12100177 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: 7802 FESTIVAL DR CON"IRACI'OR:AAA FURNACE k AIR PERMIT NO: 12100177
CONDITIONING
OWNER'S NAME: TAI EDMUND TRUSTEE 6 ET AL 1712 STONE AVE DATE ISSUED: 101242012
OWNER'S PHONE: 4085640732 SAN.IOSE.CA 95125 PRONENO:(108)293-717
❑ LICENSE.[)CONTRAC7FOR'S DFCLARATION BUILDING PERMIT INFO: BLDG r ELECT 0 PLUMB ED
License Class C go- Lic.q 7O3V//
_� DIECFI r RESIDENTIAL r COMMERCIAL _J
[n�(n�/n�
Contractor/Y2 �(.d Com. Dale `�
hereby affirm that I am licensed under the provisions of Chapter 9 .JOB DESCRIPTION: REMOVE AND REPLACE WATER IIFATER
(commencing with Section 7000)of Division 3 of the Business S Professions
Cade and that my license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
1 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. Sy.Pt Floor Area: Valuation:$1557
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the perfomiance of the work for which this
permit is issued. APN Number:36217054.00 Occupancy'fypc:
Arr1.1c\N'T•c1:1rr1F1crrloN
I certify that I have read this application and state that the above infommtion is
correct.l agree to comply with all city and county ordinances and 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 for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which inn),accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply �
with all non-point source regulatims per the Cupertino Municipal Code,Section Issued by: /ter/r' !� Date:�G-97"//x-
9.18.
Signature
RE-ROOFS:
❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material beitg 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 from the Contractor's License Law for one of inspection.
the following two reasons:
1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date:
will do the work,and the smacture is not intended or offered for sale(Sec7044,
Business R Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to ALI,ROOF COVERINGS TO IIF CLASS"A"OR BETTER
construct the project(See.7044,Business R Professions Code).
hereby affrto under penalty of perjury one of the following three IIAZARDOUS DL\TFRIAI S DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
1 have and will maintain a Certificate of Consent to self-insure for Worker's California Ilealth S 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 Ilealth S
performance of the work for which this permit is issued Safety Code,Section 25532(x)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should 1 use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bnr Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and The
Health 3 Sudety Code.Sections 25505.25533,and_5534.
1 certify that in the performance of die work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's Own r or authorizent:.
Compensation laws ofCalifomia. If,after making this certificate of exemption,I t / Date: /�C�=/s
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked CONSIRIICI-ION LENDING AGENCY
I hereby affirm thin there is a construction lending agency for the performance of work's
APPLICANT CERTIFICATION for which this permit is issued(See.3097,Civ C.)
I certify that Ihave read This application mad state that the above information is Lender's Name
correct.I agree to comply with all city and county ordinances and slate laws relating
to building construction,and hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(Nle)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ,\RCIII'I'GCI"S DECLARATIONcosts,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-poim source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
GENERAL PERMIT APPLICATION
. Z P
J
. COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 MIS C
(408)777-3228 • FAX(408) 777-3333 • building cn.cuoertino.org
CUREFITI?q� PLUMBING ❑NEECHACnCAL [-]ELECTRICAL El MISCELLANEOUS
PROTECT ADDRESS' /VOZ �WbVA Iy 1/I 1 Yom/ I APN 9 1 -7— O J
owNE"NA.'.ffi /yMuYld Tai I PHONE 0.5104. LM EMA._
STAEETADDREss 1 j)Z (�O Jj.� Y n`_p CM.STAiE.IIP ,J I L
FAX
CONTACT NAME 6a 'I�G.•1�U/ PHONE ' ' 1 -1 E-MAM
J 1 W 4W-ZC117'LI'11 1
STREL7 ADDRESS ( yc rr.sTAre �SUYI C+) .�ti F~s�{`j�j-2�o1 �S
• Cl OW.NEA 0 O"EA.BMLDER 0 OWNER AGENT 0-+ C/ON C"TOR ❑CON ACTORAGEM Cl AACNRECr ❑ ENOMEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME ;tIIN^ 1�A,^ 1 j LWENLICENSE E BUS.UCJ
COMPANY NAME 1fi {,Ma C-el E-MAIL
1 1A1 t t ��/� �,��r FAx -2 •W^34
STREET ADDRESS I•�i2 s�AK � I CITY.S*fa� !'o. l/T� -IJ+%U P --Z •7j-41n
ARCHIT C'TANGiNEEA NAME LICENSE NTAIDER YV BUS,LILY
COMEANY NAE.MAB. FAX
ME
STREET ADDRESS I CTY,STATE,ZIP
PHONE
USE OF X'SFD or Duplcx 0 Multi-Family PROJECT N WILDLA.W PROJECT N
STRUCTURE: 0 Commercial URBAN!NTERFACE AREA 0 Yes Cl. No FLOOD ZONE 0 Yes 0 NO
DESCF=ON OF WOU y.DyyS, tkf and 1A^a n
. I CJI I !v A WLC -16 q1Iw yvator vwmicff
TOTAL VALUATION: 1 J J f� 90
1
J J
By my signamm below,I cer ty to ca of�T<f ovn g: !am Lhe property owner or authorized agent to act on the property oW er'e behalf. I have read this
applies tion and Ne intartnadon I e pro ided is co :. '!have reed the Description of Work and verity it in accurate. !agree ro comply with ill applicable lochl
ordinances and state laws relati robui!di g cons 'c on. !authorize representatives of Cupertino m enter the above7�dental d property for inspection purposes.
