Loading...
B-2017-1604 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1604 7631 ERIN WAY CUPERTINO,CA 95014-4342(359 20 020) TRADISTONE MOUNTAIN VIEW,CA 94043 OWNER'S NAME: MEISSNER SONYA L TRUSTEE DATE ISSUED:09/19/2017 OWNER'S PHONE:650-9382000 PHONE NO:(650)938-2000 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class I3 Lic.#981246 Contractor TRADISTONE Date 02/28/2019 BLDG X ELECT X PLUMB X I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH 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: INSTALL GAS FIREPLACE INSERT(CHASKA-34 LOG)INCLUDING I hereby affirm under penalty of perjury one of the following two declarations: (N)GAS LINE AND ELECTRICAL. t. 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. z. 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: Valuation:$4000.00 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 359 20 020 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 applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ode,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature A._ itit Date 9.19.17 Issued by:SEAN HATCH Wr Date:09/19/2017 OWNER-BUILDER 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 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:9.19.17 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 z. 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 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should 1 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&Safety Code Secti i ,5505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:9.19.17 I certify that I have read this application and state that the above information is •► : il► ►II h. 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.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 9.19.17 Professional ' \ / GENERAL PERMIT APPLICATION d() IT- 1 L�yl f' M E P —.4. COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION bsl.19r10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 MIS C (408)777-3228•FAX(408)777-3333•buildings cupertino.orq CUPERTINO ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS77.31 ar.orN f A\a. APN# �i - � + � OWNER NAME Y"(Ps POSSW PHONFjrI,lo/t 58 2 _ D E-MAIL STREET DNAME•7 I I �J o� CITY, E,ZIP(V K _ )J /'g q ,Lt FAX CONTACTPHONE STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENTNTRACFOR 0 CONTRACTOR AGENT 0 ARCHFFECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME-MillY�ipi 64�'"1`} LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME jFilitAkkeki in0/14 • )0_ ,�r ceP� �'VebbCcM E;�,^I�) q FAX 4/6 f (G STREET ADDRESS nLt Lk1-k' 04 fa_` lIkk. 'jCITY,STATE,ZIP evofCAI v1 I/) .,i,J fPIIONE ) 33 G 0 ARCHITECT/ENGINEER NAME LICEJSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF 1IFD or DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND 0 YES PROJECT TN 0 YES IS THE BLDG AN 0 YES BUILDING: COMMERCIAL URBAN INTERFACE AREA Tcii0 FLOOD ZONE 114NO EICHLER HOME? "t0 DESCRIPTION OF WORK (jag b'ne ----.. -(4?,-W 6 iec-/r,rci � �y,s cctoy--N oc, '_ �- 31A OC C) Ic6,50 6 (3lUS 040,34 0J/Loj S TOTAL VALUATION: :/i}CO RECEIVED BY: _...... .1a-41-1\1 l By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property 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 agree to comply with all applicable local ordinances and state laws relating to kiuildin construction. I authorize representatives of Cupertino to enter the bove-identifier)property r i ec purposes. Signature of Applicant/Agent: ''"-----.4Date: \ , ✓ SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PAY TO THE ORDER OF Citi Bank OVER-THE-COUNTER 608 San Antonio RA Mountain Vow CA 321171164Mit cu cu EXPRESS FOR DEPOSIT ONLY x S 0 STANDARD 200f' �134 IM1� U 0 LARGE a 0 MAJOR MEPMiscApp_2011.doc revised 06/21/11 '1H::: FIREPLACE ELL:::_.. x;44 Old Middlefield\rkyCO,MMUNITY DEVELOPMENT DEPARTMENT YVlcuntain View, CA 04043 BUILDING DIVISION - CUPERTINO (050)938-2000 APPROVED This set of plans and specifications MUST be kept at the SC:DAn He6S` eAr job site during construction. It is unlawful to make any changes or alterations on same, or to deviate the efrom, without approval from the, Building Official. -7�31 &i n (c•, , The Stamping of th,s plan and spec;ficat.ons SHALL NOT "'^J1 be held to permit or to be an approval of the violation CU `r0 LA oksolq of any provisH s of any City rdinance or State Law. DATE g• /9 •/ v. PERMIT # 80/7-/EAOY — CA fi-e,,nfi d in G c, 506 I;v)P cr-oyy, ,€)<;-';nc) dtecAiceAivA U,S 1;r sQ. (uSec\ -to Po(JG C,uZ2-1 bul-- 1r-,c.5 Pif- •eeyn (Zed', �GC )l n0- 'i rs-at,t�) S c f 1- ,f 7/z— LI — --,fi-0,11o\*;c) O� \,c3z \I-05\k' G1c\cA -49 34 �,,���1r\ ( y G\-aoo ?sTUS �ib)y OFFICE COPY -Ex, QT) Ai- : WI - Ottyid J5 }� �%;o oo h) 4/ – II 0/ , 1/7_ P( \O ;.,, T' ft– – ':).-- On 741.-C+ /2 / j t-.aildrnp Department A) EA : t( 0 oo f)(1O :y %''TV' f_•;) H.)H CODE COMPLIANCE „ ,,arjri fav '7�f.9;, #447; / L fa ----------- -:-Iri F,. D L ___ 0 1 /11- /3- /91 Ir-\ \ , _........