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12100016CITY OF CUPERTINO BUILDING PERMIT RUILDINC ADDRESS: 1195 YORKSI[IRF CT CONTkACTOR: PF.RNIIT NO: 12100016 YQAa ' OWNER'S NAME: JAIN PUNIT/MBGI[ANA /17 16t4jUC 0(-7p DATE ISSUED: 10/022012 O\VNER'S PHONE: 4087181862 iU 8 - 8 - J!- PHONE. NO: ❑ __? LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESID&NTI \L COMMERCIAL ' - 3 S`2`b INSTALL CENTRAL HEATING SYSTEM IN ATTIC WITH License Class Lic. q �,�,���� Contractors YQL%Z i rTtv4r(]F- `ZL Date 1 "ally NEW GAS LINE ANS ELECTRIC TO ATTIC LOCATION I hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Cade and that my license is in full force and effect. 1 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 Sq. Ft Floor Area: Valuation: $6500 performance of the work -for which this permit i5 issued. I have and will maintain Worker's Compensation Insurance, as provided ter by Section 3700 of the Labor Code, for the performance of the work for which this ,U'N Number: 36211009.00 Occupancy Type: permit i5 issued APPLICAWI' CERTIFICATION I certify that I have read this application and stale 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 Issued by: ��TG�-f' Dale: (% - �� granting of this permit. Additionally, the applicant understands told will comply ✓iA/ with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ���I RE -ROOFS: Signa ure Date 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. ❑ OAVNF,R-BUILDER DECLARATION Signature of Applicant: Date: hereby affirm that I am exempt from the Contractor's License Lawfor ane of the following two reasons: ,ALL ROOF COVERINGS TO BE CLASS "A" OR BE'ITER 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, wad 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 HAZARDOUS NIATF.RIAI S DISCLOSURE construct the project (See.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505. 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Nl unicipal Code. Chapter 9.12 and the declarations: Health & Safet, Code, Section 25532(a) should 1 store or handle hazardous I have and will maintain a Cenificate of Consent to self -insure for Worker's anterial. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Ma nagement District performance of the work for which this permit is issued. will maintain compliance with the Cupertino NI unicipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safet ode, Sections.. -, 533, and 25534. Section 3700 of the Labor Code, for ds performance of the work for which this�L Owner or autho igen : IJatez0 1 2 permit is issued. 1 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 Connpensation Imvs ofCalifornia. If, after making this certificate of exemption, I CONSTRUCHON LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 must I hereby affirm that there is a construction lending agency fords 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.) Lender's Name APPLICAN"FCERTIFICATION Lender's Address I certify that I have read this application and slate that the above information is correct. I agree to comply with all city and county ordinances and state lases 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 ,ARCIIITECI"S DECLARATIONindemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand 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 Licensed Professional 9.18. Signature Date CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildincBcuoeriino.ora VPLUMBING );aMECKkKICAL NfFLECTRICAL �TMISCELLAJNEOUS MEP M'sc /a/000/6 PROJECTADDRESS OWNER NAME U 0 17- - C--,4 STREADDRESS (_I;♦_nVA JK{- /c 1�% ;P}�1EV��]I9OElM�A.IL FAX CONTACT NAME ' /- I/ P ONE — J �� �It�Y� EMAIL — IGKQ PAnw Als•!7 vtE-C S ADDRF,ss A D^ C �}❑ CIN�rA- C 64 (_ ° q C� ❑ OWNER OWNEA-BUT1DEA ❑ OWNE AGENT )Corn =R ❑ CONTRACTOR AGENT ❑ ARCNOTECT ❑ LNGBJEER ❑ DEVELOPER ❑TENANT CO OR NAME LICENSELICENSE Gc VM ME. f� BUS. LICA COMPANY NAME E-MAIL FAX STREET ADDRESS QL ao K 7 I I CTY. STATE, ZIP PHONE ARCi?TECTIENGINNEER NAME LICENSENUNSER I BUS. LIC0 COMPANYNAME' I E-MAIL FAX SfREEi ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFO Q DUPLEX MULTI -PANTRY PROTECT N