Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
12080311
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8151 PRESIDIO DR CON l'RAC`fOR: PELLE BEATING R AC INC PERMIT NO: 12080311 OWNER'S NAME: DAROZA ELSIE L TRUSTEE 3728 C CIIARTFR PARK DR DATE ISSUED:08(3012012 ON NER'S PRONE: 5104156008 SAN.IOSE,CA 95136 PIIONE NO:(408)978-7060 LICENSED CON`fRAC`fOR'SSDECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUAIB r License Class r2G L / ic.N 0 /� �/ D1EC11 (✓ RESIDENTIAL r COi111MERCIAL r Commctor%'�/�/ /`T� �7Date_n �-7--7-- 1 "1 herebyaffirm that 1 am licensed under the provisions of Chapter 9 30B DESCRIPTION:INSTALLATION OF AIR CONDITIONING SYSTEM (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 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.Fl Floor Area: Valuation:$8473 1 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. APN Number.35611086.00 Occupancy*I'yPC: Al'1'LICAN4'CIiR'1'IFICAT'ION I certify that I have read(his application and state that the above information is correct.1 agree to comply with all city and county ordinances and state Imus relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harinlessthe City ofCupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the grunting of this permit. Additionally,the applicant understands and will comply — p�2,., with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: ��A,✓ C/T�l/!7 Date: O �/ 9.18. /� Signature _ Dalc d - a RF--ROOFS: ❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material beteg installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for hereby affirm that 1 am exempt from the Contractor's License Law for one of inspection. the following rva reasons: 1,as owner of the property,or my employees with wages as their sole comM1nsation, Signature orApplicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business B Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to - ALI,ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business R Professions Code). 1 hereby affirm under penalty of perjury line of the following three DAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health S Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ileallh S performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the labor Code,for theerformance of the work for which this contaminants as defined by the Ray Arca Air Quality Management District I mill p maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. health S Safety'Code,Sections 25505,25533.and 25534. I cenify 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 _ O�w rteJuthop, ed agent: Compensation laws of Cali fomia. If.allermakingthiscerifcateofcxemption,l Date: t become subject to the Worker's Compensation provisions of the Labor Code,1 must T forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LI.NDING AGENCI' I hereby affirm that there is a construction lending agency for the performance of work's APPLICA\F CF.RTIFIC TION for which this permit is issued(Sec.3097,Civ Q 1 certify that I have read this application and state that the above information is Lender's Name cored.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 Lender's Address iupon 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 ARCI I I"1'FCI"S IlI?CL,\RAT'ION granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF-IR-ALT-HVAC Climate Zones I and 3.7 Sile Address: _ Enforcemwm Agengc Date: Permit 0: Conditioned Duct insulation E i mootT List Minimum Efficiency Floor Area requirement Thermostat Packaged Unit Over 40 fl of ducts ©Furnace ❑AFUE e COP_ OS etback Served by system added or replaced in ®Indoor Coil ®SEER HSPF_ (1/na dreodypresenr,must be Condensing Unit ❑EER ❑Resistance ?ff sf conditioned space emdl<dJ Other R 6 (CL 1.3-5) /. Equipment Type:Choose the equipment being installed;if more than onc,rystem,use another CF-I R-ALT-I1VAC for each system. 