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12040160 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10847 N STFLI-ING RD CONTRACTOR:REACO BEATING&AC. PERMIT NO: 12040160 INC OWNER'S NAME: TONY ITONG 16250 RAILROAD AVE DA'Z'E ISSUED:04/272012 OW'NER'S PIIONF,: 4083061747 MORGAN BILL.CA 95037 PHONE.NO:(408)578-6145 ❑ LICENSED CONTRACTOR'S/DECLARATION JOBDESCRIPTION: RESIDENTIAL COMMF.RCIAI. License Class a.Z G Lic.q � r h `1 .X tri REPLACE CONDENSING UNIT, ADD NEW 30 A CIRCUIT WITH Contractor{%v:='2Cri Ir•,,1. rq �CG Date li ^ i 2 DISCONNECT 1 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. 1 hereby affirm under penally 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 whichthis 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 Labor Code,for die performance of the work for which this / .\PN Number:32661003.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I ogre to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,mid hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY M LAST CALLED INSPECTION. indcmnily and keep harmless the City of Cupertino against liabilities.judgments, ,�� / costs,and expenses which may accrue against said City in consequence of the Z granting of this permit. Additionally.the applicant understands and will comply Issued by: Date: with all non-point source regulatiahs per the Cupertino Municipal Code,Section 9.18. /r 9 RE-ROOFS: Signature Dale All roofs shall be inspected prior to any roofing material being installed.If a roof is J/1/ installed without first obtaining an inspection.I agree to remove all new materials for inspection 13OWNER-BUILDERDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date the following two reasons: ALI,ROOF COVERINGS TO BE CLASS"A"OR BITTER I,as owner of property,or my employees with wages as their sole compensation, will do the work,and the stmcturc is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am excluvvely contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE: construct the project(Sec.7044,1usiness&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534, 1 will I hereby affirm under penally of perjury one of the following three maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and the declarations: Health&Saferyy Code,Section 25532(x)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to sclf-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Qualify Nlanagemenl District 1 performance oftbc work for wihich1his permit is issued, will maintain compliance with the Cupertino Municipal Code.Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the I Iealth&Safety Code.Sections 25505.25533,and 25534. Section 3700 of the Labor Code,for tie performance of the work for which this —}' P Owner or authorized agent:��/.^ �i��/�+-- Date:(LC( r27� permit is issued I cenif} that in the performance of the work for which this permit is issued,I shall not employ any person nany manner so as to become subject to the Worker's ° Compensation Imus of Cali lornih, 11;after making this certificate of exemption,I CONSTRUCTION LENDING AGF.NCI' become subject to die Worker's Compensation provisions of the labor Code,I must I hereby affirm that there is a construction lending agency for the perlbmmmhce of fortlwvith comply with such provisions or this permit shall be deemed revoked, w'ork's for which this permit is issued(Sec.3097,Civ CJ Lender's Name APPLICANT CERTIFICATION - Lender's Address I 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 to building construction,mid hereby authorize representatives of city to enter upon the above mentioned property for inspection purposes.