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12030024 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10703 RAE LN CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 12030024 CONDITIONING OWNER'S NAME: BROPHY PAUL D AND hIELONIE C 1712STONEAVE DATE ISSUED:03/05/2012 OWNERS PHONE: 4089960766 SAN JOSE,CA 95125 PHONE NO:(103)2934717 ❑ LICENSED CONTRACT/OR'QS DrCLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB C. License Class C'2U C l'/S Lic.4 7p 4 V p7 r r_ r AnA �� OIECH RESIDENTIAL COMMERCIALm Gnmctnr fF-� n �e Date herehy affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE EXISTING FURNACEAT SAME LOCATION (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. hereby affirin under penalty of perjury one of the folloniog two declarations: I have mid 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:$2800 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Libor Code,for the performance orate work for which this permit is issued. APN Number:3560707200 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application mid state that(lie above infuriation is corect.l agree to comply with all city and county ordin:mces mid 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 lir inspection purposes. (We)agree to save WITHIN 1.80 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City ofCupenino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which map accrue against said City in consequence of the granting of this pennit. Additionally,the applicant understands mid will comply with all non-point source regulatioic per the Cupertino Municipal Code,Section Issued by: Date: 9.18. Signature ( Date 3 s5 — `7 RE-ROOFS: ❑ ONVNER-BUILDER DECLARATION All roofs shall be inspec(ed 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 1 hereby affirm that 1 am exempt Dram the Contractor's License Law for one of inspection. the following two reasons: 1,as owner of(he property,or my employees wi(h wages as their sole compensation. Signature of Applicant: Date: will do the work-.mid the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,ani exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS".A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: 1 have read the.hazardous materials requirements under Chapter 6.95 of the (have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code.Sections 255115.25533.and 25534. 1 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& perfornnance of the work for which this Intuit is issued. Safety Code.Section 2.5.532(x)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of(he Libor Code,for the performance of the work for which this contaminants as defined by the Ray Area Air Quality Management District 1 will Permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Sections 25505.25533,and 25534. I certify that in die performance of the work lir which this pennit is issued I shall no(employ tiny person in any manner so as to become subject to the Worker's Owri555fff or ante agen Compensation lays ofCalifomia. If,atter making this certificate ofexemption,1 ; / Date:, become subject m the Worker's.Compensation provisions of the Labor Code,I mus( - IJnlmith comply wi(h such provisions or this permit shall he deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION forwhich this penult is issued(See.3097,Civ C.) 1 certify that I have read(his application and state(hat the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state Imes 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,judgmenls, costs,mid expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION grunting of this permit.Additionally,the applicant understands and will comply I understand my plans shall he used as public records. with all noarpoint source regulations per the Cupertino Municipal Code,Sectio 9.18• Licensed Professional Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10703 RAE LN CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 12030024 CONDITIONING OWNER'S NAME: BROPHY PAUL D AND hIELONIE C 1712STONEAVE DATE ISSUED:03/05/2012 OWNERS PHONE: 4089960766 SAN JOSE,CA 95125 PHONE NO:(103)2934717 ❑ LICENSED CONTRACT/OR'QS DrCLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB C. License Class C'2U C l'/S Lic.4 7p 4 V p7 r r_ r AnA �� OIECH RESIDENTIAL COMMERCIALm Gnmctnr fF-� n �e Date herehy affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE EXISTING FURNACEAT SAME LOCATION (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. hereby affirin under penalty of perjury one of the folloniog two declarations: I have mid 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:$2800 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Libor Code,for the performance orate work for which this permit is issued. APN Number:3560707200 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application mid state that(lie above infuriation is corect.l agree to comply with all city and county ordin:mces mid 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 lir inspection purposes. (We)agree