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13090152 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6017 BOLLINGER RD CONTRACTOR:CALIFORNIA DELTA PERMIT NO:13090152 MECHANICAL INC OWNER'S NAME: KHAJA RIAZUDDIN AND RIAZUDDIN ASMA 6056 E BASELINE RD STE 155 DATE ISSUED:09/20/2013 OWNER'S PHONE: 6502450714 MESA,AZ 85206 PHONE NO:(866)692-5273 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL License Class ��2 Lic.# �/ l/ �� —/ REMOVE AND REPLACE FURNACE IN SAME LOCATION Contractor I hereb irm 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: 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. Sq.Ft Floor Area: Valuation:$2871 flWe and will maintain Worker's Compensation Insurance,as provided for by ction 3700 of the Labor Code,for the performance of the work for which this APN Number:37538002.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application.and state that the above information is PERMITIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WIT 1 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA ROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by Dater R granting of this permit. Additionally,the applicant understands and will comply with all not-point source re ions per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signator Date% 2 / All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner]of the property,or my employees with wages as their sole compensation, will do the'Iwork,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner,of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and'will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 , 533,and 25534. Section 37100 of the Labor Code,for the performance of the work for which this Date: 91- Owner or authorized age permit is issued. 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep,harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date i GENERAL PERMIT APPLICATION j� MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 MISC CUPERTINO (408)777-3228 CW FAX(408)777-3333•building -cupertino.org ❑PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS 'oX 7 APN# OWNER NAME , P NE I�D�/ E-MAIL STREET ADDRESS CI STATE,ZIP y FAX CONTACT NAMEPHONE E-MAIL �Cc'�r/ - f YYR-?Z,P-O 707 ST RESSS - / .,` A r/�y� CITY S �EP '1 2 w FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT la CONTRACTOR '❑`CCONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT ;20R NAME, LICENS ER LICENS TYPE BUS.LIC# MP ME ,./ _/ E-MAIL FAX ST$EOET AD RESTS•. ' CTTY,`T'ATE,ZIP2 I 9�E 2.P-d,Q ' ARCHITECT/ENGINEER NAME LICENSE NUMBER ` BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD.,DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORKz1 Z ?f DD TOTAL VALUATION: � By my signature below,I certify to each of the following: I property owner or authorized agent to act on the properly er's behalf. I have read this application and the information I have provided is co have read the Description of Work d i etify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin n. I authorize represen ivesaf C p�ertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date:- SU"fENIF.WAL INFORMATION REQUIRED 1 1 MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 6017 BOLLINGER RD DATE: 09/20/2013 REVIEWED BY: Mendez APN: BP#: "VALUATION: $2,871 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK REMOVE AND REPLACE FURNACE IN SAME LOCATION SCOPE Mech.Plan Check 0.0 hrs $0.00 Phttub.Plan('heck F_.tee..Plan(,heck Mech.Permit Fee IMPERMIT Plumb.Permit Fee: Dec. Permit Fee: F01,her Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. Other flee,lnsfo. Li lns7�.Fee: Plumb. hap.I e flee.Insp,Fee: NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the relimina information available and are onlyan estimate. Contact the Det or addn'l info, FEE ITEMS(Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Mechanical Supp/.PC Fee: Reg. OT 0.0 hrs $0.00 $139.00 IMFR=<100 Furnace,Forced-Air PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-.0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 #new Construction Tax: IBCONSTAXR 0 units $0.00 Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes (E) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential (E) Travel Documentation Fee: ITRAVDOC $47.00 Building or Structure i Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $139.50 $139.00 $278.50 Revised: 08/01/2013 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL GUPERTfN4 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building al�cupertino.ora VVIIEN IS A PERMIT REQUIRED A construction permit shall be obtained from the enforcement agency prior to the erection, construction, reconstruction, installation, relocation, or alteration of any mechanical system, except as permitted in Chapter 1, Section 112.2 of the 2010 California Mechanical Code. Projects requiring permits include, but are not Iimited toc • New HVAC installation • HVAC Changeout • Replacement of furnace, coil,FAU or condenser • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconditioned space BUSINESS AND PROFESSIONS CODE, SECTION 7110 Willful or deliberate disregard and violation of the building laws, including the California Building Code, and local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board working in conjunction with the local building department. This action may consist of fines up to $5,000 per violation or suspension/revocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces; room heaters). 