12040036 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 888 BLAZINGWOOD AVE CONTRACTOR:VALLEY HEATING& PERMIT NO: 12040036
COOLING
OWNER'S NAIVE: BARCZI KENNETH A AND JOANNE B 1171 N 4TH ST DATE ISSUED:04/062012
OWNER'S PHONE: 4082575543 SAN JOSE,CA 95112 PHONE NO:(408)294-6290
❑ LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class - �V Lic.N (l/ r r r
/�/ Lam_ a — �`�/�`� � MECH RESIDENTIAL COMMERCIAL
Contractor�1(1�/ /�/ / Dte
k (
I hereby affirm That I em licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE AND REPLACE TWO(2)FURNACES AT EXISTING
SINGLE FAMILY DWELLING
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty or 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
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by Sq.FI Floor Area: Valuation:$5062
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. -i/ -
w, — APN Number:36917018.00 Occupancy Type:
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 and state laws relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source r alai its per the Cupertino Municipal Code,Section �// t' 2
9.18. Issued by: �/ Date: 7 V
Signature 411 Dale-c —i
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed.If a roof is
I hereby affirm that I am exempt from the Contractor's License Law for one or installed without first obtaining an inspection,1 agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant Date:
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BF.CLASS".1"OR BETTER
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE.
declarations:
1 have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation lawsof Califomia. If,after making this certificate of exemption,I Owner ' y ent:
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.)
correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18-
Licensed Professional
Signature Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . ... . . . : 36917018 .00
DATE ISSUED. . . . . . . : 04/06/2012
RECEIPT #. . . . . . . . . : BS000016472
REFERENCE ID # . . . 12040036
SITE ADDRESS . . . . . : 888 BLAZINGWOOD AVE
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BARCZI KENNETH A AND JOANNE B
ADDRESS . . . . . . . . . . : 888 BLAZINGWOOD AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4619
RECEIVED FROM . . . . : VALLEY HEATING & CO
CONTRACTOR . . . . . . . : JEFF AND CINDY FAULKNER LIC # 141
COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING
ADDRESS . . . . . . . . . . : 1171 N 4TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 294-6290
FEE ID UNIT QUANTITY AMOUNT PD-TO.-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
-ADMIN HOURS 1. 00 41. 00 0. 00 41.00 0.00
1BCBSC VALUATION 5, 062 . 00 1. 00 0 .00 1. 00 0 . 00
1BSEISMICR VALUATION 5, 062.00 0.51 0 . 00 0.51 0 . 00
1MFR=<100 UNITS 2.00 260.00 0.00 260.00 0. 00
1MPERMITFE FLAT RATE 2.00 44 .00 0. 00 44 .00 0. 00
1TRAVDOC FLAT RATE 1 .00 44 . 00 0. 00 44 .00 0.00
--------- --- ---------- --
TOTAL PERMIT .390. 51 0.00 390 .51 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 39.0.51 #23455
---------------
TOTAL RECEIPT 390 .51
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 888 Blazingwood Ave DATE: 04/06/2012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: 1$5,062
PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex PENTAMATION FURN/A
USE: pPERMIT TYPE: i
WORK' Remove and replace 2 furnaces at existing SFDWL.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 2 # $260
TOTALS: $260.00
Mech. Plan Check 0.0 1 hrs $0.00 I4mnb. Plan Cho A Eh". P/r.. c:h;:clr
Mech. Permit Fee: IMPERMIT I'lnn+h. Po nrir lS r: !C/" A'nnu
Other Mech. Insp. 0.0 hrs $44.00 Other Plumb Insp. Urhrr Fkr. I,a.l.
hnp. /-'rr. Phunh. 1n.p. Fea:
NOTE: This estimate does not include fees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact rite Dept for addn7 info.
