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10080127CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7428 STANFORD PL OWNER'S NAME: SUJEET VASUDEVAN JER'S PHONE: 4084724212 ❑ LICENSED CONTRACTOR'S DECLARATION 20 License Class C �.3 Lic. # Contractor (-�p of V=C 6ro-fkR CzSate $ ' I 1 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 thisl 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. 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 stricture 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 -mnify and keep harmless the City of Cupertino against liabilities, judgments, ., and expenses which may accrue against said City in consequence of the Ig.dnting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. I Signature Date. CONTRACTOR: COOPER BROTHERS, INC. PERMIT NO: 10080127 2151 D EL FRANCO ST DATE ISSUED: 08/18/2010 SAN J DSE, CA 95131 PHONE NO: (408) 437-2442 BUILDING PERMIT INFO: BLDG r ELECT F PLUMB r MECH F RESIDENTIAL I— COMMERCIAL JOB DESCRIPTION: FURANCE REPLACEMENT & ADD AIR CONDITIONING Sq. Ft Floor Area: Valuation: $9200 APN N umber: 35932024.00 Occupancy Type: PLRMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 1110 DAYS FROM LAST CALLED INSPECTION. Issue( by: `''/�Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is install( d without first obtaining an inspection, I agree to remove all new materials for inspection. Signati ire 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 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. Additi anally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maints in compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. 81l authorized agent—. Date: 49-49 CONSTRUCTION LENDING AGENCY I hereb y 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 ARCHITECT'S DECLARATION I under stand my plans shall be used as public records. Licens !d Professional CITY OF CUP:ERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35932024.00 DATE ISSUED.......: 08/18/2010 RECEIPT #.........: BSOOOOL1217 REFERENCE ID # ...: 100801.27 SITE ADDRESS .....: 7428 STANFORD PL SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ......: OWNER • SUJEET VASUDEVAN ADDRESS ........... 7428 STANFORD PL CITY/STATE/ZIP ...: CUPERTCNO, CA 95014 RECEIVED FROM ....: AMANDA VIGIL CONTRACTOR .......: TROY COOPER LIC # 26734 COMPANY ..........: COOPER BROTHERS, INC. ADDRESS ..........: 2151 D'!L FRANCO ST CITY/STATE/ZIP ...: SAN JOSE, CA 95131 TELEPHONE ........: (408) 437-2442 FEE ID UNIT QUANTITY AMOU]JT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 9,200.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BREMAIRHA NO.UNITS 1.00 33.00 0.00 63.00 0.00 1MFR=<100 UNITS 1.00 1:26.00 0.00 126.00 0.00 1MPERMITFE FLAT RATE 1.00 42.00 0.00 42.00 0.00 1TRAVDOC FLAT RATE 1.00 •2.00 0.00 42.00 0.00 TOTAL PERMIT ---------- 274.00 ---------- 0.00 ---------- 274.00 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 274.00 --------------- 274.00 VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING 304 ROUGH ELECTRICAL 502 FINAL PLUMBING ENERGY 505 FINAL ELECTRICAL 508 FINAL MECHANICAL i2EFERENCE NUMBER -------------------- AM'-',X VOICE ID DESCRIPTION -------- ---------------------------- 303 ROUGH MECHANICAL 501 FINAL ELECTRICAL ENERGY 503 FINAL MECHANICAL ENERGY 507 FINAL PLUMBING R aC10F CUPEI�TINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM APN # ✓�9 Date: Buildin Address - Owner's Name: SIz ��S c��2vci✓1 Ck Phone #: 4l°6 L4 -1 2 - LC�-I2 Contractor: Phone #: G - (nW09 i2 ck,Q r' -e -CS Cep ��' -�f'S .