10030074 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18833 TUGGLE AVE CONTRACTOR:A&H HEATING PERMIT NO: 10030074
OWNER'S NAME: EVARESTO VALDEZ 770 CHESTNUT ST DATE ISSUED:03/12/2010
:ER'S PHONE: 4082527811
SAN JOSE,CA 95110 PHONE NO:(408)279-0722
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT F PLUMB
License Class -2 y Lic.# e3aYYT-7-
,�r MECH� RESIDENTIAL� COMMERCIAL
Contractor 0 t'y HTS Date 3^fy
JOB DESCRIPTION:REMOVE&REPLACE WALL HEATER
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:$2842
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 anc Type:
Occupancy
permit is issued. APN Number:37533056.00 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
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 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 e r1( r+lo
with all non-point source regul er the Cupertino Municipal Code,Section Issued byDate:
9.18. -
Signature
- - - - Date
RE-ROOFS:
❑ OWNER-BUILDER DECLARATION All 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
I hereby affirm that I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
1,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date:
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 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 have 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 California Health&Safety Code,Sections 25505,25533,and 25534. I 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. Safety 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 contaminants 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. Health&Safety Code,Sections 25505,25533,and 25534.
1 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 Owner or authorized agent:
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 which this permit is issued(Sec.3097,Civ C.)
1 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
upon the above mentioned property for inspection purposes.(We)agree to save
nify 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
granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
with all non-point s e regulations per the Cupertino Municipal Code,Section
9.18. 4 _ Licensed Professional
Date
Signature
CITY OF CUPERTINO
7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 37533056 . 00
DATE ISSUED. . . . . . . : 03/12/2010
RECEIPT # . . . . . . . . . BS000009925
REFERENCE ID # 10030074
SITE ADDRESS 18833 TUGGLE AVE
SUBDIVISION
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER EVARESTO VALDEZ
ADDRESS . . . . . . . . 18833 TUGGLE AVE
CITY/STATE/ZIP CUPERTINO, CA 95014
RECEIVED FROM REINHARD PERLHEFTER
CONTRACTOR . . . . . . . : PHELPS, DALE LIC # 12079
COMPANY A & H HEATING
ADDRESS 770 CHESTNUT ST
CITY/STATE/ZIP SAN JOSE, CA 95110
TELEPHONE (408) 279-0722
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ----------
---------- ----
00
1BCBSC VALUATION 2, 842 . 00 1 . 00 0 .00 1 . 00 0•
1BSEISMICR VALUATION 2, 842 .00 0 .50 0 .00 0 . 50 0 . 00
lEPERMITFE 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
1 . 00 63 . 00 0 .00 63 . 00 0 . 00
1MRRAA UNITS
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 232 . 50 0 .00 232 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--------------------
---------------
-----------------
CREDIT CARD 232 . 50 VISA
---------------
TOTAL RECEIPT 232 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
_ _ -------- --------------------------
--
-----------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FURNACE/AC
CUPEkTINO PERMIT APPLICATION FORM
Date: �
BuildingA ddress: &�L� v
Owner's Name: l Phone#: 2� 7 t)i l
eVAR�-- V
Phone#: 2)R ci?2 Z
Contractor:
T1
�r,����-- � t� �-��� • Fax#:
Contractor License#: Cupertino Business License#:
*301f q72-
Phone#:
Contact:
b4-L--rz:-, Fax#:
Building Permit Info:
Elect Plumb �ML;echResidential Ccia ❑
Job Description:
For Residential Installations: 2"d floor ❑
Attic ❑ 1St floor ❑
Adhere to minimum setback re uirement ❑
For Commercial Installations:
Additional weight(structural calcs) El
Replacement same weight ❑
Structural Calculations required for new installation ❑
New installation Planning Approyal Required ❑
Cost of Projej2, %Lt1c'0
Type of Con frac n(Usage Class):
Strapped On Platform Bonded New Location Replacement
Project Size: Express ❑ Standard ❑ ..Large ❑ Major ❑
Valuation:
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 6/16/08
CITY OF CUPERTINO
FURNACE/AC
CUPEk iNO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system;incl
installation of controls regulated by this
code.
1MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
ermit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install ¬ incl in an appl permit.
Quantity Fee ID Fee Description Fee Permit Type
Groun
CITY OF CUPERTINO
f FURNACE/AC
CUPEkTINO FEE SCHEDULE
Group
FURNACE FURN/AC
1PGASRES 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 Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner,incl ducts/vents
attached to such appliance over
100,000 Btu/h
' 1 EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit P
,i 1TRAVDOC Travel Documentation B
1BUSLIC Business License B
Quantity Fee ID Fee Descri tion Fee Permit Type
M.Indoor Air Quality and Finishes
1.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes '0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=-yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes p
p
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health is
P Y=Yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y--yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes ,lid
1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
i i 1
Total Points Available: 1 1401 1301 57
Total Points Project Received: — 01 0 0
y•
G:data/progs/greenbuildingguidelines/remodelers/greenpointsfinal2.12.D4proterted.xis
CITY OF CUPERTINO BUILDING PERM • O
BUILDING ADDRESS: 20705 VALLEY GREEN DR FLR 1 &2 CONTRACTOR:NOVO CONST I PERMIT NO:09120094
1042 HAMILTON CT DATE ISSUED:02/02/2010
OWNER'S NAME: MISSION WEST
VER'S PHONE: 4087250700
MENLO PARK,CA 94025 PHONE NO:(650)701-1500
❑ LICENSED CONTRACTORR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT f— PLUMB
License Class Lic.4 ` 1 d�� MECH RESIDENTIAL COMMERCIAL
Contractor G'L�^"� `'_' '�� Date J ,
JOB DESCRIPTION:COMM'L TI INTERIOR MODIFICATIONS TO EXISTING
I hereby affirm that I am licensed under the provisions of Chapter 9 OFFICE BUILDING. NEW PARTITIONS&
(commencing with Section 7000)of Division 3 of the Business&ProfessionsC ILINGS(56266SQFT),NO OCCUPANCE CHANGE;NO
Code and that my license is in full force and effect. I _ C,�,t' Z4 PIC-rn @_ +b add
-,o LE D, (Y'1 b e.- «L C,_z.d.,/w
I hereby affirm under penalty of perjury one of the following two declarations: Q�U�SMr~T�+ r/¢_�n�C�5�1YuC�rd � Ca C-s.
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 Valuation:$3600000
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area:
permit is issued.
APPLICANT CERTIFICATION APN Number:32610046.FLRI&2 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE O
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. -Issued Date:
b��-
Signature �� Date
OWNER-BUILDER DECLARATION RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044, Signature of Applicant: Date:
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the
California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
performance of the work for which this permit is issued.
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I ___err autho .zed a�geyt: e? rg,1
become subject to the Worker's Compensation provisions of the Labor Code,I must ,rte Date:
forthwith comply with such provisions or this permit shall be deemed revoked. `/
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above in is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the
t ing of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Signature
Wei Date O` 0 Licensed Professional