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15080084CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10598 NATHANSON AVE CONTRACTOR: PELLE HEATING & AC PERMIT NO: 15080084 INC OWNER'S NAME: BRIGGS JUDITH L 3751 D CHARTER PARK DR DATE ISSUED: 08/10/2015 OWNER'S PHONE: 4088388311 SAN JOSE, CA 95136 PHONE NO: (408)978-7060 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL C "' �© Q REPLACE (E) FURNACE, SAME LOCATION License Cl Lic. # Contracto C Date I hereby affirm that I am licensed under the provisio s 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 Sq. Ft Floor Area: Valuation: $2000 pe rmance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32643012.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PE SUANCE 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 DAYS_ FR D INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the <2 l0 / granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section :Signatur �r000fn 9.18. �Date All roofs shall be inspected prior inbeing installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code�Sections25505 5533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age 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 Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION 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 MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 MISIC CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - building(d)cupertino.org / R 00 00 ( ` PLUMBING MECHANICAL FJELECTIUCAL ❑MISCELLANEOUS PROJECT ADDRESS 1 D 151 N �`I'► �%✓�' r("� APN # _ OWNER NAME E-MAIL STREET ADDRESS' C /� J -I CITY, STATE, ZIP ✓ FAX CONTACT NAME PHONE 4A 91-b E-MAIL STREET ADDRESS35 T,STAZIP /� �, F X cilyt. .4 M60 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE ER i COMPANY NAME ` E-MAIL LICENSE TYPE BUS. LIC # FAX STREET ADDRESS I' C Y STATE, Z[P PHONE \RC'HITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX ';TRFFT ADDRESS CITY, STATE, ZIP PHONE USE OF JEKFD or DUPLEX ❑ MULTI -FAMILY BUILDING: ❑ COMMERCIAL PROJECT IN W ILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECTIN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK^ _,e,C TOTAL VALUATION: By my signature below,'l certify to each of the following: I am the property r or authorized agent to act o owner's behalf. 1 have read this application and the information 1 have providedi ect. 1 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 b (ding, onstru io . 1 authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanUA a Date: / _ -- NTAL INFORMATION REQUIRED OFFICE USE ONLY R -THE -COUNTER a F 1 ❑ EXPRESS - U ❑ STANDARD a ❑ LARGE 0. ❑ MAJOR MEPMiscApp_2011.doe revised 0612l%II CITY OF CUPERTINO RM -1 FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 10598 NATHANSON AVE DATE: 08/10/2015 REVIEWED BY: MELISSA UNITS APN: 326 43 012 BP#: *VALUATION: 1$2,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex # PENTAMATION PERMIT TYPE: FURN/A C WORK REPLACE E FURNACE SAME LOCATION SCOPE S;HPPI. Insp Fee APPLIANCE / EQUIP TYPE FEE ID Plumb. Plon Cher, QTY UNITS BP FEES Furnace, Forced -Air 1MFR=<100 Chiter Llec. Insp. 1 # $143 Permit Fern: S;HPPI. Insp Fee PME Unit Fee: $143.00 PME Permit Fee: $48.00 Construction Tax. - Administrative Fee: 1ADMIN $45.00 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC 1 $143.00 Strong; Motion Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-033 Eff T1,13) Meeh. Plan Check 0.0 hrs $0.00 Plumb. Plon Cher, Eh,4�. Plan Check Mech. Permit Fee: IMPERMIT Other Mech. Insp. 0.0 hrs $48.00 Other Plumb Insp. Chiter Llec. Insp. U�c h /;7,y? 1 c Ittnrh. bt sp. Fi � k1ce. Insp. Fee NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-033 Eff T1,13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee PME Plan Check: $0.00 Permit Fern: S;HPPI. Insp Fee PME Unit Fee: $143.00 PME Permit Fee: $48.00 Construction Tax. - Administrative Fee: 1ADMIN $45.00 Work Without Permit? 