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B-2017-0051CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0051 10700 CARVER DR CUPERTINO, CA 95014-3609 (375 32 012) A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC MEMPHIS, TN 38120 I OWNER'S NAME: HUBER JEANNETTE TRUSTEE I . I DATE ISSUED: 01/09/2018 1 OWNER'S PHONE: 408-257-7437 I- I: I W411VANIM111- License Class Q -M Lic. #742039 ContractorA R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC Date 10/31/2019 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. 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. 2. 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 1(/ permit is issued. _,,1C 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 and state laws relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per th%Cupertino Municipal Code, Section 9.18. Signature Date 1/9/2018 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 2. 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. 3. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 and state laws relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. PHONE NO: (408) 283-9536 PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE WALL HEATER - SAME LOCATION (LIVING ROOM) Sq. Ft Floor Area: I Valuation: $4222.22 APN Number: Occupancy Type: 375 32 012 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: AbbyAvende Date: 01/09/2018 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 1/9/2018 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent Date: 119/2018 CONSTRUCTION LENDING AGENCY 4- hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION understand my plans shall be used as public records. CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT * BUILDING DIVISION 10300 TORRE AVENUE e CUPERTINO, CA 95014-3255 (408) 777-3228 * building@cupertino.org PEMIT #B - 2-0 It CUPERTINO I REV# DEF# ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION ❑ T.I. ❑ MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA a PROJECT ADD) APN # L � GZ e/L OWNER NAW— PHONE Zf E- 27Z STREET ADDRESS CITY, STATE, ZIP ONTRACfOR NAME ❑ OWNER -BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE �S 7 � �`Z �" Z 0 STREET ADDRESS CITY, STATE, ZIP _ 9 S cam. i 3 E-MAIL PHONE BUS. LIC # A v ❑ ARCHITECr ❑ OWNER ❑ OWNER AGENTFCONTRACTOR AGNPIr❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTACT NAME E-MAIL IQ STREET ADDRES�1 _ � tlL_/ CITY, STATE, PHONE h� � C (J i J DESCRIPfON Q C e ZZ, 9 CK1NGLE-FAM[LY/DUPLEX ❑ MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE EXISTING SF NEW FLOOR SP PORCH SF DECK SF DEMO SF STORIES # TOTAL NET SF REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ ATTACHED BATHROOM SF SF SF SF ❑ DETACHED EXISING ❑ YES FIRE SPRINKLERS ❑ NO EICHLER ❑ YES ❑ NO SECOND STORY ADDITION ❑ YES ❑ NO DWELLING SECOND DWELLING ❑ YES ❑ ATTACHED ❑ DETACHED OTHER UNrrS # UNIT ADDITON: ❑ NO S F I POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED POOL - SP SPA - SF SPA ATTACHED C3 YES ❑ NO TOTAL - SF Commercial or Multi -Family Buildings with Public Swimming Pools requires Department o(Environmental Heath apyroaal RE7fVED BY: L VALUATION: l RE -ROOF EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES[] WOOD SHAKES ❑ WOOD SH[NG- ❑ THE OTHER (SPECIFY) REMOVE /REPLACE NO IF NO PLYWOOD ❑ W E]3/8" PLYWOOD TYPE: PITCH: ROOF CLASS 13 YES # OF LAYERS I THICKNESS ❑ 5/8" OTHER [-]OSB ❑ CDX OTHER 1 -12 A PROPOSED ROOF TYPE: ❑BU[LT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF #of SQUARES By my signature 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 authorize representatives of Cupertino to enter the above -identified property for IS ec ' ores. I acknowledge and authorize all information contained on this application form to be made available for public record. Signature of Applicant/Agent: Date: j SUPPLEMENTAL INFORMATION 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.doe revised 08/01/17 ALTERATIONS - HVAC CEC-CF1 R -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#: .0 Equipment Type /7 7� Equipment EfficiencyNew: SY Ducting or Lineset Required R -value _G/� Conditioned 2 Floor Area (ft ) Thermostat ❑ Packaged System ❑ Evaporator Coil%FUE COP ❑ R-6 (CZ 1-10,12&13) Ducts Served by system ❑ Setback ❑ Split System ❑ Condensing Unit SEER ❑ R-8' (CZ 11,14-16) Ducts z d n _ft2 (If not already HSPF ❑ >_ R-2.8 Lineset3 present must El Furnace ❑ Lineset EER Ibe 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 (< 15% or, 510% to outside, or seal all accessible leaks) Exempted from duct leakage testing if: ❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building__ 112. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New DuctsZ CF1R-ALT-02-E CF2R-MCH-01-E, MCH -20-H, MCH -22-H, MCH -(23 or 24)-H 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 150.0-13 / C alternative) ❑ Exempted from duct leakage testing if existing duct systems are constructed, insulated or sealed with asbestos. 114. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in unconditioned CF1R-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. Z A 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. 3 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 inforrriation provided on this Certificate of Compliance is true and correct. 2. 1 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 1 and 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 Name: Responsible Designer Si Da e Si e : License:/Z 9 , y ) VV Ad ress: State/Zip: _ Phone: 139 ' conn y : ')� D - For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300