•_ ___ KOZY I IEAT FIREPLACES Installation and HUSS°NGMANUFACTURING CO.,INC. Operation Manual Io 0 CHASKA-34 LOG I ` ' Model#CSK-34-L " • Direct Vent Gas Fireplace Insert r' NATIONAL We suggest that our gas FIREPLACE AWA R N I N G: INSTITUTE hearth products be installed TeetsO 8 - FbNend j NI and serviced by profes- FIRE OR EXPLOSION HAZARD `l°'°°ey 0-TL Oregon USA sionals who are certified in US - the US.by the National Fireplace Instihrte`(NFI)as Failure to follow safety warnings exactly ObINFTaet L.Aaalxlr,bre. aRTIFIED NFI Gas Specialists. could result in serious injury, death, or property damage. —Do not store or use gasoline or other flammable vapors and liquids in the vicinity of this or any other appliance. —WHAT TO DO IF YOU SMELL GAS DANGER' • Do not try to light any appliance. • Do not touch any electrical switch; do not use any phone in your building. HOT GLASS WILL • Leave the building immediately. CAUSE BURNS • Immediately call your gas supplier from DO NOT TOUCH GLASS a neighbor's phone. Follow the gas • UNTIL COOLED supplier's instructions. NEVER ALLOW CHILDREN • If you cannot reach your gas supplier, TO TOUCH GLASS call the fire department. A barrier designed to reduce the risk of burns —Installation and service must be performed from the hot viewing glass is provided with this by a qualified installer, service agency or appliance and shall be installed for the protection of children and other at-risk individuals. the gas supplier. This appliance may be installed in an aftermarket, permanently located, manufactured home (USA only) or mobile ---- l English and French installation manuals are home, where not prohibited by local codes, available through your local dealer. Visit our website p•%...)1•13 www.kozyheat.com or scan the QR code for our mobile app. t#r This appliance is only for use with the type Les manuels d'installation en frangais et en anglais sont dis onibleschezvotredetaillantlocal.Visitezwww.k heat. f; of gas indicated on the rating plate. This p °ry ❑ corn ou scannez ce code QR pour notre application mobile. appliance is not convertible for use with other gases, unless a certified kit is used. INSTALLER: Leave this manual with the appliance. CONSUMER: Retain this manual for future reference. Hussong Mfg.Co.,Inc.•CSK-34-L Report No.:0216GN043S•Rev.06,October 2016 Read this manual before installation or operating this appliance. Please retain this owner's manual for future reference. CONGRATULATIONS! We welcome you as a new owner of a Kozy Heat gas fireplace.Kozy Heat products are designed with superior components and materials,and assembled by trained craftsmen who take pride in their work. To ensure you receive a quality product, the burner and valve assembly are 100 percent test fired,and the complete fireplace is thoroughly inspected before packaging. Our commitment to quality and customer satisfaction has remained the same for 40 years.We offer a complete line of gas and wood fireplaces,along with stylish accessories to complement any decor.Adding a fireplace is one of the best ways to increase the value of your home,and we are proud to offer a network of dealers throughout the country to help make your experience everything you imagine.We pride ourselves in being dedicated not only to functionality and reliability, but also customer safety.We offer our continual support and guidance to help you achieve the maximum benefit and enjoyment from your Kozy Heat gas fireplace. Jim Hussong Dudley Hussong President Board Chairman Homeowner Reference Information We recommend you record the following information: Model Name: Date purchased/installed: Serial Number: Location of fireplace: Dealership Purchased from: Dealer phone: Notes: HOMEOWNER REFERENCE 3 TABLE OF CONTENTS TABLE OF CONTENTS 5 8.0 FACING AND FINISHING 18 1.0 INTRODUCTION 6 8.1 Clearances to Combustibles 18 1.1 Appliance Certification 6 8.2 Shroud Installation 19 1.2 Requirements for the Commonwealth of Massachusetts 6 8.3 Safety Barrier Installations 19 2.0 SPECIFICATIONS 7 9.0 FIREPLACE INSERT SETUP 20 2.1 Appliance Components 7 9.1 Glass Assembly 20 2.2 Heating Specifications 7 9.2 Light Kit 20 2.3 Appliance Dimensions 8 9.3 #CK34-500 Log Set Installation 21 2.4 Part Assembly Overview 9 9.4 Control Board Removal and Installation 22 2.5 Safety Barriers 10 10.0 ELECTRICAL INFORMATION 23 3.0 EXISTING FIREPLACE REQUIREMENTS 11 10.1 Electrical Specifications 23 3.1 Appliance Placement Considerations 11 10.2 Wiring Requirements 23 3.2 Existing Fireplace Specifications 11 11.0 OPERATING INSTRUCTIONS 24 4.0 TERMINATION LOCATION 12 11.1 Initialize the Control System 25 4.1 Vent Termination Clearances 12 11.2 Backup Battery Operation 25 5.0 INSTALLATION PREPARATION 13 11.3 IFC Module Ignition Sequence 25 11.4 Reset the System for Manual Operation 25 5.1 Inspect and Clean Existing Chimney 13 11.5 Remote Control Operation 26 5.2 Flue Damper 13 5.3 Gas Line 13 12.0 ADJUSTMENT 29 5.4 Electrical Wiring 13 12.1 Pressure Testing 29 5.5 Fireplace Conversion 13 12.2 Flame Appearance Adjustments 30 6.0 INSTALLATION 14 13.0 TROUBLESHOOTING 31 6.1 Kozy Heat#816-CL Co-Linear Vent System 14 14.0 MAINTENANCE 33 6.2 Fireplace Insert Air Duct Removal 15 14.1 Burner and Pilot System 33 6.3 Run Vent System 15 14.2 Fans 33 6.4 Connect Vent Pipe to Air Duct 16 14.3 Vent System 33 6.5 Place and Secure Appliance 16 14.4 Glass Assembly 33 7.0 GAS LINE CONNECTION 17 15.0 REPLACEMENT PARTS LIST 34 7.1 Gas Conversion(sold separately) 17 LIMITED WARRANTY 35 7.2 Gas Line Installation 17 LIFETIME WARRANTY 37 TABLE OF CONTENTS 5 1.0 INTRODUCTION` / 1/1 Appliance Certification 1.2.4 Inspection /laboratory: OMNI-Test Laboratories in Portland, Oregon The state or local gas inspector of the side wall horizontally vented gas fueled equipment shall not approve the installation Standards: unless, upon inspection,the inspector observes carbon monoxide • ANSI Z21.88-2014/CSA 2.33-2014, Vented Gas Fireplace detectors and signage installed in accordance with the provisions ( Heaters of 248 CMR 5.08 (2)(a) 1 through 4. • CGA 2.17-M91 (R2014), Gas-Fired Appliances for Use at High Altitudes 1.2.5 Exemptions This installation must conform with local codes, or in the absence/The following equipment is exempt from 248 CMR 5.08 (2) (a) 1 of local codes, with the National Fuel Gas Code, ANSI 2223.1/ through 4:The equipment listed in Chapter 10 entitled "Equipment NFPA 54, or the Natural Gas and Propane Installation Code, GSA Not Required To Be Vented" in the most current edition of NFPA B149.1. 