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15110065J� CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 920 HYDE AVE CONTRACTOR: RESCUE AIR SERVICE PERMIT NO: 15110065 OWNER'S NAME: KIM CHIN MAN AND JUNG GWI-GEUM 6007 MAJORCA CT DATE ISSUED: 11/12/2015 OWNER'S PHONE: 4088868797 SAN JOSE, CA 95120 PHONE NO: (408) 655-9916 ' LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ INSTALL (N) A/C UNIT AND N) GFCl/WP OUTLET AT LicenseClassC20 Lic. #RZc'Zn REAR. Contractor ICescmp �c(` Date (i Z/ tS 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: $7900 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 APN Number: 37539005.00 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 - 2 Issued by: L Date: + granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section RE-ROOFS: 9.18. }/+ z 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) 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 and I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 the Labor Code, for the of the work for which this the Health & Safety Code, Sections 25505 25533, and 25534. , Y of performance 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 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building -cupertino.org ❑ PLUMBING MECHANICAL F— ELECTRICAL Fj MTSCF.LT.ANFni IS MEP MISIC I --) I I On � I' --)- PROJECT ADDRESS i APN # O OWNER NAME PHONE z�v/�-+�K— � E-MAIL STREET ADDRESS � � � CITY, STATE, � CIO FAX CONTACT NAME PHON E-MAIL STREET ADDRES o 1 hna o CITY, STFAX A ZIP 20 ❑ OWNER ❑ OWNER -BUILDER El OWNER AGENT & ONTRACTOR 1:1 CONTRACTOR AGENT ❑ ARCHITECT 1:1 ENGINEER 11 DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER ZD C�,�, At r LICENSE TYPE BUS. LIC # COMPANY NAME �� E -MG \ FAX STREET ADDRESSy , �^ CITY STATE, ZIP �� �C1� J PHONE ` Qf ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY BUILDING: ❑ COMMERCIAL PROJECT IN WILDLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ 1'! < EICHLER HOME'? ❑ �. DESCRIPTION OF WORK NIC, A4c� (W) GFC 1 %w � nub U TOTAL VALUATION: 6tQ O 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 property owner's f' 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 comp y with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY ❑ OVF,R-THF,-COUNTER 1 ❑ EXPRF,SS - ❑ STANDARD i ❑ LARGE: G ❑ MAJOR MEPMiscApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION RESS: 920 Hyde Ave DATE: 11/12/2015 REVIEWED BY: Phuong : 375-39-005 W BP#: *VALUATION: $7,900 E: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: PENTAMATION FURN/AC PERMIT TYPE: WORK Install N A/C unit and N GFCl/WP outlet at rear. SCOPE PME Plan Check: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 11;'1,13) Mech. Plan Check 0.0 hrs $0.00 Mech. Permit Fee: IMPERMIT Other Mech. Insp.0.0 hrs $48.00 - Elec. Plan Check 0.0 hrs $0.00 Elec. Permit Fee: IEPERMIT Other Elec. Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 11;'1,13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $72.00 Mechanical IBREMAIR A/C Units (<=10K cfm) Suppl. PC Fee: (F) Reg. () OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 F-1-1 $48.00 Electrical IBREM EP Recep/Switch/Outlets Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT r 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $96.00 Administrative Fee: IADMIN $45.00 Q G Work Without Permit? C) Yes (F) No $0.00 Advanced PlanninM_Fee: $0.00 Select a Non -Residential Building or Structure G i Travel Documentation Fee: ITPA VDOC $48.00 Strong Motion Fee: IBSEISMICR $1.03 ' Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $191.03 $120.00 TOTAL FEE: $311.03 Revised: 10/01/2015 Google Maps Go gle Maps Google Maps 920 Hyde Ave Page 1 of 1 (<,-24.