12090041 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10186 MANN DR CONTRACTOR:VALLEY HEATING& PERMIT NO: 12090041
COOLING
OWNER'S NAME: CAPENER CHRISTOPHER LAND LYNNE 1171 N 4TH ST DATE ISSUED:09/062012
OWNER'S PHONE: 4084460333 SAN JOSE,CA 95112 PHONE NO:(408)294-6290
LICENSED CON`FRACFOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ CO\IMF.RCIAL
License Class I'-2-4 11 Lic.4 Z SFfS�(d REMOVE AND REPLACE FURNACE IN SAME LOCATION
Contractor v4llz;111
_4/1-ea Date 9l/0
hereby affirm that I am licensed under the provisions of Cha pier 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided forby Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$2395
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of die Work for which this
APN Number:32619010.00 Occupancy"1"ype:
Penni[is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state dial the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction;and hereby authorize representatives of this city m enter
upon die above mentioned property for inspection purposes. (We)agree to save 180 DAYS LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the /.,
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: CLQ
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18,
RE-ROOFS:
Signature .._{_e i ..a'ar/--Date��
_ �/' All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection.I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,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,
Business&Professions Code)
I,as owner of the property,am exclusively contracting With licensed contractors to IIA%ARDOUS MATERIALS DISCLOSURE
construct the project(Sea.7044,Business R Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Ilealth&Safety Code,Sections 25505,25533,and 25534. 1 will
hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Ilealth&Safety Code.Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices e'hich emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 1
performance of the work for which this permit is issued, will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the I leallh&Safely Code,Sections 25505,25531,and 25534. �1
Section 3700 of the Labor Code,for die performance of the Work for which this Owner or authorized agent: _(�
permit is issued. g �.K-itm�� /h-dj-Date:
I certify that in the performance of die Work for which this permit is issued,I shall
not employ any person in anymanner so as to become subject to the Worker's
Compensation laws of Cal ifomia. If,alter making this certificate of exemption,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city mid county ordinances and state laws relating
to building construction,and hereby authorize 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, ARCI LITECI"S DECLARATION
costs,and expenses Which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10186 MANN DR DATE: REVIENVED BY: SYLVIA.
APN: BP#: 'VALUATION: 1$2,395
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair
PRIMARY "SFD or Duplex PENTAMATION FURN/AC
USE: PERIIIIT Tl'PE:
WORK REMOVE AND REPLACE FURNACE IN SAME LOCATION
SCOPE
Mech. Plan Check 0.0 hrs $0.00 Plumb.Plan Check Flee.Plan Check
Mech. Permit-Fee: /AIPERA1/T Plumb.Permit Fac: Elec. Permit Fee:
Other Mech. Insp. 0.0 hs $45.00 Other Plumb Insp. El
Other Elec.Lip.
.Mech.hap. Fee: Plumb. h+.p. Fee: Elec.hup.Fee:
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 baser)on the prelitninan information available and are only an estinate. Contact the Dept for adtln'I info.
FEE ITEMS (Fee Resahttion 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 = # Mechanical
Suppl. PC Fee: Q Reg. Q OT FO.0 Vhrs $0.00 $133.00 IAIFR=<100 Furnace, Forced-Air
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Fee:Q Reg. Q OT 0,0 11rs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $45.00
Conswuction Tax:
Administrative Fee: IADMIN $42.00 O
Work Without Permit? Yes (j) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 17
Travel Documentation Fee: ITRA I DOC $45.00 Building or Structure 0
i
Strong Motion Fee. IBSEISMICR $0.50 Select an Administrative Item
Bldg Sids Commission Fee: IBCBSC $1.00
SUBTOTALS: $133.50 $133.00 TOTAL FEE: $266.50
Revised: 07/01/2012
Prescriptive Certificate of Com liance: Residential CF-IR-ALT
Residential Alteralions (Pagel of5)
Project Name:Christopher Capener Climate Lone b4 1H of Stories
General Information . •
Site Address:10186 Mann Dr Enforcement Agency: Date:
Building Typc❑x Single Family ❑Multi Family Circle the front Orientation:N. 1 .S. W.or decrees
Conditioned Floor Area(CPA): 1200 Project Type: Lj Alterations❑Envclope❑Fenestration Roo( X IiVAC
Replacement or Chanee Out Duct Re lacement❑\Vater I leater
NOTE: Tltts fort is'itot a be used for A`eu,l•Constructer/Railtlings or Atirlitians
Insulation Values For Opaque Surfaces(for Furring use the Mass and Purring Strips Construction table belong
AssemblyAlteration
❑Opening of framed cavity alone-Alterations that involve the opening ofihe framed cavity ofa scall. ceiling, orfloor must install the
nianlaton,minimunrinsulation value per§150 for the altered assemble Fill in Columns A-C and enter mandnory insulation value in Column I/.
