public Swimming Pools requires Department of Environmental Heath approval (IME J_ W` ✓`
RE-400F1 EXISTING ROOF TYPE: 0 BUILT-UP ROOF•D ASPHALT SHINGLES 0 WOOD SHAKES Q WOOD SHINGLES TILE OTHER(SPECIFY)
REMOVE/REPLACE❑NO 1 IF NO PLYWOOD ❑1/2" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS
DYES #OF LAYERS THICKNESS❑5/8" OTHER ❑OSB 0 CDX OTHER .12 A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES ❑OTHER
*Provide a signed copy of the Cupertino's Tear-Off Policy SF #of SQUARES
By my signature below I certifyto each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I
have read this application and the information I have provided is correct. Ihave read the Description of Work and verify it is accurate. I agree
to comply with all applicable local ordinanc .ws relating to building construction. I authorize representatives of Cupertino to
enter the above-identified property for ins . .. - . I acknowledge and authorize all information c/ /taine on this application form
to be made available for public record.
Signature of Applicant/Agent: - Date: C!
/-
SUPPLEMENTAL INFORMATION EQ D
*New SFD/Second Dwelling Units/Mu 'family Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association
BldgApp_2017.doc revised 08/01/17
ALTERATIONS - HVAC • ' "
ea
CEC-CF1R-ALT-03-E(Revised 01/16) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E
Alterations-HVAC CZ 1,3 to 7 and 16 (Page 1 of 1)
Site Address: `` /� Enforcement Agency: Date Prepared: Permit#:
/0-LOTv n bi k'c.tI)e/l u<
New:Ducting or Lineset Conditioned
Equipment Type L. Equipment Efficiency
Thermostat
sr'Ace.[.eRequired R-value Floor Area(ft )
❑ Packaged System CLE.Gaporator Coil AFUE COP 0 R-6 (CZ1-10,12&13)Ducts Served by system 0 Setback
❑Split System l ndensing Unit / SEER 0 R-8' (CZ 11,14-16)Ducts /7 ftz (If not already
HSPF 0>_R-2.8 Lineset3 present,must
IF rnaceeset EER be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below.At permit application this
rm is allowed to be filled out by hand.For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site.
1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final:
(Can include new ducting) •
All Equipment, CF1R-ALT-02-E
Condenser Unit,Evaporator Coil, ' CF2R:MCH-01,MCH-20-H
Air Handler/Furnace CF3R:MCH-20-H
Installer Requirement:Duct leakage(__<'15%or,<_10%to outside,or seal all accessible leaks)
Exempted from duct leakage testing if:
7 0 1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned
space,or 0 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building )
❑ 2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts' CF1R-ALT-02-E ,
CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H
CF3R-MCH-20-H,MCH-22-H,MCH-(23 or 24)-H2
Installer Requirement:Duct leakage<5%,Fan Efficacy(0.58W/CFM),Air Flow>_350 CFM/ton(or Standards Table 150.0-B/C alternative)
❑ 3.All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
Includes replacing or installing All New CF1R-ALT-02-E
Ducts'and one or more of the following: CF2R-MCH-01-E,MCH-20-H,MCH-(23 or 24)-H
Condenser Unit,Evaporator Coil,Furnace CF3R-MCH-20-H,MCH-(23 or 24)-H
Installer Requirement:Duct leakage<5%,Air Flow>_350 CFM/ton(or Standards Table 150.0-B/C alternative)
❑Exempted from duct leakage testing if existing duct systems are constructed,insulated or sealed with asbestos.
❑4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
Adding or replacing ducts in unconditioned CF1R ALT 02 E
space but less than All New Ducts' CF2R MCH 20 H
CF3R-MCH-20-H
Installer Required to:Duct leakage(<15%or,<10%to outside,or seal all accessible leaks)
❑ Exempted from duct leakage testing if existing duct systems are constructed,insulated or sealed with asbestos.
"All new ducting requires R-8 insulationwhen more than 40 ft installed in CZs 11&14-16 and R-6 in CZs 1-10,12&13,and R-6 insulation when less
than 40 ft installed.This includes in walls,between floors etc.
2A New Duct system is when the.duct system is constructed of at least 75%new duct material,and up to 25%may consist of reused parts from the
dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material. ,
3 R-2:8(1"thick insulation)for linesets 1"and less.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury,under the laws of the State of California: .
1. The information provided onthisCertificate of Compliance is true and correct.
2. I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts 1 and 6 of the California Code of Regulations(CCR).
4. That the energy features and performance specifications,materials,components,and manufactureddevices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and,specifications submitted to the enforcement
agency for approval with this building permit appl' : on.
Re ponsible Designer Name• Responsible I F::,..;:-- ignature: Date ign • License:
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J�mpany: . - Addr City/State/Zip: hone: '
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//=or assistance or uestions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300