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10120012 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1014 CRANBERRY DR CONTRACTOR:COMERFORD'S SERVICE PERMIT NO: 10120012 EXPERTS OWNER'S NAME: ANIL SHARMA 6984 SIERRA CT DATE ISSUED: 12/02/2010 ER'S PHONE: 6505300717 DUBLIN,CA 94568 PHONE NO:(925)273-3468 LICENSED CONTRACTOR'S DECLARATIONF BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Z O Lic.# to S r P MECH RESIDENTIAL COMMERCIAL Contractor S Date f Z� / d 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: REPLACE FURNACE AND A/C.230 TO CONDENSER 4 (commencing with Section 7000)of Division 3 of the Business&Professions VENT Code and that my license is in full force and effect. DUCT SEAL AT EXISTING 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 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:$8582 permit is issued. APPLICANT CERTIFICATION APN Number:36204057.00 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 permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. - �2 ��d Issued bye;. -�_-'� Date Signature Date )Z' l] 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 1,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 defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with 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&Safety Code,Sections 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 Owne�utho edagent: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION 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 work'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- ' -unify 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 FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1016 Cranberry Dr. DATE: 12/02/2010 REVIEWED BY: gs APN: BP#: *VALUATION: 1$8,582 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition / Repair PRIMARY SFD or Duplex 7,07-:1 i� r PENTAMATION FURN/AC USE: t 11 00 ill/ i= PERMIT TYPE: WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $126 A/C Units (<=10K cfm) 1BREMAIR 1 # $63 TOTALS: $189.00 Mech.Plan Check 0.0 hrs $0.00 '- E,.,r,= �.r> ��G Mech.Permit Fee: IMPERMIT Ler Mech.Insp. 0.0 hrs $42.00 . NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info, t F/ C� EE/ITEMS (Fee Resolution 09-051 E f.' '%7./10, FEE QTY/FEE MISC ITEMS Poll lwcA /"O'. PME Plan Check: $0.00 Suppl, 1/1"'/)1'C", PME Unit Fee: $189.00 PME Permit Fee: $42.00 Consirlictioil 1"n T "It"OUS/L 1,01,r he'7'li'11' VCt'; Work Without Permit? 0 Yes E) No $0.00 Travel Documentation Fee: ITRA VDOC $42.00 Strong?Motion Fee: IBSEISMICR $0.86 Select an Administrative Item Bld&Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $274.86 $0.00 TOTAL FEE: $274.86 Revised: 11/08/2010 CITY OF CUPERTINO 6 ITEMS OF 9 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36204057 . 00 DATE ISSUED. . . . . . . : 12/02/2010 RECEIPT #. . . . . . . . . : BS000012129 REFERENCE ID # . . . : 10120012 SITE ADDRESS . . . . . : 1014 CRANBERRY DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . . ANIL SHARMA ADDRESS . . . . . . . . . . : 1014 CRANBERRY DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : TROY THOMAS LIC # 32138 COMPANY . . . . . . . . . . : COMERFORD'S SERVICE EXPERTS ADDRESS . . . . . . . . . . : 6984 SIERRA CT CITY/STATE/ZIP . . . : DUBLIN, CA 94568 TELEPHONE . . . . . . . . : (925) 273-3468 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 8, 582 . 00 1 . 00 0 .00 1. 00 0 . 00 1BREMAIRHA NO.UNITS 1. 00 63 .00 0 .00 63 . 00 0 .00 1BSEISMICR VALUATION 8, 582 . 00 0 .86 0 .00 0. 86 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 274 .86 0. 00 274 .86 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 628 .03 VISA --------------- TOTAL RECEIPT 628 . 03 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CITY OF CUPERTINO FURNACE/AC CUPERTMO PERMIT APPLICATION FORM APN# 0 Date: 12- Building 2-Building Address: , O 6 Owner's Name: Phone#: 650 5.3 0 O 71 Contractor: Phone#: q2_5.Z73 3 q6 9 4-&A4:1z(--oZi),5SL�2✓�ci E7zi��Z i S Fax#: 7 7-5 •556 /06 Contractor License#: Cupertino Business License#: -510 !j-71 Contact: ,Z FC Gv2 6 UZ Phone#: L 5 -Z-7 3 • Fax#: ZS . SSGJ /®G % Building Permit Info: Elect X Plumb Mech Residential ® Commercial ❑ Job Description: �) ,q �G '-730 7U if>:,l�z-,✓��-� For Residential Installations: Attic ❑ 1"floor ® 2nd floor ❑ Adhere to minimum setback requirement 91 For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Re uired ❑ Cost of Project: Type of Construction (Usage Class): W 1159 -Z = Strapped ❑ On Platform ❑ Bonded ❑ New Location ❑ Replacement Project Size: Express ❑ Standard ❑ Large ❑ Major❑ Valuation: q J� q Z G, 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