❑Replacement of entire assem bh•-Replacement ofan entire scall.ceiling. or floor assembly requires Are in'siallation ofComponem
Package-D insulation values in Table 151-C. Fill in CohannsA-J.
O a ue Surface Details For the furred portioned of Alass Walls see Furring Strips Construction Table below.
A R 1 C 1 D E F G 1 11 1 I J
Pro posed S`'Nw, Standard Values From.JA4 Table '
Framing Thickness. Framid Continuous JA4 Proposed
Tae/ Assembly Name Material Spacing. U- JA4 Table" Cavin• Insulation Assembly Assemblv
ID, or e` and Size' or Other; factor' Numbers R-value° R-Value' Row/Cole U-(actors
Note:Forfurred asseinhhes,accouming for Continuous Insulation R-value.see Pagc J.14-3 and Equanon 4-1. For calculating fuurred walls use Are Mass any/
Furrmg Cmtsiruction table below.
/. For Taglil)indicate Are identywatios name then matches the building plans.
2. Indicate.the Assemblv Nanta or ape:RoofiC'eiling, II'alls, Floors.Slabs. Craid Space, Doors and etc...indicate in column G Are Frame
material and Size: For Wood, Head, ,11eta1 Buildings. Mass.enter 2v4, 2x6, or etc... see JA4 for other possible frame type assemblies.
3. Enter the thicloessfol•mass in inches or Spacing between framing meniberr ever: 16"or 24-OC.- or Other for all otherassembly description
such as Concree Sandwich Panel.Span rel Petrel, Logs.Sirasv Bale Panel and etc....
a. Rased on the Climate%ate:enter the equivalent U factor found ill lhW Table baser/on the R-Value f'om Table l i l-R. C. or D
5. Ener the Table munber that closely resembles•Are propooed astsembly.
6. Enter Are R-oche that is being installed in the wall cavity or between rhe framing;otherwise, ever "0".
7. Enter the Continuous Insulation R-value jar the proposed assembly:otherwise, enter "0".
S. Enter the rev and cohunn of the U factor vane based on F
Column Table Number and enter the Assemblv U factor in Coh n n.1
9.The Proposed Assembh,U jaciolt Column J, must be equal to or less than the Standard U factor in Column E to conlply.
Furring Strip s Construction"I-able for Mass Walls O it
A B C 1) 1 E F G 11 1 .I I K I. M
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
Walls From Reference in Furring Space from Reference
.Joint A pendis•fable 4.3.5.4.3.6,4.3.7 .Joint Appendix Table 4.3.13
U
.l. •' G G � ,n
Final
Assembly
Mass Name or JA4 Table -'_ _ = e = c = _ _ " n Assembly
'Thickness' Tv c' Number' > - < % U-facer°'t Comment
Itegistr•ation 'umber: Registration Date/1'inle: HERS Provider;
2008 Revideniial Compliance Forms Alarch 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alteralimis (Page 2 of 5)
project Name:Christopher CapenerClimate'LoneN^ 1k of Stories
11aer.and Furring Strips Construction oornores) `t
1. Indicate the t.iVe ofassembly to include: Hollow Unit Anson,II'alls,Solid Unit Alasonrv,Solid Concrete IValls,.Etc. Additional assemblies can
befound Reference Joint Appendir JAa.
. This is the U-Factor basedon the thickness ofthe asseobly iii inches. ..
. The R-value of die insulation to be added on the interior or exterior of the assembly.
. The Calculated R-Value is the R-value ofthe fivred out section of the assembly.
-.-6.The Final Assembly is calculated using Equation 4-2 or Equation 4-4of due Reference Joint Appendkr JAa. The equation is the inverse of Column
D added to Colum;1. Coliumr K is the inverse from colunn J.