0 Yes 0 No $0.00 AdVU11(V l Planning Fees. Travel Documentation Fee: ITRA VDOC $48.00 Strong; Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $285.50 $0.00 TOTAL FEE: $285.50 Revised: 07/02/2015 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -1R -ALT -HVAC) Project Name: Briggs, Judy I Date Prepared: CF1R-ALT-02-E (Page 1 of 3 ) 2015-08-10 A. General Information CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented, use one MR -ALT -02 document for each dwelling unit. 01 Project Name Briggs, Judy 02 Date Prepared 2015-08-10 03 Project Location 10598 Nathonson Ave 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name Briggs, Judy 07 Zip Code 95014 08 Dwelling Unit Conditioned 1852 Installing Installing Installing Floor Area (ft2) Location or Area by this SC ducted containing system Number of space conditioning entirely new 09 Climate Zone 4 10 (SC) systems in this dwelling 1 component? components? feet of ducts? duct system? unit. Alteration Type B. Space Conditioning (SC) System Information 01 02 03 04 05 06 07 08 09 10 Is the SC Installing a SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System (ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Altered space Briggs, Judy Whole house 1852 Yes No Yes No No No conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib) This section does not apply to this project. Registration Number: 215-A0221463A-000000000-0000 Registration Date/Time 2015-08-10 12:08:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-10 12:08:35 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3 ) D. Altered Space Conditioning System (Sections 150.2(b)lE and F) 01 02 03 04 05 06 07 08 09 10 11 12 Heating Cooling System Heating Altered Heating Minimum Altered Cooling Minimum Required New or Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct or Name Type Components Type Value System Type Components Type Value Type Duct Length R -Value All new No cooling This field or This field or This field or This field or Briggs, Judy Central gas heating AFUE 0.8 No cooling component section is not section is not Setback section is not section is not furnace components altered applicable applicable applicable applicable Required Documentation: CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans -Duct insulation requirement for new plenums: R6. CF2R-MCH-20-H & CF3R-MCH-20-H — Duct Leakage testing required when heating or cooling components are installed in ducted systems, or when more than 40 ft of duct length is replaced. -Leakage rate compliance: < 1S%, or <_ 10% leakage to outside, or seal all accessible leaks. CF2R-MCH-25-H & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15). CF2RCF3R-MCH-23 & CF3R-MCH-23 Air Flow>_ 300 CFM/ton required when MCH -25 is required. Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH -20 Duct Leakage Testing requirements. -Heating-only systems and Air Handler/Furnace changes do not require verification of Air Flow MCH -23, or Refrigerant Charge MECH-25. -Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 Duct Leakage Testing requirements. E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F) This section does not apply to this project. F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)lC) This section does not apply to this project. Registration Number: 215-A0221463A-000000000-0000 Registration Date/Time 2015-08-10 12:08:33 HERS Provider: CalCERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-10 12:08:35 Schema Version: 0.555SDD CERTIFICATE OF COMPLIANCE CF111-ALT-02-E Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 ) Documentation Author's Declaration Statement 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: lc A -"Cw�w Sanchez, Rafael Cr �j Company: Signature Date: PELLE HEATING & AIR INC 2015-08-10 12:08:33 Address: CEA/ HERS Certification Identification (if applicable): 179 SAN RAMON DRIVE City/State/Zip: Phone: SAN JOSE CA 95111 (408) 978-7060 Responsible Person'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 Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified an this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. 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. S. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder providestothe building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Sanchez, Rafael Company: Date Signed: PELLE HEATING & AIR INC 2015-08-10 12:08:33 Address: License: 179 SAN RAMON DRIVE 809887 City/State/Zip: Phone: SAN JOSE CA 95111 (408) 978-7060 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A0221463A-000000000-0000 Registration Date/Time: 2015-08-10 12:08:33 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-03-31 Report Generated: 2015-08-10 12:08:35 Schema Version: 0.555SDD Aug 27 2015 10:22AM HP LASERJET FAX 408-978-4780 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE LQ COMMUNITY DEVELOPIZENT DEPARTMENT • BUILDING DIVISION CU P ERTI N O 103DO TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildino(a-cuoertirc,org Address p.4 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 420.6 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/o-- Carbon. Monoxide Alarms be installed in the following locations: AREA I SMOKE ALARM CO ALAItM. Outside of each separate sleeping azea in the immediate vicirsty