12030143 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10379 KRISTA CT CONTRACTOR:ATLAS-TRILLO HVAC PERMIT NO: 12030143
OWNER'S NAME: DIIRC.FSH SRIVASTAVA 1965 KYLE PARK CT DATE ISSUED:03292012
OWNER'S PHONE: 4082035491 SAN JOSE,CA 95125 PHONE NO:(408)286-8931
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class� Lic.q
� U
nn5. '�' n, �7 MECH r RESIDENTIAL r COMMERCIAL r
Contractor Fi-!�/',ar-711Z0 d/(mate S
I hereby affirm that I am licensed under the provisions of Chapter JOB DESCRIPTION: REMOVE AND REPLACE FAU(TRANE-8500 BTU)
(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.FI Floor Area: Valuation:$2500
1 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
permit is issued. APN Number:34245002.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct 1 agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply // //
with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: 5TH/✓ /lig jG eZ Date: 3• �Q•f�Z
9.18.
Signature Dale-tYC �
RF.-ROOFS:
❑ OWNER-RUILDER DECLARATION 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
1 hereby affirm that I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Dale:
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: 1 have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California Ilealth&Safety Code,Sections 25505,25533,and 25534. I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should 1 store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Health&Safely Code,Sections 25505,25533,and 25534.
1 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'sOw Q 7e/� /2
forms.Compensation laws of Cali If,after making this certificate of exemption,1 Dale:/ �C(
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING.AGENCY
I hereby affirm that there is a construction lending agency for the performance of rwrk's
APPLICANT CERTIFICATION for which this peril is issued(Sec.3097.Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
correct.1 agree to comply with all city and county ordinances and stale laws relating
to building construction,and hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Dale
Building Department
City Of Cupertino
10300 Torte Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C O P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT#
OWNER'S PHONE # fJu } ^ 6T e
GENERAL CONTRACTOR: CV—yt' (/ BUSINESS LICENSE #
ADDRESS: q(es C CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL. THE
GENERAL CONTRACTOR AND ALL S HAVE OB
TRACTORSTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors: 2
Signatu ate
Please check applicable subcontractors and complete the followin ormation:
t/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Shect Metal
Shect Rock
Tilc
Owner/Contrac re )ate
o to
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 34245002.00
DATE ISSUED. . . . . . . : 03/29/2012
RECEIPT #. . . . . . . . . : BS000016396
REFERENCE ID # . . . : . 12030143
SITE ADDRESS_ . . . . . : 10379 KRISTA CT
SUBDIVISION : . . .
CITY . . . . . . . . . . . . :: CUPERTINO
IMPACT AREA .,. . . . . .
OWNER . . . . . . . . . . . . : DURGESH SRIVASTAVA
ADDRESS . . . . . . . . . . : 10379 KRISTA CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED- FROM . . . . : ATLAS-TRILLO
CONTRACTOR TRILLO, STEVE LIC # 4269
COMPANY . . . . . . . . . . : ATLAS-TRILLO HVAC
ADDRESS . . . . . . . . . . : 1965 KYLE PARK CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 286-8931
FEE ID UNIT QUANTITY ' AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1 1.00 41. 00 0. 00 41 .00 0. 00
1BCBSC VALUATION 2, 500..00 1.00 0 .00 1.00 0. 00
1BSEISMICR VALUATION 2, 500.00 0.50 0 .00 0.50 0.00
1MFR=<100 UNITS 1 .00 130.00 0 .00 130.00 0.00
1MPERMITFE FLAT RATE 1 .00 44 .00 0 .00 44 .00 0 .00
1TRAVDOC , FLAT RATE1 .00 44 . 00 0 . 00 44 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 260. 50 0. 00 260.50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 260.50 #8686
---------------
TOTAL 'RECEIPT 260.50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10379 Krista Ct DATE: 03/29/2012 REVIEWED BV: Sean
APN: 342-45-002 BP#: 'VALUATION: 1$2,500
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex PENTAMATION FURN/AC
USE: PERMIT TYPE:
WORK Remove and replace FAU Trane - 85000 BTU
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air iMFR=<100 1 # $130
TOTALS: $130.00
Mech. Plan Check 0.0 hrs $0.00 Plnmh, Plou Eh". I'l,m C7irr:A
Mech. Permit Fee: IMPERM/T Plumb. 1,01n r F,r: Oct. /',:n»fir l�r,:
Other Mech. Insp. 0.0 hrs $44.00 00.... ('lamb/nsp. Lj
Urdu/filer. fa�p.