7. Insert the calculated U-Inetor value on to the Opaque Surface Details in Column J '
FENESTRATION PROPOSED AREAS
❑ Replacing window alone—Replacement windows shall meet the U-Factor and SI1GC Pulte requirements of Component Package D in
Table 151-C. The Total Fenestration and West facing Area requirements are not applicable.
❑ Adding 50ft'or less of window area—Ne,vly installed irindows shall meet the U-Factor and SIIGC Value requirements of Component
Package D in Table 151-C.
❑ Adding more than 5011'of window area— Newly installed windows shall meet the U-1-actor and.SIIGC Value and the Fenestration
Area requirements of Component Package D in Table 15i-C. Complete the Altered Fenestration Allowed Area Table on Page 2 tifthe CF-/R-ALT
Orientation
Fenestration-type and Frame (North, Bast. PropsedArea' Maximum Maximum NFRC or Default
(Window,Glass Door or Skylight) South. West) (Ih) U-factorz', SIIGC'-'}'' Values
1. Fenestration area is the area ofntal glazed product(i.e.glass pl s frame). F_rception: When a door is less than 50%glass,.the fenestration
area may be the glass area plus a -2 inch frame-around the glass.
2..Eater value from Component Package D Requirements in'!'able 151-C.
3.Aoutil fenestration products installed and us indicated in CF-6R-EAT'Form shall be equivalent to or have a lower U factor and/or it loiter
SIIGC value than that specified on the CF-I R ALT Form.
a.Submit a completed IVS-31?Form if a reduced SIIGC is calculated will;exterior shading.
5.brapplicable at this stage enter "NERC"for NFRC Certified windows or are CF_C "Deloult-values found in Table 116-A or B.
ALTERED FENESTRATION ALLOWED AREAS(Complete ifnare than 50f?offenestration Is added)
A B C D E F G
C17A of Allowed Existing Allowed
L'ntire %of Fenestration Area Fenestration Arca Proposed Area'.'
D%vclline C17A-'r Area' Removed' Area Added (Ax13) (13-D)+C
Total Fenestration
Area 2,(0').
West Fenestration Arca
(Required In
CZ's 2.4K7-15)
1. The Proposed(Vest Fenestration Area includes(Vest-sloping skylight area and any other skylight area with a pitch less than 1:11.
2. Enter 20%when no !fest orientation restriction or I S%when (Vest fenestration is being installed in Climate%ones 1, a, R 7-15.Note that the
maviuntm allowed fenestration can only be 5%ofdie C17A as indicated in Column F. Column G must.be equal to or less that;Colunnr.F.
3. In climate zones 1, a. 7-15. no more than 5%of the CFA is allowed for west facing glazing.
a. F_risring Fenestration area must be counted toward the marinuun allowed 15%or 20%of the whole building and calculated in Column G. 7be
Proposed Area must be less than or equal to Col nun F.
5. linter thefenestration removed as part of the alteration if any in column D.
6. Enter the Fenestration area that is being added as part o1The alteration.
Registration a\'amber: Registration Date/Pince: HERS Provider:
2008 Residential Compliance Forms Murch 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations (Page 3 of 5)
project Name; Climate Lone H 9 of Stories
Christopher Capener 4 1
ROOFING PRODUCTS(COOL ROOFS)§151(1)12
When the area of exlerior roof surface to be replaced eveeeds more than.ill%oflhe existing roof area,or more than.1,000 ft2, whichever A
leas,the new roofing area most nreel the rotfng product "Cool Roof'requirements of§t 52(b)Illi, 152(b)111ii,or 152(6)111iii.
Check applicable alternative or exception below if Are roofatteration is exempt from the roofing product "Coot Roof'requirements. Note: jams
one ofilre alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emlumrce requirements for roofing products in
§11 S(i)are not applicable. Do not fill table below.
Cool Roofs Not Required in Climate%ones 1-12. 14.and 16 with a Low Sloped. Less or 2:12 pitch.
❑Cool Roofs Not Required in Climate"Zones I through 9 and 16 with a Stccp-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 5lb/ft2.
