12100217 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7508TIPTOE LN CON"fRAC7fOR:ABC COOLING&HEATING PERMITNO: 12100217
OWNER'S NAME: MUZZI CARMELLA B TRUSTEE 31845 DAYMAN SI' DATE ISSUED: 10/31/2012
OWNER'S PHONE: 4082578395 IIAYW'ARD.CA 94544 PI IONS NO:(510)471-8181
❑ LICENSED CON"IRAC`fOR'S DECLARATION BUILDING PERMIT INFO: BLDC r ELECT r PLUMB
Ci
1-iccnse Cl.1ss GAO Lic.H �I9-�, tl 3 1" C) r
�, /D_ ?Y_ +� MF.CFI RESIDENTIAL COMM1IERCIAL
Contractor Date
hereby affirm that 1 nm licensed under(he provisions of Chapter 9 JOB DESCRIPTION: REMOVE AND REPLACE 1'URNACE
(commencing with Section 7000)of Division 3 of the Business& Professions
Code and that tar license is in full force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
1 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:$9000
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:35932053.00 OccupancyType:
.\PI'LIC.\N'f CER'1'IPIC,\'PION
I cenify 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[he CityofCupertino against liabilities,
judgments, 18(1 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accme against said City in consequence of the
graining of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: . ���,✓ �TGCf Date:
RF:ROOFS:
❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without firs(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 RE;ITER
construct the project(Sec.7044,Business d Professions Code),
I hereby affirm under penalty of perjury one of the fallowing three DAZARDOUS MATERIALS S DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter!95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California llealth&Safery Code,Sections 255115,25533,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 llealth&
perfommnce of the work for%%Inch this permit is Issued Safety Code,Section 25532(a)should 1 store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally.should 1 use equipment or devices which emir 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
maintain compliance with the Cupertino Nlunicipal Code,Chapter 9.12 and the
permit is issued. llealth&Safety Code.Sections 25505.25533.and 25534.
1 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 pwneyu out ar L� 1iI�Ji 2)._
Compensation laws of Califamia. If,after making this certificate of exemption,1
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. CONSTRIN-fl 3N[,ENDING AGENCY
I hereby affrtn that there is a construction lending agency for the performance of work's
APPLICANT CE RTI FICATION 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 consruction,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, ,\RCIII'1'F:CI"S DECLARATIONcosts,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used to public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
1 72oI ( I
GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 M '
(408)777-3228• FAX(408)777-3333° buildino(DDcupertino.org
CUPERTINO
sc
Ej PLUMBING *]MECHANICAL ELECTRICAL MISCELI-ANEOUS
PROJECTADDRESS7508 T IPrTIOE LANE APN1 359- �a - o5
OWNER NAMEBORREGO'VA/N rnj7 VI PHONE408 257 8395 EMAIL
STRCETADDRESS 7508 TRIPTOE LANE CITY, STATE,ZIPCUPERTINO CA 95014 1
FAX
COM'ACF NAME MAGGIE MENDOZA I
PHONE510 471 8181 I
E-MAIL MAGGIEM@ABCCOOLING.COM
STREET ADDRF.SS3266 INVESTMENT BLVD I
CITY,STATE,ZIP HAYWARD CA 945451 FAX 510471 8368
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT E CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME SCOTT LUNDAY I
LICENSENUMBER 382383 1
LICENSETYPE C20 BUS.LICd
COMPANYNAME ABC COOLING & HEATING E-MAIL MAGGIEM@ABCCOOLING.COM FAX 510 471 8368 .
STREETADDREss3266 INVESTMENT BLVD CITY,STATFZIP
HAYWARD CA 94545 PHONE 510 471 8181
ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC A
CONIPANY NAME E-MAIL FAX
STREETADDRESS CITY,STATE ZIP PHONE
USE OF FDor DUPLEX ❑ MULTI-FMIILY PROJECT INWILDLAND ❑ YES PROIELTIN ❑ YES IS THE BLDG AN 1"ES
BUIIDINO. ❑fOMAIERCIAL URBAN INTERFACE AREA NO FLOOD ZONE NO EICHLER NOME? NO
DESCRIPTION OF WORK
REPLACE FURNACE WITH 96% EFF
TOTAL VALUATION: / Oo C7 RECEIVED BY:
Be 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. I 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 ng construction. autho`e a sentatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: r�r Date:_����— I
SUPPLEMENTAL INFORMATION REQUIRED 'oiFTce USEbsi:Y..'
F,
❑ E\PRESS
.:may
❑ LARGEAiOR
o'-fv:nin r J�
,4lFA%fiscApp_201 Ldoc revised 06/21/11
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones 1, 3-7
Site Address: Enforcement Agency: Date: Permit#:
7508 TRIPTOE LANE Cupertino, CA 95014 City of Cupertino Oct 29, 2012
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
Ll Package Unit
®
®Furnace AFUE 96% ❑COP_ H R 6 (CZ 1, 3-5) Served by system ®Setback
❑Indoor Coil p SEER_ [3 HSPF If not already present, must
p Condensing Unit ❑EER_ [3 Resistance R 4.2 (CZ 6, 7) 1200 5f be installed)
®Other > 40' Ducts
1..Equipment Type:Choose the equipment being Installed;if more than one system, use another CF-IR-AIT-HVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.]HSPF 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: Scott Lundy Signature: Scott Lundy
Company: ABC COOLING &'HEATING SERVICES INC Date: Oct 29, 2012
Address: 3266 INVESTMENT BLVD I License: 382383
City/State/Zip: HAYWARD/ CA/94545 Phone: (510) 471-8181
i,l
Reg: 212-A0060494A-000000000-0000 Registration Date/Time: 2012/10/29 18:36:04 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forme July 2010
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 7508 TRIPTOE LANE DATE: 10/31/2012 REVIEWED BY: SEAN
APN: BP#: 'VALUATION: $9,000
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex PERMPP TYPE: FURN/AC
NVORK REMOVE AND REPLACE FURNACE. ,
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 1 # $133
TOTALS: $133.00
Mech.Plan Check Fo.0 hrs $0.00 Plumb. Plan Check Cleo. Plan Check
Mech. Permit Fee: IMPF.RMIT Plumb. Petwir Fee: Flec. Permit Fee:
011ier Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. Other F;Iec.Insp. Ll I
d•Iech.Insp.Fee: Plmuib. bccp.Fee: Flee.Insp.Fee:
!TOTE: This estimate clues not includejeer clue to other Departments(i.e. Planning, Public Woos, Fire,Sanitary Sewer District,School
District,etc.). These fees are based on the prelitninan information available and are only an estimate. Coact the Deyajor adtfn'I info.
FEE ITEMS (Fee Resolution 11-053 EIT 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee:
SuppL PC Fee
PME Plan Check: $0.00
Permil Fee:
Suppl. /nsp Fee
PME Unit Fee: $133.00
PME Permit Fee: $45.00
Consitwction Tar:
Administrative Fee: (ADMIN $42.00
Work Without Permit? O Yes Q No $0.00
Advanced Planning Fees:
Travel Documentation Fee: ITRA VDOC $45.00
Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item
Hid, Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $266.90 $0.00 TOTAL FEF: $266.90
Revised: 10/01/2012
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:_75O (; LO PERMIT# 1,0092
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR': �Go L BUSINESS LICENSE#
ADDRESS:3aC (o 1Oveo rn4.t\t U\jd I CITY/ZIPCODE: CqL1614
*Our municipal code requires all businesses working in the city to have a City of Cuperti io 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: C//_� /0
Signature Date
Please check applicable subcontractors and complete the following information:
t/ 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