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14050076 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21080 RED FIR CT CONTRACTOR:CALIFORNIA DELTA PERMIT NO: 14050076 MECHANICAL INC OWNER'S NAME: ZHANG HUI AND ZHOU HEQING 6056 E BASELINE RD STE 155 DATE ISSUED:05/12/2014 OWNER'S PHONE: 4086238011 MESA,AZ 85206 PHONE NO:(866)692-5273 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ / REMOVE AND REPLACE FURNACE IN SAME LOCATION License Class C—20 Lic.# ��`/� Contractor �—✓L�C�� =<CG� t��' T 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:$2342 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35905054 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT E IRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 8 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 180DAY M LAST CALLED IN SP CT N. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulati s per the Cupertino Municipal Code,Section 9 18. ,--�— -/ RE-ROOFS: Signature Date � Y 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: v 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 icipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age Date! 2 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 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 "J� (408) 777-3228•FAX(408)777-3333-buildino(ftuoertino.org ` � MISC ❑PLUMBING MEMANICAL [I ELECTRICAL ❑MISCELLAIQEOUS PROJECT ADDRESS `� C I APN#ZFO OWJ.'F1t1v,gl,� ` F-w-Am STREET ADDRESS CITY, STYE ZIP. FAX CONTACT NAN.E rp DRESS CITY,STATE,ZIP FAX 0 1_i;?e a S2o i� ❑ OVTER ❑ OATFER-BUILDER ❑ OV%WMAGENT W CONTRACTOR ❑CONTI ACTORAGEA? ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CO CTOR NAME LI 'S NUI�ER LICENSE TYPE BUS.LIC R <' /ter e pec�� <'ecr/ 1F!!! 20 COMP 'Y NAME E-MAIL FAX r CZ K e S AD RESS CITY,STATE ZIP I PHONE - ARCHITECT/ENGINEER NAME LICENSE NUMBER I BUS.LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI•FAMILY PROJECT IN WILDLAND ❑ YES 71LOTZ0% ❑YES IS THE BLDG AN ❑YES BUILDING ❑COMMERCIAL I URBAN INTERFACE AREA ❑ NO ❑NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK -4�� 6` c / C' - TOTAL VALUATION: �'C/3 O By my signature below,I certify to each of the followinscr:,l am the property ommer or authorized agent to act on the property er's behalf. I have read this application and the information I have provided is t. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laAvs relating to build' ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. SignatureofApplicant/Ag ent: Date: = : S EMENTAL INFORAATION REQUIRED �L oz cE s nti bNO _ ICS AdEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 21080 redfir ct IDATE: 05/12/2014 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$2,342 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: PERMIT TYPE: WORKremove and replace furnace in same location SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $139 TOTALS: '` ., $139.00 s kIR Mech.Plan Check 0.0 hrs $0.00 lllu ib,1)N111 Che:: Mech.Permit Fee: IMPERMIT l'It��z 'er;,,L Fee., x's>, Other Mech.Insp. 0.0 hrs $47.00 Othe# l'irrtrt Irrst�, fW"' t I:;r' .hi sp' 1F'Cr>. T#i_n T'c<; t'tuwb= Iris,j. I'r>cr: fs CC°. h"sp. Fee: 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 the prelfmina information available and are only an estimate. Contact the De t or addn I info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS °Iasi the ci 1�6e: #PME Plan Check: $0.00 'e%'Pmie p1'�ee: SuppL rlq�Fee PME Unit Fee: $139.00 PME Permit Fee: $47.00 Administrative Fee: IADMIN $44.00 Work Without Permit? 0 Yes (F) No $0.00 , rls'owced ISlyinni€q.F es Travel Documentation Fee: 1TRAVDOC $47.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldiz Stds Commission Fee: 1BCBSC $1.00 $278.50 $0.00 TOTAL FEE •': $278.50 Revised: 04/01/2014 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-SR-ALT-HVAC Climate Zones 1,3-7 Site Address: Enforcement Agency: Date: Permit#: 21080 Red Fir Ct Cupertino, CA 95014 City of Cupertino May 8, 2014 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ©Package Unit ®Furnace ®AFUE 0% O COP 19 Setback Q Indoor Coil ©SEER ❑HSPF [3R 6(CZ 1,3-5) Served by system If not already present must be (3 Condensing Unit EER ( Resistance 0 R 4.2(CZ 6, 7J 9D0 sf installed) ©Other 1. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-ZR-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: Brian Cannon Signature: grion Cannon Company: CALIFORNIA DELTA MECHANICAL INC Date: May 8, 2014 Address: 6056 E BASELINE ROAD#155 License: 811114 City/State/Zip: MESA/AZ J 85205 Phone: (619) 229-6800 Reg_ 214-A0032691A-000000000-0000 Registration Date/Time: 2014/05/08 19:08:29 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010