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B-2016-2367
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2367 6386 BLACKWOOD DR CUPERTINO,CA 95014-4617(369 17 048) QUAN'S ELECTRICAL CO CUPERTINO,CA 95014 OWNER'S NAME: CHIANG RAY L TRUSTEE DATE ISSUED:07/25/2016 OWNER'S PHONE:408-891-2808 PHONE NO:(408)529-0854 LICENSED CONTRACTOR'S DECILARATION BUILDING PERMIT INFO: License Class WARM-AIR HEATING VENTILATING AND AIR-CONDITIONING Lic.#706512 X BLDG_ELECT _PLUMB Contractor QUAN'S ELECTRICAL CO Date 45/31/2017 X MECH X RESIDENTIAL_COMMERCIAL 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 JOB DESCRH'-TION: license is in full force and effect. REPLACE FURNACE(HALL CLOSET);ADD A/C IN REAR YARD; REPLACE ALL ASSOCIATED DUCT WORK I hereby affirm under penalty of perjury one of the following two declarations: i. 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. `y'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 Sq.Ft Floor Area: Valuation:$7500.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county ordinances 369 17 048 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 indemnify and keep harmless the PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities,judgments,costs,.and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue against said City in consequence of the granting of this.permit. Additionally,the applicant understands and will comply with all non-point 180 DAYS FROM LAST CALLED INSPECTION. source regulations per the Cupertino Municipal Code,Section 9.18. Issued by:ME Signature , Z Date 07/25/2016 Date:07125/ OWNER-BUH DER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature ofAppiicant: 2. I,as owner of the property,am exclusively contracting with licensed Dater 07/25/2016 contractors to construct the project(See.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued.. Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25505,25533,and 25534. exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall Owner or authorized agent---'� be deemed revoked. Date:07/25/2016 .APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 07/25/2016 Professional __..............____..._........_.._. GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building(a)cupertino.org MISC [_1 PLUMBING CHANICAL E!;gLECTRICAL ❑'MISCELLANEOUS PROJECT ADDRESS ; � APN# 11 t)OWNERNAME g PHONE p� f CITY, STATE,ZIEMAIL STREET ADDRESS f!V T ,+. - P /t FAX CONTACT NAMEr PHO Ztq E-MAIL STREET ADDRESS`o J CITY,STATE;ZIPS /- ( (°1 FAX ❑OWNER ❑ OWNER-BUILDER O OWNER AGENT TRACTOR ❑-CONTRACTOR AGENT ❑ ARCHITECT i❑ENGINEER ❑ DEVELOPERS ❑TENANT CONTRACTOR NAME LICENSE 4 EIS, LICENSE TYPE BUS.LIC COMPANY NAMErfA}n/ s /`�� Gt (GYW�o� E-MAIL FAX STREET ADDRESS ) CITY STATE,ZIP ( C)C-I- y LOLA Me; a„� j 1;0C -7 ARCHITECTXNGINEER NAME LICENSE NUMBE BUS.LIC# (�� COMPANY NAME E-MAIL FAX STREET ADDRESS " CITY,STATE,ZIP PHONE USE OF SFD Or Duplex ❑ Multi-Family PROJECT IN WILDLANDPROJECT IN STRUCTURE: El Commercial URBAN INTERFACE AREA ElYes 4 <1 FLOOD ZONE ❑ Yes O DESCRIPTION OF WORK C__," TOTAL VALUATION: EI t By my signature below,I certify to each of the following: I ain the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building on tructton. I authoriz epresentatives of Cupertino to enter the above-identified property fo ins ection purposes. Signature of Applicant/Agent: Date: , SUPPLEMENTAL INFORMATION REQUIRED oFFxcrsr oNL , , 0dYERTi�E-COUNTER %. '. S`T`ANDARD El F, ;MA70R MEPMiscApp_2011.doc revised 03116111 STATE OF CALIFORNIA ALTERATIONS HVAC CEC-CF1R-ALT-03-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-IR-ALT-HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: Equipment Type Equipment Efficiency New:Ducting,Plenums,Lineset Conditioned Thermostat Required R-value Floor Area(sq ft) El Packaged System g y evaporator Coil AFUf CPP 13 R-6 (021,3-7)Ducts Served by system ❑Setback ❑Split System eCondensing UnitSEER ❑R-8' (CZ 16)Ducts sq ft (if not already HSPF 17 R-6(all Q's)Plenums present,must [furnace L9' neset EER ❑R-5 or R7.5 Lineset' be installed) HERS VERIFICATION SUMMARY installer determines work to be completed and matches to•one of the options below. At permit application this formis allowed to be filled out by hand. For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. 1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can4nclude new ducting All Equipment, CF1R-ALT-02-E Condenser Unit,Evaporator Coil, CF2R:MECH-01,MECH-20-HERS Air Handler/Furnace CF3R:MECH-20-HERS. Installer Requirement:Duct leakage(: 15%or,<10%to outside,or seal all accessible leaks) Exempted from duct leakage testing if: ❑1,Duct system registered with HERS provider as previously sealed,or❑2.There is less than 401inear feet of duct in unconditioned space,or,13 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ❑2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1R-ALT-02-E CF2R-MECH-01,MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS CF3R-MECH-20-HERS,MECH-22-HERS,MECH-(23 or 24)-HERS' Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM);Air Flow>_350 CFM/ton(or Standards Table 150-0-C/D alternative) .All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CF1R-ALT-02-E Ducts'and one or more of the following: CF2R-MECH-01,MECH-20-HERS,MECH-(23 or 24)-HERS , Condenser Unit,Evaporator Coil,Furnace CF3R-MECH-20-HERS,MECH-(23 or 24)-HERS Installer Requirement:Duct leakage<6%,Air Flow>_350 CFM/ton(or Standards Table 150.0-C/D alternative) 11 Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. EJ 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in unconditioned CF1R-ALT-02-E space but less than All New Ducts' CF2R:MECH=20-HERS CF3R:MECH-20-HERS Installer Required to:Duct leakage(<.15%or,<10%to outside,or seal all accessible leaks) ❑ Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. 