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10050073 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10441 GLENVIEW AVE CONTRACTOR:KESTER HEATING AND PERMIT NO: 10050073 Al 2 CONDITIONING "+WNER'S NAME: DINISH KUMAR 671 ALDO AVE STE 19 DATE ISSUED:05/07/2010 .1WNER'S PHONE: 4083246905 SANTA CLARA,CA 95054 PHONE NO:(408)265-1103 El LICENSED CONTRACTOR'S DECLARATION JC B DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class_,?d Lic.# 5 .5`4 REMOVE AND REPLACE FURNACE AND A/C UNIT Contractor �fc=5 r� —r4— )k Date S- 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:$5800 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 Al'N Number:36911056.00 Occupancy Type: permit is issued. 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 FROM 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 granting of this permit. Additionally,the applicant understands and will comply Is:ued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section _ 9.18. RE-ROOFS: ',ignature Date ^ ^(V Al I roofs shall be inspected prior to any roofing material being installed.If a roof is in:talled without first obtaining an inspection,I agree to remove all new materials for in:pection. ❑ OWNER-BUILDER DECLARATION Si,;nature 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 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 Lave read the hazardous materials requirements under Chapter 6.95 of the 0difornia Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three in dntain 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 in iterial. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the ai•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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Section 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent._ Date: 5 -I D 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I I ereby 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.) Li rider'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 on the above mentioned property for inspection purposes.(We)agree to save -mnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I i nderstand 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 Li;ensed Professional 9.18. Signature Date CITY OF CU13ERTINO 8 ITEMS OF 16 PERMIT R]'sCEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: =,ot : APN . . . . . . . . : 36911056 . 00 DATE ISSUED. . . . . . . : 05/07,12010 RECEIPT #. . . . . . . . . : BS0001)10350 REFERENCE ID # . . . : 10050073 SITE ADDRESS . . . . . : 10441 GLENVIEW AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : DINIS:i KUMAR ADDRESS . . . . . . . . . . : 10441 GLENVIEW AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4512 RECEIVED FROM . . . . : DAVID KESTER CONTRACTOR . . . . . . . : KESTE:Z, DAVID M LIC # 22101 COMPANY . . . . . . . . . . : KESTE:2 HEATING AND AIR CONDITI ADDRESS . . . . . . . . . . : 671 A.�DO AVE STE 19 CITY/STATE/ZIP . . . : SANTA CLARA, CA 95054 TELEPHONE . . . . . . . . : (408) 265-1103 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- ------ ---------- ---------- ---------- 1BCBSC VALUATION 5, 800 . 00 1 . 00 0 .00 1 . 00 0 . 00 1BREMAIRHA NO.UNITS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1BSEISMICR VALUATION 5, 800 . 00 0 . 60 0 . 00 0 . 60 0 . 00 1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 1MRRAA UNITS 1 . 00 63 . 00 0 . 00 63 . 00 0 . 00 1PPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0. 00 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00 ---- ------ ---------- ---------- ---------- TOTAL PERMIT 295. 60 0 . 00 295 . 60 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- - ------------------- CREDIT CARD 591 .40 visa --------------- TOTAL RECEIPT 591 .40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF C'UPERTINO v FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM - - APN # 9 l 0 5 � v Date: �` `� ► c� Building Address: y it i 6-e-� `t— Owner's Name: Phone#: Contractor: Phone#: g 2 Z L Z Gj y 1 ►�U C tito Fax#: 7 2 ► 2 r 5� Contractor License#: Cupertino Business License#: Contact: Phone#: c-N e::�' r 1Dwz?