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B-2017-1728 • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1728 7536 DONEGAL DR CUPERTINO,CA 95014-5218(366 16 056) ATKINSON • CLIMATROLLERS INC SAN JOSE,CA 95112 ' OWNER'S NAME: LIU WILSON AND SHARON TRUSTEE DATE ISSUED: 10/06/2017 • OWNER'S PHONE:408-857-1312 PHONE NO:(408)294-6290 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic.#258540 Contractor ATKINSON CLIMATROLLERS INC Date 12/31/2018 X BLDG _ELECT _PLUMB 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 FURNACE SAME LOCATION;REPLACE AC UNIT SAME I hereby affirm under penalty of perjury one of the following two declarations: 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. 9�y0�/2. I have and will maintain Worker's Compensation Insurance,as provided for by (�U(��J Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$13722.00 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 366 16 056 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 Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature t`via- `?� j/ Date 10-6-2017 Issued by:Kim Dunbar Date: 10/06/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ant 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. 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: 10-6-2017 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 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 material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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,Sections 25505,25533,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:10-6-2017 I 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.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. Signature Date 10-6-2017 Licensed Professional '�lf GENERAL PERMIT APPLICATION fill E P 1 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 1 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 MISC CUPERTINO (408)777-3228•FAX(408)777-3333•buildinqa,cupertino.orq 5 -20 +- 11- ❑PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT 5 S S b 901,\Q0 1 19 APN# 3(p u_ / p..„ D SW OWNER Nr„l—i U/ 7 V1 G`. 7(my\ Pt/ 1Q— 57- 13 IL E-MAIL STREET 5 3 z �l0 Aei Q\I_ j� CITY,y�,T`AJT ��ZIP , ,moo CA 9 So FAX CONTACT NjfefeiL va l /LI1 „tAi `\v� }•�'1V,, PHellsse _ Li—64��0 E-MAIL co(� (tel Ix 11. I (,)A0,J 6:7111S I IE770RRES .i .54 J C OATA'F,5ZIP c4 ,5112_, F O '� l�112_97 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT /di CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NA LICENSE MBR LICENSE TYPE BUS.LIC# ` �� I>�=v�11� �,�,��1� - gs�a � X20 y o ®a '7 COMPANY NAME U l t1, V�� �1 E-MAIL'O k l�i 1,c�%V ,,,ACS'Cl/`✓l�fCPw'1FAX }JQ F—n pl�]—gE H/ STREET A DtE l ,/�k 5 1 CITY,ST TE,ZIP l 5 J PHONE( L'I C � �1 111/ � -"n �,�,Jose (..�� �I 511..z...... ����2��_,6/ , p. ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DUPLEX 0 MULTI-FAMILY PROJECT IN WILDLAND 0 YES PROJECT IN, 0 YES IS THE BLDG AN 0 YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE \0 NO EICHLER HOME? 0'NO DESCRIPTION OF WORK o ,, l�/ U r'^ &�� (5 LO c�1. 1 ),c A C �-- /N l vim. Y' r O J / Il lJ�.- TOTAL VALUATION: 4' [ 3 7 Zz.-O 0 RECEIVED BY , ” 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 Ihave 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 lawsrelating to building co struction. I thorize r resentatives of Cupertino to enter the above-identified property.for inspection purposes. Signature of Applicant/Agent: ( r 1 T / W!?/ Date: SUPPLEMENTAL INFORMATION REQUIRED + ' , ,:iiF'FICE EJSE ONO Y=,.- _ r; ., ❑'OVER TRE•COUNTEI H e ' . err ©`°EES XPRS b i'. 'STANDARD ,,,,4:;,.- i-Of i2 ve V laMAJOR»r MEPMiscApp_2011.doc revised 06/21/11 CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 3) Project Name: 2017-0189 Sharon Liu Date Prepared: 2017-09-27 A.General Information CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be documented, use one CF1R-ALT-02 document for each dwelling unit. 01 Project Name 2017-0189 Sharon Liu 02 Date Prepared 2017-09-27 03 Project Location 7536 Donegal Drive 04 Building Type Single family 05 CA City Cupertino 06 Dwelling Unit Name 2017-0189 Sharon Liu 07 Zip Code 95014 08 Dwelling Unit Conditioned 3232 Floor Area(ftZ) Number of Space 09 Climate Zone 4 :' . °°': ,-, - :. -- ,,:, 10 Conditioning(SC)Systems in 1 this Dwelling Unit: B.Space Conditioning(SC)System Information ; -y, ,r r ' 01 02 03 04 05 ': 06 "07 : 08 09 10 Is the SC Installinga 7' r a k`', ti ,,., ;:,.. SC System SC System CFA served system a refrigerant Installing new SC Installing Installing Installing Identification or Location or Area by this SC ducted containing system more than 40 entirely new entirely new Name Served System(ft2) system? component? components? feet of ducts? duct system? SC system? Alteration Type Furnace and A/C Altered space whole house 3232 Yes Yes Yes No No No replacement 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:217-A020334982A-000-000-0000000-0000 Registration Date/Time: 2017-09-27 11:45:46 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-09-27 14:45:33 Schema Version:rev 10/16 CERTIFICATE OF COMPLIANCE - CF1R-ALT 02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 3) D.Altered Space-Conditioning System (Sections-150:2(b)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 All new All new This field or This field or Central gas - Central split A/C heating AFUE 96 cooling SEER 16 Setback section is not section is not - replacement furnace components AC components applicable applicable Required Documentation: CF2R-MCH-01-E-Space Conditioning Systems . -Duct insulation requirement for the new portions of supply-air and return-air ducts or plenums:R6(CZ 1-10,12 and 13)and RE(CZ 11 and 14-16) CF2R and CF3R-MCH-20-H-Duct Leakage Test 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:<=1595 or<=10%leakage to outside,or seal all accessible leaks. CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15). CF2R and CF3R-MCH-23 Airflow Rate>=300 CFMper ton;requiredwhen,MCH-25 is required.