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11050162 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10129 RANDY LN CONTRACTOR:AAA FURNACE&AIR PERMIT NO: 11050162 CONDITIONING OWNER'S NAME: JOHN MURPHY 1712 STONE AVE DATE ISSUED:05/20/2011 1 ER'S PHONE: 4083945853 SAN JOSE,CA 95125 PHONE NO:(408)293-4717 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT PLUMB License C1assC-y C_W Lic.# 7 U, S 7 / r ,� MECH RESIDENTIAL COMMERCIAL – � Contractor /'7`r� I'I{ Y��'1C:� Date___S!) 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE EXISTING FURNACE&INSTALL NEW ONE (commencing with Section 7000)of Division 3 of the Business&Professions SAME Code and that my license is in full force and effect. LOCATION 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 T- 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:$2300 permit is issued. APPLICANT CERTIFICATION APN Number:31624041.10129 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 pe Ad orally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all n - oint ourc ulations per the Cupertino Municipal Code,Section 9.18. [` �. 1 Issued by, "" Date: Signator Dat6-7 "' L 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 define the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued,I shall maintain cot 'a ce it 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&S ety e, ections 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 Owe or rtl Led agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CO TRUCTION 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"ork'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 i' inify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 5 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31624041.10129 DATE ISSUED. . . . . . . : 05/20/2011 RECEIPT #. . . . . . . . . : BS000013508 REFERENCE ID # . . . : 11050162 SITE ADDRESS . . . . . : 10129 RANDY LN 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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 423 . 00 #38500 --------------- TOTAL RECEIPT 423 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL � Z, CITY OF CUPERTINO FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM APN # `T o Date: 6- 19 - ),011, 19 _ ),01I Building Address: ' 0' LSI Owner's Name: '{Q ¢ Phone k o 01 u T-Ph -3 c7 Ll -SQ) ,T-3 Contractor: Pr4A- Phone #:40e-a93 -q 7 Fax #: 6�--o'q,3 - (o Contractor License #: (Owl _wl I Cupertino Business License #: Contact:C� Phone #:40�-meq,3 - 47/ -7 rZ- Fax #: +Qi-- 9q,3 -4p 7 --7 / Building Permit Info: 414- ., Elect Plumb Mech Residential Commercial Job Description: -PeMd VC_ ZKy-S-bn,�, F i4 rt,)o CQ- �-- /ice`►Sit /l /V t,�-� n'Y,o- scq yi'lk 10co h'd'-') For Residential Installations: Attic ❑ I` floor [/ 2"d floor ❑ Adhere to minimum setback requirement [l" For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: a 3CV , 0-6 Type of Constru on (Usage Class): Strapped On Platform Bonded New Location Replacement Project Size: Express Large Major C Valuation: -�.30D• bc) 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 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10129 randy lane DATE: 05/20/2011 REVIEWED BY: bobs. APN: BP#: "'VALUATION: 1$2,300 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK re lace exisitnq furnace with new forced air furnace at same location. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1 MFR=<100 1 # $126 TOTALS: $126.00 Mech.Plan Check0.0 hrs $0.001 T Mech.Permit Fee: IMPERMIT Other Mech.Insp. 0.0 hrs $42.00Li Li NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (P�e Resolution 09-051 I ff. 7/1""10) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $126.00 PME Permit Fee: $42.00 Work Without Permit? 0 Yes No $0.00 Travel Documentation Fee: ITRA VDOC $42.00 A Stroniz Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item BLd&Stds Commission Fee: 1BCBSC 1 $1.00 SUBTOTALS: 1 $211.50 $0.00 TOTAL FE"E7. $211.50 Revised: 04/29/2011 L%Lit��' k=T 1 I v L) Prescri five Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Page 4 of 5) Project Name: Climate Zone# #of Stories r,i lJ /Yl u r 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) �v T e Aq3� lA 000 6 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-AL T Form for additional requirements and check applicable boxes. 4. Indicate Type or Location(Ducts. Hydronic 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'" COP) Type and Location3 R-Value Type Space,Package or H dronic) 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 for additional requirements and check applicable boxes. 3. Indicate Type or Location (Ducts, H dronic 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 ga.r 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 Tvpe(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 pipes shall be insulated to meet the requirements of§150y). 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 118-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 Performance Approach. Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms .,, M August 2009 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: MAO kWil 44we PERMIT# OWNER'S NAME:Jo ?77 u r h PHONE# GENERAL CONTRACTOR: %,va d-e— BUSINESS LICENSE# 7(- 71 ADDRESS: 12Z, /AO CITY/ZIPCODE: Com— Q /L- *Our municipal code requires all businesses working in the city to have a City of Cupe o 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. 1 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 Tile Owner/Contractor ature Date