54 as adopted by the Board; and Product Approved side wall horizontally vented gas fueled equipment installed in a room or 1�2 4equirements for the structure separate from the dwelling, building or structure used in -- -- whole or in part for residential purposes. Commonwealth-of Massachusetts The following requirements reference various Massachusetts 1.2.6 Manufacturer Requirements and national codes not contained in this manual. 1.2.6.1 Gas Equipment Venting System Provided For all sidewall horizontally vented gas fueled equipment installed When the manufacturer of Product Approved side wall horizontally in every dwelling, building or structure used in whole or in part for vented gas equipment provides a venting system design or venting residential purposes, including those owned or operated by the system components with the equipment, the instructions provided Commonwealth and where the side wall exhaust vent termination by the manufacturer for installation of the equipment and the is less than(7)feet above finished grade in the area of the venting, venting system shall include: including but not limited to decks and porches, the following requirements shall be satisfied: • Detailed instructions for the installation of the venting system design or the venting system components;and 1.2.1 Installation of Carbon • A complete parts list for the venting system design or venting Monoxide Detectors system. At time of installation of side wall horizontally vented gas fueled 1.2.6.2 Gas Equipment Venting equipment, the installing plumber or gas-fitter shall observe that System NOT Provided a hard wired carbon monoxide detector with an alarm and battery When the manufacturer of Product Approved side wall horizontally back-up is installed on the floor level where the gas equipment is vented gas equipment does not provide the parts for venting the to be installed. In addition, the installing plumber or gas-fitter shall flue gases, but identifies "special venting systems", the following observe that a battery operated or hard wired carbon monoxide requirements shall be satisfied by the manufacturer: detector is installed on each additional level of the dwelling, building or structure served by the side wall horizontal vented • The referenced "special venting systems" instructions shall gas fueled equipment. It shall be the responsibility of the property be included with the appliance or equipment installation owner to secure the services of qualified licensed professionals for instructions and; the installation of hard wired carbon monoxide detectors. • The "special venting systems" shall be Product Approved by In the event that the side wall horizontally vented gas fueled the Board, and the instructions for that system shall include a equipment is installed in a crawl space or attic, the hard wired parts list and detailed installation instructions. carbon monoxide detector with alarm and battery back-up may A copy of all installation instructions for all Product Approved be installed on the next adjacent floor level. In the event that side wall horizontally vented gas fueled equipment, all venting the requirements of this subdivision can not be met at the time instructions,all parts lists for venting instructions,and/or all venting of completion of installation, the owner shall have a period of design instructions shall remain with the appliance or equipment at thirty (30) days to comply with the above requirements; provided, the completion of the installation. however,that during said thirty(30)day period,a battery operated carbon monoxide detector with an alarm shall be installed. 1.2.2 Approved Carbon Monoxide Detectors Each carbon monoxide detector as required in accordance with the above provisions shall comply with NFPA 720 and be ANSI/UL 2034 listed and IAS certified. 1.2.3 Signage A metal or plastic identification plate shall be permanently mounted to the exterior of the building at a minimum of eight (8) feet above grade directly in line with the exhaust vent terminal for the horizontally vented gas fueled heating appliance or equipment.The sign shall read, in print no less the one-half inch (1/2) in size, "GAS VENT DIRECTLY BELOW.KEEP CLEAR OF ALL OBSTRUCTIONS". 6 INTRODUCTION 2.0 SPECIFICATIONS 2.1 Appliance Components 2.2.1.1 US Installations Refer to the American Gas Association guidelines for the gas Part Number Description designed appliances derating method. For elevations above 2,000 CK34L-150 Control Board Assembly ft(610 m),input ratings are to be reduced by 4%for each 1,000 ft (305 m)above sea level. 