12040057 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10267 VISTA KNOLL BLVD CONTRACTOR:ABC COOLING&HEATING PERMIT NO: 12040057
OWNER'S NAME: AVERY&KAY CHING 31845 HAYMAN ST DATE ISSUED:041112012
OWNER'S PHONE: 8474454880 HAYWARD,CA 94544 PHONE NO:(510)471-8181
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
r r
License Class L G L2.C7 Lic.k 343Z�Q 3 r
MECH RESIDENTIAL COMMERCIAL
Contractor Asc �IIA Date . �f, /�..i I2
1 hereby affirm that I am licenseld under the provisions of Chapter JOB DESCRIPTION:REMOVE&REPLACE FURNACE
(commencing with Section 7000)of Division 3 of the Business&Professions SEE NOTES
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
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 Sq.Ft Floor Area: Valualion:513750
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:32613127.00 Occupancy Type
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above information is
correct.I agree to comply with all city and county ordinances and stole laws relating
to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this pemtil Additionally,the applicant islands and will comply
with all non-point source regulations per the ertino Municipal Code,Section /
9.18. Issued by:9Date:
Signatu Date 4 I f
❑ F.R-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any rooting material being installed If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant Dale:
Business&Professions Code)
I,as owner of the properly,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code), ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penally of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE:
I have and will maintain a Certificate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the labor Code.for the California Health&Safely Code,Sections 25505,25533,and 25534. 1 will maintain
perfurinance of the work for which this permit is issued. compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(1)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued contaminants as defined by the Bay Area Air Quality Management District 1 will
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
Compensation laws of Caiil'omia. If,a0cr making this certificate of exemption,1 Owner or a agent: y- II / Q_become subject m the Worker's Compensation provisions of the Labor Code,I must Dale:
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING Af.F.NC.\'
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec 3097,Civ C.)
correct 1 agree to comply with all city and county ordinances and slate laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulatims per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
(N ORCEMENT AGENCY
CAN CUSTOMIZE,WITH LETTERHEAD%SF,�AL),
2008 Building Energy Efficiency Standards Residential HVAC Alterations
Climate Zones 1 and 3 through 7
BUSINESS AND PROFESSIONS CODE,SECTION 7110
Willful or deliberate disregard and violation of the building laws,including the California Building Code,and
local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board
working in conjunction with the local building department. This action may consist of fines up to$5,000 per
violation or suspension/revocation of a contractor's license.
WHEN IS A PERMIT REOUfRED?
A written construction permit shall be obtained from the enforcement agency prior to the erection,construction,
reconstruction,installation,relocation,or alteration of any mechanical system,except as permitted in Appendix
Chapter 1,Section 112.2 of the 2007 California Mechanical Code. Projects requiring permits include,but are not
limited to:
• New14VAC installation
• HVAC Changeout
• Replacement of furnace,coil,FAU,or condenser
• Relocation of an existing HVAC unit
• Adding or replacing more than 40ft ducting in unconditioned space
2008 BUILDING ENERGY EFFICIENCY STANDARDS(Title 24,Part 6)REOUIREMENTS INCLUDE:
1. Heating equipment must have a minimum 78%AFUE(Exception: Wall&floor f imaces;room heaters).
2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2.
se
4. A setback type thermostat(24 hr clock wi[h'four,setpoints)is required for all alterations.
5. New or replacement ducts must meet the mandaatory requirements of Section 150(m):
• Alljoints and openings in the in the HVAC system must be sealed.
• Only UL 181,UL 181A,or UL 181B approved tapes or mastic shall be used to seal duct openings.
• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts
must be connected using a metal sleeve/coupling.
• Flex ducts that are suspended must be supported every 4ft.max for horizontal runs with no more than 2"
of sag between supports and 6 ft.max for vertical runs.
6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect
this form and verify that the model numbers are the same as the installed equipment.
CITY OF CUPERTINO
7 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 32613127.00
DATE ISSUED. . . . . . . : 04/11/2012
RECEIPT #. . . . . . . . . : BS000016512
REFERENCE ID # . . . : 12040057
SITE ADDRESS . . . . . : 10267 VISTA KNOLL BLVD
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : AVERY & KAY CHING
ADDRESS . . . . . . . . . . : 10267 VISTA KNOLL BLVD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : PERMIT SERVICES INC
CONTRACTOR . . . . . . . : GERALD UNRUH LIC # 24643
COMPANY . . . . . . . . . . : ABC COOLING & HEATING
ADDRESS . . . . . . . . . . : 31845 HAYMAN ST
CITY/STATE/ZIP . . . : HAYWARD, CA 94544
TELEPHONE . . . . . . . . : (510) 471-8181
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
lADMIN HOURS 1 .00 41.00 0 .00 41 . 00 0. 00
1BCBSC VALUATION 13, 750 .00 1.00 0 .00 1.00 0.00
1BREMAIRHA NO.UNITS 1 .00 65.00 0.00 65.00 0 .00
1BSEISMICR VALUATION 13, 750 .00 1 .38 0 . 00 1.38 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 326 . 38 0. 00 326 . 38 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 445 .38 #43416
---------------
TOTAL RECEIPT 445.38
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10267 vista Knoll Blvd DATE: 04/11/2012 REVIEWED BY: Sean
APN: 326-13-127 BP#: 'VALUATION: 1$13,750
PERMIT TYPE: Mechanical Permit=
ermit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY SFD or Duplex PENTAMATION FURNIAC
USE: PERMIT TYPE:
WORK Re lace furnace and a/c unit in same location. Furnace: 80K BTU 95%AFUE/A/C: 4 Ton 16
SCOPE SEER.
