14090048 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20748 CELESTE CIR CONTRACTOR:AAA FURNACE& PERMIT NO: 14090048
AIR CONDITIONING
OWNER'S NAME: IMOTO KOHEI AND NAOMI 1712 STONE AVE DATE ISSUED:09/09/2014
OWNER'S PHONE: 9542751056 SAN JOSE, CA 95125 PHONE,NO-(408)293-4717
LICENSED CONTRACTOR'S DECLARATION
S,_ � / BUILDING PERMIT INFO- BLDG ELECT PLUMB
License Class �—� Lic.# � ,
MECH RESIDENTIAL COMMERCIAL
Contractor AAA ��QVA 6e Date 2� j JOB DESCRIPTION FURNACE&A/C REPLACEMENT SAME LOCATION
I hereby affirm that I am licensed under the provisions of C apter 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:
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:$7490
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:32658015 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 FROM 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: e d�'� J Date: ( 7
with all rce regula io s per the Cupertino Municipal Cod ,Section
9
�f RE-ROOFS:
Signature Date 20� All roofs shall be inspected prior to any roofing material being installed. 11'a rool'is
installed without first obtaining an inspection,1 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)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE;
construct the project(See.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. 1 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 1
performance of the work for which this permit is issued. will maintai2orized
ian Cupertino i mcipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health ode,Sections 550 . 3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this .e._a/y�.� Date: 26
permit is issued. Owner or a agent:
1 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 1 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
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, ARCHITECT'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
Q-E-N'S-RAL PERMIT APPLICATION � ..
�... COMMUNITY DEVELOPMENT DEPARTMENTlVj, DING DIVISION
I, 10300 TORRE AVENUE ,CUPERTINO; CA 95014-3255
FAX(408)777.3333 buildina(acuoertino.orta •I C
CU (408)777-3228
r
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PLtlIYIDUlt3 CHAMCAL ELECTRICAL MISCELl A_N$OUS
PROJECT ADDRESS � � (�1' P, APN:N 1
OW'NERNAME �' PHONE q2j c�I7 E MAD•
S'TRBECADOP�:9 W�/�(� �yVK./ CT� � Vr a�/••���y FAX
CQV,ACP NAA v(`(> 1 PHONE �jH•MAIL
SIREET ADORESS a. CITY,STATE, ZIP FAX
❑dWNER O WNER•BUILOER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR Avera ❑ AP cm TELT ❑ENGINEER• ❑ OEYELOPER ❑ TENANT
CONTs-4CTC'. '.''tE 1M20�CAO
l 10ENST?NUMBER ��1 I.JC> �� HUS.UC i (?q
Ma&NY NAME Z+wL 1 F LcQ 3
ft<<
STREET ADDRESS CTIY ATE ZTP "NE
(1l2 WvP- -4ki v� �5 t2a
t?(EER NAM$ LICENSE Nfltr>8 ER
BUS.uC t
C Cr;T s.;?'!)7 n.�.i" E•MAJL FAX
_,�W CITY,STA7e,ZIP - PHONE
USE OF -� JFD or Duplex ❑ Multi-Family PROJECT W wa.DLAND PROJECT N
STRUCTURE; (3Cotun=ial URBAN NITRFACEkFEA ❑ Yes �8—Zd'6" PLocczoNE O Ycs3-8—�'d,4
TOTAL YALUA'RON:
ca,this
ow,i cerfify toe o the rollowing: �.M,,
the property ovmer or authorized agent to act on the property owner be alf I ^ o I
ion'si information i ha t Prov ed is correct [ read the Draeription of Work and vcr.`y n is accv�:e. agree to cn k ti .{e: ::,.�•:w and::•.x Isws relating t bu'din cora ctl I representatives of Cupertino L. t ter L,e a_c ntified prop:
SUppTEMf5NTkLRTFOR VONREQUED
- alp,
CITY OF CUPERTINO
FEE ESTIMATOR— BUILDING DIVISION
ADDRESS: 20748 celest circle DATE: 09/09/2014 REVIEWED BY: larrys
APN: BP#: *VALUATION: 1$7,490
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMIT TYPE: FURN/A C
WORK furnace a/c replacement at existing location
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 1 # $143
TOTALS: $143.00
� a W.
