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13060126 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6692 JOHN DR CONTRACTOR:AIR QUALITY HEATING PERMIT NO:13060126 &AIR OWNER'S NAME: SITYNG SHIOU-PING 720 NORTHRUP ST DATE ISSUED:06/14/2013 OWNER'S PHONE: 4082570864 SAN JOSE,CA 95126 PHONE NO:(408)293-7138 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[] License Class_ Lie.# REMOVE AND REPLACE FURNACE IN SAME LOCATION, REPLACE EXISTING DUCT,ADD A/C UNIT @ REAR OF Contractor b Date SFDWL I hereby affirm that I am licensed and the provisions Chapter 9 (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 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 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:$8700 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 APN Number:36923007.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that 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 WIT 1 0 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DA F M 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 c� Issued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-points rce regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature 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: I 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&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 which 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 I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 an I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec' n 5505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: -Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after 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 a 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 and 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 GENERAL PERMIT APPLICATION 90 � M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 by GUPERTI Ia. (408)777-3228•FAX(408)777-3333•building(a�cupertino.org MISC ❑PLUMBINGX�—MCHANICAL ELECTRICAL [:]MISCELLANEOUS PROJECT ADDRESS APN# 3b Z 2 a cyi OWNER NAME 51 1 (01t- /q /� ,�`f_ PHONE qdF-z5.��y/ D 5 E-MAIL STREET ADDRESS ('.� (,l(rJ"2 j,J.yn/ /UI�J(�J CITY,S E, -/- uf� / ��J„� FAX CONTACT NAME `jJ PHONE D MAIL(� STREET ADDRESS (� CITY S ATE, IP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONT OR A LIC � LICENSE T)TF- BUS.LIC#-710 COMPANY �� E-MAIL FAX YC CA- ST JnEbL�Z CITY TATE ZI� 917'/ PHON -.3-ARCHITECT/ENGINEERNAME LICENSE NUMBER Cep BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF Aq SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIP ON OF ORK %, AZA C2r TOTAL VALUATION: 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 roperty 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 uilding nstructio,441 authorize representatives of Cupertino to enter the above-i ntified p perry for inspection purposes. Signature of Applicant/Agent: Date: 14,11 SUPPLEMENTArORMATION REQUIRED OFFICE USE ONLY w ❑ OVER-THE-COUNTER ❑ EXPRESS AC U x ❑ STANDARD U ❑ LARGE a ❑ MAJOR MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: *VALUATION: 1$8,700 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: FURN/A C WORK remove and replace furnace in same location replace existing duct add a/c unit rear of sfdwl SCOPE Meeh.Plan Check0.0 hrs $0.00 Plumb.Plan Check Elec.Plan Check Mech.Permit Fee: IMPERMIT Plumb.Permit Fee: Dec. Permit Tee: Other Mech.Insp. 0.0 hrs $45.00 Other Plumb Insp. Other Elec.Insp. Hech.InspFe". Plumb.Insp.F,e: Islet.Insp.Fite: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees are based on the prefimina information available and are only an estimate. Contact the Dept for addn'1 info, FEE ITEMS(Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Mechanical Suppl.PC Fee: (j) Reg. Q OT0.0 hrs $0.00 $133."00 1MFR=<100 Furnace,Forced-Air PME Plan Check: $0.00 1 # Mechanical Permit Fee: $0.00 $67.00 IBREAmm A/C Units(<=10K cfin) Suppl. Insp.Fee Reg. .® OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 Ct�nstpvction :Tax. Administrative Fee:. 1ADMIN $42.00 Work Without Permit? ® Yes 0 No $0.00 0 Advanced Planning Fee. $0.00 Select a Non-Residential Travel Documentation Fee: 1TR4VDOC $45.00 Building or Structure i Strong Motion Fee: IBSEISMICR $0.87 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 u $133.87 $200.00 y. o $333.87 Revised: 04/29/2013 Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAheradons CF-IR-ALTAWAC Climate Zones I and 3- Site A �I �i Enforcement Agency: Drag Perrin#:: Conditioned Duct insulation Equipment Type' 'IakWmimutn'Efficiency2 Floor Aiea requirement 'Thermostat . Pgd Unit I` ' over 40:ft of daces SVFUrnace AFUE COP Setback VIndoor Coif SF,1;it U HSPF_ Savedby system added or replaced inXot a1r. sf ugconditioned space P°` ` °" densing Unit EER ®Resistaz►ce 7" 6 {CZ I,3-S) uutalled) er 7Ib — L Equipment Type:Choose the equipment being installed;if more than one_system,use another CF-IR-ALT-HVAC for eaeb system. 2.A linimum Equipment Efficiencies:13 SEEP,78%AFUF,VHSPF 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 this 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 forrc emment agency for approval with the permit application. Name: Signature:h V(/ Compare : Q /� (�,.�L_ rw Date: &//,41 Address: T License: City/StateMp: Pirrone 2008 Residential Compliance Forms.doc revised 04/10/12 HVAC ALTERATIONS ENERGY COMPLIANCE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTtNO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333-building aacupertino.org WHEN IS A PERMIT REQUIRED A 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 Chapter 1, Section 112.2 of the 2010 California Mechanical Code. Projects requiring permits include, but are not limited to: • New HVAC installation • HVAC Changeout • Replacement of furnace, coil,FAU or condenser • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconditioned space 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. 2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 6)REQUIREMENTS INCLUDE: 1. Heating equipment must have a minimum 78%AFUE(Exception: Wall & floor furnaces; room heaters). 2. Central air conditioners &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 requirement of Section 150(m). • All joints and openings in the HVAC system must be sealed. • Only UL 181, UL 181A, or UL 181B approved tapes or mastic shall be used to seal duct openings. • Connections of metal 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 4 ft. max for horizontal runs with no more than 2" of sag between supports and 6 ft. max for vertical runs. 6. The CF-6R-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. 2008 Residential Compliance Forms.doc revised 04/10112 1n>r p I - — fi-- --�-- — ' � J t�%r�r"I��`i�.,d.�l,� �• ,��j G� ;�—�----�_ -i—i i I. Ir- — — - ——i— IA I t vao L — -- 1 -- AM ` Tf I ' �-' - '- - - - - •-- -- — - — r —�--�.— —' r i � I ` I —1— - --' -- } 3 twc - - i r I I LA - - - - , i � i