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13050117 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6790 JOHN DR CONTRACTOR:ABC COOLING& PERMIT NO:13050117 HEATING OWNER'S NAME: SCOTT FITINGHOFF 31845 HAYMAN ST DATE ISSUED:05/£5/2013 OWNER'S PHONE: 4087477503 HAYWARD,CA 94544 PHONE NO:(510)471-8181 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALO License Class C�0 Lie.# n?7J 1 REMOVE AND REPLACE FURNACE AND A/C :&7 DUCT RUNS ContractorW_W_ Date �� cr7 (3 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. 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7000 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:36923001.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state 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 1 AYS 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 DAY M 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: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. i ate �—115— 3 any r ROOFS: Signature � 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. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1,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) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE 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. 1 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(a)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 contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9,12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this /� Owner or authorized age �L!l/L%v e:_�%r�� permit is issued. I 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the 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 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 upon the above mentioned property.for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify,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 GENERAL PERMIT APPLICATION ' M EP 10 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 misc CUPERTINO (408)777-3228•FAX(408)777-3333•buildina@cuaertino.org k'J-1 l El PLUMBING [DMECHANICAL ❑ELECTRICAL ❑✓✓MISCELLANEOUS PROJECTADDRESS6790 JOHN DR T"N# q 2-3 C)01 OWNER NAMEFITINGHOFF, SCOTT PHONE408 747 7503 E-MAIL STREETADDRESS6790 JOHN DR CITY' STATE,ZIPCUPERTINO 95014 FAX CONTACT NAME MAGGIE MENDOZA PHONE510 471 8181 E-MAILMAGGIEM@ABCCOOLING.COM STREETADDRESS3266 INVESTMENT BLVD cry°STATE°ZIP HAYWARD CA 94545 FA"510 471 8368 ❑OWNER ❑ OwNER-BUILDER ❑ OwNERAGENT IN CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME SCOTT LU NDAY LICENSE NUMBER 382383 LICENSE TYPE C20 BUS.LIC# COMPANY NAMEABC COOLING &.HEATING E-MAILMAGGIEM@ABCCOOLING.COM FA"510 471 8368 STREETADDRESS3266 INVESTMENT BLVD CITY,STATE,ZIP HAYWARD CA 94545 PHONE 510 471 8181 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK REPLACE FURNACE & AC REPLACE 7 DUCT RUNS TOTAL VALUATION: 1 OW By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on he operty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is acc ate. I agree to comply with all applicable local ordinances and state laws relating to buildin tion. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: �' S SUPP MENTAL INFO ON REQUIRED t u�. MEPMiscApp 2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 6790 JOHN DR DATE: 05/15/2013 REVIEWED BY: MENDEZ APN: BP#: *VALUATION: 1$7,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY SFD or Du lex PENTAMATION FURN/AC USE: p PERMIT TYPE: 19 WORK REMOVE AND REPLACE FURNACE AND A/C :&7 DUCT RUNS SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES A/C Units (<=10K cfm) 1BREMAIR 1 # $67 Furnace, Forced-Air 1MFR=<100 1 # $133 TOTALS: u $200.00.� � � 10 Mech.Plan Check 0.0 hrs $0.00 .Phetrrb. Plan Check Elect.Plan Check Mech.Permit Fee: IMPERMIT Plumb.Permit Tee: f lec. Permit tee: Other Mech.Insp. "00 hrs $45.00 Other Plumb Insp. Other Dec.Insp. tech. 0.0 Insp.Fee: Plumb. Insp.Tee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS(Fee Resolution 11-053 E . 7ff 11112) FEE QTY/FEE MISC ITEMS Plan Check 17ee: SuFpl. PC Fire PME Plan Check: $0.00 Permit Fee: ;Suppl. Insp Fee PME Unit Fee: $200.00 PME Permit Fee: $45.00 Conswuction Tris: Administrative Fee: 1ADMIN $42.00 Work Without Permit? ®Yes (E) No $0.00 Advanced Planning 1*ees: Travel Documentation Fee: 1TRAVDOC $45.00 Strong Motion Fee: IBSEISMICR $0.70 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $333.70 1 $0.00E.- $333.70 i n .k ,Vm Revised: 04/29/2013 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-lR-ALT-HVAC Climate Zones 1,3-7 Site Address: Enforcement Agency: Date: Permit#: 6790 JOHN DR Cupertino, CA 95014 City of Cupertino May 14, 2013 Duct insulation Conditioned Floor Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat ❑Package Unit ®Furnace ®AFUE 96% ❑COP ❑R 6(CZ 1 3-5) Served by system ®Setback ®Indoor Coil ®SEER 13.0 [3HSPF If not already present, must be ®Condensing Unit ❑EER ❑Resistance ❑R 4.2(CZ 6, 7) 1536 sf installed) ❑Other 1.Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-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. •I 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: Scott Lundy Signature: Scott Lundy Company: ABC COOLING &HEATING SERVICES INC Date: May 14, 2013 Address: 3266 INVESTMENT BLVD License: 382383 City/State/Zip: HAYWARD/CA f94545 Phone: (510)471-8181 P �k�4 VJ ,UK y r Reg: 213-A0029222A-000000000-0000 Registration Date/Time: 2013/05/14 19:40:14 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010