11050161 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20176 HOGUE CT CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 11050161
CONDITIONING
OWNER'S NAME: JOHN MURPHY 1712 STONE AVE DATE ISSUED:05/20/2011
t :.R'S PHONE: 4083945853 SAN JOSE,CA 95125 PHONE NO:(408)293-4717
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Clascl.9 1 k1!! Lic.# 7 b 3ry k-)
MECH r- RESIDENTIAL COMMERCIAL
Contractor i �'�1✓til` Date� t I
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE&REPLACE EXISTING FURNACE
(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:$2300
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:31624041.20176 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 ich ma accrue against said City in consequence of the
granting of this p it. d onally,the applicant understands and will comply
with all - Ott
sourc ulations per the Cupertino Municipal Code,Section Issued by: Date 2e)- tt
9.18. J
Signature 1 Date— _ !J
RE-ROOFS:
CJ OWNER- DER 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)
1,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. 1 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 a equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contamjeomplia
de red y ebay Area Air Quality Management District I will
permit is issued. maintace wi upertino Municipal Code,Chapter 9.12 and the
ea ode, ions 25505,25533,and 25534.
I certify that in the performance of the work for which this permit is issued,I shallnot employ any person in any manner so as to become subject to the Worker's Ownerize t:
Compensation laws of California. If,after making this certificate of exemption,I Date: J �l
become subject to the Worker's Compensation provisions of the Labor Code,I must T
forthwith comply with such provisions or this permit shall be deemed revoked. C"VC-TION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work'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
•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
5 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31624041.20176
DATE ISSUED. . . . . . . : 05/20/2011
RECEIPT #. . . . . . . . . : BS000013508
REFERENCE ID # . . . 11050161
SITE ADDRESS . . . . . : 20176 HOGUE CT
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER JOHN MURPHY
ADDRESS . . . . . . . . . . : 20176 MURPHY
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : RANDO AAA HVAC, INC
CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050
COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING
ADDRESS . . . . . . . . . . : 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 293-4717
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 2, 300 .00 1. 00 0. 00 1 .00 0 . 00
1BSEISMICR VALUATION 2, 300 .00 0.50 0. 00 0 .50 0. 00
1MFR=<100 UNITS 1. 00 126. 00 0. 00 126 . 00 0. 00
1MPERMITFE FLAT RATE 1. 00 42 .00 0. 00 42 . 00 0. 00
1TRAVDOC FLAT RATE 1. 00 42.00 0. 00 42 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 211.50 0 . 00 211 .50 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
kos
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO PERMIT APPLICATION FORM
APN # Date:
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Building Address:
01 0)1 o Q-+
Owner's Name: XS
e #:
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Contractor: �, Phone #:�� a�93 Z-/17/7
Fax #: q0 7 --, 7 /
Contractor License #: 7 �-Iz- -7 Cupertino Busines icense #:
V
Contact:GA n-�f r , �lo0-�,� Phone #: �Q� �2Cy� X7/7
�'� Fax #:
Building Permit Info:
Elect Plumb Mech
Residential Commercial LJ
Job Description:
For Residential Installations:
Attic ❑ 1" floor 2°d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: 34t). 0 0 Type of Construction (Usage Class):
Strapped On Platform El Bonded Fj New Location Replacement
Project Size: Express Standard Large Major
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Revised 01/07/09
L,uet?j'=r)Jv v
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations (Page 4 of 5)
Project Name: Climate Zone# #of Stories
'o4r� )vturPh /
HVAC SYSTEMS-HEATING
Minimum Duct or Piping Configuration
Heating Equipment Efficiency Distribution Insulation Thermostat (Central,Split,
Type and Capacity"2.3 (AFUE or HSPF) Type and Location R-Value Type Space,Package or H dronic)
urAj0cO-1 TMne
Y3 Cho 7
1.Indicate Heating Type(Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.)
2.Electric resistance heating is allowed only in Component Package C, or except where electric heating is supplemental(i.e., if total capacity
<2 KW or 7,000 Btu/hr electric heating is controlled by a time-limiting device not exceeding 30 minutes). See§151(b)3 exception.
3.Refer to the HERS Verification section on Page 4 of the CF-IR-ALT Form for additional requirements and check applicable boxes.
4. Indicate Type or Location(Ducts, Hvdronic in Floor, Radiators, etc.)
HVAC SYSTEMS-COOLING
Minimum
Efficiency Duct or Piping Configuration
Cooling Equipment (SEER/EER or Distribution Insulation Thermostat (Central,Split,
Type and Capacity"2 COP) Type and Location3 R-Value Type S ace,Packa e or H dronic)
i I t
1. Indicate Cooling Type(A/C, Heat pump, Evap. Cooling, etc)
2.Refer to the HERS Verification section on Page 4 of the CF-IR-ALT Form far-additional requirements and check applicable boxes.
3. Indicate Type or Location(Ducts, Hydronic in Floor, Radiators, etc.)
WATER HEATING
List water heaters and boilers for both domestic hot water(DHW)heaters and hydropic space heating. Individual dwelling DHW heaters must be
gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the kitchen(s)and on all underground
hot water pipes is required in all com onent packages in all climate zones.
External Tank
Water Heater Type/Fuel Distribution Type Number In Tank Energy Factor or Insulation
Type (Standard, Recirculating)' System Capacity(gal) Thermal Efficiency R-Value3
1. Indicate Type(Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of§150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank and i es shall be insulated to meet the requirements of§1506).
SPECIAL FEATURES The enforcement agencv should pay special attention to the Special Features specified in this checklist below.
These items rnav require written justification and documentation and special verification.
NEW ROOF ASSEMBLY-Radiant Barrier
The radiant barrier requirement of§151(f)2 does not apply to roof alterations.
Slab Edge(Perimeter)Insulation ❑ YES ❑NO
YES: In Climate Zone 16 in Component Packages D,R-7 insulation is required.
Heated Slab Insulation ❑ YES ❑ NO
YES:Slab edge insulation required for all heated slabs in all Climate Zones. See details in Table 1 l8-A of the standards.
Raised Slab Insulation ❑YES ❑NO
YES: In Climate Zones 1,2, 11, 13, 14& 16,R-8 insulation is required; in Climate Zones 12& 15,R-4 is required under component Package D.
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass,use the Performanc674
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 2009
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: c;G 7(o 146&Ue CA- PERMIT# ��l
OWNER'S NAME: V ujfPlll PHONE # —& ` Y
GENERAL CONTRACTOR: 4yjA r, r.�j.,,r e_.0 BUSINESS LICENSE # 7 47kr7 l
ADDRESS: 5. Az i-S CITY/ZIPCODE• d3e I g,S`I 2
*Our municipal code requires all businesses working in the city to have a City of Cupet4o 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:
Signature Date
Please check applicable subcontractors and complete the following information:
V 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
He
0wner/Contractor Sign a Date