B-2017-0699CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0699
22208 QUINTERNO CT CUPERTINO, CA 95014-2749 (357 09 069)
T F F HEATING AND
AIR CONDITIONING
MILPITAS, CA 95035
OWNER'S NAME: FISHER ROBERT M AND WING JULIE TRUSTEE
DATE ISSUED: 05/02/2017
OWNER'S PHONE: 408-398-8733
PHONE NO: (408) 500-9245
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class QM- Lic. #917350
Contractor T F F HEATING AND AIR CONDITIONING Date 06/30/2018
X BLDG —ELECT _ PLUMB
X MECH X RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:
RELOCATE FURNACE TO ATTIC; REPLACE AC UNIT SAME
I hereby affirm under penalty of perjury one of the following two declarations:
LOCATION
t. 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
C7 Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $13000.00
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
357 09 069
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.:
180 DAYS FROM LAST CALLED INSPECTION.
Signature _ 12017
Issued by: Kim Dunbar
f'
OWNER -BUILDER DECLARATION
Date: 05/02/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
z. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 05/02/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
r. 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.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:.
APPLICANT CERTIFICATION
Date: 05/02/2017
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
to building construction, and hereby authorize representatives of this city
Lender's Name
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCHITECT'S DECD ATION
and will comply with all non -point source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 05/02/2017
Professional
LCIA ► =1►� = •►'
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building0cupertino.org
—(PLUMBING RMECHAN[CAL FIELECTRTCAL 1Y I IMiS LLANF 7S
MEP
MISC
PROJECT ADDRESS ®
!
O q 0
OWNER NAME •Te , 1 ^
PHO 13- 3
r � 1
E MAII,
STREET ADDRESS Q U 1 a+e r n® C
CITY, STATE, ZIA� . ,{s �^ CA
�;�J l iJ 1 �®' 4
FAX
CONTACT NAME
PHONE
E-IMAII,
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR A CONTRACTOR AGENT ❑ ARCHrrECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME 7TE -9 VAC,
LICENSE NUMBER ®� 3 ��y
C/
LICENSE TYPE c— zo
BUS. LIC # j
COMPANYNAME TFi� / / 6 p/` 6
j��/��
E-MAIL
FAX
STREET ADDRESS y®el3 r� /L �
� (/
CITY, STATE, ZIP /' B /!® CA f SZ 2-0
CEJ 9 .7 v
PHONE 09 6 �� 2
r9
ARCHITECT/ENGINEER R NAME
LICENSE NUMBER
BUS_ LIC
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF MFD.,DUPLEX ❑ MULTI -FAMILY
BUILDING: ❑ COMMERCIAL
PROJECT IN WILDLAND 0 YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOOD ZONE NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
^❑
yy
DESCRIPTION OF WORK a oo �y t;e op ,eye / �z,e M Y4s®Mc^4-
tti✓ C fil V -1k,,L
`GV o�W �e_ P j�Ce elct' T -t /! 1 A 4� Q �C
2- l�C{ t®L®
1004--el"O p. ?e-
eS-
5-Arn P Rat -6-0&1 F. P4•�0 -,40 Ivey r..caCe 110e .
3as
TOTAL VALUATION: 3 ® ®
By my signature below, I certify to each of the following: I am the property owner or, agent to act on e property owner'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. I agree to comply 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 ApplicantlAgent: Date: �� Z
SUPPLEMENTAL INFO 11REQU RED
= o tc z#s1 orix
�
I� or�x cs�IIN
Pe
r a
15'fAdOR,
MEPMiscApp 2011.doc revised 06121111
CERTIFICATE OF COMPLIANCE CF1R-A!3-02-E:-
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page,1 of 31
Project Name: Julie Wing Date Prepared: 2017-05-01
A. General Information
CM -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
Julie Wing
02
Date Prepared
2017-05-01
03
Project Location
22208 Quinterno Ct
04
Building Type
Singlefamily
05
CA City
Cupertino
06
Dwelling Unit Name
Julie Wing
SC System
SC System
CFA served
system a
Dwelling Unit Conditioned
Installing new SC
07
Zip Code
95014
08
Floor Area (ft)
2649
by this SC
ducted
containing
system
Number of Space
entirely new
09
Climate Zone
4
10
Conditioning (SC) Systems in
1
component?
components?
feet of ducts?
duct system?
this Dwelling Unit:
Alteration Type
B. Space Conditioning (SC) System Information .. {
01
02
03
04 ..}'
'"
, ..- 06. _
07
" 08
i...-,- 09
10
Is the SC --'`t _
Install'ing`a
SC System
SC System
CFA served
system a
refrigerant
Installing new SC
Installing
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
more than 40
entirely new
entirely new
Name
Served
System (ft)
system?
component?
components?
feet of ducts?
duct system?
SC system?
Alteration Type
Entirely new or
complete
System 1
Location 1
2649
Yes
Yes
Yes
Yes
Yes
Yes
replacement space
conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Sectlon1S0.2(b)1Diib)
This section does not apply to this project.
