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08050052CITY OF CUPERTINO ik '?'t"+.�•h s§2ii'T'nx �""�- :D BUILDINGRTSION PERMIT , C01YyTRACTORINF,ri?RMA:2'IO,N a Siius. �"_ •• k-:."<a�uf k. d:i,t`$ti;i>fi�.�'�`kst5.w. ,. BUILDING ADDRESS: PERMIT NO. 1065 COLONY HILLS LN VALLEY HEATING & COOLING 08050052 OWNER'S NAME: PERMTr ISSUE DATE VINAYAK GUPTA 117.1 N 4 TH ST 05/05/2008 )NE: - SANRARY NO. CONTROL NO. (408)294-6290 ARCHMCIf/ENGINEER: BURRING PERMIT INFO BLDG ELECTPLUMB MECH 0 0 0 LICENSED COWMACTORS DECLARATION IOb Description 1 hereby mare Nat 1 em limned usual provisions of Chiral9 (communing P com wish Section 70M1)ofl) iv'ion 3ofticilwofcss'nCode, m B is RPLC FURNACE & A/C UNIT, RPLC WATER HEATER in full form eM effe Lice r — Lk. Y ' Dam Contrxror ARCHITECTS DELLA ATIOf I undewnJ my plan shall the uwA as Public records Lumnsed Pmfcuional OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am aacmpt from the Canvssto's License Lew far the following anon. (Section 7101.5, Business and Professions Calc: My city or county which aquias a Permit m commas, alar, Improve. demolW, a repair any muctun, prior b its houeMc. also requires the applicant for such Pnmil to file a signed stmement he is licensed m the of Na Conuacmrf Licaree Law (Chap=9 Sq. Ft. Floor AreaValuation that pursuant provisions (commencing with Section 7000) of Division 3 of the Business and Profession Code) or 8 0 0 0 $8000 that he is exempt theusfrom and th here$ fm the alleged exemption. Any violation of Sation 703M by retry applkmt far a Permit abject Ih applicant m a civil Penalty or Number Occu ane Type not mare Nan five hundred dollars (SM. 35930008 -V(V ❑ 1, u owns of th prapety, a my wplaycn veld wags u Neo role compewJon, Required Inspections BYmr vent da NC PVrk, and NCSWc1onsome, Lt IXat, and Code: The Commam datainan owner of Liasue Law don not apply aloy non his f is wh builds isoprovescMraoamuwho soustiltwork hintself . ilthrough owm emPioym, provldW that web improvements are tat can mortnW fmulc B, arms= i fc hawther the Wilding orimprovementiehathwithin year oft the or prove for ore of buirda will Aave Ih burden of Proving Net he did rot build a improve for puryme of ole.). ❑ 1. u awmf of the Property. w -elusively commusing with Iicem el mntommus m oanmal the project (See 70th. Buimess and Prolumme; Code:) The Contnem's U. ease Law data not apply at an owner or property who bsi1N or improv Norton. and who contracts for such projects with a cmntrxdmf(a) licensed pursuant to the Canuwnofs Lice. Law. ❑ Iauseamamunter See .BBPCrur Nismawm ' Owner Dam WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury ane of the following deceleration: I have am will ..law. • CudBmm of Cnuen to elf-insure Tar Workers Compen- ' motion, as proviaW for by Section 3700 or the Labor Code, for Ne Performance of out work for which this permit is issued. 0 1 neve and will maintain Workers Causpauadao l... as aspired by Saeiom 3700 of the Labor Code, for do pallotments of da werlr fm which this permit u issms. MY W ewtign 1 urarac carries and Policy her ort: Corti Polity Na.: e r EIfTI-GTE OF EXEMPTION FROM ORK" . COMPENSATION INSURANCE (Thu eeedon reed sent becomplead irttle permit Is froom hundred doll. (SIM) mless.) I certify that in the perroamanee of the work for which this Permit u issued. I shall not employ any person in any me oserm u m become abject to the Workere Compenudm Laws or CalifomiL Dam Applicant NOTICE TO APPLICANT: IL afar making this CcniBmm of Exemption, you should become mbiect to Na Worker's Cmu,nat tion provisions of On Latif Cade- you must forthwith comply with each provision or this Musit shall h accused revoked. CONMUCfION LENDING AGENCY I hereby affirm Nat Nae is a construction lending apercy for the performance of Ne some for which this permit Is issued (Sec. 309'/, Co. C.) Isnaers Name 1<nach Addams I sonify, 0.11 have read that application b asate