S 3192 l
APPLICANTTO FILL IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
F1,W11-1)
QP CUPER'I'INO Iti111,DING-ItLIiC'I'NICAI. PIT I�yIT NO, 3192 1 9 w
DINGDIVISION APPLICATIONIXERMYL PLlA1RING-MECHANIFIC l\l •LJ
BUILDING PROJECT IDRMI'IFICAq'ION
G AOIIRIitiS: / JSANITARY NO. APPLICATIONSUBMIl'1'ALIIAIE
� +M1fE' PHONE: CONDRAC'R ARS NAMIS LIC NO',
Ke NIC CON'IXOL#
CI I VGINEER: LIC NO, ADDRESS. ❑ D
_ONUACl': PHONE: DUIIAI C.PERMIT INFO
ry O ❑ Consultant Fees Paid by Applicant(Initial) B,L_IXI ELECT' PLUMB MCCCHH
%—O _
LICENSEDFCOINTRACAGRS DECLARATION 0r - HLECPRIC PERMIT, FL'E {
I hereby a0'n,tbtl r 1 p felt,pteri(atone s - - JOB DESCRIPTION
Od'Z with Section 20081 nfD vi,i 3of the Hua newsand Pr f -. C e, i ylice et
4100 w+ PERMIT ISSUANCE ' 0 ��'
C U F m full fees td elFe t m pl FOWL ❑KITCHEN REMODIiI.
QUU hirensc Claa Lic.# APPLIANCES-RESIDENTIAL CADDITION O PLUMBING RE PII'1E
F�j Is1 Dam _nnlNeml
'z`d ARCI I fI'EC'1'SDIiCLA I OMllla'I-0NIT ❑S"FRUCI'URAI.
z ONz IuMemmndni, to"WIi beasedaxpublic t...ds PANE?LS M(IDIPICATION
'/� UP TO 200 AMPS
❑
O Z'-0 INI'I?RIOR CIIIM1iNIEY REPAIR
F[�=W Lieeued Professional 201-1(MAMPS IAI'ROVIi.MENT O SWIMMING 11001S
s� ; OWNER-BUILDER DEChARA'I'ION OVER IOW AMT'S _ ATH RP DF.IIItEPA1R 0 DEMOLI'T'ION
C�Q I hereby affirm that I amu exempt from the Garroter',Licence Law for Elm
OyU following rerv.a.ISCcaion 20315,Business and Professions Ctxle:Any city or county
SIGNS ELECTRICALal O y which require,a Ix.it to con,l uci,alter.Improve,demolish,nr repair any analme
priort)its issuance. I. requires the applicant fsuch fiction t The gWsttement SPECIAL CIRCU[TIM ESC.
}
In.,he is licensed pti (be Provisions oi0 C ancou s1' Law Comic,
16aG0� fmannam ng with Sectio 20001ne D-vision 3 of the Dulness wd Profewsons CodOw, 'I EI,IP.M6fIR OR POLE INST. I D
d y o haat he la exempt lhemtrn+n and the hosts fur Ihu ulle,el exemption.Any viol.la n of HLD ADDII'1(lN 0 EUMO LH ION
>WfyN Section 7031.5 by any applicant for a Terrain%objects the applicant)a civil mady of POWER DEVICIiS TENANT El FOOD SERVICE
mol mmc than five hundred Jallaes($51X1). IMPROVEMENT
F Z•O ue❑ 1 as owner of the pmpcny,or my employees wish wage,as their sole compcnsalinn, SWIMMING POOL ELI:C'IRI_
will du the work,and the wricuis not intended or offered for s ile(Sec.2044,Business []OTHER
'
!E2
mand Paid .'inns Cade:'The Contractor's License I.aw Joew nor apply loan owner of OUTLETS-SWITCHES-PI XTUR17
property who builds or improves thereon,and wan does such work himself or Ihnmgh