e
W
Mech.Plan Check "00 $0.00 C'111111h. Alcan Chc ei,
Mech.Permit Fee: IMPERMIT Pirrmb. I'eama7 1'ce:
Other Mech.Insp. 0.0 hrs $48.00 Other I'lutnh Inv). Li I
Offw3.Llc:c.Insl,>. E3_L_
14Ct�h' latsp' 1'771105, hisp. Vice:I::Ifc. I s a. I°tie:
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 prelimina information available and are only an estimate. Contact the Dept./or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS
Plan Chockl"
PME Plan Check: $0.00
'c>ttrait f''<ae:
PME Unit Fee: $143.00
PME Permit Fee: $48.00
Co!i,�t7'Ltcion Tax:
Administrative Fee: ]ADMIN $45.00
Work Without Permit? 0 Yes No $0.00
Travel Documentation Fee: ITRAVDOC $48.00
Strong Motion Fee: IBSEISMICR $0.97 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
ter ;
} $285.97 $0.00 fr TOTAL FEE: $285.97
Revised: 08/20/2014
�;u i✓ -1 i r.J c, CF.IR-ALT
Pa e4of5
Preseri tine Certificate.o.f"C. m liance, Residential #of Stories
33Esidential r�iterattions
Project�ame: "'
Configuration
HVAC SYST ING Du:cr4r'i'i-PingCentral,Split,
Minimum insulation Thermostat S ace,Packa a or H dronic)
Efficiency Dissribution R.Velue T e
Heatingquipment
�FUE or MSPF e and Location)
T e and Ca l aci
( T
um Eviler. Electric Resistance, etc.) Pp if total acro,
1.lrrdicare Healing Type(Ceht,�af Furnace,.Wail Furnace, Hear pump. !Sib 3 ecce tion.
' range pe(CO is allowed only in Component Package C. or e e Pe not exceeding
30am1 ures) See p5l( )(i.e..
1e ePli0 .
2:Electric rests a rime hlmiting d applicable,• s 2 KW( 7,000 Brulhr electric heating is controlled by
3.Refer to the HERS Verification section on Page 4 of the
arors� T Form for additional requrr ements and check a p
4. 1ndicaie Type or Loca(ion (Ducts, Hydronic in Floor,
-
VAC SYSTEMS COOLING Configuration
Minimum Duct or Piping (Central,Split,
Efficiency Insulation Thermostat
SEER/EER or .Distribution T e S act,Packa a or H dronic
Cooling Equipment ( R Yalue
�Cp) T e and Location
T e and Ca acct �"
vpe
1. Indicate Cooling T, 1,p'. Hear pump,.;.'Ev(ip: Cooling, etc)
to the HERS Verification section on Page 4 ronic in Floor, Radof rhe CF.IR-ALT Form
-. Refer Jor additional requirements and check applicable boxes.
3. Indicate T e or Location (Ducts, H d
� A :" IDEATING
h r water(DKW)healers and by space hearing. Individual dwelling DI heaters must i
list water heaters and boilers for both dome.r.rrQllons. Nor water pipe insulation from the DHW heater to rhe kirchen(s)and on all undergroun
gas or propane fired, and may not exceed SO g Extemal Tani
pot..warer;:: i es is re uired in all com.Onent acka es in all climate zones. Energy Factor or insulation,
Tank VaJuc
Type/Fuel Distribution Type Number In Ca aci al) Thermal Efficient �R.---
Water Heater S stern
T et (Standard, Recirculatin )2
1. Indicate l vp'e(Storage Ga.r, Heat Pump, Iristatrt"neous, etc.1clation
!SO(n). The Prescriptiverequi>:eMV, d
?. Recir•ctrlatingsystems serving mc'j ulnawelling r eR11ngis.ystemeet the recir lbrsingle dwellingqunt requirements of§
not allow the installation of a re
3. The external wafer hea(in lank.and i es shall be insulated to Meer the re uirements o ISO
n orcemon,agency should pav special.attention to the Special Features specified in this checklist beta"'
S�pE�• IAL FEATU.RES
Thee f
These.ilems flltry re. odor, written 'usli nation and documentation and s ecal yeti rcalion.
NF1'4.Et'Ol7F A5'SI'✓1`t'YI1JY •Radiant Barrier
• T}>e radiant barrier re..yirement of I S l( 2 dons not a-.y to roof alterations.
iatfori
Ia. Edge(Perim'eter) 6 in.Comp omponennt Packages D R-7 insulation is required.
YI;S:In Climatc'Z.one 16 n
Heated Slab Insultrtion C7 ui YES al NO e uired'.urtder tom onent Pa
e i sulation re uire.d.for all.heated.slabs in aII Climate Zones. See details in Table 1 f8-A ofrhe standards.
