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09080013 ; , CITY OF CUPERTIN�� BUILDING PERMIT BUILDING ADDRESS: 1285 ASTER LN �:ONTRACTOR: AAA FURNACE & AIR PERMIT NO: 09080013 c'ONDIT10N1NG OWNER'S NAME: BENNY LAW 712 STONE AVE DATE ISSUED: 08/04/2009 � ER'S PHONE: 4086448899 !�AN JOSE, CA 95125 PHONE NO: (4o8)Z93-4717 ❑ LICENSED CONTRACTOR'S DECLARATION � � � 3UILDING PERMIT INFO: BLDG ELECT PLUMB License Class `-' 7 C� Lic. # ��O b fr� J � � � � , MECH RESIDENTIAL COMMERCIAL Contractor 7�� v1 /�U �� /�� Date �' �'-� �/ [ hereb aftirm that 1 am licensed under the rovisions orCha ter 9 •�OB DESCRIPTION:INSTALL CONDENSER & COIL 220 POWER FROM (commencing with Section 7000) of Division 3 of the Business & Professions 'ANEL TO Code and that my license is in full force and effect. JNIT [ hereby affirm under penalty of perjury one of the following hvo declarations: 1 have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided f'or by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by ;y, Ft Floor Area: Valuation: $4400 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1PN Number: 36611087.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby a thorize representatives of this city to enter pERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned prope o inspection purposes. (We) agree to save indemnify and keep harmless t Cit of Cupertino against liabilities judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs, and expenses which m acc e against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION granting of t' ermit. Ad tio ly, the applicant understands and will comply with all non-poin ource r tions per the Cupertino Municipal Code, Section C' � 9.18• Issued by �� - � '`—'_ Date: Signature Date � — 7 � � ` �� Cj OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspec[ed prior to any roofing material being installed. If a roof is 1 hereby a�rm that I am exempt from the Contractor's License Law for one of installed without first ob[aining an inspection, I agree to remove all new materials for the following two reasons: inspection. l, 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: Date: Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (SecJ044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby a�rm under penalty of perjury one of the following three HAZARDOLIS MATERIALS DISCLOSURE declarations: I have and will maintain a Certiticate of Consent to self-insure for Worker's 1 have read the hazardous materials requirements under Chapter 695 of the Compensation, as provided for by Section 3700 of the Labor Code, for the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain performance 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 2 2(a) should I store or handle hazardous material. Section 3700 of the Labor Code, for the performance of the work for which this Additionally, should us equipment or devices which emit hazardous air contaminants as de ned' by the Bay Area Air Quality Management District 1 will permit is issued. maintain complia ce ith the Cupertino Municipal Code, Chapter 9.12 and the 1 certify that in the performance of [he work for which this permit is issued, I shall & Safety e, Sections 25505, 25533, and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I Ow er o rized agent: �_�� become subject to the Worker's Compensation provisions of the Labor Code, 1 must Date: forthwith comply with such provisions or this permit shall be deemed revoked. C STRUCTION LENDINC AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that 1 have read this application and state that the above information is for which this permit is issued (Sec. 3097, Civ C.) corcect. 1 agree ro comply with all city and county ordinances and state laws relating Lender's Name to building construction, and hereby authorize representatives of this city to enter up�n the above mentioned property for inspection purposes. (We) agree to save Lender's Address ii ify and keep harmless the City of Cupertino against liabilities, judgments, c�_ .