� Map data ©2015 Google 20 ft 4a tie w -k 6CLLk-�� Or ems, QCAY' Q-Gv,ob1^ Sloe 4-c" https://www.google.com/maps/@37.3122763,-122.0102536,21z 11/11/2015 • JVDAIKIN Submittal Data Sheet 3.0 -Ton Wall Mounted Unit FTXS36LVJURXS36LVJU BENEFITS Intelligent eye occupancy sensor Weekly timer for programmable comfort * Low ambient heat operation down to 0° F Titanium apatite photocatalytic air purifying OUTDOOR UNIT to Daikin North America LLC, 5151 San Felipe, Suite 500, Houston, TX, 77056 Daikin City Generated Submittal Data (Daikin's products are subject to continuous improvements. Daikin reserves the right to modify product design, specifications and information in this data sheet without notice and without incurring any obligations) Page 1 of 4 O Submittal Data Sheet 3.0 -Ton Wall Mounted Unit FTXS36LVJURXS36LVJU Indoor Unit Model No. FTXS36LVJU Outdoor Unit Model No. RXS36LVJU Rated Cooling Capacity (Btu/hr): 36,000 Sensible Capacity (Btu/hr): 22,390 Max/Min Cooling Capacity (Btu/hr): ..... ......... / Cooling Input Power (kW): 4.000 SEER (Non-Ducted/Ducted): 17.90/ EER (Non-Ducted/Ducted): 8.37/ ......... Rated Heating Capacity (Btulhr): _-.. 11.1 38,000 Heating Input Power (kW): 3.90 Refrigerant Type: R-41 OA Holding Refrigerant Charge (lbs): 6.2 Additional Charge (Ib/ft): 0.03 Pre -charge Piping (Length) (ft): Max. Pipe Length (Total) (ft): 98 Max Height Separation (Ind to Ind ft): 66 Indoor Unit Name. SKYAIR WALL MOUNTED Outdoor Unit Name: RXS36LVJU Rated Cooling Conditions: R Indoor (°F DB/WB): 80 / 67 Ambient (°F DB/WB): 95 / 75 Rated Piping Lenglh(ft): Rated Height Difference (ft): 65.60 Rated Heating Conditions: R Indoor (°F DB/WB): 70 / 70 Ambient (°F DB/WB): 47143 HSPF (Non-Ducted/Ducted): 8.3/ Cooling Operation Range (°F DB): 14 - 115 Heating Operation Range (°F WB): 5-75 Max. Pipe Length (Vertical) (ft): Cooling Range w/Baffle (°F DB): 0- 115 Heating Range w/Baffle (°F WB): 0-75 Daikin North America LLC, 5151 San Felipe, Suite 500, Houston, TX, 77056 Daikin City Generated Submittal Data w,.`r:, dailir ac.corn www,.daiklncomfo;t co_n (Daikin's products are subject to continuous improvements. Daikin reserves the right to modify product design, specifications and information in this data sheet without notice and without incurring any obligations) Page 2 of 4 FrDAIKIN Submittal Data Sheet 3.0 -Ton Wall Mounted Unit FTXS36LVJURXS36LVJU Power Supply (V/Hz/Ph): 208-230 / 60 / 1 Airflow Rate (H/M/L) (CFM): 770/519/473 .....I ... ... ...... I............_.... Power Supply Connections: 1_1, L2, Ground Moisture Removal (Gal/hr): Min. Circuit Amps MCA (A): ............ ..__ Gas Pipe Connection (inch): 5/8 _......._.._.__._.. .... _.......... ........