` �C Fax #: Contractor Ificense #: Cupertino Business License #: Contact: Phone #: yLD8 -- V7 to - VLll Y 1 Co Q r Fax #: Building Permit Info: Elect Q Plumb �r Mech Residential Commercial Job Description: pt.e � `a C e vhu "I+ Ackc>� /A k Y CO v�c\ 1 f 1 Gin\' V) For Residential Installations: Attic ❑ 1St floor E4 2nd floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Add: tional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construdion (Usage Class): Strapped F1 On Platform Bonded New Location eplacement Project Size: Express ❑ Standard ❑ *Large ❑ Major ❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the aoalication or if applicable, include in plan set & the sheet index. ti C_,___- l Revised 01/07/09 !'47Tt7 d'"h A" TTi1TV DT71kTl1 APPLIANCE / EQUIP TYPE fill 1 Vl` <.V1 L` 1\111'qV FEE ESTIMATOR - BUILDING DIVISION -D Phl od" 1"I�a t (%1 ADDRESS: T kTE: REVIEWED BY: Mech. Permit Fee: IMPERMIT APN: BP#: *VALUATION: 1$9,200 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARYSFD or Duplex '(>7;j/, PENTAMATION 1RMAP2 USE: Ff 00R .11,1;111- PERMIT TYPE: WORK SCOPE APPLIANCE / EQUIP TYPE FEE ID Phl od" 1"I�a t (%1 QTY Mech. Permit Fee: IMPERMIT BP FEES V,' A/C Units (<=10K cfm) 1BREMAIR 1�1. tft-��. 1 1'.It�nth. li s��. (:,.. $63 Permit Fee: Sap1d, lits/> 1, ec. Furnace, Forced -Air 1MFR=<100 PME Permit Fee: 1 $126 It"01IC11('11l Rci-Ic'1b Work Without Permit? 0 Yes E) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $189.00 571rrr, ilorioll FCC, NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09-051 Eff 7/11/0) Mech. Plan Check0.0 hrs $0.00 Phl od" 1"I�a t (%1 1' " Picot t `h"'( (-7 Mech. Permit Fee: IMPERMIT Pcrr"' it F"c. V,' Other Mech. Insp. 0.0 hrs $42.00 t)rl;. , t�t,��,�t tJ, : >EJ__L_>r 1�1. tft-��. W is t,-��; I°x. 1'.It�nth. li s��. (:,.. "!C< NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh 7 info. FEE ITEMS (Fee Resolution 09-051 Eff 7/11/0) FEE QTY/FEE MISC ITEMS Plan C'iicc A Fcc: Sz pp/. PC Fee PME Plan Check: $0.00 Permit Fee: Sap1d, lits/> 1, ec. PME Unit Fee: $189.00 PME Permit Fee: $42.00 C `onstt 1w1i'm Tax It"01IC11('11l Rci-Ic'1b Work Without Permit? 0 Yes E) No $0.00 Phlwililg I"C'C'.a`; Travel Documentation Fee: ITRA VDOC $42.00 571rrr, ilorioll FCC, Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $274.00 $0.00 TOTAL FEE: $274.00 Revised: 8/17/2010 I. use ewso-y6cp.auat 1 IAO/Health pis y=yes 2. Use Low VOC, Water Based Wood Finishes 2 IA(VHealth pts y --yes 3. Use Lc)mft VOC Adhedves 3 IA(VHealth pts y=yes 4. Use Salvaged Materials for Interior Finishes 3 Re,,ounce pts y --yes 5. Use Engineered Sheet Goods with no added Urea B Res )urce pts y --yes Formaldehyde 6IMYHealth pts y=yes S. Use Exterior Grade Plywood for Interior Uses 1 IA(VHealth pts y --yes 7,Seal eel do�1�4l FF _ _ 41AO/HBalth -pts yeses B. Use FSC Certified Materials for Interior Finish 4 Re;ounce pts y --yes 9. Use Finger -Jointed or Recycled -Content Trim 1 Reiource pts y --yes 10. Install Whole House Vacuum System 31A,IHealth pts y=yes N. Fiaoring 1. Select FSC Certified Wood Flooring B Res )urce pts y --yes 2.1lsa Rap ►flenetitah(e #-7mflpg $Aatwiats4 Res wrce pts y -yes 3. Use Recycled Content Ceramic Tiles~ 4 Res )urce pts y --yes 4. Install Natural Linoleum in Place of Vinyl 5 IAQMealth pts y --yes 5. Use Exposed Concrete as Finished Floor 4 Res,)tlrce pts y=yes 6. Install Recycled Content Carpet with Low VOCs 4 Resource. pts y=yes Total Points Availablel1401 1301 57 Total Points Project Received: 8 10 0 0 0 G:data/prD_Wgresnbuildin (guidelinesfraMDdelerslgreenpointsfina1212D4pMeeted.xls CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: -7 S-t-cxv-y�orcA 1a C --e. PERMIT # X12 OWNER'S NAME: _5" e..et Vn Suc�.rC-Ln PHONE # 40 - (0 49 - 2-00 v GENERAL CONTRACTOR: (' Qr ?jro-k- f75 al- C BUSINESS LICENSE # (DOQ 0 S 3 ADDRESS: 'ZX -5 I Drzi '�—cuv-,co St I CITY/ZIPCODE: Se -4— -J�SQ CA '15 1 �l *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 S TRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. C)I am not using any subcontractors: � 's_ / � _ / Signatui•e Date Please check applicable subcontractors and complete the following information: t Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME 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 t Owner / Contractor Signature Date