12030144 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21686 NOONAN CT CONTRACTOR:A PLUS IMATING&A/C PERMIT NO: 12030144
OWNER'SNAMF.: PANELL PAUL CANDIAN C 244 GREAT MALL PKWY DATE; ISSUED:03292012
OWNER'S PHONE.: 4082554109 MILPITAS,CA 92683 PRONE NO:(408)934-0730
❑ LICENSED CONTRACTORS DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lic.q —7
t'SJ� I �_(—^I r r r
L _ I U MECH RESIDENTIAL COMMERCIAL
Contractor /} Date q 2
hereby of irm that lam licensed under the provisions of Chapter9 JOB DESCRIPTION: REMOVE AND REPLACE FAU(TRANE.120000 BTU 5 TON
(commencing with Section 7000)of Division 3 of the Business&Professions SYSTEM)
Code and that my license is in full force and effect.
1 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 peril is issued.
I have and will maintain Workers Compensation Insurance,as provided for by Sq.FI Floor Area: Valuation:$8000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued-
APN Number:35719073 00 Occupancy Type:
APPLICANT CERTIFICATION
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this peril Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9-18- Issyedl by: rl 'V Date:
Signature / Dale 3 —
❑ OWNER-BUILDER DECLARATION RF.-ROOFS:
All roofs shall be inspected prior to any tooling material being installed.If a roof is
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,mid the structure is not intended or offered for sale(Sec.7044, Signature of Applicanv Date:
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code), ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penalty of perjury one orthe following three
declarations: HAZARDOUS MATERIALS DISCLOSURE;
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California health&Safety Code,Sections 25505.25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should I store or handle hazardous material.
Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued contaminants as defined by the Bay Area Air Ouality Management District I will
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I cenify that in the performance of the work for which this permit is issued,1 shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of Cal ifomia. If,atter making this certificate of exemption,I Ow a eutho ' e agent:
become subject to the Worker's Compensation provisions of Labor Code,I must Date:
forthwith comply with such provisions or this permit shall be deemed revoked.
.ONSTRIICTION LF.NDINC.AGENCY
APPLICANT CERTIFICATION I hereby affhr that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C)
correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address
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 ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional
Signature Date
CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 35719073 .00
DATE ISSUED. . . . . . . :. 03/29/2012
RECEIPT #. . . . . . . . . : BS000016397
REFERENCE ID # . . . : 12030144
SITE ADDRESS . . . . . : 21686 NOONAN CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT, AREA . . . . . . .
OWNER. . . . . . . . . . . . . : PANELL PAUL C AND JAN C
ADDRESS . . . . . . . . . . : 21686 NOONAN CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5912
RECEIVED FROM . . . . : APLUS HEATING & AIR
CONTRACTOR ADAM P. PRAM LIC # 31293
COMPANY . . . . . . . . . . : A PLUS HEATING & A/C
ADDRESS 244 GREAT MALL PKWY
CITY/STATE/ZIP . . . : MILPITAS, CA 92683
TELEPHONE. . . . . . . . . : (408) 934-0730
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 8, 000 .00 1. 00 0. 00 1. 00 0. 00
1BSEISMICR VALUATION 8, 000.00 0.80 0. 00 0.80 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 RATE1.00 44 . 00 0. 00 44 .00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 260.80 0. 00 260 .80 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 260. 80 #2218
---------------
TOTAL RECEIPT 260. 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FEE ESTIMATOR -.BUILDING DIVISION
ADDRESS: 21686 Noonan Ct DATE: 03/29/2012 REVIEWED BY: Sean
APN: 'BP#: 'VALUATION: $8,000
PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY SFD or Duplex PENTAMATION FURN/AC
USE: PERMIT TYPE: .41
WORK Remove and:re lace FAU Trane- 120000 BTU 5 Tons stem
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Furnace, Forced-Air 1MFR=<100 1 # $130
TOTALS: $130.00
Mech.Plan Check FoO 'hrs $0.00 Phuub. 1'!cd Ouxk Elcc. Plan Clunk
Mech. Permit Fee: IMPERhIIT Plmnh. Terni/Pec: Elec. Permit Fee:
Other Mech. Insp. 1 0.0 hrs $44:00 Orlrer Plumb Insp. L CJrher lila•.Lsp.
