Loading...
14110040CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19828 LA MAR DR CONTRACTOR • i:A�/��/ PERMIT NO: 14110040 OWNER'S NAME: PHONE NO: DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL LICENSED CONTRACTOR'S REPLACE (E) FURNACE, SAME LOCATION (NO DUCT License Class C — g Lie. # 6101115739 WORK) Contractor 133 L t%?(& %Z Date I I / 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 Valuation: $3900 performance of the work for which this permit is issued. Sq. Ft Floor Area: I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36912024 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 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, �l tD7r costs, and expenses which may accrue against said City in consequence of the ssued b Date: J granting of this permit. Additionally, the applicant understands and will co withall non -point source regulation the Cupertino Municipal Cod , ection 9 18.` Date 1 I 6 l RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 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 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 255055 d 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 so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C ) forthwith comply with such provisions or this permit shall be deemed revoked. 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 C�^ NE 4L Pim, MIT ,zPPLICA T ION CC)TViMUNITY D=V=LOPI\liNT DEPARTMENT • BUILDING DIVISIOI' ID300 TORRE AVENUE - CUPERTINO, CA 85014-3255 (LOB) 777-3228 - Pry (408) 777-3333 - builOinOr uDEi fino.orO. A PLL31✓3NIG I119SCELI.A.i\_Ois n M A >7 7 : Fd7"?hj'scZap_-01 LQOc revised 06/-1/11 C., Y, >T1:1-, Z.?, C I row - �6 0 I= �✓ S771 LCOP.23S I CTY, QTS: i_? O'vFti& C�?�� =L:JrZ l� Ov,T�. �i COQ kCTO?. L—f COTS kC�D t 4G? i ❑ k?C�=QCT ❑Cti ❑ D1;�pp� ❑ i��L ,TI J CO1✓9!_1�`1'i�.t lf= � U xe A Z I �.S,F !•j, I Ir`.� ADDRESS 1 Nm C -A ti s 10 to= -2 57 ®� t Nv a�7 3o a- 0 � 66 �0 A �C:v1tC't(.:i�C-ih=cr.NAh/�' I r_iC::NSEi .7ur^.L� I BUTS. LiCr COAD%T��: i�T.d1f. I ✓ifil.'T. I :?.� ' ADT)? ms I CRY, STATt, M? L'S C: ❑ -sm or Din BT -M) MT IP. Ll Coria MXLLT NJLii-?.0 :II.Y I ?R.O:B= LTi' W -Li ,DLIUM D YBS I FROYcCT in L7 YS ua3AN1 .FA.C= 135.4 NO HEZOD?.0x_-- ❑ NO I IS _1= BLDG AN, ❑ Y S ru=._ IROmm? ❑ NO DExpurTioN Gizwova r, U 7Z _— �— 1 1Z rl L ��� J � C �I c �v / OTE1 V LUAMON: 3X10© _ w� �2 _ _ -�BREW, ` - By - sie atm below, I ce +j� to ..�.h of the- following I a,� the rope-ty o:;•mer or aurffiorud a�`aCt D, �— 04- � 5i"l` I have read _r plic€tion and the irio.—ction I have provided is co—, L I hwve : ad the D-,sc7ipt'A:1 of Work and verify it4l cr• ats. _ ^ 'p.: co-_o1y zr,�h all alicehle local s ^ i'� ela: v T lair a• T \' _�:�� o• 1�0^^ or dinanc_ and ._._ - , s r `in_ to b� _� _cion. I au hor m representatives of Ceps; -, to enter ate abope, for spec en S: --mature of A mplic_,L,,A_ert: D e: I f SU • VE_ -N17 AL �r0R_ Lk FIO?v 1ZQUjD i RM s� 6.�-ir�d-^.•-Z'l:^+-T���`_-.� `ter : Fd7"?hj'scZap_-01 LQOc revised 06/-1/11 CITY OF CUPERTINO 1PIP1V 10crr7nR A rTnD — MTTT .T 1T#JV 111VIRION L ADDRESS: 19828 LA MAR DR DATE: 11/06/2014 REVIEWED BY: MELISSA lia1' APN: 369 12 024 BP#: *VALUATION: $3,900 xPERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: 'Alteration /Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC PERMIT TYPE: i USE: $0.00 WORK REPLACE E FURNACE SAME LOCATION NO DUCT WORK SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced -Air IMFR=<100 1 # $143 TOTALS: $143.00 Mech. Plan Check 0.0 hrs $0.00 1'hw1b. P/an C /A'c 1; 'let . f'l a Check Mech. Permit Fee: 1MPERMIT Plu nh. Permit PFr=uit Other Mech. Insp. 0.0 hrs $48.00 other xz�iumib Inv) F�rti�er t��7icc. Irlst.�. i,1"("4 lies). Fee: I'lunib. hi p. Fee: t &ec_ ins,.,. NOTE: This estimate does not include fees due to other uepartments (I. e. I_tunntng, ruotM .. �tn�, ��••••�•y __, _____ _ _ d —t—i ttao Dont far addn'l info. utstrtet, etc.. mese I ees ure uuseu urt uta .