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10100002CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20061 SUISUN DR C014TRACTOR: AAA FURNACE & AIRI PERMIT NO: 10100002i I I CONDITIONING OWNER'S NAME: KOOROSH ALFATOONI WNER'S PHONE: 4083430640 ❑ LICENSED CONTRACTOR'S DECLARATION License Class^� ,„3 C'ZG Li.. # `7 4!0 8-8 -71 ContractorA" K-1 rya Qs_ Date V -10 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. 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 for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenJsourc ay accrue against said City in consequence of the granting of this itionally, the applicant understands and will comply with all non-poiulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER -BUILDER DECLARATION 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 iloon the above mentioned property for inspection purposes. (We) agree to save :mnify and keep harmless the City of Cupertino against liabilities, judgments, sts, 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. Signature Date, 171:: STONE AVE SAP I JOSE, CA 95125 DATE ISSUED: 10/01/2010 PHONE NO: (408)293-4717 JOII DESCRIPTION: RESIDENTIAL U COMMERCIAL REPPLACE FURNACE AND CONDENSER 220 ELECTRICAL Sq. Ft Floor Area: APN Number: 36928004.00 Valuation: $8187 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by, �,��iT� Date: RE -ROOFS: Al 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 ins pection. 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. I will in aintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the H !alth & Safety Code, Section 25532(x) shou d I store or handle hazardous material. Additionally, should I use equip e t or devices which emit hazardous ai r contaminants as defined by the B ea it Quality Management District I w 11 maintain compliance with the up Municipal Code, Chapter 9.12 and the Health & Safety Code, Sec n 25 , 25533, and 25534. Owner or authorized agent: Date: & CONSTRUCTION LENDING AGENCY I iereby affirm that there is a construction lending agency for the performance of H ork'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 CITY OF #UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: ('o 'I�U ;sur, ,2 . PERMIT # e16604v OWNER'S NAME: )2 -' 66,^j; PHO # S- - - 6v GENERAL CONTRACTOR: gq y& p FAX #4 65Z- - 7.7 I am not using any subcontractors: Signa--ure Date Please check avvhcable subcontractors and com lets! the following information: Owner/ Contract ignature Date 60 SUBCONTRACTOR BUSINEr-S 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 Met Sheet R9&/ T' ier- �IZ Owner/ Contract ignature Date 6 ITEMS OF 29 CITY OF CU:?ERTINO PERMIT R:3CEIPT Sec: Twp: Rng: Sub: Blk: mot: APN ........: 36928)04.00 DATE ISSUED.......: 10/01/2010 RECEIPT #......... BS000)11611 REFERENCE ID # ...: 1010002 SITE ADDRESS .....: 20061 SUISUN DR SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER KOOROSH ALFATOONI ADDRESS 20061 SUISUN DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: SylviaM COPY # : 1 RECEIVED FROM ....: AAA FURNACE CONTRACTOR RANDC, JIM LIC # 8050 COMPANY AAA FURNACE & AIR CONDITIONING ADDRESS 1712 STONE AVE CITY/STATE/ZIP ...: SAN JOSE, CA 95125 TELEPHONE ........: (408)293-4717 FEE ID UNIT QUANTITY AMCUNT PD -TO -DT THIS REC -------------------- NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 8,187.00 ---------- 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 8,187.00 0.90 0.00 0.90 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 ---------- 274.90 0.00 274.90 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 1,311.10 --------------- 1,311.10 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- :7223 VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING CITY OF CU'ERTINO r ctimTw ,r ♦ mnTl D7 -"7T T7N!'_' 1i1vTI QTin1v APPLIANCE / EQUIP TYPE rr.r. r.oi i1.ini..�.-- u, -- QTY/FEE QTY ADDRESS: DATE: REVIEWED BY: A/C Units (<=10K cfm) "VALUATION: $8,187 APN: BP#: # *PERMIT TYPE: Mechanical Permit PLAN CI[ECK TYPE: Alteration / Addition / Repair PRIMARY 7011/ PENTAMATION FURN/AC SFD or Duplex 1 , �{ ,,� €;; � PERMIT TYPE: Al USE: 1 WORK $126 SCOPE PME Unit Fee: APPLIANCE / EQUIP TYPE FEE ID u, -- QTY/FEE QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $63 Furnace, Forced -Air 1MFR=<10o sdlppi, h; "�/" 1 ev 1 # $126 TOTALS: I I I I $189.001 1 -- 1-. _ ..s:... s,. !'