06040158 CITY OF CUPERTINO
BUILDING DIVISION PERMIT � ,O ��NWP T' ON
BUILDING ADDRESS: T CLIMATE PERMITNO.06040158
10313 COLBY AV
OWNER'S NAME: PERMIT ISSUE DATE
WENDELL YEE 10570 S DEANZA BLVD 04/26/2006
ONE: SANITARY NO. CONTROL NO.
(408) 861-9545
ARCHITEMENGINEER: BUIIDINO PERMITINFO
BO EO PLO O
z LICENSED CONTRACTOR'S DECLARATION lob Description
i1 hereby affirm that 1 am licensed under previsions of Chopmr 9(commencing
z McSeedon70110)ofDivision3oftheBudnessWPrafeasiamCode.Wmyliceomis
1FURNACE REPLACEMENT
in full farce and a CL 1
.�? Littrua s Lk.a
s a• Dow ' Conuacmr
QQ ARCHTIECrS DELLA A �!
12 I undentmd my plane shall be used as public rtarN of
sdU /ris,sL• 'Q
s w Licenced Professional90 OWNER-BUILDER DE Ce ComrsON
x
i I memereby.(Sect o n I em cumpl from the r..I..lCad t My c Law ren the
5 3
which
moon. writ t 7131.3,Business and Ptafcssivas Code:Any oily at county $6138
which riquim•permit ro cress the dins, ,for such
de permit
I lir repair any suumum
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prior miuromance,rsu require the of far Cominowea Oka.Law
�< Ihal he is licensed pursuant to the pmvialau of the Conuuwre Limuo law lCNpter9 Sq.Ft.Floor Area Valuation
23 (commencing with Session 7000)of Division 3 of the Business and Professions Code)or
e ..
that he Is exempt therefrom and Ne basis for the alleged assumption.Any violation of
Smadon 7031.5 by any applicant for a permit abject/The applilmt to a Civil penalty of r Occupancy Type
not mare Neo Ow hundred dollars(1500).
❑I,umnerof Nepmpmy,mmywplayceawithngesu Nebaokcompenadoo,
will do thework.and thesw,um a not intended or offered fersale(Sec.7044,Business Required Inspections
and Interested..Code The ConuacmrB
s ence law don an awrer out apply w of q P
property who buildaorlmprovn thereon.and whodonsuchwarkhlr.11cmdramic his
onceemployee,pagor lNalsuchim Is sold itasemtearofomannedIresalee-
bawewc the building or hnPmwmmtg sold Within oral)ear of mprove f ,the aver-
builder will haw W burden of cavus dot he did onl boom m impost fm purpose of
sok.).
❑1,as awns of ram properly,,m exclusivelyad confessions with IinmeCcenuuwn -
cc.La,C case,apply
to am Businessofand Professions lou Codei The Con ecowra Lb
who IoWdoescolapplyeurvonerofproperty who bendsar antmCho thereon.W
wkoconuuu for such pmjecls with arnnmcwRe)licensed pursuant m Na Contranor'a O
IoW.
0 1 am r
I ore nempl under Sec. .B e P C for this moon \^�
Owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby dorm under proudly of perjury one of the following decl,radanr.
1 hem and wall malnW n,C,lin®loaf Cement w self-Insure fm Workers Compen-
sation.u provided For by Scotian 3700 of dm labor Code,far dm Performance of the
work for which this permit is issued.
0 1 haw W will malnuin Workers Compeaadon Irwrarme,an required by Schon
3700af the labor Cade,for the pedormmceaf Ne weak for which Na permit is Wad.
