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HomeMy WebLinkAboutB-2017-0065CITY OF CUPERTINO BUILDING PE T BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0065 8019 PUMPKIN CT CUPERTINO, CA 95014-4902 (362 02 045) N90 CONSTRUCTION SAN JOSE, CA 95135 OWNER'S NAME: WOLFSON MARTIN DTE ISSUED: 01/11/2017 OWNER'S PHONE: 408-623-8477 P ONE NO: (408) 966-5268 LICENSED D ONT A TOR' DECLARATION BUILDING PERMIT O: License Class 13 Lic. #906011 Contractor N90 CONSTRUCTION Date 11/30/2017 X BLDG —ELECT _ F LUMB I hereby affirm that I am licensed under 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: REPLACE WINDOW (9) LIKE FOR LIKE TO MEET EGRESS;(N) I hereby affirm under penalty of perjury one of the following two declarations: PATIO SLIDER DOOR (11; I have and will maintain a certificate of consent to self -insure for Worker's REPLACE FURNACES LOCATION• (I) A/C UNIT f/ Compensation, as provided for by Section 3700 of the Labor Code, for the f performance of the work for which this permit is issued. 2. 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 this permit is issued. Sq. Ft Floor Area: V uation: $16000.00 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: O cupancy Type: and state laws relating to building construction, and hereby authorize 362 02 045 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. Additionally, the applicant understandUradVill comply with all non -point WITHIN 180 D SOF PERMIT ISSUANCE OR source regulations per the CupertuNcrMu it;Ipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by: Abby Ay ende Date: 01/11/2017 OWNEBUILD ECL) TON 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 V rior to any roofing material being installed. If a roof is 1. 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 of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOFCOVIRINGS 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. HAZARD 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 t e 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(x) 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 Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safely Code, Sections 25505, 2 3, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall " be deemed revoked. Owner or authorized age t: APPLICANT CERTIFICATION Date: I certify that I have read this application and state that the above information is 4-113 AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a con ction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this perr iit i��s`sued (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 AMETE TISDFCLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date Professional I I NF.W C0N1ZTRTT('TTr)NT CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT, DEPARTMENT • BUILDING DIVISI( 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (401- 78))777-3228 • FAX (408) 777-3333 . buildin cu ertino.or I I nTIITTTnIT I� -- �+ +%T'1%i�.[�i: vtc11711VHL Yl;1CN111 TF _ PROJECT ADDRESS ' S ® APN # 2 U2- 2 2 — OWNER •�V1 ' • j 2 Q► [� MAIL STREETADDREStCM 1,0LT V V `� CI Y, STATE, /►yam J (� AZ,r FAX CONTACT N av- ca Z C, QI % 46% (10 C1 ® 661AT t "V G 1 i%M. S ST&kP AI Lb� CI I" � CI ❑ OWNE�,R, ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTORAGENT ❑ ARCHITEC' ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA Cs 0 ` aI.,LICFy L�a ATM„ ' R 4� G� L ` yI wP (`7 -CENSE f� BUS. LIC # C) C6 go FAX COMP i w (W� � ✓v a fir* i j'�� [Or^p J6.. Go !V �i U "�"'3�� /-6Cr�. STRTy$Tfg V�'�s•- I �• l Ci- wA'LZ%c CO. fi513 0, a 6 6-s 2- 94 ARCHITECT/ENGINEER NAME _ LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ll �,I r Y►5T'V� Ali YV �vV V a w A� �� r iA h.r L*C ea 0, 4 f VVC,dV .5 I1�*r 5Apv �,. ow. •�.0 e_ bC tij n L 1M t+C,e �6 e. \0, SW I wC.W A& V V0 S 1 t-. t ice• V/ - EXISTING USE PROPOSED USE CONSTR TYPE i# STORIES 1 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN REMODEL AREA REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH - ❑ ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES BEING ADDED? O SECONDSTORY ❑YES ADDITION? RNO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? AND RECEIVED B - T0'(,AL VALUATION: By my signature below„ I certify to each of the following: I am the property owner or authorized agent to act A the prcperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree4o comply with all applicable local ordinances and state laws relating to b riding cons .Muth representatives of Cupertino to enter the above -i( ntifie property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL IN f)RNIATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. Q EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11.STANDARD ❑ PUBLIC WORKS Form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ mlAaoR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH ` BIdgApp_2011.doc revised 06/21/11 i ^ . i` �5 ('V4�w11tvbov." -ro j :1 III V [ N6 6 f d.GdlJsW .'{ vw a- e Ea }p.... 0' LUPE r ' Buitding DepaltnlelI �.r f j4N 1 1 2017 (,,()DE COMPLIANCE ' ► iewed By. C� PLOT PLACF-iK V!"? DATE PLANNING DEPS I CLJPFRTINC) o . l �C� aCUM[l[AANCE Data: O U HI yam,- • �c W. "k Building Departme wrnt�vr,,r - _ JAN 1 12017 REVIE Vii) FOR CODE COMPLIANCE �i.�' ter' kV A1D41W Re .wed By:-,�C.{..�, tri AIC- � , , PLOT PLANS CHECKED Ry DATE I l I 1 PLANNING DEPT CUPERTINO °iiIIdi°hung I) e p a rt:int ein't E V U UEU':'.': U:) F U'3 CODE CONA['[AANCE oIevue ad ByAbL)y Ayaride STATE= OF CALIFORNIA ALTERATIONS - HVAC MAU CEC-C17IR-ALT-03-E (Revised 06114) - CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE _ CFIR-ALT-03-E Alterations - HVAC CZ 1, 3 to 7 and 16 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Address: Enforcement Agency: Dae Prepared: Permit##: 1 •322 Equipment7ype Equipment Efficiency New; Ducting, Plenums, Llneset C diti ned t Required R -value Floor Area (sq ft) 12 Packaged System ❑ Evaporator Coil AFUE COP CrR 6 (CZ1,3-7) Ducts Served by system etback ❑ Split System © Condensing Emit _ SEER ❑ R-8' (CZ 16) Ducts ML—sq ft (If not already urnace Lineset EER HSPF D R-6 (all CZ's) Plenums present, must LOR-5 or R7.5 Lineset' 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 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, S. HVAC CHangeout/Repair Required Compliance Documents to be left on site for Final: Can -include new ducting All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS Air Handier/Furnace CF3R: MECH-20-HERS Installer Requirement: Duct leakage (:S.IS% or, < 10%to outside, or seal all accessible leaks) Exe pied from duct leakage testing if: r1. 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 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) -HERS' Installer Requirement: Duct leakage <_ 6%, Fan Efficacy (.58W/CFM), Air Flow -: 350 CFM/ton (or Standards Table 150.0-C J D alternative) ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: Includes replacing or installing All New CFIR-ALT-02-E Ducts2 and one or more of the following: CF2RW ECH-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 15D.0 -C/ D alternative) ❑ 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 CFIR-ALT-02-E space but less than All New Ducts' CF2R: MECH-20-HERS CF3R: MECH-20-HERS Installer Required to: Duct leakage (<15% or, :�_ 10% to outside, or seal all accessible leaks) ❑ Exempted from duct leakage testing I existing duct systems are 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 A New Duct system Is when the duct system is constructed of atleast 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 iinesets 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 -4Y" Contractor (Documentation Author's /Responsible Designer's Declaration Statement) 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 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. Res n W 1) Rner NarZ; Responsible besigner sign r bate SI ned: License: C a Addr t State/Zfp:I fPhone: For assistance or questions regarding Standards, contact the Energy Hotlin(fat. 1.-800-772-3300 tEWl.WI.1) FOR CODE CONA[IILJANCE 1 Date: 0l/°l °l/ l 7