YE$:Slab ed n YDS M NO
Raised Slab Inwiation O 13 14& 16,R.8 insulation is re:uired; in Climate.Zartes C2;& 15,:R A i
YES:In Climate Zones I,2, 11, coach,
rmal ass M
To.obtain Com' Iiance Credit.for the installation of the
massr:use the:Psrformarice.
The :
HERS Provider:
Registration Dare/Time:
Registration Number:
2008 Residential Compliance Forms
r ..;....': fir:
esa ��'.����� � � +CF-1�-ALT-���:� . ._
Cent
tate of Compliance:2p�8 R
e r
six
iEr{�vrc ►�Aster
MU Ad&as etipu i;
:,D�,,..1 •t Z.:;'r` q rmosfat
eatT ?:rytjp d. i'ri t s', ''ppyer
Pad�'��' .. .. ..•C �;,�. errvcd system .a�d�d
ummnditioued:§I?a iri3tidlcc�
Pit' sf
door CQU U R 6 (CZ 1,3-S)
Condensing UnitF.ER
ed;if mole than onc.W$tmrI."so suoti CF-1R-pLT,HirAC.fs?r tach system.
1. meut Typc;Cbaose die o9�nPtncn hem 0 7.7HSPF for typioalidentiai:systtms•
2 p.�ast 1cicacies 13 3EHR.T8/o AFUE; er's Declarstida Stu
til tznient)
on Aathor's/Rcspous3tik besiga
Coutr+ector c�tc of CoruplianOr docummtntion is aee�aatc attd cant t responsibility for:tb4 design idmtified.on this
;certify that this Coro and Profcssiotss Code to
• I am eligible under Division 3 of the Caiifornia Businsss identifitd on this Ccrtif c+sto of ComP1"nc*conform to the
Certificate of Compliance- tacations for the design.
I certify that tbo cticrgy fwolj s and performmtx'spbc eons. livable
• roquitccneats of Title 24,Parts l and 6 of the California Code of Regula t e info on docnmratcd on other app
ed on this Cert ftag of(`compliance are•voasistan Z a enrcy for apPt :t11J'tho,p t
• The desigq.featt"ideatifi cans cud spccif;cations.sabm d to
complianoe for=,viorksbeets,oslculativns,p �rr
tiitn. � _
Name Dates \1A. .•
Company Ce I.iceTise;.�
Addmw. _ P3iviie: 4 �1r1 .
CitydStatc,%LP: �, - 2
1
�4:�t 2008 Residential Compliance For—.doc revised 04/10/12
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 1 of 4)
Project Name: Kohei Imoto Date Prepared: 2014-08-22
A.General Information
CF1R-ALT 02 is applicable to multiple space conditioning systems contained within a single dwelling unit.When multiple dwelling units must be
documented,use one CF1R-ALT 02 document for each dwelling unit.:
01 Project Name: Kohei Imoto 02 Date Prepared: 2014-08-22
03 Project Location: 20748 Celeste Circle 04 Building Type: Single family
05 CA City: Cupertino 06 Dwelling Unit Name: Kohei Imoto
Dwelling Unit Conditioned
07 Zip Code: 95014 08 1199
Floor Area(ft2):
Number of space conditioning
09 Climate Zone: 3 10 (SC)systems being altered in 1
this dwelling unit.:
B.Space Conditioning(SC)SystemvKK formation
01 02 03 04`' ! 06 07 ' �8 . 09 10
44
Installing new-" - w v Is`the entire
components? duct system
(packaged unit,or accessible Are all of the
condensing unit, Installing for sealing, system's
Is the altered Altering or or more than 40 and is more components
or installed installing a cooling/heating linear feet of than 75%of and ducts new
SC System SC System CFA served system a refrigerant coil,or new or the duct or replaced?
Identification or Location or Area by this SC ducted containing air-handling unit, replacement system new (entirely new
Name Served System(ft2) system? component? etc) ducts? or replaced? system) Alteration Type
Tranewhole house 1850 Yes Yes Yes No No No Altered space
conditioning system
C.Extension of Existing Duct System,Greater Than 40 Feet(Section 150.2(b)1Diib)
This section does not apply to this project.
