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14040036CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10370 PLUM TREE LN I CONDITIONING DG HEATING & AIR I PERMIT NO: 14040036 I OWNER'S NAME: LICENSED CONTRACTOR'S DECLARATION License Class Lic. # l� Nc„T-A Date � C� Contractor 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 �t a erformance of the work for which this permit is issued. ve 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 permit is issued. 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 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 may accrue against said City in consequence of the granting of this 91mut. Additionally, the applicant understands and will comply with all non-po source regulations per the Cupertino Municip l Code, Section 9 Sr ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 Section 3700 of the Labor Code, for the performance of the work for which this 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 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. APPLICANT CERTIFICATION 1 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Date SAN JOSE, CA 95125 1 PHONE NO: (408) 978-1411 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL F] REPLACE A/C UNIT IN SIDE YARD. REPLACE FURNACE & RELOCATE TO ATTIC. INSTALL (N) DESIGNATED GAS LINE TO FURNACE Sq. Ft Floor Area: I Valuation: $13500 APN Number: 31633019 00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS ISSUANCE OR 180 DAYS LAST ED INSPECTION. by: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by th Bay Area Air Quality Management District I will maintain compliance with t e upertino Municipal Code, Chapter 9.12 and the Health & Safety CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C ) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO F -W FFF. F.CTTMATnU — RTTTT.DINf T)TVTgTnN LEIADDRESS: 10370 PLUM TREE LN DATE: 04/07/2014 REVIEWED BY: MELISSA QTY/FEE APN: 316 33 019 BP#: *VALUATION: 1$13,500 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Du lex p PENTAMATION FURN/AC USE: hrs PERMIT TYPE: WORK REPLACE A/C UNIT IN SIDE YARD. REPLACE FURNACE & RELOCATE TO ATTIC. INSTALL N SCOPE DESIGNATED GAS LINE TO FURNACE Mech. Plan Check 10.0 hrs $0.00 Plumb. Plan Check 10.0 1 hrs $0.00 Mech. Permit Fee: IMPERMIT Plumb. Permit Fee: IPPERMIT th—, !,,­,W; Other Mech. Insp. 0.0 hrs $47.00 hrs $47.00 Other Plumb Insp. ED t?�t:�;. Lkil", ln"P. ED .2_Pech. hit i, fn,,fv, Fe,: NOTE. This estimate does not include fees due to other Departments (i.e. r[anning, ruotic tworKs, rare, ounuury newer "istricy ocieum District, etc.. Theseees are based on the relimina information available and are onlyan estimate Contact the Det or addn7 info. FEE ITEMS (Fee Resolution .11-053.Ef. 711/.13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $139.00 Mechanical IMFR=1100 Furnace, Forced -Air Suppl. PC Fee: (E) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.001 # $70.00 Mechanical 1 1BREMAIR A/C Units (<--I OK cfm) Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0,0 hrs $0.00 0 # Plumbing $70.00 IPGASRES Piping, Gas <=4 Outlets PME Unit Fee: $0.00 PME Permit Fee: $94.00 Administrative Fee: 1ADMIN $44.00 0 E) Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure Travel Documentation Fee: ITRAVDOC $47.00 Strom Motion Fee: IBSEISMICR $1.35 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $187.35 $279.00 �ToL )H'EE: $466.35 Revised: 04/01/2014 n GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION l� O 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(Mcupertino.org misc .,.