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04020150CITY OF CUPERTINO ?=r" '-•TM+-��`" �r ' BUILDING DIVISION PERMIT kCONTRACTORANFOT.tMATION. BUILDING ADDRESS: WEIGEL MECHANICAL & REFRIG PER""04020150 OWNER'S NAME: PERMIT ISSUE DATE ONE: (408) 252-23-18 SANITARY NO. CONTROL NO. ARCHITEC (ENGINEER: BUILDING PERMIT INFO RILED ELECT PLUMB MECH LICENSED CONTRACTOR 'SDECLARATION 5 JobDescri tion 1 hap affirm Nn I am liceued Under provisions caf Chapter 9 (cemmcnse p is with Sudon7IXp)of Division Sof do Buara.. and ProfekdonsC mylicenwu ion 7 Trail rnme e�n ein and e t. o Lieenw Class FURNACE REPLACEMENT r �swasovesom Dau Comncmr 333Y ARCHITECI-S DECLARATION I undcnland my shall he used u mcmds MAP C plans puhlie 1 1 2004 l.icencd Professional 5 OWNER -BUILDER DECLARATION I� E 1 Wmby affirm that I am attempt inner the Contractors License Law for tW D following mown. (Section 7101.5, Basinw and Professions Cade: Any City Of County a�(� which mquites a permit to mnwuct, alter. improve, demolish, or repair any structure d prior in its issuance, also requires the applicant for such permit to file a signed summent W is liccnsml to Ne of tW Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that pursuant provisions (commencing with Section 7(1 of Division 3 of the Business and Professions Cnae) tar Nat be Is ewmpt tWrefrom and the basis far IW alleged exemption. Any vlola0on of session 7071.5 by arty applicant for a pewit subjects the applicant to a civil penalty of 3 5�D1-%btlRbgrO 0 Occupancy Y T Ype an hundred dollars ($50(l).P no, more NRK ❑ [,mo roof Nepmpcny,ormyemploymwiNv guuNeuwlemmM=don. will&tWwork. and this structure, tanotinlended oroRered Waste(Sec. 7( 1, Baca as and Professions Code: The Communes License Law does rot apply to an owner of Required Inspections property who builds or improves thrmon, and who does such work himsel f or through his own employees. Provided that such improvements are not intended wo0ud for We. If, however, the building or improvement is sold within on year of mmpledon, the owner - builder will have the burden of proving that M did not Wild or improve for purpose of nn.I. I. u owner of the property, am =elusively Contracting with licensed contractors to construct Ne project (Sec. 70,14, Business and Professions Code:) The Contractors W- cense Law does not apply in an owner of property who Wilds or improvas Nemon. and who convects for such projects with a conmctor(s) Ilunsed pursuant to the, Contractors License Law. ❑ lam exempt undersec. . B & P C fm Nis mason Owner Dau WORKER'S COMPENSATION DECLARATION 1 hereby aRr anile, penalty of perjury one of the following declarations: 1 hoe sed will mums.. Cenificate or Consent to self -insure for Wmkcra Compcn. urian, as provided for by Section 3700 of the Labor Code. for the performance of the work for which his permit is issued. 1 have and will maintain Worker's Compensation Inrurwa, as required by Section 3700 of the Labor Code, for du perfawmee of the work for which this permit is issued. ' MyWork Codi ado wnnce Cartier and Politynu Wr am: Cartier. Policy No.: Z CERTIFICATE C, E%FMPr10N FROM WO K RS' COM ENSATION INSURANCE (This section need not W complexed if the permit is for one hundmddollars (si(I0) caricas) I eenify that in the perfcarmanec of the work for which this permit is issued. I shall not employ any person in any mannesZsn� w become subject w don Workers Compensation Laws of California. Dam G Applicant r, NOTICE TO APPLICANT: If. after making this Cedificam of Esc niumn. you should become subject to the Worker) CamPClmallnn provisions of the Labor Code. yen muss w forthwith comply with such prevision or this Permit shall W doomed revoked. CONSTRUCTION LENDING AGENCY I Wr thatduraiCacanswctinn lending agcnry for NC Pcrfuwance of ' which ' the work for which Nis pewit u issued Lender's Name !lL lenders Aaem•. 1 codify Nat 1 have mad this application and suite Nat Ne about information is ' COMM 14me to comply with all city and County ontinmets and sun laws relating to Wilding construction. and hereby auNarim mpmsenutives of this city to cnmr upon out about -mentioned property for inspection Pugwsea (We) agree th save, indemnify keep harmless City and the of CuPtaSanst j liabilities. Judgments, casts and expenses which may in any way acme againstseiCity in consequence of Ne granting of this permit. ' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date 2� SOURCE REGULATIONS. Q Re -roofs Signarure of ApphearnVontnmor De HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dm applicant or future building accupmt nom or bandlc havardau mamrisl U deftnd by da Cupertino Municipal Code. Chapter 9.12, and the Heal% and Safety ode. 0Yes 25572(a)? 6at� Yes All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove it ha'rardous air contaminants u defined by tW Bay Area Air Quality Management all new materials for inspection. isvict? ❑Ycs pNd/ I have read the harsrdmumakerialsmqusenums under Chapmr 6.95 oftW Califor. nia Health&Safety Cock. Sadons35505,25573 and 35534. I undemmnd Nm ifthc Wilding does not cuwndy have a mnme that it 4 my responsibility to notify tW occupant of the m nimmcnts which muss to met prior to issuance ofa CcniRean of Occup Igna[Ure of Applicant Date de All roof coverings to be Class "B" or better Owner Orauthonredagent CITU Of �UPERTINO U • g: OWNER'S NAME: CSI. CONTI I am not using any subcontractors: Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building De utment PERMIT # PHONE # d Z Z Z �S F -- 0 Signature Date F,.«� �.,rl nn,v.rtlo4o +ha fnllnwina infnrtnatinn- a •cct,c a. SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating �. Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile —ev"m / o�r Signa e 10/28/03 Date / CITY OF CUPERTINO FURNACE/AC CITY OF IrUPt111NU YL+ KIVll l AJrrh1UA I MiN IV 1L)1CV1[ Nor APN # 5�— O a MECHANICAL Building Address: A/C Unit > 10,000 cfrn © /Q BREMAIRHAN O ner's N ame: hone #: / � 7 MECHANICAL Co tra oPhone: 5.123 License #: L Rec tl, Switch & Outlets Contacl,, Phone- R Cupertino Business License #: !o it- Z'S $'2:� BSEISMICRE X BSEISMICOM Building Permit Info: BUILDING BUILIDNG Bldg ❑ Elect ❑ Plumb ❑ Mech Elec Permit Issuance Job Description: 4.0 ZALA MPERMITFEE c r 14 MECHANICAL Residential Commercial ❑ Plumbing Permit Issue For Residential Installations: BPERMFEE Attic ❑ 1" floor 0 2 ' floor ❑ BUILDING Adhere to min set back requirement ❑ Plan Check Fee or Commercial Installations: BUSLIC eplacement same weight ❑ Additional weight (structural calcs) ❑ BUILDING Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project Type of Construction: Occupancy group: Strapp d ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location Replacement ❑ Qty. if ADDlicable FPr ITS BENERGY EnerEy i'l.ti V1VU BUILDING BREMFURN Relocation of Furnace MECHANICAL BREMACOVER A/C Unit > 10,000 cfrn MECHANICAL BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL BSEISMICRE X BSEISMICOM Seismic Fee Res Seismic Commercial BUILDING BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING 1-4 �t (0y.3