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B-2017-1802 • • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1802 10346 NORWICH AVE CUPERTINO,CA 95014-2446(316 29 095) CONVECTEK SUNNYVALE,CA • • 94085 OWNER'S NAME: VICKAM NAYAK DATE ISSUED: 10/20/2017 OWNER'S PHONE:415-608-7341 PHONE NO:(408)687-5754 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: • License Class C-20 Lic.#953068 Contractor CONVECTEK Date 10/31/2018 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 thatmy license is in full force and effect. JOB DESCRIPTION: REPLACE FURNACE(GARAGE) 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 he/Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3200.00 .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 316 29 095 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. Signat �% _ %ate 10-20-2017 Issued by:Kim Dunbar Date: 10/20/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ani 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. 1,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: 10-20-2017 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 a. 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• ager �Z APPLICANT CERTIFICATION Date:10-20-2017 I certify that I have read this application and state that the above information is CON 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 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 10-20-2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA.95014-3255 j" ,'h -- � sTr','sr? (408) 777-3228 • buil d.ing r>>cuPertino.orti PEMITB-toCUPERTINO REVS DEFS E NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ®MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS /0./t/ #10e A/ ' (4)/C \ ,4 APN A 3/ 2-c 0 5- OWNER NAME V i/ �� / PH 7 6166?^ 7. , /E-MAIL STREET ADDRESS /0 /('4 d CITY, STATE,ZIP 4 l C - /4, 6 c4 9r-o/ 1 )CONTRACTOR NAME 0 OWNER-BUILDER Q1A:1PA+r'R'ttl.°.fE;r� NOM,1ib, ( SEEADDRESSCITY ST E ZIP Izro ate fryr...a E-MAIL J Z 6 /BUS.LIC# 0 ARCHITECT ❑OWNER,❑OWNER AGENT ❑CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME E-MAIL ef,( s . • STREET ADDRESS CITY,STATE,ZIP 17 3 I 0 ` F/3 1N I • DECRIPTON r l/ ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET.SF USE TYPE OCC SQ.FT. VALUATION(5) 'REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING ❑YES EICHLER 0 YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS 0 NO ❑ NO ❑NO DWELLING SECOND DWELLING ❑yES ❑ATTACHED❑DETACHED OTHER UNITSa UNITADDITON: 0 N 5F POOLS1 0 FIBERGLASS 0 VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO 1 TOTAL-SF • REC Li T TtVV�TION: Commercial or Multi-Family buildings with Publir Swimming Pools requires Department of Environriienlnl Heath avnrovnl RE-RO OFI EXISTING ROOF TYPE: D BUILT-UP ROOF E ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE 0 NO IF NO PLYWOOD 0 1„ ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑yEs a OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF aof SQUARES By mysignature below I certify to 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 construction. I a representatives of Cupertino to enter the above-identified property for inspection purposes. I acknowledge and authorize . • ormation contained on this application form to be made available for public rae.r. Signature of Applicant/Agent,, . ./ Date:4"�'�ZU 2a>7 - SUPPLEMENTAL INFORMAON REQUIRED *New SFD/Second Dwelling Units/Multifamily 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 j. CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: Nayak,Vikram Date Prepared: 2017-10-20 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 Nayak,Vikram 02 Date Prepared 2017-10-20 03 Project Location 10346 Norwich Avenue 04 Building Type Sin' m_IIyy 05 CA City Cupertino 06 Dwelling Unit Name Iaakfn f Dwelling Unit Conditioned s •, / 8 •• LIP 07 Zip Code 95014 08 Floor Area(ftZ) R ��` ' OOr `'�/d'n9 D��'N Number of Space //.- 1�L; , �4 0 9nx �`�-germ 09 Climate Zone 4 • 10 Conditioning(SC)Systems in 11c ' O/j�� this DwellingUnit: �, r'''—;' �, -or- ""` •'' tF,; V��w�d ey. �" )DC7-71-,L f B.Space Conditioning(SC)System Information `. 