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11020005
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10375 HENEY CREEK PL CONTRACTOR:ABC COOLING& PERMIT NO: 11020005 HEATING OWNER'S NAME: RATTAYYA RAMANAMMA V AND JASTI 31845 HAYMAN ST DATE ISSUED:02/01/2011 VNER'S PHONE: 6509682037 HAYWARD,CA 94544 PHONE NO:(510)471-8181 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL EJ License Class C `)�, . (-2-ULic.# ".?'-'? 2 `>y� REMOVE AND REPLACE FURNACE IN SAME LOCATION. / (UPSTAIRS CLOSET) Contractor �'��—'�; t%'t?r,jr Date I hereby affirm that I am licensed under t e 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. 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:$1961 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 whic this APN Number:34248026.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION //A I certify that I have read this application and state that the abov6dformation is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY RO LAST CALLED INSPECTION. 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 Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ��_ RE-ROOFS: Signature Date ( / 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. J OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent. Date: I 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ,demnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION ;ts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. Granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date 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: ^7�3.75 0c J E Y �rZn,-� PL PERMIT# 0 Z OWNER'S NAME:JA5-7 FAJ A`t'`r/l PHONE# 6 5en ,I4 2-03 2 GENERAL CONTRACTOR:Pr's, C �.4�Li�,�� t.. r?t`� t�1 BUSINESS LICENSE # ADDRESS: 3 j 945 SMA J 57 CITY/ZIPCODE: ll`-0441) 1745.lq *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: re 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 Owne or Signature Date Jan 27 11 04: 02p ABC COOLING 6 HEATING 5104718368 p. 3 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-lR-ALT-HVAC Alterations Climate Zones 1, 3-7 Site Address: Enforcement Agency: Date: Permit#: 10375 HENEY CREEK PL (SYS UP) Cupertino, CA 95014 City of Cupertino Jan 14, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat 73 Package Unit Furnace R AFUE % I.1 COPServed by system P!Setback 1-'Indoor Coil [-I SEER (I HSPF �R 6(�1, 3-S) If not already present, FA Condensing Unit F1 EER p Resistance n R 4.2 (CZ 6, 7) iraso sf must be installed) n Other 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies: 13 SEER, 78%AFUE, 7.7HSPF for typical residential systems. Contractor(Documentation Author's /Responsible Designer's Declaration Statement) •I certify that this Certificate of Compliance documentation is accurate and complete. •I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design Identified on this Certificate of Compliance. .I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts I and 6 of the California Code of Regulations. •The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets, calculations,plans and specifications submitted to the enforcement agency for approval with the permit application. Name. Brenda Blair Signature: Brenda Blair Company: ABC COOLING &HEATING SERVICES INC Date: )an 14, 2011 Address: 31845 HAYMAN STREET License: 382383 City/State/Zip: HAYWARD 1 CA% 94544 Phone: (510)471-8181 Reg: 211-AOOC2219A-00000000-0000 Registration Date/Time: 2011/01/14 16:30:09 REPS Provider: CaICERTS, Inc 2008 Residential Compliance Forms Jul; 2010 CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34248026 . 00 DATE ISSUED. . . . . . . : 02/01/2011 RECEIPT # . . . . . . . . . : BS000012624 REFERENCE ID # . . . : 11020005 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 . . . . . . . : GERALD UNRUH LIC # 24643 COMPANY . . . . . . . . . . : ABC COOLING & HEATING ADDRESS . 31845 HAYMAN ST CITY/STATE/ZIP . . . : HAYWARD, CA 94544 TELEPHONE . . . . . . . . : (510) 471-8181 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 1, 961 .00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 1, 961 . 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 ----------------- --------------- -------------------- CREDIT CARD 211 . 50 visa --------------- TOTAL RECEIPT 211.50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 10375 Heney Creek PI DATE: 02/01/2011 REVIEWED BY: RDW APN: BP#: ��,' Z 000 *VALUATION: 1$1,961 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORK SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $126 TOTALS: $126.00 Mech.Plan Check0.0 hrs $0.00 [Mech.Permit Fee: IMPERMIT "%r ;r ._ t; lit ,:.r ' '_ Other Mech.Insp. 0.0 hrs $42.00 Li o,hJ'i;"' f� Li h. 11"', In-l" Pcc� b w NOTE. Thesefees are based on the prelintinary in ormation available and are only an estimate. Contact the De t or addh 7 info, FEE ITEMS (Fee Resolution 09-051 E,fE 7%1./10) FEE QTY/FEE MISC ITEMS Platz (iw('f f cc: salol"11. P(, F PME Plan Check: $0.00 sI pp/. 111 sf i Yet' PME Unit Fee: $126.00 PME Permit Fee: $42.00 Conso-11ction J'cn F-1 1c:r,t strccrr' 1�cvieli 1 c4" Work Without Permit? 0 Yes 0 No $0.00 1'Irat,rtil,J 1`c'E`�: Travel Documentation Fee: ITRAVDOC $42.00 Strom Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg:Stds Commission Fee: IBCBSC $1.00 SUBTOTALS:` $211.50 $0.00 TOTAL FEE: $211.50 Revised: 01/15/2011 CITY O CITY OF CUPERTINO FURNACE/AC CUP RTINO PERMIT APPLICATION FORM //O'z APN# L34;? A-IoY J �Ci Date: Building Address: (�C.J / Owner's Narne: Phone#: 3 A � T A-r l A T'A A &50 3452 52 Z.©j 7 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 ❑ Mech E] Residential x Commercial Job Description: 2t"P4�1cc ►-v Z,�: :Fc� S�N'1 E C-oc.t tic^�,1 v�5 r�F� 5 L l'c'S� T�.. For Residential Installations: Attic ❑ 1"floor ❑ 2nd floor Adhere to minimum setback re uirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: c-r Type of Construction(Usage Class): Strapped ❑ On Platform Bonded ❑ New Location Replacement Project Size: Ex ress ❑ Standard ❑ Lar e ❑ Major❑ Valuation: 1 r I (7 6 / C-c 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