08050218 BUILDING DIVISION PEPMUTPERMYT NO.
CONTRACTOR INFURMt#'CION' '
�gx;a Zc:•' `h .,•a sem;% 4w .dd x_ -n[s:=xZ m :�.
BUITn4TypEKSIDGEWAY DR ELITE HEATING & AIR 08050218
NEWS NAME: PERMIT ISSUE DATE
RACY MATRAY 5565 RUSSO DR 05/28/2008
ONE: SANITARY NO. CONTROL NO.
(408) 726-1618
ARCHITECDENGINEER: BUILDING PERMIT INFO
-BLDG ELECT PLUMB MECH
0 0 0 0
too LICENSED CONTRACTOR'SDKLARAT1ON JobDescri tion
m I hereby affirm that 1 am licensed.oder provisions of Chaper 9(commmming P
;�� wimSection70fB)ulpirion3othe
ivfBudneasand ProfessiomCook."my licvvau CHNG OUT FURNACE & INSTL NEW A/C
,„ in fulltura and off _ Lk g
Z License Clu
-Fp Date Co"Oe'" r ..
f ARCHTfECI-S DECLa ATION
Ig
< 1 underuanJ my phos shill he used u public recross MR
tj
gC Licensed Profmai.rud
3 OWNER-BURDER DECLARATION
i IS 1 Wrthy,air,.Out I em vempl frum On Contractors License Law for the
C p o following moon.(Section 7831.5,Business and Prolesieu Cole:Any city or county
e Pi which requires a permit to construct.alter,improve,demolish,or repair any structure
prim o its issuance.alw requires the applicant rorwch Permit M file a signed SOMMOM
££ < thatheislicntscdpurwanttoOnprovisiauoftheComocwr'5UcenmLaw(Chapn9 Sq.Ft. Floor Area 5000 Valuation
yF$ (commencing with Section 70)0)of Division 3 of the Busirwas and Professions Code)or
`<-
that M is exempt therefrom and the basis for On alleged exemption.Any violation of
SecOm 7031.5 by arty Appiicsnt for a Permit subjects the applicant to a civil Penalty ofNumber Occas
.or mora man BK hundred dollar(s30($50T). 3 42 410 2 5 .46N Occupancy Type
❑I,u wxr of On property,or my employees with wage as their win compensation,
will do On M1.and remotion,Is net intended or offered for sale(See.70/x,Business
and Prufmalm.cede:The nslo counselor,License Low does not apply an owner of Required Inspections
property who builds Or improve thereon,and wbodeessuehwmkleimself ormrough his
own employees,provided mu such impmvemenu are not intended moRered fmsak IL
however.me building or improvement is sold lmin mm yev of completion,the owrcr-
Wildv will have the humen of proving mar he did an,build or improve for purpose of
sat.).
❑1.as..or of the properly am exclusively convening with licensed ronuaeom to
coumct the project(Sec.7015,Business and Freest..Cede:)The Coommers U. .
cense Law dors not apply to an owner of property who Wilds or improves memen,and.
who contracts for such pmjccu with a cooncloKs)Remnant punwant to the Conuammes
Licenm Law.
❑lamexemplunderSee ,B&PCfmmh Sawa
nv Dau
WORKERS COMPENSATION DECLARATION
1 hereby,Rim under penalty of Perjury arc of the following dedantioe:
❑1 nave and will maintain a Cmueote ofCom ort to self-insert for Workers Compen-
union,as provided for by Section 37W of the Ishm Code.for the performance of the
work for which this Permit is issued.
have and will maintain Worker's Compewuon I.,as returned by Section
3 anise lsbor Code,for the pdormance ofdre were Al mil Permit is issued.
My workers Com wtien Inwrwa anriv and Polity number an: _
Carrier. Eae�l.✓�we� Polity No.:w6✓LL210'1'7S
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
TOshsection reed totbe completed if The Permit is ferono hundred dollars(SIM)
or less.)
Out in the performance of the wart for which No
is permit isssnued.l to not
employ
mrc
Lawso anypen in soy manner so ss e become subject the e Wetton'Compensation
Laws
of California.Gliromia.Dae �r
NOTNOTICE
NOTICE TO APPLICANT:If,aftercom making role Certificate O Exemption,you snood ���
become subject lo the Watters Gmpewlionermisions of me Ishm Code you most
Oforthwith comply with such provisions or role permit shall he damW muted. '
ti Di CONSTRUCTION LENDING AGENCY
F Ithereby still.mumcn hacenwuetirn leading agency for Ne performancm Of T'
> > mmicesNfor wmethapermniAu a(sec.309 .civ.c) [ ���---
ta z Undoes Address Z 1<naerA AedS,x
U 0 1 certify mat I nave nod this application W sum mm the above information is
Ls, P coma I Agra lo comply with all city and county doll.and sum laws relating to n
'0 U Wilding combustion.and thereby uthorianrtpneunuuve of this city to now upon Vie
prop
aboilubca uoncd os.cny tone Neses purinueswhichm. S
F a (We)agree to nue.Indemnify and keep hamleaf the City of C.prdno against
fn in Consequent of Oneoausnd efpenseimit may in any way accrue Agaiutsaid City
U z A APPLICANT
ormegrantingof this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
91""&W--,
s/fin/�h
�sy11 `V Re-roofs
Signature mfAPPhc.VC.OMmUu f Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupantsme or handle nvudow material
u deBu l by me Cupertino Municipal Code,Chapter 9.11,and the Hvlm and Safety
ode.OrYes on13332(a)? All roofs.shall be inspected prior to any roofing material being installed.