Registration Number:214-A0081756A-000000000-0000 Registration Date/Time: 2014-08-22 14:59:29 HERS Provider:CaICERTS
CA hilding Energy Efficiency Standards-2013 Residential Compliance Rep 111111 sion:2014-03-31 Report Generated:2014-08-22 14:59:09
CERTIFICATE OF COMPLIANCE CF1R-ALT 02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 2 of 4)
D.Altered Space Conditioning System (Sections 150.2(b)1E and F)
01 02 03 04 05 06 07 08 09 10 11 12
Heating Cooling
System Heating Altered Heating Minimum Altered Cooling Minimum Required New or
Identification System Heating Efficiency Efficiency Cooling Cooling Efficiency Efficiency Thermostat Replaced New Duct
or Name Type Components Type Value System Type Components Type Value Type Duct Length R-Value
Central gas Gas furnace Central split Outdoor Less than or
Trane furnace AHU AFUE 0.78 AC condensing SEER 13 Setback equal to 40 R-6
unit feet
Required Documentation:
CF2R-MCH-01-E-Space Conditioning Systems Ducts and fans
-Duct insulation requirement for new plenums:R6.
CF2R-MCH-20-H&CF3R-MCH-20-H—Duct Leakage testing required when heating or cooling components are installed in ducted systems,or when more than 40 ft of duct length is replaced.
-Leakage rate compliance:515%,or<_10%leakage to outside,or seal all accessible leaks.
CF2R-MCH-25-H&CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered(applicable in CZ 2,8-15).
CF2RCF3R-MCH-23&CF3R-MCH-23 Air Flow>300 CFN4/tofa required when MCH 25�s�TOPreq fired
Exceptions:
Duct systems registered with HERS provider as previously sealed are„exempf rpm MCH-20 Duct Leakage Testing reguiraments _ E
-Heating-only systems and Air Handler/Furnace Changes do not requif a ven€ficatdn of Air Flow MCkI 23,or Refngerant Charge MEE -25.
-Existing duct systems constructed,insulated of§aled with astaestos are eXemptfrom MCH 20 Duet Leakage Testing requ€remen.s, '
E. Entirely New or Complete Replacement Duct System,with or without Equipment Changeout(Sections 150.2(b)1Diia and 150.2(b)lE, F)
This section does not apply to this project.
Registration Number:214-A0081756A-000000000-0000 Registration Date/Time: 2014-08-22 14:59:29 HERS Provider:CaICERTS
CA ftl�ing Energy Efficiency Standards-2013 Residential Compliance Rep grt Tsion:2014-03-31 Report Generated:2014-08-22 14:59:09
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-1R-ALT-HVAC) (Page 3 of 4)
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)1C)
This section does not apply to this project.
='
e
f
fie, i i
Registration Number:214-A0081756A-000000000-0000 Registration Date/Time: 2014-08-22 14:59:29 HERS Provider:CalCERTS
CA-11 f g Energy Efficiency Standards-2013 Residential Compliance Rep III
Ision:2014-03-31 Report Generated:2014-08-22 14:59:09
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems(formerly CF-IR-ALT-HVAC) (Page 4 of 4)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature:
Rando,Eric
Company: Signature Date:
RANDO AAA HVAC INC 2014-08-22 14:59:29
Address: CEA/HERS Certification Identification(if applicable):
1712 STONE AVENUE n/a
City/State/Zip: Phone:
SAN JOSE CA 95125 (408)293-4717
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Busmess.and Professions Code to accept responsibility for the buildingdesign or,system design identified on this Certificate of Compliance(responsible designer).
3. That the energy features and performan`i€e specifications,materQs,corp nests and manufactured devices far the building design`s or system design identified on this Certificate of Compliance conform to the
requirements of Title 24,Part 1 and Part 6 of the California CodAf Regulations
4. The building design features or systerrrdesign features identified o&Wis Certificate of Compliance are consistent with t e information provided on other applicable compliance documents,worksheets,
calculations,plans and specifications,submitted.to the enforcement agency for approval'with this buiidmg pprmrt appt ation
i
5. 1 will ensure that a registered copy of tttisCerfific aEof mpliahce shallbe made avallabie wit h,kf e buildir�gi#qrmit(sJl,Issued fbi the buildings and-mdcl available to the enforcement agency for all applicable
inspections.I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Rando,Eric
Company: Date Signed:
RANDO AAA HVAC INC 2014-08-22 14:59:29
Address: License:
1712 STONE AVENUE 768871
City/State/Zip: Phone:
SAN JOSE CA 95125 (408)293-4717
Digitally signed by Ca10ERTS. This digital signature is provided in order to secure the content of this registered document,and in no way implies Registration Provider responsibility for the accuracy of the
information.
Registration Number:214-A0081756A-000000000-0000 Registration Date/Time: 2014-08-22 14:59:29 HERS Provider:CaICERTS
CA pull fg Energy Efficiency Standards-2013 Residential Compliance Rep Ili
IIIsion:2014-03-31 Report Generated:2014-08-22 14:59:09