'All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls,between floors etc. 'A New Duct system is when the duct system is constructed of at least 75 percent new duct material,and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system(e.g.,registers,grilles,boots,air handler,plenums,duct material. I R-5(1"thick insulation)for linesets 1"and less. R-7.5(1.5"thick insulation)for linesets over I inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T-2%",2.5-3T-2%",3.5 to 4T-2%",5T-4%" Contractor(Documentation Author's/Responsible Designer's Declaration Statement) I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. 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(CCR). 4. That the energy features and performance specifications,materials,components,and manufactured devices for,the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the CCR. 5. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. Responsti�ble Designer Name: Responsible Desig w Sgnature: Date Signed: License: 7&4 rl Comp ny: Address: City/State/Zip: Phone: For assistance or questions regarding the Energy Standar s,contact thel Energy otline at:1-800-772-3300 Q.-FFICE, COP " ' i 41, N", � r I Ca. �3 a c " 'r IDrn f p C7- 0 s m Z U cy ► rg �; rJ ' L 0 a Z Q om c� � Qm 04 C, CD ® � � �> W c� zT O m (D Q (� tip 0) � g O a Pet tea < 7r z �GN (' v > °a0 -i m Il UE 1 ' COMMUNITYDEV ELOP<MENTIDEPARTvMiB T-BUILDING DfUfBION '0lulN-EIR UD 10300 TORRE AVENUE GU;P8RTI 4,G,CA 95014-3255 (408)M-1228*FAX(4a8)777-3333 baildio ,acUpr jno org r FUR OSM 'nlis affidavit is a self-Certifica ion for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access.for inspection's are',required. G-ENERAl;INFORMATION Fisting single family and rnrilti-family dwellings 8h be provided with Smoke Alarms and Carbo-j1 Monoxide alarihs W,hteft,the valuation of additions,alterations,or repairs to existing dwelling units exceeds X1.0001©'0;CI-`C Section 1314 and CSC Sections 907.2.11:.5 aild 420.6 require that Smoke Alarms arrcl/or Carbon MlortUXII e Alarmsbe,in stalled in the following locations:: - AAVA ,A�M CQ'A�.A��l Outs ide of each separate sleepingg area in Else irilrnediate vicinity of the bed��orm.s<:f On eve;',I level of a dweller' wit includin .b se-rneruEs itn eac11 Slee rn room h Carbons WRIVAIde alarms are not re ,qaired in dwellffigs which do no,t corrtancr fuel biirng appliances a_nd thad d®not 12a e ani attached garage Carbon monoxide alarms coimmtined with s�F,oke alaT,ms shall co mm w€th CRTC Sedt 41261h and shall sae approved by the Office of the Spate Fire Ivl[arsl4al. Power Supply:In £4welliizg rxndts with no co s i.��ercial power supply,alart ;(s).1 y be solely b attery opera.ed.. Zr existing dkielling uiuts alax. m,s are ermitted to be soles;bather a> I p' y y Operated w'l�ere repairs or alferatiggis d@® not res`A m�they rerntoval of Wali'and cerli2zg finishes or,ther,e is iio,access by me ,ns,of attic,easement or crawl space Defer to=CRC S chop 8314 ai1d CBC Sections 9'0T7.2.31.4 and142) 6;.2.Are electr==real''(pernut is require for alla'rnis wTniclti must be co3ulected to t he building wiriiug. As owner of the:above-refer. ,y y � ) encecl r© ert I Itereb eertd that the alar, enced aho p l� yf in,s refer ve lias t' ave b /h eefi; instal+led i-rt3 amer,dailc.e with the m�altiufactmer's;instruction&aild ixi compl�ance with the Ca4lifa,rnaiai Rci�ildi,,,lg and Ca+I%foriaia;Resxdsentia�l.Cad`es. I e ala=rms Dave b�eeiq tested aizd are operation>all,as of the date sigL edi below.. M- G fiaue re;;adand>a=ree.G4'coca (; wrfh Elie'fterms antd candrfr:©ns,o #-Vs;s,f .Gerrtenf -- Date _; WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING'DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• t AX(408)777-3333•building(akugertho.org 0wtaei Naim-1 r L C_- r-1'ermzt No. ,.. Y Address% � C i/t!�►� 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. El C(No Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. (� FeNo Go to Question 3. 3. Is water service permanently disconnected for your building? Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. [9'No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? El No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: R- My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑' My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plunbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). I,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's.Signatiur_e ' Date: 7� 7J?Aif.� Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB407 2015'doc revised 08126115