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11010148 •CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20150 PEACHTREE LN CONTRACTOR:COMERFORD'S SERVICE PERMIT NO: 11010148 EXPERTS 6984 SIERRA CT DATE ISSUED:01/27/2011 "NER'S NAME: SUTATHA SANPHANAR DUBLIN,CA 94568 PHONE NO:(925)273-3468 uWNER'S PHONE: 9252733468 19� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL Z O Lic.# 3 j © � ,� f REPLACE FURNACE AND A/C SAME LOCATION,91 K BTU License Class 95%AFUE A/C 4 TON Contractor L+"9 Q-Z_zt1_-2� Date 11 -2- 2(411 1 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 Valuation:$10751 performance of the work for which this permit is issued. Sq.Ft Floor Area: 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 APN Number:31633058.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION PERMIT E I certify that I have read this application and state that the above i /h,�ation IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WIT 180 DAYS F PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter ST CALLED IN CTION. upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY O I 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: Date . granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertin Municipal Code,Section 9.18. RE-ROOFS: afore Date 7 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. ❑ O -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER the following two reasons: 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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). I 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 Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminantscomplianceasdefined by ythe Cupertino the Bay Area it Q ualipal,Code,Chapter Management District and performance of the work for which this permit is issued. will maintathe Health&Safety Code,Sections 25505,25533,and 2553 I have and will maintain Worker's Compensation Insurance,as provided for by 2 7 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall 7 not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must work's for which this permit is ere is a cissued(Secnstruction,309, 7,Civ ending eC)for the performance of forthwith comply with such provisions or y affirm that this permit shall be deemed revoked. Lender'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 pon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION ademnify 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 Building Department City Of Cupertino LM 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: Z-0 150 -r PERMIT# Yo I() OWNER'S NAME: 3 ,jy T q PHONE# GENERAL CONTRACTOR:45wozfui -)S 5ca-') _ 4 i1 71 BUSINESS LICENSE# ADDRESS: q �r�zr (:f,,7CITY/ZIPCODE: CA `! *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: ure Date Please check applicable subcontractors and complete the following information: V 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 Owne ontractor Signature Date Simplified Prescriptive Certificate of Compliance: 2008 Residential HVA C Alterations CF-IR-ALT-HVAC Climate Zones 1 and 3-7 Site Address: Enforcement Agency: Date: it#: 20i50 aw-ri Tz� ��ti� cv���-TI jo7Perm Conditioned Duct insulation Equipment T e' List Minimum Efficienc Floor Area requirement Thermostat Packaged Unit Over 40 ft of ducts Furnace ®AFUE95 BCOP Setback Served by system added or replaced in Indoor Coil ®SEER HSPF_ (If not already present,must be Condensing Unit ❑EER ❑Resistance sf unconditioned space installed) Other /. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-1 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. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • 1 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 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 forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit application. Name: &--�1� *)ZA I N E Signature: �-� Company: , Date �wi�,z Rfz7 5 J1 cc Exi 5 Address: b q<Z,T j !>/,0-ZR A �- License: City/State/Zip:/ ' 3`t,J G 4 Phone: 12-5 -Z73 3 L2 ::;f�ff�,9 W.k 2008 Residential Compliance Forms March 2010 24-Jan-2011 01:08 PM Comerford. s Service Experts 925.463-1340 9/24 s scp 100ht �, '. �� 1. , I. n�caet-o4 I SiSa k 8diessi I e 2 0�'2 rm ��5� PegC�'{'f/QQ� G ��j h p I�iz�rctrueut� ccys I•Poii Number. s DIIcb and raw §I50(in),Duce,and vgt3 ' 1.All sii dls4i'ausioa syagr n duate cad pl2n ;WtelIad; od add, Som tale raqu:�-eutcn�o>2'CMC Sections 601,602,608,40 605 and S�dard pply�air du ead P1wins are iasuhted to a mkdmtuu hd�Wect level ofR-4.,2 or enclawt 4int bed otted ace. dd 1 he sealed mastic e . space. arida ,tap I oro e<dzbt_clostm:system ahs*a¢eeSs the at1pr?r�les regnUceta of uL 181, ISI' cr 1JL i SIB 61'amwsol seely Chit theft thh r_�it9re.m6*U o,M. 723. I m�s4io 6p 6 is uW ib s64 opeah4gs vveer tnan 1/4 inch,the I c=ibb iWw of mastic cad either:'Heal"be tette baa trsod;an plenums defier or co0quotedwish:Matcras Otho: � tift sued shemmeW,data bond or dinble d snail not b9 Wed for cortvey�condl'*dued air. lauildiag cav les aad sup por'pladbAms oW oontem ducts. Mob iqs' ed i+l to "'es and eXvPO. plattb shall not be compressed to I 6 use redactions h the mss-secdottal aft of jhe ucas, ❑ 2D,Joints eaa wears d.duct systems and ta- compbA"shell not br s dd whiz loth back rdo aer adhos:ve duct taxa tti len$tach tape is used ft--combfi m2stic dad draw beads. " 11. 7.E chmst iia systems have bask draft or a ni.sdo&rdp�ze. M $.Cavity veirtlwng evens swih t condM med space have orae+ectt 'c orA,- fly accessible,mamally ppwated dampers. I . © 9.Pra¢ecdon ofinsulation.Ensuledon shah b pYoucted frtIM dsroage.loci , d ' ' tine 5o szztzl• ao o'zsttn e, j eguhftent meiateaaam wad wlad..0-I f&foam sbftl be pYotectet4• ehave o Pekbed vvf M a cozgnz that is � wator rbrardatr`2titl pmirldes s3iieldifrg foss soler r 'on to,&scan ca used 'ort o° e material. 13 10,Flexible dues c=ot have po is hinw, res. R cecLARAjiom aTA Cflfl1=1I'I' o I certify u1dr pezwty dp6da.Uaft dw laws offt S 6fCzm a,the bdlrol auaio PmviVII71on b fo=is uu*=d oo ~ C I aM eligiole Lader Division 3 vfrhe Busmesa end ft cz$Code vormow oil for oQ Codon,or=autorxlzd °`:.... regrew a bf;he p2$cn zssp6�aible fb:eowncdcd ole I G I ctsdfy 1=I&*fiwtaued tghtdack +MetnitbB cdMPO or besn.rftbtted drOka idxttti led on tU,,cartifcite(tae fttstslk on) com`orms ro atI eaplicabte ebo+s end regolxligls� d rhe o>x to(CotnfsOtnt�vIds plea atec�£csdoas aapcoved by tie eafiorr�norr rgomcy. 4 1 reviewed a cop_+' of I&%CerBffaeia of Compu=06(CF' fozm Vp*�'ved•by tlta est by tbzt ideLtmot dw*-'a& zeq,L{-�neets fbz s$'iAs4a atioa. I iia the tsq cicr�ile$on tt o CRIk apply tq been ma•.. e I WM eusard dot It oosiptdted,S4 ndd•copy of th4a�' #on Co�Scate STUO-be p ,or :db avaftblo•r+itTa the btcfidsag I petYaff(s�is iced fo�tab badldfz and frastda ivd PIo the eely& .neat s Ztey for aPP to ltrspecsfo�. f auderstaztd _ i ti tw m s ed•copy 6S;WS kns hwott C�sate H a',a e'4 to be cIi<d'ed wi&the octtraa `aa tho buiidor �' ` the bttiId OWZ1¢1'2t occupanc). " Comte Vma: (Iaa',alling Subco=Aacmr or Codes 'r o:Euildiriowabr) 5 RaporifoloPc:roa'SName: • 'bloPerson's igna:u.