No
will me. rent r rotor Wilding Occupant use If a roof is installed without first obtainingan inspection,I agree to remove
PP e P component or Mann which P
emit haradnus air contaminants as defined by the Bay Ana Air Quality Management all new materials for inspection.
Duu ct?
Ycs
I hove Svimehu oemaorich5533nmenu underCMpmrd.95ef Wiidior-
doesnotnhSafelyCvcanoumun&iti MY rond1333C.I undnut,On Up Wilding
dues not mmntiy haw a mnan4 Nu it is my mtapeeibilinY o noufY me acupwt Of the
rtquirtmenu which met W met Poor to issuance of a Cmtifcase of Signature of Applicant Date
r
MCA
CA
Ownerenutharisd agent Date All roof coverings to be Class'j?."or better
. 6)�d5 Dzi�
S
CITY OF CUPERTINO
FURNACE/AC
*CUPERTINO PERMIT APPLICATION FORM
APN # y a ` L Date:
5/-z o�}
Building Address:
' jn� Zq Rld ec�,ay da
Owner's Name: Phone#:
—rr,54 (� YO!�) 307- 77/.S
Contractor: E1.;to /s,,1 p COvtdi lid vi G� Phone#1: qo J 7Z(,— 1 L ( -
J Fax #: (408) 4S 2 — fl9 Z
Contractor License#: Cupertino Business License#:
-t�- T4s Gy
Contact: Phone #: \ )Q) 7277r- :�� t$
Fax #: (��) �SZ—(fgjZ
Building Permit Info:
Elect Plumb K Mech
Residential L2K, Commercial
Job Description: � �e V o. a D .C Qw t-I& 4---1VkS VCt\,
For Residential Installations:
Attic ❑ I" floor � 2"d floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural talcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
/ Cost of Project: r 57 oo p � Type of Construction (Usage Class):
Strapped On Platform Bonded New Location Replacement
Valuation: �[ S o0 0 • °O
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.
CITY OF CUPERTINO
FURNACE/AC
OF
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
1 MCREPALT 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 evaporative cooling sys,
incl install of controls regulated by •
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1 BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed & not incl in an appliance
permit.
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,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocateea M •
suspended heater,recessed.wall htr, or
floor mounted unit heater.
r—ri MRAPPVNT Residential for the install/relocate/ or M
replacement of ea appliance vent
install & not incl in an a 1 ermit.
CITY OF CUPERTINO
l���''' FURNACE/AC
�CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
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.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
IMFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
61 attached to such appliance up to and
include 100,000 Btu/h
IMFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer,'incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
IPPERMITFEE Plumbing Permit P
ITRAVDOC Travel Documentation B
/ 1BUSLIC Business License B
•
CITY OF CUPERTINO
tiL�Gd'� FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Units<= l Ok CFM B
1MCRAA Commercial Mech Repair/alt/add M
IBSEISMICO Seismic Commercial B
1 PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREMAIRHAN Residential A/C units <= IOk CFM B
I 1MRRAA Residential Mech Repair/alt/add M •
I 1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
I 1MPERMITFEE Mechanical Permit M
i 1PPERMITFEE Plumbing Permit P
I1TRAVDOC Travel Documentation B
IBUSLIC Business License B
•
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
a
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 72points
11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 5. Use Truss with heels, (detail) S-2 6. B. OSB Sheathin detail S-2
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 oints
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec, A-3 1 point
P. Other 1 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 40 points
•
•
Plan Review Process Work Book Page-12-Revised 3/25/08
,Green Points Rating System for Remodeling Projects
• Due to the diversity of remodeling project types,assigning a"total points°value to a project to be considered environmentally friendly is
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for'greening'your project.