FEE ITEMS (FeeResahnion 11-053 EFI: 711,11/) FEE QTY/FEE MISC ITEMS
Ph Irl C'lyd<k Ice:
SnppL PC Pcc
PME Plan Check: $0.00
Pcrrnil F"C'
Sup/,l. heels h"
PME Unit Fee: $260.00
PME Permit Fee: $44.00
Crne�/nrrviun T'11: 1 1
Administrative Fee: IADMIN $41.00
Work Without Permit? O Yes 0 No $0.00
,I Arum cd Phumin� I'rm.i
Travel Documentation Fee: ITRAVDOC $44.00
A
Strong Motion Fce: IBSEISMICR $0.51 Select an Administrative Item
131dg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $390.51 $0.00 TOTAL FEE: $390.51
Revised: 04/01/2012
` (ENFORCEMENTAGENCY
CAN CUSTOMIZE'WITH LETTERHEAD/SEAL)
2008 Building Energy Efficiency Standards Residential HVAC Alterations
Climate Zones 1 and 3 through 7
BUSINESS AND PROFESSIONS CODE,SECTION 7110
Willful or deliberate disregard and violation of the building laws, including the California Building Code,and
local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board
working in conjunction with the local building department. This action may consist of fines up to $5.000 per
violation or suspension/revocation of a contractor's license.
WHEN IS A PERM IT REOU[RED?
A written construction permit shall be obtained from the enforcement agency prior to the erection,construction,
reconstruction, installation, relocation,or alteration of any mechanical system,except as permitted in Appendix
Chapter I,Section 112.2 of the 2007 California Mechanical Code. Projects requiring perm its include,but are not
limited to:
• New HVAC installation
• HVAC Changeout
• Replacement of furnace,coil. FA U.or condenser
• Relocation of an existing HVAC unit
• Adding or replacing more than 40ft ducting in unconditioned space
2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24, Part 6) REOUIREMF.NTS INCLUDE:
I. Heating equipment must have a minimum 78% AFUE (Exception: Wall & Floor furnaces: room heaters).
2. Central air conditioners d heat pumps less than 65.000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2.
4. A setback type thermostat(24 hr clock with four set points) is required for all alterations.
5. New or replacement ducts must meet the mandatory requirements of Section 150(m):
• All joints and openings in the in the HVAC system must be sealed.
• Only UL 181. UL I81A.or UL 181 B approved tapes or mastic shall be used to seal duct openings.
• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts
must be connected using a metal sleeve/coupling.
• Flex ducts that are suspended must be supported every 4ft. max for horizontal runs with no more than 2"
of sag between supports and 6 ft. max for vertical runs.
6. The CF-61R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect
this form and verify that the model numbers are the same as the installed equipment.
Simplified Pre scrip tiveCertificate ofCompliance: 2008Residential HVACAlterations CF-IR-ALT-HVAC
Climate Zones I and 3-7
Site Address:8 8 000 8 B la Z i n g W o o d Ave v e Enforcement Agency: Date: Permit q:
D U Conditioned Duct insulation
E ui mensT List Minimum EfficientFloor Area requirement Thermostat
Packaged Unit Over40 ft of ducts
x Furnace ❑x AFUE80% COP QSetback
Served by system added or replaced in PI
Indoor Coil []SEER HSPF 2400 sr unconditioned space "or alreadp present,mast be
Condensing Unit EER _ ❑x Resistance — ❑R 6 (CZ 1,3-3) installed)
Other
1. Equipment Type:Choose the equipment being installed:if more than one system,use another CF-I R-ALT-11VAC for each system.
2.1l inim um F.quipm ent Efficiencies: 13 SEER.780%AFUE,7.7HSPF for typical residential systems.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on[his Certificate of Compliance conform to the
requirements of Title 24,Parts I and 6 of the California Code of Regulations..
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Signature:
Company:
}'Valley Heating and Cooling Date:
Address1171 N4Th Street License:258540
city/state/zipsan Jose,CA 95112258540 Phone:408-294-6290
2008 Residential Compliance Forms ,larch 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations Pae I of 5
Project Name:Joanne Barczi Climate ZoneN4
2B of Stories
General Information
Site Address:888 Blazingwood Ave Enforcement Agency: Date:
Building Typc❑Single Family ❑Multi Family Circle the Front Orientation:N,F:,S.W,or degrees
Conditioned Floor Area(CFA): 2400 Project Type: LJ AlterationsEnvelope Fenestration Roof IIVAC
Replacement or Change Out PDuct Replacement❑Water Il cater
NOTE: This form is novo be used for Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces(for Furring use the Alass and Furring Strips Construction table below)
Assembly Alteration
[10 pening of framed cavity alone-Alterations that involve the opening of rhe framed cavity of wall,ceiling,or floor must install the
mandatary minimum insulation value per§150 Jar the altered assembly.Fill in Columns A -C and enter mandatory insulation value in Column 11.
