Loading...
10060049 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7568 RAINBOW DR CONTRACTOR:VALLEY HEATING& PERMIT NO: 10060049 COOLING WNER'S NAME: PRACHI RAICHURA 11 tl N 4 TH ST DATE ISSUED:06/09/2010 OWNER'S PHONE: 4089739649 SP N JOSE,CA 95112 PHONE NO:(408)294-6290 PK- _ LICENSED CONTRACTOR'S DECLARATION JC B DESCRIPTION: RESIDENTIAL COMMERCIAL License Class -y�� _ Lic.# REPLACE FURNACE&ADD A/C UNIT Contractori Date I hereby affirm tha am licensed der 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. Sc.Ft Floor Area: Valuation:$4285 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 A?N Number:36611040.00 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 180 DAYS 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 DAYS FROM 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 I!sued 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: matur Dat s C V A Il roofs shall be inspected prior to any roofing material being installed. If a roof is it stalled without first obtaining an inspection,I agree to remove all new materials for it spection. 07 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 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 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: I lealth&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 r taterial. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the P it contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. 1411 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 25 ,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: �— Dat T` y 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 NSTRUCTION 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 1 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. 1 vork's for which this permit is issued(Sec.3097,Civ C.) l,ender's Name APPLICANT CERTIFICATION 1,ender'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 to building construction,and hereby authorize representatives of this city to enter ,n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION _,lemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the 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 icensed Professional 9.18. Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: / 1 PERMIT# OWNER'S NAME: 7 C A i PHONE # GENERAL CONTR CTOR: BUSINESS LICENSE# C _ ADDRESS: f CITY/ZIPCODE: ll *Our municipal code requires all businesses working in the :ity to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INS 'ECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. c 970 I am not using any subcontractors: Signature Date Please check applicable subcontrtors 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF C'UPERTINO FURNACE/AC OF CUPErkTINO PERMIT APPLICATION FORM 1co cPC0' q APN# 040 l Date: r � 1 . U V Building Address: Owner's Name: Phone#: rct04: Rau' k101-1 ontractor: Phone#: 1 141 ��1.✓� Fax #: Contractor Lic nse#: Cupertino Business License#: a � Contact: Phone rfi G 1'0/1 e,75 Fax #: Building Permit Info: Elect Plumb Mech [� Residential [�� Commercial L] Job Description: For esidentialInstallations: Attic ❑ 1St floor ❑ 2nd floor ❑ Adhere to minimum setback requirement ©� For Commercial Installations: Replacement same weight ❑ iidditional weight (str�ICtural CalCsj ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required..❑ Cost of Project: Type of Con;truction(Usage Class): a aT`61 Strapped ❑ On Platform ❑ Bonded New Location Replacement Valuation: Green Building: Must attach Green Building Checl: list to this application CITE' OF C'UPERTINO FURNACE/AC Y OF CUPEkTINO FEE SC REDULE Quantity Fee ID Fee Descriptio i Fee Permit Type Group AIR FURN/AC CONDITIONING 1BCAIRHAN Commercial A/C Units <= lOk CFM B 1MCRAA Commercial Mech Repair/alt/add M 1BSEISMICO Seismic Comme_-cial B 1PGASCOM Commerical for :a gas piping System P 1-4 outlets 1PGASRES Residential for e i gas piping system P of 1-4 Outlets IBPGAS For each gas piping system of 5 or P more per outlet. :�omm/Resid IBRENLAMUiAN Residential A/C units <= IOk CFM B 1MRRAA Residential Mech Repair/alt/add M ' 1BSEISMICR Seismic Residential B 1EPERMITFEE Electric Permit E 1MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permi-. P 1 T RA VDOC Travel Documer,tation B 1BUSLIC Business License B CITY OF CUPERTINO FURNA_CE/A.0 CM OF CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC IPGASRES ---Residential for ea gas piping system of- --P-- 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Zheck M 1MFR=<100 Furnace Syst <=100k BTU install or M relocate ea forces-air/gravity type furnace/burner, incl ducts/vents attached to such ,ppliance up to and include 100,000]3tu/h 1MFRN>100 Furnace Syst> I 00 BTU install or M relocate ea forcec'.air/gravity type furnace/burner, incl ducts/vents attached to such ,ippliance over 100,000 Btu/h 1 EPERMITFEE Electric Permit F-_e E 1NTERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business Licens(: B