B-2016-1560 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1560
7766 HUNTRIDGE IN CUPERTINO,CA 95014-4206(MO 06 042) ATKINSON
CLIMATROLLERS INC
SAN JOSE,CA 95112
OWNER'S NAME: WONG YUN SENG AND MERY DATE ISSUED:03/17/2016
OWNER'S PHONE:408-859-8366 PHONE NO;(408)294-6290
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class S-20 Lic.#258540
Contractor ATKINSON CI IMATROLLERS INC Date 12/31/2016, X BLDG _ELECT _PLUMB
I hereby affirm that I am licensedunder the provisions of Chapter 9(commencing X MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: REPLACE(E)FURNACE AND A/C SAME LOCATION
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.
/� 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. Sq.Ft Floor Area: Valuation;$9737.00
APPLICANT CERTMCATIM
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 359 06 042
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 expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applic nt understands and will comply,with all non-point
source regula'o pe the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
1'
Signature Date /17/2Q`16 Issued by:ABBY AYENDE
Date:3/17/2016
O ,R-B rrI D R DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
a. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection,
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant;
contractors to construct the project(Sec.7044,Business&Professions Code). Date:3/17/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material, Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cuper` o nicipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, ec o 25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall /�
be deemed revoked. O'caner or authorized agent:
APPLICANT CERTIFICATIQN Date:3/17/2016
1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.30973 Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in tender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9,18. 1 understand my plans shall be used as public records.
Licensed
Signature Date173/ 2/ ,010 Professional
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
CUP RTINO (408)777-3228•FAX(408)777-3333•building0cupertino.orq MISC
❑PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS � ®t ® i%!D
PROJECT ADDRESS 1 1� �I APN#
OWNER NAME. (0 �/t/j� PHONE ((I(j � '5% E-MAIL
STREET ADDRESS t (Vl. �`�'`6 �lT� CITY, 7AT;(II'IG/2 6A _�-OJ�(�.6 . FAX
CONTACT NAME / PHONE -cD/J .F �/�n E-MAIL
STREET ADDRESS - �(` �II L CITY,STATE,ZIP<&Aj & FAX�o /V� _ Z
11 OWNER 11OWNER-BUILDERl El OWNER AGENT CONTRACTOR 11 CONTRACTOR AGENT 11 AABCHrrECT 11 ENGINEER 11DEVELOPERR ❑TENANT
CONTRACT NAME LICENSE NUMBER sb P'I/6 LICENSE TYPE A BUS.LIC ff
COMPANYNAME A � E-MAIL /➢7V 4iJV�1.l / _ - FAX// 9p�/aD�f
(� [il1(EF L(
STREET ADDRESS (/
i J CITY,S TE,ZI (� PHONE((g q
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF IL SFD m DUPLEX ❑ MULTI-FAMILY PROJECT W WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES
BUILDING: r6tONEVIERCIA1, URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO
DESCRIPTION OF WORK
TOTAL VALUATION: I
By my signature below,I certify to eac The fo lowing: I am the property owner or authorized agent to act on the property o, er's behalf. I have read this
application and the informaflon I hav r vided's correct, I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relate s on. I authorize representatives of Cupertino to enter the ab ve-i ntified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED3,` art k
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CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 1 of 3)
Project Name: 2015-0625 Yun Wong Date Prepared: 2016-03-17
A.General Information
CF111-ALT-02 is applicable to multiple space conditioning systems containedwithin a single dwelling unit.When multiple dwelling units must be documented,
use one MR-ALT-02 document for each dwelling unit.
01 Project Name 2015-0625 Yun Wong 02 Date Prepared 2016-03-17
03 Project Location 7766 Huntridge Lane 04 Building Type Single family
05 CA City Cupertino 06 Dwelling Unit Name 2015-0625 Yun Wong
08 Dwelling Unit Conditioned 1100
07 Zip Code 95014 Floor Area(ft2)
Number of space conditioning
09 Climate Zone 4 10 (SC)systems in this dwelling 1
unit.
B.Space Conditioning(SC)System Information
01 02 03 04 0 06 ; 07 �, Q8 09 10
Is the SC' installing a
SC System SC System CFA served ystem a ► frigeart Installir� iew f Irstali0g '11nsalhrig Installing
H"a
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
Furnace and A/CAltered space
replacement Whole house 1100 Yes Yes Yes No NO NO conditioning system
C. Extension of Existing Duct System,Greater Than 40 Feet(Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number:216-A0101985A-000000000-0000 Registration Date/Time: 2016-03-17 08:23:24 HERS Provider:CalCERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-03-17 08:23:15
Schema Version:0'.555SDD
'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 1503(b)1E 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
Furnace and Central gas Central split All new All new This field or This field or
A/C furnace heating. AFUE 0.95 AC cooling SEER 14 Setback section is not section is not
replacement components components 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:_515%,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&CF311-MCH-23 Air Flow 2 300 CFM/ton required when MCH-25 is required.
