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10110181 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10332 CRESTON DR CONTRACTOR:A PLUS HEATING& PERMIT NO: 10110181 A/C iER'S NAME: BART&IRIS GACH 244 GREAT MALL PKWY DATE ISSUED: 11/29/2010 OWNER'S PHONE: 4087208026 MILPITAS,CA 92683 PHONE NO:(408)934-0730 9 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG� ELECT r PLUMB r— License Class C-Z Lic.# —I 6 S � Sr MECH RESIDENTIAL COMMERCIAL Contractor A " P \U S Date 11 Z R C,-D JOB DESCRIPTION: REMOVE AND REPLACE FURNACE ADD A/C I hereby affirm that I am licensed under the 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:$9500 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 APN Number:32637042.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 18YS 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 �- M 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 Issued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Rure 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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 Owner or authorized agent: Date: `t permit is issued. 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 CONSTRUCTION LENDING AGENCY 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 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 ilding construction,and hereby authorize representatives of this city to enter .1 the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,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 Q f0 CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32637042 . 00 DATE ISSUED. . . . . . . : 11/29/2010 RECEIPT #. . . . • • • • • : BS000012107 REFERENCE ID # . . . : 10110181 SITE ADDRESS . . . . . : 10332 CRESTON DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BART & IRIS GACH ADDRESS . . . . . . . . . . : 10332 CRESTON DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : A PLUS 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 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 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 274 .95 0 . 00 274 . 95 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 274 . 95 1607 --------------- 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: 10332 Creston Dr. DATE: 11/29/2010 REVIEWED BY: gs APN: BP#: *VALUATION: 1$9,500 *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 A/C Units (<=10K cfm) 1BREMAIR 1 # $63 TOTALS: $189.00 Mech.Plan Check F070 hrs $0.00 Mech.Permit Fee: I MPERMIT Other Mech.Insp. 0.0 hrs $42.00 Ga=�� =f l�rsrLi -t_ �r< f`11.'� fns"" Li 11", 1�1�1�. (�,t>, rlrrrl i h. f�ct- 1,1<r.Itar1`. . NOTE. Thesefees are based on the preliminarUT in ormation available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resolution 09-051 Ef. T`1/1 0) FEE QTY/FEE MISC ITEMS 1'lon Che, Fcc: PME Plan Check: $0.00 f'c>t'trlfl 1`e�e' F71 PME Unit Fee: $189.00 PME Permit Fee: $42.00 C"`ons,11.1"', "io.;l 7a Work Without Permit? 0 Yes No $0.00 Travel Documentation Fee: 1TRA VDOC $42.00 Strong Motion Feer 1BSEISMICR $0.95 Select an Administrative Item Bldj;Stds Commission Fee: 1BCBSC $1.00 - SUBTOTALS $274.951 $0.00 TOTAL FEE: $274.95 Revi Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ,UPEKTINO Building Department JOB ADDRESS: 3 2 �-� Sn pY PERMIT */O j/o 1G j OWNER'S NAME: PHONE # - 7� GENERAL CONTRACTOR: FAX# -3 - ' ,-�, I am not using any subcontractors: — 11/2,9110 Siggatur6 Date Please check applicable subcontractors and complete 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 CITY OF CITY OF CUPERTINO its FURNACE/AC CUPERTINO PERMIT APPLICATION FORM /OC/ 0/ I APN# Date: �3zLr 3-7 vya�o� v 29 2010 Building Address: /0, 3 0,3 *) 2 Owner's Name: �art c a C h Phone M j J�� y 7 '-720 62 Contractor: Phone M -q3 {-07;?)0 A Fax#: OV0 ." q -7 ?4 Contractor License#: Cupertino Business License#: Contact: n ,,] Phone#: LU)� �3j f_�-7* 30 � 1007 Fax#: `7 Building Permit Info: Elect Plumb Mech Residential Commercial Job Description: rL m 0 tle op up// 0CP 1ti7 tluv 10(0f1W. Pdd o-n rLeAtil A / b For Residential Installations: Attic El1 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(Usage Class): Strapped D On Platform Bonded New Location Replacement Project Size: Ex ress ❑ Standard ❑ Large ❑ Major❑ (,Y/��' T�'� <<' Valuation: 1.5 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