08080217 (2) CITY OF CUPERTINO �r riz,.. �- •�e
BUILDING DIVISION PERNIIT CONTRACTOR.INFORMA.TION
K �s ;u,r9. trH®t.. a.
BUILOIMp(.D��lFSS: PERMIT NO.
iUS /tl I.,.I:NDSAY AVE ALLIED AIRE SERVICE INC 08080217
HER'S NAME: PERMIT ISSUE DATE
KEA'I`:I:NG JERROLD K AND LOUISE F 661 SINCLAIR FRONTAGE RD 08/27/2.008
PHONE SANITARY NO. CONTROL NO.
ARCHITECT(ENGINEER: BUILDING PERMITIN
REPLACE EXISTING FURNACE AND BLDG ELECT PLUMB MECH
0 0 0 0
�Op LICENSED CONTRACTOR'S DECLARATION
tad C1 hcnby affirm Net 1 un limvea unacr pmvision of Chapty 9(mmmcncing Job Description
t� iN Section 7")o(Division 3afdm ButinesO and Profusions Coq,,and my license is
_may in full fortxan Dec D
la lice I s E) D 3 Lie.
E
Dau Cama r
eARCHITECTS DEC ATTON
e U I understand my plans Nall he rued as Public records '
DE
g,In Licensed Professional
p OWNER-BUIUER DECLARATION
y 1 hereby alum that I am exempt from the Contractor's License law for the
EO O following mason.(Section 7B3I.5.Business and PNfmions Codc:Any city or County
3$ which requires a permit In c eswcL slur.impmve.demolish,or repair my mostum
prior to its issmncc.aim toluenes the applicant for such Permit a filo a signed statement
that hculicensed pursuantto the pmvisum of the Contractors timer Law(Chapter 9 Sq.Ft. Floor Area Valuation
FG (commencing with Section 7000)of Division 3 of the Business and Profrsiom Cnde)or
E R$ that he is exempt therefrom and dre baso for the alleged exemption.Any violation of
Section 7031.5 by any applicant fora Permit subjects the applicant he a civil Penalty of APN Number Occupancy Type
m an
emora thfive hundred dollars ISM P Y YP
❑1,a ownar of the pmprny,a mY wplpym with wages u dm'vrole cpmpcnation,
aid Pr the wort,and the he Cont u tors Laded or a w do s ant apply 0a1,mmor o•
and orywh oba Code The vesthe torr and
law dans tot apply m rd owner is Required Inspections
Own emy who builds orimpww thereon,and whoduesauchwork mmol(mfor Ulm
his
own toes.the ingor that wmimProwmmts art oat ear cded meQerW for ale a.
however.thebuildingordepmvemmlg told within We ildorcompledm.theowuer-
b le.). will Itaw the burden of Proving dot he ata rot Huila or improve for purpose or
ale.).
1,as Mean of the propcnY•am exclusively Contacting with licensed mnuactms m
construct the Project(Sec.7044.Business and Profusion Code:)The Commerce's U.
come taw,don out apply as an owner of property who builds or improves thereon,and
who memos fm such pmjens with a comramwK.)licensed p.to the Ourawcor's
License taw.
Iamaxemptundm See .B&PCfprthis tossm
uer Dam
WORKER'S COMPENSATION DECLARATION
I botchy aldore under pemlry of perjury was of dm following decimations:
1 ham and will maintain a Certillme ofConscnt to sell-imum for Wod sComRn-
smon,as provided for by Section 37M or the labor Cone.for the Performance of the
woods for which this permit is issued.
❑I have and will maintain Wort es Compewdon Insurance,as minimal by Section
3700 of the labor Code.fee the Perfomanm of the wait for which Nu permit is issued.
My Wm sCpmpenmd Imm�nce carrier and Policy rmrn`.iare:-'7
Carrie 9 ' n Policy No.: 3 J Q /
CE& GTE 0 EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This realm need ml v cempleud if We Permit is fueom nunthNaodan(SIM)
or lest)
1 cerufy that in the pmfameuee of the rook for which this permit is issued.I shall ria
employ airy person in my mamur an as u become object to the Warton'Caopemndom
Laws of California.Dam
Applicant
NOTICE TO APPLICANT.If.a1Nr making this CerdBau of Exemption,you should
become subject an the Workers Compcoonsm provisions of the tabor Cm m,you most
.J O forthwith comply with such provisions or this permit Nall be deemed revoked.
Z^ CONsrBucnON LENDING AGENCY
(r.�. I Iumby.111.than them u a construction lending agency for the pmformwac a
C dm work for which this permit is issued(Sec.3077,Civ.C.)
