13100058*10
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10345 MORETTI DR
CONTRACTOR: ALLIED AIRE SERVICE
PERMIT NO: 13100058
INC
OWNER'S NAME: MAE MINATO
887 AMES AVE
DATE ISSUED: 10/08/2013
OWNER'S PHONE: 4082528314
MILPITAS, CA 95035
PHONE NO: (408)934-8844
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
LICENSED CONTRACTOR'S DECLARATION
License Clasgle e-ra �� Lic. # P02$3,
REPLACE (E) WALL HEATER, SAME LOCATION
///"Contractor,, �//. c (�;,-iGQ Date
I hereby affirm that I am licensed under the provisions of 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
Sq. Ft Floor Area:
Valuation: $900
;performance of the work for which this permit is issued.
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: 37514009.00
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
WITHIN 180 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 DAYS FRO T 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
l0
granting of this permit. Additionally, the applicant understands and will comply
I ate:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
r r�
RE -ROOFS:
Signature "ate �l/
�
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
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,
Business & Professions Code)
1, 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, Sober 5505, 25533, and 2553-4.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Owner or authorized agent - Date
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
CUPERTINO
GENERAL PERMIT APPLICATION o0 MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Q
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �o
(408) 777-3228 • FAX (408) 777-3333 • building(-cupertino.org \� MISC
[:1 PLUMBING `ERidECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS IP3 AL -S— e
APN # 3 7 S — t ( f — 6
�(
OWNER NAME l r .a
PH NFA,, ��� �/
E-MAIL
STREET ADDRESS
CITY TATE, ZIP mit i0 LC
FAX
CONTACT NAME 04e6,
PHO /g `/
C� /
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER-BUMDER ❑ OWNER AGENT %4ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRA $NAME `
LICENSE NUMBER
LICENSE TYPE
-26, c=
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
ST T ADDRESS Vxeu /% ,e_
CITY, ST r 1 / .r-� 3.�
_TLk J i�
P ON
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF or DUPLEX ❑ MULTI -FAMILY
BUILDING.❑ COMMERCIAL
PROJECT IN WI DLAND ❑ YESPROJECT
URBAN U47ERFACE AREA ❑ NO
IN ❑ YES
TFLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
TOTAL VALUATION:
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prope s behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. agree to comply with all applicable local
ordinances and state laws relati m onstru2=5;gresentatives of Cupertino to enter the above-' entifie property for inspection purposes.
Signature of Applicant/Agent:�i►r2Date:
SUPPLEMENTAL INFORMATION REQUIRED
Q
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;
OF$lCEI3SE!0�'L]
SRINE
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CCUUNTER
EXP$ESS
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MEPMiscApp_2011.doc revised 06/21/11
i
CITY OF CUPERTINO
FEES ESTIMATOR — BUILDING DIVISION
x
ADDRESS: 10345 MORETTI DR
DATE: 10/08/2013
REVIEWED BY: MELISSA
UNITS
APN: 37514 009
BP#:
*VALUATION:
$900
*PERMIT TYPE: Mechanical F ermit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY
USE: SFD or Duplex
$70
PENTAMATION
PERMIT TYPE: FURN/AC
WORK
REPLACE E WALL HEATER SAME LOCATION
SCOPE I
I
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
Heater, Recessed Wall
1MRSUSHTR
1
#
$70
$0.00
I
.Suppl. Insp Fee
i
i
PME Unit Fee:
$70.00
PME Permit Fee:
$47.00
Construction Tax:
Administrative Fee: IADMIN
$44.00
1 TOTALS:
$0.00
Adv,,..inced Planning Fees:
$70.00
i
Travel Documentation Fee: I 1TRAVDOC
Mech. Plan Check 1 0.0 1 hrs
Mech. Permit Fee: 1
Other Mech. Insp. 1 0.0 1 hrs
Phimb. Plan Check
Plumb. Permit Pee:
.00 I Other Plumb Insp.
Elec, Plan Check
Elec. Permit Fee:
Other Elec. Insp.
I*,,eh. Insp. I�e:e: I I Plumb. Insp. Fee: I Elec. Insp, Fee: I
NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School
TIJcf>inf ofn 1 Th.— f... aro haaoA an 11,a availnhlo and aro nnhf not oQfimato Cantart tho Dont far addn'l infra
FEE ITEMS (Fee Resolution 11-053 Eff. 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
Suppl..PCTee
I
PME Plan Check:
$0.00
Pertnit Fee:
.Suppl. Insp Fee
i
PME Unit Fee:
$70.00
PME Permit Fee:
$47.00
Construction Tax:
Administrative Fee: IADMIN
$44.00
Work Without Permit? ®.,Yes (E) No
$0.00
Adv,,..inced Planning Fees:
i
Travel Documentation Fee: I 1TRAVDOC
$47.00
Strom; Motion .Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
4 a
$209.50
$0.00
$209.50
Revised: 10/01/2013
CUPERTINO
HVAC ALTERATIONS ENERGY COMPLIANCE FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building a5cupertino.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 than40ft 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 Forins.doc revised 04110112
Srte Addrers
EnJorcerrrerrt Agency:
I?aie , Perirst #:,.-'
Conditioned
Duct insulation
entT
"hili 2vfmii5ai Efi3cienCYPloor.Area"
re "
i3Pmosfat ;
Packaged Unit
urhace
�-/i OF
'COP
�HSPF
g ' r
Serve&bysystem
Cher 44 8 of duc ts''
gildedormph d in `
E Setback
Indoor Cot? '
�SEE1t
13
sf
ummnditioped-1, space ..bjQ
{iJiror readypreseru mins!be
.
Condensing Unit
® EER
Resistance
4
Odw
1. Equipment Type: Choose the equipment being installed; if more than one -system, use another CF -JR -ALT -HVAC for each system
2. Afn►imum Equipment Efficiencies: 13 SEER, 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 comi)lete. ;
• I am eligible under Division 3 of the CalMrma Business and Professions Code to accept responsibility for the design identified_. on this
Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Tifile 24, Parts l and 6 of the California Code of Regulations.
• The design featturs identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms, worksheets, calculations, pians and specifications submitted to the enfareement agency for apprnval,with the permit
application. _
Name: Signature:
Company
Date
Address: �
fit•'
LtceneoZ!
City/Stale
JZip: 5'f��j :..
Phone: 93� �j?�
��'
' f r
2008 Residential Compliance Forms.doc revised 04110112