10010023 UPERTINO BUILDING PERMIT
CITY OFC PERMIT NO:100 10023
CONTRACTOR:A PLUS HEATING&A/C ISSUED:01/06/2010
BUILDING ADDRESS: 10380 LOCKWOOD DR#B DATE
244 GREAT MALL PKWY
PHONE NO:(408)934-0730
OWNER'S NAME: BARBARA BAYHA MILPITAS,CA 92683
aER'S PHONE: 4082532685 PLUMB
BUILDING PERMIT INFO: BLDG ELECT
13 LICENSED CONTRACTOR'S DECLARATION L COMMERCIAL
Lic.#-7 ' 31 ' � MECH RESIDENTIAL
License Class
Date ` JOB DESCRIPTION:CHANGE OUT FURNACE&ADD ON A/C
Contractor _
hereby affirm th am licensed under the prov)of Division 3 ofisions
Bus ness Chapter 9
IhProfessions
y
(commencing with section
Son full force and effect.
Code and that my license
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
Labor Code,for the Valuation:$5000
provided for by Section 3700 of the
Compensation,as p Sq.Ft Floor Area:
performance of the work for which this permit
Insurance,as provided for by
I have and will maintain Workers CompensationOccupancy Type:
k for which this
Section 3
700 of the Labor Code,for the performance of the worAPN Number:34229017.#B
permit is issued.
APPLICANT CERTIFICATION RES IF WOE IS NOT STARTED
that I have read this application and state that the above information a PERMIT EXPI NCE OR
I certify with all city and county ordinances and state laws relating IT ISSUANCE correct.I agree to comply representatives of this city to enter WITHIN 180 DAYS OF PERM
and hereby authorize rep agree to save
to building construction, for inspection purposes. (We) g FROM LAST CALLED INSPECTION.
upon the above mentioned property of Cupertino against liabilities,judgments, igp DAYS FR
indemnify and keep harmless the City in consequence of the =
accrue against said City� -------�,_,_., Date:
costs,and expenses which may applicant understands and will comply –� ._-- ,-- - -'
granting of this permit. Additionally,lei theCupertino Municipal Code,Section Issued
with all non-point source regulations p
9.18. `.._. Date
Signatur .,,-,-ROOFS:froin erial being installed.If a roof is
All roofs shall be inspected prior to any roofing
TION without first obtaining an inspection,I agree to remove all new materials for
OWNER-BUILDER DECLARA installed wrt
inspection.
hereby affirm that I am exempt from the Contractor's License Law for one o Date:
I he y licant:
the following two reasons: es as their sole compensation, Signature of App
or my employees with wag
1,as owner of the property,
the work,and the structure is not intended or offered for sale(Sec.704 , COVERINGS TO BE CLASS"A"OR BETTER
will do ALL ROOF
Business&Professions Code) with licensed contractors to
I,as owner of the property,am exclusively contracting
HAZARDOUS MATERIALS DISCLOSURE .95 of the
construct the project(Sec.7044,Business&Professions Code). Chapter 6
under penalty of perjury one of the following three
affirm P Code,Sections 25505,25533,and 25534. I will maintain
I hereby
I have read the hazardous materials requirements under Health&
declarations: Chapter 9.12 and the
Certificate of Consent to self-insure for Worker's California �with the Cupertino Municipal Code,
hazardous material.
I have and will maintain a Cert complianceshould I store or
m ensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section I use a(a)
Co p ' sued. nail should I use equipment or devices which emit hazardous air
provided for by Additionally,y� the Bay Area Air Quality Management District I will
performance of the work for which this permit is is as contaminants as defined by Chapter 9.12 and the
I have and will maintain Worker's r theCompensation
pe satin ance of the�wo k for which this maintain compliance with the Cupertino Municipal Code,
Section 3700 of the Labor Code,for the perform Health&Safety Code,Sections 25505,25533,and 25534.
permit is issued. ' ed a en• G7 f
t in the performance of the work for which this permit 1 et0 ker'shal Owner ut � Date:
I certify that
not employ any Person in any manner so as to become subject to th
California. If,after making this certificate of exemption,Lust Y
Compensation laws of provisions of the Labor Code,I m
subject to the Worker's Compensation p deemed revoked. CONSTRUCTION LENDING AGENCY
performance of work';
become 1 enc for thep
forthwith comply with such provisions or this permit shall be
I hereby affirm that there is a construction lending ag y
for which this permit is issued(Sec.3097,Civ C.)
