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B-2017-1881 CITY OF CUPERTINO BUILDING PERMIT ' BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1881 11010 NORTHSKY SQ CUPERTINO,CA 95014-0565(316 40 065) RANDO AAA HVAC INC SAN JOSE,CA 95125 OWNER'S NAME: SUBRAMANIAN MANI AND SITA DATE ISSUED: 11/01/2017 OWNER'S PHONE:408-203-0287 PHONE NO:(408)293-4717 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-43:C-20 Lic.#768871 Contractor RANDO MA HVAC INC Date 09/30/2019 JX BLDG _ELECT _PLUMB X • I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH RESIDENTIAL_COMMERCIAL 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) 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 pensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance,as provided for by lc:6LSection 3700 of the Labor Code,for the performance of the work for which this p ermit is issued. Sq.Ft Floor Area: ' Valuation:$6195.00 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 40 065 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the 1 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 re .e.n per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. le o i`s gnature 1114 l--d/ Date 11/1/2017 Issued by:AbbyAyende I Date: 11/01/2017 OWNER-BUILDER DECLARATION I hereby affirm that Y am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: 1: ' 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:11/1/2017 . 1 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 ections 2550:,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be be deemed revoked. a'Owner or authorized agen . "T. .�ii APPLICANT CERTIFICATION Date:11/1/2017 V I certify that I have read this application and state that the above information is CONSTR. TION 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 cityy 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 11/1/2017 Professional 'CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ®"BUILDING DIVISION ® , °•10300 TORRE AVENUE©°CUPERTINO,CA 95,014-3255 ' (408)777=3228 building@cupertiino:org 13.SEMI T#g,- CUPERT`INQ REV# . DEE ❑°NEW CONSTRUCTION,CJ-ADDITION Q ALTERATION ❑'T.I. Q 1Vl)✓P, ❑•RE=ROOF` Q SWIMMING POOL/SPA ' PROJECT ADDRESS I I�, ""tin APN�: OWNE�ra 8 ' 1 Clet Roil /I ,/� �, E-MAIL'° STREE , DDR S C J A/-11y-hvi iP cpt �� 1 1��1 '4J ANY NAME LI DlER a S C NTRACrOA ❑OINNER:BUILD CO . LICENSE TYPE • tr 1 ft fori.tc luflt . _C 311.G7,0 , 1 , STTtI;� ADDRESS CI STATE, ZIT" --- I , ,: I� S1oriri41 QS J o c; �,SE2-- E= IL ^, •PHOA • BUS.LIC 8 0 ARCHrTNCT 0 OWNER ❑OWNER T.ENT i I CONTRACTORAGENT❑ENGINEER 0 DEVELOPER 0 TENANT . ., . ,. . CONTACT NAME,, ��rA 1, • �0 E-MAIL, I t Vp 1. " STREET o•' ° ATE,7 t ' 1. _ t,r C13 �• DECRIPTON; i .,p �� t , it j , ❑SINGLE-FAMILY/DUPLEX ,*MULTI=FAMILY ,❑INDUSTRIAL ❑COMMERCIAL ' ' 'EXISTING USE EXLSTINGSF NEW-FLOOR'SF PORCH SF DECK SE' DEMO SF STORIES'ATOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(8)„ I REMODEL REMODEL•KITCHEN. REMODEL'OTHR •GARAGE 0 ATTACHED BATHROOM SF . SF : SF' SF ❑DETACHED • ° I EXISING ❑YES EICHLER ❑YES' SECOND STORY ADDITION, ❑YES - 44 FIRE'SPRINKLERS❑"NO ❑.NO ❑NO _ DWELLING', SECOND DWELLINGS DYES ❑ATFCH AED❑DETACHED OTHER - ^ ` UNITS# UNI ADDITON , ❑No` ° , ,SE : _ m , POOLS .D.FIBERGLASS"❑VINYL LINED;❑,"GUNITE "❑PREFABRICATED' `° ,R,001.:-$R.• --- SI'A-SF -"•J SPA ATTACHED OYES.,❑NO ,��,TOTAL-SF - • ON: 'REC V.ED BY: T 11 Cmn+riiranMrM:,lhFmm1e13ruldmesu+thPutLtSw:m+ningPools rc2urresDeparlmootofEnvironmeufal.Heath approval Q_Q �p1QTLV `', � I gAirki RE=ROOF EXISTING ROOF TYPE' IDBUILT-LT ROOF'[]-ASPHALT SHINGLES Q WOOD SHAKES r],WOOD SHINS Q TIL - OTT•IER(SPECIFY) REMOVE,/REPLACE,Q^NO IFS LAYERS '. THICKND ESS 05/6.. P❑OSBD❑E: O_THIIZ •PITCH: ° 1, ROOT CLASS' • 9� • • ❑YES ❑ . A, ; PROP,OSEDROOFTYPE:';❑EUILT-UP-ROOF DASPHALTSHINGLES 0 WOOD-SHAKES:WOOD'SHINGLES ❑'.OTHER• • . - *Prrovide a signed copy of the Cupertinq s Tear Off Pokey ' SF #oISQIi RES"' By,iny signature below I certify to each,of the.following: "I am the property owner or authorized agent to actor the,p%opertyowner's behalf, I, have read this application arid the informationI have provided is Correct.-I have read the Description of Work and verify itis accurate: I'agree. .