• Exceptions: -Duct systems registered with HERS provider as previously sealed are exempt from MCH 20 Duct Leakage Testingfequireents \ . -Heating-only systems and Air Handler Furnace changes do not require•verification of Air Flow MCH=23,or Refrr geraht Cmharge MCH 25 ,> -Existing duct systems constructed,insulated or sealed with-asbestos are exemptfrom MCH-20 Duct�'Leakage Test ng requirements. _,; E. Entirely New or Complete Replacement.Duct System,with or without Equipment Changeout(Sections,150 2(b)1Diia and,150 2(b)1E, F) . •. It; - 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:217-A020334982A-000-000-0000000-0000 Registration Date/Time: 2017-09-27 11:45:46 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance Report Version:2016.1.006 Report Generated:2017-09-27 14:45:33 • Schema Version:rev 10/16 -. CERTIFICATE OF COMPLIANCE • CF1R-ALT=02-E Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 3 of 3) Documentation Author's Declaration Statement 1. I certify that this Certificate of Compliance documentation is accurate and complete. �� Documentation Author Name: _ - Documentation Author Signature: a ,/O C1'L000t'//� .2 /?i Faulkner,Cindy l Company: __ - Signature Date: - ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL 2017-09-27 11:45:46 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 of Compliance is trueand correct. 2. I am eligible under Division 3-of theBusiness and Professions Code to accept:responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer). 3. That the energy features and performance specifications,materials,components and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6'of the California:Code of Regulat ons. z. ' 4. The building design features or system design features identified or this Certificate of Compliance are consistent with the informatioi provided off other•applicable co`inpliance documehts,worksheets, calculations,plans and specifications submitted to the enforcement'agency forapproval with this building permit application. • 5. I will ensure that a registered copy of this"Certificate of Compliance shalt be made available with:the building issued forthe buiild ng and made available to;the nforcement agency for all applicable 3-" inspections.I understand that a registered copy of this Certificate of Compliance is,required to be included with the documentration,,thebuilder prpvides tothe e buildi n g owner at occupancy. Responsible Designer Name: °"- Responsible Designer Signature. yC�GUGGf� Faulkner,Cindy Company: - Date Signed: ATKINSON CLIMATROLLERS INC dba VALLEY HEATING,COOLING&ELECTRICAL _- 2017-09-27 11:45:46 • Address: License: 1171 NORTH 4TH STREET 258540 City/State/Zip: Phone: SAN JOSE CA 95112 408-294-6290 Easy to Verify at CaICERTS.com t~ • r++moi. ,,_ {. _ Digitally signed by CaICERTS. This.digital signature is provided in order to secure the content of this registered document,and in no way implies Elo Registration,Provider responsibility for the accuracy of the information. r' �''=. Registration Number:217-A020334982A-000-000-0000000-0000 Registration Date/Time: 2017-09-27 11:45:46 HERS Provider:CaICERTS CA Building Energy Efficiency Standards-2016 Residential Compliance - Report Version:2016.1.006 - - Report Generated:2017-09-27 14:45:33 Schema Version:rev 10/16 CUPERTINO PURPOSE SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(cDcupertino.ora PERlYIIT. C N O T:B NALEll UNTIL THIS CERTIF 4CATE".HAS BEEN rCUMPLEnD,,S, 10"i AND'RETURNED T07HE BUILDING:DI'VISIOI 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 mterior access for inspections are required. ---GEIQER1At INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon _ Monoxide aims. WTe'n tie valuation of additions, alterations, orer pairs to existing dwelling units exceeds P $1000 00, CRC Section R314, R315, 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 bedroom(s) – (Smoke alarms shall not be located within 3 feet of bathroom door) X X 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, alarms) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated -,AThere.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�-�c -Wust_ e_c9nnecedd 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 ye N- TA- —(4LyeiLx lk Z) CAgy Permit No. 6 2-Q 11 Address Specify Number of Alarms # Smoke Alanns r-7-1 # Carbon Monoxide Detectors. l have read and agree to comply with the terms and conditions of this statement Ownero `OwnerA' Agent's) Name:( 9 ) Name l S L Signature.. ........... .. Date: .`...�� ..1.. Contractor Name: nature Date: Smoke and COform.doc revised 01110/2017