Alternatives to§152(6)1 Iii and§I52(b)tlii.Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr li'0I'/13tu or at least a 3/4 inch air-space is added to the roof deck
over an attic:or
❑ Existing ducts in the attic are insulated and settled according to§151(1)10:or
❑ In climate zones 10. 12 and 13.with 1 li'of free ventilation arca ofattic ventilation for even• 150 fl'of attic floor arca.and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge:or
❑ Building has at least R-30 ceiling insulation:or
❑ Building has radiant barrier in the attic meeting the requirements of§151(02:or
❑ Building has no ducts in the attic:or
❑ In climate zones 10. 11. 13 and 14.R-3 or greater roof deck insulation above vented attic.
Exception to§I52(b)I Biii, Low-slope roof(pitch<2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑Rooting area covered by building integrated:photovoltaic panels and solarthcn al panels are exempt from the below Cool Roof criteria.
El Roof constructions that have thermal mass over the:roof membrane with at Icast 25 Ib/fl'-is esem t from the below Cool Roof criteria.
Note: Ifno CRRC-I label is available,this compliance method cannot be used.use the Performance Approach to show compliance.otherwise.
Checkthe applicable box below if Exe pt from the Roofing Products"Cool Roof'Tic uireme t:
Rool'Slope Product Weight Product Aged Solar Thermal.
CRRC Product ID.Numberl < 2:12 >2:12 < 5lb/ft2 >_ 5Ib/ft2 _ c'- Rctlectanee"" 1?mivanec SKIS
❑ ❑ ❑ ❑ ❑l
❑ I ❑ ❑ ❑ ❑1
I.-Tho CRRC Product ID Nionber cern be obtained from the Cool Roof Rating Council's Raled Product Direcion'at ererrr.rnolruols.nr¢Inroducl,t<search.nim
2.Indicate the ape of prothici is being used for dee roof top.i.e.single-pie roof,asphalt roof,metal roof,etc.
3. /fthe Aged RcJleclarce is not available in Are Cool Roof Rating Council's Rated Product Directon,then use the Initial Reflectance value from the sante
directon• and use the equation(0.2+0.7(1)i„ani„t—0.2)to obtain a calculated aged value. Where pis the Initial Solar Reflectance.
4.,Check'bar if die Agecl Reflecia¢e is a calctdared value using the equatimr above.
5.Calculate the.SRI value hip using the SRI- 11'orksheei at hunrhinvo%enerev ca em/ritle24/and enter the resulting value in the SRI Colunm above andattach dcopv of
the SRI-Worksheei to the CF-I R.
7'o apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dn•mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §I I8(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating ❑Cemcnt-Based Hoof Coating T0 Other
Regisrratioir Number: Registration Date/Time: ITERS Provider.'
2008 Residential Coniplitince Fornts iWarch 2010
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residewittl Alterations (Page 4 of I
Project Name:Christopher Capener Climate Zone#4
NofStories
HVAC SYSTEMS- HEATING
Minimum 'Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation •Thermostat (Central.Split.
Tvpc and Ca acir-1,M (AFUE or lISPF) Tv a and Location° R-Value Type Space. Package or Hvdronic)
Central/7Ok 8O% Ducts/Crwl I R-6 ISETBACK CENTRAL
I.Indicate Heating Tvpe(Central Furnace. Nall Furnace. Heat pump, Boiler, Electric Resistance.etc.)
2.Electric resistance heating is allowedonly in Component Package C, or except where electric healingissupplemental(i.e., if rata/capacih'
<2 K11'or 7.000 Bndhr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See y�151(b)3 exception.
3.Refer to the HERS Verification section on Page 4 ofthe CF-I R,I LT Form for additional requirements and check applicable boxes.
4. Indicate Type or location(Ducts, Hvdronic in Floor. Radiators.etc)
HVAC SYSTEMS-COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central. Split.
Tvpe and Ca acity"2 COP) Tvpe and Location R-Value Type Space.Package or I-Ivdronic)
1. Indicate Cooling Tvpe(WC. Heat pump. Evap. Cooling. etc) '
2. Refer to the IILRS Verification section on Page 4 of the CF-I R-AL7'Farm far additional requirements and check applicable bares.
3.,Indicate Type or Location(Ducts, Hvdronic in Floor, Radiators.etc.)
WATER HEATING
List seater heaters and boilers for both domestic hot water(DHII)-hearers and Irvdrouic space heating. Individual dyvelling Dlll i'heaters must be
gas or propane fired. Hot water pipe insulation from the DHIV heater to die kiichen(s)and on all underground hot stater pipes is required inall
cont anent packages in all climate=ores.