It, ,we enpinycas,provldcd Thal such intpmvenmnb am ant I ted or oliened our NEW RESIDEN'T'IAL ELECTR SQ rT '
sada If.however,rhe building..improvianect v4dwithinone yeandrompletinn,rhe SQ.IT FLOORAREA $/SQ.FI's
e,builder will havo the hunlen of provit,.hill he did not build ur improve for per-
"waf.IeL �..-7 -7 O- y. 8"o
E_] I.an nwoer of tee In,teny ala exel.00rl,emaraealtg win lieenwed..rams.++r,m 'TOTAL:
consumer dr,project(S 70,14.Business- d Professions Codco the_.....acro L ,
ceme Law does rea applyI f property who builds or improves themonand QTY. PLUNIRINGPERMIT FEE' /.' - q,y'
who ontractsfor suchprojects with a mmrmtor(s)I'c used punno
uanthe Co nodus _' �_/') 7
License Law. PERMIT ISSUANCE �,y✓
1] Iemexemprundersea. ,If&VCfa'Iiiareluon
AITHR-DRAIN&VENT-WATER(EA) / VALL
Owner Dem q
WORKER'S COM1IPENSAIION DECIAR,\TION BACK FLOW I'NUTELT DEVICE d / y r ?�
1 hereby nlmai.mina penalty of penury enc of the fnllowi..r Je rker's ms:
Ihxa.and will to,binalive 37omof theLmto wilt-in Car tier Workersce if
DRAINS-FLOOR.ROOF,AREA.CO R '1'YPF:CONS'112UC1'ION
amino,uv pmvIDhi for by Ss nun 321X1 nl the LuArt Gxln,for the purfnmwme of rhe
wed for which this apsmalmemi is issued, FIX9'UNIiS-PIiR TItAI'
❑I have and will maintain Workers Cance"Ohio 'k lot hi h required by Section
32110 of NC LvMn COJa ferlhc purinnnencenl the wed for which this pu'mil if ianucd. GAS-CA.SYS'FEM-I INC.4OU'ILE'f5 OCC.GROUP APN
My Wakr///E.mpcasmioti 1111ppppyIIIttttttt////mmmm. a rand the bar ace: GAS-EA.SYSTEM OVEk4(F.A)
Cnnicc 'T?r0/DNMB_(_Jw�f
CIiRTIiICATiVMPENN'c;'R--E`IONINN OM ORKERS' GREASUINUUS'fRL WA5'IE IN'IERCCITOR
COMPENSATION INSIIRANCF. i II )I ,DIVISION IEHS
or lc.vs.)Thic sec eciyt9tJJyu.gly{e PU tytiX cry fo ys permit�tl.risslueJ'Swbal GREASE'FRAP "LANCHrp /. 40
I ccnifY +mm Ne perinnnans, fthc w: k .r IUCh SI:WER-SANITARY-ST(1RMEA.2(H)17
not emtpl.yany person in any manner so as to become subject the WmkcP Cmnpen. ENE 44 ' x.20
Z Cation Low,of Cvliforniu.Dam WAI'F.R IIEATER W/VENT/ELFCI'li
Appliwml GRA IN eE
y NOIiCE TU APPLICANT 11,after making this Ceniticate of llxenmdon,y.0 xh.uld WRIER SYST17 M?R PATI NO SOILS
1••' eco mesabject a.the Worker,Compensmion provision,of tire Lbor Code,you mull
don Itwithenmply wishmal pmvisinu,nr lhlapenni,shall bedcemcd cranked. WATER SERVICE
Q
CONS'IRUCFION LENDING AGENCY NI?W RESIDENTIAL PLMR. SQ.FT PAID
G2' I hereby affrm that there is a conammle
i.a ading agency for l he prmfuricuute of Dare
z Rucip.# lP V
W 2 the work for which,hi,pvarma is issued(Sea 3092,Ci,.C) ,
OLender's Nae
U TOTAL'
Lenders Address TOTAL.