that de, above information is n cors, 1 aOce In, comply with all city and county ordinances alb some laws relating in Wilding conmuction, and hereby •uthorim mpfemnmiv of this city to enter upon the astute-mcnudgm property for inspection purposes. (We) agree m rove, indemnify and kap harmless the City of Cupertino against lie e.N. may us anyway acrna galnUald City - consequence Of IM this pewhich Aconsequence of ere RS"TAN of Nu permit. APPLICANT UNDERSTANDS AND COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REOULATI 1 l` ,V Re-roofs Siemurt ppl' on ser Dam OUS MATERIALS DISCLOSURE Type of Roof Will the app imnt a future building occupant start or bandit lumardnm material asJannad by da Cupertino Municipal Code. Maloof 9.11• and the Health and Safety Code. O es zss3z(.)7 Yno All roofs shall be inspected prior to any roofing material being installed. Win the applicant or rum Willing aavPant um equipment or ucvima which If a roof is installed without first obtaining an ins cation, I agree to remove g P g . hevArdou all mnmminnts defined by the Bay Asa Air Quality Management all new materials for inspection. _WrictT ❑ Yn o 1Mwrealthe me p ss4.l 5, Sccouus n M5533mden undcaGN9or5ocfthbuilding uilding t tnyCd, doessamca"renly haw tharniism amponsbtYlonarJaoecoanlofthe Y requiretotswhic- or af.certifiaaaf Signature of Applicant Date All roof coverings to be Class';W' or better ownom jAoi&;4gcaI1 Dow 7 • 7 ITEMS OF 7 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35930008.00 DATE ISSUED.......: 05/05/2008 RECEIPT #.........: BS000004666 REFERENCE ID # ...: 08050052 SITE ADDRESS .....: 1065 COLONY HILLS LN SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: patg COPY # : 1 OWNER VINAYAK GUPTA ADDRESS 1065 COLNY HILLS LN CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5801 RECEIVED FROM ....: JEFFREY A FAULKNER CONTRACTOR .......: ATKINSON, THOMAS LIC # 141 COMPANY ..........: VALLEY HEATING & COOLING ADDRESS ..........: 1171 N 4 TH ST CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)294-6290 • FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL 1BPWATER UNIT 1.00 40.79 0.00 40.79 0.00 1BSEISMICR VALUATION 8,000.00 0.80 0.00 0.80 0.00 1EPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1MRRAA UNITS 1.00 61.19 0.00 61.19 0.00 IPPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ----------- 265.94 ---------- ---------- 0.00 265.94 ---------- 0.00 METHOD OF PAYMENT AMOUNT ----------------- --------------- CREDIT CARD 265.94 --------------- TOTAL RECEIPT 265.94 VOICE ID DESCRIPTION -------- ---------------------------- 505 FINAL ELECTRICAL 508 FINAL MECHANICAL REFERENCE NUMBER -------------------- MC VOICE ID DESCRIPTION -------- ---------------------------- 507 FINAL PLUMBING FROM :VRLLEY HEATING & COOLING FAX NO. :4082948247 May. 05 2008 11:09RM P2 CITY OF CUPERTINO alT FURNACE/AC CUPkTINO PERMIT APPLICATION FORM E • APN# 593 0 vC4, Building Address: _.......... ----.-, ------ ---- Owner's Name: - U; Phonc #: Contractor: JV Vail �1-e�1-1 GG�i' _ Fax #: Contractor ioense #: v , Cupertino Business License #: ods s l_i _.._.._-- —•--- .-.....___ ��%� _ Contact: _Phone #: Fax #: o -asy _tea Building Permit Info: Elect Plumb Mech [� -- _ Residential Commercial ❑ _ Job Description: re P lAw,e r-%. O'n 4-4, For Residential Installations: - — - Attic ❑ I" floor [il- 21d floor ❑ Adhere to minimum setbacic requirement LJ _ For Commercial Installations: - Replacement same weight ❑ Additional weight (structural ca)cs) ❑ Structural Calculations required for new installation ❑ New installation Plaij! nH Approval Required ❑ Cost of Project: Type of Construction (Usage Class): - Replacement-� Strapped On Platfonn- Bonded New Location Valuation: .... -... Green Building: Must attach (seen Building Cheek list to this application � FROM :VALLEY HEATING & COOLING FAX NO. :4082948247 May. 05 2008 11:10RM P3 • • CITY OF CUPERTINO FURNACE/AC CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group FURNACE TURN/AC 1MCRAA Con=crcial-Repair/Alteration/Add to M ea heating appliance,refrigcration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. _ M 1 MCREPALT Commercial for the repair of alt/add to ea heating appliancc,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absolption,or evaporative cooling sys, incl install of controls regulated by this code, IMCSIJSHTR Commercial Install/Relocate ca M suspended heater,recessed wall htr, or floor mounted unit heater. 