14050046 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7510 DE FOE DR CONTRACTOR4"f-�6-BE PERMIT NO: 14050046
DETIE�ED
OWNER'S NAME: JINPYO KIM E .•C-1!-r✓1 G (✓ DATE ISSUED:05/06/2014
OWNER'S PHONE: PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL E]
r REMOVE AND REPLACE FURNACE AND ADD A/C&
License Class ( -2� Lich�#,,�� (A.(to DUCTS
Contractor 0Date 601
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:
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:$9700
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:35924032.00 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 laws relating WITHIN ffiO DAYS OF PERMIT ISSUAN E 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 F M LAST CALLED INSPE TION.
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 Issued by: Date:
with all non-point so rce re tions per a Cupertino Municipal Code,Section
9 18.
7� RE-ROOFS:
Signature Date
(� 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)
I,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 Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 505 3 ,an 25534.
Section 3700 of the Labor Code,for the performance of the work for which this t tt
permit is issued. Owner or authorized agent: Date.
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 CONSTN LENDING AGENCY
RUCTIO
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
GENERAL PERMIT APPLICATION M1 E P
>s
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 MMM I S C
Et1pl`ATINO (408) 777-3228•FAX(408)777-3333•buildinaCcDcuoertino.org
❑PLUMBING HANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS I APN9
OWIN'ERN.4ME PHO ce) I_�� E-MAIL 1
bz�C,
STREET ADDRESS O CRY, STATE,ZIP I FAX
AD
Cc �,
CO\1TACT NAIAffi PHONE 1iNIAII
STREET ADDRESS CITY,STATE,ZIP FAX
❑ OWAe-R ❑ OwNER-BUIIAER ❑ OIATMAGENIT ❑ CONTRACTOR ❑CONTRACTORAC.-NT ❑ ARCrIITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME !�y y LICENSE NUIBER� q`r LICENSE TYPE( r1 r� BUS.LIC`4
COMNPAY NAME 4� i� `\(/` EMAIL �� � FAXr�
STREET ADDRESS 4;7� CITY,STATE ZIP�� _n 0,73-7 PHOI'y rI
ARCHTTECTIEENGINEERNAME LICENSENUNIBER. ��•�t(, •ri `'`J , I BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF ❑SM.,DUPLEX ❑ MULTI-FAMILY I PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YFS
BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICIMER HOME? ❑NO
DESCRIPTION OF WORK
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TOTAL VALUATION: t * � M
By my signature below,I certi o each of a following: I am the prop or authorized agent to act o th operty owner's behalf. I have read this
application and the information I have pY ided is.co t. hive r e Descri on of Work and verify itis accurate. I agree to comply with all applicable local
ordinances and state laws relating to bu' Ing co ctio I a ` or' ese tives of Cupertino to enter the abov identified property for inspection p rposes.
S i mature of ApOicant/Agent: Date:
17-
SUlf LEMENTAL INFO ATION RE =D -
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MEPMisa4pp_2011.doc revised 06/21/11
HVAC ALTERATIONS ENERGY COMPLIANCE FORM
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildinpacupertino.ora
WHEN 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.
• OnIy UL 181; UL 181A, or UL 18 IB 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
Simplified Prescriptive Certificate of Compliance:2008 Residteirtiril HYACAIieratiorzs. CF-1R-ALT-HVAC
Zimate Zones 1 and 3-7 -
ate�4ddr�s: Bnforcemerrt Agency: D :`_ .Permit.#,
d 1
Con&ioned Duct insulation
EquipmentType,
.. 3r:.
unnace Over 4U�of ducts �Setback
®AFUE_ COP Steed added or -laced-in ,
Indoor Cath jSIt_� �HSPF �fiorufreudypresent,must ve
s'f unconditioned space.-
Condensing unit ®EBR 1312osisrericeR 6 (CZ I,3-5)
other
1.Equipment Type:Choose the equipment being installed;if more than onne_syste.a,use another CF-IR-ALT-HVAC for each system.
2.Afinimum Equipment Efficiencies:13 SEER,78%AFUE,7.7FWF for typical residential systems.
Contractor(Docurdentation Author's!Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and comviete.
+ I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for_the design identified,on 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 TRIP 24,Pads 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,worksheets,calculations,plans and specifications submitted to the enfor t agency for approval with the permit
application.
Name: U Siiature:
Company (� ,'^ Date: i
VI
Address Licenser �q l
CitylStatwZip: Phone: „•
2008 Residential Compliance Forms.doc revised 04/10/12
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