❑Replacem ent or entire assem bly-Replacement of an entire wall,ceiling,or floor assembly requires the installation of Component
Package.D insulation values in Table 151-C. Fill in Columns A -J.
0 ag u Surface Details For the furred portioned of Mass W ails see Furring Strips Construction Table below.
,\ B C I DMfactor' Numbcr'
G II 1 J
Pro osed 'e °" Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tagl Assembly Name Material Spacing, Cavity Insulation Assembly Assembly
ID' or Tv e' and Size or Other' R-value' R-Value' Row/Cols U-factor'
,YateForfnrred assemblies.accounting for Continuous Insulation R-value.see Page JA4-3 and Equation 4-1. For calndaung furred walls use the A/ass and
Furring Construction table Fetor.
I.For Tog11D indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:Roof Ceiling, (Valls, Floors,Slabs, Crawl Space, Doors and etc...Indicate in column G the Frame
material and Si--e:For IVood,Afetal,Afetal Buildings, plass,enter 2x4,2.x6,or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter: 16"or 24"OC:or Other for all other assembly description
such as Concrete.Sandwich Panel,Spandrel Panel.Logs..Strait,Bale Panel and em....
4. Based on the Climate Zone:enter the equivalent U-factor found in JA4 Table based on the R-I'alre from Table 151-B, C, or D
5. Enter the Table number that closely resembles the proposed assembly.
6. Enter the R-value that is being installed in the wall cavity or between the framing:otherwise, enter "0".
i. Enter the Continuous Insulation R-value for the proposed assembly:orhenrise.enter "0".
8.Enter the row and column of the U factor value based on Column F Table Number and enter the Assemblv
y U-faor in Column J
9.The Proposed Assembly U-foclor, Column J,must be equal to or less don the Standard U factor in Column E to comply.
Furrin Stri s Construction Table for Mass Walls Onl
A I I C I D I F. F G 1 II 1 .1 1 6 1- YI
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
Walls From Reference in Furring Space from Reference
Joint A ppendix Table 4.3.5.4.3.6,4.3.7 Joint Appendix Table 4.3.13
V U
Assembly �- j `o `o ' F ` c m-v -„ %"� Final
11 ass Name or JA4 Table < u E E Assembly
Thickness' T' a Number' <> = r c e ok
� > U-factor Comment
F--
(Registration Number: Regisrralion Daie.nTi=e:_ _1/ERS Prodder:
2008 Residential Compliance Forms Alarch 2010
Prescri tireCertificate ofCompliance: Residential CF-IR-ALT
Residential Alterations (Page 2 of 5)
Project Name:Joanne Barczi Climate Zone but`'F 2k or Stories
(lass and Furring Strips Construction(footnotes)
I. Indicate dee(rpe of assemble to include:Hollow Unit,Masonry II'alls,.Solid Unit Alasonri,Solid Concrete Walls, Etc Additional assemblies can
befound Reference Joint Appendix JAq.
2. This is dee U-Factor based on the thickness of the assembly in inches.
. The R-value of the insulation to be added on the interior or exterior of the assembly.
J. The Calculated R-I'alue is the R-value of the furred out section of the assembly.
-.-6.The Final Assembly is calculated using Equation 4-2 or Equation J-Jof the Reference Joint Appendix JA J, The equation is the inverse of Column
added to Column L Column A'is the inverse from column J.
7. Insert the calculated U-lactorvalue on to the Opaque Surface Details in Coluna J
FENESTRATION PROPOSED AREAS
❑Replacing window alone— Replacement windows shall meet the II-Factor and.SIIGC I'alue requirements of Component Package D in
Table 151-C. The Total Fenestration and 11'est facing Area requirements are nor applicable.
❑ Adding 50ftr or less ofw'indow area —A'en•/) installed windows shall meet the U-Faciorand SIIGC Value requirements of Component
Package D in 7"uble 151-C.
❑ Adding more than 50fttorwindow area — Newiv instilled windows.shall meetihe U-Factor and SHGC I slue and the Fenestration
Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF-IR-111.7-
Orientation
Fenestration Type and Frame (North.East, PropsedAreal Maximum Maximum NERC or Default
IW indoo.Glass Door or Skylight) South,West) Ift') U-factor'' SIIGC"''' Value`
I. Fenestration area is the area of total glazed product(i.e.glass plus frame). Exception: when a door is less than 5O% glass,the fenestration
area ma) be the glass area plus a "2 inch frame"around the glass.