700-203 Manual Gas Shut-off Valve 2.2.1.2 Canadian Installations CK34L-135 Burner Assembly When the appliance is installed at elevations above 4,500 ft(1,372 CK34-500 Log Package m),the certified high altitude rating shall be reduced at the rate of 700-001T Glass Assembly 4%for each additional 1,000 ft(305 m). CK34-075 Fan Kit(1)-75 CFM 500-CK34 Grill Assembly 700-408 Remote Control 2.1.1 Additional Components Required 2.1.1.1 Shrouds Part Number Description CK34-2740 27"x 40"shroud(1 pc.) CK34-3044 30"x 44"shroud(1 pc.) CK34-3346 33"x 46"shroud(1 pc.) CK34-A3444 34"x 44"shroud(1 pc.) CK34-CUS Custom Shroud CK34-ACUS Arched Custom Shroud 2.1.1.2 Approved Vent Systems Kozy Heat#816-CL co-linear vent system For use with minimum 6"x 8"I.D. masonry or 7"I.D. Class A metal chimneys;includes 12 ft. (3.66 m)compressed, expandable co- linear 3"x 3"flexible pipes and termination cap. Other approved vent manufacturers ICC, Selkirk,American Metals(Amerivent), Olympia Venting Supply, Inc., Simpson Dura-Vent 2.2 Heating Specifications Natural Gas LP Gas Maximum 34,000 Btu/h(9.96 kPa) 34,000 Btu/h(9.96 kPa) Input Rating Minimum 18,500 Btu/h(5.42 kPa) 18,500 Btu/h(5.42 kPa) Input Rating Manifold Pressure 3.8"WC(.95 kPa) 11"WC(2.74 kPa) (High) Manifold Pressure 1.1"WC(.27 kPa) 2.9"WC(.72 kPa) (Low) Orifice Size(DMS) #38 #52 2.2.1 Altitude Adjustment This appliance may be installed at higher altitudes.Please refer to National Fuel Gas Code ANSI Z223.1/NFPA 54, CSA-B149.1 Natural Gas and Propane Installation Code, local authorities, or codes having jurisdiction in you area regarding derate guidelines. SPECIFICATIONS 7 2.3 Appliance Dimensions Table 2.1 Physical Dimensions Description Height Width Back Width Depth Back Height Back to Gas Front to Vent Back to Vent Line Access Center Center I Inches 23 33-3/8 24-3/8 16 17-3/8 5-9/16 10-3/8 5-5/8 Millimeters 585 848 618 407 442 142 264 143 TOP 243/8" (618mm) r �'. 16" Tann al 0 i 0 \ (407mm) 53/8" 32W 103/8" (143mm) (822mm) (264mm) 173h" 23" 263/X" 2" (442mm) (585mm) (513mm) (51mm) 0 Iff `7 333/8" 1111111 59/u' (848mm) (142mm) LEFT FRONT RIGHT Figure 2.1,CSK-34 Unit Dimensions 8 SPECIFICATIONS 2.4 Part Assembly Overview WARNING: Failure to position these parts in accordance with these diagrams, or failure to use only specified approved parts with this appliance, may result in property damage or personal injury. D \.... G F , ir,L r_, IloiFigure 2.2,Proper Positioning of CSK-34-L(Exploded View) Table 2.2,Field-Assembled Parts 07 Fireplace Insert " Log set B. Spring-loaded latch glass assembly -- Refractory panels jt Control board with burner cover ,_„,,,!".rip` Fan kit .rp -; Co-linear air duct SPECIFICATIONS 9 • 2.5 Safety Barriers WARNING:A barrier designed to reduce the risk of burns from the hot viewing glass is provided with this appliance and shall be installed for the protection of children and other at-risk individuals. If the barrier becomes damaged, the barrier shall be replaced with Hussong Mfg.'s barriers for this appliance. Only doors certified with the appliance shall be used. 37 me" 3913le" (895mm) (895mm) i ate „' r-- , k �f 251524�� ;4' � ^" Mi (658m m)-, ;(632mm) CK34-BSF CK34-CXF 351/" 35'/" 35W (895mm) (895mm) (895mm) - 24 �- � ( 24" L:„y'"'_, �z -1" .£.._ 24"- � `$ his '�`` , (609mm) , (609mm) , a - :--- (609mm) < j _ T CK34-PSF CK34-RSF CK34A-MSF 35'/" 351/" 351/' (895mm) (895mm) (895mm) 1 = ,it II it 1 11 I ; 24 24" 1 I I 24" r? (609mm) (609mm) I, i 1' (609mm) i , '` I - IBJ -. --, CK34A-SF CK34A-PSF CK34A-FPDSF 10 SPECIFICATIONS 3.0 EXISTING FIREPLACE REQUIREMENTS 3.1 Appliance Placement 3.2.2 Existing Chimney Specifications Considerations WARNING:Any chimney clean-outs must fit properly. WARNING: Due to high surface temperatures, the fireplace This fireplace insert Is to be installed into a solid fuel masonry insert should be located out of traffic and away from furniture or factory built non-combustible fireplace that has been and draperies. installed in accordance with the national,provincial, state, and local building codes. • This fireplace must be installed on a level surface capable of supporting the fireplace insert and venting. The existing chimney must be comprised of one of the following: • This fireplace insert may be installed in a bedroom. • Factory-built solid fuel chimney: 7 in (178mm) minimum • Please be aware of the large amount of heat this fireplace inside diameter insert will produce when determining a location. • Masonry chimney: 6 in x 8 in (152mm x 203mm) minimum inside diameter 3.2 Existing Fireplace Specifications Existing chimney height: IMPORTANT: Adequate accessibility clearances for servicing • Minimum: 12 ft(3.66 m) Maximum: 50 ft(15.24 m) and proper operation must be maintained. • Any smoke shelves, shields, and baffles may be removed 3.2.2.1 Determine Length of Existing Chimney if attached by mechanical fasteners. If necessary, 1. Remove and discard existing chimney cap. remove firebrick to obtain at least the minimum opening requirements. 2. It is helpful to have two people complete this step.Position one person at the fireplace and another person at the top of • Cutting of any sheet metal parts of the existing fireplace is the chimney. prohibited. 3. Measure from the fireplace base to the top of the chimney. • If the metal floor is removed,the insert must be placed directly on metal base of metal fireplace. Mechanically 4. Subtract the height of the insert from the previous attach 'THIS UNIT HAS BEEN MODIFIED' label at bottom of measurement.This is the total length of the co-linear flexible existing firebox so it will be visible if this gas fireplace insert aluminum pipe required for your installation. is removed. 3.2.1 Existing Fireplace Opening Minimum Requirements (A) Height 23-1/2 in (597 mm) 411P (B) Front Width 33-1/2 in (851 mm) (C) Depth 16-3/8 in (419 mm) (D) Back Width 24-1/2 in (622 mm) tt - MIN: 10 ft (3.05m) D - MAX: 50 ft (15.24m) • B ---'` A •• Figure 3.1,Existing Opening Guide `1 Figure 3.2,Min/Max Chimney Length EXISTING FIREPLACE REQUIREMENTS 11 4.0 TERMINATION LOCATION 4.1 Vent Termination Clearances WARNING:This appliance must not share or be connected to a chimney flue serving any other appliance. • Approved vent caps require 12 in (305mm) clearance to intersecting walls, overhangs or eaves as verified by test. APPROVED kt,:' VENT CAP MINIMUM 12" (305mm) I CLEARANCE 4A Figure 4.1,Vent Cap Clearance 12 TERMINATION LOCATION 5.0 INSTALLATION PREPARATION NOTE: This gas fireplace insert is approved for installation in masonry and factory-built solid fuel burning fireplaces. ATTENTION: Any removed parts must be capable of re- installation if this insert is ever removed. Removal of rivets or screws is acceptable. 