(We)agree to save ,\RC.I I ITF.f."f'S DECLARATION and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. grinning of this permit Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Dale Simplified Prescriptive Ce`rtLeete of Compliance:2008 Residential HVACAIterafions CF-IR-ALT-HVAC Cfunate Zones 1 and 3-7 she � Enforce era Agatcy: Date Permit p: 16 11 (Q • +&—ll 1 .. V Me ( q ; , 0147d,-711A Conditioned Duct insulation Equiroment Type' List M"mioiitm Efficiency' Floor Amo requirement Thermostat Paadraaged Unit ,ce 0 AFuE COP y�. Over 40 It of ducts Ij indoor Coil SEER ®HSPF_ ' /�� /�system added"replaced 01 ❑Setback Condensingoil Unit BEER— B Resistance +1-�-�z sf unconditioned space Installed) °�'pre'fO1t'mud be ©R 6 (Cl 1,3-3) Omer 1.Equipment Type:Choose the equipment being installed;if mote than one system,use another CF-I R-ALT•HVAC fm each system. 2.M rilmum Equipment Efficiencies: 13 SEER,78%AFUF,7.7FISPF for typical residential systems. Contractor(Documentation Antbor's/Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • I an eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I citify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requimmeuts of Title 24,Parts 1 and 6 of the California Code of Regulations. • The design(canoes identified on this Certificate of Compliance am ea sistcat with the infomstion documented on other applicable compliance foams,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the perrait implication. Name: r loon kn C2 Sigtianoe: CompDate: C' e C c- OL1 7/I Address: mi6a,4( e . License: -716 11S 4 Ciry/State/Zip: Motqgrik,jl .'C Phone: t10 ^ c) 29— I 1008 Residential Compliance Forms.doc revised 04110112 CITY OF CUPERTINO 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32661003 . 00 DATE ISSUED. . . . . . . : 04/27/2012 RECEIPT #. . . . . . . . . : BS000016645 REFERENCE ID # . . . : .12040160 SITE ADDRESS . . . . : 10847 N STELLING RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : TONY HONG ADDRESS . . . . . . . . . . : 10847 N 'STELLING RD. CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : REACO HEATING CONTRACTOR . . . . . . . : STEVE REA LIC # 24293 COMPANY . . . . . . . . . . : REACO HEATING & AC, INC ADDRESS . . . . . . . . . . : 16250 RAILROAD AVE CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE . . . . . . . . : (408) 578-6145 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 1BREMAIRHA NO.UNITS 1 .00 65. 00 0. 00 65.00 0. 00 1BREMRECEP NO. OUTLETS 1 . 00 44 . 00 0 . 00 44 . 00 0. 00 1BSEISMICR VALUATION 2, 800. 00 0. 50 0 .00 0. 50 0. 00 1EPERMITFE FLAT RATE 1 . 00 44 . 00 0 .00 44 . 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 283 .50 0. 00 283 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ------------ ----- --------------- -------------------- CREDIT CARD 283 . 50 VISA --------------- TOTAL RECEIPT 283 .50 GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 M I sc CUPERTINO (408)777-3228•FAX(408)777-3333•buildinaCcDcuoertino.org PLUMBING OMECHANICAL^ ELECTRI CAL NIISCELLANEO PROTECT ADDRESS APN aJ OWNERNAhE PHON /aCDG � E-MAIL� - /7T STREETADDRESS CITY. STATE.ZIP USh CONTACT NAMEPHONE E-MAIL ,�S(TREET ADDRESS CITY,STATE. ZIP FAX IOOWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT 11 ARCHITECT ❑ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME � e n- J LICENSE NUMBER LICENSEJ� EBUS.LIC as ya�J3 COMPANY NAME ae� /�_ i, /1 /� E-MAIL�, Greco. Lrr"LPA 'AN ,/ r-9 STREETADDRESS// � ,n-r yad Azle CITY,STATE.ZIP ,,,/ A ,// /n � Z37 PHONEyryojc_S,d7j1 ys ARCHITECT/ENGINEER NAME LICENSE NUMBER ��/� �, Ley J BUS.LICA COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE.ZIP PHONE USE OF [I SM.,DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECTIN [I Nis IS THE BLDG AN 0 1"Es BUILDING: [3COMMERCIAL URBAN INTERFACE AREA NO FLOOD ZONE ❑NO EICHLER HOME? ❑ 60 DESCRIPTION OF WORK sic a7, 16 65e P 30 morin c t"4 a-.114/7 . Cl/ TOTAL VALUATIO, "RECEIVED BY By my signature below,1 certify to each of the following: I am the property owner or authorized agent to act on the property owners behalf I hate 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 slate laws relaYagau. w 'ze representatives of Cupertino to enter the above-i ntified property for inspection purposes. Signature of Applicant/Agent: Date:-_qIZ SUPPLEMENTAL INFORMATION REQUIRED " oFSICP:usEONLY �.rv. ❑ OVER-THE'-COUNTER . .�•� ..❑ :EXPRESS "-a <Z_1' U ., i 5 ❑ I..WCE �6 F. ❑ MAJOR L llfl'hliscdpp_20I Ldnc revised n6nln I