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15120187CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10300 E ESTATES DR CONTRACTOR: A-1 HEATING AND PERMIT NO: 15120187 COOLING OWNER'S NAME: KOTHARI ANAND AND VIBHAKAR SHILPA 476 W TAYLOR ST DATE ISSUED: 12/22/2015 OWNER'S PHONE: 4156903237 SAN JOSE, CA 95110 PHONE NO: (408) 283-9915 Z LI INSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL .— REMOVE AND REPLACE FURNACE, SAME LOCATION; n License Class C�% Li,. # q QP Co 909 REPLACE r Contractor M M C-ag, kke Date 10 SUPPLY DUCTS I hereby affirm that I am licensedd un�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 Co p nsation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $13000 p rfor nce of the work for which this permit is issued. I lave nd will maintain Worker's Compensation Insurance, as provided for by e f n 370 of the Labor Code, for the performance of the work for which this APN Number: 36907022.00 Occupancy Type: permit is i ued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORD 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 upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTI N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, r costs, and expenses which may accrue against said City in consequence of the Issued by: Date: iJtJ� flh✓�� granting of this permit. Additionally, t app icant understands and will comply with all nont s rce regu tion er the upertino Municipal Code, Section 9.18. (��� RE -ROOFS: Signature Date 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 inspection. El OWNER-BUILDEa.IWLARATION 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 A' iality anagement District I performance of the work for which this permit is issued. will maintain compliance with the Cupertin uni 'pal CMode, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code,gtio 25 05, 533, nd 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 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 constriction, 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 CUPERTIt-40 GENERAL PERMIT APPLICATION I5GQ0 13�1- CO<\ MUNITY DEVELOPhVENT DEPARTMENT - BUILDING DIVISION 10300 T ORRE AVENUE • CUPEP. T INO, CA 5501'-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino(a)cuoertino.orcl ❑ PLUh/'BING • MBCN_A-NICAL ❑ ELECTRICAL ❑ 3,41ISCELLANT OUS PROJECTADDRESS tc3oo �3�cJ.�� �DY OCvTiRN-11J' J� }� j I� _ {�j„ ,'vi'I v r ( - I Pi?0?�E I E-1✓=tom vtt5 Eos- 323'1 STREETA.DDRESS 1c3�C, �,. S�c��e5 CITY, STA -17, ZIP FAX 4�• I Cue(�Vxo. c"A 9soj� CONTACT�, 1- PHONE ` 7� ` ) 9 E Tek STREETP DRESS �� CITY, STATE, ZIP J05'z CA lv�-I k ' FAX ❑ O)� ❑ OR^'i?-BUi DER ❑ 0Fr2N­FR AG -.T ❑ COI\'TP 4CTOR EZONURACTOR AG:NT ❑ .tRC?.iTtCT ❑ _! GL ==R ❑ D=V'cLOP� ❑ i _I ts7 CO?�TP.? CT,oR; d' �'%�; �e KIM 13 r.-I/��{� �� LICt?�S ?S[Jh EXISE TI PE [08 I C 2c I BUS. LIC FAX Coll/2.4`Y NA -11E E -N 4IL STREET ADDRESS CITY,STATE, IP PHONE < RCHITECT/in GL��ER 1 .Sh4E LICENSE ?\UI .BER BUS. LIC CO3,12ANYNA]YCE — E-IJLSII I FA- STREET ADDRESS I CITY, STATE, Zip I PHOTt USE: OF &rSFD or DTj?LE : ❑ MULTI -FA ,9LY PROj=CT LN'R'IL7L<?.'D ❑ Y: -:s PR07ECT IN ❑ :%S IS THE BLDG AN ❑ Y=S BTJ r"'G: ❑ CON2,T- '--.CTAT— I UIZ3 NLN=- FACE A—PEA ❑ T'O I FLOOD ZONE ❑ x -o I EICI? �tfiON.=T ❑ NO DESCRIPTION OF WORK C 1 "C h u� r\ Gce 6- 10 sC1 uc s TOT?.LVr4LUAT10N: By my signature below, I ce tify to each of the following:yaornizer operty o Ener or autborized agent to act on the prope owner's behalf. I have read this application and he information I have provided is c .ect.7p-- Work and verify it is accurate. I agree to comply with all applicable local ordinances aad state laws relating to building consu. tion.ntatives of .upenino to enter the above -identified property for inspection purposes. Siyature ofA plicant/Agent: Date: Sli- P_E_ iEN I AL Lir ORvIATION IZ. DMM E'ER THS -.;.'� 11Y3�✓ TaMM\ERE•JS 3k -.r " r� •ai :�`: Su . 