WBDI.WD ❑ Y -S I PROJECT IN BUILDING: ❑CDFB.IEACW. D S rRY URBAN INTERFACE AREA NO FLOOD ZONE ❑YES �N0 IS THE BLDG AN ❑ YES MCHLEA HOME? O DESCRIPTION OF WORK S II cu-- �� A• r _A_�,L IIb r 1 1 p�,yl/� Or— Z� s7 -L A -,;;71,, -,Pic 1�l it a,jJ I k7V/ ai_ 6 Sg," N -v-- 1 f1J) d4 t UV[ �n7��lIQL N2rfn&t" 4s W-efl , t/4 CF, fel (i va W Ai- - TOTAL VALUATION: 6 RECEIVED BY: �E _ By my signature below, I certify to each of the fallowing: I= the property owner or authorized agent to act on the property owner's behalf. I have read this application =tithe information I have provided is cov ct. 1 have read the Descnption of Work and verify it is accurate. I agree m comply wi:h all applicable local te laws _ _ .din consavcdon. I authorize representatives of Cupertino to enter the above-identi5ed'propemy for inspection putposes. ordinances and state N Signature of ApplicanVAgen Dam: SUPPLEMENTAL INFOR-'RATION REQUIRED OFFICE USE ONLY y r _ J J 0 Z OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD ❑ LARCE ❑ MAJOR Ag'PAfucApp_201 Ldoc revised 06/21/11 .M WN�� CITY OF CUPERTIN'O 01 FEE ESTIMATOR— BUILDING DIViSiON / lot) D1,6 LMADDRESS: 1195 Yorkshire Ct DATE: 10/02/2012 REVIEWED BY: Sean Mech. Permit Fee: IMPERA1IT APN: BP#: *VALUATION: $6,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY Multi -Family Dwelling USE: 1 Buildina is >3 Stories O Yes (F) No PENTAD7ATION FURN/AC PERMIT TYPE: WORK Installation of central heating system in attic with new gas line and electric to attic location. SCOPE $0.00 NOTE: This estimate does not include fees dire to other Departments (i.e. Planning, Public II'orks, Fire, Sanitay Server District, School District, etc.). These fees are baser/ on the preliminary information available and are onh, an estimate. Contact the Dept for athin 7 info. FEE ITEMS (Fee Resolution 11-053 F_!1 7/1/11) Mech. Plan Check 1-0-61hrs $0.00 Plumb. Plan Check 0.0 1 hrs $0.00 Elec. Plan Check 1 0.0 1 hrs $0.00 Mech. Permit Fee: IMPERA1IT Plumb. Permit Fee: IPPERAHT Elec. Permit Fee: IEPERAHT Other Mech. insp.0.0 hrs $45.00 Other Plumb htsp. 0.0 Other Elec. insp. El hrs $45.00 Hach. Ince. Fee: Phanb. lisp. Fee: Elec. beryl. Fee: NOTE: This estimate does not include fees dire to other Departments (i.e. Planning, Public II'orks, Fire, Sanitay Server District, School District, etc.). These fees are baser/ on the preliminary information available and are onh, an estimate. Contact the Dept for athin 7 info. FEE ITEMS (Fee Resolution 11-053 F_!1 7/1/11) FEE QTY/FEE A'IISC ITED'IS Plan Check Fee: $0.00 0 # $133.00 Mechanical IA1FR=<100 Furnace, Forced -Air Suppl. PC Fee: (D Reg. Q OT 0,0 hrs $0.00 PME Plan Check: $0.00 1-1 # $67.00 Plumbing IPGASRES Piping; Gas <=4 Outlets Permit Fee: $0.00 Suppl. insp. Fee:Q Reg. Q OT FO.0 hrs $0.00 0 Electrical $133.00 IRREA1A11SC Conductors PME Unit Fee: $0.00 PME Permit Fee: $135.00 Construction Tax: Administrative Fee: 1ADMIN $42.00 O G Work Without Permit? O Yes (2) No $0.00 Advanced Plannine Fee: $0.00 Select a Non -Residential Building or Structure Q i Travel Documentation Fee: ITRAVDOC $45.00 Strong Motion Fee: IRSEISAIICR $0.65 Select an Administrative Item Bldg Sids Commission Fee: IRCRSC $1.00 SUBTOTALS: $223.65 $333.001 TOTAL FEE: $556.65 Revised: 07/01/2012 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAlterations CF -IR -ALT -HVAC Climate Zones I and 3 - 7 - Sfte Address: Ageney: D e.- Permit Ur i l r C-7,Enforcement U O�e Conditioned Duct insulation Equi mens Type I List Minimum Efficiency 3 Floor Area requirement Thermostat El Packaged Unit Ftanace AFU B COP Swed by system Over 40 fl of ducts ad c r replaced N _ pQ Setback door Coil ❑SEER HSPF �n sf unconditioned space / ) (fres afrmdvpresenr, mart 6e Condensing Unit ❑ EER _ ❑ Resistance R 6 (CZ 1. 3-5) irutaltrdJ El Other /. Equipment Type. Choose the equipment being installed; if more than one system, use another CF -I R -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER 78%AFUE. 7.7HSPF for typical residential systems. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I 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. • I certify that the energy features and performance specifications for the design identified on this Cervi fimie of Compliance conform to the requirements of Title 24, Parts 1 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 forts, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. ' Name: •C Signa Company: K t& Date: b O I oL . Address: I I is -"kL- 2 4 a—I to Lice=: 1 City/Stme/Zip: .e , SI I • Phon . _ 2008 Residential Compliance Formcdoc revised 04110/13 CITY OF CUPERTINO BUILDING PERMIT O_-1 r BUILDINGADDRESS: 1195YORKSHIRECT CON"I'RAC'MR: ID PF-RMI.1'NO: 12100016 OWNER'S NA\IF-: JAIN PUNIT/MEGIIANA �f /Y� �r„� DA'Z'E ISSUED: 10/022012 OWNER'S PHONE,: 4087181862 .--\4 PLIONF-NO: ❑ LICENSED CON'1'RAC`f0R'S DECLARATION (_ r U Licen Lie.9 Gn V1� _p BUILDING PERMIT INFO: BLDG ELECT PLUMB (- (_f (- 1IECIi RESIDENTIAL COMMERCIAL Con o Date loclgw I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL CENTRAL HEATING SYSTEM IN ATTIC (commencing with Section 7000) of Division 3 of the Business & Professions WITH NEW GAS LINE AND ELECTRIC TO AT'I•IC LOCATION Code and that my license is in full force and effect. 10/8/2012-REVN I-ELIDIINATE(4)WALL HEATERS(ELECTRICAL). 1 hereby affirm under penalqof perjuy one of the following two declarations: RUN GAS LINE FOR DRYER. Cl-IANGE OUT TI IE DUCT WORK ON I have and will maintain a certificate of consent to self -insure for Worker's FIRST FLOOR -10/8/2012 RL'VNI ISS'D Compensation, asprovided 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 Sq. Ft Floor Area: Valuation: $9000 Section 3700 of the Labor Code, for the performance of doe work for which this APNNumber: 36211009.00 Occupancy Type: permit is issued. AI'1'LICAN'I' CER'fIFICA'I'ION I certify that I have read this application mrd state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter upon the abaye mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities• judgments• 180 DAYS FROM LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply 91 ithh all non -point source regulations per the Cupertino Municipal Code, Section , Issued by: A% N-,j,A1 Dale: �O • -/�— ,/<�/`� Date�v Sign Date RE ROOFS: ❑ OWNER -BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed. If a roof is hereby affirm that I am exempt from the Contractor's License Law for ane of installed without first obtaining an inspection. I agree to remove all new materials for the following two reasons: inspection. I, as owner of the properly, or my employees with wages m their sole compensation, Signature of Applicant: Date: will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) L as owner of the property, am exclusively contracting with licensed contractors m t ALL ROOF COVERINGS TO BE' CLASS "A" OR BETTER construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under pertly of perjury one of the following three IIA•LARDOIIS MATEIRIALS DISCLOSURE declarations: I hive read the hazardous materials requirements tinder Chapter 6.95 of the I have and will maintain a Certificate of Consent to self -insure for Worker's California Ilealth & Safety Code. Sections 25505. 25533, and 25534. I 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 Ilealth & performance of the work for which this permit is issued. Safety Code. Section 25532(') 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 the performance of the work for which this contaminants as defined be the Bay Arca Air Oualit Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I certify that in the performance of Ute work forwhich this permit is issued, I shall Health & Safety Code. Sections 25505, 25533, and 25534. not employ any person in any manner so as to become subject to the Worker's seiner or aulho zed agent Compensation laws of California. If, after making this certificate of exemption, I pate; o� become subject to the Worker's Compensation provisions of the Labor Code, I nest. forthwith comply with such provisions or this permit shall he deemed revoked. CONS'IRUCHON LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of ssork's AI'1'LICAN'I' CliR'1'IFIC,\TIO\ for Which this permit is