1. Eater value from Component Package D Requirements in Table 151-C.
3.Actual fenestration products installed and as indicated in CF-6R-ENV Form shall be equivalent to or have a lower U-factor and,or a lover
SHGC iahne than that specified on the CF-IR ALT Form.
4..Submii a completed IVS-3R Form if a reduced SIIGC is calculated wiih exterior shading.
i3l'applicable at this stat a enter "A'FRC" or A'FRC Certified windows or are CF-C "Default"ra/ues found in Table 1/6-A or R.
A LT E RE D FENESTRATION ALLOW ED AREAS (Complete if more than 50fr of fenestration is added)
A B C D E F G
CFA of Allowed Existing Allowed
Entire 90 of Fenestration Arca Fenestralion Area Proposed Arca' '
Dwelling CFA''' Area' Removed' Arca Added' (AxB) (E-D)+ C
"Fetal Fenestration
A rea i'(fl')
West Fenestration Area
(Required In
CZ's 2.A.@7-15) 1 1 1 1 1 14
1. The Proposed West Feneslrarion Area includes West-sloping skylighl arra and an).other skvlighi area with a pitch less than 1:12.
2. Etter 20% when no (Vest orienlarion restriction or/j% when lVesi fenestration is being installed in Climate Zones 2, J, & 7-15. Note dot rhe
maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must he equal to or less than Column F.
3. In climate cones 2, J, 7-15,no more than 5% of the CFA is allowed for crest facing glaring.
J. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The
Proposed Areu must he less than ar equal to Column F.
5. Fuer dee fenesiralion removed as part of the alteration if any in column D.
6. Enter the Fenestration area that is being added as part of the alteration.
IRegtsrration.Aumber: _ _ Registration Dale.!Time -_
2008 Residential Compliance Forms /larch 2010
y o D
GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 I A
CUPERTINO (408)T77-3228•FAX(408)77Cd),
7-3333• buildinGcuoertno.orO /v—
❑PLUMBING fAM ECHANICAL CIELFcrRicAL ❑MISCErrANEOU5
R
PROPEADDRESS ///���
�'�✓ /� APNa I J —1 --7— vl
OWNER NAME ' PHONE S� E-MAIL
STREET ADDRESS GZ1� / CITY,STATE Z? �✓ �� ����d` FAX
CONTACT NAME �d PHONE T i E-MAD-
SPAEETADORESS CITY,STATE, ZIP FAX
❑OWNER ❑ OWNER-BLnLom ❑ OWNER AGQ+r ❑ OJNTmcm ❑CONTRACTOR AGENT ❑ ARfAf= ❑FNODJEEtt ❑ DEVELOPER ❑TFJlAfIT
CONTRACTOR NAMEIJCFNSE NUMBER [JCIIJSE TYPE HUS LIC a
COMPANY NAME /r� E'MAD. FAX
SSAEETADDRESS / ^ ' L CITY.STATE-ZIP PHONE
ARcHmmENGINEER NAME /✓ LICENSE NUMBER BUS.LIC p U
COMPANY NAMEE-MAIL FAX
STREET ADDRESS CITY.STATE.ZIP PHONE
USE OF .DUPLEX ❑ O.
MULTIFAMILY PROJECT IN WDLANh ❑ YES PROJFDT Ht ❑YES JSTHEEDGAN [I YES
BU W(L CDMMERCL L MEAN UnIRFACEAREA ❑ NO FLOOD ZONE ❑NO EOOIR HO.MET ❑NO
DESCRIPTION OF WORK
TOTAL VALUATION: RECEIVED BY:
By my sigmatime below,I cetify to each of the Coll I am th FmpcM owner wauthorized agent to act on the propety ownces behalf I have read this
application and the iofomnazim I have provided' toad the Desviptiom of Work and verify it is accmate. I ag=to comply with all applicable local
mdmmacra and state laws relat'mg to buil ' rize medves of Cllpetino to enter the above-identified perry fur inspecdom pu@oses.
Signore ofApphcauNAgeum - Dare:
Slip AL INFORMATION REQUaM OFFICE USE ONLY
u ❑ OVER-THRCOUNTER
6
❑ CRESS
Y
V
S ❑ STANDARD
V
3 ❑ LARGE
c
❑ MAJOR
MBPMiuApp 2011.doc revised 0621111