El
.ILrh.Lr,p_hLn: Phnnh. ln,p. Fr.: /filer. LnP.l'rer
NOTE: This estimate does not include fees due to other Departments(ie. Planning, Public Works, Fire,Sanitary Sewer District,School
District,eta). These fees are based on the Prelimina information available and are only an estimate. Contact the Dept for addn7 info.
FEE ITEMS(Fee Resolution 11-053 EIL' 7/1/1 U FEE QTY/FEE MISC ITEMS
Plan C 1wck l"cc:
Supp/_ l'Cl�rr,
PME Plan Check: $0.00
1".1mil Fps-:
Supp/ In.sp /-ce
PME Unit Fee: $130.00
PME Permit Fee: $44.00
C'rM/clrmriorr T(tc:
Administrative Fee: (ADMIN $41.00
Work Without Permit? O Yes E) No $0.00
:Idrunrrd P1,umim" Firs:
Travel Documentation Fee: ITRAVDOC $44.00 A
Strong Motion Fec: IBSEISMICR $0.50 Select an Administrative Item
l31du Stds Commission Pee: IBCBSC $1.00
SUBTOTALS: $260.50 $0.00 TOTAL FEE: $260.50
Revised: 1/1912012
Prescri tive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations to Existing Buildings (Pae 1 of 4)
Site Address: _ Enforcement Agency: Date:
Project Name: Climate Zone# #of Stories
Project Type❑Alterations
Building Type Single Family❑ Multi Family Circle the Front Orientation: N, E,S,W,or degrees
Conditioned hoor Area of Altered Space(CFA): Fuel Type(Gas,Electric,etc):
NOTE:Complete and submit applicable sections of the CF-IR-ALT Form jar the altered building component(s).
Opaque Surfaces
Assembly Alteration
❑ Opening of framed cavity alone—Alterations that involve the opening ofthe framed cavity ofa wall, ceiling, or floor must install the
mandatory minimum insulation value per§150 for the altered wembly.
❑ Replacement of entire assembly—Replacement ofan entire wall, ceiling, or floor assembly requires the installation of Component
Package D insulation values in Table 151-C.
Assemblies: Standard Wood-frame"3 Assemblies: Other Than Standard Wood-frame 2,3
Standard Assembly Pro osed Assembly
1 2 3 4 5 6 7 8 9 10
Assembly Type Frame Type Cavity Continuous Ref.JA4 Column U- Ref.JA4 Column U-
Roof,Wall,Floor Wood, Metal,Mass R-Value R-Value Table and Row factor Table and Row factor
(Sample)Wall Wood 13 6 4.3.1 A5 0.069 4.3.1 D3 0.063
, Fill our Columns 1-4 only for wood frame built assemblies that meet the Component Package minimum Cavity R-value. If
unable to meet the Cavity R-value then ALL 10 columns must be filled out.
2. For all other assemblies fill out ALL 10 columns by indicating values from the Reference Joint Appendix JA4. The U factor of
the Proposed Assembly must be equal or less than the Prescriptive Standard Wood Frame assembly.
3. Refer to the Special Features section on Page 4 of the CF-IR-ALT or additional requirements and check applicable boxes.
FENESTRATION PROPOSED AREAS & ENERGY FACTORS
❑ 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 50f1z 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. The Total Fenestration Area requirement is not applicable, but the existing west facing fenestration area shall not be
increased by more than 50 fr.
❑ Adding more than 50ftz 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 Orientation PropsedArea Maximum Maximum
(Window,Glass Door or Skylight) (North,East,South.West) (R) U-factor''3 SHGC'-''4
1. Fenestrationarea is the area of total glazed product(i.e.glass plus frame). Exception: When a door is less than 50%glass,fenestration area
may be glass area plus 2" 'frame-around the glass.
' Eater value from Prescriptive Package Requirements from either Table 151-C.
.Actual fenestration products installed shall be equivalent to or have a lower U factor and/or a lower SHGC than that specified on the
Installation Certificate(Form CF-6R-ENV).
4.Submit a coat let ed WS-31?if a reduced SHGC is calculated with exterior shading,
Registration Number: Registration Date/Time: HERS Provider.:
2008 Residential Compliance Forms December 2008
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations to Existing Buildings (Page 3 of 4)
Site Address: Enforcement Agency: Date:
HVAC SYSTEMS-HEATING
Minimum Duct or Piping
Heating EquipmentEfficiency Distribution Insulation Thermostat Configuration
Type and Ca pact
,.-., AFUE or HSPF) Type and Location 11-Value" Type (Split or Package)
1.Indicate Heating Type(Central Furnace, Wall Furnace. Heat pump. Boiler, Electric Resistance,etc.)
