13120125 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1532 ASTER CT CONTRACTOR:VALLEY HEATING& PERMIT NO: 13120125
COOLING
OWNER'S NAME:
SAN JOSE,CA 95112 PHONE NO:(408)294-6290
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL11
License Class C-26 ��Liic.#pp 25 S 54L� REMOVE AND REPLACE FURNACE IN SAME LOCATION
Contractor Va 1r,0-(i /7PaTiila Date lz l 1
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 perrimit is issued. Sq.Ft Floor Area: Valuation:$2241
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for be performance of the work for which this APN Number:36616043.00 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 DA 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
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
918.
RE-ROOFS:
Signature, Date12,4741 T 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
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
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,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: �. _ �
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
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION /
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 0
CUPERTINO (408)777-3228•FAX(408)777-3333•buildin-gacupertino.org \3 1Z misc
❑PLUMBING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESS/J /5 ler, /1 J APN � (�
OWNER
STREET ADDRESSc Z CITY,STATE,ZIPr� / FAX
CONTACT NAME J C PHONE C l ' E-MAIL
STREET ADDRESS CITY,STATE,ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ACONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC#
11 258"5 0 -2o ref f
COMPANY NAME /� f E-MAIL FAX
li
STREET ADDRESS CITY,STATE,ZIP PHONE
l7 A S>t. 54,E 1511Z
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND El YES PROJECT M El YES IS THE BLDG AN ❑YES
BUILDING: r7 COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO
DESCRIPTION OF WORK
2 K F ioe qnr" e see 10e4 f.o
TOTAL VALUATION: 2 _7 L.r(+►' RECEIVEDBY:
By my signature below,I certify to-each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I hav this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree p yNJ applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-ide led pLLY for inspection purposes.
c
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED orcE LF5AMY
,,. 04ER-TRE-COUNTER
EXPRESS
. "STANDARD
v,
O LARGE:
MAJOR
MEPMiscApp_201 1.doe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1532 Aster Ct DATE: 12/17/2013 REVIEWED BY: Mendez
APN: BP#: "VALUATION: 1$2,241
*PERMIT TYPE: Building Permit. PLAN CHECK TYPE: Alteration/Repair
PRIMARY SFD or Duplex PENTAMATION FURN/AC
USE: I I PERMIT TYPE:
WORK remove and replace furnace in same location
SCOPE
� { E n ,1U>1131111 3
3
.':il"3 �,a.0 n.1...il3333�At1Y�3�3Y3 V 3}13 ivy 333
Mech.Plan Check 0.0 hrs $0.00 :"lwnit.iXlli C,"k z>irr . 11'an(.'k,"77
Mech.Permit Fee: IMPERMIT
Other Mech.Insp. 0.0 hrs $47.00 t'1?,acs .T€�r;1;,N;,p. CJ.°her t':'>azt;. ht,�p.
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on therelinsna information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff. 711113,) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 1 # Mechanical
Suppl.PC Fee: O Reg. OOT 0.0 lus $0.00 $139.00 1WR=<100 Furnace,Forced-Air
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp.Fee.e Reg. O OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $47.00
Administrative Fee: IADMIN $44.00 O
Work Without Permit? O Yes (R) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential
Travel Documentation Fee: 1TRAVDOC $47.00 Building or Structure O
i
Strong Motion Fee: 1BSEISMICR $0.50 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
,3' ' 13 ''`1 $139.50 $139.00 0j0M FEE: $278.50
Revised: 10/01/2013
Simplified Prescriptive Certificate of Compliance:2008 Residential HVACAlterations CF-IR-ALT-HVAC
Climate Zones 1 and 3-7
Site Address: Enforcement Agency: Date. Permit#:
15 32 Ad lir C-v 12/1 13
Conditioned Duct insulation
Equipment T e' List Minimum Efficiency
2 Floor Area requirement Thermostat
Packaged Unit Over 40 ft of ducts
Furnace AFUE�a COP Setback
Served by system added or replaced in
Indoor Coil [JSEER H HSPF (If not already present,must be
Condensing Unit E3EER Resistance sf unconditioned space installed)
Other
R 6 (CZ/,3-5)
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 Signature:
Company: Date:
'A
/2/l 7/
( 1
Address: License:
117t N f S'f 25 b
City/State/Zip: Phone: Llb 9-2 14— 7-
2008
2008 Residential Compliance Forms March 2010