05070169 CITY OF CUPERTINO
P}IILDING tjIVISION PERMITa CONTRACTOWINFORMATION:
BUILDING ADDRESS: A PERFECT CLIMATE PERMIT N0,05070169
ER'S NAME: PERMIT ISSUE DATE
LOUIS CAPUTn
PHONE: SANITARY NO, CONTROL N0,
408 861-954
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
:00 LICENSED CONTRACTOR'S DECLARATION Rrtse
I hereby affirm But I am licensed under provisions or Chapter v(commencing Job Dead Is
Zn with Section 7MBofDiision 3 of the Business and Profession Code.and my licence is �" 4
n`o r`� in ren rarte,na_ecLVs - 3158 INSTALL FURNACE & A/C /
p z ween cls tie.«
o Dare - Comracmr Y I
e ARCHITECTS DECLARATION
C 14jjju d n la d my plans shall he used S uhli cnr
>yu
a G Licensed Pmfcssianal- [{ g
1 3
OWNER. DECLAR ON ,,JJ ryrypf TTrpppkkk//s \\\\@nry
<f It
I hereby affirm that I am exempt from the Convaerofs License Law for the tl t9
z n O following maven.(Section 7031.5.Business and Profession Code:Any city m roomy
<S Pi which requires a permit to consumer,alter,improve,demolish,or repair any struame
priomniu issuance,alw requires the applicantorsuch Permit o file aligned Statement
< that he is licensed pursuano the provisioor the Common's License,LnLaw(Chapter 9 Sq.Ft. Floor Area Valuation
yFG ttn(commencing wi th Stttmn 7000)of Division 3 of the Business and Proressions Code)or
i that he is exempt thmefrom and the bum for the StReSed exemption.Any violation of
Section 7031.5 by any applicant for a Permit ubjects the applicant to a civil penalty of 3 R IM61&r 0 0 Occupancy Type
not more Nan five hundred dollars($5007.
❑I,an;owner of the property,or my employees with wages as their sole compensation,
will do the work.and Ne swmurt isnot intended or offered(ovale(Sec.7044,Business
and Profession Code:The Com actor's License Law don not apply to an owner of Required Inspections
property who builds orimproses Burson,andwho doe such work himselfor Ihmogh his
own employees,providcd that such improvements art not intended or offered for sale.If.
however the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not Wild or improve for purpou of
Sole
❑1.as owner of the property,am exclusively convecting wit licensed contractors to
consumer the pmjem(Sec.7044,Business and Professions Code:)The Contractor's Li.
ere law does not apply to an owner of property who Wilds or improve Merton,and
who contracts for such projects with a conlracmru)licensed pursuant to the Contractors
License Law.
l am exempt under Sec. .B&PC for this mason -
cr_ Dale
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penally of perjury one of Ne fallowing declarations:
I have and will maintain a Cenifcaut or Consent o self-insure for Worker's Conifer-
work
f u or which thihi providfor by Section 3700 of the labor Cotic,for the pcRarmana p(the .. -
work for Permit is issued.
❑1 have and will maintain Worlrefs Compensation Insuranse,u required by Section
3700 of the labor Code.for the performance of the work for which this permit is issued.
My Workers Compensation,aInnssurance artier and Policy number art:/'
Cartier:stKr/ 1�� Policy No.:/s f I/7 2
�- - CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE -
(This Section Steed not becompleted if rhe permit is for one hundred dollars(SIMB `
or less)
I certify But in the performance of the work for which this permit is mord.1 shall not
employ any person in any manner ser u to become subject to the Worker'Compensation
Laws of California.Dau
Appimm
NOTICE TO APPLICANT:If.after making Nu Certificate of Exemption,you should
become subject to the Workers Compensation provisions or the lahnr Code,you most
.JO foMwith comply with Such provisions or his permit shall be deemed revoked. -
Z " CONSTRUCTION LENDING AGENCY
[-v I hereby affirm Nat there is a conumction lending agency for the performance of
Ne wank for which Nis permit is issued(Sec.3097,Civ.C.)
f[] 0 Lenders Name
UZ) z Underi Address
C)Q I ccnee Nat 1 have read this application and Bute Nat the salve information motion is
0 U corm. agree to comply with all city and county ordinances Or and Cute laws relating to
QU abovengconsumerion.and hcnbyauthomentiound property for n purposes.
sof his City menusUpon cite
F,o, (We)agreetoSave.andexpenand keepnarreplaus yinmtheymnteCity of aainstSno agarosy
py incoitiequenc ofutcostsangofpmues which may in any way attrve against Sold
City
U z APPLI ANT of UNDERSTANDS
of this permit.
