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10020037
CITY OF CUPERTI NO BUILDING PERMIT BUILDING ADDRESS: 21091 RAINBOW DR CONTRACTOR:A PLUS HEATING&A/C PERMIT NO: 10020037 OWNER'S NAME: MARTY GUNTHER 244 GREAT MALL PKWY DATE ISSUED:02/05/2010 WNER'S PHONE: 4082573709 MILPITAS,CA 92683 PHONE NO:(408)934-0730 ❑ LICENSED CONTRACTOR'S DECLARAT�IION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class G 2� Lic.# i CHANGEOUT EQUIPMENT ONLY ADDING NEW HVAC EQUIPMENT Contractor -Date [ NEW(E,P)GAS DRAINS I hereby affirm that m licens 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:$13000 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 APN Number:36223052.00 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 relatin; 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 Issued by: Date: s 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. L RE-ROOFS: Signature Date 4?— J 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 inspection. �I OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one i if the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensatio i, 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 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: Health&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 material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will 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 25505, 55 3,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 CONSTRUCTION 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 I 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. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender'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 relatilig to building construction,and hereby authorize representatives of this city to enter upon 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, ts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. I wanting of this permit.Additionally,the applicant understands and will comply with all non-point source re lations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature c - Dated CITY OF CUPERTINO 9 ITEMS OF 9 PERMIT' RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: B1}:. Lot: APN . . . . . . . . . 36223052 . 00 DATE ISSUED. . . . . . . : 02,'05/2010 RECEIPT #. . . . . . . . . : BS0i00009698 REFERENCE ID # . . . : 10020037 SITE ADDRESS . . . . . : 21091 RAINBOW DR SUBDIVISION : . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER MARTY GUNTHER ADDRESS . . . . . . . . . . : 21091 RAINBOW DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5074 RECEIVED FROM . . . . : APLUS HEATING CONTRACTOR . . . . . . . : ADAM P. PHAM LIC # 31293 COMPANY . . . . . . . . . . : A ]FLUS HEATING & A/C ADDRESS 246 GREAT MALL PKWY CITY/STATE/ZIP . . . : MILPITAS, CA 92683 TELEPHONE . . . . . . . . : (408) 934-0730 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- 1BCBSC VALUATION 13, 000 . 00 1. 00 0 . 00 1 . 00 0 . 00 1BREMAIRHA NO.UNITS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1BSEISMICR VALUATION 13, 000 . 00 1.30 0 . 00 1 .30 0. 00 1EPERMITFE FLAT RATE 1 .00 42 . 00 0 . 00 42 . 00 0 . 00 1MFR=<100 UNITS 1. 00 126 . 00 0 .00 126 . 00 0 . 00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1MRRAA UNITS 2 . 00 126 . 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 485 .30 0 . 00 485 .30 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 485 .30 1187 --------------- TOTAL RECEIPT 485.30 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 1 1 i A� � tu rvi U IN AGCORUAN, i �JITH TVA :ITY OF CUPERTINO C-OUE ANU ORC INANCES I DATE SIGNE This set of plans ,Tec rfrcatr ins MUST __--be kept on the Ic,t) ,il-times and.d ts.__ i' unlawful to make any clranyes or alterations on same without written perms stun from the Building Department. Carty of Cuppeertino. The stamping of this plan,ind sr ecificationp SHALL NOT be held to permit r r to be an approval of the violat-n of any provision, i of any City Ordrnam,t,or Sta'e Law. ilii,__ y ---— ------ I ;1 t; j v � I � -1�5 i I I T C � Z 0 0 m > o zv � OriC0M 0 .737 -im - r, m M 2 -0C T - ro> m* C In i (nrnm0p � i �\ -� � o �� caw o „ m o x0 m :D z rn Z a� -•q zi: z0O- o a e mT � 3 c I� mrC�- m �3 4 3 �=Ed0 z 4 D C D C00Z O Z D �rnoc r N x mNr- C 3 OM M, 3 w _ z AzC) c 3 0 ^ r � � -n3 � xX mmm > M -0NO -4m3 � Tm 3 Z � m0 Z D � o c 005mCZ3 m D N T �� 3 0 '00 " > O x p R' 3 C -4Z r.. m > x M:; O - • _ --4G� oXZ3 7 I:4... • 4 � M,- 0 N 3 w u7 Z -40 -0 - > o (33 -.4 =i mm3 Doc) 0 c-) 3 zI me = mx 3 3 N 3 3 v CITY OF CUPERTINO FUIViACE/AC CUPERTINO PERMIT APPLICATION FORM APN # 052 Date: (� 2. E3 -� Building A6A ess: 21© 4'l cLt`N bow Dir Cu cv fl'LAa -q 5©1 . Owner's Name: Phone#: Contractor: Phone#:ya C/ P!v s Fax#: Contractor License#: Cupertino Business License#: ? 43 / 54 Contact: Phone#: �0 -q-54- 0' 3 0 W/.<-ev Fax #: Building Permit Info: Elect EO Plumb Mech Residential Commercial ❑ Job Description:',)-"-f1oo{Z For Resi ntial Installations: Attic 15` floor �� 2°d floor F-1 Adhere to minimum setback requirement For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction (Usage Class): 13 UoG Strapped ❑ On Platform Bonc.ed New Location Replacement Project Size: Express 2r�`StandardFl-- Large ] Major❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, inc_ude in plan set & the sheet index. Revised 01/07/09 CITY OF CUPERTINO S-,L- FURNACEAC CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Descriptior. Fee Permit Type Group AIR FURN/AC CONDITIONING 1 BCAIRHAN Commercial A/C Units <= l Ok CFM B 1MCRAA Commercial Mec1 Repair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commer-,ial B 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1 PGASRES Residential for ea gas piping system P of 1-4 Outlets 1 BPGAS For each gas piping system of 5 or P more per outlet. ('omm/Resid 1 BREMAIRHAN Residential A/C units <= l Ok CFM B 1 MRRAA Residential Mecl: Repair/alt/add M r 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1 EPERMITFEE Electric Permit E 1 MPERMITFEE Mechanical Permit M ' 1 PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel Documentation B IBUSLIC Business Licensf B zr-, CommunityDevelopment 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 XPERTINO Building Department JOB ADDR S: C /,Oev -I`L,C� PERMIT # !� � D OWNER'S NAME:G v vi'f h if PHONE 4 408 - Y GENERAL CONTRACTOR: v> FAX # / I am not using any subcontractors: Si;nature Date Please check applicable subcontractors and com Mete 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 Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date