G1 certify that I hove road this npdoation and,rare thin the above Infnmmion Is - BUILDING IEE gya, O'9
tq conem.I agree to comply with all city and county ordinances and state laws relining to QTY. f .MECHANICAI,PERMIT FEE'
UZ b.Ed:ngeousirnma+n,;Lmdhetin+ynnthea,erepre,entaraeanf.ma.ilymeamateldel
isn't-normtaut pmpeny for impcaionparsne" PERMITiSSUANCE s„ Q
(We)aco m wve,indemd k
nify are lamac,s the Cil,of Cupertino again.) IiLECI'RIC PIiE
gr
liahilities,judgments.costs and expenses which nwy in any way ammo aBain.a suit CllY ACI ER OR ADD TO MECH.
In cunscgne n(the cormorant thispermit in
DEC
APPLI . f UNDERSTANDS D WILL COMPLY WITH ALL N Pq PEI N'1' Alit HANDLING UNI''TTO 10,1100CPM)
SOU B ' RELATION MECHANICAL VI?E
Alit HANDLING UNITIOVER Hr0g0CFM) CONS,RUC'IION'I'AX
IV 904AD
Signatmeof pplicant/Commc� �.c EXHAUST HOOD(W/DUCT) IOUSINGMITIGATIONPEE -
HAZARDOUS MAgERTAI S DISCLOSURE
Will tbeamrili I...Enure huilding ecr'upaat store er handle hazardous m#teriul BEATING UNI'I(TO IW.(#g BT ID
aw JefineJ by the Cupcwfnn Municipal Cele,Chapter 9.12,and me Health and Safety #
Code,Seatime 25512(..)21113AI'[NO UNIT(OVER 100.000 BTU)
C3 Yes 1tV,��� VENTILATION FAN(SINGLE RIi.SIDI PAID Data Receipt#
Wlllthe nppllutm nr Gmirebulldmg.ccupent.uc cyulpmom in dcvfccc which
poll-ER-COMP(3111'OR 10B,INIB BTII)
nit hazardous air comaminan defined by the Bay Area Air Quality Managenteml
lslnct". a+ BAILER-COMP(OVER 100,01100 IOf
❑Yes N, 7
I have ward the haznrdousntmerials requitcmen4 under Chapter 6.95 of the Cali- AIR CONDITIONER r7 ISSUANCE
DATE
�
F min I I r ?Safety Code,Sections 255 5,25533 and 25534.1 undersand rhea if the NEW RESIDENTIAL MECH. SQ.PT.
M1uildiv Ace etc^ntyhwca ren t u tis my resp.nxihility inn ify the ecnpunt
ofihe :lairnswhj mu.q .o issuan cola Ceni ('c
r Owner..
tithe
rizc ugcm a TOTAL: ISSUED BY:
TIKE
:)EC.20, 1955 5 Q4Ft BR:RPi KAIiGRS F01-LK iO.716 P.2/2
Brian Kangas Faulk
Engineers • surveyors . Planners
•
December20, 1999
960069.50
Chuck Schoenberger
O'Brien Oroup
2001 Windward Way,Suite 200
San Manor,CA 94404
Subject: Oak Valley=FoundationVerifiation
Dear Chuck,
Oe December 20, 1999 we perforraod a field survey of the location of the foundatiuh fortes for the
buildings being constructed an Lots 4.03,4.05,4.33,and 4.34 of the Oak Valley project In Cupenino.
The results of that survey clearly show that the location of the foundation forms are Consistent and in
confai a nce with the design locaticu of Ute buildings,as said locations are shown on the plans prepared by
our foo,
This letter is intended to provide you with the verification of those units per our survley. If there arc any
other questions cuncertiing that Incaution,please do not hesitate to cell.
Sincerely, .our
5�0 la N
MARTIN a
BRIAN KANGAS FOLLY, itfJIP.!/ 000 y r
Billy Martin, PLS 5797
Expires:06130,12000
• F�CALIF�Q
54C Prlee Avenue Reow0a0 Clty,CA 94C65 r (65014826500 PAX(650(462-6399
DATE JOB NO. {
Consulting Engineers and Scibntists
425 ROLAND WAY PROJECT
OAKLAND, CA 94621 �k Inc 1!: Pe.5 i dr'S H.c. l
• (510) 568.4001 LOCATION
l.' CONTRACTOAR
, OWNER.
d �.1• WEATHER - TEMP.' -llV°at AM
Data wre.,.�1,�.r r97T ti�v�' rlc.y ! -�^at
r PM
A C I -G
Cyl PRESENT AT SITE
Hours Charged To Project '� Nuclear Density Tests - .
