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14060160CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10190 STERN AVE CONTRACTOR: VALLEY HEATING & PERMIT NO: 14060160 COOLING OWNER'S NAME: GURZHI ALEXANDER AND ELENA TRUSTE 1171 N 4TH ST DATE ISSUED: 06/25/2014 OWNER'S PHONE: 6504831282 SAN JOSE, CA 95112 PHONE NO: (408)294-6290 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] REPLACE 2 (E) FURNACES & 2 (E) A/C UNITS, SAME P�( P C� License Class Lic. # �J t7J l LOCATIONS [ (/ 9' �� C., [ " 1 Contractor _ ate 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: $15400 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 37512003 00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 180 DAY 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 DAY LAST ED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in of the costs, and expenses which may accrue against said consequence - te: granting of this permit. Additionally, the applicant understands and will comply su with all non -point source regulations per the Cupertino Municipal Code, Section -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is 9 18. / Signature Date G�` l 410, 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 for this the Health & Safety Code, Sections 2 05, 25533, and 25534. / C12 -/l Section 3700 of the Labor Code, for the performance of the work which 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 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 (See 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 �PVAKI E P COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION (nO 10300 TORRE AVENUE • CUPERTINO, CA 05014-3255 �J (408) 777-3228 • FAX (408) 777-3333 • buildino(a)cuaei ino.org M I S �O I-1 orTn,FUTTar- nTJPrTNANTrA7. F-FLRCTRICAL F1 PROTa ADDRESS ! (X( �f r 1 v / I OVJI,MNA,hS I PHOT !' 0 7 _ /Z' G��C� �' STREET ADDRESS t Jl th FAX c COINTACT NANr PHONE E-1JN,II �,nfir�E, fvr STREET ADDRESS CITY, STATE, ZIP FAX ❑OR *RGt ❑ 0'(Aj R-B=ER ❑ OW SRAGENr CONTRACTOR ❑ CONTRACTORAGE>\T ❑ ARCrIlTECT ❑ ENGIN= ❑ DEVELOPER ❑ TEN -1 -NT CONTP ACTOR NAME LICENSE TYP I BUS. LIC COMDAT Y NAl✓E( r�\�.ja�'�( �,y I E M� I FAX �•s +�,' '///"' STRaei ADDRESS /�' fi h 1 ` / U' I CITY, STATE ZIP Z_ (' ARCHrIB /ENGINEERh,U F- LICENSENUNiBER. I BUS. LIC 4 COMPANY NTAME E-MAIL, FAX STREET ADDRESS CITY, STATE, ZIP PHOTS USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY PROSECT LN WIIALAND ❑YES PROTECT IN ❑ YES BTJI DING: ❑ COMMERCIAL I URBAN INTERFACE AREA ❑ NO I FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YFS EICHLIIt H01IE? ❑ NO DESCRIPTION OF WORK a e -v n f C x • TOT,41 VALUATION: carte" $ By my signature below, I certi to each of the following: I am the property oumer or ' d agent to act on the pr er's behalf. I h read this application and the information I have provided is correct. I have read the Description of Work and verity it is accurate. I agree to comply all applicable local ordinances and state laws relating to bu' ing construction. I authorize representatives of Cupertino to enter the ab t enti�fie pro or inspection purposes. Si mature of Applicant/Agent: Date: ��cJ 2� SUPPLEhIfNTAL INFORMATION REQTJ=D • -0�zgm I � '��3CiR .�PAjiscXpp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION APPLIANCE / EQUIP TYPE DDRESS: 10190 STERN AVE DATE: 06/25/2014 REVIEWED BY: MELISSA W PN: 375 12 003 BP#: *VALUATION: $15,400 PE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Du lex p # PENTAMATION FURN/AC PERMIT TYPE: USE: Furnace, Forced -Air 1MFR=<100 WORK REPLACE 2 E FURNACES & 2 E A/C UNITS SAME LOCATIONS # $278 SCOPE PME Unit Fee: APPLIANCE / EQUIP TYPE FEE ID Mech. Plan Check0.0 hrs $0.00 QTY UNITS BP FEES Zazh. A/C Units (<=10K cfm) 1BREMAIR Ohhei, Alum&Irr.in 2 # $140 Furnace, Forced -Air 1MFR=<100 SZdppif, 111sp 2 # $278 PME Unit Fee: $418.00 PME Permit Fee: $47.00 C:on�trc,=ct"oto Tcol: Administrative Fee: ]ADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 TOTALS: i Travel Documentation Fee: ITRAVDOC $418.00 Strong Motion Fee: IBSEISMICR N '—ft NOTE: FEE Mech. Plan Check0.0 hrs $0.00 111,1w1h. P!, -.in Mech. Permit Fee: IMPERMIT Zazh. Mech.Insp. 0.0 hrs $47.00 Ohhei, Alum&Irr.in f>rf�z� L��- ��'.,'P rther 111unib, IZ Fee- ee- NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public works, rare, Sannary .ewer utacricq oawuc n:...,.: — A—ad nn the nreli.y inar„ infnrmadan availahle and are only an estimate. Contact the Deptfor addn'l info, ..... ..........._---.