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10050163 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21044 LAURETTA DR CONTRkCTOR:TFF HEATING AND AIR PERMIT NO: 10050163 CONDI I ION ING f'"NER'S NAME: YEN-KUANG CHEN 299 CORNING AVE DATE ISSUED:05/21/2010 v vvNER'S PHONE: 4088238869 MILPI7 AS,CA 95035 PHONE NO:(408)786-8120 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB r License Class �-'2y Lic.# ?I q MECH f- RESIDENTIAL r- COMMERCIAL Contractor f � �Date JOB DESCRIPTION:REPLACE EXISTING FURNACE&ADD A/C 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. Sq.Ft Floor Area: Valuation:$6600 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 anc Type: Occupancy permit is issued. APN N ember:32654032.00 P Y YP 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 10 DA S FROM _ T CALLED INSPECTION. 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 Issued by: Date: 9.18. S� Z./ � V Si-nature Date 2 RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All roc fs 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 I hereby affirm that I am exempt from the Contractor's License Law for one of inspect ion. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signat ire of Applicant: Date: 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I havc read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's Califc rnia Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safeh Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this conte ninants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Healt n&Safety Code,Sections 25505,25533,and 25534. 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 Ownauthor' Compensation laws of California. If,after making this certificate of exemption,I Date: 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for w rich this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name 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 Lender's Address r the above mentioned property for inspection purposes.(We)agree to save mify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply I und.-rstand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CUPEFTINO PERMIT RECEIPT OPERATOR: patg 5 ITEMS OF 5 COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot; : APN 3265403:: . 00 DATE ISSUED. . . . . . . : 05/21/2010 RECEIPT # . . . . . . . . . BS000010456 REFERENCE ID # 1005016.3 SITE ADDRESS 21044 LAURETTA DR SUBDIVISION . . . . . . . CITY CUPERTIVO IMPACT AREA . . . . . . OWNER YEN-KUANG CHEN ADDRESS 21044 LAURETTA DR CITY/STATE/ZIP CUPERTINO CA, CA 95014-1656 RECEIVED FROM TFF HEP.TING & AIR CONTRACTOR TONY FERREIRA LIC # 31778 COMPANY TFF HEl.TING AND AIR CONDITIONI ADDRESS 299 COF.NING AVE CITY/STATE/ZIP . . . : MILPITI,S, CA 95035 TELEPHONE (408) "86-8120 FEE ID UNIT QUANTITY AMOUNT PD-TO,-DT THIS REC- - NEW-BAL- ---------- ------------- ---------- ------ 1BCBSC VALUATION 6, 600 . 00 1. 00 0 . 00 1 . 00 0 . 0 0 .70 0 . 00 0 . 70 0 . 00 1BSEISMICR VALUATION 6, 600 . 00 1 .00 1.26 . 00 0 . 00 126 . 00 0 . 00 1MFR=<100 UNITS 1MPERMITFE FLAT RATE 1 .00 12 . 00 0 . 00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 12 . 00 0 .00 42 . 00 -- --- - ----- ----- ---------- --------- TOTAL PERMIT 211.70 0 . 00 211 . 70 0 . 00 METHOD OF PAYMENT AMOUNTREFERENCE NUMBER-- ----------------- --------------- - CREDIT CARD 211 . 70 VISA --------------- TOTAL RECEIPT 211. 70 VOICE ID DESCRIPTION VOICE ID ----DESCRIPTION ---- _ -------- ---- ----------- ----------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FURNA(:E/AC CUPEf�TINO PERMIT APPLICATION FORM APN # �U S ,1 Date: Building Address: c 1() Lf�/ TT/°� Dom, GtjP'r-�T:r:AJO 95-01 LJ Owner's Name: Phone#: Contractor: Phone - 'f-F- H�PC� f��r�— Fax#: Contractor License#: Cupertino Business License#: q/ '35-0 '319 Q & Contact: .