The URL can be used to link to this page

B-2016-1240CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1240 19988 TWILIGHT CT CUPERTINO, CA 95014-2304 (316 31 027) (RANDO AAA HVAC INC) SAN JOSE, CA 95125 OWNER'S NAME: BERGER, IRENE E 2008 REV TR/ DATE ISSUED: 01/21/2016 OWNER'S PHONE: PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: Class Lic. t lC� � 1�s (C License Contractor (RANDO AAA HVAC INC ) Date 1 (� X BLDG _ELECT _PLUMB ( X MECH X RESIDENTIAL _ COMMERCIAL I hereby affirm that I am licensed under the provis ons o Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: Replace (e) furnace and A/C I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. r.s . I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which Sq. Ft Floor Area: Valuation: $6000.00 this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above Number: Occupancy Type: information is correct. I agree to comply with all city and county 3 316 31 027 16 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, costs, and PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. . Code, Section 9.18. ignature _. Date [1,2t (ip Issued by� Date: l� OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: 2. 1, as owner of the property, am exclusively contracting with licensed Date: contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance, as provided for California Health & Safety Code, Sections 25505, 25533, and 25534. I will by Section 3700 of the Labor Code, for the performance of the work for which maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous this permit is issued. a. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & o , ections 5 5 25533, and 25534. exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall owner or auth rized agent: be deemed revoked. Date: i r APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's Flame to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARCHITECT'S DECLARATION understands and will comply with all non -point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date GENERAL PERMi i APPLICATION COMMUNITY DEVELOPI\/ENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPER 1 INC), CA 9501 , 3255 (408) 777-3228 • FAX (408) 777-3333 • bui1dlnO6D01JDerilnO.Orq ❑ PLu,/s' G MT -Ca XIC.AL ❑ ELECTRIC? -1 6 v m I ts G V2,40 ma PROEKT A DDP.ESS �/� I7` I A*PN 1 OWNER NAME5 PFOC O ZS (o2ou 6 c�A S STREET ..DDR SS I 0 (r" w I CITY, sl�4 C� 1 t CONTACT NAME J UE•?JLkL7- 1 D J Q 'I STREET a vDP.ESS CI STA T E c bl FAX ❑ OF9.'m ❑OV1.?=�liTi�=R ❑ ohneAc:?,- ?�CO.mSCTOR ❑Co.,gm4CTOR.),Gm:-r ❑ ARC=CT ❑ ENGD:' ❑ r��rLOp ❑ !_X41 r CONTR4CTORN4J,M LICEI:SETL], ER'��(��1 I LICy.'c=4 . / I BUS. LIC- 1. O eo C01112.eN NA -1 v___ A L E-MIAIL ( otAJ w'i 6L)(# ,e 0) Z93 G14 STREET FJDDRESS I� -�-�� CAU� i CITY, - = ZIP . i , YCc,4 25 ?HO.'_ c(0 FRCH1TEC7E*X,GLkBER N:kM'F. LICENSENUMBER BUS. LIC r COIJ3AAY NAIL' STREET AUDR SS CITY, S T.4_E, ZIP I pt?OI\L USE OF ❑ 57 or DUPLEX ❑ YL1LTI-FAI,M Y PROTs:CT LN W1TTDL/_ND- ❑ Y: s PRO7=CT IN ❑ YES IS THE BLDG N ❑ ),:s BUTT_TiLNG: ❑ CO1,G,=_ r'.CIAL L?2B �? L> T tFACE kRak ❑ NO FLOOD ZO?M- ❑ NO EICIiLEt iOl✓E? ❑ No DLSCRIPTION OF G; ORK . l TOTAL V.4LUATI0?�: 000 RR By Lvy signa«L-e below, I certify to each of the following: I am the prope_-ty owner or aut,�orized agent to act on the properly owner's beb ^d I have read LES applicztion and -he uiforsation I have provided is correct I have, -cad the Desc.ip ion of VTork and verify it iS accurate. I azree to cos ly with all applicable local Ord»a�ces and state laws r .'.�.� LO o pingoco -U-1 Q n. I aetho:I_e representatives of Cupertino to enter the above-identiis= prop' L for MSpection purposes. ' Signu e atof ".. icaut/.sgeat: Date: SLTPP_EI`TEIT�. ! N 'r ORIvIATION REQULRED s -" - - W _!i OFFI@E.i SE D=NL1:.ray . W ..... ..:. Kx) I zzLL` Y a , 3Ni M s u, A�FPhlise 4pp_2011.doe revised 06/21/11 CERTIFICATE OF COMPLIANCE Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) Project Name: HOGIN & ASSOCIATES LAUNDRY ROOM I Date Prepared: CFIR-ALT 02-E (Page 1 of 3 ) 2015-12-28 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 CHR -ALT -02 document for each dwelling unit. 01 Project Name HOGIN & ASSOCIATES LAUNDRY ROOM 02 Date Prepared 2015-12-28 03 Project Location 19988 TWILIGHT COURT 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name HOGIN & ASSOCIATES LAUNDRY ROOM 07 Zip Code 95014 08 Dwelling Unit Conditioned 2240 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 , P 08 09 10 ;Is the SC ` Installing a K 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 TRANE/BRYANT WHOLE HOUSE 2240 Yes Yes Yes No No No Altered space -t conditioning system C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)1Diib) This section does not apply to this project. Registration Number: 215-A6513433A-000000000-0000 CA Building Energy Efficiency Standards - 2013 Residential Compliance Registration Date/Time: 2015-12-28 15:29:57 Report Version: 2013-1.006 Schema Version: 0.555SDD HERS Provider: CaICERTS Report Generated: 2015-12-28 15:30:05 t CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems (formerly CF -1R -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 it 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 Central gas Gas furnace Central split Outdoor This field or This field or TRANE/BRYANT furnace AHU AFUE 0.78 AC condensing SEER 13 Setback section is not section is not unit 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: <_ 15%, ors 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 verificatiori of Air Flow MCH -23, or Refrigerant Charge MECH 25 -Existing duct systems constructed, insulated or sealed with asbestos.are exemptfrom MCH -20 Duct Leakage Testirig,requirements. " E. Entirely New or Complete Replacement Duct System, with or without;Equipment Changeout (Sectionsl150.2(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)1C) This section does not apply to this project. Registration Number: 215-A6513433A-000000000-0000 Registration Date/Time: 2015-12-28 15:29:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-28 15:30:05 Schema Version: 0.555SDD i CERTIFICATE OF COMPLIANCE CF1R-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: �'tii/li Rando, Eric Company: Signature Date: RANDO AAA HVAC INC 2015-12-28 15:29:57 Address: CEA/ HERS Certification Identification (if applicable): 1712 STONE AVENUE N/A City/State/Zip: Phone: SAN JOSE CA 95125 408-293-4717 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 on 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 enforcementagency 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 provides to the building owner at occupancy. Responsible Designer Name: = Responsible Designer Signature: Rando, Eric�'�% Company: Date Signed: RANDO AAA HVAC INC 2015-12-28 15:29:57 Address: License: 1712 STONE AVENUE 768871 City/State/Zip: Phone: SAN JOSE CA 95125 408-293-4717 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: 215-A6513433A-000000000-0000 Registration Date/Time: 2015-12-28 15:29:57 HERS Provider: CaICERTS CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013-1.006 Report Generated: 2015-12-28 15:30:05 Schema Version: 0.555SDD