- FEE ITEMS (I ee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS L suppl. PC P',>e 171 PME Plan Check: $0.00 t e oJit J`ce: SZdppif, 111sp PME Unit Fee: $418.00 PME Permit Fee: $47.00 C:on�trc,=ct"oto Tcol: Administrative Fee: ]ADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 i Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $1.54 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 qt OCL' �f n $558.54 $0.00 TOTAL FEE; $558.54 Revised: 04/01/2014 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC- CF -1R -ALT Revised 03110 CALIFORNIA ENERGY COMMISSION Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 1 of 7 Project Name: Climate Zone # # of Stories Alexander Gurzhi 4 2 General Information Site Address:10190 Stern Ave Enforcement Agency: Date: Building Type ❑ Single Family ❑ Multi Family Circle the Front Orientation: N, E, S, W, or degrees Conditioned Floor Area (CFA): 2700 Project Type: ❑ Alterations ❑ Envelope ❑ Fenestration ❑ Roof AWAC Replacement or Chane Out ❑ Duct Replacement ❑ Water Heater NOTE. This form is not to be used for Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑ Opening of framed cavity alone—Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per §150 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H. ❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C. Fill in Columns A — J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B I C D E F G I H I I 11 J Proposed beeNote Standard Values From JA4 Table Tag/ ID' Assembly Name or Type 2 Framing Material and Size Thickness, Spacing, or Other' Framed U- JA4 Table Cavity factor° Numbers R-valueb Continuous JA4 Proposed Insulation Assembly Assembly 1 R -Value' Row/Col' U-factor9 Joint A ppendix Table 4.3.5, 4.3.6, 4.3.7 Joint Appendix Table 4.3.13 m o w a 6.? " w Assemblye cow s U .U Final Name or JA4 Table Type' Number; d > ° > ` Assembly Uctor' -faThickness' Comment Note: For furred assemblies, accountingfor Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furring Construction table below. 1. For Tag/ID indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc ... Indicate in column G the Frame material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC; or Other for all other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4.Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R- Value from Table 151-B, C, or D 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ". 8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J 9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A B C D E F G H I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint A ppendix Table 4.3.5, 4.3.6, 4.3.7 Joint Appendix Table 4.3.13 m o w a 6.? " w Assemblye cow s U .U Final Name or JA4 Table Type' Number; d > ° > ` Assembly Uctor' -faThickness' Comment w .. r 2008 Residential Compliance Forms March 2010 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 2 of 7 Project Name: Climate Zone # d I # of Stories ass and Furrin Strips Construction botnotes 1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can be found Reference Joint Appendix JA4. 2. This is the U -Factor based on the thickness of the assembly in inches. 3. The R -value of the insulation to be added on the interior or exterior of the assembly. 4. The Calculated R- Value is the R -value of the furred out section of the assembly. -6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA4. The equation is the inverse of Column added to Column I Column K is the inverse from column J. 7. Insert the calculated U -factor value on to the Opaque Surface Details in Column J FENESTRATION PROPOSED AREAS ❑ Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. The Total Fenestration and West facing Area requirements are not applicable. ❑ Adding 50ft2 or less of window area — Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. ❑ Adding more than 50fe of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT Fenestration Type and Frame (Window, Glass Door or Skylight) Orientation (North, East, PropsedArea' Maximum Maximum NFRC or Default South, West) (ft) U-factorz' 3 SHGCZ' 3' ° Value E F G CFA of Allowed Existing 1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration area may be the glass area plus a "2 inch frame" around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the CF -IR ALT Form. 4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading. 5. If applicable at this stage enter `NFRC" or NFRC Certified windows or are CEC "De ault" valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft2 of fenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire %of Fenestration Area Fenestration Area Proposed Area' °4 Dwelling CFA2, 3 Area4 Remove& Area Added (A x B) (E -D) + C Total Fenestration Area 2,(ft2)— West Fenestration Area (Required In > CZ's 2,4&7-15) 2008 Residential Compliance Forms March 2010 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC- CF -1 R -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 3 of 7 Project Name: Climate Zone # 4 # of Stories AlevnnrCnr (_`ii"hi 1 2 1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12. 