Field Task Number 6'tF" Concrete Cylinders Y'
THE FOLLOWING WAS NOTED:
i` m 33 K 3y Ift "�-G3
iYQ-
CJP' ItC'I !'1' +-CC1- �
C\ '(C .4 I t-1', 5I YC< 1: R,,z I-t'-Ex ' C.Qe-• ,F-
'('1',.'r_�<C�, I �. ' '= O�JSP.v'Jtl,C.I r-OUI�' O•♦ CC'4_l,,// PC'"L�;"� C�G l\ Cn \ (( G11
1' - 7 CC' F�2 I-e IL�-- `_'�Lh^1""G C1(1 ,-C.� 1'U�1>1Q ho'✓\ f-rfe
,
rt 4 Cle ( het . IovSe r'IalT.r c ( i _C. Isc.• n.Ue(Y_ l-..ol I.Cyr
11CIJ- C-t_ 1 %` B ? 1312
�.
✓- Clr."fevl"L-KC ;,._')evC vr�ne{.r
I n ^ rl ' 't-1�r' I- 'T1-Ll•� P 121 C, I! .C71 I v) 0CP I I (DI I CLA
(.l.), "H'1 r^C v� � t'C'.' �@.i- IQ-t^i,`'.i Q,. •GI � `�'JPT:i . (U�:�U 1 /1 L't�.0 C�Y �/.�,...-t. e
N, 1'ti1 Q l"vI,
0 I° ,. .;( r " .Iti((x..(_I I✓.Q T' ) ('f l-'i,t Y'rl �CJI'Y'1CYYLrC....)
COP!£S TO R 7E�LSD;
SIGNED
CLIENT
• ENGINEERING WEST INC.
O13SERVATI0N CHART
.OAK VALLEY EVELOPMENT CUPERTIN0,CA.
SAM PETERS STRAUSS OROS bAGE 1 OF 4
(6501237-0076 (4081267.1923 DATE: 7.12-2000
'HIS CHART INDICATES THE DATES AT WHICH EACH COMPONENT OF EACH S JILDING WA
OBSERVED AND FOUND IN SUBSTANTIAL CONFORMANCE WITH THE DRAWINGS.
LEGEND
N.C. = CONSTRUCTION NOT COMPLETELY OBSERVED
= CORRECTIONS REQ'D. LIST GIVEN TO CONTRACTOR.
FDN.• - STEEL REINFORCING,HOLDOWN ANCHOR BOLT OBSERVATION
1ST FLOOR = UNDERFLOOR FRAMING OBSERVATION
ROOF PLY. PLYWOOD NAILING OBSERVATION
EXTERIOR PLY. = PLYWOOD NAILING,HARDWARE OBSERVATION .
BASIC FRMG. = GENERAL FRAMING AND HARDWARE OBSERVATION
UNIT Lot an OPTiON Fdr. 1slfloor I Roaf l xt I' Sic. ft mo. ssic m .
