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10110115I , CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10591 GLENVIEW AVE I CONTRACTOR: ATLAS-TRILLO HVAC PERMIT NO: 10110115 1 OWNER'S NAME: KUO CHIH F AND HSU H ( 1965 KYLE PARK CT I DATE ISSUED: 11/19/2010 1 NER'S PHONE: 4082528905 `License Clas ' # �Q % t - i( \\ Contractor ate 1, I t I hereby affirm thatTam liiserer the provisions of Chapter 9 (commencing with Section 7 ) of Division 3 of the Business &Professions Code and that my license is in 11 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 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 ection purposes. (We) agree to save indemnify d keep harmless the ity of Cu rtino against liabilities, judgments, costs, and penses w ' may crue a d City in consequence of the granting o this p Additi ally, a app t understands and will comply with all no -point a regu tion rtino Municipal Code, Section 9.18. Signature Date u I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 Section 3700 of the Labor Code, for the performance of the work for which this 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 4emnify and keep harmless the City of Cupertino against liabilities, judgments, s, and expenses which may accrue against said City in consequence of the n..,nting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature. Date SAN JOSE, CA 95125 PHONE NO: (408)286-8931 BUILDING PERMIT INFO: BLDG T— ELECT I— PLUMB r MECH RESIDENTIAL I— COMMERCIAL I— JOB DESCRIPTION: REMOVE & REPLACE EXISTING FURNACE Sq. Ft Floor Area: I Valuation: $2500 APN Number: 36926022.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Dater���l RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use eq t or devices which emit hazardous air contaminant as detinrd b he Bay ea Air Quality Management District I will ma tain comp ' nce wi Cu erti o Municipal Code, Chapter 9.12 and the He th & Sg[ety Co ?25533, and 25534. Date: 6 ` I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 5 ITEMS OF 5 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36926022.00 DATE ISSUED.......: 11/19/2010 RECEIPT #.........: BS000012059 REFERENCE ID # ...: 10110115 SITE ADDRESS .....: 10591 GLENVIEW AVE SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: TraciC COPY # : 1 OWNER ............: KUO CHIH F AND HSU H ADDRESS ..........: 10591 GLENVIEW AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014-4567 RECEIVED FROM ....: ATLAS TRILLO CONTRACTOR .......: TRILLO, STEVE LIC # 4269 COMPANY ..........: ATLAS-TRILLO HVAC ADDRESS ..........: 1965 KYLE PARK CT CITY/STATE/ZIP ...: SAN JOSE, CA 95125 TELEPHONE ........: (408)286-8931 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 2,500.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 2,500.00 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 ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 211.50 --------------- 211.50 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- 2441 VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING FM-7 CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION APPLIANCE / EQUIP TYPE 10591 glenview ave. DATE: 11/17/2010 REVIEWED BY: building lialADDRESS: APN: BP#: "VALUATION: 1$2,500 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: 7-07:I[ 17 0()/? .11, f el PENTAMATION FURN/AC PERMIT TYPE: WORK Pt"rlrut Fee: SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Furnace, Forced -Air 1MFR=<100 C)rtaE�t 1"7C(' 1 # $126 Pt"rlrut Fee: PME Unit Fee: $126.00 PME Permit Fee: $42.00 C"onslt' tylion 7"I "I ousiical 1&-riP1L V("C Work Without Permit? 0 Yes (F) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $126.00 Strong Motion Fee: IBSEISMICR NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS ('Fee Resolution 09-051 Elf %1;101 Mech. Plan Check0.0 hrs $0.00 QTY/FEE MISC ITEMS Mech. Permit Fee: 1MPERMIT Other Mech. Insp. 10--01 .0 hrs $42.00 F C)rtaE�t 1"7C(' :i'1"' h, hiw. l'e'e': ii7i11�_ 11 c�l. C'c NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS ('Fee Resolution 09-051 Elf %1;101 FEE QTY/FEE MISC ITEMS Plun Cheek Fuc: sup1d, P(l, Fee F PME Plan Check: $0.00 Pt"rlrut Fee: PME Unit Fee: $126.00 PME Permit Fee: $42.00 C"onslt' tylion 7"I "I ousiical 1&-riP1L V("C Work Without Permit? 0 Yes (F) No $0.00 Plani'linu 1'CC' ' Travel Documentation Fee: ITRA VDOC $42.00 Strong 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: 11/08/2010 CITY OF CUPERTINO FURNACE/AC CUPEkTINO PERNHT APPLICATION FORM /x/10// -S- APN # 3/ a � f-. O �� Date: Buildin Owner's Name: � Phone #:�- (. U o Contractor:QA Phone #:�©. �I �S Fax #:7;�qdqj q Contractor License : Cupertino Busin s Licens #: Contact: � � r I /' -` Phone #: Fax #: Building Permit Info: Elect ❑ Plumb ❑ Mech Residential Comm cial ❑ Job Description: - �_G�( ��/ For Residential Installations: Attic ❑ 0 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 Required ❑ Cost of Project: Type of Construction (Usage Class): Strapped El On Platform Bonded New Location ReplacementEl Project Size: Express ❑ 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 01/07/09 CITY OF CUPERTINO BUILDING PERMIT REVISION # I BUILDING ADDRESS: 21073 GARDENA DR I CONTRACTOR: MAN413P SINGH I OWNER'S NAME: MANDEEP SINGH OWNER'S PHONE: 4087778231 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date 1 hereby affirm that 1 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. 1 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. 1 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 permit is issued. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date ❑ OWNER -BUILDER DECLARATION h by affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 1, 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 he�byaffirm under penalty of perjury one of the following three decI 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. 1 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 permit is issued. 1 certify that in the performance of the work for which this permit is issued, 1 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, 1 become subject to the Worker's Compensation provisions of the Labor Code, t must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. A 21075 GARDENA DR I DATE ISSUED: 09/16/2009 CUPERTINO, CA 95014 1 PHONE NO: BUILDING PERMIT JINFO: BLDG r ELECT r PLUMB r MECH r— RESIDENTIAL r— COMMERCIAL JOB DESCRIPTION: WEW ATTACHED 2ND UNIT,63ISQ, RELATED PERMIT #09070008 (EXISTING HOUSE) - NEW ADDRESS ASSIGNED 9/1/09 REVISE TRUSS LAYOUT Sq. Ft Floor Area: I Valuation: $94650 APN Number: 32608077.02 1 Occupancy Type: PERMIT EXPIIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant:_ Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 255k(a) should I store or handle hazardous material. Additionally, should I use; equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Date: 1 to CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records.