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BLD-2021-2354 AC Sound Rating WorksheetG:/Planning/AC Sound Rating Worksheet/ - revised 09/16/20 Step 1: Select scope of work: Step 2: Select Make and Model of A/C Unit. Enter Make and Model of unit(s) then enter maximum A/C Unit Sound Rating from manufacturer’s specifications: *Make: *Model: *Sound Rating: db *Make: *Model: *Sound Rating: db (For unit #2) Step 3: Enter minimum Sound Blanket Sound Rating from manufacturer’s specifications, if used: Sound Blanket Rating: db (–) Sound Blanket Rating: db (–) (For unit #2) Step 4: Specify distance from closest property line to nearest face of unit(s): feet inches Distance Factor, DF = – 20 * Log ( 0.3048 * ) – 8 = db (–) Step 5: Location of unit(s). Choose which image best indicates the location of your unit: Location Factor, LF = db (+) Step 6: Do you have a solid Concrete Block or Masonry wall a minimum of 6 feet in height along the property line closest to the A/C unit(s)? Yes No Wall Factor, WF = db (–) Sound Pressure Sound Pressure Level ÷ 10 (Unit #1) Level ÷ 10 (Unit #2) EFFECTIVE SOUND RATING = db = 10 x Log [ ( 10) + (10) ] √ COMPLIES ADDRESS: BP #: I have reviewed the information on this form and certify the information provided to the best of my knowledge is true and correct. I understand an authorized representative of Cupertino may provide an on -site verification prior to the final inspection of the project. Owner or Owner’s Agent’s Signature: ....................................................................................................................... Date: .............................. AC UNIT SOUND RATING WORKSHEET COMMUNITY DEVELOPMENT DEPARTMENT • PLANNING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3308 • FAX (408) 777-3333 • planning@cupertino.org Arnold Hom 11/30/21