a.site
— INPUT Resources Energy IAQ/Health
11 Recycle Job Site Construction&Demolition Waste
165%=1 point;75%= 2 points;80%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials __ 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pis y--yes 0
4.Protect Native Soil 2 Resource pts y--yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design _ 2 Resource pts y=yes 0
B Design Resource-Efficient Landscapes and Gardens _ ( 4 Resource pts y=yes 0
9.Reuse Materials/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
B.Foundation
• 1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 Point for every 10°%
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1
C.Structural Frame 1
1.Substitute Solid Sawn Lumber with Engineered Lumber _ _J 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts, 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6"or more 2 Energy pts Y=yes 0
6.Use Finger,Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
S.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Ener is
9Y P Y=Yes 0
c.Root
3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes 0
12.use 058 – — --
• i a.Subfloors ( 1 Resource pt y=yes 0
It.Sheathing
1Resource pt Y=Yes 0
1 1
D. error rmsh
INPUT RBSDurces Energy [ADIHealth
1.Use Sustainable Decking Materials •
a. Recycled content 3 Resource pts y=yes 0
b.FSC Certified Wood 3 Resource pts y=yes 0
i
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y=yes 0
13.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0
14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes D
E.Plumbing
it.install Water Heater Jacket _ J 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
I3.Retrofit all Faucels and Showerheads with Flow Reducers j
a.Faucets(1 point each;up to 2 points) Up to 2 Resource pts. 0
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toiled with Ultra-Low Flush Toilets
I(1 point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y--yes 0
6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes D
1 1 1
r,trecmcai
it.Install Compact Fluorescent Light Bulbs(CFLs) . •
,(6 bulbs—_2 points,10 bulbs=3points,12 bulbs=4 points) Up to 4 Energy pts. 0
2 Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
1 1 1
G.Appliances
�1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
'Conservation Features 1 Energy pt y=yes 0
3.lnstall Energy Star Refrigerator ( 1 Energy pt y--yes 0
4.Install Built-In Recycling Center 3 Resource pts y=yes 0
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts Y_—Yes 0
It.Ceilings 2 Energy pts y=yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0
3.Install Recycled-Content,Fiberglass Insulation with i
No Added Formaldehyde 31AO/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes . 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts Y--yes 0 •
b.Ceilings 4 Resource pis y=yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
It.uemngs 4 Resource pts y=yes 0
1
INPUT Resources Energy A011,1ealmo
1.WYri
• 1.Install Energy-Efficient-Windows
a.Double-Paned 1 Energy pt Y_—Yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames 2 Energy pts y=yes 0
-2.Install Eow Heat Transmission Glaiing _ 1 Energy pt y=yes D
1 1 1
J,Heating Ventilation and Air Conditioning
1.Use burl Mastic on All bud Joints _ _ 71AQ/HeEdth
Y--yes 0
2.Install Duc wo k within Conditioned Space Energy y=yes D
3.Vent Range Hood to the Outside pt y--yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts Y_—Yes 0
6,Install Attic Ventilation Systems 1 Energy pt Y--yes; 0
7.Install Whole House Fan 4 Energy pts y=yes D
8.Install Sealed Combustion Units
a.Furnaces 3IAQ/Health pts y=yes 0
b.Water Heaters 31AQ/Health pts y=yes D
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts Y--yes D
10.Install 13 SEER111 EER or higher AC Mth a TXV 3 Energy pts y=yes 0
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes 0
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoves/inserts 1 IAQ/Health pt y=yes D
b, Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yas 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes D
15.Install High Efficiency Filter 4 IAQ/Health pts y--yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes D
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes 0
2.Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4,Install Photovoltaic(PV)System -
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts D
6.-Select Safe and burable Roofing Materials _ 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes D
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts Y---yes 0
• 1 1 1
M. n oor 1r OuaIITy an Inis es
5.Use Low/No-VOC Paint 1 IAQ/Health pts y=yes 0 •
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes D
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes D
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes D
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
;7.Seal al Exposed Particieboardor MDF _ _ __ _ 4 IAQ/Health pts y=yes 0
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 31A0/Health pts y=yes 0
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y--yes 0
(2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes D
3.Use Recycled Content Ceramic Tiles 4 Resource pis y=yes D
4.Install Natural Linoleum in Place of Vinyl 5 IAO/Health pts y=yes 0
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
Total Points A 1 1401 130F 57 •
Total Points Project R 1 01 0 0
G:datalpmgslgreenbuildingguidelineslremodelerslgmenpointsfinal2.12.04protected.xls
•
CITY OF CUPERTINO
7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk.: Lot:
APN 34241025 . 00
DATE ISSUED. . . . . . . : 05/28/2008
RECEIPT # . . . . . . . . . : BS000004910
REFERENCE ID # . . . : 08050218
SITE ADDRESS . . . . . : 10129 RIDGEWAY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO '
IMPACT AREA . . . . . . :
OWNER . . . . . . . . . . . . : TRACY MATRAY
ADDRESS . . . . . . . . . . : 10129 RIDGEWAY DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ELITE HEATING & AIR
CONTRACTOR . . . . . . . : RALPH B ALCARAZ LIC # 28438
COMPANY . . . . . . . . . . : ELITE HEATING & AIR CONDITION ,
ADDRESS 5565 RUSSO DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95118
• TELEPHONE . . . . . . . . : (408) 726-1618
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 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 2 . 00 122 . 38 0 . 00 122 . 38 0 . 00
1PPERMITFE 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
-7-------- ---------- ---------- ----------
TOTAL PERMIT . 396 . 04 0 . 00 396 . 04 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 396 . 04 #0994
---------------
TOTAL RECEIPT 396 . 04
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 .FINAL PLUMBING
508 FINAL MECHANICAL
•