�••�• FEE ITEMS (Tee Resolution 11-053 E : 7ff /1/13) ••�••••»••�•- ---___ FEE __ _____ ___ _ QTY/FEE ____ MISC ITEMS Plant Check Fee: P'e PME Plan Check: $0.00 PME Unit Fee: $143.00 PME Permit Fee: $48.00 Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes 0 No $0.00 /lciVcaracVcl /'Ictrrrfing IE'c3c':s': i Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.51 Select an Administrative Item Bldp, Stds Commission.Fee: IBCBSC $1.00 77$285.51 $0.00 TOTAL FEE: � $285.51 Revised: 10/01/2014 STATE OF CALIFORNIA ALTERATIONS - HVAC t i �tt CEC-CFIR-ALT-03-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-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#: 198dg LA 6V- D Iz. Equipment TypeEquipment �(� IZ7)%R Efficiency New: Ducting, Plenums, Lineset Conditioned Thermostat F15 CI Required R -value Floor Area (sq ft) ❑ Packaged System ❑ Evaporator Coil W QAFUE COP 01-6 (CZ 1,3-7) Ducts Served by system etback ❑ Split System ❑ Condensing Unit SEER ❑ R-8' (CZ 16) Ducts sq ft (If not already eFurnace ❑ Lineset EER HSPF ❑ R-6 (all CZ's) Plenums present, must ❑ 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 form is 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. 0 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can include 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 40 linear feet of duct in unconditioned space, or ❑ 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) ❑ 3. 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) ❑ Exempted from duct leakage testing I existing duct systems are constructed, insulated or sealed with asbestos. ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing duds in unconditioned CFIR-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. s R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T 2%", 2.5 -3T -2y.", 3.5 to 4T-2%", 5T-4%8" 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. to !V. C>gs ; -5-I- ID City/State/Zip: cv o,LAMP eR 95--14 Phone: 410)("6A For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 Z__ WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cupertino.orm Owner Name ���,n'7 PermilrNo. Address L a /1I�, ►r ��'�1 /� Ct.� Yom, 10 C A % �� l Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.8 do not apply. Sign below and skip the rest of the form. 1; Owner' Signature: vt__� Date: [/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? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. �/ Owner' Signature: �Ti�` j Date: C1�f No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 11��0.�1.1�� through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: �iGr'��""� �� Date: eNo Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ 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. Sign below and skip the rest of the form. Owner' Signature: Date: 64OR/6S' Oyes My real property isvbuilt and available for use or occupancy on or before January 1, 1994. / Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. 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.' SB407 2015.doc revised 02/04/15 "'s 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). VW% the owner(s) 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 plumbiN fixtures comply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature: MOM. IL . a_/ Date: 6/�/ Upon completing and signing this Certificate, please Meturn it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or!lower than the figure shown, it is not required to be upgraded. SB407 2015. doc revised 02/04/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage (Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallonstflush (Toilets) Gallonstfiush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily Increase May temporarily up to 2.2 gallons per Increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or!lower than the figure shown, it is not required to be upgraded. SB407 2015. doc revised 02/04/15 Vi �y J P, Address / �,'2 Fa: IL SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 85014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a0cuoertino.org nA /� Permit o. I$ 1100 4- 0 Z A G vl A r Prue # of Alarms Smoke: Carbon Monoxide: PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 4220.6 and.907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X. On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions. and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have marl anti anme to nmmnly with tha terms and conditions of this statement Owner (or Owner Agent/'s) Name: - - - Jr V✓C n - - - - - - Si nature. . Date: l' ..................................................................................................... Contractor Name: Signature ..Llc.# .Date: Smoke and CO form.doc revised 03/18/14