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11020034 CITY OF CUPERTINO BUILDING PERMIT CONTRACTOR: PERMIT NO: 11020034 BUILDING ADDRESS: 19851 BAYWOOD DR � C DATE ISSUED:02/09/2011 � OWNER'S NAME. YOURN ZHU PHONE NO: C R'S PHONE: 4088231708 ' 0 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class 2 v Lic.# Q'27 I C( MECH r RESIDENTIAL COMMERCIAL rt Date OC 1 i Contractor Z - q t rl JOB DESCRIPTION:INSTALL ONE(1)NEW FURANCE IN EXISTING LOCATION, y `` ADDING NEW DUCT WORK&A/C.FURNACE AFUE 95%. I hereby affirm that I am licensed undet'the provisions of Chapter 9 CONDENSER SEER MIN=I SEER (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 Valuation:$9000 Section 3700 of the Labor Code,for the performance of the work for which this rAPN Ft Floor Area: permit is issued. JC Occupancy Type: APPLICANT CERTIFICATION Number:31630076.00 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, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 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. -; Date 0 1 Issued bye� Date: �" Signature � f7 S � 1 OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of installed l roofswithout firshall be t obtaining an iected prior to nspection,ton,roofing agree rto remove all ial being new materialsed.If a roof for the following two reasons: 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, Date: Signature of Applicant: Business&Professions Code) 1,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 HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's CI have read the hazardous materials requirements under Chapter 6.95 oft e Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I 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. Section 3700 of the Labor Code,for the performance of the work for which this 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 r to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 255534. / Compensation laws of California. If,after making this certificate of exemption,I Owne .a ize gent: Q 2/C� I become subject to the Worker's Compensation provisions of the Labor Code,I must Date_ 111 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I herebyaffirm 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 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address sts,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION o.anting 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. Signature Date Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 31630076 . 00 DATE ISSUED. . . . . . . : 02/09/2011 RECEIPT #. . . . . . . . . BS000012675 REFERENCE ID # . . . : 11020034 SITE ADDRESS 19851 BAYWOOD DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA OWNER YOUJIN ZHU ADDRESS . . . . . . . . . . . 19851 BAYWOOD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JOSEPH E CALVEY 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 9, 000 .00 1. 00 0 . 00 1 . 00 0 . 00 1BREMAIRHA NO.UNITS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1BSEISMICR VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 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 1MRRAA UNITS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0 . 00 42 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 337. 90 0 . 00 337 . 90 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------------- CREDIT CARD 452 . 90 MC --------------- TOTAL RECEIPT 452 . 90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ------------------------ 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 19851 baywood dr. DATE: 02/09/2011 REVIEWED BY: bobs. APN: BP#: VALUATION: $9,000 xPERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY PENTAMATION FURN/AC USE: SFD or Duplex PERMIT TYPE: WORK replace 2 exisitnq furnaces with 1 hvac unit adding all new duct work. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $63 Furnace, Forced-Air 1MFR=<100 1 # $126 Heating System 1MRRAA 1 # $63 TOTALS: $252.00 Mech.Plan Check hrs $0.00 E1„�- �' '� -`�'� ``”` L'h;cAc T-T 0.0 Mech.Permit Fee: IMPERMIT _� FT,",, Other Mech.Insp. 1 0.0 1 hrs $42.00 0 Ia:�. l�c�� r�t�, �`; f.��,, glee_ 1 '"-. Pcc 11tc � NOTE: These fees are based on the preliminary in ormation available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09-051 ff. 7/1/10) FEE QTY/FEE MISC ITEMS Pl ati ('lw l, Fce .Stipp . PC`I"ce PME Plan Check: $0.00 I'c>t trttl I`,>c- S111,)PI. Inst 1.' PME Unit Fee: $252.00 PME Permit Fee: $42.00 C`onstiwcfion Tax L --7 I<'rftlsFla:r.tll�na°t�'li FC('. Work Without Permit? 0 Yes E) No $0.00 Pl artrtingr V c', Travel Documentation Fee: ITRAVDOC $42.00 14 Strom Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldp-Stds Commission Fee: 1BCBSC $1.00 ' SUBTOTALS: $337.90 $0.00 TOTAL FEE: $337.90 Revised: 01/15/2011 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: l,Jb PERMIT# zC-- OWNER'S NAME: L U�� n 2�'Lv PHONE# SO 6 3�ZU GENERAL CONTRACTOR: cGVP- BUSINESS LICENSE# ADDRESS: r i j CITY/ZIPCODE: *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: 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 �i Heating C- Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contra for Signature Date CITY OF ! i0'7- / \ 3q CITY OF CUPERTINO 2 FURNACE/AC CUPERTINO PERMIT APPLICATION FORM APN# • :2� `(� Date: o 1 Qq l L� Building Address: IRU cLi If residential, is house an Eichler? Yes ❑ No 'If yes, needs planning approval. Owner's Name: Phone#: L{e-8 Contractor: Phone#: cc,\ve-4 4C VV rt Fax#: Contractor License#: J Cupertino Business License#: Contact: r Phone#: CS-0 b �� 3 '7 Q Fax/e-mail: Building Permit Info: Elect n--_ Plumb �— Mech Residential []% Commercial ❑ Job Description: C r"irlC,k C Q 1 r'1 Q/ vls occ-vior-,, L-1 L, For Remside al Installations: 1 Attic L1'111' St flo r ❑ 2°d floor El 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 Constructs n(Usage Class): `� COC � Strapped On Platform Bonded ❑ New Location ❑ Replacement Project Size: Counter �xpress ❑ 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 12/06/10