.Extenial Tank
Water Heater Type/Fuel Distribution'rype Number In Tank Energy Factor or Insulation
Type - (Standard.Recirculatin ) System Ca aciib(gal) Thermal lifficicncv R-Value}
I. Indicate Type(Storage Gas. Heat Pump, Instantaneous.etc)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§IjO(iJ. The Prescriptive requirements do
not allow the installation ofa recirculating water heating system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the requirements of FI50(i).
SPECIAL FEAT U RES'rhe enforcement agency should pay special attention to the Special Features specified in this checklist below.
7"hese items may re vire written justification rind docunuentatimn and s tecial verification.
NEW ROOF ASSEMBLV-Radiant Barrier
The radiant barrier re uirement of ss U I(q2 does nota v to roof ahcrations.
Slab Edge(1'erime[er) Insulation IES NO
VES: In Climate Zone 16 in Component Packages D. R-7 insulation is required.
Heated Slab Insulation ❑ VES NO
YES: Slab edge insulation re aired for all heated slabs in all Climate Zones. Sec details in Table 118-A of the'standards.
Raised.Slab Insulation 1'ES QNO t
1'ES: In Climate Zones I.2. 11. 13. 14& 16. R-8 insulation is required: in Climate Zones 12 R 15.R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thenal mass.use the Performance Approach.
Registration:Vumber: Registration Date/rime: /IERS Provider:
2008 Residential Compliance Forms ,March 2010
Prescriptive Certificate of CornIiance: Residential CF-IR-ALT
Residential Alterations (Page 5 of 5)
Project Name:Christopher Capener Climate Zone N4 1N of Stories
HERS VERIFICATION SUMMARY The enforcement ngencv should pav a'pecia/attmuion to the HERS Measures specified in this
checklist below. A completed and signed CF-JR Fono for all the measures specified shall be submitted to the building inspector before final
inspection.
Duct Sealing & Testing IIEItSt•er-ylcotionisretptirer/fordrismeasure.
❑ YES ❑x NO YIiS:hi Climate%ones 2 and 9-16,irmore than 40 linear feet of new or replacement ducts are installed inunconditioned
space,the ducts are to be scaled per§152(6)1 Dii and the newly installed ducts are to be insulated per§151(010.
El EXCEPTION: Existing duct systems that are extended,which are constructed,insulated or sealed with asbestos.
DYES ❑x NO YES: In Climate Zones 2 and 9-16, if the existing space-conditioning system(flVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(6)I Di.
DYES ❑x NO vl:s: In Climate%ones 2 and 9-16, if the existing li VAC equipment isreplaced(including the replacement of the air handler,
outdoor condensing unit of a split system,cooling or heating coil.or the furnace heat exchanger)the ducts are to be
Sealed per§152(b)I li.
❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through ITERS
verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
rl EXCEP'T'ION: Existing duct systems constructed,insulated or scaled with asbestos.
Refrigerant Charge - Split System 11ER.Sverificadonisrequireditr this measure.
❑ YES ❑x NO VES In Climate%ones 2 and 3-I5.when the existing IiVAC equipment is replaced(including the replacement of the air
handler.outdoor condensing unit of a split system A/C or heat pump,cooling or healing coil.or the fumace heat
exchanger)a refrigerant charge measurement shall be verified per§152(b)I F.
Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw
The vent i lit ion.requirements of§I50(o)do not apph,to cxistin g residential homes.
Ducted Split Systems- Air Conditioners and Heat Pumps: Airflow HERS verification isrequiredforthis.measure.
❑ YES ❑x .NO YfS: In Climate Zones 10 through 15,when the existing space-conditioning s•stem(I-IVAC equipment mid ducting)is
replaced.the airllow and tan watt draw shall be verified per§152(b)ICi to meet the requirements of§151(1)713.
Documentation Author's Declaration Statement
• I certifv that this Certificate of Compliance documentation is accurate and complete.
Name: Signature:
Company:Valley Heating and Cooling Da1C:
Address:1171 N4Th Street lfApplicablc CEA or CFPE
(Certification N):
Ci"'/State"`p:San Jose,CA 95112 ''h°n"408-294-6290
Responsible Building Designer's Declaration Statement
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, fans I and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms,worksheets.calculations.plans and specifications submitted to the enforcement
a encu for approval with this building permit application.