4 1
4 2
4 3 1D 12.21- 3-2.2000 1 5-21-2000 5.2121=00D tl.n.a. 6.21.20 2
4 A N/A
4 50 _) 12-21-99__3-2:2000 6-16.2000 5-21.2000 d M2 5.21.2000
4 A 78 j 03/10/99 04112190 /2 OB r9 0624199
4 8 7C03/11/99 04114/99 06/24/99 06!24199 07
!, 31,
4 9 5C /BON 1119 _51i 41-09 07/DS/99 . 07/09199 07/29/99
4 10 1 20 3 1 03/01199 04/02199 07120199 7/0 14189 07/20 9
4 11 3B 03/01199 04!02199 07101/99 06/30/'99 07118/29
4 12 4B 3 11/1 B _L2/1019@ 0t121/99 01!21159 0125k6
4 13 6C 2 09126198 10/09/98 11/001,98 11113/98 �� 121
• 4 13 6C ADDITION 1 02/09/99 02/09/99 02!08199 02109198
4 14 2A 2 02/12/99 03/01/99 05/19/99 05121199 1 J 08104199
4 16 5D 2 1 02/02/99 03/0AI99 05127/99 06/09/99 1--04/14/99
9199
4 17 2C 031,01/99 0 /3 I 1 ! 06130/99 6199
4 18 6E 2lBONU£ 12114/98 12/24/98 031108/99 03108199 2199
4 20 4D 31 0 12122/96 04114/99 03!18190 03/22/99 4 21 2B 2- 03/19/99 04114/99 072 0? 719 0/99. 4 22 SA 2!80 US 03/19/99 04/14/99 07!20119 07/23/990594 3 3A 3 1/12199 119 9 / l9c 05-0799 11994 24 6D 31BONUS 01112/99 02/17/99 05-03.99 04.30.99 74 25 G 3 122310 D2N8199 04102.99 04/05/99 4199
4 26 20 2 01/08/99 D2112/99 05/10 04!26199 06111199
4 27 4C 31 01/U8/99 02/05/99 04114199 04/12/99 05.07.99
4 28 6E WBONUS 1 12/14/98 1104! 03/03199 03/0359 03130199
4 29 7A 2 11/13M 12/10/98 02110199 02110/99 31
4 30 C 3 11113198 12/10/98 0210319902/01199
03!11199
4 31 5B 31EIONLIS 02/12199 03/1 Mg 1 06/0 06/0 08117199
4 32 11 B 3 02112199 03/10/99 06!11;99 08/17199 0
4 33 SA ^• 1• 5.21-2000 5-21-2000 8.21-2000
4 34 1 7C 1 12-21.99 13.7-2000 B•8-2000 6-8-2000
n1 000
NOTES:(PENDING ISSUES/
(1) LOT 13 PLAN SC FDN. (OFFIC9 OPTION): CORRECTIONS NOT OBSERVED.
' .! r . . r-C]� C. r IC'P lw cln•'.' .-ip . cl`f i'1P1 ? J1� IT ,In-" .. 1n-
FROM CRMSJI FAX NO. : 8313350329 Aug. 20 2000 04:29PM P3
• Cantnm�elalaoothisna alwilt5aa Josr, lnc.
/� Int ,,.• _
Ree:r:e,rria/R;qf D'ysl8or Lspeedw. Report ?s- `��,/r��
ProJeet:'Ax �L(Ey_ 1?PIES Ins PCetlon Date:
Addross �N C7. . City: Qyoettfno State: CAA
Client: Tag O'Bris'j WOUO
', Contact:Pat g•,�k,��
Roofing Contractor: PID iyr 60Ft'1Cl
CRM Inspoctor: �:znjc-%R
Lot Number:
Typo of Inspectioll: Rillt Final
Typo of Roof: 811in®le Tile — Other
Undertayltlont: _.,,. , Silt Metal Plashing: Cutler :
Vents s
Skyllghts: Aats
achments: Pipes:
Valleys: Ridges: ventEaves:
• •��sso�+���+ea+
Commonts/Observations:
A"477*rA4 , En!') FROM Roo- 4Fr6
CCI Rid-Ou!Roofing
•
� .
AUG-28-00 IS : 57 FROM-COAST INSULATION SAN JOSE 10:408 28a 378B PAGE
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. 3PZEN
• .CROUP
urke
JIM RIPloy(SMTP,rlployd9opaobolLnol)
Monday, March 06, 1999 2;26 AM
PATAURKE
OAK VALlEY
CA
Linear parkway planllnq,
s wllhln the Ilnoor perk aro conslslonl wllh Iho londsoapo
n documents prepared by Ihls or(Ice and rovlowod by the clly
996 and,conform wllh the prollminary'approvol doomonls,
l ley
3n Group, Inc,
,
•TH 2On, SAN MATCO, nALIFONNIA 7101,2473 T14IIPIIONh(610)377•odeo FACSIMILC(610)!19.2417
S2wlu� Mgrrh I, 1996 .
r
INSTALLATION CERTIFICATE (page 1 of 4) — CF-6R
Ite sass
e—r—m IF Num er
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection, a copy rftust be provided to the building department(upon request) and the building owner at
occupancy, per Section 10-103(b).
