The URL can be used to link to this page

11070149 � � CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10103 SENATE WAY CONTRACTOR:CALIFORNIA DEI,TA PERMIT NO: 11070149 MECHANICAL INC OWNER'S NAME: BRIJESH KHANNA LIV TR 6056 E BASELINE RD STE 155 DATE ISSUED:07/21/2011 � ER'S PHONE: 4084462 1 1 0 MESA,AZ 85206 PHOIYE NO:(866)692-5273 ❑ LICENSED CONTRACTOR'S DECLARATION I� � I� O BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class �'2 J Lic. a(�� MECH� RESIDENTIAL� COMMERCIAL � Contractor Date Z�- �� I hereby fti at I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE HVAC(4 TON)iJN[T,LIKE 4 LIKE (comme mg �th Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and efTect. I hereby affirm under penalty of perjury one of the following two declarations: [have and will maintain a ceRificate 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:$3500 I have and will maintain Worker's Compensation Insurance,as provided for by � Section 3700 of the Labor Code,for the performance of ihe work for which this permit is issued. APN Number:32653048.00 Occupancy Type: APPLICANT CERTIFICATION [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 Issued by• Date• 9.18. < � Signature Date ��" l� � RE-ROOFS: � WNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material beng installed.If a roof is installed withoid 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 �nspection. 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) [,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 aftirm 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 [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 912 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. [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 deTined by the Bay Area Air Quality Management District I will perrr►i[is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Sections 25505 533,and 25534. I certify that in the performance of the work for which this perrr►it is issued,I shall � not employ any person in any manner so as to become subject to the Worker's Owner or ag t: �2� �( Compensation laws of California. If,after making this certificate of exemption,I Date: become subject to the Worker's Compensation provisions ofthe Labor Code,I must , % forthwith comply with such provisions or this permit shall be deemed revoked. � CONSTRUCTION LENDING AGENCY [hereby affirm that there is a construction lending agency for the performance of Hork'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 corcect.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 i� �nify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32653048 . 00 DATE ISSUED. . . . . . . : 07/21/2011 RECEIPT #. . . . . . . . . : BS000014128 REFERENCE ID # . . . : 11070149 SITE ADDRESS . . . . . : 10103 SENATE WAY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BRIJESH KHANNA LIV TR ADDRESS . . . . . . . . . . : 10103 SENATE WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : CALIFORNIA DELTA ME CONTRACTOR . . . . . . . : TODOR KITCHUKOV LIC # 32375 COMPANY . . . . . . . . . . : CALIFORNIA DELTA MECHANICAL IN ADDRESS . . . . . . . . . . : 6056 E BASELINE RD STE 155 CITY/STATE/ZIP . . . : MESA, AZ 85206 TELEPHONE . . . . . . . . : (866) 692-5273 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- lADMIN HOURS 1. 00 41 . 00 0. 00 41. 00 0 . 00 1BCBSC VALUATION 3, 500 . 00 1 . 00 0 . 00 1 . 00 0. 00 1BR'LMAIRHA NO.UNITS 1. 00 65 . 00 0. 00 65 . 00 0. 00 1BSEISMICR VALUATION 3, 500 . 00 0 . 50 0 . 00 0 .50 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 : 195 .50 0 . 00 195 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 195.50 #7760 --------------- TOTAL RECEIPT : 195.50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Simpflfied Prescriptive Certificate of Compliance: 2008 Residential HVAC Alteratiorts CF-iR-ALT-HVAC Climate Zones 1,3-7 Stte Address: Enforcement Agency: Date: Permit#: 10103 Senate Way Cupertino, CA 95014 City of Cupertino Jul 20, 2011 Duct insulation Conditioned Floor E4uipmenC Typel List Minimum EfficiencyZ requirement Area Thermostat J�Package Unit �Furnace �AFUE 78�o G COP �Sethack �Indoor Coii �SEER 13•0 C HSPF �R b�CZ 1, 3-5) Served by system �f not already present,must be iJ R 4.2(CZ 6, 7) I900 Sf ��Condensing Unit ❑EER ❑Resistance instaUed) !�Qther 1.Fquipment Type:Choose the equipment being installed;rf more than one system,uSe another CF-1 R-ALT-NUAC for each system. 