+e: •--•-""'� CI AAA 3 G fay CSI,$Wrzb: n'e S Potron Wafa Com (Title): ADO$ft&42Dtal Gohaplr'dncs rdrnrs Attgcst 2009 i I CITY OF CUPERTINO 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31633058 . 00 DATE ISSUED. . . . . . . : 01/27/2011 RECEIPT # . . . . . . . . . BS000012582 REFERENCE ID # . . . : 11010148 SITE ADDRESS 20150 PEACHTREE LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SUTATHA SANPHANAR ADDRESS 20150 PEACHTREE LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM JEFF RIANEY CONTRACTOR TROY THOMAS LIC # 32138 COMPANY COMERFORD'S SERVICE EXPERTS ADDRESS . . . . . . . . . . : 6984 SIERRA CT CITY/STATE/ZIP DUBLIN, CA 94568 TELEPHONE (925) 273-3468 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- 1BCBSC VALUATION 10, 751 .00 1 . 00 0 . 00 1 . 00 0. 00 1BSEISMICR VALUATION 10, 751 .00 1. 08 0 . 00 1 . 08 0. 00 1MFR=<100 UNITS 1 .00 126 . 00 0 . 00 126 . 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 1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 .00 42 . 00 ------0_00 ---------- ---------- ---------- TOTAL PERMIT 275 . 08 0 .00 275 . 08 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --- CREDIT CARD 275.08 visa --------------- TOTAL RECEIPT 275. 08 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- __ _ -- ----------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 20150 peach tree In DATE: 01/27/2011 REVIEWED BY: bobs. APN: BP#: *VALUATION: $10,751 R-PERMITTYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition / Repair PRIMARY PENTAMATION FURN/AC USE: SFD or Duplex PERMIT TYPE: WORK replace forced air and ac unit at same location SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $63 Furnace, Forced-Air 1MFR=<100 1 # $126 TOTALS: $189.00 Mech.Plan Check 0.0Fhrs $0.00 Plumb-1'lcr,r h,,(k I - F Mech.Permit Fee: 1MPERMIT Fo"<� Pooh;FI"' Other Mech.Insp. 0.0 hrs 1 $42.00 010"x-r't,.,nrtr InrpLi 0/h"T/'70''.tr,st'. Li NOTE. Theseees are based on the preliminaryin ormation available and are onl an estimate. Contact the De t or addno. '1 in FEE ITEMS (Fee Resolution 09-05I E . 7,11110) FEE QTY/FEE MISC ITEMS Plan Check Fce: Srpp/. P('FCC" PME Plan Check: $0.00 Per snit Fee: silppl. Irtsp Fee PME Unit Fee: $189.00 PME Permit Fee: $42.00 (.`onstr fiction Tax F71- ,;Icouslicul Work Without Permit? 0 Yes E) No $0.00 Plarli img 111!(',': Travel Documentation Fee: ITRAVDOC $42.00 A Strong Motion Fee: 1BSEISMICR $1.08 Select an Administrative Item B1dyStds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $275.08 $0.00 TOTAL FEE: $275.08 Revised: 01/15/2011 CITY Of CITY OF CUPERTINO IW6 FURNACE/AC CUPERTINO PERMIT APPLICATION FORM b/Ul4F, APN# 33 bL Date: r L r Building Address: J 7-Ci50 CAC«A T1zEC- L,4,) Owner's Name: Phone#: , 01AT�4A -S, ,JPt4A�JA!?, 909 -o�g ,65`-f1 Contractor: Phone#: 17Z5 - 2 7 3, 3 g 6 9 ►�1�Zr=v iz�S t-7Z J r�E EXP&J72—T 5 Fax#: Contractor License#: Cupertino Business License#: 3 i o�5 ? ► Contact: Phone#: c)Z 4. Z'7 3- 3 -16 1 �2A,,Jr-- Fc6zJ►26uiZ Fax#: 'IZS SSL /06 Building Permit Info: Elect 5d Plumb Mech Residential 154 Commercial Job Description: j?F''t_Ar-E 1-=012 )AZ-E /► .�� A-�G 7 SOi E l�t�t_�7i��r✓ . —LJ,2.A)Ac.0 ' � I KIS -TL) ) 15'rk A rL) z4 70,1, /3 SSR . For Residential Installations: Attic Elis`floor R 2"d 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): � 1 0�?,5 / I L"0 --- Strapped 11 On Platform El Bonded New Location Replacement Project Size: Express ❑ Standard ❑ Lar e ❑ Major❑ Valuation: W /OI 751 C1 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