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B-2017-1589 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1589 20835 SCOFIELD DR CUPERTINO,CA 95014-2922(359 12 007) ATKINSON CLIMATROLLERS INC SAN JOSE,CA 95112 OWNER'S NAME: HWANG MAY-SHINE TRUSTEE&ET AL DATE ISSUED:09/15/2017 OWNER'S PHONE:858-999-1218 PHONE NO:(408)294-6290 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic.#258540 Contractor ATKINSON CLIMATROLLERS INC Date 12/31/2018 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(SAME LOCATION);REPLACE A/C(SAME I hereby affirm under penalty of perjury one of the following two declarations: LOCATION) 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 ' erformance of the work for which this permit is issued. `.'' I have and will maintain Worker's Compensation Insurance;as provided for by rr� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7401.00 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 ol-dinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 12 007 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the e�Cutp/eerrtino Municipal Code,Section 9:18. 180 DAYS FROM LAST CALLED INSPECTION. S'_mature s/'-ei `� Date 9/15/2017 Issued by:Abby Ayende Date:09/15/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:. following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 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:9/15/2017 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 shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shallG_fJ7TC! �l, be deemed revoked. �•�e ereor authorized agent: APPLICANT CERTIFICATION Date:9/15/2017 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and 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 9/15/2017 Professional i6-1o14 - 15q s'�Lir f GENERAL PERMIT APPLICATION M E P , _-/v . COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �yt 9,,.' 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(a cupertino.orq II/ IS C CUPERTINO ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL El MISCELLANEOUS ,i 104-OPROJECT ADDRESS 2.dO I 5 S G I !1^ I A n r" APN# G4 ,-11,004- OWNER WNER NAME 111���Q /1I� a� kt 'Of nt PHO _ `�1)1�IAIL STREET ADDRESS ,1 6 3 JjGA.' t D CITY, �iV STATE,ZIP4.� C ni ) FAX CONTACT ME C—/ V. PH�N u, JhR /16 �f t11rMAIL lJ dd�,� C�i� �"V�lie N4ry EjQ(J—2�LFO IQ C a,t11&15 Vol 1l ASV h4jr62l STREET ADDRESS CITY,STATE,ZIP FAX •J 1 I I s d.� Joe, G . °l So 1 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT /CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAgQEn�\e-_, ✓1/��� (J //////H ettoill/( n LICENSE NUMBArE��0 LICENSE TYPE ..2....0 BUS.LIC# /J58 5 4 /ICOMPANY NAME v v 'H1 EMAIL "' S! FAX /J b/ OICIAfteil V G. kit/ !)2 0 IIII STREET ADDRESSlti 5_1CITY,STATE,ZIP 511 PHONE n _ _,,‘.- 0 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DUPLEX 0 MULTI-FAMILY PROJECT INWILDLAND ❑ YES PROJECT IN 0 YES' IS THE BLDG AN 0 YES BUILDING: 0 COMMERCIAL/� URBAN INTERFACE AREA ❑ NO FLOOD ZONE 0 NO EICHLER HOME? 0 NO DESCRIPTION OF WORK n �� G��� L '^ „ 0, I 91(1)/ [c„Q, ° r Go i d t4]lam in GSo�,pyt (,o Gcv Poll1 l f TOTAL VALUATION: 141 L0 A.U 1 J ,RE IVEDDBBY r� q ,..v' / �,1,�'r 1[ l 1 V By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property ow a er's beha f.' 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 brlcfur structiOn. I aut� a representatives of Cupertino to enter the above-id 1 tified property for inspection purposes. Signature of Applicant/Agent: GJVT ICpiGY/�^ Date: 7/J JL �� 1 Z 'SUPPLEMENTAL INFORMATION REQUIRED O� O ,*.j7LY::::1*.;ip,44,7,,,5:::, -� 4'''`0 F � MEPMiscApp_2011.doc revised 06/21/11 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: 2017-0226 Mayshine Hwang Date Prepared: 2017-09-14 A.General Information CF1R-ALT-02,is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented,use one CF1R-ALT-02 document for each dwelling unit. - - -- -- — ----- ---- - -- -- 01 Project Name 2017-0226 Mayshine Hwang 02 Date Prepared- 2017-09-14 03 Project Location 20835 Scofield Dr 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 2017-0226 Mayshine Hwang _ 08 Dwelling Unit Conditioned 07 Zip Code 95014 1913 Floor Area(ft2) Number of Space - 4 r, "` � 09 Climate Zone , �� v`wT`0; 10 Conditioning(SC)Systems in 1 this Dwelling Unit: e y t , it, ¢ ''''''",'A' Ni �`,1 is 4-4'4" --- B.Space Conditioning(SC)System Information 01 02 ; 03 ;11, 04 05 X 14, 06 07 08 0 10 ,� ,, ;. at' � sad ;+''� N^ �`�^"���. v. e s". .. �r •,;. '`'Is the SCS jIn talling.a ;, LA' _` SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Replace Furnace and Air Whole House 1913 Yes Yes Yes No No No Altered space Conditioner conditioning system C. Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib) - - This section does not apply to this project. Registration Number:217-A020317066A-000-000-0000000-0000. Registration Date/Time: 2017-09-14 10:40:42 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-09-14 10:41:12 Schema Version:rev 10/16 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 3) D.Altered Space Conditioning System(Sections 150.2(b)1E and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling I System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components' Type Value System Type Components Type Value Type Duct Length R-Value Replace Furnace All new All new This field or This field or and Air Central gas heating AFUE 80 Central split cooling SEER 14 Setback section is not section is not Conditioner furnace components AC components applicable applicable Required Documentation: CF2R-MCH-01-E-Space Conditioning Systems .A -Duct insulation requirement for the new portions of supply air and return-air ducts or plenums:R6(CZ 1-10,12 and 13)and R8(CZ 11 and 14-16) CF2R and CF3R-MCH-20-H-Duct Leakage Test required whenheating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced -Leakage rate compliance:<=15%or<=10%leakage to outsitie;.or seal all accessible leaks. CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15). CF2R and CF3R-MCH-23 Airflow Rate>=?300 CFM pertonErequirred when MGH-25-is required Exceptions: NM! .'