The URL can be used to link to this page

B-2017-1729 • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1729 1044 TUSCANY PL CUPERTINO,CA 95014-4352(359 29 039) ATKINSON . CLIMATROLLERS INC SAN JOSE,CA 95112 OWNER'S NAME: HOM JOHN AND ANGELA C TRUSTEE DATE ISSUED: 10/06/2017 OWNER'S PHONE:408-368-1731 PHONE NO:(408)294-6290 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC=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);(N)INSTALL AC UNIT I hereby affirm under penalty of perjury one of the following two declarations: (BACKYARD) 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. • Rife f I have and will maintain Worker's Compensation Insurance,as provided for by (�Yl(� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$10071.00 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 359 29 039 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. Signator ` � � '�" �� Date 10-6-2017 Issued by:Kim Dunbar Date: 10/06/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ant 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:10-6-2017 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 912 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 agent• et -/Zeri �✓//(il/'�� APPLICANT CERTIFICATION Date: 10-6-2017 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 918. I understand my plans shall be used as public records. Licensed Signature • Date 10-6-2017 Professional -„..\\‘ 1,/, GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,r.„ 's 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 MISC (408)777-3228•FAX(408)777-3333•buildinga.cupertino.orq CUPERTINO ❑PLUMBING El MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS L0 _1i PROJECT ADDRESS 10 14 4 T 15 6�r)1/) I L APN# 3 (J- ...42...q 6 3 9 OWNER NAME 0 -I�J Q (J PH`E� _ f 7 3 q E-MAIL STREET AD?RRE k.1 Tus c,wpl0Sy fl CITY STATE,ZIP FAX CONTACT NApq zir V ~ tic" 16/ / I U I PI IONti 0 /J 1 zi J(Li O E-MAIL II I a�(le is e,votl(e) �,e 1,,„ dr. STREE l / ESS to (.1 VI 54 CI P STAT ZI J 0,5' ., 95 (1 -2 tel�{ FA . 0?_ 6 g C.i 1 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR ME / LICENSE NUMBER LICENSE TYPE BUS.LIC#Li NAME� �k- Vg 11 e e,41Ao -zs 15 ii-0 f�zo FAX (, 0 0 o 0l� COMPANYV al l ,�+7 ��--�1 vi/y/ E-MAIL�� 'I!�1 e�Seva 1��onLa�1 ✓�9au�w� "I �J 2�-6��2-�40 STREET �DiSI VVl L Y1 1 V CITY, S TE�PGJOS� cA /�51.5.1.12.- PHO o _2.504 —6,..z., O / I�F ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ,FD or DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND 0 YES PROJECT IN 0 YES IS THE BLDG AN 0 YES BUILDING: 0 COMMERCIAL URBAN INTERFACE AREA 0 NO FLOOD ZONE 0 NO EICHLER HOME? 0 NO DESCRIPTION OF WORK Ld,Vz_ , f r °/ Q- l ^ 6 t°s (5�� /O /�4 f 0 c! W r1 lJ ' 1 L V J Acr— s sr ..s s t TOTAL VALUATION: 5 \Q Q-7( 0 .0 R C)~t�,. t 11Y ; F :*,, .t.<' By my signature below,I certifito 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. 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 con tructtiion. I aauuthorize representatives of Cupertino to enter the above-identified property� for inspection purposes. Signature of Applicant/Agent: c.�/lj / V hC/ - Date: `.-v SUPPLEMENTAL INFORMATION REQUIRED _ KE s bN1 414,.. C , spy`§_,,r;g3a,,.,,,,w ,,,, q"t �#, ,,,,,, .t r,,,,,,,,-Q'EXPRESS x ,,z, , 4 *4'l AxRII- r , 3' -} k' as$s 3 ;,„A.MAJOR;.f ,.., `. -,:a. MEPMis cApp_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: 2017-0279 John Horn Date Prepared: 2017-10-05 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 2017-0279 John Horn 02 Date Prepared 2017-10-05 03 Project Location 1044 Tuscany Place 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 2017-0279 John Horn 07 Zip Code 95014 08 Dwelling Uni ZConditioned 2000 Floor Area(ft2) • Number of Space 09 Climate Zone 4 10 Conditioning(SC)Systems in 1 this Dwelling Unit: B.Space Conditioning(SC)System Information , 4t. ttl 4 l ,*DKV 01 02 03 1.&:" �� 04 `� 05� � X06 ' 07 08 a09 10 Is the SC F Installing',a ,, _ ,. 1.,.