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B-2016-3078
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: ii CONTRACTOR: PERMIT NO:B-2016-3078 20519 CEDARBROOK TER CUPERTINO,CA 95014-0437(323 45 009) COOPER BROTHERS INC SAN JOSE,CA 95123 OWNER'S NAME: VIDAL SHEILA TRUSTEE DATE ISSUED:11/09/2016 OWNER'S PHONE:408-732-2856 PHONE NO:(408)437-2442 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic.#874695 Contractor COOPER BROTHERS INC Date 03/31/2018 X BLDG _ELECT _PLUMB X MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: REPLACE FURNACE,SAME LOCATION(CLOSET) 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 y ( % performance of the work for which this permit is issued. /Pf z.eI 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:$3514.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 323 45 009 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,jud• ents,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue agai t said City i c. e• enc.of the ranting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the pplicant un•9 t. ds .nd II co ly with all non-point source regular' ns per the • Irrti o uni cal C ,Section 9.18. 180 DAYS FROM L INSPECTION. Signature Date 11/09/2016 Issued by: yil ISSA NAMES �f ,f Date: 11/09/2016 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 1. I,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 of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:11/09/2016 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. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. 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 e y uipment or de '... wh ch emit hazardous air contaminants as defined bythe :' Area Air r i ,age,,ent Dist,ct I ytY g Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the f upertino ip: o,e, , pter 9. and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Co,•, ction '0 , .3 ,an, -534. Labor Code,I must forthwith comply with such provisions or this permit shall / be deemed revoked. Owner or authorized agent:, rl 11/09/2016 APPLICANT CERTIFICATION Date: s N • eltit ND I 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 I hereby affirm that there is a cons�ruction len•ng agenc for the pe ormance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,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 Lender'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. I understand my plans shall be used as public records. Licensed Signature Date 11/09/2016 Professional \ /..,/ GENERAL L PERMIT APPLICATIONME r* COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 ' 4"4=+r�CUPERTINO (408)777-3228•FAX(408)777-3333•buildingAcupertino.orq FtiI I S C Q PLUMBING `ll MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS '-' J ,'vtl K.J'® 11�/9 APN# �3� y — 0 y � /'�,,p� �NE ^�"'��^--/� /�J JCS` C t OWNERNAM! ) )U I C� Pqo(1 - 3 —^^," J� EMAIL STREET ADDR V •Q C. e { I T CITY, STATE' ' FAX ic CONTACT NA HE / ^ V/,✓ L (� `I \, S ( P © b E-MAIL i(((±±±,,, I STREET ADDRE,` ,�1 �c , - , CITY TATE,ZIP1_17 FAX zs "Nd OWNER 0 OWNER-BUILDER 0 OWNER AGENT 0 CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NA I I V , {j` �1 J II LICENSE NUMBF 2_� % STATE OF CALIFORNIA Imo.: ALTERATIONS- HVAC . CEC-CFIR-ALT-03-E(Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-03-E Alterations-HVAC CZ 1,3 to 7 and 16(formerly CF-1R-ALT-HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Date Prepared: Permit#: fa k ) a 0 1-..C- 1 1 Q_e_.e)W-.10 o iri-trQA, New:Ducting,Plenums,Lineset ConditionedEquipment Type Equipment Eficienty Thermostat Required R-value Floor Area(sq ft) 0 Packaged System 0 Evaporator Coil AFUE COP 0 R-6 (CZ 1,3-7)Ducts Served by system ltl Setback 0 R-81 (CZ 16)Ducts J (If not already Split System ❑Condensing Unit SEER f sq ft HSPF ❑R-6(all CZ's)Plenums present,must Furnace 0 Lineset EER 0 R-5 or R7.5 Lineset3 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-II e filled out by-hand? For final inspection all forms are to be registered(no hand filled forms allowed)and a copy left on site. ' t,f, 1.HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: Can-include near 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: 0 1.Duct system registered with HERS provider as previously sealed,or 0 2.There is less than 40 linear feet of duct in unconditioned space,or 0 3.Existing duct systems are constructed,insulated or sealed with asbestos(list manufacture date of building ) 0 2.New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts2 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)-HERS2 Installer Requirement:Duct leakage<6%,Fan Efficacy(.58W/CFM),Air Flow 350 CFM/ton(or Standards Table 150.0-C/D alternative) 0 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) r 0 Exempted from duct leakage testing I existing duct systems are constructed,insulated or sealed with asbestos. 0 4.New Ducting over 40 feet Required Compliance Documents to be left on site for Final: Adding or replacing ducts in unconditioned CF1R-ALT 02 E space but less than All New Ducts2 CF2R:MECH-20-HERS ,f CF3R:MECH-20-HERS Installer Required to:Duct leakage(5_15%or,<10%to outside,or seal all accessible leaks) 0=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. 2 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. 3 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-2%",3.5 to 4T-2%",5T-414" 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. I 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. j / Responsible Des' er Nam Res onsible Des'g` S g tur Date Signed: 9 J Lica " ti i-Joe-0 /l '`/�d'�� / JJVVj// r7 C pang: Address: i /State/Zip: Phone: e- GO1 /you {�-57_e. (_ '-6(riT2 - For assistance or questions regarding the Energy Standards,contact the Energy Hotline at:1-800-772-3300 FP- SMOKE / CAROIV MONOXIDE ALARMS ° -� OWNER CERTIFICATE OF COMPLIANCEtiL os � � is, COMMUNITY.DEVELOPMENT DEPARTMENT• BUILDING DIVISION �.f P II;TLNO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333, buildinq a(�cupertino.orq PERMIT CIWOTBE F LEp NTIL TIIIS CERTIFICATE HA..S BEEN OI'LTEI� C . r'- PURPOSE This affidavit is a sell-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 requ_re 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 X X the 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 c.ntain 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: hi 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 specified below have been tested and are operational,as of the date signed below. Address: / i900 ,G r j Permit 0Fil " i ��° 0 Specify Number of Alarms: #Smoke Alarms: k 3 I #Carbon Monoxide DetectorsI % Owner(or Owner�gent'sgNameVe read and agree t6 cora l with the terms d conditions of this statement 7a / � t(�1 / /- Contractor Signature Date:� � Cei/e/ ki Contractor Name: Signature Lic.# Date: Smoke and COform.doc revised 09/27/16