5.1 Inspect and Clean Existing Chimney • Verify existing chimney is constructed of non-combustible material. • Verify existing chimney is clean and in good working order. Clean existing chimney and fireplace to prevent a creosote odor from entering the home. • Verify combustible mantel and sidewall clearances comply with Section 8.3 Safety Barrier Installations on page 19. • The refractory, glass doors, screen rails, screen mesh,and log grates may be removed from existing fireplace before installing this gas fireplace insert. 5.2 Flue Damper • The fireplace flue damper can be fully blocked open, or removed for installation of this gas fireplace insert. Remove existing chimney cap. 5.3 Gas Line • A gas line must be able to be installed to the insert. Refer to Section 7.0 Gas Line Connection on page 17. • If the factory-built fireplace has no gas access hole(s) provided,an access hole of 11/2 in.(37.5 mm) or less may be drilled through the lower sides or bottom of the firebox in a proper workmanship like manner.The access hole must be plugged with non-combustible insulation after the gas supply line has been installed. • Run gas line to the gas fireplace insert through the gas line hole provided. Do not run gas line in a manner that would obstruct fan operation. • If the gas fireplace insert is to be installed into minimum opening dimensions,the gas line may need to be run after appliance placement due to space limitations. 5.4 Electrical Wiring • Provisions must be made to provide electrical power for appliance operation. • Refer to Section 2.3 Appliance Dimensions (Figure 2.1) on page 8 for electrical outlet box location to run any necessary electrical wiring to the gas fireplace insert. 5.5 Fireplace Conversion • Mechanically attach the label with the following warning to at the bottom existing firebox so it will be visible if this gas fireplace insert is removed. WARNING: This fireplace has been converted for use with a gas fireplace insert only and cannot be used for burning wood or solid fuels unless all original parts have been replaced, and the fireplace re-approved by the Authority Having Jurisdiction. INSTALLATION PREPARATION 13 6.0 INSTALLATION 6.1 Kozy Heat #816-CL Co- 2. Slide the combustion air intake pipe(the end without a collar) Linear Vent System over termination cap collar(A).Secure to termination cap(E) y with provided (3) self-tapping screws(D). IMPORTANT:Proper operation of this insert requires the exhaust 3. Place a bead of sealant around the inner edge at the end of and combustion air pipes to be connected to the correct collar, the exhaust pipe (without collar/red marking)and slide onto on both the termination kit and the gas fireplace insert air duct. the corresponding labeled collar(B) on termination cap(E). The fireplace insert air duct exhaust collar is located on the 4. Secure the exhaust pipe to termination cap (E)with the right side. Install termination cap with the exhaust collar on the right side. provided (3)self-tapping screws.Apply additional sealant around joint to ensure a proper seal. NOTE: The exhaust pipe will have a red marking. 5. Complete vent system installation. IMPORTANT: Maximum horizontal vent runs of 24 in(609 mm) require a 1 in(25mm)rise per 12 in (305 mm)run. 1. Carefully extend the exhaust and combustion air intake pipes to the total chimney length required. Refer to 3.2.2 Existing Chimney Specifications on page 11. #816-CL CO-LINEAR VENT SYSTEM (A) Intake Collar(extends through bottom plate) (C) Sealant (B) Exhaust Collar(extends through middle (D) Self-Tapping Screws-(3)total(2 shown) divider plate) (E) Termination Cap e- E ❑❑❑❑❑❑❑ ❑11❑❑❑❑❑ A ®L!®®®®® B C C •0.11 41-4 Figure 6.1,#816-CL Termination Cap(your component may look different than the one shown) 14 INSTALLATION 6.2 Fireplace Insert Air Duct Removal 641;ATTENTION:All information outlined in Section 5.0 Installation ¢ `' " ,' Preparation on page 13 must be completed before continuin •g : _' _� ,,,,,-;:r with this installation. 1 t #fir 1. Remove the air duct at the top of appliance by sliding the air 1 duct back out of channels. Refer to the following instructions ;,. , : for vent system attachment to the air duct. d _ 44t 4. 4 �qf �`` _ ,,,44- "'mss v f ` 't :; _:". Il El= - , - 1— I ll, I= ■ ._ ,VIII I M_os- 166:1.II I I I I I 1::1:111 i 1.1 111:111: III OM m 1110 Figure 6.2,Air Duct Removal -$' M �� 1MMO _ Ell I■ — II 6.3 Run Vent System NOTE: If offsets are present in existing chimney, place a NI �� weighted rope around the pipe ends to guide them through MM; M the chimney. DO NOT ATTEMPT TO TIE ONE ROPE AROUND . \` 1U BOTH PIPES. MINI • To prevent cold air drafts, Hussong Manufacturing ! recommends to insulate the 3"x 3"flexible vent pipes EI and chimney using unfaced insulation products listed as mom noncombustible per ASTM E 136. Figure 6.3,Chimney Vent Run 1. OPTIONAL: Before installing vent system down through the chimney, place unfaced insulation around the first 3 ft(914 mm)of vent system below termination cap.Secure with wire. 2. Install the 3"x 3"flexible pipes down through existing chimney. Guide ropes(if used)to aid installation. 