HVAC SYSTEMS'
Heating Equipment
Equip. Al of Efficiency Duct Ductor Heating Healing
-rype(pkg. CECCenified Mfr Name Identical (AFUE,etc.)[ Location Piping Load Capacity
kcal um and Model umber Systems 2CF-IRvalue attic etc. R-value Btu/hr Btu/hr
r / --L— ;' - S—�
Cooling Equipment
Equip. CEC Certified Compressor N of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER,etc.)' Location Duct Load Capacity
heat pump) Model Number Systems [2CF IRvaluel (attic etc) R-value (Btu/hr) (Btu/hr)
_-76 15-WK
1. >_reads greater than or equal to.
1, the undersigned,verify that equipment listed above is: 1) is the actual equipment installed,2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-1R) submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
• `manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable. /
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS:
bistribution irRecir- N of Rated' Tank Efll- External
Heater CEC Certified Mfr Type(Std, culalion, Identical Input(kW Volume cieneys Standbys Insulation
Type Name&Model Number Point-ofUse) Control Type Systems or Btu/hr) (gallons)7 (EF,RE) Loss(%) R-value
2 For small gas storage(rated input of less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 EmAr),list Recovery Efficiency,Standby Loss and Rated Input.
For instan(ancom gas water heaters,list Recovery Efficiency and Rated Input
Faucets &Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6, Subchapter 2, Section
Ill.
1,the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance (Form CF-IR) submitted for compliance with the
Energy Efficiency Standards for residential buildings; and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
• Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
1014A) WrM d2 a ,4houT arNUr
I-or /3
&STALLATION CERTIFICATE (page 1 of 4) — CF-6R
rte A cess
Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy, per Section 10-103(b).
HVAC SYSTEMS-
Heating Equipment
E4uip. B of Efficiency Duct Duct or Heating Heating
Type(pkg. CEC Certified MCr Name Identical (AFUE,etc J, Location Piping Load Capacity
heal um and Model Number Systems F-IRvalue (attic.etc. R-value (Btu/hr) Btu/hr
`.aur o
!NDpotlds7o fL9 JZ1 yes 097111 P, 24,OC70
Coaling Equipment
Equip. CEC Certified Compressor 0 of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER.etc.), Location Duct Load Capacity
heat ourmil Model Number systems CF-lkvalucl attic etc. Rvalue (Btu/hr) 0114
idt,22 0 11160
1. >_reads greater than or equal to.
• I,:the undersigned,verify that equipment listed above is: 1)is the actual equipment installed,2)equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-1R)submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable.
Signature,Date Installing Subcontractor(Co.Name)
OR General Contactor(Co.Name)OR Owner
WATER HEATING SYSTEMS•
Distribution IfRecir- 0 o Rated s Tank Efft- External '?
Heater CEC Certified Mfr Type(Std, culalion, Identical Input(kW Volume eieney2 Standby= Insulation
Type Name&Model Number Point-of-Use) Control Type Systems or Btu/hr) (gallons) (EF,RE) Lou(%) R-value
2 For small gas storage(rated input of less than or equal to 75,000 Btuthr),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 Btu/hr),list Recovery Efficiency,Standby Lass and Rated Input.
For instantaneous gas water heaters,list Recovery Emcieney and Rated Input
Faucets &Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter2, Section
Ill.
1, the undersigned,verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance (Form CF-1R)submitted for compliance with the
s.
• Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
gnature, ate Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
• Ao..:,e,1 Morrh 1. 1996
3 AIA �
Gar ¢-3a
.STALLATION CERTIFICATE (page I of 4) - CF-6R
Site Address Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy,per Section 10-103(b).