-- ,-,lrzf , --- -Duct systems registered with HERS provider as pre,iously sealed are exempt fro MCH 20 Duct Leakage�Y g requirementstenwa a , , -Heating-only systems and Air Handler Furnace changes do not-14, Fe Verification of Air Flow MCHi23 o'r efrigc1a t Charge MOH 2 i ) . 1 -Existing duct systems constructed,insulated or seated with a5ltest : re exemptfrom MCf-i 20 u 14#age Testing r#quiremeft s. 4 } ' t ;3 3 .cs as �" W xh f;W: s� KV ,:s; E. Entirely New or Complete Replacem.ent Duct Syst4vaem,w th or without Equipment Changeout(Sections 150 2(b).1Dn .and,�150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System(Section 150.2(b)1C) This section does not apply to this project. Registration Number:217-A020317066A-000-000-0000000-0000 Registration Date/Time: 2017-09-14 10:40:42 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-09-14 10:41:12 Schema Version:rev 10/16 CERTIFICATE OF COMPLIANCE ' CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. I certify that this Certificate of Compliance-documentation is accurate and complete. Documentation Author.Name: Documentation Author Signature: ��,,��Q� Faulkner,Cindy - .- CJ'GCGGC/> li. Company: Signature Date: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2017-09-14 10:40:42 Address: CEA/HERS Certification Identification(if applicable): 1171 NORTH 4TH STREET City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 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 nd acorrect 3 o 2. I am eligible under Division f the usiness and Professions Code to,acceptrasponsibilityfor the building design or system design identified on this Certificate of Compliance(responsible designer). 3. That the energy features and performance specifications,materials'corn pgnents and manufactured devices foci a budding design or ystem design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Parf,6ofthe California Code of gillations ' ��f* �x 4. The building design features or system design features identified ori his Certifca�e bf ompliance areo nsistetitwit he inf rmataon'41,provided on tithe ap icab a to npliance documents,worksheets, calculations,plans and specifications submitted to the 6aforcemenf agency for"approvaLwr this building permiit application: - PI 5. I will ensure that a registered copy of tfi s Certificate df Compliance shall kre h ktrAv„aileble wttiyt re,a cp g,p rmit(5),issu tl fortjta,aid ri ancfriaite ava,)vablekfijienforcement agency for all applicable inspections.I understand that a registered copy of thisCe ificate of Cornpl'ance(s,requiredto be�included ith the docume�ttation the builder provides t Qi,e bujldmg owner at occupancy. -- • -si a Responsible Designer Name: •� � � ;" , Responsikile Designer Signature. i�. �r7L7 Faulkner,Cindy Company: Date Signed: • ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2017-09-14 10:40:42 Address: License: • 1171 NORTH 4TH STREET 258540 City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 — Easy to Verify ■ i at CaICERTS.com �"ler- �,. iii••tel, 7r ppaY� Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies .i o Registration Provider responsibility for the accuracy of the information. Q'- ; •+' Registration Number:217-A020317066A-000-000-0000000-0000 Registration Date/Time: 2017-09-14 10:40:42 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-09-14 10:41:12 Schema Version:rev 10/16 fi '4 SMOKE / CARBON MONOXIDE ALARMSt, WI 1 OWNER CERTIFICATE OF COMPLIANCE `..4,y'"1.,0 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinnacupertino.orq F" PERMIT CANNOT BE FINATQED UNT L HIS CERTIFICATE'HAS BEEN s dd C©MP TED,SIGNED,AND TT NED TO THE BUILDIN D ISI© 1 --. •�,.., .,s,..... .,.. .>.�, �.� �.,..,��, tri , , PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314,R315,2016 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions; alterations,or repairs to existing dwelling units exceeds $1000.00, CRC Section R314,R315, 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 theX X bedroom(s)—(Smoke alarms shall not be located within 3 feet of bathroom door) On every level of a dwelling unit including basements and-habitable attics X X Within each sleeping room X Carbon Monoxidealarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above-referenced property,I hereby certify that the.alarm(s)referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational , as of the date signed below. n Address: 49-0(81)S-- S Cm--q ( enc' h o ti Cet Permit No. Q"daf-l Specify Number,of Alarms: #Smoke Alarms: 1 - - I #Carbon Monoxide Detectors: I 1 I I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's)Name: Date: C. `o 4.V11\es.4)Signature r �' ontractor ame: U Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017