My Wora pc, n Inmre nc,confer and Policy number are: '!'a
Grrler. Poliry No.:
CERTI CATEOFEXEMPITONFRO WO�
COMPENSATION INSURANCE v
fine section need not be complemd Holes remelt is fmone hundreddallae(SIM) r
or Ice)
1 wtify that In the performance of Ne work for which this Permit a Inucd,l"1 near
employ any person in any roomer m as to became subject to the Worlterr Compemalon
Laws of California.Dam
Appllunt
NOTICE TO APPLICANT.If.after making this Certificate of Exemption.you should
bacon subject m tie Wotker's Compensation provision of Ne lahw Coo you most
Z forthwith comply wit such provision or this permit shall W deemed revoked.
z cn CONSTRUCTION LENDING AGENCY
(..a IbemhyalRrmteaummaacmmrmdo.lmWing ageney for on,performance of
C4 > din wurk for which this Permit Is issued(Sec.3097.Ca.C)
�W p Ianwrs Namc
7 z Lemice.Addmm
U0 I certify that I haw rob this applicWon W sum Nu the.bow oformsdon a
{2i F coact.1 agrn or comply with all city and county ordinances and aisle laws relating to
O U building construction,and hereby interim rcprtcentaives ardor city to Color upon the
W above-mentioned property for inspection purposes
G (We)agree to an,indemnify and keep humin the City of Cupertino against
rr y Iiabilitim judgments.emu and epemes which may N my way acme agalast said City
fJ 7 in consequence of the gracing of this permit.
s� AP CANT STANDS AM WILL COMPLY WITH ALL N N-POINT Issued by: Date —Z I-U 1
S R A ONS. � L'.�/
—i � Re-roofs
Sigiummaf AppllandComrsome Data Type Of ROOF
HAZARDOUS MATERIALS DISCLOSURE
Will de appliant m future building attupantemm or hWl.harmdou maedd
as @Med by Uro Copeman Mmieipal Code.Chapter 9.11.W des Health W Safety
Code,SccY. �25533(.)? All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building Occupant use equipment or dcvlcea which If a roof is installed without first obtaining an inspection,I agree to remove
reit hrn❑m.rdous air conuminams as donned by Na Bay Arca Air Quality Management all new materials for inspection.
D sW,l
❑Ye N
I haw rend the haardaue srequmunenu under Chapor6.95 of Ne Califor.
lilalical"Safety Codc.See6,u25505.35533 and 25534.1 undcnund thalft a building
doss mut cunen0y hew a team,Net it u my mpouibillly m notify the ace pal or Ne
men who muabemetptj mmnceor, Ocm Signature of Applicant Date
m
` ` of All roof coverings to be Class "B"or better
Owner m mlhadu�,crow"
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OUPERTINO
Building Department
JOB ADDRESS: C o r� PERMIT #
,, D6o yo s,
OWNER'S NAME: e PHONE #
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors — LC)L
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
,•em 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 31629026 . 00
DATE ISSUED. . . . . . . : 04/26/2006
RECEIPT # . . . . . . • • . : 34147
REFERENCE ID # . . . : 06040158
SITE ADDRESS . . . . . : 10313 COLBY AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WENDELL YEE
ADDRESS . . . `. . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2421
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
BREMFURN NO UNIT 1 . 00 14 . 31 0 . 00 14 . 31 0 . 00
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BSEISMICRE VALUATION 6, 138 . 00 0 . 70 0 . 00 0 . 70 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 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 164 . 98 0 . 00 164 . 98 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 164 . 98 024628
TOTAL RECEIPT 164 . 98
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
-------- ---------------------------- -------- ----------------------------
304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY
505 FINAL ELECTRICAL
•
CITY OF CUPERTINO yr l
FURNACE/AC
ta
• CUPEkTINO PERMIT APPLICATION FORM
APN# 2 ^� �n _ Date:
Building Address:
3 ib �qj
Owner's Name-
'^ t Phone #: Jr '33I a
Contractor: v V _ License #:
Contac[: Cupertino Business License #:
Building Permit Info:
Bldg ❑ Elect Plumb Eg—"' Mee
Job Description:
Y
Residential Co ercial ❑
For Residential Ins Ilations:
Attic ❑ 1 ` floor VJ 2"d floor❑
Adhere to min set back requirement❑ .
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost Project: rType of Constru tion: Occupancy' roup:
Strapped On Platform T!-1, Bonded Sq.Ft. Floor ea:
New Location ❑ Replacement
Qty. if
A licable Fee ID Fee Descri tion Fee Group
BENERGY Ener BUILDING
BREMFURN Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL
BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL
BSEISMICRE Seismic Fee Res BUILDING
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 I Business License BUILDING