11/ech. ln.,p. Pcc- Plumb. hup. Fee: Elec. lisp.Fce:
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 prefimina information available and are only an estimate Contact the De ( or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Efl7/1/II) FEE QTY/FEE MISC ITEMS
Plan (:'heck I ire:
Su/j/21. PC Fee
PME Plan Check: $0.00
Permit Gee:
T71-
Supp/. hrsp Fee
PME Unit Fee: $130.00
PME Permit Fee: $44.00
Conslrucrion Ta.l.
Administrative Fee: /ADMIN $41.00
Work Without Permit? O Yes (j) No $0.00
Advanced Planning Fees:
Travel Documentation Feer ITRAVDOC $44.00
Strom;Motion Fee: IBSEISMICR $0.80 Select an Administrative Item
Blde Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $260.80 ' $0.001 TOTAL FEE: $260.80
Revised: 1/19/2012
Simplified Prescriptive Certificate-of Compliance:,2008-Residential HVAC Alterations CF-1R-ALT-HVAC
Climate Zones 1, 3-7
Site Address: Enforcement Agency: Date: Permit#:
21686 Noonan Court Cupertino, CA 95014 City of Cupertino Mar 29, 2012
Duct Insulation Conditioned Floor
Equipment Typel List Minimum Efficiency2 requirement Area Thermostat
0 Package Unit
®Furnace ®AFUE 78% 0 COP 0 R 6(CZ 1, 3-5) Served by system 0 Setback
0 Indoor Coil 0 SEER 13.0,, 0 HSPF 1f not already present, must be
0 Condensing unit 0 EER O Resistance 0 R 4.2 (CZ 6, 7) 2300 sf installed)
0 Other_
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 EHlclencles: 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.
•1 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 Callfomla 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 per-nit application.
Name: Jane Alp Signature: Jane Alo
Company: A PLUS GENERAL CONTRACTORS INCDate: Mar 29, 2012
Address: 11330 KNOTT STREET License: 763154
City/State/Zip: GARDEN GROVE;/,CA/,92841 Phone: (714) 901-0500
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Reg: 212-AO01548BA-00000000-0000 Registration Date/Time: 2012/03/29 12:34:36 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forme July 2010
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12 14
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•.buildinalcDcuoertino.om Rfi
PLumBING t MECHANICAL ELECTRICAL ❑NIsc reNFDUS
PROJECT ADDRESS ai 66110
Noonm" . C+, - APN0 i 19
.- 01 ,5
OWNER NAME P L P y� pJI PHONE 40b-2,55.W EMAIL
SBEETADDRESS 2II� 0VVj" C CTY,STATE,IIP L ytQ I
CONTACT'NAME 1 ^may S�I _I Nfi 1` E-
STREETAODRESS I�/W U =.STATE.ZIP FAX
:1 OWNER ❑ OwNFR.BUaDR .13 OWNER AGENT, =NTRACMR 13 CONTRACTOR AGENT ❑ AacemcT ❑ENcvmniR ❑ DEVES.OPR ❑TENANT
CONTRACTORrN flus Heating&Alr C6ndftl011 I=mo,E, 31 E4 LICENSE TYPE C BUS.LIC# 612&1 3
COMPANY NAME 244 Great Mall Parkway E-MAIL FAX $� -013
STREETADDRESS Milpitas,CA 99035 CITY.STATE,MP PHONE 3 -
Mc
ARCFDIECTIENOINEER RAME LICENSE NUNMR BUS.UC a
COMPANY NAME' &MAD: FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF SFD sOUPI.IX ❑ MULTI-FAMD.Y -PROIECt Bl WDDIAND ❑ YES PROJECTBI [IYES Is Tiff BI.DGAN [3 MBUBDING: COML mmJa ,I URBAN MTRFACE AREA ❑ NO FtDOD JANE 0 N EICIDFR HOMM 0 N
DESCRIPTION OF WORX
rRP,ma(e otd fjArnotce'I re- lace wif-h new in same
Add new kj c
TOTAL VALUATION: 50co RECEIVED BY: �CA�
By my signatara below.I certify to each of the following: I am the property owner or authorized agent m=an the property owner's behalf I bave read this
application and the information I have provided is correce`1 have read the Description of Work sed verify it is accurate. I agree m comply with all applicable local
ordinances and state laws relating b ' c 'on. I aatbatia representatives of Cupertino to enter the abo -icim property for inspection oses.
mP f�P
Signature ofApp6eTnVAgrnt Date; y
SUP INFORMATION REQUIRED OFFICE USE ONLY
OVER-THE-COUNTER
Y ❑ EXPRESS
u
u ❑ STANDARD
u
❑ Wtce
c ❑ MAJOR
MEPMur Ipp_2011.doc revised 06121111