— �`% � Fax #: '/F Z - 12-15— Building 1ZI5 - Building Permit Info: Elect ❑ Plumb Mech Residential Kr Commercial ❑ Job Description: p— _}_- p_ )C� For Residential Installations: Attic ❑ 1St floor � 2nd 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: Type of Construction (Usage Class): r 1177�' Strapped ❑ On Platform F1 BondedE] New Location eplacement Project Size: Express Standard ❑ 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 01/07/09 CITY OF CUPERTINO FURNACE/AC CUPE�TiNO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/idteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absor ption or evaporative cooling s ystem,incl installation of controls regulated by this code. 1 MCREPALT Commercial for the ropair of alt/add to M ea heating appliance,refrigeration unit,cooling unit,VA`I boxes, absorption unit or ea ieathing, cooling absorption,or evaporE.tive cooling sys, incl install of control:, regulated by this code. 1MCSUSHTR Commercial Install/Relocate ea M suspended heater,reecssed wall htr, or floor mounted unit he ater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1 MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed &not incl it an appliance permit. 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Commercial Seismic B 1 MRRAA Residential Repair/A]teration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorptic,n unit,or ea ! heating,cooling,ab sorption or evaporative cooling s ystem,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,rece,ssed wall htr, or floor mounted unit he ater. CITY OF CUPERTINO FURNACE/AC CUPEkTiNO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group 1MRAPPVNT Residential for the install/relocate/or M replacement of ea �Lppliance vent install &not incl iri 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. I 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT l TYPES / 1 BSEISMICR Residential Seismi-, B 1MECPLNCK Mechanical Plan Check M 1MFR=<100 Furnace Syst<=100k BTU install or M relocate ea forced-iir/gravity type furnace/burner, incl ducts/vents attached to such ap pliance up to and include 100,000 Biu/h 1MFRN>100 Furnace Syst> 100k BTU install or M relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance over 100,000 Btu/h 1 EPERMITFEE Electric Permit Fey; E 1MPERMITFEE Mechanical Permit Fee M I 1 PPERMITFEE Plumbing Permit P 1TRAVD0C Travel Documentation B 1BUSLIC Business License B CITY OF CUPERTINO 1-114 FURNACE/AC CUPEI,TINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group AIR FURN/AC CONDITIONING 1BCAIRHAN Commercial A/C Units <= lOk CFM B 1MCRAA Commercial Mech Rfpair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICO Seismic Commercial B 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1 PGASRES Residential for ea gas piping system P of 1-4 Outlets 1 BPGAS For each gas piping system of 5 or P more per outlet. Comn/Resid 1 BREMAIRHAN Residential A/C units<= l Ok CFM B 1 MRRAA Residential Mech Repair/alt/add M 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B 1 EPERMITFEE Electric Permit E 1 MPERMITFEE Mechanical Permit M 1PPERMITFEE Plumbing Permit P 1 TRAVDOC Travel Documentation B 1BUSLIC Business License B M.Indoor Air Quality and Finishes 1.Use Low1No-VOC Paint 1 IACJHealth pts y=yes p 2.Use Low VOC,Water-Based Wood Finishes 2 IACJHealth pts y=yes p 3.Use Low/No VOC Adhesives 3 IACJHealth pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Re source pts y=yes 0 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61ACJHealth pts y=yes p 6.Use Exterior Grade Plywood for Interior Uses 1 IAC/Health pts y=yes p 7•Seal all Partials l or MDF 4 IAC/Health pts y=yes p S.Use FSC Certified Materials for Interior Finish 4 Re,;ource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Trim 1 Re:;ource pts y=yes 0 10.Install Whole House Vacuum System 3 IAO/Health pts y=yes p 1 1 1 N.Flooring 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ Health pts y=yes p 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 1 Total Points Available: 1401 130 57 Total Points Project Received:1 1. 01 01 01 G:data/progs/greenbulldini guidelines/remodelers/greenpointsfinal2.12.04protected.xis s � Jc � RESIDENTIAL PROJE(: 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/ SUB('ONTRACTOR LIST JOB ADDRESS: i`t`41 L-A vt^A-A- 0, PERMIT# 1 OWNER'S NAME: �t '� ),q yo V-; PHONE# GENERAL CONTRACTOR: {Lje.� BUSINESS LICENSE# ADDRESS: &`71 pc,'Do IV CITY/ZIPCODE: 5Al2�1 44AP-A 9 SDS *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. I am not using any subcontractors: Signat.ire 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