APPLICANT CERTIFICATION that I Lender's Name
have read this application and state that the above information is
I certify 1 with all city and county ordinances and state laws relating
correct.I agree to comp y
d hereby authorize representatives of this city to aveenter Lender's Ad ress
to building construction,anfor inspection purposes.(We)agree to
a ainst liabilities,judgments, ARCHITECT'S DECLARATION
upon the above mentioned property P
nnify and keep harmless the City of Cupertinog m consequence of the plans shall be used as public records.
,,and expenses which may accrue against said City 1 I understand my p
applicant understands and will comp y
granting of this permit.Additionally,the
he Cupertino Municipal Code,Section Licensed Professional
with all non-point source regulations p P
9.18.
t Date ly
Signature
CITY OF CUPERTINO
RECEIPT OPERATOR: patg
PERMIT COPY # 1
7 ITEMS OF 14
Sec: Twp: Rng: Sub: B4229017 .#B
3
APN • " " "
DATE ISSUED. • • • • " 01/06/2010gS000009500
RECEIPT # . . " " 10010023
REFERENCE ID # • • •
SITE ADDRESS 10380 LOCKWOOD DR #B
SUBDIVISION : : : : : : ; CUpERTINO
CITY . . . . . . .
IMPACT AREA . . . . . .
OWNER BARBARA AYHADR # B
ADDRESS . . . . . . . . . . : 10380 LO
CITY/STATE/ZIP . • •
CUPERTINO, CA 95014
VED FROM APLUS HEATING & AIR# 31293
RECEI ; ADAM P. PHAM
IC
CONTRACTOR APLUS HEATING & A/C
COMPANY • • • " " 244 GREAT MALL PKWY
ADDRESS • • • • • . . MILPITAS, CA 92683
CITY/STATE/ZIP (408) 934-0730
TELEPHONE . . • • • • • •
THIS REC NEW BAL
PD-TO-DT ______
UNIT QUANTITY _ OT___ _--------- ---------- - . 00
FEE ID _ ---------- 0 00 1 . 00 0
-------- ------------ 5 000 .00 1 .00 0 . 50 0 . 00
VALUATION 0 .50 0 .00 0 . 00
1BCBSC TION 5, 000 .00 0 .00 42 .00
1BSEISMICR VALUATION 1 . 00 42 . 00 42 .00 0 . 00
42 . 00 0 .00 0 . 00
lEPERMITFE FLAT RATE 1 .00 .00 0 .00 126 .00
1MPERMITFE FLA 2 .00 126 42 .00 0 .00
UNITS 42 . 00 0 .00 0 .00
1MRRAA 1 .00 0 .00 42 .00 -
1PPERMITFE FLAT RATE 1 .00 42 . 00 _ ______---- ---------
1TRp,VDOC FLAT RATE _________- --------- 295 . 50 0 .00
295 .50 0 . 00
TOTAL PERMIT :
AMORT REFERENCE NUMBER
METHOD OF PAYMENT --------------- __----
-
591.00 #1140
CHECK ---------------
591. 00
TOTAL RECEIPT : VOICE ID DESCRIPTION_-_-_--_-
VOICE ID DESCRIPTION_-_------ -------------------
--------------- 507 FINAL PLUMBING
505 FINAL ELECTRICAL
508 FINAL MECHANICAL
r
CITY OF
CUPERTINO
ACE/AC
FU1RN
Cin oFPES IT APPLICATION FORM
CUP TING
Date:
APN # -z----} -� i -T
Building Address: , b7g 1
p�j �C) � vG� �✓ Phone 4C
)P#: �-
7,-
own s Name: Y�) `
/-
901—v^ -� Phone#: 73C
Contractor: Q t .��� - �3ct
f � N5/� Fax#. �'
/ V �V-1Cu ertino Business License#:
Contractor License#: 3
--7 Phone#:
Contact:
� Fax#:
A .� / �--
o
Building Permit Into:
Plumb
Mech �-
�-- commercial
❑
Elect[� Co
Residential
Job Description:
/4 L/
en ial Installations: S2na floor
[D
For Resid 1t floor
Attic ❑
setback requirement El to minimum se nt
For Commercial Installations: Additional weight structural calcs) D
Replacement same weight ❑
Structural Calculations required ht red for new installation ❑
❑
New installation Planning Approval Required T e of Construction(Usage Class).