W Zanders Name
z l<ndces Addrces
U O 1 ratify that 1 have real this appltmsim end sure this the above information is
Un P cmrccb l agrte to comply with all city and county ordinances and soon laws mlaung an
UWilding construction,and hereby sodium.represenutiws of this city m Cour upon the
r[A snow-mendoned Pelson,for impeedo t purpoms .
I„t PL (Ws)agree to ave.indemnify and keep harmless the City of Cupertino against
to IiWiliti gmcnu,cosuand expenses which may In my way accrue against saidCity
V z ire ear the grind of Nu peomil �+�-7 ^„
^ APP CA U DERSr DS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date t1`
SO C E
>7 � Re-roofs /
Si num ofd IicandCoammoor eta
HAZARDOUS Wilding
MATERIALS DISCLOSURE Type of Roof
WIIIy Carola fMun buildingoecvpmtsome or cul the
h eallommaushl
Is.Sea by dr Cupenim Municipal Code,Chapter 9.11,aM da Hnith and Safety
.section 25s3xo7 All roofs shall be inspected nor to an roofing material beim
❑Yrs � P P Y g g installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Will du applior forum building occupant use a Air eat or devims which P
eon hvaNnm air cmuta minants a dcOnN by the Bay Ansa Air Quality Mwg:mcnt all new materials for inspection.
District? P
❑Yrs Nu
I ba"au the hvallounwerialsnquiremenes umkr Chapnrb.95 ofthc Califon
nia HeaulLA,5 cly Cad.Se vane MCU,25533 w125534.1 undcmaM dutifNe building
doest cu dl be a tenant. it u my mer ashility an mmo
dfy dor upmt of tie
rcquone when 'ue uasax:ofa Cmdfiuu of cmpafry.
& a a Y Signature of Applicant Date
o aantheri> gent Dam' All roof coverings to be Class'1W`or better
CITY OF CUPERTINO
Z10"
FURNACE/AC
•CUPRTINO PERMIT APPLICATION FORM
APN # 0 Date:
o2Z,o
Building Address:
p 3 70 Li,vOS{�� v�
Owner's Name: Phone#:
Contractor: Phone#: ,4pg 93,{—&g-y
p.wle , 1�%aLr- S&W- Fax#: Z(-Og 93q-89qb
Contractor License#: Cupertino Business License#:
Contact: (� Phone #:
f'Cr�IJ l e �1'�7A L'�k Fax #:
Building Permit Info:
Elect ❑ Plumb Mech [9--
Residential Commercial Lj
Job Description:
�t=pLAcC LXISTr.J (a f UO210ACC AA1�
For Residential Installations:
Attic ❑ I" floor FT�- 2"d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
# &, CZ-D
Strapped On Platform Bonded ❑ New Location Replacement
Project Size: Ex ress`T Standard ❑ Laze ❑ Major ❑
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set& the sheet index. -6)—
Revised 6/16/08
CITY OF CUPERTINO
FURNACE/AC •
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system;incl
installation of controls regulated by this
code.
IMCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M •
suspended heater,recessed wall htr, or
floor mounted unit heater.
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
IMCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
( heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
IMRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater. •
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install & not incl in an appl permit.
Quantity Fee ID Fee Description Fee Permit Type
CITY OF CUPERTINO
•CUFURNACE/AC
PERM I TINO FEE SCHEDULE
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
IBSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> I 00 BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
uanti Fee ID Fee Descri tion Fee Permit Type
CITY OF CUPERTINO
FURNACE/AC •
CUPEkTINO FEE SCHEDULE
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= 10k CFM . B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMIC0 Seismic Commercial B
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. CommfResid
1BREMAIRHAN Residential A/C units <= IOk CFM . B
IMRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B •
IEPERMITFEE Electric Permit E
I 1MPERMITFEE Mechanical Permit M
IPPERMITFEE Plumbing Permit P
ITRAVDOC Travel Documentation B
1BUSLIC Business License B
•
Green Building Plan Check
Ilk Index of Green Building Points/Categories
A Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
I mom
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 __Lpoints
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) 3-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 cints
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11.A 2500 Gal.Tank, (Note/Spec) L-1 10 cints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 paints
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. EnergyStar Refrigerator, (Note/Spec.) AJ 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
Plan Review Process Work Book Page-12-Revised 325/08
Green Points Rating System for Remodeling Projects
• Due to the diversity of remodeling project types,assigning a'total points'value to a project to be considered environmentally friendly is
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
INPUT Resources Energy 1ADIHealth
A.Site
�1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Matedals 4 Resource is es
3.Remodel for Mixed Use,Adaptive Reuse,and
P Y=Y 0
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt Y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
IB.Design Resource-Efficient Landscapes and—Garde—ns- _ _J 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resource ptsnoo
2.Use Recycled Content Aggregate 2 Resource pts y=yes
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
.1._Subs4ute Solid Sawn Lumber with Engineered Lumber _ 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6"or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