of. the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room I X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burring 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 end ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 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 abcN e -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. (or Contractor 1 have read and agree to comply with the terms and conditions of this statement Agent's) Name:I I �� ^ (-N:b -Qc', s Date . N Smoke mut COform.doe revised 031,18/14 Rug 27 2015 10:21RM HP LRSERJET FRX 408-978-4780 p.2 CUPERTINO Own�1`Faine Address At WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildfng(ED-cuaertino.orq t sz�y Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: 1kNo 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: 121�No Go to Question 3. Date: 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: 1$.No Go to Question 4. Date: 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: >_Pk Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. 5C 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). D 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 re%4sed 02104115 Aug 27 2015 10:21AM HP LASERJET FAX 408-978-4780 p.3 On or before Jaauary 1, 2019, all nen-aoMptj int plurrnbit+tg fixtw" shall by replaced With water- consor^viU plumbing fixtures throughout the building (regardless of whether property undergoes alterati©ns or irnnrovements). UWe, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures wi71 }sb r' `aced 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 reaui=ments, and that the water-omU rt✓ip lambing fix corn1 wi the uirerrients as itdicatod iri the table bolbw. — :.- IT .., ,.,,.. IM%incr ae,nA c;aninQ this Certifica vlease return it to the Building Division in o er to final your permit. 1. If the existing piumojng nxnu-c wa1Gr usagc.avw •a.= ,a ..�,.4• . �.. _-• -_- _ - __-- - - _ SB407 2 01 S. doc revised 02104115 Non -Compliant 4Wa;tier-Consenrltim F%mbtno IFIXture nt de Applicable to New Construction) (Fixture Complying with CurreCo Plumbing Fixturef Maxlrnum.Wate Use a/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 COC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CAILGreen i01V. 4:3 2093 l.0 et -4tiw X4 3:: Mid r! ex Qivr, 3. . IFlow Rate Single -Family Vu4ti-Family Commercial Residential Residential Water Closets Exceed 1.6 Gallons/flush Single flush toilets: 1.28 gallons/flush Dual flush toilets: 1.28 gallons flush effective flush volume (the composite:' (Toilets) avers a flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Showerheads Gallons/flush Exceed 2.5 2.0 gallons per minute Q 80 psi. Also certified to the performance criteria of gallons per minute U:S. EPA WaterSense Specificestion 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 gallonsper Honore @ 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 minutd @ 1.8 gallons per minute 1.8 gallons per minute @ 60 - Kitchen Faucets per minute 60 psi May temporarily increase @ 80 psi May teritairarily p.W 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 914 - •4.may may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. A ,__ a...,— ei.n if ;c nnr rr�rn,ired to he ungraded. 1. If the existing piumojng nxnu-c wa1Gr usagc.avw •a.= ,a ..�,.4• . �.. _-• -_- _ - __-- - - _ SB407 2 01 S. doc revised 02104115 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 1 of 7 ) Project Name: Briggs, Judy Enforcement Agency: City of Cupertino Permit Number: 15080084 pwelling Address: 10598 Nathonson Avej City: Cupertino i Zip Code: 95014 A. General Information 01 Dwelling Unit Name Briggs, Judy 02 Climate Zone 4 06 = 07 09 09 Number of space conditioning (SC) 03 Dwelling Unit Conditioned Floor Area 1852 04 systems being altered In this dwelling 1 Installing (n2) SC System unit. by this SC 05 Certificate of Compliance Type Prescriptive alterations (CF1R-ALT) 06 Method used to calculate HVAC loads NotApplicableEquipmentChangeout 07 Calculated dwelling unit Sensible This field or section is not applicable 08 Calculated Dwelling Unit Heating Load This field or section is not applicable system Cooling Load (Btuh) new duct entirely new (gtuh ) Name MCH -01b Prescriptive Alterations -Space Conditioning Sg9tems Ductsr► Fans 4. i B. Space Conditioning (SC) System Information'':I'� - l' Ol 02 03 04 OS 06 = 07 09 09 10 CFA served Is the SC Installing a Installing SC System SC System by this SC system a refrigerant Installing new SC Installing more entirely Installing Identification or Location or Area System ducted containing system than 40 feet of new duct entirely new Name Served (ft2) system? component? components? ducts? system? SC system? Alteration Type Altered space Briggs, Judy Whole house 1852 Yes No Yes No No No conditioning system Registration Number: 215-A0221463A-M0100002A-0000 Registration Date/Time: 2015-08-26 15:14:15 HERS Provider: CaICFRTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -US -13 Report Generated: 2015-08-2G 15:14:09 Schema Version: O.SSSSDD CERTIFICATE OF INSTALLATION CF2 R-MCH-Ol-E Space Conditioning Systems, Ducts, and Fans (Page 2 of 7 ) C. Space Conditioning (SC) System Alterations Compliance Information 01 02 03 04 0S 06 07 08 09 10 11 12 13 Heating Efficiency Type Heating Efficiency Value Heating Unit Manufacturer Heating Unit Model Number Heating Unit serial number Rated Heating Capacity, Output (BTUH) Briggs, Judy AFUE 0.8 Bryant 310JAV048090 291SA24928 Central Fan N otes: Integrated Heating Cooling New or (CFI) System Altered Heating Minimum Altered Cooling Minimum Required Replaced New Ventilation Identification Heating Heating Efficiency Efflclency Cooling Cooling Efficiency Efficiency Thermostat Duct Duct System or Name System Type Component Type Value System Type Component Type Value Type Length R -Value Status This This field field Briggs, Judy Central as g All new heating 8 AFUE 0.8 No No cooling or section is N/A - no or sectio Not a CFI furnace componen cooling component SEER not Setback ducts n is system is altered applicabl replaced not e applic able D. Installed Heating Equipment informatiorill s,.!.: :: ,I .- .. ... t• 01 02 ;i U3 ,. ;` 04 r... ; 05 r 06 ::,r 07 System Identification or Name Heating Efficiency Type Heating Efficiency Value Heating Unit Manufacturer Heating Unit Model Number Heating Unit serial number Rated Heating Capacity, Output (BTUH) Briggs, Judy AFUE 0.8 Bryant 310JAV048090 291SA24928 90000 N otes: E. Installed Cooling Equipment information: This section does not apply to this project. Registration Number. 21S-A0221463A-M0100002A-0000 Registration Date%Time: 2015-08-26 15:14:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-08-26 15:14:09 Schema Version: 0.555SDD CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 3 of 7 ) F. Extension of Existing Duct System, Greater Than 40 Feet This section does not apply to this project. G. Installed Duct System information This section does not apply to this project. H. Installed Air Filter Device Information This section does not apply to this project. I. Air Filter Device Requirements Registration Number: 215-A0221463A-MD100002A-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2015-08-26 15.14:15 Report Version: 2014-05-13 Schema Version: 0.555SDD HERS Provider. CaICERTS Report Generated: 2015-08-26 15:14:09 CERTIFICATE OF INSTALLATION CF2R-MCH-01-E Space Conditioning Systems, Ducts, and Fans (Page 4 of 7 ) J. HERS Verification Requirements O1 02 03 04 05 06 07 08 09 10 MCH20 MCH21 MCH22 MCH23 MCH25 MCH28 Exemption from Minimum Exemption R -Value for AHU Fan AHU SC System SC System From Dud Duct Ducts In Ducts Located Efficacy Alrflow Identification or Location or Area Leakage Leakage Conditioned In Cond Space (W per Rate (cfm Refrigerant Return Duct Design Name Served Requirements Test Space Verification Cfm) per ton) Charge Table 150.0-C or D Existing duct system is Not Briggs, Judy Whole house insulated or No applicable No No No No No sealed with asbestos�> 'rt Registration Number: 215-A0221463A-MO10000ZA-0000 for y: at lI: II. uth :it: y rbl� r= ^r;rr.3 Registration Date/Time: 2015-08-26 15.14.15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 201405-13 Report Generated' 2015-08-26 15'14.09 Schema Version: 0.55550D CERTIFICATE OF INSTALLATION Space Conditioning Systems, Ducts, and Fans CF2R-MCH-01-E (Page S of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures applicable to only newly installed equipment or portions of the Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be app Y system that are altered. Existing equipment may be exempt from these requirements. Heating Equipment 01 Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency Regulations. 02 Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant to program the temperature set points for at least four different periods in 24 hours. See Sections 1S0.0(i), 110.2(b). 03 Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections 150.0(h)1 and 2). 04 Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum inlet -to -outlet temperature rise specification. See Section 150.0(h)4. 05 Standby Losses and Pilot Lights: Fan -type central furnaces may nolchdve b oirntlnuoiS ty,,burftmg pilotjlght 'lection 110.5ar4tl pti9 ! 