06060097 F
OFCUPERTINO �: �amvc OrvISIC pEgMITC�TOR INFORMATION.
G ADDRESS: AAA FURNACE & AIR CONDITI 'A)�"006060097
0 BUBB RD
'ER'S NAME PQU.4'C LSUE DATE
HUMA ABIDI 1712 STONE AVE 06/13/2006
ONE SANITARY NO. CO OL NO.
(408) 293-4717
ARCHRECrfFNGINEFid: BUILDING PERMIT INr-0
BLDG ELER PLUMB MECH
l�
uoo LICENSED CONIRACTORSDK=W TTON Job Description
e�+C 1 hmty af4ne mu 1 m IoW Bodes ptovitlow or Ceager 9(mmmeoci^g
e�m with Scc,]000)of Dtvism 3 ofthe Budnev and Pmfemm,Code,sod my licnnso is
+�� mrwumaW rw, REPLACE 2 A/C' S 36, 000 BTU
2qz Licmso ass, *�
CT�.Is
nF Dam — D
ARC HITECTS DECIA &
1 vndenunJ my P .h.11 he wed u pub)k rccortd
JU
s ttt Licroscd Pmressionlol
OW MER-BUILDER DECLARATION
r� f I bcmby sar'.ON I M csmq fmm the cmty oes liccmv low r«ft
a 0 following mwotu(Sccdon 7431.5,Busies sod Pmfesiam Codc:My city«mtmty
9 h �
wh ttmo.permit m cc Wucl,Mint. dcm lsb. -WmxY mtcvom $7100
'�—r^ '«to its ivwtcc.also tryuim,thec plf« «
, h pmmit to 0suwmcn k..i,ncd
On he H kkcmd pursuan
et w co ome prrs oftW Cmu,nor,L,crsc low(CWpiu9 Sq.Ft.Floor Area Valuation
ytt--n (c.rtciog w O Scctim 7000)a Divicm 3 of ttc Bvsin¢s W Prafcslom Codc)«
Q — thso be is esempt(hnrdrm sod the bei,f«do dkgcd a®W W.A,viodtim of
Secdm 70313 by smy.PdKsot W.pc mit sobiccv me.wumtt to a emI pmaty of Occupancy Type
Bos Tort tfiu Ifw hmdmd doldn(33001.
❑1.u axom of Ne gngny,«my empbyT w W wagn u theb sole emnpensn4o.,
um e.w wme m.wee.P PePea«meed« .l (s«. 0u.e
Required Inspections
W Pmrc dl Code The Co.uscmes T i Law'don sot apply to an owom aaq pe
pos ny vho Wilds w h%r,sses tM. zod whodm„ucb watt hire-for tttouth hu
awe omplaycs,ryt ided door such brr, emmm art m Imvded..ff a r«nle If,
howeser.the duldmt«Imgow is sold MOm«e yea.of moron o.thea
Wilda rW Nye tb dmdtat N MArg that k did rot dull or Imprme f«pu,pose of
ak.).
❑1.rs r tc of ct prvgny.w emd troct c cssii=Ci�h:)Turd oaouau«s -
mnvru«tpc es NN (Sec.W so Buuvs load rtIr tla,u Cade)The foeue«11i.
Toe Iolw mu sot lopPlr m m owrta Mgapmty wt-Wilds or P.tbcem,W
hc.Lace f«such pvjccu wdlt lo cmvamorG)14smeA pmm.m m Qc Cmou.nor, ��E�
LI¢rce low. r
❑ Iw4acamtmdm See ,BAPCfc 4this m
WORI(FR9 COMPENSATION D�701,1 ft
I hereby allism mode,peachy of petj«7 oc of the forty of,d«saruioni Yv'X 3 I 2006
❑IWr<W wifl I.ItwinaCulifrX)4th Laboxr odt%for f«WartchCt of ft ((f� �C�,�
sfor pmb Ou'«oY Samn 7'/00 d the lobo,Code.r«the pedarms,t¢ar the ���f O I
wa,Y r«whkb Tis pmmit u fmPw. �alL�!/f}]t
❑1 Enc and will tnalnuin Workers CompwWon Im� .u lwartil by 3cctim
3'1()0.1 do Lobar Com,for the pmfomtacs of da weak f«which mu Permit H isacd
My WartrY,!Cam/peautim 1 tan¢art{v W Pdwy nomher aR:
Cartier Policy Na.:_
F (EMPIION FROM WUL'
COMPENSArION INSURANCE
0 his segloa ocd sot be TnpIctcd if We pctmh is for.hmtrcL dor Ns(SIOD)
orles4)
1 amfr Ott,Iv de puformuce or tk wart r«which Nis perm,u'.«-n I sh.:i nm
employ my Pcrsm In my maonerso ss nbecwm sub)ect to me wmM1 rs'CST..xm
Lam of Ca:iromia.Dec
NUnCm
NOTICE TO A W tbJ NT:4.Noor Nmd1rJngmati Nu Ccn4loe the
atm cit,you should
bavmc mb)cn y the WorkC,Compoor O crorWow of Nc Iib«Code ym mutt
�O rantwitt cvmPlY wilt such pmiri«u«the prnnil shall he dmtcd tc,ahN.
zNCO MUCT10N LENDING AGENCY
IbctcbY.mrm tlw Nm 4.mmttctkm krAin{.Focy f«the Pcrfom.d .
a> do w I.whkh tffi Pmmll is Urucd ISc.3097.CO.C")
SQ Umbers Name
z 1'� r`sAddrcss
U0 1 n.:rY N.t I Luse ted Ws appliwtim Byrd sus.tt.l tic.bvsc mfonm4an u
L.H ccc a :.gr¢to c«oply w di all city sod!comity«thrones W stye Isom«luint m
OU Wilding cownction.and Wmby authorlae mproenuu of Nu city m cntcr upon the
a alwve-memimed ptopeny for impecuun purpose,.
