The URL can be used to link to this page

12020003 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7915 BELKNAP DR CONTRACTOR:SERVICE EXPERTS PERMIT NO: 12020003 HEATING&AIR OWNER'S NAME: HUANG CHENG-HSIUNG AND MEI H 6984 SIERRA CT DATE ISSUED:02/01/2012 OWNER'S PHONE: DUBLIN,CA 94568 PHONE NO:(925)400-6024 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class v Z� Lie.# 5 lu I MECH RESIDENTIAL COMMERCIAL Contractor -Date j_ Z JOB DESCRIPTION: REPLACE FURNACE IN SAME LOCATION 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 Valuation:$4009 performance of the work for which this permit is issued. Sq.Ft Floor Area: 1 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:36208040.00 Occupancy Type: permit is issued. l7' 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 M LAST 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 Issued by: ✓ Date: 2— 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: SignatureL4m� Date 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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to 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 1 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 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Secti s 25505, 533,and 2.5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued,1 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 work's for which this permit is issued(Sec.3097,Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address 1 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 CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 36208040 . 00 DATE ISSUED. . . . . . . : 02/01/2012 RECEIPT # . . . . . . . . . BS000015896 REFERENCE ID # . . . : 12020003 SITE ADDRESS 7915 BELKNAP DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER HUANG CHENG-HSIUNG AND MEI H ADDRESS 7915 BELKNAP DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4973 RECEIVED FROM . . . . : E! INC CONTRACTOR . . . . . . . : TROY THOMAS LIC # 32138 COMPANY SERVICE EXPERTS HEATING & AIR ADDRESS . . . . . . . . . . : 6984 SIERRA CT CITY/STATE/ZIP . . . : DUBLIN, CA 94568 TELEPHONE (925) 400-6024 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- -- -ADMIN HOURS 1 . 00 41 . 00 0 . 00 41 . 00 0 . 00 1BCBSC VALUATION 4, 009 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 4 , 009 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1MFR=<100 UNITS 1 . 00 130 . 00 0 . 00 130 . 00 0 . 00 1MPERMITFE FLAT RATE 1 . 00 44 . 00 0 . 00 44 . 00 0 . 00 1TRAVDOC FLAT RATE 1 . 00 44 . 00 0 . 00 44 . 00 0 . 00 - ---------- ---------- ---------- ---------- TOTAL PERMIT 260 . 50 0 . 00 260 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 260 . 50 chk --------------- TOTAL RECEIPT 260 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------ 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 795 Belnap Dr. DATE: 02/01/2012 REVIEWED BY: RDW APN: I BP#: VALUATION: 1$4,009 PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION FURN/AC USE: P PERMIT TYPE: WORK Replace existing furnace only. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Furnace, Forced-Air 1MFR=<100 1 # $130 TOTALS: $130.00 Mech.Plan Check F0.0Tfirs $0.00 Ef\:'Iech.Permit Fee: 1MPERMIT Other Mech.lnsp. 0.0 �hrs $44.00 A10TE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These,Lees are based on the relinsna information available and are onlyan estimate. Contact the Det or addn7 in o. FEE ITEMS ''`z'{ 1?e5o nn ion 11-L053 E11 " 1/11 FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $130.00 PME Permit Fee: $44.00 Administrative Fee: I.ADMIN $41.00 Work Without Permit? 0 Yes Q No $0.00 Travel Documentation Fee: ITRA VDOC $44.00 its lit 9: r;3 F(-': IBSEISMICR $0.50 Select an Administrative Item liti _C rissit n, 'c�.; IBCBSC $1.00 SUBTOTALS: $260.50 $0.00 TOTAL FEE: $260.50 Revised: 1/19 12 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: '11-{ i 5 6eA pCti> Pr PERMIT# l 2a2 00b-'4-' OWNER'S NAME: bq-�-ylHUuv, PHONE GENERAL CONTRACTOR: �O Yu2.('t�t�� BUSINESS LICENSE# ADDRESS: �� S(�.rrCk cif CITY/ZIPCODE: J(-�bht4 t �YSZa *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. p I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum /Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Sim lifted Prescriptive Certificate of Compliance:2008 Residential ATVACAlteradons CF-IR-ALT-HVAC Climate Zones 10 to 15 S&e Addrem- tj l S 17�C?i 11G� Enf-cement Age-7: nate: Permit#: -/ -/ Z 12�Ztx�03 Equipment T ' List Iv�tituuta E(fieim Conditioned Floor Ihtd itssulation t Area Thermostat Q P--i—ged unit Over 40 ftofdocts added or I5Fwmce @4 AFUE�(� O OOP its Setback O Indoor Coil OSEER O HSPF replaced in unconditioned space Served by system arm a,—a5, O Coadeasmg Unit O EER O Resisuitce O R 6 (CL 10-13) I—of I Present.mwf be O Other OR S (CZ 14=15) butalledf I_Egaipmart Type Choose the equipment being butaUed rf mwr Ilrmr one s,W ,sae mmther CF-IR-4LT-HVAC for earh system 2.Mbrirrras4 Equipme7e EKackvscim I3 SEER,78%AFUF,7.7HSPFfor opfcd residential systems: HERS VERM CATION SUMMARY listed below art fan HVAC alteration Options The instal ler decides what work is bring dome and picks one of the appropiiate Options. Each Option fiats the HERS me==that must be conducted_A copy of the forms shall be left on site for final inspection and a copy given to the bomeawncr. At final,the inspector verifies that the work listed an this foam was in fact the work completed by the installs. The inspector also verifies that each appropriate CF-6R and registered CF-4R farms(no hand filled CF-4Rs allowed)art filled cat and signedBeginning October 1,2010,a regittered copy of the CF-1R and CF-6R sW also be on site for final inspection. 