Loading...
09120084I _ CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10439 PLUM TREE LN NER'S NAME: KANIEL BATYA AND AKAVIA OWNER'S PHONE: 4089968550 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Contractor Lie. # Date 1 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. 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 permit is issued. 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 upon the above mentioned property for inspection purposes. (We) agree to save 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date 12— _(Lf —V V/ 'OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. 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 I—ilding construction, and hereby authorize representatives of this city to enter i 'ie above mentioned property for inspection purposes. (We) agree to save in,- - mify 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature. Dater Z `T CONTRACTOR: PERFORMANCE AIR PERMIT NO: 09120084 SERVICE 1805 LITTLE ORCHARD ST DATE ISSUED: 12/14/2009 SAN JOSE, CA 95125 PHONE NO: (408)920-6170 BUILDING PERMIT INFO: BLDG f— ELECT I— PLUMB r— MECH r— RESIDENTIAL I— COMMERCIAL r JOB DESCRIPTION: NEW FURANCE, OLD ONE DIED ON DEC. 8, 2009 Sq. Ft Floor Area: I Valuation: $3880 APN Number: 31633084.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by, Date: 42') cG-CV!5� RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. authorized a t: Date: CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM j t - APN # �l � ���{, <� Date: �, � G_ 4-260 o/ CA gS-01 j Building Address: 10439 Cupe r tTo / O439 P i t ee- Lo Owner's Name: J fl Ylls P one #: 44- qq6 - gT Contractor: Phone #: 4o 8 — 4�,2,— -&:-3-&:-3o Pe*-+vrvnaAu A-0- S eyt/ t c !b , Fax #: (10 - 20 Contractor License #: 9 / , � 3 ( Cupertino Business License #: Contact: _ Phone #: U k —4 -ZZ- S 5 g D Z0,C �-aw-/+'1 by Fax #: a6 -q20- b l 91 Building Permit Info: Elect Plumb [�''J Mech ❑�-- Residential Commercial ❑ Job Description: N evi F tkrn (-c Old ©i�.c „1 � kJ OK jet . $ , 2-0 7 For Residential Installations: Attic El1" floor �� 2"d floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: (� Q� Type of Construction (Usage Class): Strapped ❑ On Platform ❑ Bonded New Location Replacement Project Size: Express �tandard ❑ Large ❑ Major ❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Revised viiviivy CITY OF C UPERTINO aa FURNACE/AC CUPEi�TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ea heating applia-ice,refrigeration unit, cooling unit,absorption unit,or ea heating, cooling, absorption or evaporative cooling system,incl installation of co:itrols regulated by this code. 1MCREPALT Commercial for the repair of alt/add to M ea heating appliance,refrigeration unit,cooling unit. VAV boxes, absorption unit or ea heathing, cooling absorption,or ew porative cooling sys, incl install of controls regulated by this code. 1MCSUSHTR Commercial Instill/Relocate ea M suspended heatei,recessed wall htr, or floor mounted urdt heater. 1PGASCOM Commerical for ,;a gas piping System P 1-4 outlets 1 BPGAS For each gas pip; ng system of 5 or P more per outlet. 1MCAPPVNT Commercial for :he install/relocate/ or M replacement of e a appliance vent installed & not incl in an appliance permit. 1BCBSC Cal Bldg Standa:-ds Commission Fee B ALL PERMIT TYPES 1BSEISMICO Commercial Seismic B 1 MRRAA Residential Repz.ir/Alteration/Add to M ea heating appliznce,refrigeration unit, cooling unit,absorption unit,or ea heating, cooling,,Ibsorption or evaporative cooling system,incl installation of cc ntrols regulated by this code. 1 MRSUSHTR Residential Install/Relocate ea M suspended heate-,recessed wall htr, or floor mounted u;iit heater. CITY OF CUPEkTINO CITY OF CUPERTINO FUIViACE/AC FEE SCHEDULE Quantity Fee ID Fee Descript,on ZFee ou Permit Type 1MRAPPVNT Residential for the install/relocate/ or M replacement of ea appliance vent install & not ir_cl in an appl permit. FURNACE FURN/AC 1 PGASRES Residential for ea gas piping system of P 1-4 Outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES f 1BSEISMICR Residential Seismic B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst <;=100k BTU install or M relocate ea forced-air/gravity type furnace/burne -, incl ducts/vents attached to su,;h appliance up to and include 100,000 Btu/h 1MFRN>100 Furnace Syst :> 100k BTU install or M relocate ea foi ced-air/gravity type furnace/burner, incl ducts/vents attached to su:,h appliance over 100,000 Btu/I. p I IEPERMITFEE Electric Perm.t Fee E N 1 MPERMITFEE Mechanical P -rmit Fee M 1PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel Documentation B 1BUSLIC Business License B 1. Use LowNo-VOC Paint 2. Use Low VOC, ``dater -Based Wood Finishes 3. Use Low/No VOC Adhesives 4. Use Salvaged Materials for Interior Finishes 5. Use Engineered Sheet Goods with no added Urea Formaldehyde S. Use Exterior Grade Plywood for Interior Uses 7. Seal ail Expbsad i>ai+of A or MDF B. Use FSC Certified Materials for Interior Finish 9. Use Finger -Jointed or Recycled -Content Trim 10. Install Whola House Vacuum System N. Flooring 1. Select FSC Certified Wood Flooring 2. Use Raodly Renewable Flooring Materials 3. Use Recycled Content Ceramic Tiles 4. Install Natural Linoleum in Place of Vinyl . 5. Use Exposed Concrete as Finished Floor 6. Install Recycled Content Carpet with Low VOCs Total Points Available: Total Points Project Recelved: 1 IAO/Health pts y=yes 21A(OJHealth pts y=yes 3IADJHealth pts y --yes 3 Resource pts y=yes 61AQ/Health pts y --yes 1 IAQ/Health pts y=yes 4 Resource pts y=yes 1 Resource pts y=yes 3 IAD/Health pts y --yes B Resource pts y=yes 4 Resource pts y=yes 4 Resource pts y=yes 5 IAD/Health pts y=yes 4 Resource pts y=yes 4 Resource pts y=yes 1 1401 1301 57 1 01 01 0 C' 2- G:data/progslc reenbuiidingguidelines/mmodelers/greenpointsfina121204protected.xls ,-ti CITY OF ..'UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: ( 043 r <" fA S-D PERMIT # 9?/2410 �I OWNER' NAME: PHONE # 40 — Sl -u GENERAL CONTRACTOR: FAX # I am not using any subcontractors: ell / ��-- f 2 —14 —Z��% Si afore Date Please check annlicable subcontractors and complete the following information: Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical 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