2. Central air conditioners &heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. 4. A setback type thermostat(24 hr clock with four set points) is required for all alterations. 5. New or replacement ducts must meet the mandatory requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no more than 2" of sag between supports and 6 ft. max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 a. Simplified Prescriptive Certificate of Compliance:2008 Resfdenfid HYACAlieratinns CF-IR-ALT-HVAC Climate Zoues 12nd 3-7 Szte<4ddrees Enforew—raAgeacy: Digi. :: PennU Cotulitioned Duct insulation ent T Isi' cies Float t0.rea re ` I lr: sistai Packaged COR Unit ' Uver 44 8 of duds Furnace GAF UE S b3'g3 added orrepla xd inSetback IndoorCotl ( SEF.t �HSPF g?zOralreudypreseat wz!vbe GO sf unconditioned space. . Condensing Unit ®EER E3 Resist�ce IM R 6 (CZ I,3-5) Other 1b I.Equipment Type:Choose the equipment being installed,if mare than one-system,use another CF-IR-ALT-HVAC for each system. 2.ATtrimurn Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declarstiou Statement) • I certify that this Certificate of Compliance documentation is accurate and comblete. • I am eligible ander Division 3 of the California Susiness and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksbeets,calculations,plans and specifications submitted to the enforcement agency for approval,with the permit application, Nane: �� / v Signature: P 3 Date: n qd License: City/State/Zip: 0 2008 Residential Compliance Forms.doc revised 04110112 CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD BUILDING ADDRESS:6017 BOLLINGER RD CONTRACTOR:CALIFORNIA DELTA PERMIT NO: 13090152 CHANICAL INC OWNER'S NAME:KHAJA RIAZUDDIN AND 6056 E BASELINE RD STE 155 DATE ISSUED:09/20/2013 AZUDDIN ASMA OWNER'S PHONE:6502450714 MESA,AZ 85206 PHONE NO: (866)692-5273 FOUNDATION/PIERSlH.D.S.J BUILDING PERMIT INFO: BLDG r ELECT PLUMB MECH UFER GROUND RESIDENTIAL r— COMMERCIAL PAD/SET BACK-CERT JOB DESCRIPTION: REMOVE AND REPLACE FURNACE IN SAME GARAGE SLABSTREGUNITE LOCATION f UNDERGROUND/SLAB UNDERGROUND PLUMBING UNDERGROUND ELECTRICAL UNDERFLOOR PLUMBING VV UNDERFLOOR MECHANICAL UNDERFLOOR ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA ERN UNDERFLOOR FRAMING VENTS TO ARRANGE INSPECTION UNDERFLOOR INSULATION Call 777-3228 between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours before required inspection.Job address and Permit Numbers are needed when ROOF SHEATHING requesting an inspection. ROUGH PLUMBING CUPERTINO SANITARY DISTRICT TUBS&SHOWER PAN Closed circuit video inspection of property line cleanout,point of connection ROUGH MECHANICAL and street lateral required prior to passing FINAL CITY PLUMBING INSPECTION. Call the District(408-253-7071)for an appointment. ROUGH ELECTRICAL/POOL BOND FRAMING/STAIRS/E.EGRESS NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED INSULATION/VENTILATION BUSINESS LICENSES ARE OBTAINED PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT EXTERIOR SHEAWHOLD DOWN ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. INTERIOR SHEAR/HOLD DOWN SHEETROCK/SHEETROCK SHEAR IMPORTANT EXTERIOR LATH/W-SCREED When a permit has expired,a charge totaling one-half the fees to obtain a new permit must be paid in order to reactivate the permit.If a permit has been expired for more INTERIOR LATH than one year,a charge totaling the full fees to obtain a new permit must be paid to reactivate the permit. SCRATCH COAT NOTES: SEWERIWATER T-BAR/MECH/ELECT ABOVE CEIL ELECTRIC METER RELEASE SPECIAL INSPECTIONS Inspector: Date: GAS TEST/METER RELEASE ROOF INSPECTIONS GRADE-PUBLIC WORKS PRE-INSPECTION:Inspector: Date: FIRE–CALL(408)378-4010 TEAR-OFF: Inspector: Date: PLANNING(408)777-3308 PLYWOOD: Inspector: Date: SANITARY(408)253-7071 BATTENS: Inspector: Date: ELECTTRICAL IN PROGRESS: Inspector: Date: MECHANICAL PLUMBING FINAL: Inspector: Date: HANDICAP NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION. ENERGY *OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY INSPECTOR BUILDING CERTIFICATE OF OCCUPANCY' 7-0P C/7-1k x � 1.��90/j2 , `T_ �"o� L✓� /`�C'C�c7 n�Ccs � /��=�i�7c.� p.v �'Li � �j� �o�� i �S �'�•�f7j--� �-4 ��/7Lco CIE'C�`la�/Ccs a