2.New heating equipment shall be limited to natural gas. lique,0d petroleum gas, or the existing fuel type. Electric resistance heating is allowed
as supplemental heating if the total capacity<2 KW and electric heating is controlled by a time-limiting device not exceeding 60 minutes
3.Refer to the HERS Verification section on Page 4 of the CF-IR-AL T Form for additional requirements and check applicable boxes.
4. Indicate Type or Location(Ducts. Hvdronic in Floor. Radiators,etc.)
HVAC SYSTEMS-COOLING
Minimum
Efficiency Duct or Piping
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat Configuration
Type and Capacity COP) Type and Location R-Value Type (Split or package)
_l. Indicate Cooling Type(A/C,Heat pump, Evap. Cooling, etc)
Refer to the HERS Verification section on Page 4 of the CF-I R-ALT Form for additional requirements and check applicable boxes.
1. 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,and may not exceed 50 gallons. 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 al(climate zones.
Water Heater Type/Fuel Distribution Type Number Tank Energy Factor or Tank Insulation
Type'.2 (Standard,Recirculation)[ In System Capacity(gal) Thermal Efficiency R-Value°
1. Indicate Type(Storage Gas,Heat Pump, Instantaneous,etc.)
2. The new water heater Npe shall be limited to natural gas. liquefied petroleum gas,or the existing filet type.
3. 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.
4. The external water heating lank and pipes shall be insulated to meet the requirements o $150 ).
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below. These
items may require written justification and documentation and special verification.
NEW ROOF ASSEMBLY-Radiant Barrier O YES 13 NO
Yes: In CIZs 2,4,and 8-15,replacing the entire roof assembly requires the installation of a radiant barrier to meet$151(f)2.
Slab Edge(Perimeter)Insulation O YES O NO
YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required.
Heated Slab Insulation O YES O NO
YES:Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 1 I8-A of the standards.
Raised Slab Insulation O YES O NO
VES: 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.
hermal Mass
fo obtain Compliance Credit for the installation of thermal mass,use the Performance Approach.
Registration Number: Registration Date/Tinte: HERS Provider
2008 Residential Compliance Forms December 2008
3
GENERAL PERMIT APPLICATION E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 I /�
CUPERTINO (408)777-3228• FAX(408)777-3333• buildina(EDcuoertino.orD (v—
❑PLUMBING MECHANICAL EInEcriticAL ❑MISCELLANEOUS
PROTECT ADDRESSO 2 , AFN p
J
OWNER NAME L,7Ln )//,� PXONE�o3 _ S-�XL/ EMAIL
STREETADDREiS (� CRY.STATE 7 >, d �G( FAX
CONTACT NAME PRONE E-MAD.
STAEETADDRELS CRY.STATE,ffi FAX
❑ OwNER ❑ OwNER-HUHDER ❑ OWNER AGENT NTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑F (TINE X ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME G (/ HUS.LIC p
,qp` LH687 LF
COMPANYNAME E-MAR
FAX
STREET ADDRESS CITY.STATE,DP ,24�r
ARCHITECUFNGINEER NAME LICENSE NUMBER / EUS.UCT0
COMPANY NAME E-MAIL FAX
STRFFTADDRESS CITY.STATE,23P PHONE
USE OF mDUPLEX ❑ MULT1-FAMB.Y PRWECTINWIDIA?N ❑ YES PROTECT 01 ❑YES IS THE HIDG AN ❑YES
MING: COMMS]ICIAf. URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHTSR ROME! ❑NO
DESCRIPTION OF WORK
�S Goy f`
TOTAL VALUATION: �fQp ^ RECEIVED BY:
By my signature belaW,l certify m of the following: I am the property owner or anthorimd agent to act on the property owner's behalf I have read this
application and the i�ormetion 1 have p u L have read the Descriptio¢of Wade and verify it is acemate. I agree to comply With all applicable local
ordinances and cram laws relating to buil ' muhorize reprrs®tadves of Cupertino to Ater the above-i ti5edpro erty for inspection pup�oses.
Signature Signa of ApplicanNAgenC Data:
SUPPLEMENTAL MORMATION REQUIRED OFFICE USE ONLY
m OVER-THECOUNTER
e
T'p m
Y
U
m ❑ STANDARD
U
3 ❑ URGE
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❑ MAJOR
A EPMIrcApp_1011.doc revised 06121111