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10050087
I CITY OF CUPERTINO ]BUILDING PERMIT BUILDING ADDRESS: 21796 HYANNISPORT DR t""NER'S NAME: AGARWAL PUNEET & NARANG KAMINI u,vNER'S PHONE: 4084768241 ❑ LICENSED CONTRACTOR'S DECLARATION C 30 License ClassLic. # op :Zq Contractor !%�0L {J Date 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 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. Si^^ature- �s"'J 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. 1 cerfii`y 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 mi 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 u 'he above mentioned property for inspection purposes. (We) agree to save i iify 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 jd d CON rRACTOR: TBD -TO BE DETERMINED PERMIT NO: 10050087 DATE ISSUED: 05/10/2010 PHONE NO: BUILDING PERMIT INFO: BLDG F ELECT r— PLUMB F MECH r— RESIDENTIAL i COMMERCIAL r— JOB DESCRIPTION: REMV & RREPLC FURNACE & A/C &10 DUCTS "SEI, NOTES" Sq. Ft Floor Area: Valuation: $9100 APN Number: 35613016.00 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED 'WITHIN 180 DAYS OF PERMIT ISSUANCE OR 1.80 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is insta led 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 hai a 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 & Safe y Code, Section 25532(a) should I store or handle hazardous material. Add tionally, should I use equipment or devices which emit hazardous air cont iminants as defined by the Bay Area Air Quality Management District I will mail tain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: � Date: CONSTRUCTION LENDING AGENCY I her ;by affirm that there is a construction lending agency for the performance of work's for v hich this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I unc erstand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO 7 ITEMS OF 8 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: ]got: APN ........: 35613016.00 DATE ISSUED.......: 05/10,2010 RECEIPT #.........: BSO00010361 REFERENCE ID # ..• 10050087 SITE ADDRESS .....: 21796 HYANNISPORT DR SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OPERATOR: patg COPY # : 1 OWNER ............: AGARWAL PUNEET & NARANG KAMINI ADDRESS ..........: 21796 HYANNISPORT DR CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: EURO CLIMATE CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........ FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- ---------- 1BCBSC ------------- VALUATION ---------- 9,100.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 0.00 1BSEISMICR VALUATION 9,100.00 1.00 0.00 1.00 0.00 1EPERMITFE FLAT RATE 1.00 42.00 0.00 42.00 0.00 1MPERMITFE FLAT RATE 1.00 42..00 0.00 42.00 0.00 1MRRAA UNITS 2.00 L26.00 0.00 126.00 0.00 1PPERMITFE 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 ---------- 296.00 ---------- 0.00 ---------- 296.00 ---------- 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING RECEIVED BY: PATRICIAG TODAY'S DATE: 05/10/10 TIME: 11:05 8 1BCBSC 1BSEISMICR 1EPERMITFE 1MPERMITFE 1MRRAA 1PPERMITFE 1TRAVDOC BUSINESS LICENSE TAX CHECK CITY OF CU?ERTINO RECEIPT NUMBER: BS000010361 PAYOR: EURO CLIMATE R:3GISTER DATE: 05/10/10 10050087 10050087 10050087 10050087 10050087 10050087 10050087 EURO CLIMATE TOTAL DUE: $410.00 REF NUM: #1630 TENDERED $410.00 $1.00 $1.00 $42.00 $42.00 $126.00 $42.00 $42.00 $114.00 $410.00 CHANGE $.00 CITY OF CUPEkTINO CITY OF C:UPERTINO FURNACE/AC PERMIT APPLICATION FORM APN # __ Date: Building Address: 7 9 ► 12r WZ - � c� � Owner's Name: Phone : Con actor: Phone #: L�0$ -l4t4 (-C*4(pg Fax #: 1' -CI(7"1 - O D l 2 Contractor License #: (] (c) a7 -n Cupertino Business License #: Contact: Phone #: (0 9 -L441 _©tkag cl'-i I\_1 \4 f� Fax #: Building Permit Info: Elect Plumb ❑ Mech Residential Commercial ❑ Job Description: I t I / For Re idential Installations: Attic 1St floor 2°d floor ❑ Adhere to minimum setback requirement ❑ e,A NAE , For Commercial Installations: Replacement same weight ❑ Aiditional weight (structural calcs) ❑ Structural Calculations required for new installation �] New installation Planning Approval Required ❑ Cost of Project: Type of Construction (Usage Class): Strapped ❑ On Platform El Bonded7] New Location ❑ Replacement Project Size: Express ❑ Standard ❑ Lar e ❑ Major ❑ Valuation: ,i q I I C)o 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 Ui/U//Uy at CITY Of CUPEI,TINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1 MCRAA Commercial-Repair/l,lteration/Add to M ea heating appliance,i efrigeration unit, cooling unit,absorptic n unit,or ea heating, cooling,absor?tion or evaporative cooling s �stem,incl installation of controls regulated by this code. 1MCREPALT Commercial for the repair of alt/add to M ea heating appliance,i efrigeration unit,cooling unit,VAII boxes, absorption unit or ea'ieathing, cooling absorption,or evaporative cooling sys, incl install of control: regulated by this code. 1MCSUSHTR Commercial Install/Relocate ea M suspended heater,rece;ssed wall htr, or floor mounted unit he: ater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1 BPGAS For each gas piping s stem of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed & not incl ir. an appliance permit. 1 BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Commercial Seismic B 1 MRRAA Residential Repair/A: teration/Add to y M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating, cooling, absot ption or evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Rclocate ea M suspended heater,recossed wall htr, or floor mounted unit heater. CITY OF CUPEI,TINO CITY OF CUPERTINO FURNACE/AC FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type 1 MRAPPVNT Residential for the install/relocate/ or replacement of ea ,.ppliance vent install & not incl ir. an appl permit. M FURNACE FURN/AC 1 PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. P 1BCBSC Cal Bldg Standard:; Commission Fee B ALL PERMIT TYPES 1 BSEISMICR Residential Seismi B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst <=100k BTU install or relocate ea forced- iir/gravity type furnace/burner, incl ducts/vents attached to such afpliance up to and include 100,000 Btu/h M 1MFRN>100 Furnace Syst > 100k BTU install or relocate ea forced- air/gravity type furnace/burner, incl ducts/vents attached to such al pliance over 100,000 Btu/h M 1 EPERMITFEE Electric Permit Fee. E 1 MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit P 1TRAVDOC Travel Documentation B 1BUSLIC Business License B CITY OF CUPERTINO FURNACEAC CUPEI,TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type AIR CONDITIONING FURN/AC 1BCAIRHAN Commercial A/C Units <= IOk CFM B 1 MCRAA Commercial Mech R;pair/alt/add M 1BCBSC Cal Bldg Standards C ommission Fee B ALL PERMIT TYPES 1 BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ea gz.s piping System 1-4 outlets P 1 PGASRES Residential for ea gas piping system of 1-4 Outlets P 1BPGAS For each gas piping system of 5 or more per outlet. Comm/Resid P 1 BREMAIRHAN Residential A/C units <= l Ok CFM B J 1 MRRAA Residential Mech Repair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B J 1 EPERMITFEE Electric Permit E j 1MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P / 1 TRAVDOC Travel Documentation B 1BUSLIC Business License B