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13100029 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10900 WUNDERLICH DR CONTRACTOR:DOVE'S SERVICES INC PERMIT NO: 13100029 OWNER'S NAME: NEDUNCHELIYAN DURAISWAMI PO BOX 2061 DATE ISSUED: 10/03/2013 OWNER'S PHONE: 4084062543 SAN LEANDRO,CA 94577 PHONE NO:(510)376-6543 in LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class LIT 2© Lic #� ,OqA-:� REPLACE(E)FURNACE IN ATTIC&(E)A/C UNIT IN Contractor 464Z Date �� SIDE YARD 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:$4500 I have and will maintain Worker's Compensation Insurance,as provided for by "t Section 3700 of the Labor Code,for the performance of the work for which this APN Number:37522005.00 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 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 F AST 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 =_ Id3 /1 granting of this permit. Additionally,the applicant understands and will comply sued ,— Date: with all non-point source regulations per the Cupertino Municipal Code,Sectio 9.18. n RE-ROOFS: Signature Date /D 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. ❑ OWNER-BUILDER DECLARATION ' Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of 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 compensation, 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 25505,25533,a 5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent:C16,2j'),n 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the.applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION �� MEP Gd64I DEVELOPMENT DEPARTMENT BUILDING DIVISION O 10300 TOIRR E AVENUE•CUPERTINO,CA 95014-3255 ^ CUPERTINO (408)777-3228 FAX(408):777333•building ancuaertino.org /{�` misc PLUMBING KNECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS ciyI O ,. r APN# OWNER NAME " I�l-�G --PHO 2 t y 3/. -E-MAIL STREET ADDRESS �oa..N Q �tGh �r CITX,STATE,ZIP C CY�I�� FAX CONTACT NAME 0/ PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER..::❑ OWNHI[AGENT.: COA}TRACTOIt. ❑CONTRACTORAGENT ❑ ARCHITECT 11ENGINEER 11 DEVELOPER 11 TENANT CONTRACTOR NAME r,6-kC may/ 'nor �+ LICENSE NUMBER LICEN TYJ;E BUS.LIC COMPANY NAME 1�_ n„`S S CJ��Y,(�C�J E-MAIL d., ((.1,�'l.OD�(M FAX5(0 -361-16,91 STREET ADDRESS ��O��/���j n ,,D�' CITY,STATE, U tw q q 5'1 1 PHONE _ (V~� 10-x+'5LI3 ARCHIT'ECT/ENGINEER NAME ! LICENSE NUMBER BUS.LIC 11 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING. ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK e 6,66 -u's_g e c TOTAL VALUATION: By my signature below,I certify to each of the following: I am the property owner or authorized agent to actproperty er's behalf have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I ee tow with all applicable local ordinances and state laws relating wilding constru I authorize representatives of Cupertino to enter the above-iden roperty for inspection purposes. Signature of Applicant(Agent: Date: 101o3I t 3 SUPPLEMENTAL INFORMATION REQUIRED of tCis vsE oNLY w OVER=T'[iECOIINTER Q'EXPRESS_ C� .STANDARD :LARGE - w ,MAJOR. MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10900 WUNDERLICH DR DATE: 10/03/2013 REVIEWED BY: MELISSA APN: 375 22 005 BP#: `VALUATION: 1$4,500 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: p PERMIT TYPE: WORK REPLACE E FURNACE IN ATTIC & E A/C UNIT IN SIDE YARD SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $70 Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: $209.00 ti Alm Mech.Plan Check 0.0 hrs $0.00 .Plumb.Plan('heck Elec.Plan(heck Mech.Permit Fee: 1MPERMIT Ptumh.Permit F'ee: Elec. Permit Flee: Other Mech.Insp. 0.0 hrs $47.00 Other Plumb Insp. 01ber Glee.Insp. Lj Ile& Insp. Fee: Plumb. lisp.Fee: Elec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These-fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS(Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC.I'ce PME Plan Check: $0.00 Permit Fee: Suppl. Insp Fee PME Unit Fee: $209.00 PME Permit Fee: $47.00 Conslr-action Tax. Administrative Fee: 1ADMIN $44.00 Work Without Permit? ®Yes (2) No $0.00 Advanced Planning Fees: Travel Documentation Fee: ITRAVDOC $47.00 Stroniz Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 - 348.50 $0.00k � TOAFEE $348.50 Revised: 08/01/2013 STATE OF CALIFORNIA 2008 RESIDENTIAL HVAC ALTERATIONS: CLIMATE ZONES 1 AND 3-7 ' CEC-CF-IR-ALT-HVAC Revised 03110 CALIFORNIA ENERGY COMMISSION Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 Site Address: En oreement A ency: Datq. Permit#: 10 DO ourndwhotl Lbrr �► trF G n t� 1 Conditioned Duct insulation Equipment T ` List Minimum Efficient z Floor Area requirement Thermostat ❑Packaged Unit Over 40 ft of ducts ®-Furnace Z AFUEt4 ❑COP Setback Served by system added or replaced in ❑Indoor Coil WEER ❑HSPF sf unconditioned space (ynot already present,must be J1 Condensing Unit ❑EER ❑Resistance ❑R 6 (CZ 1,Spa installed ❑Other 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system. 2.Minimum Equipment Efficiencies: 13 SEER,78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application Name: .>t)ncL +d Dove— Signature: Company: Date: 1013 0 /3 3 �C�Ve-s SeJ2VICe S Address: Pb 5Ok 206 ` License: �6&` 017— City/State/Zip: ZCity/State/Zip: S h !-,oCLnj rb 4A c145-7-7 Phone:5/n 3-7 2008 Residential Compliance Forms March 2010