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11010097 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10375 HENEY CREEK PL CONTRACTOR: PERMIT NO: 11010097 OWNER'S NAME: RATTAYYA RAMANAMMA V AND JASTI Q-,C�CX, — DATE ISSUED:01/18/2011 - NER'S PHONE: 6509682037 PHONE NO: ` LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB r License Class (o 2 f:> Lic.# 5 qZ 3 9 3 MECH RESIDENTIAL COMMERCIAL r Contractor A-?:Ic S'r'i Af< r ����'`C Date i JOB DESCRIPTION:REPLACE FURNACE,SAME LOCATION 80K BTU 95% 1 hereby affirm that I am licensed under the provisions of Chapter 9 AFUE (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. I have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$5000 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:34248026.00 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 to building construction,and hereby authorize representatives of this city to enter PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date: Business&Professions Code) I,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 and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material. 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 defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I Owner odifor�d agent: 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. ONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, c and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION ing of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10375 heney creek DATE: 01/18/2011 REVIEWED BY: bobs. APN: I BP#: *VALUATION: 1$5,000 R*PERMITTYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY PENTAMATION FURN/AC USE: SFD or Duplex I PERMIT TYPE: WORK replace existing furnace at garage location of sfd. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $126 TOTALS: F $126.00 Mech.Plan Check 0.0 hrs $0.00 Mech.Permit Fee: IMPERMIT 1'r, Ef. Pyr=it t :: t;. c. Pair?rig 1` f: Other Mech.Insp. 1 0.0 hrs L $42-00 0(h'r "u�n3�irrsy� ooh t laec.Imp, ED ,11"'ch.I?z,7�. FCCPiurrth. 1it.p' /"C", I iet.My, NOTE: Theseees are based on the preliminaryin ormation available and are onl an estimate. Contact the De t or addh 7 info. FEE ITEMS (Fee Resolution 09-051 E(f. T"l,"1(jY FEE QTY/FEE MISC ITEMS Plan Check Fee: slfppl. I'(_'f'eeF--I= PME Plan Check: $0.00 Peranit Fee: suppl. Iatsp Fee PME Unit Fee: $126.00 PME Permit Fee: $42.00 Collstrarction li'aa, lcousficr.tl Rc view Work Without Permit? 0 Yes E) No $0.00 I'lranning 1"(1c, : Travel Documentation Fee: ITRAVDOC $42.00 i Strong;Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $211.50 $0.00 TOTAL FEE: : $211.50 Revised: 01/03/2011 CITY OF CUPERTINO 5 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34248026 .00 DATE ISSUED. . . . . . . : 01/18/2011 RECEIPT #. . . . . . . . • : BS000012503 REFERENCE ID # . . . : 11010097 SITE ADDRESS . . . . . : 10375 HENEY CREEK PL SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RATTAYYA RAMANAMMA V AND JASTI ADDRESS . . . . . . . . . . : 10375 HENEY CREEK CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-0829 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 5, 000 . 00 1 . 00 0 .00 1. 00 0 .00 1BSEISMICR VALUATION 5, 000 . 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 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: 10 37 S /J E PERMIT# OWNER'S NAME: J-/1.5-t I 2 Y/4 PHONE# 650 -96 •LO 7 GENERAL CONTRACTOR: /" BUSINESS LICENSE# ADDRESS: '519-45 w,+,J ts7. CITY/ZIPCODE: V *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. I am not using any subcontractors: j /ter/ /� ure 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/Co Signature Date CITY OF CITY OF CUPERTINO III FURNACE/AC CUPER INO PERMIT APPLICATION FORM APN# Date: Building Address: 103 ?5 0&,JELr Owner's Name: Phone#: Contractor: Phone#: 510 471-8181 ABC Cooling and Heating Inc. Fax#: 510 471-8368 Contractor License#: 382383 Cupertino Business License#: Contact: Brenda Phone#: 510 471-8181 Fax#: 510 471-8368 Building Permit Info: Elect[ � Plumb ❑J Mech Residential x Commercial Job Description: � � ✓ Mit r ��,f -�«� q For Residential Installations: Attic F-11St 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: Type of Construction(Usage Class): 4 S, L--V Strapped D On Platform Bonded New Location Replacement Project Size: Ex ress ❑ Standard❑ Lar e❑ Major❑ Valuation: -, S 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 BUILDING PERMIT BUILDING ADDRESS: 20900 HOMESTEAD RD BLDG 76 CONTRACTOR: PERMIT NO: 10100177 � 17 D 140r� S OWNER'S NAME: PROMETHEUS88 , DATE ISSUED:01/13/2011 OWNER'S PHONE: 6509313476 S I1j ' 4PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ BLDG 76 C'Z REMODEL EXISTING K ITCHEN(50SQ)CA BIN ETS License Class �� Lic.# �S &LIGHTS,INSTALL NEW WASHER/DRYER AT EXISTING CLOSET(IOSQ),INSTALL NEW AIR CONDITION UNITS;NO Contractor,' 6,1 T p�-9,Y 6o-yl ,6 Date / !/ I hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: Sq.Ft Floor Area: Valuation:$20000 i. 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. APN Number:32609065J6 Occupancy Type: 2. 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. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 180 DAYS FROM LAST CALLED INSPECTION. to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Issued by - Date: 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 regula' ns per th upertino Municipal 5ode,S ction 9.18. RE-ROOFS: Signature Lri� `/ Datil f 5 ,) 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 inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: eby affirm that I am exempt from the Contractor's License Law for one of tue following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 1,as owner of the property,or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for HAZARDOUS MATERIALS DISCLOSURE sale(Sec.7044,Business&Professions Code) 2. 1,as owner of the property,am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the construct the project(Sec.7044,Business&Professions Code). California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 1 hereby affirm under penalty of perjury one of the following three declarations: Safety Code,Section 25532(a)should I store or handle hazardous material. t. I have and will maintain a Certificate of Consent to self-insure for Worker's Additionally,should I use equipment or devices which emit hazardous air Compensation,as provided for by Section 3700 of the Labor Code,for the contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534. 2. 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 Owner or aut ttz-ed� _ % permit is issued. 'D?.�/� Date: 3. 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 CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) must forthwith comply with such provisions or this permit shall be deemed Lender's Name revoked. Lender's Address APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is ARCHITECT'S DECLARATION correct. 1 agree to comply with all city and county ordinances and state laws relating I understand my plans shall be used as public records. to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Licensed Professional indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 i-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date