...,innf iho Dom far addn'I Znfa. NOTE: These fees are based on the pretinunary in orrnuuvn FEE ITEMS (Fee Resolution 09-051 E('. 7%lil0j Mech. Plan Check 0.0 1 hrs $0.00 u, -- QTY/FEE MISC ITEMS Fmech. Permit Fee: IMPERMIT Other Mech. Insp. 0.0 hrs PME Plan Check: $0.0C -- 1-. _ ..s:... s,. !'...,innf iho Dom far addn'I Znfa. NOTE: These fees are based on the pretinunary in orrnuuvn FEE ITEMS (Fee Resolution 09-051 E('. 7%lil0j uvuu suit FEE u, -- QTY/FEE MISC ITEMS sirpp/. 1 J{" I' cc PME Plan Check: $0.0C Pet-�nld I-'t�e" sdlppi, h; "�/" 1 ev PME Unit Fee: $189.0( PME Permit Fee: $42.0( Con.wrlicig"o 'i 1� Work Without Permit? 0 Yes E) No $0.00 i Travel Documentation Fee: ITRA VDOC $42.00 Strong, Motion Fee: $0.82 Select an Administrative Item BldyStds Commission Fee: IBCBSC $1.0) SUBTOTALS: $274.82 $0.00 TOTAL FEE: $274.82 • nnwn VV Iov - N/ LTJ/ LV . v 1. Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 2. Use Low VOC, Water -Based Wood Finishes 2 IAQ/Health pts y=yes 3. Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 4. Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 5. Use Engineered Sheet Goods with no added Urea 4 Resource pts y=yes Formaldehyde 61AQ/Health pts y=yes 6. Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 7. Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes B. Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 9. Use Finger -Jointed or Recycled -Content Trim 1 Resource pts y=yes 10. Install Whole House Vacuum System 3 IAQ/Health pts y=yes N. Flooring 1. Select FSC Certified Wood Flooring 3 Resource pts y=yes 2. Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 3. Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 4. Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 5. Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 6. Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes Total oints Availablel Total Points Project Received: G:datWprogs M X I -f AM ,r3n I57 CITY OF CUPERTINO FURNACE/AC ^.. CUPEkTINO PERMIT APPLICATION FORM 1 IN�� APN # 0oq ;-y Date: I /t Building Address: 'POOL I S tA hStar\ l"v£ Owner's Name: XQa Q ti-, A 1` LCA+cX,--! t Phone #: Z}1)8 - 3-9 3 - o(o y C) Contractor: Ran (3D _ Phone #: 4-o�-_ X93 _ 4()/' Fax #:4 -OS -ag3 _ & "77 / _ Contractor License #: �o Cupertino Business License #: 8U5v Contact: C-7a12Y �t � ,-- / �� C -1 {/ / Phone #: � X9,3--�/ 7/ 7 -- Fax #: 409 - 9 3 ' 7 `t f building Permit Into: Elect Residential Job Description: '�em0ve Ctd 4 Ocyaen-ser 4 - Plumb For Residential Installations: Attic ❑ PttrV0CC Mech Commercial 7-2 Adhere to minimum setback rec 1" floor i:3— irement 2"d floor ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) [] Structural Calculations required for new installation ❑ New installation Planning Approval Reouired F - Cost of Project: Type of -onstruction sage Class): Strapped ❑ On Platform ff Project Size: Express ❑ Standard Valuation: Bon Jed New Location Replacement ❑ Major ❑ 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. Reviled 01/07/09 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20211 SUISUN DR CONT 2ACTOR: OWNER'S NAME: JUMANA & ZOAIB RANGWALAL % cx_�) PERMIT NO: 10100104 DATE ISSUED: 10/14/2010 T_R'S PHONE: 4088281438 I of 6—re 2 Q -TI 00 _," L1 I PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # G 2.5 Contractor&��pi��GDate 10— t Lt —k-0 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. 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. n APPLICANT CERTIFICATION 4 ' tt . 