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B-2017-0518BUILDING ADDRESS: ;izo6kljP�FLL.�PLCUPE-PTIX6,CA§5014-5049(36230042) CONTRACTOR. �PERINIXTNQ.11-2(117-0318 COLD CRAFT INC LOS GATOS, CA 9$032 GWNER'S NAME- DUNN MC R AND LJU TJNGCHUN IDATE ISSUMOY31127017 GAVNgR'S PHONE. 408-391-1812 IPFJONENO. (409) 374-7292 License Class : C MO: 038- CA3 Uc. #fia= Contractor COLD QR6U INC Dato-11130120V I hereby affirm that I am Iteffised under the provisions of Chapter 9 (commencing With Section 7000) at'Division 3 of the Business & Professions Code and that my license is in full forte and effect - I hereby affirm under penaRy *orperjurypne of the following two declarat'ions. a. I have and will maintain a ecroftenic ofconsent to stjfi * Inare fur Worker's COMPM atiOn, as Provided f0fhy Section 3 700 of the Labor Cnife. fprilie pCilbrinanceafthe Vork for, which this permit is issued. . I 'I have and will mainiaitt Worlo r s Compensation 1,usuranee, as provided for by Section 3700 of the taborCode.,for the performance ofthe work for "ich this perraitisissued. APPLTCAN�T �. CjRTjFICATj014 Icertify that.I have read this application and state that;the above infor state is correct. I agree to comply with all city and county ordinances and state laws relating to btilldlinq appstmotlon , and hereby authorize representatives of this city tioenter upon the above mentioned property for inspection purposes. (We) agree tai_ save e s Ind mrilly and keep hamiless the: City oftuPertino against liabilities, judgthenik costs, and expenses Which may accrue against said City Inconsequence ofthe granting qf this perrnit. kilditionally. the applicant understands. and Will comply with all nah-polrd. =rae regulation? , per the Cupertino Municipal Code, SectionA% 43/1 . -f 111Z_ Date 411712017, I hereby, affirm that l - am exempt from the Co acmes License Lair for one of the foloWig f" reasons: L 1, as owner ofthe property, or my employees ivith, wages as their sole compenstuion, ivill do the woil-, and the structure is not intended . or offered for sale (Sec.7044, Business & kmfessions Code) 2. J, as owner ofthe property, am exc . lusive-ly, cootraciing,.jith licensed contractors to construct the prc�jwt (S=7044, Business & Professions Code). 1.1tereby affirm under penalty ofperjuryone of the following three declarations. i. I have and win maintain a Certificate-ofcnWentto self -insure for Work-er's Compensation, as provided forby-Section 3700 ofthe Labor Cvde, for the perflabbance of the work for which his permit is issued. 2: 1.1nive *and min maintain "Worker's Compensation Insurance, as provided. for by Section 3700 ofthe Labor Code, for.the performance of the work for which this permit is issued. s. I certify that in the performance of the Nvork for which this permit is ism -m -A. I .shall not employ any person in an), manner so as to becomo subject to the Worlmr's Compensation laws of California. lf,.aficr making this p-criffleate of exemption, I become subject to ihoNVorker's Compimsation provisions ofthe Labor Co3e, I must ffifth%wiffi comply with such proAisions or this permit shall be deemed revoW. APPLJCCANT M71171CATJON certnythat I hiive read this application and state that the above Information Is ,orreqtJ agree to comply with all city and county ordinances and state laws -elaffnij to building construction, and hereby authorize representatives of this city o enter upon the above mentioned property for Inspection purposes. (We) agree o s4ya indemnify and keep harmless the Qty -of Cupartino against liabilities, udgm.ents, costs, and expenses which may accrue against said City in *nsoquenro of the granting of this perinit. Additionally; the applicant understands, arid .411 .,Ply. with all non -point source regulations per the Cupertino Municipal ,ode, Section 9.18, Date 411712017 BUILDING PERIMIT INFO, BLDG —ELECT _PLUAM- WIECH X RESIDENTIAL m COMNURCIAL DESCRIPTION: .ACE A/C (SAME LOCATIONJ FtFloorArea.