1a 11 t `� 01 02 03 04 05 06 07 08 09 10L ,. a ,. y Is the SC� Installing a �` 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 System 1 Whole House 1552 Yes No Yes No No No Altered space 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-A020363291.A-000-000-0000000-0000 Registration Date/Time: 2017-10-20 08:05:18 HERS Provider:CaICERTS CA Building Energy Efficiency Standards_-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-20 11:05:01 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 All new No cooling This field or This field or This field or This field or System 1 Central gas heating AFUE 95 Central split component section is not section is not Setback section is not section is not furnace components AC altered applicable applicable applicable applicable Required Documentation: . CF2R-MCH-01-E-Space Conditioning Systems 'f• � . -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) flip_ - /` - CF2R and CF3R-MCH-20-H-Duct Leakage Test required when heating or cooling components are installed in ducted systems,or when more than 4e f a ttength is replaced -Leakage rate compliance:<=15%or<=10%leakage to outside,or seal all accessible leaks. ' j -.' ' ./ i ip CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered(applicable ink yl. &C// CF2RandCF3R-MCH-23 Airflow Rate>=300 CFM per ton required when MCH-25 is required. ��,�/� OCT /"9 be "IVO Exceptions: (• -Duct systems registered with HERS provider asitTh 'previously sealed are exempt from MCH-20 Duct Leakage Testing requirements vF/ o 2®'? a ent NaF .�lnM.c.. � .' F nc S -Heating-only systems and Air Handler Furnace changes do not require verification of Air Flow MCIi,23,br Refrigerant Charge MCH-25. -Existing duct systems constructed,insulated or sealed with asbestos are exempt from MCH-20 Duct$Leakage Testing-requirements eV/014:40k- y - - t ✓� ia E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections,1S0 2(b)1Dua and 1 CF 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-A020363291A-000-000-0000000-0000 Registration Date/Time: 2017-10-20 08:05:18 .. HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-20 11:05:01 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: �7 ��77- Frazier, Ken c.lCen c7razier Company: Signature Date: Golden State Energy Efficiency Services 2017-10-20 11:05:18 /e' Vfiker Address: CEA/HERS Certification Idents i oncable): 1463 Circus Ct. / i%t v City/State/Zip: Phone: �' a�;, F. Turlock CA 95380 209-667-2164 /?4:i, `'i' 0/+ `rU• dd/,�'��.bit, Responsible Person's Declaration statement ''' rd G•/ 9®ep I certify the following under penalty of perjury,under the laws`of the State of California: .Yep/. G9(' , 'l� /6) 1. The information provided on this Certificate of Compliance is true and correct. x'6'016 ��F 2. I am eligible under Division 3 of the,Business and Professions Code to accept responsibility for the building design or system design identified oniis C,e .' tgralpliance(responsible designer). 3. That the energy features and performance specifications,materials,components and manufactured devices for the building design or system design Id 'sed on thiss4 s icate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of,I gulations 3� r C� 4. The building design features or system design features identified or Phis Certificate of Compliance are vo tsi tentw'ththe information.provided on othet a plicable ofn ce documents,worksheets, calculations,plans and specifications submitted to the enforcementtagency forapproval with this building permit application. �1 5. I will ensure that a registered copy of this Certificate of Compliance shallbe:madle available with.the building permit(s)issued for thebuiild.(ng,and made available,to;the;enforcement agency for all applicable inspections.I understand that a registered copy of thisCertificate of Compliance is„requirred to bejncluded with the„documentation the budder provides to,,the building owner at occupancy. Responsible Designer Name: , Responsible Designer Signature: Hornung,Karl Company: Date Signed: CONVECTEK 2017-10-20 08:05:18 Address: License: 955 BENECIA AVENUE 953068 City/State/Zip: .Phone: SUNNYVALE CA 94085 408-687-5754 Easy to Verify E . r,. 0 at CaICERTS.com . in..: I. 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 I.. •.o q. Registration Provider responsibility for the accuracy of the information. ,• Registration Number:217-A020363291A-000-000-0000000-0000 Registration Date/Time: 2017-10-20 08:05:18 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-20 11:05:01 Schema Version:rev 10/16 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO N© 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq( cupertino.orq PERMIT CANNOT.BE FINALED UNTIL THIS CERTIFICATE"::HAS:BEEN: COMPLETED SIGNET;AND PLE- D T'D THE;BUILDING 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 alamis. 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 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 907.2.114 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 f�=� < / v' Permit No. !0/7""'1 ®2- Specify Number of Alarms #Smoke Alarms I 6 I #Carbon Monoxide Detectors I 1 I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: /C62 fr"/ r#71.1 G? Signature__ .... . Date: / /16 Contractor Name: CO`l VeCje Signature '97 Lic.# Cri.7668 Date: .//. Smoke and COform.doc revised 01/10/2017