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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