Loading...
13020130 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10764 MARTINWOOD WAY CONTRACTOR:RESCUE AIR SERVICE PERMIT NO: 13020130 OWNER'S NAME: SHUAIREN LIU 6007 MAJORCA CT DATE ISSUED:02252013 OWNER'S PHONE: 4089739262 SAN JOSE,CA 95120 PHONE NO:(408)655-9916 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL License Class G 20 Lic.N2�02� , REMOVE AND REPLACE FURNACE IN SAME LOCATION Contractor I_! .SL.We— (^: Date I 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. I 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. Sq.Ft Floor Area: Valuation:$0 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36935029.00 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 agree to comply with all city and county ordinances and state laws relating WITHIN0 DAYS OF PERMIT ISSUANCE OR to building construction,.and hereby authorize representatives of this city to enter upon the above mentioned property forinspection purposes. (We)agree to save 180 DAY OM LAST CALLED INSPECTION. 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 Issued by: Date with all non-point source.regulations per the Cupertino Municipal Code,Section - 9.18. - 2�•Z5 ` RE-ROOFS: Signature �o�C�� Date 4� All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, - will do the work,andthestructure isnot intended or offered for sale(See.7044, Business&Professions Code) - I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I 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 penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: - Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-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 Quality Management District I performance of the work for which this 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 Health&Safety Code,Sections 25505,25533,and 25534. _ Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Cir_ Date: permit is issued. 3 I certify that in the performance of the 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a concoction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) . - - 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,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting 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 Date GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION,, )j 3 U 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 I/� lLll II MISC CUPERTINO (408)777-3228•FAX(408)777-3333•buildiniciecuoertino.orO J ❑PLUMBING MECHANICAL IELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS 1 lL- Mw-A O 1 -m a APNq OWNERNAM' ljou �� L ll � PHONE _ ^r E-MAIL(l STREET ADDRESS W%L mllr%1_ft\Woo \ 1„ CITYC-'4 Zip (n i r UD �50�� . FAX CONTACT NAME � me \1P y1 Q '1V HO -0i^`k E-MAIL STREET ADDRESS( QO� �` CA CITY TATE,ZI l� 1^ O FAX El OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT V'CONFRACI'OR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT (ON'I'ItACI'OR NAME Cn LICENSE NUMBL•R �-D / �O ` LICENSE TYPE BUS.LIC9 COMPANY NAME ,\ E-MAIL G--b I FAX STREET ADDRESS (D00-1 00-1 f �� CITY,STATE,ZIP S;CNIl ,1� 2b P D _Cos;Aq,b ARCHITECTIENGINEEER NAME LICENSE NUMBER LV BUS.LIC9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SM.,DUPLEX ❑ MULTI-FAMILY PRnMCTPIWILDLAND ❑ YES PROJECT IN ❑YES ISTHEBLDGAN ❑YES BUILDING. ❑COMMERCIAL URBANBYFERFACEAREA NO FLOOD ZONE ❑NO EICHLERHOME9 ❑NO DESCRIPTION OF WORK K2 �lA( Y\ byC 1-h S SC t� \ C -e�a TOTAL VALUATION: LkLv/n - �- RECEIVED BY. By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on thof ro owner's behalf I have read this application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate. agree to comply with all applicable local ordinances and state laws relating to building�con/s�_ucoon�. I authorize representatives of Cupertino to enter the above-i entified pr'ppierry for inspection purposes. Signature of Applicant/Agent: ZADate: Z4ZLls I > SUPPLEMENTAL INFORMATION REQUIRED OFFICR USEONLY 1 R TBE-COYINTER bYEXPRF''S'S Iq- (ET4NBAR1}, E- ❑�LAROE MAJOR MEPMiscApp_2011.doc revised 06/21111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10764 martinwood way DATE: 02/25/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: $4,100 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: FURN/AC WORK remove and replace furnace in same location SCOPE n N" fid . Mech.Plan Check 0.0 hrs $0.00 Plumb. Plan Check Elec.Plan Check Mech.Permit Feer 1MPERMIT Plumb. Per nit Fag: Elec. Permit Fee:_ Other Mech.Insp. 1 0.0 hrs L $45.00 Other Plumb Insp. - Ovher Elec.Insp. Ej d4ech.Insp.Fee: Plumb. hisp. Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District etc). These.fees are based on there nWdna information available and are only an estimate Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 E8' 7/1112) FEE QTY/FEE MISC ITEMS Plan Check Feer $0.00 = # Mechanical Supp1. PC Fee: Q Reg. .Q OT0.0 hrs $0.00 $133.00 1MFR=<100 I Fumace,Forced-Air PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp. Fee.e Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 Construction Tax: Administrative Fee: IADMIN $42.00 Q Work Without Permit? O Yes O No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential Travel Documentation Fee:. ITRA VDOC $45.00 Building or Structure O . Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bide,'StdsCommission.Fee: IBCBSC $1.00 $133.50 $133.00 i ,'', 1 T,OLFEEf $266.50 Revised: 01/01/2013 Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 SiteAddress: Q•--1p ,EnforcemenfAgency- d Dal Permit#. Z��/l3 Conditioned Duct insulation Equipment Type] List Minimum Efficiency2Floor Area requirement Thermostat wumaged Unit 0 AFUEA%qo COP_ Over 40 ft of ducts Setback um ace Coil ®SEER ®HSPFCondensing Unit ®EER � ®Resistance Served by system added or replaced in not Brea,7j( sf unco ditioned space (11 dypresent,must be _ ©Other �� 6 (CZ 7,3-5) installed) 1.Equipment Type:Choose the equipment being installed;ifmore than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies:13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Aesponsible Designer's Declaration Statement) . • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 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: —7 rnSignature: Company:J Date: 1. .\ cz�c-we Rcc �ecV� Address: P_ U�, a1 Or l� ` ' License: 'Z('0 Citylltatellip: We\ ( Com- S ,Z b Phone: 2008 Residential Compliance Forms March 2010