�pN�� � �_z-A Phone#: (toy SCS — �b 1 z C-) Fax #: Building Permit Info: Elect ❑ Plumb ❑ Mech Residential Commercial ❑ Job Description: LP�-cT x5- TS PCG PSD For Residential Installations: Attic ❑ 1St floor 2°d floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Ad Etional weight(structural calcs) ❑ Structural Calculations required for new installation [] New installation Planning Approval Required ❑ Cost of Project: Type of Constriction (Usage Class): (o &oo o� Strapped On Platform Bonded L New Location Replacement ❑ Project Size: Express ❑ Standard ❑ Large ❑ Major ❑ Valuation: 0, 0-0 Green Building: Please complete relevant portion of 6e Green Building Checklist& attach it to the application or if applicable, include is plan set& the sheet index. Revised 01/07/09 CITY OF CUPERTINO FURNACE/AC :..c..TY OF FEE SCHI"dDULE CUPERTINO Fee Description Fee Permit Type Quantity Fee ID Grou 1MRAPPVNT Residential for the install/relocate/or M replacement of ea arpliance vent install &not incl in an appl permit. FURNAC FURNACE 1PGASRES Residential for ea g,-.s piping system of P 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1BCBSC Cal Bldg Standards Commission Fee B Al PL PERMIT t 1BSEISMICR Residential Seismic B 1 1 MECPLNCK Mechanical Plan C ieck M 1MFR=<100 Furnace Syst<=100k BTU install or M relocate ea forced-sir/gravity type furnace/burner, incl ducts/vents attached to such appliance up to and include 100,000 B�u/h 1MFRN>100 Furnace Syst> 100k BTU install or M relocate ea forced-air/gravity type furnace/burner, in,-,I ducts/vents attached to such a.)pliance over 100,000 Btu/h IEPERMITFEE Electric Permit Fee E 1MPERMITFEE Mechanical Perm.t Fee - M - 1PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel Documeni.ation B ` B 1 BUSLIC Business License Building Department City Of Cupertino ELI] 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 D U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 210q" LA0'2ET ,4r b1Z- PERMIT# k— 1 OWNER'S NAME: PHONE# &0V) 79&—W70 GENERAL CONTRACTOR: --F-f-- &Gf— BUSINESS LICENSE # '✓- 1 r/r/ ADDRESS: ZqGq.•,E 503 ITY/ZIPCODE: *Our municipal code requires all businesses working in the c ity to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSF'ECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. Z/ I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS N 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 CUPERTINO BUILDING PERMIT CONTRkCTOR:MASTERSERV INC PERMIT NO: 10050046 BUILDING ADDRESS: 10350 LEOLA CES-G. 2 DATE ISSUED:05/04/2010 560 LIBRARY ST OWNER'S NAME: AVTAR&SUMEET PHONE NO:(800)806-7674 SAN FE RNANDO,CA 91340 PER'S PHONE: 4087684850 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# o/7 MECH r RESIDENTIAL COMMERCIAL Contractor J,A� �fP� Date �� JOB DESCRIPTION:COPPER REPIPE,REPLACE MAIN LINE 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 Valuation:$10000 performance of the work for which this permit is issued. Sq.Ft floor Area: 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 APN Number:37504026.112 Occupancy Type: 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 PIA.RMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, 1;30 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,,the applicant understands and will comply �) - Date: with all non-point source regul k�9rts per th Cupertino Municipal Code,Section Issued bac' i. 9.18. Signature Date_�__ 7" RE-ROOFS: V OWNER BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is instal'ed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: Date: 1,as owner of the property,or my employees with wages as their sole compensation, Signaure of Applicant: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I ha,,e read the hazardous materials requirements under Chapter 6.95 of the declarations: to self-insure for Worker's Cali'ornia Health&Safety Code,Sections 25505 2553Chapter 9 12 and the Health main 1 have and will maintain a Certificate of Consent Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should Icom)Iiance with the Cupertino sto a orhandlehazardous material. performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air I have and will maintain Worker's Compensation Insurance,as provided for by contaminants as defined by the Bay Area Air Quality Management District I will Section 3700 of the Labor Code,for the performance of the work for which this mai main compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Sections 25505,25533,and 25534. 