13100121Raw
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10207 WILL CT
CONTRACTOR: A & H HEATING
PERMIT NO: 13100121
OWNER'S NAME: CHAI THOMAS Y AND PING C
770 CHESTNUT ST
DATE ISSUED: 10/17/2013
OWNER'S PHONE: 4082562587
SAN JOSE, CA 95110
PHONE NO: (408)279-0722
❑ LICENSED CONTRACTOR'S D(�E(C�LARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ff
Lic. #
REMOVE AND REPLACE FURNACE AND INSTALL A/C IN
License Class
REAR
Contractor Date
OF SFDWL
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
erformance of the work for which this permit is issued. ;
Sq. Ft Floor Area:
Valuation: $4850
ave and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 31625025.00
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 aboveinformation is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 1 0 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 DAY M LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
/0
costs, and expenses which may accrue against said City in consequence of the
Issued b Date:
Y'
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.
RE -ROOFS:
Signature Date 7
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
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,
Business & Professions Code)
1, 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, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: � /7
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 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
O
CUPWINO
CITY OF CUPERTINO 1
FURNACE/AC
PERMIT APPLICATION FORM `b
APN#
Date:
Building Address: .7 WILL e-!,
Owner's Name:
TH0at4_
Phone #:
Contractor: A o awn q&- p e&o b. Ste.
Phone M Yom Z 71-&7 zZ
��C •
Fax #: li6fj A? q—
Contractor License #: 3�E 7 Z
Cupertino Business License #:
Contact: �L t� � 5
Phone #: �rl% 5-.7- 71, p 7 Z Z
cakL- 889523—ccg-7
Fax #: 41ePj!r-0 7
Building Permit Info:
Elect Plumb Mech
Residential Commercial El
Job Description: f tz- i:�vzaqFo Ai j�L r�a� LO Oti
ASD.n �, _ ��- �"l C— e� c B� (!'1 sect T
For Residential Installations_:
Attic El IS, floor ❑ 2' 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 44 5-D _ Type of Construction (Usage Class):
Strapped On Platform Bonded ❑ New Location El 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.
/911
113 Revised 6/16/08
F-ao Twe f 7
CITY OF CUPERTINO
7lTT T10T71&ii A TlIU 727X7 7171VC`_ nrv>rc>rnN
Mech. Plan Check 10.0 hrs: $0.00 p1lijub- Plan Check
Mech. Permit Fee: IMPERMIT Plumb. Permit I ec:
Other Mech. Insp. 0.0 hrs $47.00 Other Plumb Insp.
klech. Insp.- Fee: Plumb. Insp. Fee:
Elec. Plan Check
Elec. Permit Fee:
Gluier Eley. Insp.
Elec. Insp..Feee:
_-•__ re__ n,.. -s,. 0... .. T•.nf..inl Qnr�nn/
NOTE: This estimate doesnot include fees due ro orner veparrmenw tae. rsu tre—s,_ ��•�� • �•��. - •• -- - • - - - - -
District, eta). These fees are based on the relimina information available and are onlyan estimate Contact the Dept or addn'1 in o.
FEE ITEMS LFee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1 # Mechanical
Suppl. PC Fee: Q Reg. Q OT 0:0 hrs $0.00 $139.00 1MFR=<100 Furnace, Forced -Air
PME Plan Check: $0.00 1 1# Mechanical
P F S0.001 $70.00 IBREMAIR A/C Units (<=10K cfm)
el111 ee.
Suppl. Insp. FeeQ Reg. ® OT
••viu.0:i..
-- — --
$0.00
ADDRESS: 10207 will ct
DATE: 10/17/2013
REVIEWED BY: Mendez
iwi'La:j
i
BP#:
*VALUATION:
$4,850
APN:
$44.00
_j
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Repair
PRIMARY
SFD or Duplex,
Select a Non -Residential
Building or Structure
A
PENTAMATION FURN/AC
PERMIT TYPE: i
USE:
Stromz Motion Fee: IBSEISMICR
$0.50
WORK
remove and replace furnace and install a/c in rear of sfdwl
$1.00
SCOPE
Mech. Plan Check 10.0 hrs: $0.00 p1lijub- Plan Check
Mech. Permit Fee: IMPERMIT Plumb. Permit I ec:
Other Mech. Insp. 0.0 hrs $47.00 Other Plumb Insp.
klech. Insp.- Fee: Plumb. Insp. Fee:
Elec. Plan Check
Elec. Permit Fee:
Gluier Eley. Insp.