�nd expenses which may accrue against said City in consequence of the ARCHITECT'S DECI,ARATION granting of [his permit. Additionally, the applicant understands and will comply - with all non-point source regulations per the Cupertino Municipal Code, Section 1 understand my plans shall be used as public records. 9.18. I.icensed Professional Signature Date ' � . 0�-'��%� ��/� � � CITY O]� CUPERTINO FIJRlJACE/AC CUPEf�TINO PERMIT APP:LICATION FORM APN # h / �' � / <-'�� -� �) Date: � -� � — O `'� �--- t�' Building Address: ) Z 8 S � 5� �r �—U n 2 ��''� � N t� Owner's Name: Phone #: P L �&- �u�l - 88 9 �' Contractor: �� n C� C� t � A C t� c• Phone #: �dg� —� Q� j� �f 7� � Fax #: �'' -� �,3 _ 6 > '7 / Contractor License #: `7 (o �s�'7/ Cupertino Business License #: �� Contact: C� a 2 � ( �. Z e Phone #: Z�a� _� f'� - L/ 7/� 2 Fax#: D,�f -o�`�, _ 6 ?7/ Building Permit Info: Elect [� Plumb ['� Mech �� Residential 0' Commercial ❑ Job Description: / N,5�� y// C' U C%P:�,Se ,�- � C''v �� L Z Zc� �u t,� P r - .�'�c��-►�� `'> n PL � Gt � ' �� • For Residential Installations: Attic ❑ l floor [� 2 floor ❑ Adhere to minimum setback requirement [Y For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ ` Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project:-$�,[�lp�j ,p�, Type of Construction (Usage Class): � �� Strapped ❑ On Platform Bonded New Location Replacement ' Project Size: Express [�Standard ❑ Lar e �] Major ❑ _ Valuation: � /�L��DG Green Building: Please complete relevant portio» of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. �y Revised O 1 /07/09 CITY OF CUPERTINO . FURN�.CE/AC CUPEI�TINO FEE SCI�EDULE Quantity Fee ID Fee Descriptior,. Fee Permit Type Grou AIR FURN/AC CONDITIONING 1 BCAIRHAN Commercial A/C Units <= l Ok CFM B 1 MCRAA Commercial Mec 1 Repair/alt/add M 1BCBSC Cal Bldg Standar�is Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commer:,ial B 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1 PGASRES Residential for ea gas piping system P of 1-4 Outlets 1 BPGAS For each gas pi�►ing system of 5 or P more per outlet. (;omm/Resid 1BREMAIRHAN Residential A/C i�nits <= lOk CFM B / 1 MRRAA Residential Mecr Repair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT � TYPES 1BSEISMICR Seismic Residential B ' 1 EPERMITFEE Electric Permit E ( 1MPERMITFEE Mechanical Pern�it M 1 PPERMITFEE Plumbing Permit P j — 1TRAVDOC Travel Documentation B / 1BUSLIC Business Licensf; B . � - . n oor ir uality an in►s es 1��p.yp� p�� 1 IAQMealth pts y=yes � 2. Use Low VOC, Water-Based Wood Fnishes 2 IAQ/Health pts y=yes � 3. Use LowlNci VOC Adhe�ves 3 IAQ/Health pts y=yes � 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 � 6. Use Exterior Grade Plywood for lnterior Uses 1 IAQ/Health pts y=yes � 7, geal aU F.�OSed P,at#idebpard oc,NDF 4 IAQ/Health. pts y=yes � 8. Use FSC Certified Materials for Interi�r Finish 4 Resource pts y=yes � 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 � , 1 1 1 N. Flooring 1. Select FSC Certified Wood Flooring B Resource pts y=yes � 2. Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes o 3. Use Recycied Content Ceramic Tiles 4 Resource pts y=yes � 4. Install Natural Linoleum in Place of Vinyl 5 IAQ/Heaith pts y=yes � 5. Use Exposed Concrete as Fnished Floor 4 Resource pts y=yes � 6. Install Recycled Content Carpet with Low VOCs 4 Res�urce pts y=yes � , 1 1 ! Total Pomts Availabie: 140 130 57 Total Points Pro'ect Received: � �� - � � -- , �_�--�°, G:data/progs/gr :enbuildngguidelinzs/remodelers/greenpointsfina12.12.04protected.xis _ ' . Community Development � - 'F �� ; 10300 Torre Avenue ��.. , ; �'� �,s. Cupertino CA 95014 Telephone (408) 777-3228 C(TY OF Fax (408) 777-3333 �UPEt�TINO Buildin De artment JOB ADDRESS: � Z�'3 5�'�- 5 }-P r� n e PERMIT # ��, � � 'NO � ��, G� / ��O .� OWNER'S NAME: �� i� r� L a i.J PHONE # �-b� -( � �J - 9 S' GENERAL CONTRACTOR: FAX # I am not using any subcontractors: `�-- ��° 5 _ , Si gna Date Please check a licable subcontractors and com,�lete the followin information: SUBCONTRACTOR BUSIrJESS 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 Tile � Owner/ Contractor Signature Date