— AT N I­-Jeri--r-TnTr,AT F1MTCC-RT.T.ANE0US (J -- PROJECT ADDRESS ?' , ` t w APN # I / _ Q / OWI�TERNAME� PHONE EVA,'' O 3 E-MAII —_ STREET ADDRESS CITY STATE, ZIP_ I FAX CONTACT NAMEv � PHONE I E-MAIL STREET ADDRESS CITY STATE ZIP F '❑ OWNER -BUILDER ❑ OATIERAGENT ❑ CONTRACTOR ❑ CONCRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �^ 1 LICENSENUI�E / b l I! LICENSE E BUS. LIC lj COMPANY NAMEE-MAIL FAX[ '[ ST1tE DRES CITY, STATE, ZIP C�-1- ► u a C 5 D -1 f) ARCHITECT/ENGINEERNAME LICENSE NUMBER, BUS. LIQ COMPANY NAME E-MAIL FAX STREET ADDRESS r.- '-- CITY, STATE, ZIP _ PHONE USE OF)2S or DUPLEX ❑ -MULTI-FAMII.Y PROJECT IN Wn.DLAND El YES PROJECT IN ❑YES ❑ IS THE BLDG AN ❑YES EICHLER HOME? ❑ NO BUHAING ❑COMMERCIAL URBAN INTERFACE AREA "NO FLOOD ZONE NO �� 6 a� DESCRIPTION OF WORK �' y T +� �� 1 �J (T I (JI' l/ V-Ki�V( / �r e , i D t - l �/lJc Q 5 E, TT � 5 t A r=DV!� /✓/T�� CIO C41-77 19 141� 6V riot �vrn-acs - - TOTAL VALUATION: w ©� _'_"'- .�:._ _-� ' r s •z., '^ By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the pr o s behalf. I have read this application and the information I have ovided is correct. I have read the Description of Work and verify it is rat- ree to comply with all applicable local ordinances and state laws relating to lding construction. I authorize represe tives of Cupertino to ente ove-identified property for inspection purposes. '9 Signature of Applicant/ ent: Date: 1 SUPPLEMENTAL INFORMATION REQUIRED . No STANDARD W OR- MEPMiscApp_2011.doc revised 06/21/11 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 • buildina aacupertino.ora 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 i7 • Relocation of an existing HVAC unit • Adding or replacing more than 40ft ducting in unconLioned 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: I. 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 04/10/12 Site Address Enforcement Agency: Ike: ;x Per�rrit.#:r > ; 1 t�3�1(7 PLtYn N ConditionedDuct insulation ert T ' i ast lv€utiinii `E#cieu` ' I loor Ali a , thermostat ,: i Packaged=Unitio Q Aver 40 8 o`f urnace Indoor Coil ' A SEi GOP ®HSPF mad by s}%stem sf added orri placed in unconditionc�dspace:.- Setback {lfnar Aeady preso 4 V.1 st be Unit MEER E3 RcsistZ e 6 (CZ 1, 3-3) WWdensing L Equipment Type: Choose the equipment being installed; if more than one system, use another CF -I R -ALT HVAC for each system. I A mimum Equipment Efficiencies; 13 SEER, 78% 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 rortylete: • 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 enforcement agency for approval.with the permit application. Name: _ Sim Company Date: l /ll�D Addres«��'6"b W , License: City/State/Zip: 'Pwne: 4OL2-011011 2008 Residential Compliance Forms.doc revised 04110112 a'. CUPERTINO M„ r lhilding Depaftent � =I . I i NAME: KAVITA APM516-33-0111 ADDRESS: 10370 PLUM TREE LANE - SCOPE: INSTALLATION OF RELOCATED FURNACE TO ATTIC, AC CHANGEOUT, SUPPLIES, NEW LIGHT SWITCH IN ATTIC, DEDICATED GAS LINE TO METER INSTALL WILL COMPLY WITH ALL 2013 MECHANICAL CODES dr i AOLFieV PLOT PLANS CBECKED BY )DATE P ING DEPT. DATE.— I Vl -'I. i ev I I 1 a 4 M n7 4 �v. i c`a i t L' 1 ------------ I � i i-Til", tr I I IV � 77�� 4�' �¢D N' p11 VITY LOP�9gi�� I 1 i l (� N I I i ON '�N 1l�ENT m Seto p� /o cid d All A ERI � joy nd c nstr�peci icafi ns US r I#era ctioi, ifs o ' I be keptt a I I i ; the re- star�,in un ions on s,awfyl oft , a frog to t h evlafe I� + ' NT OF HOUSE )of b held to of t1�i Pf- ---+s n ili r�irt qr to b )Deification ing Official. j I 4®4 - s tle I ®r�yinance SHALL NOT I DTpi or#afe Laion . I i NAME: KAVITA APM516-33-0111 ADDRESS: 10370 PLUM TREE LANE - SCOPE: INSTALLATION OF RELOCATED FURNACE TO ATTIC, AC CHANGEOUT, SUPPLIES, NEW LIGHT SWITCH IN ATTIC, DEDICATED GAS LINE TO METER INSTALL WILL COMPLY WITH ALL 2013 MECHANICAL CODES dr i AOLFieV PLOT PLANS CBECKED BY )DATE P ING DEPT. DATE.— IAP CUPERTINO REVIEVVED FOR GOL)>- COMPLIANCE Reviewed By, lu' 0,C - 5 W/0tv-1 A � i Ce T14 31S 3D Y. 22 5 W/0tv-1 A � i Ce