10110112 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10129 MELLO PL CONTRACTOR:A24 SOLAR PERMIT NO: 10110112
CORPORATION
OWNER'S NAME: WEI WEI&KING WAH YEUNG 2191 A DEL FRANCO ST DATE ISSUED: 11/17/2010
vER'S PHONE: 4083204970 SAN JOSE,CA 95131 PHONE NO:(408)677-8111
{� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
A/C INSTALLATION
License Class Lic.#a 2,9 Igo C
Contractor 2415_ALAR� &p %4Date
I 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.
Sq.Ft Floor Area: Valuation:$8880
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self-insure for Worker's APN Number:36905029.00 Occupancy Type:
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
2. 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 PERMIT EXPIRES IF WORK IS NOT STARTED
permit is issued. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
APPLICANT CERTIFICATION 180 DAYS FROM LAST CALLED INSPECTI
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 l I
to building construction,and hereby authorize representatives of this city to enter Issued by: V Date:I �_
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
granting of this permit. Additio Ily,th plicant understands and will comply with RE-ROOFS:
all non-point source regulati per C ertino Municipal Code,Section 9.18. 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
Signature Date ZZO inspection.
Signature of Applicant: Date:
OWNER-BUILDER DECLARATION ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1. I,as owner of the property,or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE
compensation,will do the work,and the structure is not intended or offered for I have read the hazardous materials requirements under Chapter 6.95 of the
sale(Sec.7044,Business&Professions Code) California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
2. I,as owner of the property,am exclusively contracting with licensed contractors to compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
construct the project(Sec.7044,Business&Professions Code). Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
I hereby affirm under penalty of perjury one of the following three declarations: contaminants as defined by the Bay Area Air Quality Management District I will
t. 1 have and will maintain a Certificate of Consent to self-insure for Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation,as provided for by Section 3700 of the Labor Code,for the Health&Safety Cod ections 25505,25533,and 25534.
performance of the work for which this permit is issued. Owner ora e
z. I have and will maintain Worker's Compensation Insurance,as provided for by Date:_WZZ&0
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. CONSTRUCTION LENDING AGENCY
3. I certify that in the performance of the work for which this permit is issued,I shall
I hereby affirm that there is a construction lending agency for the performance of work's
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If,after making this certificate of exemption,I for which this permit is issued(Sec.3097,Civ C.)
become subject to the Worker's Compensation provisions of the Labor Code,I Lender's Name
must forthwith comply with such provisions or this permit shall be deemed Lender's Address
revoked.
ARCHITECT'S DECLARATION
APPLICANT CERTIFICATION I understand my plans shall be used as public records.
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 Licensed Professional
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the
.ling of this permit.Additionally,the applicant understands and will comply with
all non-point source regulations per the Cupertino Municipal Code,Section 9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
Eli ADDRESS: 10129 mello pl. DATE: 11/17/2010 REVIEWED BY: building
APN: BP#: ! /';�- *VALUATION: 1$8,880
*PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARYSFD or Du lex PENTAMATION FURN/AC
USE: p I�'« PERMIT TYPE:
WORK add a/c unit for SFD
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
A/C Units (<=10K cfm) 1BREMAIR 1 # $63
TOTALS: $63.001 1
Mech.Plan Check0.0 hrs $0.00
Mech.Permit Fee: IMPERMIT f
Other Mech.Insp. 0.0 hrs $42.00 � '�l-;� „t"���� LI
Ill"h 11;o)' P"o, t.7.ai.'3. t�t°c_ I"V"
NOTE. Thesefees are based on the prelinddnayy in ormation available and are only an estimate. Contact the De t or addh 7 info.
FEE ITEMS (Fee Resolution 09-051 Ef.Z%1,10) FEE QTY/FEE MISC ITEMS
Mail Chc(k Fck':
PME Plan Check: $0.00
Pc rinit Fcc.
sitly)[ 111',,p I'c'y'
PME Unit Fee: $63.00
PME Permit Fee: $42.00
Con"arl"ction
,1c:ot�sr`tt°crllic's°It'?t-�=E'e':
Work Without Permit? 0 Yes E) No $0.00
P�Ldttntt7�'/'t'e'.i:
Travel Documentation Fee: ITRAVDOC $42.00
Strong,Motion Fee: IBSEISMICR $0.89 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $148.89 $0.00 TOTAL FEE: $148.89
Revised: 11/08/2010
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: suew
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36905029.00
DATE ISSUED. . . . . . . : 11/17/2010
RECEIPT #. . . . . . . . . : BS000012031
REFERENCE ID # . . . : 10110112
SITE ADDRESS . . . . . : 10129 MELLO PL
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : WEI WEI & KING WAH YEUNG
ADDRESS . . . . . . . . . . : 10129 MELLO PL
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : HAI DO
CONTRACTOR . . . . . . . : HAI DO LIC # 31508
COMPANY . . . . . . . . . . : A24 SOLAR CORPORATION
ADDRESS . . . . . . . . . . : 2191 A DEL FRANCO ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95131
TELEPHONE . . . . . . . . : (408) 677-8111
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BCBSC VALUATION 8, 880 .00 1. 00 0 . 00 1. 00 0. 00
1BREMAIRHA NO.UNITS 1.00 63 . 00 0 .00 63 . 00 0.00
1BSEISMICR VALUATION 8, 880 . 00 0.89 0 .00 0.89 0.00
1MPERMITFE FLAT RATE 1 .00 42 . 00 0 . 00 42 .00 0. 00
1TRAVDOC FLAT RATE 1.00 42 . 00 0 .00 42 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 148. 89 0 . 00 148 .89 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 148 . 89
---------------
TOTAL RECEIPT 148.89
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
try of
CITY OF CUPERTINO
19 FURNACE/AC
SCUP RTINO PERMIT APPLICATION FORM
APN # :�(L /►� �S - d� Date: Z/
Building Address:
Owner's Name: Phone#:
Contractor: Phone4:
Ilay VtogG -7-74+4
�6
( D "� Fax#:
Contractor License#: Cupertino Business License#:
Contact: Phone#:
2Fax
Building Permit Info: '
Elect 1�4 Plumb �� Mech
Residential Commercial ❑
Job Description:
For Residential Installations:
Attic El1St floor ( "] 2°d floor ❑
Adhere to minimum setback require ent
For Commercial Installations:
Replacement same weight ❑ Additional weight(structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Re uired ❑
Cost of Project: c Type of Construction (Usage Class):
1�
Strapped ❑ On Platform ❑ Bonded ❑ New Location ❑ Replacements
Project Size: Express ❑ Standard JZ Large ❑ Major ❑
Valuation:
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