Elec. Insp..Feee:
_-•__ re__ n,.. -s,. 0... .. T•.nf..inl Qnr�nn/
NOTE: This estimate doesnot include fees due ro orner veparrmenw tae. rsu tre—s,_ ��•�� • �•��. - •• -- - • - - - - -
District, eta). These fees are based on the relimina information available and are onlyan estimate Contact the Dept or addn'1 in o.
FEE ITEMS LFee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1 # Mechanical
Suppl. PC Fee: Q Reg. Q OT 0:0 hrs $0.00 $139.00 1MFR=<100 Furnace, Forced -Air
PME Plan Check: $0.00 1 1# Mechanical
P F S0.001 $70.00 IBREMAIR A/C Units (<=10K cfm)
el111 ee.
Suppl. Insp. FeeQ Reg. ® OT
0;0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$47.00
Conslrzic;tion T caa:
Administrative Fee: 1ADMIN
$44.00
Work Without Permit?0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
A
Travel Documentation Fee: ITRAVDOC
$47.00
Stromz Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
$139,501 $209.00 $348.50
Revised: 10/01/2013
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�UPER�a�,�nt
C0MpLtANCE
Reviewed
.i�
ANT
i iNo
-)ns t):UST be
e any
�j Uc" I'a
NOT
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/02-01
eLm, PLAiN.-
CINE KE BY
FATE 0/17/0
PLANNING QEPT.
DATE
BLDG. DEPL
Simplified Catificale of 2008 Residential HVAC Alterations CF�IR-ALT VAC
Gate 1 and 3-7
lRA-
Model Ni mbec 7?V � G A&6p �4-,j !6
�t173 3d�o�-tom
Site Address:
E tAgeciry:
Date:
PemutNo.
/07-07 Wf Lt M.
eoym�&a
10/17/13
EquipmentTppt'
ListMtnimam2
Conditioned
DuctInstAation
Thermostat
Mciency
Floor Area
nequtrement
o Pgdmgcd Unit
�
ACOP p
Served by
Over 40 ft of ducts
uSetback
nASPF_--jL,*�
system
Added crreplaced
(if not already
g Indoor CAR
CEM
❑Resistance
1607 sf
is Ummndidoned
present, must
CondensingUmt
space
bemstalled)
0 Other
❑ R 6 (CZ 1,3-5}
1. M tType: Choose the equipment beinginstal W; if more than one system, use another CF-1R ALT
HVAC fix each system.
2 Mwmwm Fit 13 SOLER, 78'/o AFETE, 7.7 HSPF fior tppicalrestdential systems.
Contractor(DoamzentationAndwes/Responsible Design's Declaration Statement)
o I certify that this Certificate of Comphance documentation is accurate and completes
• I am eligible under Dbision 3 of the CaVormia Business and Professions Code to acceptzesponsAafty
For the design idenfi6odandiisCerfificAirofCxvapfianm
• I catify that A energy features ami pelf tramce-specifications for the design identified on this
C,te of Compliance conform to the requirements of Tide 24, Parts 1 and 6 of the California
Code of Reguhtioos.
• The design fimoxies identified on this Comte of Cake are consistent with. the radon
doa>mmibed an otbec moble c ompEance firms, woaksheets, calculations, plans and specifications
subminedto the eafimemecit agency for ap Dvalwiththepermit q4Awation.
Name:
Date: 149-1'7- - /
Addaess: r K T license Na: Y2 O cfct7 Z
51-tO
Phone Now -fJ ZZ
PlanntngAppnoval:
Setback from property:
!-