1PGASCOM Commerical for ea gas piping System P _ 1-4 outlets _.. --' _..-- _ 113PCrA,S Por eac pips __.....__...._._ h gas'piping system of 5 or P more ner outlet. Commercial for the instalVrelocate/ or M 1MC.APPVNT replacement of ea appliance vent installed & not incl in an appliance e1 -mit. 1BSEISMICO Commercial Seismic B 1MRRAA Residential Repair/Alteration/Add —to —M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,ihcl installation of controls regulated by this code. 1MRSL]S1-TTR Residential Install/Relocate ea M suspended heater,rocessed wall htr, or floor mounted unit beater. M 1MRAP.PVN'f Residential fom the install/relocate/ or replacement of ca appliance vent L— _- install & not incl in an appl permit. FROM :VRLLEY HEATING & COOLING 0 CITY of CUPER,TINO FAX NO. :4092948247 May. 05 2008 11:10RM P4 CITY OF CUPERI ' JNO FURNACE/AC FEESCREDULE Quantity Fee ID Fee Description . ..... ... Fee Grou p Permit Type FURNACE for 1-4 Outlets FURN/AC TPGWSMr S --R-e—sid7Cntih1 IBPGAS -i—BSEffWfCR For each gas PIPIng system of 5 or more per outlet. P Residential Seismic B 1M-ECPTNCK Mechanical FKm Check- —m — — ---- Furnace Syst <=1001( BTU ins—tall" or relocate ea forced-air/gravity type furnace/burner, incl ducts/vents attached to such appliance up to and include 100,000 Btu/h �BTU M I MFRN> 10 0 -iEP—E EE Furnace Syst > 100k instal -1";—r relocate ea forced-aii/gravity type furnace/buruer, inclducts/vents attached to such appliance over 100,000 Btu/h — —M Electric Pennit Fee I MPERMITFEE Mechanical —Permit Yee''-- — M I PPERMFrFEE 11i Permit P P 13 ITRAVDOC Travel Documentation IBUSLIC Business License B . ..... FROM :VALLEY HEATING & COOLING FRX NO. :4082948247 May. 05 2008 11:10RM P5 0 0 CITY OF CUPERTINO FURNACE/AC%0F CUPEkTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type ATR CONDTTIONING FUIZN/AC I B C—ARZHXK W B 1MCRAA Commercial Mech Repair/alt/add M IBShi§WiCO--- Seismic Commercial *"----13 p 1PGASCOM Commerical for ea gas piping System 1-4 outlets 1PGASRES Residential for ea gas piping system of 1-4 Outlets P -B—P —GAS For each gas piping system of 5 or more per outlet. Comm/Resid Residential A/C unit"s, —'---j 6�CFW— —B 1MRRAA Residential Mecb Repair/alt/add M IBSEISM]CR Seismic Residential B I EPERMrITEE gl—ectric-Permit INTPERMITFEE Mechanical Peirnit Plumbing Permit M P IPPERMITFEE 1TRAVD0C Travel Documentation B IBUSLIC Business License 13 FROM :VALLEY HEATING & COOLING FAX NO. :4082948247 May. 05 2008 11:09AM P1 0 Valley Heating .And Cooling Since 1962 " The Home Of Old Fashioned Service 1171 North 4th Street San Jose, CA 95112 408-294-6290 650-322-8145 408.294.8247 Xao Jnse Palo Alto Fax License 4258540 www.valleyheating,cnm FAX COVER SHEET Date: May 5, 2oo8 To: Building Dept Company: City of Cupertino Fax #: 408 - Phone # From: Julie Katawicz Company: Valley Heating & Cooling Phone: 4o8-294-6290 Fax #: 4o8-294-8247 Notes: We are faxing a permit application. J in you office in 10 minutes to pay for permit will be 9 Number of pages to follow: i ^_ Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Devartment JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # (J GENERAL CONTRACTOR: /iA�y J"llfie— I FAX # I am not using any subcontractors: Please check applicable / Signature complete the following information: Date er/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 er/Contractor Signature Date