The URL can be used to link to this page

09110067 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1110 STEEPLECHASE LN CONTRACTOR:CONDITIONED AIR PERMIT NO:09110067 OWNER'S NAME: AMUDHAVALLI&RANGANATHAN SRIDHAR 1701 LITTLE ORCHARD ST DATE ISSUED: 11/12/2009 ( :R'S PHONE: 4088738534 SAN JOSE,CA 95125 PHONE NO:(408)291-2220 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# y�/�Z-- MECH f— RESIDENTIAL COMMERCIAL Contractor G1 elf/ �`� `4 vale l D JOB DESCRIPTION:NEW 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 Sq.Ft Floor Area: Valuation:$7700 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by APN Number:35931036.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating 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 ir �_'� Dat ��l granting of this permit. Additionally,the applicant understands and will comply Issued W. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. J �jcj Signature� Date /A RE-ROOFS: _ All roofs shall be inspected prior to any roofing material being installed.If a roof is [� OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree to remove all new materials for inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of Date: the following two reasons: Signature of Applicant: 1,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, ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Business&Professions Code) 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 have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain a Certificate of Consent to self-insure for Worker's compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air performance of the work for which this permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I have and will maintain Worker's Compensation Insurance,as provided for by maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Section 3700 of the Labor Code,for the performance of the work for which this 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 Own r or su orr nt' 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 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 for which this permit is issued(Sec.3097,Civ C.) APPLICANT CERTIFICATION Lender's Name I certify that I have read this application and state that the above information is correct.1 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 ARCHITECT'S DECLARATION mify and keep harmless the City of Cupertino against liabilities,judgments, I understand m plans shall be used as public records. ,and expenses which may accrue against said City in consequence of the y granting of this pen-nit.Additionally,the applicant understands and will comply Licensed Professional with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Date Signature /' CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35931036 .00 DATE ISSUED. . . . . . . : 11/12/2009 RECEIPT #. . . . . . . . . BS000009176 REFERENCE ID # 09110067 SITE ADDRESS 1110 STEEPLECHASE LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER AMUDHAVALLI & RANGANATHAN SRID ADDRESS . 1110 STEELECHASE LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5817 RECEIVED FROM CONDITOINED AIR CONTRACTOR RICHARD READ LIC # 22334 COMPANY CONDITIONED AIR ADDRESS 1701 LITTLE ORCHARD ST CITY/STATE/ZIP SAN JOSE, CA 95125 TELEPHONE (408) 291-2220 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---- 1BCBSC VALUATION 7, 700 . 00 1 . 00 0.00 1. 00 0 .0 1BSEISMICR VALUATION 7, 700 . 00 0 . 80 0 .00 0 . 80 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 1 . 00 63 . 00 0 .00 63 . 00 0 .00 1PPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 ------0_00 ---------- ---------- ---------- TOTAL PERMIT 190 .80 0 . 00 190 .80 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- -------------- -- CREDIT CARD 190 .80 visa --------------- TOTAL RECEIPT 190 .80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION _ ----------------- _ -------- --------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO 11- FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM APN# Date: 35 g3103CP -a) Building Address: MO 11 O S�e��e2Grag� Ln � pe��o CA QSo l �^ Owner's Name: Phone#: Contractor: Phone#: )ASSDC• Fax#: 2-C11- Contractor -ql-Contractor License : Cupertino Business License#: t4 Li cot 6 Z Contact: Phone#: Fax #: Building Permit Info: Elect[]� Plumb ❑— Mech Job Description: Residential Commercial For Residential Installations: Attic ❑ l" floor ❑ 2nd floor ❑ 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 (Us a e Class): Strapped On Platform Bonded New Location Replacement 1166 Valuation: Green Building: Must attach Green Building Check list to this application CITY OF CUPERTINO F zFURNACE/AC CITY OF CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group AIR FURN/AC CONDITIONING 1 BCAIRHAN Commercial A/C Units <= I Ok CFM B I MCRAA Commercial Mech Repair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commercial B 1 PGASCOM 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. Comm/Resid 1 BREMAIRHAN Residential A/C units <= I Ok CFM B 1 MRRAA Residential Mech Repair/alt/add M I 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1 EPERMITFEE Electric Permit E ' 1 MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel Documentation B 1BUSLIC Business License B NOT M.Indoor Air Quality and Finishes 1.Use Low/No-VmC Paint 1 IAD-/Health pts y=yes0 2.Use Low VOC,Water-.Based Wood Finishes 2 IADJHealth pts y=yes 7 0 3.Use Low/No VOC Adhesives 3 lAQ/Health pts y--yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 7.Ssal ail olebaada;tr MDF 4 IAQIHealth pts= es D B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts Ayes D 10.Install Whole House Vacuum System 3 IAQ/Health pts Ayes 0 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring B 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 IAD/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 1 1 1 Total Points Available: 1 1401 130 57 Total Points Project Received: 01 0 G:data/progslgreenbuildngguidelinestramodelerslgreenpointsfinal212D4proteOied.xis