1.HVAC Changeout Required Forms: • All HVAC Equipment replaced CF-6R fptrns MEC TI-04,N ECII-21 HERS and(for split systems)MECH-25-HERS CF4R foams: MECH-21 and for split s MECH-25 • Condenser Coil and/or Indoor Cool and/or CF-6R fermi` MECH,21-11ERS and(for split dna)MECH-25-NERS Furnace GF4R form : MEH-21 and(for split sysems) MEC U-25 For-Split Systems:Duct leakage<15 percent; RC,CCA>300 CFM/tan(Minuuum Air Flow Requirancnt),TMAU For Packaged Unfts: Duct Ieakage<15 per=t Exempted fram duct leakage testing if! O 1.Duet-system was docameuto bave been previously sealed and confirmed through HERS vcrificatiaa,or D 2.Duct gsttms with less tban 40 linear Seat in unconditioned spare,or : O 3.Existing duct systems art constructed,insulated or sealed with asbestos ❑2.New HVAC Systtmt Required Forms. Cert in or Changeout with new CF-6R forms: MECH-04,MECH-204iERS far dudx:(all new ducting and all •�( �h SYS)MDCH-22-HERS,and MECH-25-HERS C new eat F4R forms: MECH 20-,and(for split syctems)MECH-22,and MECH 25 For Split Systems:Dud leakage<6 percent;RC,CCA>_350 CFWfty%FWD,TMAH,SIMS,and either HS"or PVP. For PacLmged Unftx:Duct leakagc<6 percent O 3.New Ducts with Replacement Required Forms: • Includesteplaciag or installing all new ducting CF-6R forms MECH-04,MECfT-20-HERS,and(for split systems)NECH-25-HERS and/or outdoor candensing unit and/or f xioor CF-4R tions hlEM20 and(for split systema)IAECH-25 cog and/or firmace. Not all equipment changed - For Split Systems:Dud 1 eakage<6 percent,RC,CCA>_300 CFMAon,TMAH [For or Packaged Units:Dud leaks a<6 =cut 4.New Ductingover 40 feet Required Forms: Includes adding or replacing more than 40 CF-6R forms: MECH-04,MECH-2I-HERS CF-4R forma MEM-21 linear feet of duet inunconditioned ace. split_system orpackaged units: Duct leakage<15 percent 12 EXC MON:Existindud conshu uualated or scaled with asbestos.ntractor(Documentation Anthbei/Responsr'bli Designer's Declaration Statement)' 1 entity that this Certifimm of Com Prance documentation is accurate and complete. . I nm eligtbk tntlderlJjviaion 3.odthe California Basins and Professions Code to accept rupoasrbirity for the design ideatiHad on this Ccrtifieate of Compliance. I certify that the eaagy feoutres and p=farmance specifications for Hee design identified an this Certificate of Compliance conforit to the rogmrements of Tide 24, rotor 1 and 6 if the Calffnruia Co�a_of Re{,alatiaae., • The design fawtes identified m this Cati6cato of Compliance Ase condacut with the information docmncated on other awlicabie compliaam forms,,worksheets, caladagons,plans and sp=Wcaiians sd=itted to the cafnrcement agency fir approval wilb the penAitloppsawon. t OIS6 iii e— i3 rcx"k 5 Signature: Address: (v` 5 21^r et C'0�_L r' t- Lieenst 3 Gc7 7 t '" A Ns Phone �t5 .�`i3v 2008 Residential Compliance Fornu March 2010 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 954143255 (408)77-3228• FAX(408)777-3333•building cuperfino.orq misc CUPERTINO CEwU� ❑PLUMBING 12MECHANICAL ELECTRICAL ❑MIS U 1 J�%1 pal-) Or AFN Stog (� / f FMOjEC7rZADDFMS 1PHONE E-bfAII.�.�tQ 70 ,Ua ,yCS� srxsEr ADDRESS CrrY,STATE,7B FAX PHONE E-MAM CONTACT NAME CITY.SLATE. W FAX 7� STREET ADDRESS ❑OWNER ❑ OWNER-HUII.DER ❑ OWNER AGENT CDNrRACLOR ❑CONTRACTOR AGENT ❑ ARcmTwr ❑F?7GINEER ❑ DEVELOPER ❑TeAAm LICENSE NU.NBER n, LICENSE T7- HBFAX VS LICEAZ NAME !�y,A' f�` A(�(JY'lY V` E�M E ( � (� J arY.STATE,T� I✓I K� / b l'Z �L��'IUB U ESS bj�g`� "5 T� SmLIC NGINEER NAME LICENSENJMHIIC FAX E-MAIL MECITY,STATE.ZIP PHONE ESS IS THE BLDG AN ❑YES USE OF ar mm E7C ❑ MULTS FAMILY � WWrW�� a NO �D� ❑YES YES PROJECTIN IICHLIIC HOMi! ❑NO R=INQ ❑COMMERCIAL DESCREMON OF WORK I1�n rr� RECEIVED BY: FTOTALVALUATION' �{W , UV erty owner's behalf I have read this m each Of the following am the property owner ar anihorized agent>n act on the gcapIage below,l certify ,, e m comply with aIl applicable local the information I have provided is correct,j have read the Description of Work at:..ref}*it is acc�aaLe Iafire PURPOSMoculastate laws relating to din constracti 'I authorize represeatames of Cupertino m eater the above-identified property Signat=of Applicant(Agent! � - - r� Date: `� ( � LF.IvIF_NTAL INFORr�MAITON REQUIRED OFFICE USE ONLY SUPP ❑ OVER-THE-COUNTER �y E ❑ IJCIRESS Y U ❑ STAtMARD T V < ❑ LARGE ❑ MAJOR MEjoMjsCApp 2011.doc revised 06121111