3. To secure chimney termination cap to chimney, apply a liberal bead of sealant(provided) around the top of the chimney. Set termination cap into position as instructed by vent system manufacturer's installation manual. OPTIONAL Kozy Heat#816-CL:Secure termination cap to existing chimney with 2 in (50 mm)self-tapping screws and anchor straps(provided)through the pilot holes, located on the sides of the termination cap. 4. From inside the existing fireplace, carefully pull ropes(if used) or the flexible pipes down until both exhaust pipe and combustion air intake are into the existing fireplace firebox. 5. OPTIONAL:To prevent heat loss up chimney, place unfaced insulation products between the 3"x 3"flexible vent pipes and chimney. INSTALLATION 15 6.4 Connect Vent Pipe to Air Duct 6.5 Place and Secure Appliance IMPORTANT: Proper operation of this appliance requires 1. Slide the gas fireplace insert into existing fireplace opening exhaust and combustion air pipes to be connected to the until the channels on top of the appliance are aligned with correct collar, on both the termination kit and the gas fireplace the air duct. insert air duct. 2. Insert the air duct pull rod handle through access slot at the 1. Place previously removed air duct 6.2 on page 16 into top of appliance and place pull handle hook through the hole existing fireplace opening. in pull rod. Simultaneously push the gas insert into existing 2. Connect exhaust vent pipe(red marking)to exhaust collar fireplace and pull the air duct forward until seated. on air duct.Apply a bead of sealant(provided)around 3. Secure air duct to appliance by using slots at the top of exhaust pipe and slide inside collar marked 'Exhaust:Secure the appliance to secure with (2) 1/2 in (13 mm)sheet metal with provided (3) 1/2 in(13 mm)self-tapping screws.Apply screws(included in components packet). additional sealant around join to ensure an air tight seal. 4. Use the pull rod handle to pull the air duct back to starting 3. Connect air intake vent pipe to intake collar on air duct. position. Remove pull handle.Verify vent system connection Apply a liberal bead of sealant around intake collar on air 5. If necessary, level the gas insert by threading leveling bolts duct.Slide combustion intake pipe over the collar and secure (included in components packet) into nuts at the bottom with provided (3) 1/2 in (13 mm)self-tapping screws.Apply of the insert(2 each side).Verify appliance is properly additional sealant around joint to ensure an air tight seal. positioned. 4. Visually check vent pipe connection to air duct.. I I i]4 I 1 1 ' I -7= I I III I = II I I I I I I I _ I IlI - 1 4 I 'I ' lI Ii = I VI I I _ ;I I I I I _. 1I L I I II �I I V I I I I I VII I = III IIIIII II I I �l I I 3� I I II -_ VIII/ _ II I I I �/ N. III IIID I I( il; 1 I I 11 ' I ALIGNED I I - I I I 1 . ' GAS INSERT I I I ,-i ' I AIR DUCT I II 1 I f' ... .) _ i ' 1 I I I� 1 III O IIII I, Figure 6.5,Air Duct in Existing Fireplace Figure 6.7,Aligned Gas Insert in Existing Fireplace FLEXIBLE PIPES Ill'.1110" SECURE WITH(2)SCREWS , - - PULL ROD SHEET METAL �J SCREWS(3 TOTAL) ----=------',`_` vZ>� Figure 6.4,Seated Air Duct(shown without venting attached for clarity purposes only) SEALANTSEALANT Figure 6.6,Secured Vent Pipes to Air Duct 16 INSTALLATION 7.0 GAS LINE CONNECTION 7.1 Gas Conversion (sold separately) ATTENTION:The conversion shall be carried out in accordance with the requirements of the provincial authorities having jurisdiction and in accordance with the requirements of the ANSI Z223.1 installation code. This fireplace is manufactured for use with natural gas. Follow the instructions included with the conversion kit if converting to LP gas. 7.2 Gas Line Installation CAUTION: Installation of the gas line must only be done by a qualified person in accordance with local building codes, if any.If not,follow ANSI 223.1. Commonwealth of Massachusetts installations must be done by a licensed plumber or gas fitter. NOTE: The appliance and its individual shutoff valve must be disconnected from the gas supply piping system during any pressure testing of that system at pressures in excess of '/2 psi (3.5 kPa). For test pressures equal to or less than '/2 psi (3.5 kPa), the appliance must be isolated from the gas supply piping system by closing its individual manual shut-off valve. • A listed (and Commonwealth of Massachusetts approved) 1/2 in. (13 mm)tee handle manual shut-off valve and flexible gas connector are to be connected to the 1/2 in. (13 mm)control valve inlet. If substituting for these components, please consult local codes for compliance. • If installing this insert into minimum opening dimensions, the gas line may need to be run after placement due to space limitations. Refer to 3.2.1 Existing Fireplace Opening Minimum Requirements on page 11. • This fireplace is equipped with a 3/e" (10 mm)x 18" (457 mm) long flexible gas connector and manual shut-off valve. • Run gas line into fireplace, preferably through left or right gas line holes provided.The gas line should be run to the point of connection where the shut-off valve and flexible gas line will connect. • Do not run gas line in a manner that would obstruct fan operation. • For high altitude installations, consult the local gas distributor or the authority having jurisdiction for proper rating methods. Table 7.1,Inlet Gas Supply Pressures Fa"ei a s e U[ 1Aax(RuM pressure ' Natural Gas 5"WC (1.25 kPa) 10.5"WC (2.62 kPa) LP Gas 11"WC (2.74 kPa) 13"WC (3.24 kPa) GAS LINE CONNECTION 17 