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12080223 y�yt, CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS-.,1 'POPLAR GROVE SQ CO,\'IRACI'ORi PERMITNO: 12080223 OWN ER'SNAM E: / / _ C.!i(].Cw. ) A�. V I e Iff�Cs DATE ISSUED:08(212012 Ma )n�_7_.I/ OWNER'S PUONE: 4084317829 PDONE NO: ❑ LICENSED CON17tACfOR'S DECLARATION BUILDING PERMIT INFO: BLDG (- ELECT r PLUMB r License ClassLie.N /�L d.o !/ �133�,5 D1ECI1 r RESIDENTIAL(- COMMERCIALr Contractm-13 flh �SoS/4� i if w Date hereby affirm that I am licensed ander the pro%is�iofns�oflCha pier 9 .JOB DESCRIPTION: INSTALLATION 01:A/C wrrii ZONE SYS]IN (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury ane of the following tiro declarations: I have and mill 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 mill maintain\Vorker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:54745 Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. \I'N Number::!' _. Ocegm:mryType: AI'1'I,IC\N'I'CIiR'I'IFIC 'I'ION 2 , 3.023r�v 1 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,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 expanses which may aceme against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. graining of this permit. Additionally,the applic:utt understands mid will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued bv:���%l/� Date: Signature Date ❑ OWNER-BUILDER DECLARATION RF:ROOFS: All roofs shall be inspected prior to Imy roofing material being installed.If a roof is I hereby affirm am than I m exempt from thLaw for Contractor's License Lafur one of installed without first obtaining an inspection,1 agree to remove all new materials for the following two reasons: inspection. 1,as owner of property,or my employees with mages as their sole compensation, will do the work,mid the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business R Professions Code). ,\ht.ROOT COVEItINGS'I'O Bpi CLASS",\"OR I3P�I'I'EK I hereby affirm under penalty of perjury one of the fullowing three dcclarttions: HAZARDOUS MATERIALS DISCLOSURE I have and will maintain a Cenilicate 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&Safety Code.Sections 25505,25533,and 25534. I mill nmintain performance of the work for which this permit is issued, compliance with the Cupertino Municipal Code,Chapter 9.12 and the I Iealth S I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code.Section'"5532(a)should 1 store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air contaminants as defined M'the Ba'Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Jlunicipal Code.Chapter 9.12 and the I certify than in the performance of One work for which this permit is issued,I shall Ilealth S 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 California. If,after making this certificate ofexemption.l O ter ar autht cd dent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: fonhwith comply with such provisions or this permit shall be deemed revoked. CONST RO(E-1'ION LENDING AGENCY A PPI.ICANr CF.RTI FIC TION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application mid state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances mid state Imes 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 indernify 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 ,\RCII I'I'ISCI"S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 1 understand my plans shall be used ms public records. 9.18. Licensed Professional Signature Datc CITY OF CUPERTINO 7i2g94E ESTIMATOR - BUILDING DIVISION ADDRESS: 2286 Polar Grove Square DATE: 08/21/2012 REVIEWED BY: Sean APN: 342-33-019 BP#: 'VALUATION: *PERMIT TYPE: Mechanical Permit PLAN CIIECK TYPE: Alteration /Addition / Repair PRIMARY Buildina is PENTAMATION Multi-Family Dwelling' FURN/AC USE: >3 Stories (� Yes (j) No PERMITTI'PE: A WORK Installation of A/C with zones stem. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=1 OK cfm) iBREMAIR 1 It $67 TOTALS: $67.00 Mech. Plan Check 0.0 1 hrs $0.00 Plrsnrb.Plun Check Flee.Plan Check Mech. Permit Fee: I MPERAI/T Plumb.Permit Fec: rle:. Permit Fee: Other M 0.0 hrs ech. lnsp. $45.00 Other Plumb insp. OtherElce.Insp. El ,Mech.hap.Fee. Plumb.Insp.Fee: Elec.Irrsp.Fee: NOTE': Tris estimate floes not include fees due to other Departments(i.e. Planning, Pab/ic Works, Fire,Sanitary Server District,School District.etc.). These ees are based air the prelitninan information available and are wilt,an estimate. Contact the Dept for addn'I info. FEE ITEMS (Fee IZesohition ll-053 EO' 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee PME Plan Check: $0.00 Permit Fee: Suppl. Insp Fee PME Unit Fee: $67.00 PME Permit Fee: $45.00 Consltvction Tax: T 7- Administrative Fee: 1.IDMIN $42.00 Work Without Permit? O Yes 0 No $0.00 Advanced Planning Fees: Travel Documentation Fee: ITRA PDOC $45.00 Stronta Motion Fee: IBSEISAIICR $0.50 Select an Administrative Item I3lde Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $200.501 $0.001 TOTAL FEE: 1 $200.50 Revised: 07/01/2012 � 2 � � o7iZ3 GENERAL PERMIT APPLICATION MEP COMMUNITY DEIIELOPMEN T DEPART,IENT• BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 950143255 GUPERTINO ® /.