HVAC SYSTEMS:
Pleating Equipment
Equip. k of Efficiency Duct Duct or Heating Heating
Type(pkg. CEC Certified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity
heal um and Model Number Systems 2CF-I R value attic etc. R-value tu/hr Btuthr
W
A -
?ND S9Ral/e>e-/2 _ CFO V12 ArrfG
Cooling Equipment
Equip. CEC Certified Compressor A of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER etc.)' . Location Duct Load Capacity
heat um Model Number System CF-IR value attic etc. R-value (Btu/hr) tuthr
rSi SpL.r I ,iva�*,o ,
38CKCo>o /D__Wc`A 7'
?ND /0Si4_0Q AMC V.z
1. >_reads greater than or equal to.
•1,the undersigned,verify that equipment listed above is: 1) is the actual equipment installed,2)equivalent to or more
efficient than that specified in the certificate of compliance(Form CF-1R) submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable.
�����1."y/c�ut-eau ,�"zr-99 y.fes�r0.y✓ f/e�i�u�� � ,4'/C�
Signature, Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS:
Distribution If Recir- 0 of Rated' Tank Eftl- External
Heater CEC Certified Mfr Type(Sid, wlation, Identical Input(kW Volume ciency' Standby' Insulation
Type Name&Model Number Point-of-Use) Control Type Systems or Btu/hr) (gallons) (EF,RE) Loss(Y.) R-value -
t.
2 For small gas storage(rated input of less than or equal to 75,000 Bru/hr),electric resistance and heat pump water beaten,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 BoAr),list Recovery Efficiency,Standby Loss and Rated Input '
For iastan taneous gas water heaters,list Recovery Efficiency and Rated Input
Faucets&Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter2,Section
Ill.
1,the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance(Form CF-IR)submitted for compliance with the
• Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
Aaviaarl 1%4grrh 1. 1996
6STALLATION CERTIFICATE (page 1 of 4) — CF-6R
rte A ress erml[Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this farm is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy,per Section 10-103(b).
HVAC SYSTEMS,
Heating Equipment
Equip. it or Efficiency Duct Duct or Heating Hearing
-type(pkg. CEC Certified MCr Name Identical (AFUE,tic
-type Location Piping Load Capacity
heat um and Model Number Systems 2CF-IRvalue attic ale. R-valuefans/hr) Btu/hr
ts7r ,_�A as B 411 Z / 0
cwheA
?ND rJ a s59Ri4YU¢D7e-fz �_ . �1G__ �LrIL� �36,4 74 L6�000
Cooling Equipment
Equip. CEC Certified Compressor 0 of Efficiency Duct Cooling Cooling
Type(pkg Unit Mfr Name and Identical (SEER,etc.)t Location Duct Load Capacity
heat um Model Number Systems 2CF-IR value atfi etc. R-vslue (Btu/hr) lumr
lsT sial �— �0
?ND ?BGKGo3o �_ is Xee� L� �
reads greater than or equal to.
•I, the undersigned,verify that equipment listed above is:. 1) is the actual equipment installed,2)equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-IR) submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable.
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS•
Distribution IfRecir- 0 o Rated' Tank Efll- External
Heater CEC Certified Mfr Type(Std, eulation, Identical Input(kW Volume eieneys Standbys Insulation
Type Name Ee Model Number Pointaf--Usc) Control Type Systems or Btuthr) (gallons) (EF,RE) Lou(':) R-value
2 For small gas storage(rated input orless than or equal to 75,000 Btulhr),electric resistance and heat pump water beaten,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 Btu/hr),list Recovery Efficiency,Standby Lou and Rated Input
For Instantaneous gas water heaters,list Recovery Efficiency and Rated Input
Faucets&Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter 2,Section
111.
I, the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance (Form CF-IR)submitted for compliance with the
• Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Nance)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
Roviaprl Mnrrh 1. 1996
D•�� ����y - 7 I�1r4KJ
OSTALLATION CERTIFICATE (page 1 of 4) — CF-6R
Site Address Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. Cne
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy,per Section 10-103(b).
