The URL can be used to link to this page

11090102 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 11140 CHADWICK PL CONTRACTOR:ABC COOLING&HEATING PERMIT NO: 11090102 OWNER'S NAME: STEVE&LAURA PETERS 31845 HAYMAN ST DATE ISSUED:09/15/2011 OMINER'S PHONE: 4086745256 HAYWARD,CA 94544 PHONE NO:(510)471-8181 LICENSED CONTRACTOR'S DECLARATION I— F ` h BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C 6 C 20 Lic.# �� 2 375 MECH RESIDENTIAL COMMERCIAL Contractor C LCA 1I Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE FURNACE,ADD A/C UNIT (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:$10675 1 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 permit is issued. APN Number:35617080.00 Occupancy Type: APPLICANT CERTIFICATION 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 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 may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Issue(Lby` i= ~'"` Date: 9.18. Signature,._-�77771�� Date ) S i) RE-ROOFS: NER-BUILDER DECLARATION 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I 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 Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I 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 Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Owner or authorized agent. Compensation laws of California. If,after making this certificate of exemption,I Date: 7 It 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of mrk's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, qts,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION ,ting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. .,h all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 7 ITEMS OF 13 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35617080 . 00 DATE ISSUED. . . . . . . : 09/15/2011 RECEIPT #. . . . . . . . . : BS000014768 REFERENCE ID # 11090102 SITE ADDRESS . . . . . : 11140 CHADWICK PL SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : STEVE & LAURA PETERS ADDRESS . . . . . . . . . . : 11140 CHADWICK PL CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4705 RECEIVED FROM . . . . : PERMIT SERVICES INC CONTRACTOR . . . . . . . : GERALD UNRUH LIC # 24643 COMPANY . . . . . . . . . . : ABC COOLING & HEATING ADDRESS . . . . . . . . . . : 31845 HAYMAN ST CITY/STATE/ZIP . . . : HAYWARD, CA 94544 TELEPHONE . . . . . . . . : (510) 471-8181 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 10, 675 . 00 1. 00 0. 00 1. 00 0. 00 1BREMAIRHA NO.UNITS 1 .00 65 . 00 0. 00 65 . 00 0. 00 1BSEISMICR VALUATION 10, 675 . 00 1. 07 0. 00 1 .07 0 . 00 1MFR=<100 UNITS 1 . 00 130 . 00 0. 00 130 . 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 326 . 07 0. 00 326 .07 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1, 255. 93 #2876 --------------- TOTAL RECEIPT 1, 255. 93 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL I 10(? 01 uZ GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 misc CUPERTINO (408)777-3228•FAX(408)777-3333•building cupertino.org PLUMBING ERMECHANICAL FlELECTRICAL MISCELLANEOUS PROJECT ADDRESS 1 , L O /• �^ ` l �� ApN# I / J OWNER NAME `QE_ C..•' (/ W p"^*'� E-MAIL`/ �E r 0,9 4, STREET ADDRESS CITY, STATE,ZIP FAX I I LlO C"-i-f/ti-)6j 1 Gk" I G-/�6- Gc/T,6,,; %rN Li GA 5 � CONTACT NAME �� A I I c-� PHONEt 2- y2-60 E-MAIL STREET ADDRESS 1' EGL/'E7?T L/�J CIT`-YfS7 Y[/p„ 1� C/� C�ij�� FAX 7,9-3-ID CI ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR PkCONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# Z - C_ E G ZO COMPANY NAME E-MAIL F X AS c N �r,..1 , ,+A43 STREET ADDRESS CITY,STATE,ZIP P ONE �t i'tA " MA,) 5T, 0mz-L> 1qS `a �/O 47) ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF %,SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO FLOOD ZONE ❑ Yes ❑ NO DESCRIPTION OF WORK N zA)n 2 K 3"TU TOTAL VALUATION: / -7 c!_v RECEIVED BY: 1 By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. cription of or andverify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co on. I authorize represen a mo to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTA ATION REQUIRED r+rO^FFICE USE ONLY GI OVER-THE-COUNTER w ❑ EXPRESS m ❑ STANDARD ❑ LARGE a ❑ MAJOR MEPMiscApp_2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 11140 chadwick pl. DATE: 09/15/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $10,675 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: wORK re lace furnace add a/c unit. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $65 Furnace, Forced-Air 1MFR=<100 1 # $130 TOTALS: $195.00 Mech.Plan Check Fo.0 hrs $0.00I T Mech.Permit Fee: 1MPERMIT Other Mech.Insp. 0.0 hrs $44.00 ILI __L_ NOTE. This estimate does not include fees due to other Depts(i.e.Public Works,Sanitary Sewer District,School District,etc.). Theseees are based on the preliminary in ormadon available and are only an estimate. Contact the De t or addh7 info, FEE ITEMS (Fee Rcesohition 11-053 Elf. 711/11) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $195.00 PME Permit Fee: $44.00 Administrative Fee: ]ADMIN $41.00 Work Without Permit? 0 Yes 0 No $0.00 Travel Documentation Fee: ITRA VDOC $44.00 Strong Motion Fee: IBSEISMICR $1.07 Select an Administrative Item 131da Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $326.071 $0.00 TOTAL FEE: $326.07 Revised: 09/02/2011 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 Site Address: Enforcement Agency: Date: Permit#: I I I q CO C-K Pe-A--C- wpoz-i-I,j C) 9/ 1 11 Conditioned Duct insulation E ment T el List Minimum Efficiency, Floor Area requirement Thermostat Packaged Unit ��77 cc��. Furnace ®AFUE/0/o B COP Over 40 ft of ducts Served by system added or replaced in (ffSetback Indoor Coil [�SEER� HSPF- sf t (If not already present,must be Condensing ❑ unconditioned space Unit EER Resistance 13R 6 (CZ 1,3-5) installed) Other 1. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-1 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) • 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: �� Signatur 1N C Company: Date: Al C - -4,j - 71N - f.Jc_ 9' lS ii Address: -5 3 / 95 . 4A-`> � S r 3gz3S�3 City/State/Zip: �.f C A 7e� 4 q Phone:15/0 , 4 7 f 2008 Residential Compliance Forms March 2010 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: i 1 L40 CrtAD )c-1c. („_ PERMIT# it 01A o t D OWNER'S NAME: 5'Tc=P�4e-,J , 7c)Z PHONE # 40q 0`I ' 5'2-!5 6 GENERAL CONTRACTOR: &13C Coo(.j.J #-I�C BUSINESS LICENSE # ADDRESS: 3 j c`s Ah j ST I CITY/ZIPCODE: zp '745 *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. I am not using any subcontractors: W15; /1 ign Date Please check applicable subcontractors an complete the following information: 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 O Contractor Signature Date