- APiN Number. Occupancy TY13M M2 30 042 i I PERMIT EMPIRES IF WORKISNOT STARTED WITHIN 180 DAYS CSF PERI ISSUANCE OR 180 BAYS TROMT. LAST CALLED INTSPECTIOM by: AbbyAycride: k F -R 0 001. All roofs shall he inspemed.p4or to any roofing material being installed. 11'a roof is installed wifliout first obtaining an inspection. I agree to remove all new materials for inspoetion. lure ofApplic1mt: 4117t2017 "A* HAZARDOUSANTEKIALS DISCLOSURIS thave, read the hazardousmaterials requirements under Chapter 6.95 ofthe California Health & Safety Code, Sections 255tY5, 25533, 2hil 25534. 1*111 maintain compliance with fhe Cupertino Municipal Code, Chapter 432 and the Health & Safety Cade, Section 25512(a) should I store or handle linard4ous materiaL kilditionalky, should lose equipment or dekices which emit hazardous air contaminants as defined by the Bay Area Air Quality Maifttgemeat District I "Tfu maintain compliancewith the Cttp rtftio Municipal Code, Chapter. 9,11 and the Health & Safety Codt,tions 25505, 25533, and 25534: Owner or authorized agent- Dale- 411712017 CON"MUCTTON'! LKX0u%'GAGE1NCY I hereby affitin that there is a construction tending agency for the rwforrnance, ofwork's for which this permit is issued (Sec. 3097, Civ C.) Linder's Name Lender's Address ARC ION I understand my plans shalt be used as public. records. El GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - htli�uperiino org MISC PLUAMING 0MECHANICAL DELECTIMAL MISCELLANEOUS PROJECTADDRESS 06 R PP L PLACE AP3N6# -30-04 NE N OWM ERIC-DUNN STREET PHONE E-MAM 4 -3-2-1812 E2002Y ®.COM ADDRESS 12 06 U P �PLEA7Q-E CITY STATE, ZIP FAX CU T NO, CA 95014 CONTACT NAME co c I c. PHONE E-MAIL 408-374-7292I-SERVII STREET ADDRESS CC DCR FT. O 181 LOST LAKE LANE CITY STA ZIP CAMPWELL. CA 95008 P408-374=7333 ❑ OWNER ❑OWNER BUE.DER ❑ OWNERAOFm ❑ CONTRACTOR ❑ CONTRACTORA{�IT ❑ ARCHITECT ❑ ENQNEfiR ❑ DEVELOPP.R ❑TENANT CONTRACTOR NAME COL© CRAFT INC. BEB LICENSE TYPE i3, EUS, LIC# C10, C20, C38, C43 44 COMPANYNAAW COL® CRAFT INC. ::tSE-RVICE@COLQCRAFT.COM FAX 408-374-7333 STREET ADDRESS 181 LOST LAKE LANEMP STATE, ZIP CA 95008 PHONE 408-374-7292 ARCHTIECTIENCrINEERNAME LICENSE NUMBER HUS. LIC # COMPANYNAAM E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OFSFDorDUPLE.Y ❑ MUn-FAMMY EUILDING ©COM[+dERCIAL PROJECTINWII.DLAND ❑ YES URBAN7NTERFACEAREA PROJECTIIV' ©YES ISTHEBLDCAN ❑YES ❑ NO FLOODZONE ❑ NO EICIRERHOMm ❑ NO DESCRIPTIONO_F WORK REPLACE EX 7 NG AC TOTAL VALUATION: $4,000.00 ' By my signature below, I certify to each ofthe following: I am the property owner or authorized agent to act on the ,property owner's behak 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 to b lding construction. I orize representatives of Capertino to enter the aboove-id ntifie{d pr gerty for inspection purposes. Signature ofApplicanyAgent: � ��� %7 j Date: J / SUPPLEMENTAL INFORMATTONREQUIRED : R- MEPMIscApg 2011.doc revised 06/21111 lv ;�1: CERTIFICATE OF VERIFICATION _ CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 1 of 3) Project Name: 2150 Dunn Enforcement Agency: Cupertino City of Permit Number: b-2017-0518 Dwelling Address: 1206 Ruppell Place City: Cupertino Zip Code: 95014 A. System Information 01 Space Conditioning System Identification or Name System 1 02 Space Conditioning System Location or Area Served Outside 03 Building Type from CF -111 Single family 04 Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Credit from CF1R? No, credit is not taken 05 Verified Low Leakage Air Handling Unit Credit from CF1R? No, credit is not taken 06 Duct System Compliance Category Alteration MCH -20d - Complete Replacement or Altered Duct System B. Duct Leakage Diagnostic Test 01 Condenser Nominal Cooling Capacity (ton) 3 02 Heating Capacity (kBtu/h) 0 03 Conditioned Floor Area served by this HVAC system (ft2) 1876 04 Duct Leakage Test Conditions Test final 05 Duct Leakage Test Method Total leakage 06 Leakage Factor 0.15 07 Air Handling Unit