2.Minimum Equipment ElTiciencies: 13 SEER 78%AFUE,7.7HSPF for typical residential systems. Contractor(Documentation Author's/Responsible Designer's Declaration Statement) • 1 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. (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 l and 6 of the California 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 permit kation. ' Name: Signature: Compan• Date: Vii- C 1 9si�� Uee dse- -, City/State/Zip: 0,S��G Phon ./�u/ Cj'7�-7oGo 2003 Residential Compliance Forms.doc revised 04110/12 GENERAL PERMIT APPLICATION " COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 T ORRE AVENUE •CUPERTINO, CA 95014-3255 m EMISC CUPERTINO (408) 7—tt-3228 • FAX (-08)T-77-3333 • buildinc/cDcuoerino.om m ` / ❑?LLR.flIh'G NEC_4.NCAL D=c-2?CAL ❑M=ni—kNzOUS E.MAD- //� FAX CONTACT NAME PIlON'c -MAIL STRE-:ADDRESS =,.,STATS L FAX ❑OwNM ❑ OWNER-BUIl)=R ❑ CWN_3 ACEY ❑ CONTR,=R ❑C,N, ci'OR AG,, ❑ ARC-D^S ❑ERGTcr�l ❑ DEY_pP=i ❑ =4ANi CONTRACTOR NAME I LICENSE NUNMER I L1C_NSc TYPE I BUS.L!C q IE MA1 I FAx P9O i Cn ole, � ARL'U—,-CTfENGD=NAME LICENSE NUMEEi BUS.L.'c 9 COMPANY NAME' I E-MAB. FAX STREET ADDRESS MY,STA T Z Z' I PHONE USE OF Fa w DUPLEX ❑ MUL,7-FA Y I PROSECT IN WD-OLAND ❑ Y=S PROr_CT IN ❑ YES I IS i?�3LDG AN ❑ YS 3U1-DMG ❑CONAffRCLV. LMSAN NTc'RFACE AREA NO FLOOD ZONE NO EC-1+"ti:O1Hc. O DESC=ON OF WORX 7rorALYALunroN: RECEIVED BY: By my signa=c below,I cn'Y m each Or-L, a:ollowi_g: I as:be prcpcTf owne er r_d:orz-d agea[m act on;he pre?cy owce-.'s becaif. I have read this aopucadon zeal the iiomarioa I bzve provided is conecL I have:.ad the Desc:ipdon of Wom and vciy it is acc=,te. I ag,Zgjo comply Will ZB znolicPSle local orcinaices and sam laws relating' //ag-ce •c' " avuorzo rp. se:atives of Cwe7-.: _^�::he above-idpau_e3 prpe/-y/•:er i-.soerion cv:¢eses. SigatL:-o`ApphcandAgcnn tr��%/ y Da:c: i��io `rU// z 0 SUPPL-'MNTAL.TNFORL?4 :ON REQLI'Itt.-.D OFFICE USE ONLY OVTR-THE-COUYTER ❑ EXPRESS u ❑ STANDARD U Z ❑ LARGE ❑ NWOR A�PMsc�pp_:011.doc revised 06/?I/11 CiTY OF CUPERTiNO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 8151 Presidio Dr DATE: 09/30/2012 REVIEWED BY: Sean APN: BP#: `VALUATION: $8,473 *PERM17•T1'PE: Mechanical Permit PLAN CIIECK TYPE: Alteration/Addition/ Repair PRIMARY SFD Or Duplex PENTAMATION FURN/A USE: pPERMITTYPE: WORKInstallation of air conditioning system. SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Cooling System 1MRRAA 1 # $67 TOTALS: $134.00 Mech. Plan Check 0.0 hrs $0.00 Phonh.Plan Check Flee.Plan Check Mech. Permit Fee: ImPERMIT Plumb. Permit Fee: Flee.Permit Fee: Other Mech. Insp. 0.0 hrs $45.00 Other Plumb Insp. Other Flcc. Imp. El Mech.Imp.rec: Plumb. hap. Fee: Elce.Insp.Fee: NOTE: This estimate does not includejees due to other Departments(i.e. Planning, Public Rorke, Fire,Sanitary Sewer District,School District,etc. . Thesefees are based on the relindnarl information available and are onb,an estimate Contact the De t or adda'I info. FEE ITEMS (ree Resolution /1-053 E0 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: .Supp!. PC Fee PME Plan Check: $0.00 Pernnit Fee: SappL Insp Fee PME Unit Fee: $134.00 PME Permit Fee: $45.00 Consowetion Tax: Administrative Fee: MDMIN $42.00 Work Without Permit? O Yes 0 No $0.00 Advanced Planning Fees: Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: IBSFISMICR $0.85 Select an Administrative itepl / Bldg Stds Commission Fee: IBCBSC $1.00 �Ul SUBTOTALS: 1 $267.85 $0.00 TOTAL FEE: 1 $ .85 Revised: /0112012