(We) C.m saw,indemnify sod I ,b ),,s the City N Cvpcltiro.gwwt
F'f/1 ftNifiucs,udgntcu.cmu W eapcnus wi icb may in my.y�.Flos so City
Uz Io conmlue«c of We tr,nuot of tris p«mit
r. APPLICANT UNDERSTANDS AND WILL COMPLY WRH ALL NON-POINT Issued by: Date
SW REGU 77ONS.
iTI-Z)4 Re-roofs
mor pelt
HAZARDOUS MAT7:RIALS DISCLOSURE Type of Roof
WW tbc.ppliont«rutusc dd:dlot=orr ttsr.«band).h.>Ldac m.mid
derurd by Ne CuMUco Mudciplol Codc.ChIpw 9.11 W the Piu:dt and WnY
.Scmim 2553$4)7All roofs shall be inspected prior to any roofing material being installed. -
❑Yu
W.11 the applicsnt« Wiwi,amcupsot.e9wgnmt«msiT whkb If a roof is installed without first obtaining an inspection,I agree to remove
W.11 ft ,t,licsnt.Y.I.Y.
emit he�nw dm
,aconwtw u m0ned by the Bay Arcs Air Qw)hy Msos,ctnant all new materials for inspection.
Dimxil J-
❑yto, No
1 h.rvc real the ha Sccuo mased.45533 s me 5534.1 .ptu6.93 of4te Glif«-
di.Lkwth 8 S.0,MC ,Ssedao o,it i my W 25334.:W Wofytd tt,csuPl dwGnt
don tat cvtently MK.tome.Mss it is my mgamidlitY m maty do«nswt of doe o
r.0 msMoch m b m tpbw vwrcear,Cmufc.caroavp»y Signature of Applicant Date
� J -r�i1� "1^` ro All roof coverings to be Class"B"or better
orw cda cnt —�— Dec'
CITY OF CUPERTINO
�m 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36202053 . 00
DATE ISSUED. . . . . . . : 06/13/2006
RECEIPT # . . . . . . . . . : 34823
REFERENCE ID # . . . : 06060097
SITE ADDRESS . . . . . : 10840 BUBB RD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : HUMA ABIDI
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : JIM RANDO
CONTRACTOR . . . . . . . : RANDO,, JIM LIC # 8050
COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING
ADDRESS . . . . . . . . . . : 1712 STONE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 293-4717
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
-- -------- ------------- ---------- ---------- ------ -- ----- ---
BREMAIRHAN NO.UNITS 2 . 00 20 . 52 0 . 00 20 . 52 0 . 00
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BSEISMICRE VALUATION 7, 100 . 00 0 . 80 0 . 00 0 . 80 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 171 . 29 0 . 00 171 . 29 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
----------------------------
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 508 FINAL MECHANICAL
ev Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408) 777-3333
&PERTINO
Building De artment
JOB ADDRESS: PERMIT #
la�lo /.30Gd&I
O 'S NAME: N b ' PHONE # -i® —
GENERAL CONTRACTOR FAX #
I am not using any subcontractors: .
Signature D
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical C
Excavation
Fencing
Flooring. Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO WOVY091
FURNACE/AC
�UPEkTINO PERMIT APPLICATION FORM
APN # 9j -Q�O5 Date:
2
Building Address:
O AoXi
Owner's Name: Phone #:
v *f`-
Contractor: Phone: License 17
#:
'
U G a a/ - NoPZ 71
Contact: Phone: Cupertino Business License#:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb ❑ Mech ❑
Job Description: 14ce
Z G J-
Residential R- Commercial ❑
For Residential Installations:
We ❑ 1 st floor ❑ 2°d floor❑,
dhere to min set back r uiremen
For Commercial Installations.
Replacement same weight ❑ Additional weight(structural talcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required
Cost of Project: Type of Construction: Oc�cgp"group:
On
Strapped ❑ On Platform Bonded Sq.Ft. Floor Area:
New Location ❑ Replacement
Qty. if
A licable Fee ID Fee Description Fee Group
BENERGY Energy BUILDING
BREMFURN Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL
B-R MRECEPT Rec tl, Switch & Outlets ELECTRICAL
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILIDNG
t
FEE Elec Permit Issuance ELECTRICAL
TFEE Mech Permit Issuance MECHANICAL
FEE Plumbin Permit Issue PLUMBING
EE Bld Permit Fees BUILDING
HK Plan Check Fee BUILDING
em Fee PLUMBING
I Business License BUILDING