HVAC SYSTEMS:
Heating Equipment
Equip. 0 o Efficiency Duct Duct or Heating Heating
Type(pkg. CEC Certified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity
heat um and Model Number Systems CF-IR value attic etc. R•valua (Btu/hr) (Btu/hr)
Cooling Equipment
Equip. CEC Certified Compressor I of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER etc.)' Location Duct Load Capacity
heal um Model Number 5 stemsCF-IRvalue (artic.etc. R-value Btu/hr (Btu/hr)
.e
1. >reads greater than or equal to.
•1, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed,2)equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-IR)submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable.
�%j2ic�t.(d�. .�•�7-99 �/ Sent-J'oat/' �'�.�/� � �/�'i
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
MATER HEATING SYSTFMs•
Distribution IfRecir- gof Rated' Tank Em- External
Heater CEC Certified Mfr Type(Sid, culation, Identical Input(kW Volume eieney' Standby' Insulation
Type Name de Model Number Point-of-Use) Control Type Systems or Blulhr) (gallons) (EF,RE) Lou(Y.) R-value
J.
2 For small gas storage(rated input of less than or equal to 75,000 Btu/hr),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 Blu/hr),list Recovery Efficiency,Standby Lou and Rated Input.
For instantaneous gas water heaters,list Recovery Efficiency and Rated Input
Faucets At Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter 2,Section
III.
1,the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance(Farm CF-IR)submitted for compliance with the
Energy Efficiency icien Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements
• for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
P--igpd Mnrrh 1. 1996
/,7,dA-! /01*)u wrM oR we-o4ov% ot9ewuf
Lo; 8
.STALLATION CERTIFICATE (page 1 of 4) — CF-6R
rte A re's Permit Number
An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The
information provided on this form is required;however,use of this form to provide the information is optional.) After
completion of final inspection,a copy must be provided to the building department(upon request)and the building owner at
occupancy,per Section 10-103(b).
HVA CYST .MS:
Heating Equipment
Equip. ft or Efficiency Duet Duct or Heating Hearing
Type(pkg. CEC Ccnified Mfr Name Identical (AFUE,etc.)' Location Piping Load Capacity
heat um and Model Number S Isms 2CF-IRvalue attic etc. R-value tu/hr Btu/hr
% ,at/dw/ Z r,^
D XPA0OV070-!>- Z' /9 153 s
Cooling Equipment
Equip. CEC Certified Compressor Sof Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER,ete.)i Location Duct Load Capacity
heat um Model Number 5 stems CF-IRvalue ante etc. R-value Btu/hr tuAa
>_reads greater than or equal to.
1W the undersigned,verify that equipment listed above is: 1) is the actual equipment installed,2)equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-IR)submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3)equipment that meets or exceeds the appropriate requirements for
manufactured devices(from the Appliance Efficiency Regulations or Part.6),where applicable.
Signature,Date Installing Subcontractor(Co.Name)
OR General Contractor(Co.Name)OR Owner
WATER HEATING SYSTEMS-
Distribution trRecir- 0 of Rated' Tank Ef6- External '!
Heater CEC Certified Mfr Type(Sid, wlalion, Identical Input(kW Volume eieney' Standby' Insulation
Type Name&Model Number Pointof-Use) Control Type Systems or Btu/hr) (gallons) (EF,RE) Lou(Y.) R-value
2 For small gas storage(rated input oriess than or equal to 75,000 Moths),electric resistance and heat pump water heaters,list Energy Factor.
For large gas storage water heaters(rated input of greater than 75,000 BoAr),list Recovery Efficiency,Standby Lass and Rated Input .
For instantaneous gas water heaters,list Recovery Efficiency and Rated Input
Faucets&Shower Heads:
All faucets and showerheads installed are certified to the Commission,pursuant to Title 24,Part 6,Subchapter 2,Section
Ill.
1,the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that specified in the certificate of compliance (Form CF-IR)submitted for compliance with the
•Energy Efficiency Standards for residential buildings;and 3)the equipment meets or exceeds the appropriate requirements :.
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Name)OR Owner
COPY TO: Building Department
Building Owner at Occupancy
Avole�d Morrh 1. 1996