Registration Number: 217-A020141565A-000-000-0000000-0000 Registration Date/Time: 2017-05-0114:19:40 HERS Provider: CalCERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-01 14:15:31
Schema Version: rev 10/16
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 2 of 3)
D. Altered Space Conditioning System (Sections 150.2(b)1E and F)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)1Diia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
01
02
01
04
05
06
07
08
09
10
11
Heating
Cooling
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type ` .
—Component
Type ,
Value
System Type
Component
Type
Value
Type
R -Value
Annual Fuel,
Central gas
All new heating
Utilization
Centralsp(it
All newtool)ng
17
SetbackTher
R-6
System 1
furnace
components.::"
Effic%ency
95
AC ;--
components
• SEER
mostat
(AFU Ej
Required Documentation:-
CF2R-MCH-01-E- Space Conditioning Systems
-Duct insulation requirement for the new portions of supply -air and return -air ducts or plenums: R6 (CZ 1-10,12 and 13) and R8 (CZ 11 and 14-16)
CF2R and CF3R-MCH-20-H Duct Leakage Test required
- Leakage rate compliance: <= 51.
CF2R and CF3R-MCH-22 Fan Efficacy
CF2R and CF3R-MCH-23 Airflow Rate Verification
-
- Compliance: Fan Efficacy <= M8 W per cfm and System Airflow >= 350 cfm per ton.
_ - Alternative Compliance: CF2R and CF3R-MCH-28 Return Duct Design verification is an alternative to MCH -22 and MCH -23 verification.
CF2R and CF3R-MCH-25-H Refrigerant Charge verification required when refrigerant containing components are installed or altered (applicable in CZ 2, 8-15).
Exceptions:
Heating -only systems are exempt from the 0.58 W per cfm and 350 cfm per ton requirements.
Note: An "entirely new or replacement duct system" means at least 751 of the duct system is new duct material, and up to 251 may consist of reused parts from the dwelling unit's existing duct system (e.g., registers,
grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage
Registration Number:217-A020141565A-000-000-0000000-0000 Registration Date/Time: 2017-05-01 14:19:40 HERS Provider: CaICERTS
CA Building Energy Efficiency Standards - 2016 Residential Compliance Report Version: 2016.1.005 Report Generated: 2017-05-01 14:15:31
Schema Version: rev 10/16
Nick Juliano
385,Montecito Way
Milpitas Ca 95035
949-903-1395
nick.juliano@yahoo.com
T F F 1 H VWMA-1 C
aig
Heating, Air Conditioning & Sheet Metal
TFF HVAC Warranty Terms: New installs include parts and labor up to one year.
Warranty takes effect on date of signed install.
Description for work to be done
REPLACE FURNACE
Remove and recycle existing furnace
New furnace to be Carrier 80% single -stage 45K BTU model 58STX045108
Accessible filter rack
New gas valve
New vent connection
REPLACE A/C
A/C to be Carrier 2 ton 14 seer R-410 model 24AAA524AO03 with plastic A/C pad 74 dB 26x26x32
Vertical evaporator coil R-410 with TXV
Copper A/C line set
PVC condensation line
Reconfigure electrical for A/C
Pressurize, evacuate, and charge copper A/C line
SEAL AND INSULATE DUCTWORK IN ATTIC (REQUIRED FOR HERS TESTING)
Removal and disposal of existing insulation at all joints
Seal all joints with approved duct sealant
Remove and replace damaged portions as needed
Insulate ductwork with fiberglass at exposed joints
Seal all ceiling/floor and wall boxes at drywall
HERS Rating (Duct Testing Required with City Permit) Homeowner to be present for testing approx 2 hours
Permit - Homeowner to be present for inspection
OPTIONAL UPGRADE COSTS IN ADDITION TO BASE PRICE
Upgrade furnace to Carrier Performance 80% two-stage variable speed 45K BTU model 58CTY045112
Upgrade A/C to 2 ton Carrier Infinity series 17 seer R-410 model 24ANB724AO03 69/71 dB 31x3lx36
Upgrade A/C to 2 ton 15 seer Carrier Performance Slimline R-410 model 24AHA424AO03 66 dB 37xl7x31
Carrier manufacture product and warranty information
http://www.carrier.com/homecomfort/en/us/products/
Estimate
Date 5/1/2017
Estimate 0818
Phone 408-786-8120
TFFHVAC.COM
Lic 917350
CARRIER FURNACE MANUFACTURE WARRANTY FOR 80% EFFICIENCY
To the original owner, the Carrier Gas Furnace is covered by a 10 -year parts and 20 years heat exchanger limited warranty. See warranty
certificate at carrier for complete details.
CARRIER A/C MANUFACTURE WARRANTY
To the original owner, a 10 -year parts limited warranty on your new equipment. See warranty certificate at carrier for complete details.
Pricing good for 30 days from date of estimate.