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 1 # $130
A/C Units (<=10K cfm) 113REMAIR 1 # $65
TOTALS: $195.00
Mech. Plan Check 0.0 hrs $0.00 Thumb. flan Chcrk /ilea. Plan Ch,C.k
Mech.Permit Fee: IMPERMIT Plrrmr
h. Pcnrir Pee: tiler.•. Pe"i'r Fre:
Other Mech. Insp. 0.0 hrs $44.00 011ier Plumb Insp. ED 011ier tiler.Insp. ED
.tlerh. Amp. /ia•: l'luorh. heap. Fee. Elec. ln.sp. Fuer
NOTE: This estimate does not include fees due to other Departments(Le. Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelimina information avaliable and are only an estimate Contact the De t or addh7 info.
FEE ITEMS (Fee Resolution 11-053 Fff 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Chuck Feu:
.Supp/. PC Fee
PME Plan Check: $0.00
Premie Fec:
Supp/. hisp Fee
PME Unit Fee: $195.00
PME Permit Fee: $44.00
Consnvclion Tt Is.
Administrative Fee: IADMIN $41.00
Work Without Permit? O Yes 0 No $0.00
Advmrced I'lunning Fecs:
Travel Documentation Fee: ITRAVDOC $44.00 A
Strone Motion Fee: IBSEISMICR $1.38 Select an Administrative Item
131 dg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: 1 $326.38 $0.00 TOTAL FEE: $326.38
Revised: 04/01/2012
12,c) >
GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 950143255 M I A
CUPERTINO (408)777-3228•FAX(408)777-3333• buildinmai)cuoettino.orD (v_
❑PLUMBING MECCHA TCAL (�j� ELECTRICAL ❑?,GsaTLANFOUS
PROLECT ADDRESS,t10z67 011`5�4 i—f,)01 ! /lip A? 9 32-6 � 13 /Z7
OWNER NAME ^ JA2 I �H I I PND 47' Lf 5. 4 110
E'MArL
STRFETADDAES4l'1 2( 7 J1 -T,+ N� IU// '�iID �YCUIPhffi 1,J0 �A 9 5D/� FAX
CONTACT NAME ,^A 'O GI! /M •�V / PHONE E-,MAM
1"1 C Com_/ io �f7/ �I I
TMEECADDRES9 3/ q57, CTTY*AT$ FAX
❑ OWNER ❑ owm-BCmmmt . ❑ OWNERAGENr Y(mNERACtOR ❑CONTRACIORAGENT ❑ ARCRDE.T 0ENGDt6R ❑ oEYFIJ)PER ❑TFNAM
CONIRACTORNAME LICENSE NUMBFR�ry�Z 3J LICENSE TYPE BUS.LICA /� /�7
INCOMPANY
C<,Y7L�.J h^77 t-h'I r,v ME E ZZSS ....JJ 'S F 47/' 2'3 6 `f
STREET AODRSS4 C[fY,SrAT'�ffi PHONE
�F J-�-A-YwtA.J S'7• L✓/I 7 eA 4 5`L 5,o 47
ARCHn cCT/FNr1NEER NAME LICENSE NUMBER BUS.LIC 0
COMPANY NAME' E-MAIL FAX
STREETADDRFSS CM.STAM ZIP PHONE
USE OF ❑SFDor DUPLEX [3 MULTI-PAMo_Y PR[17FLTIN WRDLWO ❑ YE4 Fftc%=w ❑YES LSTHEBLDGAN ❑YES
BUDJOING: 0CDA4.mumkL URBAN INTERFACE AREA pN0 Ff.00D ZONE 0 N ER]BERHOMET 0 N
DESCRIPRON OF WORK
rwj hr—E : D -37V
TOTAL VALUATION: I 5O RECErm)BY:
By my signature below,I certify m each of the following. I am the property owner or anthotiad agent to act on the property owner's behalf I have read this
application and the indotmatioo I have provided is rmrect j have read the Desmiption of Work and verify it is accurate. I agree m comply wide all applicable local
erdmaoces and a=laws relating m building construction. .1 authorize representatives of Cupertino to cater the above•ideaGfied property for inspection pu@oses.
Signature ofAppticant/Agent Dam: -z—
=AL
SUPT AL 21FORNI ON REQUIRED OPTICS Use ONLY
r OYER•THY-COUNTEt
e,
❑ EXPRESS
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❑ STANDARD
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3 ❑ LARGE
❑
MAJOR
MEPA&cApp_2011.doc revised 06121111