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11120055 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1507 ASTER LN CONTRACTOR:A PLUS HEATING&A/C PERMIT NO: 11120055 OWNER'S NAME: MILLER JAMES 244 GREAT MALL PKWY DATE ISSUED: 12/072011 NER'S PHONE: 4082530436 MILPITAS,CA 92683 PHONE NO:(408)934.0730 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Lic.q / o 3 1 J r"" r r MECH RESIDENTIAL COMMERCIAL " Contractor A —P lIo 5 Date 12 I hereby affirm that I am licensed under the provisions of Ch pter 9 JOB DESCRIPTION:REPLACE FURNACE IN SAME LOCATION (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is In full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: 1 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:54000 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. APN Number:36624006.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply �•7 L with all non-point source regulations per the Cupertino Municipal Code,Section Issued bDate: 9.18. ..�� Signature Date�j! • ROOFS: my roofing OWNER-BUILDER DECLARATION All roofs shall be inspected prior to roofing material being installed. If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should 1 use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Ow r eut ize agent: Compensation laws of California. If,after making this certificate of exemption,I Date: 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. G AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Wand expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION ing of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records, all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date • CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: TraciC COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36624006 . 00 DATE ISSUED. . . . . . . : 12/07/2011 RECEIPT #. . . . . . . . . : BS000015517 REFERENCE ID # . . . : 11120055 SITE ADDRESS . . . . . : 1507 ASTER IN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MILLER JAMES G ADDRESS . . . . . . . . . . : 1507 ASTER IN CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5214 RECEIVED FROM . . . . : A PLUS HEATING & CONTRACTOR . . . . . . . : ADAM P. PHAM LIC # 31293 COMPANY . . . . . . . . . . : A PLUS HEATING & A/C ADDRESS . . . . . . . . . . : 244 GREAT MALL PKWY CITY/STATE/ZIP . . . : MILPITAS, CA 92683 TELEPHONE . . . . . . . . : (408) 934-0730 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- -ADMIN HOURS 1. 00 41 . 00 0. 00 41. 00 0. 00 1BCBSC VALUATION 4, 000. 00 1 . 00 0. 00 1. 00 0 . 00 1BSEISMICR VALUATION 4, 000. 00 0 .50 0.00 0. 50 0 . 00 1MFR=<100 UNITS 1. 00 130 . 00 0. 00 130. 00 0 . 00 1MPERMITFE FLAT RATE 1. 00 44 . 00 0 . 00 44 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 44 . 00 0. 00 44 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 260 .50 0 . 00 260 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 260.50 2080 --------------- TOTAL RECEIPT 260 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION • ILI ADDRESS: 1507 aster In. DATE: 12/07120111 REVIEWED BY: bobs. APN: BP#: *VALUATION: $4,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD Or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK re lace add new furnace at same location. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $130 TOTALS: $130.00 Meeh.Plan Check 0.0 hrs $0.00hGt+„h Ptrn Cheuk Islec.I'mrr Chet%° Mech.Permit Fee: IMPERM/T Plumh, Pe,mk Fee: F;/a,. Pem:ir lee. • Other Mech.Insp. 0.0 hrs $44.00 Otte Phunb firs, Oilier Elea Insp. El lle h.Imp. Fee: Pluwb. Insp.Fee: filer.In.V>. Per.: NOTE:This estimate does not include fees due to other Departments(le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These fees are based on the prefindna information avdliable and are only an estimate. Contact the Dept for addn7 infa FEE ITEMS (fee Resolalion 11-053 Eff 7/U1U FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Pce PME Plan Check: $0.00 f'crntif Fee: Sapp/. htsp Fee PME Unit Fee: $130.00 PME Permit Fee: $44,00 rn struelion Tax Administrative Fee: 1ADM/N $41.00 Work Without Permit? () Yes (j) No $0.00 Advanced Planning Fres: Travel Documentation Fee: ITRA VDOC $44.00 strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item • Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $260.50 $0.001 TOTAL FEE: 1 $260.50 Revised: 10/01/2011 GENERAL PERMIT APPLICATION \eMEP • COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION \� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•buildinD(Mcuoerdno.om misc TNGCAL ELECCR]CAL ❑MISCELLANEOUS PROJEcTADDRESs 15m Af f,nr I /l /1 /1 APNx OWNER NAME�IaajG Ortll'�l e �� 1�� lot— Z`t.7 —O e MAI. STREET ADDRESS 15M nA(JJ./)� I /j LW I1 /l ) CITY,STATE,ZIP Cwft no �I FAX CONTACT NAME David I C7 ax,_ ?HONB _ E--M STREETADDRESS CTTY,STATE,ZM FAX ❑OWNER ❑ OWNER-BUE.DER 0 OWNERAGENT CONTRACTOR 0 CONTRACTORAGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER ❑rENANT CONTRACTOR NAME LICENSE NUNDIER-7 315 LICENSE TYPE CU BUS'LIC 3129 3 cowATA*idlae Heating 8 Air Condliloning, Inc. H-MATE "I'll j DRESS 244 Great Mall Parkway CITY.STATE.ZIP 3 3O AEauTECrmNODNEERNIffilpfte9,CA95035 UCENSENutmER. Bus.ucx CaMPANYNAME E-MAIL. FAX STREETADDRESS CITY.STATE,ZIP PHONE • USE OP .DUPLEX ❑ NNLTI-FAMO.Y I PROIECTNW t.Axo ❑ YES PROMCTW OYES NS THE=0 AN EJ YES BUDDINO: OCOMM CAL URBANWTERFACEAREA NO FLOOD ZONE 0 N EICFDFA HOMO 0 N DESCR@TWNOF WORX Woo, oid TCtmoce ce mce W n In same (patfi o✓L- TOTAL VALUATION: W IIECEIVED BY: By my pilin nure below,I certify to each of the fallowing I am the property owner or authorized agent to act on the property owner's behalf. I have read this applicadon and the information I bees provided is correct.). have read the Description of Work and verity it is eecurete. I agree to comply with all applicable local ordinances and state lam rtladnm g ceostroctlan. tborize representatives of Cupertino m enter the above-i �d/5 mperty for inspection ptr4�ases. SignaturadApplicant/Agent Data I L SUPPLEMENT ORMATION REQUIRED OMC�E USE ONLY 0_d6ER-'RTE-COUNTER ❑ EXPRESS ❑ STANDARD V ❑ LARGE d ❑ MAJOR MEPMucApp 2011.doc reeked 06121111 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC Climate Zones 1, 3-7 Site Address: Enforcement Agency: Date: Permit#: 1507 Aster Lane Cupertino, CA 95014 City of Cupertino Dec 7, 2011 Duct insulation Conditioned Floor qulpment Typel List Minimum Efficiency2 requirement Area Thermostat Package Unit V Furnace V AFUE 78% COPSetback Indoor Coil SEER HSPF R 6 (CZ 1, 3-5) Served by system If not already present, must be Condensing Unit EER Resistance R 4.2(CZ 6, 7) 1400 sf installed) Other 1.Equipment Type:Choose the equipment being Installed;If more than one system, use another CF-IR-ALT-HVAC for each system. 2. Minimum 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 complete. •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 1 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 the enforcement agency for approval with the permit application. Name: lane Alo Signature: Tone Alp Company: A PLUS GENERAL CONTRACTORS INC Date: Dec 7, 2011 Address: 11330 KNOTT STREET License: 763154 City/State/Zip: GARDEN GROVE/ CA/ 92841 Phone: (714) 901-0500 • � �� V b•�4 {fib�F� ` �f • l.( • � C fr 4?r/r �,y�3'.'�' . -`.' J ,".- .e 1,.,... •r^J �j �:�'"�^ �. r Ir.F./L ,� Reg: 211-A0063404A-00000000-0000 Registration Date/Time: 2011/12/07 11:40:28 HERS Provider: CaICERTS, Inc. 2008 Residential Compliance Forma July 2010 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 «U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# OWNER'S NAME: HONE# (DLf 3 6 GENERAL CONTRACTOR: — BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requires all 'IN. orking W the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE .SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 1 am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum /Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile -' -7 Owontractor Signature Date