2.A4In)mum Eqaipment E�ciencies:13 SEER, 78�o AFUE, 7.7HSPF for typrcal residenlial sys[ems. Contractor(Documentation Author's/Responsibie Designer's Declaration Statement) .I cerkify thaC this Certificate of Compliance documentation is accurate and complete. .I am eligible under Division 3 of the California Business and Professions Code to accept responsbitity for the design idenCified on this Certificate of Compliance. .1 certlfy that the energy features and performance spedficaiions for the design identified on this Certificate of Compliance co�form to the requirements of Title 24,Parts i and 6 of the CaliFomia Code of Regulations. .The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,woricsfieets,calculations,pfans and specifi�ations submetted to the ettforcement agency for appl-oval with the permlt appifcation. Name: Brian Cannon Signature:gri� ��a� Company: CALIFORNIA DELTA MECHANICAI INC Date: Jul 20,2011 Address: 1235 GRAND AVE License: 812114 Ci#y/State/Zip: SPRING VALLEY/CA/91977 Phorte: {480)898-0007 - w �? : :° - `- _ - :,, , . ;. - ; ,., .-! .. , _ .. ,:,-: .... .:::. . ; .: �� - �. . .. ., ...;. .:: .:_ .....- -- - - - _ ._. _ ,_ ,._... :�:::.. .:- _ _ : ; .. .�.._ �_ . �.; . _;-;:;._ :::. :;." ' � _-:_._ ..>.::.... :;.-...- _�. .,..;__-: - - ... __. ....... _ , . ......_. .. ,... _ :... _ -. -. ,..: . _ . . _ � . � _ `=- , ;: � .:r >. ..... � ,_ .... . ,_ - �`.:.�as�i i��... ;�3 lts:'' �au;'t:.k � �'� '9' �� - ��. �� -:�, � � � ,-�,�, � � ; ;. ; Aeg: 211-A0036076A-04000040-0000 Registration Jate/Time: 2011/0'7/20 11:54:07 HERS Provider: Ca10ERT5, Inc. 2008 Residential Compliance Forms July 2010 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 I,IST JOB ADDRESS: � / 3 ��v,}�.� (�c/,� � PERMIT# � l� � OWNER'S NAME: �j',��'. � {� �,t,�lV ,� PHONE# �� 'o ��itg- GENERAL CONTRACTO : � �1• ��,� � �v�c BUSINESS LICENSE # lll�y ADDRESS: �c�i�b � � ,UQ # /y' y CITY/ZIPCODE: �eS ��- �'�2� *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 WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT ORS H OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. � z /� �� I am not using any subcontractors: — � ignature Date Please check applicable subcontracto omplete 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 � �^ 2 /; �� wner/Contractor Signature Date � � � �7 `�� GEN�RAL PERMIT APPLICATION � E P COMMUNIIY DEVELOPMENT DEPARTMENT•BUILDlNG DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408}777-3228• FAX(408)777-3333• buildinq(c�cupeRino.orq M ' S� CUPERTINO '.PLUMBING �NIC?.L ECTRICAL ❑MISCELLANEOUS � PROJECT ADDRESS � `�� S� ' �� p p APN�� J r w /�,s� /�C„/" p ( l�� /t/�j� ,�``I �� t� OWNERNAME n � ti, ��g Y K<v2�lc� E�II' � - G r� STREET ADDRESS l /�� /� d-'�_� /�, ,,� �m( LITA�/21�1 nan.c> � /"'( r FAX P/ �r w n corrrncr N.ansE /' ��- ��2�f/��!C� rxorrE ��, �2�- a M.an. / r STR.E ADDRESS � CITY�STATE, ZIP/"( �.9� Z^ r �'` FAX /n,---� D�' /tiJ� � �'y c�'.� 2cJ � �'G 6�2, � ❑OWNER ❑ OWNER-BUIIJDER ❑ OWNER.4GENT ❑ CONTRACTOR ❑CONTRACTORAGEN"f ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONi'RACTOR NAME LICENSE NUMBER�!//�� LICSNSE TYPE G,� BUS.LIC# !( COMPANY NAME � � N /,9 �d � � E-MAR� FAX�V �j �/2 �. 2.�'tJ'— �T �f� srxEEr��s�'., i9 ' %ki,G �i� {t`/�3� crrY,ST.4TE,��S�5F �fl Z ., c� 5�2t� PHONE�' �� "7 2 1 2 �� ARCHITECT/ENGINEER N.4ME LICENSE NUMBER HUS.LIC# COMPANY NAME' E-MAIL FAX STF2.EET ADDRESS CITY,STATE,ZIP PHONE JSE OF D or DUPLEX ❑ MUI.TI-FANm_Y PROIECT IIJ WII.DLAND ❑ YES PROJEC'f IN ❑YES IS THE BLDG AN ❑ YES BUILDING: �COMIvIERCIAL URBAN INTERFACE AREA � NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK � ��_ U s�/.' � ��. / �K� �' 1'K%� TOTAL VALUATION: �,#D� RECEIVED 8Y: By my sig�ature below,I certify to each of the following: I am the property owner or authorized agent to act on the properry owner's behalf. I have read this application and the informarion I have provided is correct.,�have rea e Description of Work and verify it is accurate. I agree to comply��ith all applicable local ordinances and state laws re]ating to building co 'I authori presentatives of Cupertino to enter the above-'dentified properry for inspection pu{poses. Signature of ApplicandAgent: Date: � �� UPP AL INFORMATION REQLIIRED OFFICE USE ONLY � ER-THE-COUN7'ER a � ❑ EXPRESS :t U W ❑ STANDARD U ; ❑ LARGE ❑ AIAJOR MEPMucApp_2011.doc revised 06/21/11