^
APPLICANT
IlE UULATI ST/As�ND�S AND WILL COMPLY
,.WITH
/ALL NON-POINT Issued by: Date
v SOUR/Y/rEGa L&i _ 4 A� l
SigIIIII5.of ApplicaDate Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will But a Cupertino
an future building e.Chapter
on hmMlc hrnAOand Safety
u defined Section
the Cupertino Municipal Cade.Chapmr 9.11,and the Health and Safety
e. 0 es zss3z(a37 - All roofs shall be inspected prior to any roofing material being installed.
❑Yes y/�-y��.a''��
Will the applicant. m/ mrc Wilding Occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
.mit haumims air oonumin rats as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
Yes
I have mad Be ha; ; smamrialsmquimmenuun@r Chapwr6.95ofthc Califon
.is Heahh&SarctyCodc,Sanson 25505,15533 and 25534.1 no dew dew do Wilding
don n t curently have a reran Nat it u my responsibility u no ry the arupon or the
requi�^ftswhichmmulm Ipartoi Man ❑CcmcaH foccupry. Signature of Applicant Date
14' 6 kz dc„ � 1Q � 7"� �
Owner or authorized agcnl Dere AI I roof coverings to be Class"B"or better
® CITY OF CUPERTINO
Item 4 of 4 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot: -
APN . . . . . . . . : 35628009.00
DATE ISSUED. . . . . . . : 07/26/2005
RECEIPT #. . . . . . . . . : 30520
REFERENCE ID # . . . : 05070169
SITE ADDRESS . . . . . : 10923 CANYON VISTA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOUIS CAPUTO
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3908
RECEIVED FROM . . . . : A PERFECT CLIMATE
CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144
COMPANY . . . . . . . . . . : A PERFECT CLIMATE
ADDRESS . . . . . . . . . . : 10570 S DEANZA BLVD
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 861-9545
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
BPERMFEE VALUATION 10, 858.00 180.36 0.00 180.36 0.00
BREMAIRHAN NO.UNITS 1.00 10.26 0.00 10.26 0.00
BENERGY PERMIT FEE 180.36 86.57 0.00 86.57 0.00 '
BREMFURN NO UNIT 1.00 14.31 0.00 14.31 0.00
PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
BSEISMICRE VALUATION 10,858.00 1.10 0.00 1.10 0.00
EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
MPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00
TOTAL PERMIT 407.71 0.00 407.71 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ __---_-_____------
CHECK 1299.21 023100
TOTAL RECEIPT 1299.21
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 508 FINAL MECHANICAL
0
Community Development
10300 Torre Avenue
1 I Cupertino CA 95014
Telephone(408)777-3228
� CITY OF O Fax(408)777-3333
Building De artment
JOB ADDRESS/: /n�_ �pe/fu w PERMIT #
109 3 QLQ &q ISS a -- O%SD i o -70/ 6
OWNER'S NAME: 5 PHONE e92-S?2
GENERAL CONTRACTOR: ai�- CA , rylJCL Lp- - / /FFAAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
FURNACE/AC
OF
CUPEkTINO PERMIT APPLICATION FORM
Date: .
APN # 313o 22 oQ Cv -i s-aS
Building Address: Gk 5b
MUS Ct.n ✓i,�l-eJ
Owner'q Name: Phone #:
a- �a
tra or: Phone: License #:
ntac : P one: Cupertino Business L"cense #:
Building Permit Into:
Bldg ❑ Elect Plumb ❑ Mech
Job Description: AdC(
lc 144(
Residential` Commercial ❑
For Residential Installations:
4IKttic ❑ 151 floor ❑ 2"d floor❑
Adhere to min set back re uirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Pro'ect: Type of Construction: Occupancy group:
Strapped ❑ �j On Platform ❑ Bonded ❑ Sq.Ft."Floor, ; `ea:
New Location /' Replacement ❑ l
i
Qty.y. f '
A f e Fee ID Fee Descri tion _ Fee Group
/ BENERGY Energy BUILDING
BREMFURN Relocation of Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 c&n MECHANICAL
BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL
BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL
/ BSEISMICRE Seismic Fee Res BUILDING.
BSEISMICOM Seismic Commercial 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
rancho Deep Off
Jfomeowners Association
July 7, 2005
Rose Eufinger
Louis Caputo
10923 Canyon Vista Drive
Cupertino, CA 95014
Dear Lou,
The Board of Directors of Rancho Deep Cliff HOA is aware that you have installed a new heating and air
conditioning unit on the roof of your home at 10923 Canyon Vista Drive.
The installation of this unit has been approved by the Board of Directors.
��CEr�Eb
JUL 8 zoo
Sincerely,
RANCHO DEEP CLIFF HOMEOWNERS ASSOCIATION
Z) —
Lyle Peddicord
Association Manager
cc. Board of Directors
Unit file
Compass Management Group,Inc. 20 Great Oaks Blvd.,Suite 220 San Jose,CA 95119 Phone: 408.226.3300 Fax: 408.226.3406
09/20/2004 12: 52 4084370934 JOANNA PAGE 01
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