to save WITHIN 1.80 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City ofCupenino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which map accrue against said City in consequence of the granting of this pennit. Additionally,the applicant understands mid will comply with all non-point source regulatioic per the Cupertino Municipal Code,Section Issued by: Date: 9.18. Signature ( Date 3 s5 — `7 RE-ROOFS: ❑ ONVNER-BUILDER DECLARATION All roofs shall be inspec(ed 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 1 hereby affirm that 1 am exempt Dram the Contractor's License Law for one of inspection. the following two reasons: 1,as owner of(he property,or my employees wi(h wages as their sole compensation. Signature of Applicant: Date: will do the work-.mid the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,ani 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: 1 have read the.hazardous materials requirements under Chapter 6.95 of the (have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code.Sections 255115.25533.and 25534. 1 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& perfornnance of the work for which this Intuit is issued. Safety Code.Section 2.5.532(x)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of(he Libor Code,for the performance of the work for which this contaminants as defined by the Ray Area Air Quality Management District 1 will Permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Sections 25505.25533,and 25534. I certify that in die performance of the work lir which this pennit is issued I shall no(employ tiny person in any manner so as to become subject to the Worker's Owri555fff or ante agen Compensation lays ofCalifomia. If,atter making this certificate ofexemption,1 ; / Date:, become subject m the Worker's.Compensation provisions of the Labor Code,I mus( - IJnlmith comply wi(h such provisions or this permit shall he deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION forwhich this penult is issued(See.3097,Civ C.) 1 certify that I have read(his application and state(hat the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state Imes 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,judgmenls, costs,mid expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION grunting of this permit.Additionally,the applicant understands and will comply I understand my plans shall he used as public records. with all noarpoint source regulations per the Cupertino Municipal Code,Sectio 9.18• Licensed Professional Signature Date Building Department City Of Cupertino 10300 Tone Avenue C U P E RT I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# 3 6 G Z`J OWNER'S NAME: PAU1 6c j PHONE# E 6 GENERAL CONTRACTOR: Le. 1BUSFNFSSLICENSF # 7/ ADDRESS: Z CITY/ZIPCODE: S,7 64 *Our municipal code requires all businesses working in 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: Signat a 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 Shect Metal Shect Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35607072 .00 DATE ISSUED. . . . . . . : 03/05/2012 RECEIPT # . . . . . . . . . : BS000016192 REFERENCE ID # . . . : 12030024 SITE ADDRESS . . . . . : 10703 RAE LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BROPHY PAUL D AND MELONIE C ADDRESS . . . . . . . . . . : 10703 RAE LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4040 RECEIVED FROM . . . . : AAA FURNACE & AIR C CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050 COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING ADDRESS . . . . . . . . . . : 1712 STONE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 293-4717 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 2, 800 .00 1. 00 0.00 1 .00 0 .00 1BSEISMICR VALUATION 2, 800 .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 #39948 --------------- 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 ADDRESS: 10703 rae In. DATE: 03/05/2012 REVIEWED BY: bobs. 12-41 APN: BP#: *VALUATION: 1$2,800 *PERMIT TYPE: Mechanical Permit PLAN CHECK TVPE: Alteration /Addition / Repair PRIMARY PENTAMATION USE: SFD Or Duplex PERMIT TYPE: FURN/AC WORK a lace existing furnace at same location. 71 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 $0.00 Phanb. Plan Check Elec.Plan Check Nfech. Permit Fee: IA1PERWT Pluruh. Pe rut Fee Ekc: Pemtit Fee: Other Pfech.Insp. 0.0 hrs $44.00 Other Phanhbcp. El 01he"Elm. Insp. ilech.lnyz Fcn:.