Name: Signature: -
Company:Valley Heating and Cooling Date:
Address:1171 N4Th Street License:258540
City/SImclzIp:San Jose,CA 95112 Phone:408-294-6290
For assistanceor questions regarding the Energr Standards,contact the Energy 11otline at: 1-800-772-3300.
Registration umber: Registration DwWl'inte: 11ERS Provider:
2008 Residential Compliance Fornei tblarch 2010
Simplified Prescriptive Certificate of Compliance: 2008 Resillentinl HVAC AIterations CF-IR-ALT-HVAC
Climate Zones I and 3-7 '
Site A`drevs`10186 Mann Dr En'farcemenl Agency: Date: Permit#:
Conditioned Duct insulation
Equipment Ty et List Minimum l3fficiencv2 Floor Arca requirement Thermostat -
Packagcd Unit
x Pomace ° Over 40 ft of ducts
❑ El eCOP ❑x Setback
Served by system added or replaced in
e-Indoor Coil ❑$L'L'R_ IISPF_ 7200 (lt(now already,presenr.msi be
Condensing Unit ❑ f Eli_ ❑Q Resistance sf unconditioned spdec brsmlled)
❑Other E]R 6 (C%1: 3-j)
1. Equipment Type:Choose the equipment being installed: if more than one system,use another CF-1 R-ALT-IiVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER. 78%APUF. 7.71ISPF for typical residential systems.
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• 1 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 this Certificate of Compliance conform to the
requirements of—fitle 24, Pans I mrd 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance arc 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:
Address:1171 N4Th Street License:258540
City/stater/_ip:San Jose,CA 95112 Phone408-294-6290
2008 Residential Compliance Forms March 20/0
GENERAL PERMIT APPLICATION 'ld�` M E P
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION av
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 /1 ri M ' (�
CUPERTI NO (408)777-3228• FAX(408)777-3333•buildino(okupertino.oro V\
❑PLUMBING MECIIANICAL []ELECTRICAL ❑MISCI3hLANf:OUS
PROJECTADDRESS IDTBGMarv? Ar. I
APN0 -39- /\ 10A
O t o
OWNER NAME . PHONF. O`'V" E-NIAIILL` `
O�'<G e eRCr °l -9'16-63()37 '�j
SfREETADDRE55ID1fsG Q.rq CITY, STATE.
/1LSO11
FAX,
CONTACT NAME PHONE E-MAIL
STREET ADDRESS CIT',SrATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGE,, T ❑ CONTRACTOR I CONTRACTORAGENT 0 ARCIMTMr O ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME // LICENSE.NUMBERLICENSE TYPE BUS.LICK
14 Co'f.:L £ Coe ' '25 K5 r-16 -2N 1 q f
COMPANY NAME. it E-NIAIL FAX
STREET ADDRESS II7I /V, L///L JT- CITY.STATE,ZIP C /j. 2 1H1NFY46
9-,2 19-62?d
ARCHITECF/ENGINET:RNAME LICENSENUMBER •7 BUS.LICK
COMPANY NAME E-MAIL FAX
STREET ADDRESS CIT',STATE;ZIP PHONE
UST:OF WFD.DIJPLEC ❑ MULTI.FANIILY PROJELTINWILDLAND El 77 PROTECTIN ❑t'ES IS'HIE BLDG AN ❑ \'ES
rE
BUILDING. COMMERCIAL URBANINRFACEAREA ❑ NO FLOODZONE ❑NO EICHLER HOME! ❑NO
DESCRIPTION OF WORK - rj
TOTALVALUATION: 2J3 fJ� RECEIVED BY:
By my signature below,I cenify to each of the lullowing: 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\York and verify it is accurate. I agree to comply With all applicable local
ordinances and state laws relating to buildin�CoretmCIIon. I auu}_hortze representatives of Cupertino to enter the above-identified property for inspection purposes.
SignalureofApplicant/Agem: h -\�/T�%4(�/ Date: q/-/
Io
INFORNIATION R17QUIR17D OFFICE USE ONLY
❑
OVER-1 HK-COUNTER
❑ EXPRESS
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U
❑ STANDARD
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_ ❑ T.\RCE
❑ MAJOR
MEP,1 DcApp_2011.doc revised 06121111