- comply with all applicable'local ordinances and state laws relating.to building construction. T.authorize representatives of Cupertino to enter the above-ideii ified.property f• '. •,ection.purposes. I'acknowledge and authorize all iinforination costa ned'On,this'applicatiori form ', to be Made available P for ublicteco ` 'Signature of Applicant/Agent:" .13 �1Z _. /I Date:.. . SUL'PL1 IVIENTALINF,OAMATION RE 1 IRED *New SI'D/Second,Diveihng Units/Multifamily Dis ethngs: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. *I OA,Provide,a letter<of approval from the Home Owner's,Association ' ' B.ldlg4pp 2O Z..doc�resised 08/01/17'- - CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: MANI SUBRAMANIAN Date Prepared: 2017-10-04 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 MANI SUBRAMANIAN 02 Date Prepared 2017-10-04 03 Project Location 11010 NORTHSKY SQ 04 Building Type Multi-family 05 CA City Cupertino 06 Dwelling Unit Name MANI SUBRAMANIAN 07 Zip Code 95014 08 Dwelling Unit Conditioned 1060 Floor Area(ft2) Number of Space 09 Climate Zone 4'y ' 10 Conditioning(SC)Systems in 1 this Dwelling Unit: -- .. .e. . B.Space Conditioning(SC)System Information . � .. 01 02 03 04 05. 06 07 08 4 09 10 histhe SCM Installing.a . ;"" fti, ,_.1 ,t i L, 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 TRANE WHOLE HOUSE 1060 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-A020342135A-000-000-0000000-0000 Registration Date/Time: 2017-10-04 04:26:44 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-04 07:27:00 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 Central gas Gas furnace Central split No cooling This field or This field or This field or This field or TRANE AFUE 81 component section is not section is not Setback section is not section is not furnace AHU AC altered applicable applicable 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 whei 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 fro MCH-20 Duct Leakage Testing requirements ,.,. -Heating-only systems and Air Handler Furnace changes do not require venficat n of Air FlowMC t23 or Refrigerant Charge MCH 25; '" , -Existingduct systems constructed,insulated or sealed with asbestos are exem tfrom MCfI-20 Duct Leaka a Testin re uirements. Y s. � �M �rr g g G �. ��, E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150 2(b)1Diia 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-A020342135A-000-000-0000000-0000 . Registration Date/Time: 2017-10-04 04:26:44 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-04 07:27:00 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: t TQC Rondo,Eric Company: Signature Date: RANDO AAA HVAC INC 2017-10-04 04:26:44 Address: CEA/HERS Certification Identification(if applicable): 1712 STONE AVENUE N/A City/State/Zip: Phone: SAN JOSE CA 95125 408-293-4717 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 Complianceis true and correct. 2. I am eligible under Division 3 of 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 bwldm 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 on this Certificate of Complianceare consistent with the information provided ontherappticali(e ornpliance documents,worksheets, calculations,plans and specifications submitted to the enforcement agency fora oval with,this buildingpermitit applicati h. - 5. I will ensure that a registered copy of this;Certificate of.Corrapliance shall be niaderavailable witl (ie buildingp?tmit(s)issued fortheiliblamg,and lade availab e,to the,enforcement agency for all applicable inspections.I understand that a registered copy of this Ce ificate of Compliance is,required to bejncluded with the documentation the builder provides to the budding owner at occupancy. Responsible Designer Name: Responsible Designer c SEignaYure: Rando,Eric . Eif: 90/- 41, Company: Date Signed: RANDO AAA HVAC INC 2017-10-04 04:26:44 Address: - . _ License: 1712 STONE AVENUE - - - - 768871 -- -- - - - City/State/Zip: - - - - - - Phone: - SAN JOSE CA 95125 408-293-4717 Easy to Verify ; at CaICERTS.com Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies • L:q.; - -- Registration Provider responsibility for the accuracy of the information. Registration Number:217-A020342135A-000-000-0000000-0000 Registration Date/Time: 2017-10-04 04:26:44 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-10-04 07:27:00 Schema Version:.rev.10/16 -