• Pluneb.Insp,Fw; Fier.Indy. Fen: NOTE: This estinurte does not include fees due to other Departments(i.e. Planning, Public Narks, Fire,Smtinuy Sewer District,School District,etc.). These ees are based on the prelininan in ornnetion ava/lab/e and are onh,an estimate. Contact the De t or adds 7.info. FEE ITEMS (Fee Resolution 11-053 EB' 7/1/11) FEE QTY/FEE MISC ITEMS Plzen Check Fee: Suppl. PCFee PME Plan Check: $0.00 Permit Fee: Suppl,Beep Fee PME Unit Fee: $130.00 PME Permit Fee: $44.00 Construction Tar: Administrative Fee: IADMIN $41.00 Work Without Pemtit? O Yes Q) No $0.00 Adtnneed Planning Feer: Travel Documentation Fee: ITRA PDOC $44.00 Strong Motion Fee: I BSEISHICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $260.50 $0.001 TOTAL FEE: $260.50 Revised: 1/19/2012 L,U r7 'te-t I J C, Prescriptive Certificate of Compliance: Residential CF-1R:ALT Residential Alterations (Page 4 of 5) Project Name: -� j� Climate Zone N c/ H of Stories 1 Awl 3r-o4 � x FIVAC sysrEi`IS - HEATING Minimum Duct or Piping Configuration HeatingEquipment Efficiency Distribution Insulation Thermostat (Central,Split, T e and Ca aci l'''t (AFUE or HSPF) Type and Location' R-Value T e Space,Pack a a or H dronic) 7AA&R— 901620 U O C10I)e L ,Oket /U'1 1.Iulicare Heating Tvpe(Central Furnace, Wall Furnnce. Hent pump. Boiler. Electric Resistance, etc.) 2.Electric resistance heating is allowed only in Component Package C.or except where electric heating is supplemental(i.e., if total capacity < ?KlV or 7.000 Btu/hr electric heating is controlled by a rime-limiting device not exceeding 30 minutes). See JM(b)3 exception. 3.Refer to the HERS Verfcation section on Page 4 of the CF-I R-ALT Form for additional req pu; iftEntt'as1e�C ap IrLi_cab�fe`boxes. 4. Indicate Type or Location(Ducts. Hvdronic in Floor, Radiators.etc.) elLs'l� •ID HVAC SYSTEMS-COOLING MAA O ;Z ons, m - - iVlinimum Efficiency Duct or Piping Configuration Cooling Equipment ( ERIEER.or Distribution Insulati a Central,Split, Type and Ca acit l' COP) T e - alue Type Space,Package or H dronic' L Indicate Cooling Tv eat pump. Evap. Cooling, etc) - - - 2. Refer to H S Verification section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes. 3. Indicate Tvpe or Location(Ducts, Hvdronic in Floor. Radiators, etc.) NATER HEATING List wareeaters and boilers for both domestic hot water(DHiV)heaters and hydronic space heating. Individual dwelling DH W heaters must be gas or propone f red and may not exceed 50 gallons. Hot water pipe insulation from the DHW ret to the kitchert(s)and on all underground hot water pipes isre"uired in all corn onenr packaRes in all climate cones. External Tank Water Heater Type/Fuel ~` Distribution Type umber In Tank Energy Factor or Insulation (Standard, System Capacity( al) Thermal Efficiency R-Value[ Type' ru 1. Indicate Tvpe.(Slorage Gas. Heat Pump. Instantaneous, etc.) 2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§/50(n). The Prescriptive requirements do not allow the installation of a recirculating water heating system for single dwelling units. 3. The external water heating tank and pipes shall be insulated to meet the requirements of$150(1). SPECIAL FEATU RES The enforcement agency should pory special attention to the Special Features specified in this checklist below. These items may require written justification and documentation andspecial verification. NEW.ROOF ASSEMBLY-Radiant Barrier The radian[barrier requirement of§15 1(02 does not apply to roof alterations. Slab Edge(Perimeter) Insulation ❑ YES ❑NO YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required. Heated Slab Insulation ❑ YES ❑ NO YES:Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 118-A of the standards. Raised Slab Insulation ❑ YES ❑ NO YES: In Climate Zones I.2, 11, 13, 14& 16, R-8 insulation is required; in Climate Zones 12& 15, R-4 is required under component Package D. Thermal nNass To obtain Compliance Credit for the installation ofthermal 1{ J4yCer}n.7+o A r t�Q Q Registration Number: Registration Date?ime: HERS Provider: 2008 Residential Compliance Forms August 200 GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTI1 N'O11' (�4�.0/8�)C7'U7�7-'I3�221�8/• FAX(4N08)�777-33I33 • 5uildineInA•cPvNucI'tertino.�ora M IJ E ci EE� AX, C-ANICAL rCAL E^MISCELLAYEOUS PROJECT ADOR:SSOS0-7,;� OWNER NAME PHONE mo ofUE-MAC. FAX CONTACT NAME I PHONE C I EMAl STR.EET ADDRESS CRY.STATE g I FAX Cl OWNER ❑ OWNER-aUILOEA ❑ OWNER AGENT —4X-CONTRACTOR ❑CONTRACTOR AGE.Yr ❑ ARCH 7ZCT Cl ENCNEER ❑ DEVELOPER ❑TENANr CONTRACTOR NAME (yin ,^^^ e I LJCEN ( I P' I r„F€tuS Eap r�Jf�I Bus.LICi COMPANY NAI-AE (r��-1 1• I1v1 E V!-� Uv�. �..`-�Aj �IIIr•"�"I' P� 'Z�i1 .7JJ:Y1' STREET rry s �I Vr� .'# ( I C �tE. . Z. PHONE ARCHREC T/EN(JDIEEA NA,vd: LICENSE NIJhOER `/• I BUS.L:C 4 CON(PANY NA.I(E E-NLty I -AX . STREET ADDRESS I CRY.STATE ATE,IIP I PRONE USE OF ( C]XFD or Duplex Njuld-Ftumi ly PROJECT INWRCI DLAND PROJECT STRUCTURE: ❑ Commercial URBAN LNTERFACE AREA ❑ Yes ND I FLOOD ZONE Cl Yes ❑ No OFSCROM, ON OF WORK �e C maw n� I u (7k TOTAL VALUATION: xi U`fW��. V V J(� Eli L U By my sigramre below.I ceri:y to each of the following: I am the property owner or authorized agent to act on the prupery owner's behalf. I have read this application and Lha information I ha a vided is corecL ( ve mad the Description of Work and verify it is accurate. I agree to comply with all applicable local ardinancee and sate laws mladhg t u ing co,,Zuc cn. authorize repruentaives of Cupertino to enter the above= endH property far inspecdun purposes. Signature of ApplicandAgenC Date: I2 SUPPLE'N NT INFORMA N MEPiWuc3pp_2011.doc revised 03/16/11