Signature of ApplicandAgenC I Data: �UIZ3j12
SUPPLENfEMt INFORMATION REQUaED
ba. c
_ a
c.
MEPhfucApp_201 Ldoc revised 03116111
Prescriptive Certificate of Cum liance: Residential CF-IR-ALT
.a
(Page Residential Alterations Stories
of�)
Climate Zone #of St
Project Name:
#
HVAC SYSTEAIS - HEATING
Minimum Duct or Piping .Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split,
Type
and Capacity,
a aci '''-') (AFUE or HSPF) Type andLocation' R-Value Type Space,Package or H dronic
I.Indicate Hensing Tvpe(Central Furnace. Wall Furnace. Heat pump, Boiler..Electric Resistance, etc.)
3.Electric resistance heating is allowed only in Component Package C. or except where electric hearing is supplemental(i.e:, if rota/capaciry
• - < 2 KW at-7.000 Btu/hr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See§151(6)3 exception.
3.Refer to.the HERS Veriitication section on Page 4 of the CF-I R-ALT Form/br additional requirements and check applicable boxes.
4. Indicate Type or Location(Ducts. Hvdronic in Floor, Radiators..etc.)
HVAC SYSTEMS - COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central,Split,
T e and Ca acus ''' COP) T e and Locations R-Value Type Space,Package or H dronic
1. Indicate Cooling Type M/C. Heat pump. Evap. Coaling, etc) -
2. Refer to the HERS Verification section on Page 4 of the CF-1 R-ALT Form for additional requirements and check applicable boxes.
3. Indicate Type or Location (Ducts, H dronic in Floor. Radiators, etc.)
NATER HEATING
List water heaters and boilers for both domestic hot water(DH{V)heaters and hydropic space hearing. Individual dwelling DH W heaters must b
gas or propane fired,and may not exceed 50 gallons. Hat water pipe insulation from the DHIV heater to the kitchen(s)and on all underground
hot water I i es is required in all component packages in all climate zones.
External Tank
• Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
Type' (Standard, Recirctdatin )'- System Capacity( al) Thermal Efficiency R-Values
1
1. Indicate Tvpe(Storage Gas, Hear Pump, Instantaneous. etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§150(n). The Prescriptive requirements do
not allow the installation of a recirculating water hearing system for single dwelling units.
3. The external water heating tank and pipes shall be insulated to meet the re uiretne is of$150(1).
- SPECIAL FEATURES The enforcement agencv should payspecial attention to the Special Features specified in this checklist below.
These items may require written justification and documentation and s ecial verification.
NEW.ROOF ASSENIBLY- Radiant Barrier
The radiant barrier requirement of 151(1)2 does not apply to.roof alterations. _
Slab Edge(Perimeter) Insulation U YES ❑NO
YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required.
Heated Slab Insulation ❑ YES ❑ NO
YES:Slab ed a insulation required ter all heated slabs in all Climate Zones. See details in Table 113-A of the standards.
Raised Slab Insulation O YES ❑ NO
YES:In Climate Zones 1,2, 11, 13, 14& 16,R-S insulation is required; in Climate Zones Q.& 15, R-4 is required under.component Packa a D.
• Thermal Dlass
To obtain Compliance Credit for the installation of thermal mass,use the Performance Aooroach.
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 20,
CITY OF CUPERTINO
-i!po' FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 7802 festival dr. DATE: 10/ 412 0 1 2 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $1,557
*PERMIT TYPE: Plumbing Permit PLAN CIIECK TYPE: Alteration /Addition / Repair
PRIMARYPENTANIATION
USE: SFD or Duplex PER�11TT1'PE: PRWHEATR
WORK remove and replace water heates.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Water Heater 1PRWHEATR 1 # $27
TOTALS: $27.00
Meeh. Plan Check Plumb. Plan Check 0.0 hrs $0.00 li/ec.Plan Check
blech. Permit Pee: Plumb. Permit Fee: IPPERMIT Elec.Permit Fee:
Other'tech. Irivp. Other Plumb Insp. 0.0 hrs $45.00 Other Elce. bap.
ddcch.Insp.Fee: Plumb. beep.Fee: Elec. Insp. Fee:
NOTE. This estimate does not inctudejeev clue to other Departments(i.e. Planing, Puhlic Works, Fire,Sanitary Sewer District,School
District.etc.). These ees are based at floe preliminan information available and are on A•an estimate. Contact the De t or addm'I info.
FEE ITEMS (Fee Resohaion 11-053 Elf. 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
Sappl. PC Fee
PME Plan Check: $0.00
Perinit Fee:
Suppl. Insp Fee
PME Unit Fee: $27.00
PME Permit Fee: $45.00
Consnvction Tar:
Administrative Fee: 1dDblhv $42.00
:Work Without Permit? 0 Yes 0 No $0.00
Advanced Planning Fees:
Travel Documentation Fee: ITRAVDOC $45.00
Strove Motion Fee: IBSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fec: 1BCBSC $1.00
SUBTOTALS: $160.501 $0.001 TOTAL FEE: 1 $160.50
Revised: 10/01/2012
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
-CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: Z `eIU / PERMIT#
OWNEWS,NAME: t'4UAd _ Z PHONE # ' "I 7/
GENERAL CONTRACTOR: AQj BUSINESS LICENSE # 76 71
ADDRESS: /7/2 r w, CITY/ZIPCODE: -5m.
*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: in
Sig i ure Date
Please check applicable subcontr. ctors and complete the formation:
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
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature 'Date