Amount
2,300.00
4,150.00
650.00
400.00
280.00
400.00
1,250.00
950.00
Respectfully submitted by TFF HVAC Lic 917350. All material is guaranteed to be specified, and the work to be performed in accordance with manufacture specifications in a substantial
workmanlike manner. Payment in full upon completion, check or cash accepted. *Pricing good 30 days from date of estimate.
SMOKE I CARBON MONOXID�dALAR
E
ER CERTIFICATE OF CONC
OWN -Y DEVELOPMENT DEPARTMENT - BUILDING DIVISI
COMMUNIT
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-322B •- FAX (4 08) 777-3333 - bu!IdinQAd)-cuS-e]±-n-0-0-'-9
S-1 9- lit
f /V
-is for
Moj�oxide arn
Carbon
PURPOSE tificat'on for the installation of all -required Smoke and .11.2-whe're no inAlterior access
a self -ce-r
This affidavit is I 8315, 2016 CBC Sections 4:20.6 and 907.
2
compliance with 2016 CRC Section R314'
for inspections are required, arms and Carbon
L INFORmAnON dwellings shall be provided with Sn-10existing
Al dwellinunits exceedsGENERA -familyExistina sinale-fairdlY and multi alterations, orrepais to
C, S. When the valuation of additions, d 4? -0.6 require that smoke Alarms and/or
Monoxide alarms. R315, and CBC Sections 907.2.11.5 an
$1000.00, CRC Section 8314, followina, locations: COAL
ARM
Carbon Monoxide Alarms be installed in the SMOKE ALARMx
AREA - x
------- of the
ig area in the immediate vicinity -1 do �-)r)
separate sleeping x
Outside of each se -is hl not be located Within 3 feet of bathroom x
_Smoke alarms s )1e attics
room(s) (Sir 7uj �tcjudj -,basemei-its 2ndhabital
bed x
: a awellinoo
0-n every level of room Onl d that
Within each sleep contain moke
�yappliances an10 not -hallcon"Ply with
e not requireclin dwellincrs wi ch C alarms SCarbonMonoxide alarms a' mono)dde alarms combined with s
ga-rage. bon Fir Marshal.
do not have an attached ZD 0 the Office of the State e
0.6 and shall be approved by
CBC Section 42
supply, alarm(s) may be solely battery operated
units with no commercial powerrepairs Or alterations do
ower Supply- In dwelling -mitted to be solely operated where . basement Or crawl
ellin, units, alarms are per ccess by means of attic permit is required for
-"T 0 , -dshes 907
here is no ain existin' d e -removal ofwall and ceilin' fil 11.4 and 420.6.2. Anelectrical Pernnot -resultin th R314 tothe
BCse2
space. Refer to CRC Section
ected building wiring -
alarms which must be Conn certify that the omm(
s)referenced above has/have been
ferenced property, I hereby ce ith the California Buildin'0As Owner of the above -re facturer's instructions and in cpliance W ope-rational, as of the
been tested and are
installed in accordance with 'he "a"" specified below have
and California Residential Codes. The alarms SP Permit ,0o
date signed below.
12 'de�DetectQM
C - "re
- �io--"
N,d ------ L
l#' -Smoke -pdarins
T7
Alarmsl
SEp-ec--1-1f)-'--N-d be -6f y with the terms and
a and gree �tocOm Y
P'Y
1 have read and agree to C11111
E�rrie:
Ownerr
W, jer XgCnt-)� N
_re
_Owner (or 0
oviner (or 01' . . .....
'Signature
.. . ..... .
-o n
siqnaL-2-
-50—nlr-elor Name,
F -el rre-f Signature ................... .............. .....
of this statement
............ -
...............
Date:
S,wke and Coforimdoc 1,ci,ised 011101_01:
C ddress
(NATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE /
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX(>a (406) 777-3333 - buildinacupertino.ora
tV)i Vi(1 &bPff* h/1 P.9,AtxA v- Permit Nn
S` d
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
XNa Go to Question 2.
Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
plumbing, installation of water -conserving plumbing fixtures is not technically feasible?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
❑ The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
kNo Go to Question 3.
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
,,5t,,No Go to Question 4.
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My real property is built and available for use or occupancy after January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form..
Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of foram...
5. Ple e check ONE of the following:.
My property is a single family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with water-conseiving plumbing fixtures throughout the building. On or before January 1, 2017, all non-
compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether
property undergoes alterations or iumprovements).
❑ Mypropertyis a multifamily residential real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require mon- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water -
conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements).
❑ My property is a commercial real property. See Civil Code Section 1101.5.
On and after January 1, 2014, specified building alterations or improvements shall require mon- compliant
plumbing fixtures to be replaced with water -conserving plumbing fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving
plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements).
I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the following aa2e.
�U er-.•or-Uwner-Hgenrs Signature: w �uare:1
Upon completing and signing this Ce ific te, p14Ae return it to tlib Building Division in order to final your building permit.
SB407 2015.doc revised 01/05/17