Airflow (AHUAirflow) Determination Method Cooling system method 08 Measured AHUAirflow This field or section is not applicable 09 Calculated Target Allowable Duct Leakage Rate (cfm) 180 10 Actual Duct Leakage Rate from Leakage Test Measurement (cfm) 176 11 Compliance Statement: System passes leakage test 12 Notes: Registration Number: 217-A020101610A-000-001-M20001A-M20A CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-04-10 13:08:21 HERS Provider: CaICERTS Report Version: 2016.1.005 Report Generated: 2017-04-10 13:07:55 Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 2 of 3) C. Additional Requirements for Compliance 01 System was tested in its normal operation condition. No temporary taping allowed. 02 Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required, may configure the OA damper to the closed position during duct leakage testing. 03 If a complete replacement, all supply and return register boots were sealed to the drywall. 04 Building cavities were not used as plenums or platform returns in lieu of ducts. 05 If cloth backed tape was used it was covered with Mastic and draw bands. 06 All connection points between the air handler and the supply and return plenums are completely sealed. 07 If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample groups for HERS verification compliance. 08 Verification Status: Pass - all applicable requirements are met 09 Correction Notes: The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met unless otherwise noted in the Verification Status and the Corrections Notes in this table. D. Determination of HERS Verification Compliance All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order for this Certificate of Verification as a whole to be determined to be in compliance. 01 1 Complies: All specified verification protocol requirements on this document are met. Registration Number: 217-A020101610A-000-001-M20001A-M20A CA Building Energy Efficiency Standards 2016 Residential Compliance Registration Date/Time: 2017-04-10 13:08:21 HERS Provider: CaICERTS Report Version: 2016.1.005 Report Generated: 2017-04-10 13:07:55 Schema Version: rev 03/16 CERTIFICATE OF VERIFICATION CF3R-MCH-20-H Duct Leakage Diagnostic Test (Page 3 of 3) Documentation Author's Declaration Statement 1.1 certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Eric Kirk CJ Company: Date Signed: Builders' Energy Services, Inc. 2017-04-10 13:08:21 Address: CEA/ HERS Certification Identification (if applicable): 1478 Bird Avenue City/State/Zip: Phone: San Jose CA 95125 408-202-9075 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 Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building approved by the enforcement agency. 4. The information reported on applicable sections of the Certificate(s) of Installation (CF2R) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified on the Certificate(s) of Compliance (CF1R) approved by the enforcement agency. 5. 1 will ensure that a registered copy of this Certificate of Verification shall be posted, or made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): COLD CRAFT INC Responsible Builder or Installer Name: CSLB License: Brian Penning 631837 HERS Provider Data Registry Information Sample Group Number (if applicable): Dwelling Test Status in Sample Group (if applicable) Tested HERS Rater Information HERS Rater Company Name: Builders' Energy Services, Inc. Responsible Rater Name: Responsible Rater Signature:,p Eric Kirk %_ x c�U� Responsible Rater Certification Number w/ this HERS Provider: Date Signed: CC2006374 2017-04-10 13:08:21 Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered document, and in noway implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-04-10 13:08:21 HERS Provider: CaICERTS 217-A020101610A-000-001-M 20001A -M 20A CA Building Energy Efficiency Standards Report Version: 2016.1.005 Report Generated: 2017-04-10 13:07:55 2016 Residential Compliance Schema Version: rev 03/16