2. Enter 20% when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, & 7-15. Note that the maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones 2, 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. 5. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as part of the alteration. �3 z.3. 2008 Residential Compliance Forms March 2010 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 4 of 7 Pro ct Name: Climate Zone # 4 # of Storms ixlexander Gurzhi ROOFING PRODUCTS (COOL ROOFS) §151012 When the area of exterior roof surface to be replaced exceeds more than 50% of the existing roof area, or more than 1, 000 f , whichever is less, the new roofing area must meet the roofing product "Cool Roof" requirements of§152(b)IHi, 152(b)IHii, or 152(b)IHUL Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof' requirements. Note: If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(1) are not applicable. Do not fill table below. ❑ Cool Roofs Not Required in Climate Zones 1-12,14, and 16 with a Low Sloped. Less or 2:12 pitch. ❑Cool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep -Sloped Roofs (pitch greater than 2:12) and product unit weight less than 5lb/ft2. Alternatives to §152(b)IHi and §152(b)Hii, Steep -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr•ft2•°FBtu or at least a 3/4 inch air -space is added to the roof deck over an attic; or ❑ Existing ducts in the attic are insulated and sealed according to § 151(f)10; or ❑ In climate zones 10, 12 and 13, with 1 ft of free ventilation area of attic ventilation for every 150 ft2 of attic floor area, and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge; or ❑ Building has at least R-30 ceiling insulation; or ❑ Building has radiant barrier in the attic meeting the requirements of § 151(02; or ❑ Building has no ducts in the attic; or ❑ In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §152(b)1Hiii, Low -slope roof (pitch <_ 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. ❑ Roof constructions that have thermal mass over the roof membrane with at least 25 ib/ft2 is exempt from the below Cool Roof criteria. Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, Check the applicable box below if Exem t from the Roofing Products "Cool Roof' Re uirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 > 2:12 < 5lb/ft2 > 5lb/ft2 Type2 Reflectance3'4 Emittance SRI ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www. coolroofs.org/products/search.php 2. Indicate the type ofproduct is being used for the roof top, i.e. single ply roof, asphalt roof, metal roof, etc. 3. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation (0.2+01(p;n i pt — 0.2) to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at hap:/Avww.energy. ca.vov/title24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF -IR. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating: ❑ Aluminum -Pigmented Asphalt Roof Coating ❑ Cement -Based Roof Coating ❑ Other 2008 Residential Compliance Forms March 2010 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC- CF -IR -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 5 of Projec ame Climate Zone # 4 # of Stories t lexander Gurzhi I 1 1) HVAC SYSTEMS - HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones. Minimum Duct or Piping Configuration Heating Equipment Type and Capacity 1•2,3 Efficiency (AFUE or HSPF) Distribution Insulation Type and Location R -Value Thermostat Type (Central, Split, Space, Package or H dronic) CF -70K 80% DUCTS r-4 SB 1. Indicate Heating Type (Central Furnace, Wall Furnace, Neat pump, Boiler, Electric Resistance, etc.) 2. Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity < 2 KW or 7,000 Btu/hr electric heating is controlled by a time -limiting device not exceeding 30 minutes). See §151(b)3 exception. 3. Refer to the HERS Verification section on Page 4 of the CF -1 R -ALT Form for additional requirements and check applicable boxes. 4. Indicate Type or Location (Ducts, Hydronic in Floor, Radiators, etc.) HVAC SYSTEMS - COOLING not allow the installation of a recirculating water heating system for single dwelling units. Minimum Efficiency Duct or Piping Configuration Cooling Equipment Type and Capacity '°Z (SEER/EER or Distribution Insulation Thermostat P) Type and Location' R -Value Type (Central, Split, S ace, Packa e or Hydronic A/C -36K 101 1 1 DUCTSr-4 P I 1. Indicate Cooling Type (A/C, Heatpump, Evap. Cooling, etc) 2. Refer to the HERS Verification section on Page 4 of the CF -IR -ALT Form for additional requirements and check applicable boxes. 