_..._.............. - Max Overcurrent Protection (MOP) (A): Liquid Pipe Connection (inch): 3/8 Dimensions (HxWxD) (in): 13-3/8 x 47-1/4 x 9-7/16 Condensate Connection (inch): Panel (HxWxD) (in): Sound Pressure (H/M) (dBA): 47/40 Net Weight (lb): 38 Sound Power Level (dBA): Panel Weight (lb): Ext. Static Pressure (Rated/Max) (inWg): / THE MARK (->) SHOWS PIPING DIRECTION 47-1/4 (1200mm) fiREAR LEFT RIGHT FTXS30/36LVJU (SPACE FOR (SPACE FOR MAINTENANCE) REQUIRED SPACE MAINTENANCE) FRONT GRILLE E' FIXED SCREWS AIRFLOW (INDOOR) (INSIDE) _ /INCLUDING (MOUNTING PLATE BOTTOM ` LOUVERS v SIGNAL RECEIVER INTELLIGENT EYE SENSOR 9.1/2 (242mm) OPERATION LAMP 9.7115 (240mm --TIMER LAMP INTELLIGENT EYE LAMP NAME INDOOR UNIT ON/OFF SWITCH PLATE ROOM TEMP. THERMISTOR (INSIDE) TERMINAL FRONT GRILLE FIXTURES MODEL NAME PLATE � � BLOCK WITH GROUND TERMINAL Daikin North America LLC, 5151 San Felipe, Suite 500, Houston, TX, 77056 Daikin City Generated Submittal Data rrn dai k+ac.corn www.daikincornfort.com (Daikin's products are subject to continuous improvements. Daikin reserves the right to modify product design, specifications and information in this data sheet without notice and without incurring any obligations) Page 3 of 4 BMW 2 1-15116 (50mm) MIN lc1 1-1:5/16 50mm MIN (SPACE FOR (SPACE FOR MAINTENANCE) REQUIRED SPACE MAINTENANCE) FRONT GRILLE E' FIXED SCREWS AIRFLOW (INDOOR) (INSIDE) _ /INCLUDING (MOUNTING PLATE BOTTOM ` LOUVERS v SIGNAL RECEIVER INTELLIGENT EYE SENSOR 9.1/2 (242mm) OPERATION LAMP 9.7115 (240mm --TIMER LAMP INTELLIGENT EYE LAMP NAME INDOOR UNIT ON/OFF SWITCH PLATE ROOM TEMP. THERMISTOR (INSIDE) TERMINAL FRONT GRILLE FIXTURES MODEL NAME PLATE � � BLOCK WITH GROUND TERMINAL Daikin North America LLC, 5151 San Felipe, Suite 500, Houston, TX, 77056 Daikin City Generated Submittal Data rrn dai k+ac.corn www.daikincornfort.com (Daikin's products are subject to continuous improvements. Daikin reserves the right to modify product design, specifications and information in this data sheet without notice and without incurring any obligations) Page 3 of 4 FrDAIKIN Submittal Data Sheet 3.0 -Ton Wall Mounted Unit FTXS36LVJURXS36LVJU Power Supply (V/Hz/Ph): 208-230 / 60 11 Power Supply Connections: L1, L2, Ground Min. Circuit Amps MCA (A): 19.50 ............................................. ..... _......_.._...................._....................................... Max Overcurrent Protection (MOP) (A): ... - 20.00 ...... ......... ........... Max Starting Current MSC(A): 4 GAS Rated Load Amps RLA(A): 20.3 Dimensions (HxWxD) (in): 38-15/16 x 37 x 12-5/8 Net Weight (lb): 179 qi Compressor Type: Inverter Capacity Control Range (%): Airnow Rate (H) (CFM): 2,627 Gas Pipe Connection (inch): 5/8 Liquid Pipe Connection (inch): 3/8 Sound Pressure (H) (dBA): 54 Sound Power Level (dBA): 68 RKS30/36LVJU, RXS30/36LVJU MINIMUM SPACE FOR AIR PASSAGE WALL HEIGHT ON AIR OUTLET SIDE = LESS THAN 47.114 4 -CUTS FOR ANCHOR BOLTS r ' (M12) 4 o a 7 LF �.. atzlts LET iOSE FOR CONNECTION. a. s NAME PLATE GAS STOP VALVE TERMINAL STRIP k ` LIOUID STOP VALVE OUTDOOR AIR , s 33 f: N I I I I I I b 4 GAS PIPE tlt6 '1(q&g SINGLE UNION) -LIQUID PIPE (pate SINGLE VNIONI Daikin North America LLC, 5151 San Felipe, Suite 500, Houston, TX, 77056 Daikin City Generated Submittal Data w. .;. 1a;kinac,(„orn Svr i.;f9,z+lkitl(..... Ori f__r3f4.t'om ....... (Daikin's products are subject to continuous improvements. Daikin reserves the right to modify product design, specifications and information in this data sheet without notice and without incurring any obligations) Page 4 of 4