‘„? r 7*, 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 Furnace Altered space replacement add whole house 2000 Yes Yes Yes No No No A/C 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-A020344459A-000-000-0000000-0000 Registration Date/Time: 2017-10-05 09:39:24 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-05 12:39:42 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 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 Furnace ' All new All new This field or This field or replacement Central gas Central split heating AFUE 81 cooling SEER 14 Setback section is not section is not add A/C furnace components AC components applicable applicable Required Documentation: CF2R-MCH-01-E--Space Conditioning Systems -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 when.heating 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 outside;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 per ton'required;;when•MCH-25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH-20 Duct Leakage Testing requirements -Heating-only systems and Air Handler Furnace changes do not requireverification of Air Flow MCH-23r or Refrigerant Charge MCH 25 -Existingduct systems constructed,insulated or sealed with asbestos are exem 4tafrom MCI 20 Duct L aka a Testm a uir meats ' '� �� E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections.15O 2(b)1Diia andy,1.50.2(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-A020344459A-000-000-0000000-0000 Registration Date/Time: 2017-10-05 09:39:24 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 - - Report Generated:2017-10-05 12:39:42 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: a ,/O �yU.el Faulkner,Cindy l Company: - Signature Date: - ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2017-10-05 09:39:24 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 and correct. 2. I am eligible under Division 3'o€the Business"and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer). . 3. That the energy features and performance specifications,materials"components and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the. " requirements of Title 24,Part 1 and Part6`of the California:Code of Regulations. ' 4. The building design features or system design features identified ori;his Certificate of C mpliance are consisteat4with the information provided on other applicable o npliance documents,worksheets, I calculations,plans and specifications submitted to the en#orcementagency for`approvalpirth this buildg p inermit application. 5. I will ensure that a registered copy of this Certificate of Cot)ipliance sl all be made;available witty the buildin'gpermit(s)(issued forthe bedding,andmade available to theenforcement agency for all applicable inspections.I understand that a registered copy of this Certificate of Compliance)s.requiirred to be included with they documentation the builder provides to_the building owner at occupancy. Responsible Designer Name: �� j :its:, � Responsible DesigrerSgnature. •y s �� p Faulkner,Cindya �Cl�!?/l2Ph C�UY Company: Date Signed: QOC� ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2017-10-05 09:39:24 Address: License: 1171 NORTH 4TH STREET 258540 - City/State/Zip: - - --__ _ Phone: SAN JOSE CA 95112 408-294-6290 Easy to Verify ', r. at CaICERTS.com ;_r tiLr Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies -0 :'e Registration Provider responsibility for the accuracy of the information. Registration Number:217-A020344459A-000-000-0000000-0000 Registration Date/Time: 2017-10-05 09:39:24 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 - Report Generated:2017-10-05 12:39:42 Schema Version:rev 10/16 - FELE ' SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE tas� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildincK cupertino.orq PERMIT CANNOT BE` IALED UNTIL:THIS L ;RTIFICATE.HAS.BEEN: COMPLETED,SIGNED,AIN])RETURNED TO I lIE BUILDJNG DIVISION 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 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 whererepairs 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 Address: /0 1749- $ Cm-u Permit No. -7-'0)7'1724 Specify Number of Alarms #Smoke Alarms #Carbon Monoxide Detectors I I I l have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's) Name: C s" 44-041A Signature iF Date:/0-111--17-17 Contractor Name: Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017