11020040 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 837 KIM ST CONTRACTOR:A PLUS HEATING&A/C PERMIT NO: 11020040
OWNER'S NAME: JAMES BOND 244 GREAT MALL PKWY DATE ISSUED:02/10/2011
O"'NER'S PHONE: 4082525930 MILPITAS,CA 92683 PHONE NO:(408)934-0730
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB
License Class �� Lic.#
t 6 MECH F RESIDENTIAL F COMMERCIAL F
Contractor � "'�\V S Date
SAME
JOB DESCRIPTION:REMOVE OLD FURNACE,REPLACE W/NEW FURNACEI hereby affirm that I am licensed under the provisions of C�apter 9 IN
(commencing with Section 7000)of Division 3 of the Business&Profess ons
LOCATION.ADD A NEW A/C
Code and that my license is in full force and effect. jj
I hereby affirm under penalty of perjury one of the following two declara'fia
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:$9500
permit is issued.
APPLICANT CERTIFICATION APN Number:35920006.00 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, 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:
Issued by:
Signature Date
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,
Signature of Applicant: Date:
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
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 Owner or author' ed agen • I
forthwith comply with such provisions or this permit shall be deemed revoked. % Date:
404
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
indemnify 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
ng 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
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN 35920006 . 00
DATE ISSUED. . . . . . . : 02/10/2011
RECEIPT' #. . . . . . . . . : BS000012687
REFERENCE ID # . . . : 11020040
SITE ADDRESS . . . . . : 837 KIM ST
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JAMES BOND
ADDRESS 837 KIM ST
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : DAVID J BARRAGAN
CONTRACTOR ADAM P. PHAM LIC # 31293
COMPANY A PLUS HEATING & A/C
ADDRESS 244 GREAT MALL PKWY
CITY/STATE/ZIP . . . : MILPITAS, CA 92683
TELEPHONE . . . . . . . . : (408) 934-0730
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 9, 500 . 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, 500 . 00 0 . 95 0 . 00 0 . 95 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 . 95 0 . 00 274 . 95 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 274 . 95 VISA
---------------
TOTAL RECEIPT 274 . 95
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 837 kim st. DATE: 02/10/2011 REVIEWED BY: bobs.
APN: BP#: 'VALUATION: $9,500
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY PENTAMATION FURN/AC
USE: SFD or Duplex PERMIT TYPE: i
WORK replace existing furnace at same location add new a/c unit at rear yard
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
TOTALS: $189.00
Mech.Plan Check 0.0 hrs $0.00 Plo "I" 1'14111 (7 e,k1 T
I L
Mech. Permit Fee: 1MPERMITLl I
P1i11111 /'�1 ,;1r tc 1 r11i11. -
Other Mech. Insp. 0.0 hrs $42.00
1'.,cIt1sp 1'c'.
NOTE: Theseees are based on the preliminary information available and are only an estimate. Contact the Dept/or addn'l info.
FEE ITEMS (Fee Resohition 09-051 Eff. 7/1/10) FEE QTY/FEE MISC ITEMS
Ilan C'hcck 1,'cc;
Supp/. PC P'cc
PME Plan Check: $0.00
Permit 1'Cc,
11/~1) Fcc
PME Unit Fee: $189.00
PME Permit Fee: $42.00
o;1stroctim! Tax
L 011"'ticr(41 1&,viciv Fee:
Work Without Permit? O Yes E) No $0.00
Plamlill� f`c:c.i:
Travel Documentation Fee: ITRAVDOC $42.00
Strong Motion Fee: IBSEISMICR $0.95 Select an Administrative Item
Bldg Stds Conunission Fee: IBCBSC $1.00
SUBTOTALS: $274.95 $0.00 `TOTAL FEE:: $274.95
Revised: 01/15/2011
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-IR-ALT-HVAC
Alterations
Climate Zones 1, 3-7
Site Address: Enforcement Agency: Date: Permit#:
337 Kim Street Cupertino, CA 95014 City of Cupertino Feb 10, 2011
Duct insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
❑Package Unit
CEJ Furnace p AFUE 78% F-1COPR R 6 (CZ 1 3-5) Served by system �Setback
*Indoor Coil p SEER 13.0 F]HSPF sf If not already present,
p Condensing Unit ❑EER E]Resistance R 4.2 (CZ 6, 7) 1600 must be installed)
R Other > 40' Ducts
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 1 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: Jane Alo Signature: Jane Alo
Company: A PLUS GENERAL CONTRACTORS INC Date: Feb 10, 2011
Address: 7600 GARDEN GROVE BLVD License: 763154
City/State/Zip: WESTMINSTER/ CA/ 92683 Phone: (714) 901-0500
�.
Reg: 211-A0006401A-00000000-0000 Registration Date/Time: 2011/02/10 13:39:41 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CIV OF Fax(408)777-3333
0:UPEkTINO
Building Department
JOB ADDRESS: 627 �� jt77 9,L PERMIT # / 0 /
OWNER'S NAME: -f L0 7 PHONE #
GENERAL CONTRA OR: 4 PlUs FAX # — c3 —O 1,34
I am not using any subcontractors: 0
Si e Date
Please check applicable subcontractors and co to the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
116) 12 00�ID
CITY OF
CITY OF CUPERTINO
FURNACE/AC
CUP. TINO PERMIT APPLICATION FORM
APN# Date:
Building Address: Q vim S�
Owner's Name: iG�mes bondPhone# 0� 9,— 5g3c
Contractor: Phone#:f-i' C0C5 _&?3i'1"I _0730
A ( '14S Fax#: o 6"- L734-07L3
Contractor License#: Cupertino Business License#:
-1o31L5W 2q3
Contact: Phone#: //n8 _q3/ l _o'73
D"'
�a,r-ra F/�U
Fax#:
Building Permit Info:
Elect' Plumb [!f/- Mech ]�
Residential Commercial
Job Description: c n" �k�nace in ea"Z
R,�mort ,old 70 ac , ply v✓�
p G
For Residential Installations:
Attic ❑ 1 S` floor ❑ 2nd 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 Re uired ❑
Cost of Project: Type of Construction sage Class):
0
Strapped On Platform Bonded New Location Replacement
Project Size: Ex ress 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. -0
Revised 01/07/09