Yp
Cost of Project: V
Bonded New Location Replacement
for [�
Strapped ❑
On Plat'[ ❑
Ex ress ❑ andardgL
Large❑ Major❑
Project Size: p
Valuation:
• en Building Checklist & attach it tot e
• complete relevant portion of the Green a sheet index.
Green Building: Please c p plan set & the
application or if applicable, include in p
pp Revised 01/07/09
CITY 4F CU-pER,TINO
�p
FURNACE/AC
OF FEE
SCIIEDULE
CUPEkINO
Fee Permit Type
Quantity
Fee Description Grou
anti Fee ID FjJRN/AC
AIR B
CONDITIONING
N 1 A/C Units
<= lOk CFM
CAIK�IACommercia
1B M
cial Mech Repair/alt/add
Commer .B ALL PERMIT1MCRAA fission Fee
Cal Bldg Standards Comm TYPES
1BCBSC B
Seismic Commercial
1BSEISMICO stem P
Comm
erical for ea gas piping Sy
1PGASCOM 1-4 outletsP
Residential for ea gas piping system
1PGASRES of 1-4 Outlets of 5 or P
For each gas pp i ing system
omm/Resid
1BPGAS more per outlet. C
. its<= 10k CFM B
AN Residential A/C un
1 BREMAIRH lt/ad d M
Residential Mech Rep air/a
B
ALL PERMIT
SC Cal Bldg
Standards Commission Fee TYPES
1BCB B
11,111,11,
1BSEISMICR
Seismic Residential
E
EE Electric Permit
1 EPERMITF M
PERMITFEE Mech
anical P ermit
1M P
1 PPERMITFE
E Plumbing Permit
B
Travel Documentation
� 1TRAVDOC B
. 1BUSLI
C Business License
M.indoor Air Quality and Finishes 0
1 IAWHealth pts Mes p
1.L*LV.m -VOO 2 lAOJHealth pts y=yes
2.Use Low VOC,Water-Based Wood Finishes 0
- 3lAQIHea]th pts Y--Yes,3. �"
•ass L° - 3 Resource pts Y--Yes
0
4.Use Salvaged Materials for Interior Finishes
0
5.Use Engineered Sheet Goods with no added Urea 6 IAQ/Health pts yy'25 p
Formaldehyde 1 IAQ/Health pts y=yes
B.Use Exterior Grade Plywood for Interior Uses 0
�, 4IAQ/Health.pts y=yes p
7. .,. - -_... 4 Resource pts Mes
S.Use FSC Certified Materials for Interior Finish p
1 Resource pts Y--Yesp
9.Use Finger-Jointed or Recycled-Content Trim 31AC�IHealth pts y=yes
10.Install Whole House Vacuum System
N.Flooring0
B Resource pts y Yes
1.Select FSC Certified WoDd Flooring 0
4 Resource pts y=yes
2 Use a idly _ flooring�► �s p
4 Resource pts Mes p
3.Use Recycled Content Ceramic Tiles 51AQ/Health pts y=yes
4.Install Natural linoleum in Place of Vinyl p
5.Use Exposed Concrete as Finished Floor
4 Resource pts Y--yes
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes
140
Total Points Fv-E labte.
130 57
OL 2J
Total Points Pro'ect Received:
G:data/progslgreenbuildingguidelineslremodelerslgreenpointsfina12.12.o4protectedxis
Community Development
10300 TorreAvenue5014
Cupertino
Telephone(408)777-3228
a ate,;
Fax(408)777-3333
CITY OF
p� TINS ent
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Bu
11
din
e
PERMIT # r?
jpB ADDRESS.
D ® c� PHONE
# ca
Odig
AX#
OWNERS NAME: v F
GENERAL CONTRACT
I 6
Date
• an subcontractors:
I am not using Y lgnature
ete the followin information: #
subcontractors and coin l BUSINESS LICENSE
lease check a livable su INE S S NAME
P TRACTOR BUS
SUBCON
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
Date
owner/Contractor Signature