� (408)777-3228mI8 • FAX(408)T-3333 • Suilding0ruoerino.ore v` O--11 PLUMBING NIECF:AMICAL ❑E ECIRIf-7 CP.L L "usca-LANECIUS PROi ADDRESS ! .AFN a rave, SAS&g I G/ OWNER NAME 27 MA hiss V1 t I PNONE4' l I E-MAII- v sTR ADD' f 7(D O L4_r 6ttwoi 50 pr I c:�r�r,A'•� FAX _ L �i►10 LA CONTACT NAME I "h 1 - ^I�� r' ..( � l I PHO i, - ` - I fro Y� I ❑owNm ❑ ow a-Bc,:�EF ❑ 0wrr_a ACIv7 MTRACTOR ❑CONrRACDR AGENT ❑ ARcw-r, ❑aG=- ❑ Devn.ora AN, 3li5.LIC q CONTRAC�'OR NAME I .. I C''�'S'c TYPE iqh LICLI (, I COMPA.N:NAME L_! / c MAB.h r:., I, 1.• 1 .r FAX i Pool rt, I V • >Z. 1 -kin TT A�DL&A PU 1(o LL I TATE G U 7y*,,&g L L •' z AactnnrreNcz` NAME n uc=wsNutm=R I Bus.ucn COMPANY NAME' I E-MAIL. FAX STREET ADDRESS CITY,STATE,Z3 PHONE USE OF ❑SFO m DOPLEX %M -FA Y I PROJECT W wy,UND '�&YS PROJEC"N ❑YES 3 The BLDG AN ❑ YS SV NG: [3 COM CIAL URi9ANW FACEARFA ❑�NO I FLOOD ZONE `1f NO I aonm HOME! NO DESCF1PTIONOFWOR.0 MAAI Za nQ S V 1 TOTAL VALUATION: S, �Q I RECEIVED SY: 3y my signa.:.r_bciod•,II c^'yto each of the following: I am;he p�pe;y owoe. or avhorud zgen;;D ac:on;hep----pJJJe-y ewoe.'s`bc!:alf I F.ave read;his aoplieadon and LSe informatlor.I have provided is cortncL I have mad the Descipdon of Work and verify is is accurte. I agree,p comply with all applicable local erdinancs and smte laws.Mlating• uilding poruauczi II auz;ho zz mpresearadves of Cupery.c::enx.%e above-identified pre�.1 for insnecdon pu�oses. Signatu.-e ofApplirar tAgenc m /"lL(Y�UI Da:z: SUPPLENENTAL INFORMATION REQUIRED OFFICE USE ONLY „ OVER-THE-COUNTER ' ❑ EXPRESS u ❑ STANDARD u 5 1:1 LARGE ❑ NWOR AEPMua4pp_1011.doc revised 06111111 s Cir-MD COMMUNITY MANAGEMENT SERVICES, INCORPORATED 5i1�I August 6. 2012 btahesh Vittal Vive2anandhan Radhika Palani y 22826 Poplar Grove Square Cupertino. CA 95014 Re: DcAnza Oaks hlomeowncrs Association (Lot #54 Dear Owner: The Architectural Committee has approved your application I'or installing a new air conditioning condenser per the information in the attached application. with the following stipulations: 1. Please obtain all necessary building permits from the city of Cupertino. 2. Please make sure all electrical and plumbing conduits running on the exterior of your unit be painted to match the surfaces on which they are mounted. For paint colors. please contact Flores Paint i n,at 408-942-1177. 3. Please contact Architectural Committee member Louis Kim prior to the completion of the work as the committee would like to inspect the work prior to completion. He can be reached at 366- 3367. If I can be of any further assistance, please contact Sii cerely. ClImmunity lanamement Services. Inc. Bil,.,Iit�.A iation Manager DeAn ai Oaks Homeowners Association BI I/st Enclosure cc: Board of Directors 193Wry Creek Road. Suite 203 ^ Camobell CA = 95008-3631 ^ voice (408) 559-1977 = fax (408) 559-1970 h ti' Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 r' Site Addr n Enfomerrem Agenq: Dae: Permit 0: t�UPi Conditioned Duct insulation E men[T I List Mbumum Efficiencv r Floor Area requirement Thermostat Packaged Unit Over 40 R of duce Q Furnace E)AFIJE ®COP_ ❑Setback Served by system added or replaced in ®CoIndn odensing Unit ©SEERr Coil _ ©EER RuPistana TLsf tmcanditiooed space � "a im�all��eadypresenr,muss be Other ❑R 6 (CZ 1,3-3) /. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-I R-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies: 13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • 1 certify that this Certificate of Compliance documentation is accurate and complete. • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the design identified on this Certificate of Compliance contest to the requirements of Title 24,Pans I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application. ' Name: r' Signattuc: CompanyJC G I I J n Datc: [a Address: I /' ,[l /, ^ t License(:) / l T City/Stme/Lip: 5 1 Phone: G ' q_67 1 2008 Residervial Compliance Fornrs.doc revised 04110112 f� � o � Qa r-6 =-- I i; { e NN 4 INN t ' e ou:. Cl