8.0 FACING AND FINISHING 8.1 Clearances to Combustibles is COMBUSTIBLE 0 Li Q MATERIAL - 000 J6" (152mm) CLEARANCE TO SIDEWALL 1 - COMBUSTIBLE MANTEL COMBUSTIBLE MANTEL } 45° 12"(305mm) 45' - - 12"(305mm) 9"(229mm) } = 9"(229mm) } - ;/4"(19mm) I - ` 'A"(19mm) 1 (406mm) I 19 (406mm)11" (483mm) (305mm) I 1 (483mm) (305mm) mii I 1 I • 7"(178mm) L' COMBUSTIBLE FLOOR--tet 1 I I COMBUSTIBLE FLOOR-_-_,_� } ) NON-COMBUSTIBLE I 1"(25mm)* THIS APPLIANCE IS ZERO CLEARANCE TO A COMBUSTIBLE FLOOR IF 7" (178mm) OF NON-COMBUSTIBLE FLOORING IS *IF COMBUSTIBLE FLOORING IS CONSTRUCTED IN CONSTRUCTED IN FRONT OF THE UNIT FRONT OF THE UNIT,THE APPLIANCE MUST BE RAISED 1" (25mm) 18 FACING AND FINISHING 8.2 Shroud Installation 8.3 Safety Barrier Installations CAUTION: Trim panels or surrounds must not seal ventilation 1. Locate the(4)slots on the shroud (2 each side). openings in existing fireplace that this appliance is installed in. 2. Align the tabs located on the back of the safety barrier with WARNING:The flow of combustion and ventilation air must not the slots on the shroud. be obstructed. 3. Raise the safety barrier slightly into the slots and allow the For shrouds #CK34-2740, #CK34-3044, #CK34-3346, tabs to lower into position. #CK34-A344, #CK34-CUS,and#CK34-ACUS. • To remove safety screen:lift the screen up and out of slots. 1. Remove the upper hood by lifting up and out of the mounting flanges. 2. Remove lower louver by lifting the louver out of the slots on the mounting bracket. 3. Remove the glass assembly. 4. Align the mounting holes on the shroud to the corresponding mounting nuts on the sides of the insert metal cabinet. 5. Secure with (4)truss head screws(provided). 6. Reinstall all components previously removed. r' r- - i ..�." d = Figure 8.1,Upper Hood Removal - ---_Et. maw-— i i , f'-'':E'll-1::::::034.." _ . Figure 8.2,Lower Louver Removal -- MOUNTING NUTS (2 EACH SIDE) Figure 8.3,Mounting Nuts Location FACING AND FINISHING 19 9.0 FIREPLACE INSERT SETUP 9.1 Glass Assembly 9.2 Light Kit WARNING:Do not operate this fireplace with the glass removed, CAUTION: Disconnect all electrical power from the fireplace cracked, or broken. Replacement of the glass assembly, #701- before performing this task. 001T,should be done by a licensed or qualified service person. ATTENTION: If converting to LP (propane) gas, complete the 9.1.1 Remove Glass Assembly conversion before installing any light kit components.Follow the instructions provided with the conversion kit(sold separately). WARNING:Do not remove the glass assembly when hot. NOTE: To avoid damage and prolong the life of the halogen 1. Locate (2)spring-loaded latches securing the glass assembly bulbs, never touch with bare hands. Always use a soft cloth at the bottom of the firebox. when handling. 2. Pull the spring-loaded latches out and down to release the bottom of the glass assembly. 9.2.1 Install Light Kit 3. Lift glass assembly up and off of the(2)tabs located at the 1. Remove the safety barrier and glass frame assembly. top of the firebox. 2. Remove logs. 9.1.2 Install Glass Assembly 3. Remove the burner assembly, secured with (2)screws. 1. Align the slots on top of the glass assembly over the tabs at 4. Remove side log mounting stands/refractory clips and the top of the firebox while lowering the bottom of the glass refractory panels. assembly into position. 5. Remove the ember panel from the firebox. 2. Pull the spring-loaded latches out and up to secure the 6. Remove burner heat shield,secured with (2)screws at the bottom of glass to the bottom of the fireplace. back corners of the firebox. 7. Install (4) halogen bulbs(included in components packet) into lamp bases. TABS 8. Reinstall ember panel. 9. Place 2 lb.(0.91 kg) of crushed glass media(included with fireplace)into ember media cavity. Randomly place klinkers on top of glass media. 10. Reinstall burner heat shield. 11. Reinstall side log mounting stands/refractory clips and refractory panels. 12. Reinstall burner assembly. 13. Reinstall logs, glass frame assembly, and safety barrier. Reinstall SPRING-LOADED LATCHES Figure 9.1,Glass Assembly Figure 9.2,Installed Halogen Bulbs Figure 9.3,Completed Light Kit Installation 20 FIREPLACE INSERT SETUP 9.0 FIREPLACE INSERT SETUP 9.1 Glass Assembly 9.2 Light Kit WARNING:Do not operate this fireplace with the glass removed, CAUTION: Disconnect all electrical power from the fireplace cracked, or broken. Replacement of the glass assembly, #701- before performing this task. 00IT,should be done by a licensed or qualified service person. ATTENTION: If converting to LP (propane) gas, complete the 9.1.1 Remove Glass Assembly conversion before installing any light kit components.Follow the instructions provided with the conversion kit(sold separately). WARNING:Do not remove the glass assembly when hot. NOTE: To avoid damage and prolong the life of the halogen 1. Locate(2) spring-loaded latches securing the glass assembly bulbs, never touch with bare hands. Always use a soft cloth at the bottom of the firebox. when handling. 2. Pull the spring-loaded latches out and down to release the bottom of the glass assembly. 9.2.1 Install Light Kit 3. Lift glass assembly up and off of the(2)tabs located at the 1. Remove the safety barrier and glass frame assembly. top of the firebox. 2. Remove logs. 9.1.2 Install Glass Assembly 3. Remove the burner assembly,secured with(2)screws. 1. Align the slots on top of the glass assembly over the tabs at 4. Remove side log mounting stands/refractory clips and the top of the firebox while lowering the bottom of the glass refractory panels. assembly into position. 