0.2(d). :.. Cooling Equipment Equipment Efficiency: All cooling equipment must`(iteet the minimum ecieney Pequirernentsu5ectfori 110:1 and Seddon 12-0.2(a) and the Appliance Efficiency 06 Regulations. r conditioners and heat pumps must meet the R value and protection requirements of Section 07 Refrigerant Line Insulation: All refrigerant line insulation in split system ai 150.0())2 and 3, and Section 150.0(m)9. 08 Condensing Unit Location: Condensing units shall not be placed within five (5) feet of a dryer vent outlet. See Section 150.0(h)3A. Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section 09 150.0(h)1 and 2. Air Distribution System Ducts, Plenums and Fans 10 Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be required by the prescriptive or performance requirements. See Section 150.0(m)1. Registration Number: 215-A0221463A-M0100002A-0000 Registration Date/Time: 2015-08-26 15:14:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-08-26 15:14:09 Schema Version: 0.55550D CERTIFICATE OF INSTALLATION Space Conditioning Systems, Ducts, and Fans MR -MCH -01-E (Page 6 of 7 ) K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicableto only newly installed equipment or portions of the ,ystem that are altered. Existing equipment may be exempt from these requirements. Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0, 11 602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6-0 or enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.8. Heat Pump Thermostat 12 1 A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c). 13 1 The thermostat shall be installed in accordance with the manufacturers published installation specifications 14 1 First stage of heating shall be assigned to heat pump heating. is Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met - The responsible person signature on this compliance,�locume6t affirms that ail applicablqutf¢mtt=nts IR thlsl2le have berltieE Registration Number: 215-A0221463A-MO100002A-0000 Registration Date/Time: 2015-08-26 15:14:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014-05-13 Report Generated: 2015-08-26 IS:14:09 Schema Version: O.S55SDD CF2R-MCH-01-E CERTIFICATE OF INSTALLATION (Page 7 of 7 Space Conditioning Systems, Ducts, and Fans Documentation Author's Declaration Statement 1.1 certify that this Certificate of Installation documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Sanchez, Rafael Signature Date: Company: 2015-08-26 15:14:15 PELLE HEATING & AIR INC _ :r ia.n*;r; ar;nn lit annlicahlel: 179 SAN RAMON DRIVE Phone: City/State/Zip: 1(4081978-7060 SAN JOSE CA 95111 Responsible Person'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 Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer l ` liable codes and regulations, and the 3- The constructed or installed features, materials components or rr+ ufactureltdili ce4�th installabd�jj Identt#ed oWthis Certdk of InstallaUO cotlTpdFtRto?4;Fpp installation conforms to the requirements given on the; ans and Wciflcatiorys a, prot4�d the enfdflcement gefrcy. l "I " _ H+c uu ` ent „• epe pe of,C;onouct(on cifiipstallation identified on this Certificate of a. I reviewed a copy of the Certificate of Compliantt pro d by the dntBrterrfir+t iken6 that;ioenWfiBe Lf4q SpL V Installation, and I have ensured that the requirementst apply to the construction or installation have been met.f r all S. I will ensure that a registered copy of this Certificate o(fiis llation shati-bC poAed, or o+ade availpble with ih@ build g permitls) issu2d forthe Eluilding ar+d ma¢e2vailable to the enforcement agency o applicable inspections. I understand that a registered copy - this Cert;: c 1 e of fn'stallation is required to be included wah the documentation the builder p" rovides to the building owner at occupancy. Responsible Builder/Installer Name: Responsible Builder/Installer Signature, aI(GGl Sanchez, Rafael Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position With Company (Title): PELLE HEATING & AIR INC Manager C5LB license: Address: 179 SAN RAMON DRIVE 809887 Phone: Fate Signed: City/State/Zip: SAN JOSE CA 95111 1(408)978-7060 2015-08-26 15:14: Digitally signed by UCERTS This digital signature is provided in order to secure the content at (his registered document, and in noway implies Registration provider responsibility for the accuracy of the information. Registration Number: 215-AO221463A-MO100002A-0000 Registration Date/Time: 2015-08-26 15;14:15 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2014 -OS -13 Report Generated: 2015-08-26 15:14:09 Schema Version: O.SSSSDD c o� W J fV O Ln .A O m 1 tD v m i J to O