B-2017-1716 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1716
20310 MICHAEL CT CUPERTINO,CA 95014-4423(369 36 025) G I A ELECTRICAL
AND SOLAR
SANTA CLARA,CA
•
95050
•
OWNER'S NAME: JU KEN JENGOW AND WANG DAPHNE LEI-HUNG DATE ISSUED: 10/05/2017
OWNER'S PHONE:408-896-1968 PHONE NO:(800)942-0094
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-20 Lic.#966747
Contractor G I A ELECTRICAL AND SOLAR Date 10/31/2017 _ X BLDG _ELECT _PLUMB
X MECH X RESIDENTIAL_COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
INSTALL MULTI-P=SPLIT D.AIKIIN SYSTEM
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.
fer2. I 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
permit is issued. Sq.Ft Floor Area: Valuation:$7500.00
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 369 36 025
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save•indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signa tf - Date 10-5-2017 Issued by:Kim Dunbar
Date: 10/05/2017
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 roofis
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: 10-5-2017
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
z. I have and will maintain Worker'sCompensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code',for the performance of the work for which this California Health,&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the.Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.;
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized age t
':APPLICANT CERTIFICATION 'Date: 10-5-2017
I certify that I have read this application:and state that the above information is CONS RUCTION 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 theperformance
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 abovelmentioned 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.
Signature Date 10-5-2017 Licensed
Professional
\ I / GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
/e.,flsT 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 MISC
CUPERTINO (408)777-3228•FAX(408)777-3333•building(ccupertino.or
['PLUMBING ®MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS 20310 Michael Ct. APN# 369-36-025
OWNER NAME Ken Ju PHONE 408.896.1868 E-MAI-kju666@gmail.com
STREET ADDRESS 20310 Michael Ct. , CITY,STATE,ZIP Cupertino, CA 95014 FAX
CONTACT NAME Mikhail Mayzles PHONE 510.387.8768 E-MAIL Mikhail@giapm.com
STREET ADDRESS CITY,STATE,ZIP FAX
1040 Di Giulio Ave Suite 100 Santa Clara, CA 95050
❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT M CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT ❑ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME GIA Power Management LICENSE NUMBER 966747 LICENSE TYPE C-20 BUS.LICE
COMPANY NAME GIA Power Management E-MAIL Mikhail@giapm.com FAX
STREET ADDRESS 1040 Di Giulio Ave Suite 100 CITY,STATE,ZIP Santa Clara, CA 95050 PHONE 510.387.8768
ARCHITECT/ENGINEER NAME N/A LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF LY SFD.or DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN fin(YES IS THE BLDG AN 0 YES
BUILDING: 0 COMMERCIAL URBAN INTERFACE AREA MI NO FLOOD ZONE NO EICHLER HOME? NO
DESCRIPTION OF WORK ,Installation of multi-split Daikin heat pump system for Air Conditioning
TOTAL VALUATION: $7500.00 RECEIVED
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the p perry owner'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 buildin• co I truction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Sig PP nature of A lican iymY / Date: 10/4/2017
SUPPLEMENTAL /14 ORMATION REQUIRED •
OFFICE:USE
L 1 ❑ OVER TME COUNTER x"
❑ EXPRESS
U �=
Ua STANDARD
a ❑`.LARGE
-1. MEPMiscApp_2011.doc revised 06/21/11
a Ir+Iturc.,,urvrcINuA
ALTERATIONS - HVAC
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#:
21931 44r`e4 e_ e.;(- C°u�peP-t+�,o t0-O S / 7 6-2017- 17�
D C.f G L/eNew:Ducting or Lineset Conditioned
Equipment T �cype/t j i4-t sell-. p Equipment Efficiency Required R-value Floor Area(ft2) Thermostat
❑ Packaged System 0 Evaporator Coil AFUE COP 0 R-6 (CZ1-10,12&13)Ducts Served by system 0 Setback
❑ R-8' (CZ 11,14-16)Ducts n_,4,2QA ftz (If not already
❑Split System 0 Condensing Unit Z7SEER /e 2 HSPF >_R-2.8 Lineseta present,must
❑ Furnace 0 Lineset EER be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below.At permit application this
form 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(515%or,5510%to outside,or seal all accessible leaks)
Exempted from duct leakage testing if:
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
sp ce,or 0 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building )
r 2.New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts2 CF1R-ALT-02-E-
`2 EQC1(P)vi j/1/ •CF2R-MCH-01-E,MCH-20-H,MCH-22-H,MCH-(23 or 24)-H
New N�D ac.)T-S• 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 CF
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.
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 on this Certificate 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 manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part Land Part 6 of the 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 application. '
Responsible Designer Na.rneA Responsible Design r Signature:. Dat Signed: License:
M(�e//t AyiL, M �l 2,nL�� �( r /Q��� p (off/Q c1/ (7 96 6�7477
Company I/1
a'j1. nrp t 7S( 4 �t ((c.Llt°lgU C /At/vI� `' `�71 Phon 1t� jLl /
For assistance or questions re r i Energy Standards,contact the Energy Hotline at:1-800-772-3300 ,
E.r..)trrnau E
/� SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
41-.10:\
-4` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333•buildings cupertino.orq
E
Pit7 PERMIT,O.ANNOZBE' ALED UNTIL'thiS CERTIFICATEjHA`S BEEN ,�
COMPLETED, IGNED ETU D TO ;G LDING DIVI ION
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 the X 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 Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that
do riot 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: 2-031 O BCH 1\a CT./ Cik,p. $ZAD t c4 '"1 w fr1` Permit No.S-20(44 ma
�ern aice
Specify Number of Alarms: #Smoke Alarms: " #Carbon Monoxide Detectors: I 3
I have read and agree to comply with th erms and conditions of this statement
Owner(or Owner Agents)Name: 10-1-2-017
au( Signature Date:
Contractor Name: A !'� n
I�I K H A I L. MAYZ LES SignatureAakl,A6C Lic.#9 ' Date:).0.. '2 1 7
i3/e-Io/C .O
Smoke and CO form.doc revised 01/10/2017