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11080168 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10146 LAMPLIGHTER SQ CONTRACTOR:A&H HEATING PERMIT NO: 11080168 OWNER'S NAME: SELV RAMABATHIRAN 770 CHESTNUT ST DATE ISSUED:08/23/2011 "MINER'S PHONE: 4086741794 SAN JOSE,CA 95110 PHONE NO:(408)279-0722 LICENSED CONTRACTOR'S DECLARATIONr ,, /,f 7 BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class ( Z ,Lic.# 3&c-14472-&�"4 l _ MECH RESIDENTIAL COMMERCIAL Contractor , -t7/V Ce- Date �F_,—2-7 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE FURNACE AT GARAGE LOCAL&ADD NEW A/C (commencing with Section 7000)of Division 3 of the Business&Professions UNIT(ADHERE TO 5'SETBACK FROM PROPERTY LINE)220 Code and that my license is in full force and effect. VOLT CIRCUIT 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. 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 Sq.Ft Floor Area: Valuation:$7650 permit is issued. APPLICANT CERTIFICATION APN Number:34242009.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ?`f( Issued b ' 3 Dater Signature // OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must ftner or authorized aj^_ forthwith comply with such provisions or this permit shall be deemed revoked. 1 'e' APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address r• - and expenses which may accrue against said City in consequence of the ung of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION ��.... all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional COMMUNITY MANAGEMENT SERVICES,INCORPORATED August 18,2011 RamabathiranArumugam 10146 Lamplighter Square Cupertino,CA 95014 Re: DeAnza Oaks Homeowners Association (Lot 208) Dear Owner: The Architectural Committee has approved your revised application for the installation of a new furnace and air conditioning condenser,per the attached information. Here are the Committee's requirements for approval: Cables will be in a metal conduit per Cupertino city code requirement and painted the same color as body of unit. For paint colors, contact Flores Painting at 942-1177. Sincerely t� Community M4Aon Services,Inc. Bill Hub ard, Manager De�za Oaks Homeowners Association BH/st Enclosure cc: Board of Directors T 1935 Dry Creek Road, Suite 203 Campbell CA a 95008-3631 voice (408) 559-1977 fax (408) 559-1970 � I0 � 01 � R GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• building(5Cuoertino.org MISC ❑PLUMBING MECHANICAL ELECTRICAL ❑MISCELLANEOUS PROTECT ADDRESS f r \APN# C) t c � OWNER NAME yj� J(� E-MAIL &��ADL71� STREET ADDRESS/() CITY STATE,ZIP 1.�4cZt �f 4 �., - > CONTACT NAME ( I ^7 PHONEC(if) 027 >�2 E MAII 6 STREET ADDRESSC .S/i77C,O_ -5 � '�� ( � ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME g 47–( LICENSE NUMBER7 �� LICENSE TYPE4 �� BUS.LIC# COMPANY NAME �� / EMAIL //J �t� FAXP STREET ADDRESSCITY,STATE,ZIP C O PHON77z-,77C[{L e �' yf ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE .ISE OF ❑SFD or DUPLEXMULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: 11 COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK TOTAL VALUATION: 7&�,5 RECEIVED BY: 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.j have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction"�Iafhonize representatives of Cupertino to enter the above-identified pprop for inspection pu{poses. Signature of App]icant/Agent: /L�-- Date: Z ✓�7 SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY w P OVER-THE-COUNTER c ❑ EXPRESS Y U w ❑ STANDARD U ❑ LARGE ❑ MAJOR MEPMiscApp_2011.doc revised 06/21/11 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: PERMIT# OWNER'S NAME: PHONE# G7 GENERAL CONTRACTOR: �-FBUSINESS LICENSE # ADDRESS:'?76°'0 E;5 i/CC(C r '-5T— CITY/ZIPCODE: 511) *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. 4 I am not using any subcontractors: Signature Date Please check applicable subcontractors and 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 Owner/Contractor Signature Date