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13100100 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10440 GLENVIEW AVE CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 13100100 CONDITIONING OWNER'S NAME: ANDY YU 1712 STONE AVE DATE ISSUED: 10/15/2013 OWNER'S PHONE: 4088232566 SAN JOSE,CA 95125 PHONE NO:(408)293-4717 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE] License Class �`�' Li..# : �'�I REMOVE&REPLACE(E)FURNACE,SAME LOCATION Contractor cJ C Date 0 I hereby affirm that I am licensed under the provisions of C apter 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:$3160 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 APN Number:36911018.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state law4te WITHIN S ERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to upon the above mentioned property for inspection purposes. (We)agree to 1 YS F ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judg _ costs,and expenses which may accrue Against said City in consequence of granting nderstands and will co a e: wi#v&P6o Municipal Code,Se .18. / RE-ROOFS: ( Signature=Date c© 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 work,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 compli upertino Mu icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health& Code,Sections 50 5 and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:_ Date: 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 soas 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 V GENERAL PERMIT APPLICATION �0 � MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 MISCDUPER] (408)777-3228•FAX(408)777-3333•building a(-cupertino.org ❑PLUMBING —"E3-NECHANICAL []ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS 'h/1/111 G)MMA o r.I K e N)VQ, APN# -3 6 - 1 01 g OWNER NAME r..L p {�J/t �J �w PHOJ�F, �r,� C' E-MAIL STREET ADDRESS -��t!Q -f_ •, 54� - __- l04 CITY-$�1.��/. L L� - FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT/8-CON-IRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME 4_ \'1 t fVCe LICEN$ 1�UI�fB $- I LICENSE T G BUS.LIC# COMPANY NAME A E-MAIL STREET ADDRESS CITY$f�,Z C* p�c'lr7 f' P 1 1 ,{(/t � �(Jp ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF _L18TLror DUPLEX ❑ MULTI-mmmy PROJECT IN WB.DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUU-DING: ❑COMMERCIAL URBAN INTERFACE AREA __EL NQ FLOOD ZONE n No EICHLER HOME? `-EI-NO DESCRIPTION OF WORK �.p,M�y,p �,^� ��� ���^ ��r•�� TOTAL VALUATION: 3i�i 3, IYEDB: r t By my signature below,I certify to each of the f7S-'t'r wing: I am the property owner or authorized agent to act on the pro owner's behalf. I have read this application and the information I e provided orrect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rela g to b ilding couction. I authorize representatives of Cupertino to enter the abo a-iden'feed property for inspection purposes. Signature of Applicant/Agent: ` Date: S LEMENTAL INFORMATION REQUIRED 10.M'011111 of c usE olvi aim Ti " EXPRES 91 _ MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10440 GLENVIEW AVE DATE: 10/15/2013 REVIEWED BY: MELISSA APN: 369 11 018 1.BP#: *VALUATION: 1$3,160 %PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK REMOVE& REPLACE E FURNACE SAME LOCATION SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air. 1MFR=<100 1 # $139 EN TOTALS: fil i� $139.00 e Liu Ora k, cX.�- ,taa i wimp, U Mech.Plan Check 0.0 hrs $0.00 Ptu nb.Alan Check Elec,Plan Check Mech.Permit Fee: IMPERMIT Plumb.Permit Fee: 1 lec. Permit Fie: LOt,her Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. Other Stec.Insp,Insp.Fee: Plumb. Insp.Fee: Elec.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 Deptor addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check F'ee: Suppl. .PC Fey: PME Plan Check: $0.00 Perinit.Fee: Suppl.Insp T'ee PME Unit Fee: $139.00 PME Permit Fee: $47.00 Conslpwction 7 ax: Administrative Fee: IADAffN $44.00 Work Without Permit? ® Yes ja.No $0.00 Advrtneed Planning/Fees: Travel Documentation Fee: 1TRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.50 Select an.Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 - lyi [ a$278.50 $0.00 tis $2 w 78.50 Revised: 10/01/2013 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR,P.E., C.B.O., BUILDING OFFICIAL GUPERTfhfU 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building aacupertino.org �VIIEN 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 limited to: • 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 $5,000 per violation or suspension/revocation of a contractor's license. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6) REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall &floor furnaces; room heaters). 2. Central air conditioners &heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER. 3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2. 4. A setback type thermostat(24 hr clock with four set points) is required for all alterations. 5. New or replacement ducts must meet the mandatory requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metal ducts and the inner core of flex ducts shall.be mechanically fastened. Flex ducts must be connected using a metal sleeve/coupling. • Flex ducts that are suspended must be supported every 4 ft. max for horizontal runs with no more than 2" of sag between supports and 6 ft. max for vertical runs. 6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect this form and verify that the model numbers are the same as the installed equipment. 2008 Residential Compliance Forms.doc revised 04/10/12 S-pplified Prescriptive Certificate of Compliance:2008 Resisiential HYACAIierations. CF-IR-ALTAWAC CEmste Zoues 1 and 3-7 SSteAddre,s^c �A� Enforcement Agettcyt I?afe<,;= penult 0::--' Con(Etioned Duct insulation ent Tvpel 1*loor:Ana re s.: Th' ostai Umt „ i, Over 4011 of dr Ftnnace ®;AFUB COP Served$y system added orn-glared in QSedb Indoor Coil ®IISPF_ (di nos already presets n7cr!be Condensing Unit ®EER E3 Resistance sf unconditioned space, Other ®R 6 (CZ 11 3-5) • 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. I Mahnurn Equipment Efficiencies:13 SEER,78%AFUF,7.7ASPF for typical residential systems. Contractor(Documentation Author's/Responsible Designees Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and com iE . • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for,the design identified,ort this Certificate of Compliance. • I 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 informalion documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted totIfoxzrnent agency for approval with the permit apglication. Name C ��S �vQwZi Signaling: Company I�s �T\ �ViMCA Date'(]IZ11, 15 Address: 11 2;. S (1R� 7`lVt � License:: CitylStwe/Zip: C'i.. c!912-5- . 'Phone: -2<-A,4�) - --i. "' 2008 Residential Compliance Forms.doc revised 04110112