3 7/Fish/iSCA4PP_ 0J].doc remised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR —BUILDING DIVISION ADDRESS: 10300 E Estates Dr Nq . DATE: 12/2212015 REVIEWED BY: PAUL APN: 369 07 022 BP#: *VALUATION: 1$13,000 '--PERMIT TYPE: Mechanical Permit Furnace, Forced -Air J T—PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: 1 # PENTAMATION FURN/AC PERMIT TYPE: A WORK Remove and replace Furnace, Same Location; Replace 10 Supply Ducts SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY/FEET QTY UNITS BP FEES Furnace, Forced -Air J 1MFR=<100 "'er 1 # $143 F0,", PME Unit Fee: $143.00 PME Permit Fee: $48.00 'to Administrative Fee: 1,4DYWIN $45.00 Work Without Permit? 0 Yes Q) No $0.00 TOTALS: A Travel Documentation Fee: I TR4 VD 0 C $143.00 Strong Motion Fee: I BSEISMICR NOTE: This estintate 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 vrelinzinary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 1.1-053fff T" /.131 Mech. Plan Check 0.0 hrs $0.00 QTY/FEET L IN/fech. Permit Fee: IMPERMIT hrs Other Mech. Insp. 0.0 hrs $48-00 Lj "'er M h AlfI P,V: $0.00 NOTE: This estintate 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 vrelinzinary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 1.1-053fff T" /.131 FEE QTY/FEET MISC ITEMS I ) lan C'heck Fee: PME Plan Check: $0.00 F0,", PME Unit Fee: $143.00 PME Permit Fee: $48.00 'to Administrative Fee: 1,4DYWIN $45.00 Work Without Permit? 0 Yes Q) No $0.00 A Travel Documentation Fee: I TR4 VD 0 C $48.00 Strong Motion Fee: I BSEISMICR $1.69 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $286.69 $0.001 TOTAL FEE:' I � $286.69 Revise . 10/01/2015 ALTERATIONS - HVAC(_Clear F®m,. " CEC-CFIR-ALT-04-E (Revised 06114) CALIFORNIA ENERGY COMMI551oN CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: 10300 E. ESTATES DRIVE Enforcement Agency: Date Prepared: Permit#: City offtokiato 12- JL -15 Equipment Type Equipment Efficiency New Ducting, Plenums, Lineset. Conditioned Thermostat Required R -value Floor Area (sq ft) ❑ Packaged System ❑ Evaporator Coil .96 AFUE COP 10 R-6 (CZ2, 8-13) Ducting Served by system 10 Setback ❑ Split System ❑ Condensing Unit ❑ R-8' (CZ 11, 14,15) Ducting sgft (if not already ❑ Mini Split ❑ Compressor SEER HSPF ❑ R-6 (all CZ's) Plenums present, must 19 Furnace 10 Lineset ❑ R-5 or R7.5) Lineset' be installed) ® TXV EER 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. 1211. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2 Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2 Air Handier/Furnace' (Can include new ducting) Installer Requirement: Duct leakage (S_15%. or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: 10 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' CFIR-ALT-02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS' CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2 Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge 113. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New Ducts3 and one or more of the following CF1R-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage < 6%, Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: ❑ 1. 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: New ducting but less than All New Ducts3 I CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Installer Required to: Duct leakage (: 15% or, < 10% to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. t 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. 2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consis�" f" ry dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) ' 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-2Va", 2.5-3T-2%", 3.5 to 4T-2ya", 5T-4%" [1 i- (' cu. Q. ?M9 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 Ce cat of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, alcul ions, pla s and specifications submitted to the enforcement agency for approval with this building permit applicati n. Responsible Designer Name: Responsible Desi g r Signature: Date Si & License: BRAD GENTILE 12- -15 966809 Company: Address: City/State/Zi Phone: A-1 HEATING & COOLING 476 W. TAYLOR ST. S , CA 95710 1408-283-9915 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800,772-3300