Exceptions:
Duct systems registered with HERS provider as preciously sealed are exempt fromCH 20 Duct Leakage !,sting r u reents
Heating-only systems and Air Handler/Furnace changes do not require verificat€p"�of Air Flow MCH 23 o itefrig9J6m
t Cha e MNF H 25�
Existing duct systems constructed,insulated or sealed with asbestoare exem :from MCH`-20 Auc�Leakage Testing rquireents
V
yWIN x 1'
E. Entirely New or Complete Replacement Duct$stem,withf r vyithout fqu ent Chpn out(,Secttans 0.2(b)1,Dila andh150.2(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:216-A0101985A-000000000-0000 Registration Date/Time: 2016-03-17 08:23:24 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated:2016-03-17 08:23:15
Schema Version:0.555SDD
fi
CERTIFICATE OF COMPLIANCE CFIR-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-1R-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: G „/,,
Faulkner,Cindy l� �Oi
Company: Signature Date:
ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2016-03-17 08:23:24
Address: CEA/HERS Certification Identification(if applicable):
1171 NORTH 4TH STREET
City/State/Zip: Phone:
SAN JOSE CA 95112 408-294-6290
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 df Compliance is true and correct.
2. 1 am eligible under Division 3 ofthe 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,comp Ionents,and nufactured devices for the buiidin 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 Oulat ons ., ;
4. The building design features or system design features identified onhis Certificatof Compliance are nste th;the iformatfr rovided o thef�pltcae coiYtpliance documents,worksheets,
calculations,plans and specifications submitted to the enf rcementagency fQ pprava w this but[ ng perritit a Slicatic6
av rmrt ,issued for )ae buildtrig,and.maie avaifabe)o1henforcement agency for all applicable
5. I will ensure that a registered copy of this Certifica Cctrpliance shalt maw ailtle he k ding pe, ( ,
inspections.I understand that a registered copy of thi „rtificate of Complance eq ;ed to b ,included wihth, pcumeptation the bilder prow des to;,She b 41cing owner at occupancy.
��.":.. � "fit
Responsible Designer Name: . ,.- v Responsible De gner S gnafGre: 6�4
(( ��
Faulkner,Cindy
Company: _ Date Signed.
ATKINSONCLIMATROLLERS INC dba VALLEY HEATING,000LING&ELECTRICAL 2016-03-17 08:23:24
Address: License:
1171 NORTH 4TH STREET 258540'
City/State/Zip: Phone:
SAN JOSE CA 95112 408-294-6290
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:216-A0101985A-000000000-0000 Registration Date/Time: 2016-03-17 08:23:24 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards-2013 Residential Compliance Report Version:2013 Rev 1.007 Report Generated`2016-03-17 08:23:15
Schema Version:0.555SDD
'NATER=CONSERVING PLUMBING FIXTURE
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228 FAX(408)777=3333 buildinaC@-cuoer ino ora
Owner Namef� � dvC� Permit No. -Z®f 6 � '/j
y;
Address `-fi' G,�l f� �
1. Is your real property a registered historical site?
❑11Yes Civil Code Sections 1101.1 through 1101..8 do not apply. Skip the rest of the form and sign bottom of fonn.
No Go to Question 2.
2. Does your real propertyhave 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.
Skip the rest of the form and sign bottom of form.
4
No Go to Question 3,
3. Is water service permanently disconnected for your building?
res Civil Code Sections 1101.1 through 1101.8 do not'apply. Skip the rest of the form and sign bottom of form.
o 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. Skip the rest of the form and sign bottom of form.
Vyes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections:1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Ple se check ONE of the following:
9 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 propeity. 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-coinpliant plumbing fixtures shall be replaced with water- conservin
= lumbiri fixfilres throe hau fire bnrldin re ai less of whetterproperty n3er oes a teratons or iin rovements
g p )•
I,-as the owner or owner's agent of this property-certify- er penalty of"peijury that non-coinpliant plumbing fixtiues will be
replaced prior to date specified above with water-conservi g 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 plumbing fixtures comply with the requirements as indicated in the
table on the following page,
Owner or Owner Agent's Signature."'r' "L ��'-� Date
Upon completing and signing this Certificate,please rete it t e Building Divi ion in order to final your building permit.
SB407 2015.doc revised 08/26/15
F ILE
SMOKE / CARSON MONOXIDE ALARMSe-' 1C�
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
C U P E RT I N O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building a(-cupertino.org
&°Z"
�frRZ �
rAddressi #of Alarms Smoka.' Carbon Monoxide:,
PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE
HAS BEEN SI' YN .D AND.RFT iTRNED TO THE BUILDING DIVISION
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/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 X X
bedroom(s)
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 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 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 read and agree to comply with the terms and conditions of this statement
Owner(or 0wneF Agents)Narne.`. A
,Si nature................................ ........ ............. ................................... ..L
�ContractoT_Namg. � ....................................!Ci-.#;......................................Date'r................... I
Signatii e..............................
Smoke and COform.doe revised 03/18/14