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 re ations per the Cupertino Municipal Code, Section 9.18. � / Signature _ Date ` l "t _(0 O L OWNER -BUILDER DECLARATION 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 it ' -nify and keep harmless the City of Cupertino against liabilities, judgments, C nd expenses which may accrue against said City in consequence of the grunting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r MECH F RESIDENTIAL F COMMERCIAL r— JOB I DESCRIPTION: INSTALL NEW FIBER CEMENT SIDING OVER EXISTING WOOD Sq. Ft boor Area: APN N amber: 36928015.00 Valuation: $6000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 1H DAYS FROM LAST CALLED INSPECTION. Issued by: Date:—j RE -ROOFS: All roof s shall be inspected prior to any roofing material being installed. If a roof is installeA I without first obtaining an inspection, I agree to remove all new materials for inspecti in. Signatu -e 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 Califor aia Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compli:Lnce with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additic nally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will mainta n compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Saf Zons 25505, 25533, and 25534. Ow r r Dater CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for whi(.h this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I under, tand my plans shall be used as public records. ISignature Date I Licensed Professional CITY OF CUPFRTINO 4 ITEMS OF 4 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36928015.00 DATE ISSUED.......: 10/14/,'010 RECEIPT #.........: BS000011744 REFERENCE ID # ••.: 10100104 SITE ADDRESS .....: 20211 f;UISUN DR SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER ............: JUMANA & ZOAIB RANGWALA ADDRESS ..........: 20211 c:UISAN RD CITY/STATE/ZIP ...: CUPERTINO, CA 95014-4427 RECEIVED FROM ....: ALEKSEY MORONCHIK CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........ FEE ID UNIT QUANTITY AMOUrfT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 6,000.00 -------------------- 1.00 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 6,000.00 0.60 0.00 0.60 0.00 1BUSLIC FLAT RATE 1.00 114.00 0.00 114.00 0.00 1SIDEOTHER SQ FEET 500.00 5"0.00 0.00 570.00 0.00 TOTAL PERMIT ---------- ---------- 6£5.60 0.00 ---------- 685.60 ---------- 0.00 METHOD OF PAYMENT AMOUNT F'EFERENCE NUMBER ----------------- --------------- CREDIT CARD 685.60 -------------------- VIE;A --------------- TOTAL RECEIPT 685.60 Building Department City Of Cupertino 10300 Torre Avenue 191 Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUB(±ONTRACTOR LIST , JOB ADDRESS: 70 2 j( G LA -i 5,:, t,, NIZ PERMIT # OWNER'S NAME: 7oki rz PHONE # - 30<2 - 3 pC) GENERAL CONTRACTOR: {­Qtz Co :t A USINESS LICENSE # ADDRESS: ,��Q S �CLfF� L S,tk-_ cam (*--? ?If CITY/ZIPCODE: -`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 SUBCONT CORS AVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 7gnatiire Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS 1` AME 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 Owner / Contractor Signature Date ,�. CITY OF CUP]ERTINO FFF FCTIMATOR - BUILDING DIVISION AInTG'. Tb.,c., f .,c "r A"cod nn rho nrofiminary infnrmatinn availahl o and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 09-051 Ef'. '%li/0j ADDRESS: DA rE: REVIEWED BY: tf'�"ref. h 1YNl1 f �C'L'. APN: BP#: *VALUATION: 1$6,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: SFD or Duplex f { 7 [ , ' r �;�rt,° ,,,; ;� PENTAMATION 1 GENRES PERMIT TYPE: WORK SCOPE AInTG'. Tb.,c., f .,c "r A"cod nn rho nrofiminary infnrmatinn availahl o and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 09-051 Ef'. '%li/0j FEE 11TY/FEE MISC ITEMS tf'�"ref. h 1YNl1 f �C'L'. � It."?,. ' <tf7� r: c•t,. 7>.rc ('. ��ci'177(! %`-;,'er' 500 s.f. $570.00 Siding ISIDEOTHER All Other Cit ,, f 1, k7 ( lush. 1t'� fr tf 4 1 P..rn 3 1.: ! : 1"_Wc. Ius>f Fci AInTG'. Tb.,c., f .,c "r A"cod nn rho nrofiminary infnrmatinn availahl o and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 09-051 Ef'. '%li/0j FEE 11TY/FEE MISC ITEMS Plan Check Fee: $0.00 500 s.f. $570.00 Siding ISIDEOTHER All Other Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (-Uit. ff'Ir`t FT017 711", Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes E) No $0.00 Plannin� $0.00 Select a Non -Residential E) Building or Structure 7 p 'TTj-({�>c l.)C)C1t177£'p7 iCdf'(1J7 Fcf,.1.' Strong; Motion Fee: IBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.60 $570.00 TOTAL FEE. $571.60 Revised: 9/29/2010 CHE''GEi ;a : By i I OF CU CITY PERTINO : 4 CITY OF _... . Cu FEKTI NO GENERAL BUILDING } . PERNUT APPLICATION FORS zvoo/o/ AP T#, CJ`" ,l' - i