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 Ow u �rid t: Dater 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 CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Leiider's Name 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 Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save -mify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION and expenses which may accrue against said City in consequence of the grting of this permit.Additionally,the applicant understands and will comply I u iderstand my plans shall be used as public records. Lwi-thallnon-point so rce regulationwper t e Cupertino Municipal Code,SectionLi ensed Professional e Date ' CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lct: APN 37504026 .1/2 DATE ISSUED. . . . . . . : 05/04/2010 RECEIPT #. . . . . . . . . BS000030316 REFERENCE ID # 10050046 SITE ADDRESS 10350 I,EOLA CT UNIT 1, 2 SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA OWNER AVTAR tc SUMEET SINGH ADDRESS 10350 LEOLA CT UNIT 1 CITY/STATE/ZIP CUPERT:=NO, CA 95014 RECEIVED FROM . . . . : MASTERSERV INC OF C CONTRACTOR GEORGE ANDERSON LIC # 30854 COMPANY MASTER3ERV INC ADDRESS 560 LI:3RARY ST CITY/STATE/ZIP SAN FE:2NANDO, CA 91340 TELEPHONE (800) 306-7674 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- --- 1BCBSC VALUATION 10, 000 .00 1. 00 0 . 00 1 . 00 0 . 00 1BPWATER UNIT 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1BPWSVCS WATER SERVICE 1 . 00 21 . 00 0 . 00 21 . 00 0 . 00 1BSEISMICR VALUATION 10, 000 . 00 1. 00 0 .00 1 . 00 0. 00 1PPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1PRREPIPE NO OF FIXTURE 1 . 00 11. 00 0 . 00 11 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 160 . 00 0 .00 160 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------------- CHECK 160 . 00 #1055 --------------- TOTAL RECEIPT 160 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------- 301 ROUGH PLUMBING 507 FINAL PLUMBING ( �-p CITY OF CITY OF CUPERTINO is REPIPE/SEWER/MAIN SERVICE C U P E RT I N O PERMIT APPLICY STI ON FORM APN# Date: / /lam ([ Building Address: /o5so Lwo C`t. rf frw � / �o t' Ow e�Na e: c Phone# `T� -/ (, _ 48 'I Oir h r 1t roc Contractor: n Phone#: � -� 73�� (/ rV ► 1 Fax#: - Contact: Phone#: Z/O? r72 a Fax#: Contractor License#: Cupertino Business License#: Job Description: � �r_ ��(� 4 /)� ����� ���f/'t �n,Q , Residential Commercial ❑ Valuation: ,n/("Co Project Size: Express Large❑ 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 shl!et index. Green Building Points: Quantity Fee ID Fee Description Fee Permit Type Group I PCSEWER Commercial building P ICPSS sewer/sanitary sewer I BPREPIPE Commercial re-pipe pc:r fixture P ICPRP FPGASCOM Commercial Gas Pipirg System P 1-4 Outlets 1BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES 1 BSEISMICOM Seismic Commercial P Revised 01/07/09 CITY Of CITY OF CUPERTINO REPIpE/SEWER/MAIN SERVICE III FEE SCHEDULE CUPERTINO Fee Permit Type Fee Description Quantity Fee ID p Group IBCBSC Cal Bldg Standards Commission B ALL TYPES Fee 1 BSEISMICR Seismic Residential P --------------- IPRSEWER Residential building P 1RPSS sewer/sanitary sewer IPRREPIPE Residential re-pipe pet fixture P IRPRP P 1CPWS or IBPWSVCS Water Service 1RPWS I PPRSEWG Private Sewage Dispo;;al System P I PCESS Cesspool P 1BPWATER Install/alter Water Pip: P 1 BPFIXTURE Plumbing Fixture P I PGASRES Residential Gas Pipin.;System P I-4 Outlets IBPGAS Gas Piping System 5-+ Outlets P IPPERMITFEE Plumbing Permit Fee Issuance P 1 PLMBLNCK Plumbing Plan Check P 1 PLMBINSP Other Plumbing/gas Insp. P ITRAVDOC Travel&Documentation Fee B 1 BUSLIC Business License B Building Department 'isCity Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: LJue a PERMIT# a ©D OWNER'S NAME: S'fn PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: 0 CITY/ZIPCODE: �, 3 Y-0 *Our municipal code requires all bu 'nesses working in th c ty to have a City of Cupertino busines license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBC TRACT0) tS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Date Signatui•e Please check applicable subcontractors 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