8.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes p
'12.UseOSB-- — - --- - - -
• a.Subfloors 1 Resource pt y=yes 0
b.Sheathing _ 1 Resource pt y=yes 0
1 1 1
-
INPUT Resources Energy
alth
ztenor Fims
.1.Use Sustainable Decking Materials - •
a.Recycled content 3 Resource pts y=yesF 0
Ib.FSC Certified Wood 3 Resource pts y=yes 0
12.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding i1 IAQ Health pt y=yes 0
I4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
1.Install Water Heater Jacket _J 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts .y=yes 0
I3.Retrofit all Faucets and Showerheadc with Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
�4.Replace Toilest with Ultra-Low Flush Toilets I
(1 point each,up to 3 points) _ _ Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts Y--yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQlHealth pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
I 1 1
r.rrecmcai
1.Install Compact Fluorescent Light Bulbs(CFLs)
(6 bulbs_2 points,10 bulbs=3 points,12 bulbs=4 points) J Up to 4 Energy pts. 0
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. o
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 1 Energy pt y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 0
1 1 1
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
13.InsCelhRecycled-Content,Fiberglass Insulation with —�
No Added Formaldehyde 3 IAQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes 0 •
b.Ceilings 4 Resource pts y=yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
I).uemngs 4 Resource pts y=yes 0
1 1
INPUT Resources Energy IAO/Health
I.Windows
• TInstall Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames
� Y _ _____ __ 2 Energy pts y=yes 0
2,Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 1
J.Heating Ventilation and Air Conditioning
F.Use Duct Mastic on All Duct Joints 2 Energy pts y--yes 0
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y--yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7,Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 31AO/Health pts y=yes 0
J.Water Heaters 31AQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
• 12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoveslnsens 1 IAO/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14,Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 4 IAQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pis y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points)_ _ Up to 18 Energy pis
0
16.Select Safe and Durable Roofing Materials_ _ 1 Resource of y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes p
Emir
L.Natural Heating and Cooling 1 1 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
.In oor Air Quality and Ftnrshes
1.Use Low%No-VOC Paint - _ 1 IAQ/Health pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Finishes 2 IAO/Health pts y=yes 0
3.Use LowAciVOC Adhesives _ 3 IAO/Health
. 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses _ 1 IAOIHeallh pts y=yes 0
i7.
Seal--alF Exposed Particleboard or MDF _ 4 IAQ/Health pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0
10.Install Whole House Vacuum System - 3 IAQ/Health pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring _ 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials - _ J 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y-yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
1 1
Total Points A 1 1401 1301 57 •
Total Points Project R 1 0 0 0
G:datalprogstgreenbuildingguidelineslremodelerslgreenpoimsfinal2.12.04protBM8d.xls
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
' Telephone(408)777-3228
WU PEI� F Fax(408)777-3333
ABuildin De artment
JOB b S7c) 1�ASR AV PEddf>0<7� -2—1
OWNER'S NAME: tCc-)&,T-jL)G PHONE # W09
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors: 7 S7 O
Signature Date
Please check applicable subcontractors and complete the followinginformation
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
T'
Owner/Contractor Signature Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: ' Lot:
APN . . . . . . . . : 36912022 . 00
DATE ISSUED. . . . . . . : 08/27/2008
RECEIPT # . . . . . . . . . : BS000005920
REFERENCE ID # . . . : 08080217
SITE ADDRESS . . . . . : 10370 LINDSAY AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KEATING JERROLD K AND LOUISE F
ADDRESS . . . . . . . . . . : 10370 LINDSAY AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4518
RECEIVED FROM . . . . : ALLIED AIRE SERVICE
CONTRACTOR . . . . . . . : STEINER,. ARNOLD R LIC # 19207
COMPANY . . . . . . . . . . : ALLIED AIRE SERVICE INC
ADDRESS . . . . . . . . . . : 661 SINCLAIR FRONTAGE RD
CITY/STATE/ZIP . . . : MILPITAS, CA 95035
TELEPHONE . . . . . . . . : (408) 934-8844
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
].EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
].MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1MRRAA UNITS 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
].PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
7.TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 14 0 . 00 286 . 14 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------- --------------------
CHECK 286 . 14 20202
---------------
TOTAL, RECEIPT 286 . 14
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•