5. Remove the ember panel from the firebox. 2. Pull the spring-loaded latches out and up to secure the 6. Remove burner heat shield,secured with(2)screws at the bottom of glass to the bottom of the fireplace. back corners of the firebox. 7. Install(4) halogen_bulbs(included in components packet) into lamp bases. TABS 8. Reinstall ember panel. 9. Place 2 lb. (0.91 kg)of crushed glass media(included with fireplace)into ember media cavity. Randomly place klinkers on top of glass media. 10. Reinstall burner heat shield. 11. Reinstall side log mounting stands/refractory clips and refractory panels. 12. Reinstall burner assembly. 13. Reinstall logs, glass frame assembly,and safety barrier. SPRING-LOADED LATCHES Figure 9.1,Glass Assembly Figure 9.2,Installed Halogen Bulbs F Figure 9.3,Completed Light Kit Installation 20 FIREPLACE INSERT SETUP 9.3 #CK34-500 Log Set Installation 1. Position the ember panel in front of the burner as shown. CAUTION: Do not place logs directly over burner port holes. 2. Align the two (2)holes in the bottom of log 1 CK with the two Improper log placement may affect flame appearance and may (2) mounting pins at the back of the burner. Push the log cause excessive soot to build upon the glass. down onto the pins to seat. Repeat for log 2CK. • If converting to LP(propane)gas, complete the conversion 3. Align the holes on the bottom of logs 3CK and 4CK with before installing the log set. Follow the conversion mounting pins on burner. Push the logs down onto the pins instructions included with the kit. to seat. • Log numbers are located on the bottom of each log.Refer 4. Align log 5CK with the notches in logs 1CK and 3CK. to following instructions and illustrations for proper log 5. Align log 8CK with the notch in log 4CK. placement. 6. Position logs 6CK and 7CK as shown in Figure 9.6. / ' ` ''°' �} h .._Zi ( - i r 4 �.. e Figure 9.4,Logs 1CK&2CK 4 1 . :":, ,-.'. all Figure 9.5,Logs 3CK&4CK ry ti1 I 3 ✓ ,, kir . 41660C- , Figure 9.6,Completed Installation FIREPLACE INSERT SETUP 21 9.4 Control Board Removal and Installation WARNING: If burner and/or pilot have been burning, use appropriate protection to avoid burns or damage to personal property before removing any components. DO NOT OPERATE THIS APPLIANCE WITHOUT THE SEALING GASKET(LOCATED UNDER THE CONTROL BOARD) IN PLACE. IF GASKETING IS DAMAGED, IT MUST BE REPLACED. CAUTION: Check all connections for leaks with soapy water, whether field or factory made. 9.4.1 Control Board Removal 1. Disconnect electrical power. 2. Locate the manual valve installed by your qualified service 1 technician. III1IIII�IIII 3. Turn the manual valve clockwise to the OFF position. IIII 4. Remove the safety barrier and glass assembly. 5. Remove logs. 6. Remove the burner assembly,secured with (2)screws. 7. Remove side log mounting stands/refractory clips and refractory panels. 8. Remove burner heat shield (secured at back corners-2 screws). CONTROL BOARD 9. Remove secondary burner heat shield resting on control board. 10. Remove(10)screws securing control board. Remove the control board. 9.4.2 Control Board Installation 1. Place the control board in firebox, aligning the holes in board BURNER Oi with mounting studs at the bottom of the firebox. ASSEMBLY SECONDARY VERIFY SEALING GASKET IS IN PLACE ON THE BOTTOM .` � HEAT SHIELD OF THE FIREBOX. �o � , -;� BURNER 2. Secure the control board with screws previously removed. 'mil �• HEAT SHIELD , / 3. Reinstall secondary burner heat shield by placing it on top of the control board. 4. Reinstall burner heat shield. Position the cut-outs over pilot assembly and burner orifice,centering from side-to-side and as far back as possible. 5. Secure the burner heat shield with screws previously removed. 6. Reinstall refractory panels,then reinstall the side log -a� , ��, mounting plates/refractory clips. *MIS 1JNIIIIiII' 7. Reinstall burner assembly.Verify the burner tube is iliktNtorkp � positioned over burner orifice.Secure with screws previously removed. Figure 9.7,Control Board Removal and Installation 8. Reinstall log set. 9. Turn the manual valve counterclockwise to the ON position. 10. Reconnect electrical power. 11. Reinstall the glass assembly and safety barrier. 12. Verify proper log placement,operation of fireplace, and any electrical components. 22 FIREPLACE INSERT SETUP SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 9nUA-C6 q ft 0%19 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CIUPERTINta 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq( cupertino.orq 111' VPERMIT CANNOT BEyINALED UNTIL THIS CERTIFICATE HASBEEN ,(��� COMPLETED SIGNED AND RETURNED TO THE BUINDI ILDG VISIONz,=.‘-x-14‘11 '` PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314,R315,2016 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 1314,R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarins 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)-(Smoke alarms shall not be located within 3 feet of bathroom door) On every level'of a dwelling unit including basements and habitable attics 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 specified below have been tested and are operational, as of the date signed below. 1 Address: `7(0,3/. �c ;,� (Ja.,1 p:.r4 v` Permit No. -aO I -11Q04 Specify Number of Alarms: #Smoke Alarms: I 5: #Carbon Monoxide Detectors: 13 1 I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: ! S °A & A/1,C-�l S':5 e - Signature.....f-y6/.� .. Datet'Q/,./L Contractor Name: � Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017