issued (Sec. 3097, Cie C.) I certify that I have read this application mid stale that the above information is Lender's Name correct. I agree to comply with all city and county ordinances and state laws relating _ to building construction, mid hereby authorize representatives of this city to enter Lender's Address 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 ARCIIITECf'S DECLARATION granting of this pernit. Additionally, the applicant understands and will ComPI% 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 CUPERTINO GENERAL PERMIT APPLICAT(r EMSO®N # COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinarcDcuoerino.org IIPLUMBING 1?4MECHANICAL LISIELECTRICAL ❑MISCELLANEOUS MEP mISC PROn17ADDRESs J ILS I APN9 OWNER NATWITME PHONE i4-IBb eM. - STRFT ADDRES� TIC ,11 CITY. STATE,? 1 PS O CA FAX COITTACT NAME PHONE E-MAIL ST KEFTADDRESS CTIY, STATE, ZIP FAX ❑ OWNER ❑ O%N'Dt-BUMDER ❑ OWNERAGEN7 CON,, ACTOR ❑ COMAACTOR AGE.T ❑ ARCFUTECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME sA.AC.� (V LICENSE NUMBER 1 �c'Do LICENSE M=_ I BUS. LIC p COMPANY E.MAtL FAX SZRI��T ADDRESS C4.. -Pow -2 CITY, STATEIIP cn i tt ?HON= `b 5-415 ARCHFMCT/ENGa'EER NAME LICENSE h'VM9 I BUS. LICA COMPANY NAME' I E -MATT. FAX STR.EFr ADDRESS I CITY, STATE, ZIP I PHONE USE OF ❑ SFJ m DUPLEX MLR.TFFAMILYPAmECf P' wBDt.ATm ❑YES BUI NG: ❑CommERCL&L URBAN ATcRFACE AREA NO PROTECT [N [I YES FLOOD ZONE ❑ NO is TF BLDG AN ❑ YES EICHL-A HOMED NO DESCRIPTION OF WORK ' '£-1-+ h I aaT6 4 o W w FP (i'9S Qec L-A N3-- Gi►ta�a E a7 � �1�E-- [-oaf+` ror�u�.-t �a,— o.+�?��Q-k-_ . TOTALVALUATION: ZSR'_ I RECEIVED BY: '1 By my signature below, i certi;.y to each of the following: lam the prcpeY, owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct I haveread the Description of Work and verify it is accurate. I are , to comply with all applicable local ordinances and sate laws mlatin , ' ,•' in construction. I authorize r epresnatives of Cupemno to enter the above -identified prope—,y for inspection pw'�oses. Signata-e of Applicant/Agenc Dina: Ic> 012 SUPPLEMENTAL INFORMATION REQUIRED ' OFFICE USE ONLY OPER-THE-COUNTER ❑ EU'RESS = U ❑ STANDARD ❑ LARGE ❑ MAJOR MHP.M1scApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION 19 ADDRESS: 1195 Yorkshire Ct DATE: 1 0/0 812 01 2 REVIEWED BY: Sean Mech. Permit Feu: APN: BP#: 'VALUATION: $2,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: Elec. Insp. ree: PENTAMATION 1 RPGAS PERMIT TYPE: WORK Revision #1: Eliminate 4 wall heaters(electrical),run as line ford er, change out the duct work on SCOPE first floor. NOTE: This estimate does not include jeev due to other Departments (i.e. Planning, Public Htorks, Fire, Sanitary Sewer District, School District, etc.). These fees are baser/ on the nrelinninan, information available and are onlr an estinune. Contact the Dent for addn'I info. FEE ITEMS (Fce Resnhuion /1-053 Efl' 7/1/11) Much. Plan Check Plumb. flan Check 0.0 1 hrs $0.00 Elec. Plan Check Mech. Permit Feu: Plumb. Permit Fee: l PPERA- Elec. Permit ree: 01herdlech. Insp. Other Plumb Insp. 0.0 hrs 45.00 Other Elec. lap. 19ech. Insp. Fee: Plumb. hasp. rue: Elec. Insp. ree: NOTE: This estimate does not include jeev due to other Departments (i.e. Planning, Public Htorks, Fire, Sanitary Sewer District, School District, etc.). These fees are baser/ on the nrelinninan, information available and are onlr an estinune. Contact the Dent for addn'I info. FEE ITEMS (Fce Resnhuion /1-053 Efl' 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Plumbing $67.00 IPOASRFS I Piping, Gas <=4 Outlets Suppl. PC Fee: (j) Reg. Q OTFO-OThrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? O Yes 0 No $0.00 Suppl. Insp. Fee.0 Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 Consowcdon Tar: Administrative Fee: InDMhv $ O 0 Work Without Permit? O Yes (j) No $0.00 Advanced Plannine Fee: $0.00 0 hours Inspections 0 $266.00 1STINSP Inspection, Hourly Travel Documentation Fee: /TR.U'UOC $ 0 Strone Motion Fee: IBSEISAHCR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $133.50 $333.001 TOTAL FEE: I $466.50 Revised: 10/01/2012