3. Indicate Type or Location Ducts, H dronic in Floor, Radiators, etc. WATER HEATING List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be gas or propane fired. Hot water pipe insulation from the DHW heater to the kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones. External Tank Water Heater Type/Fuel Type Distribution Type (Standard, Recirculatin )Z Number In System Tank Capacity (gal) Energy Factor or Thermal Efficiency Insulation R-Value3 1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and i es shall be insulated to meet the requirements of §1506). SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These items may require written 'usti tcation and documentation and special verification. NEW ROOF ASSEMBLY - Radiant Barrier The radiant barrier requirement of §151 2 does not apply to roof alterations. Slab Edge (Perimeter) Insulation ❑ YES ❑ NO YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required. Heated Slab Insulation ❑ YES ❑ NO YES: Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation ❑ YES ❑ NO YES: In Climate Zones 1, 2, 11, 13,14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D. 2008 Residential Compliance Forms March 2010 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC- CF -IR -ALT Revised 03/10 CALIFORNIA ENERGY COMMISSION Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 6 of 7 Project Name: Climate Zone # # of Stories Thermal Mass To obtain COmDliance Credit for the installation of thermal mass, use the Performance Approach. HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealino Testing HERS verification is required for this measure. ❑ YES a NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §152(b)IDii and the newly installed ducts are to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES &NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the f ducts are to be sealed per § I52(b)1Di. ❑ YES Cd'NO YES: hi Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per § 152(b)1E. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant fdharge -Split System HERS verification is required for this measure. ❑ YES 13 NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per § 152(b)IF. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of §150(o) do not apply to existing residential homes. Ducted Splitt § 'stems -Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ❑ YES 13 NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per § 152(b)1Ci to meet the requirements of § 151(f)7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. Name: Signature: ComR2I1ey Heating and Cooling Date: Add r s IS 71 Street If Applicable ❑ CEA or 13CEPE N4Th (Certification ft City/State/zip: P'Wn-294-6290 Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. NOR o 2008 Residential Compliance Forms March 0 STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEC- CF -1 R -ALT (Revised 03/10) Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations (Page 7 of 7 Pro ec Name: Climate Zone # # of Stories Aexander Gurzhi 4 1 2 Name: Signature: CornVanhey Heating and Cooling Date: Add, f, l N4Th Street License: 258540 City/ tate/Zip: Sian Jose ,CA 95112408-294-6290 Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. 2008 Residential Compliance Forms March 2010 (ENFORCEMENT AGENCY CAN.CUSTO IffZE WITH LETTERHEAD/SEAL; 2008 Building Energy Efficiency Standards Residential HVAC Alterations Climate Zones 1 and 3 through 7 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. WHEN IS A PERMIT REQUIRED? A written 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 Appendix Chapter 1, Section 112.2 of the 2007 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 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 requirements of Section 150(m): • All joints and openings in the in the HVAC system must be sealed. • Only UL 181, UL 181 A, or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metals 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 4ft. 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. STATE OF CALIFORNIA 2008 RESIDENTIAL HVAC ALTERATIONS: CLIMATE ZONES 1 AND 3-7 CEC- CF -1 R -ALT -HVAC (Rev(ised 03110) CALIF Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF -IR -ALT -HVAC Climate Zones 1 and 3 - 7 Site Address: Enforcement Agency: Date: Permit#: Conditioned Duct insulation Equipment T e' List Minimum Efficienc 2 Floor Area requirement Thermostat ❑ Packaged Unit Over 40 ft of ducts ❑ Furnace ❑ AFUE ❑ COP Served by system added replaced in ❑ Setback ❑ Indoor Coil ❑SEER ❑ HSPF sf unconditioned ioned space (If not already present, must be ❑ Condensing Unit ❑ EER ❑ Resistance installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • 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 Title 24, Parts 1 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 enforcement agency for approval with the permit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: 2008 Residential Compliance Forms March 2010