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VISION
BUILDING DIVISION PERMIT
CON=TRACTOR INFORMATION
BUILDING ADDRESS:
A PERFECT CLIMATE
PERMIT"°04070083
1192 CRESTLIN
OWNER'S NAME:
PERMIT ISSUE DATE
LARRY & LISA ARONOVITZ
10570 S D
E:
SANITARY NO. CONTROL NO.
(408) 861-9545
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MFi
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
Job Description �0
with Section 7") of Division 3 of Nc Business and Professions Code, and my license is
n
��,��
imm�Nrteandeffect.
INSTALL CENTRAL A/C
License Class Lic.N
Date Comracor
ARCHITECTS DECLARATION
.
AUG j 9 Z��4
I understand my plans shell W used as public record,
Six
Licensed Prafessionel
m CLARATI°N
Oat I am exempt from License Law for Nc
1 hereby .)Fent that 11. exempt from tW Contractor's
�/e�
and Prodsve,de am Code: Any city or county
following massa C
IDnfor
1. Mnas
which rcyvires a pcmtit m <onswn. aloe improve, JemalLsh, or repair any stmcwre
Permit
prior o its Issuance. also mquira use applicant for such permit to rile a signed statement
Sq. FL Floor Area
Valuation
that he is licensed pursuant Mac provisions of the Commcmr's License Law (Chapter 9
(commencing with Section ?0(101 Of Division 3 of the Business and Professions Cid0 o,
Nat he is exempt thamfrom and the basis for the alleged exemption. Any violation of
3g 0
Occupancy Type
Section ?031.5 by any applimn for a permit subjects Ne applicant m a civil penalty of
not mom Nen five hundred dollars ($500).
v
❑ 1, as owner of the ppemy, or my employees with wages as their sole compensation,
Required Inspections
will do the wok. and Ne Mminum is nos intended or offered for sale (Sec. 7044, Businus
and Professions Code: The Conuacmes Lici law does not apply m .n owner or
property who builds or imprasss themen, and who docs such work himself or through his
own employees, provided that such improvements ase not inended or offered faraale. If,
however, the building or impmvement is sold within one year of completion. the owner -
builder will have the burden of proving that he did not Wild or improve for purpose of
I, as owner of the pmperty, am exclusively contracting with licensed eonbacors m
on mutt the project (Sec. 704,4, Business and Profusions Cade:) The Contncler's Li-
censclaw not apply,. an owner of property who Wilds or improves thereon.and.
who con for such pmjecs with a conuacmr(s) fancied pursuam w Nc Conuacmts
L mac w
❑ 1 am e e pt er Sec B & P for thts axon
IO
Ow Dale
WORKER'S COMP SATI NDECCMyT7pN
folTOwing declarations:
I e by drum under penalty of tiny one of Nc
have and will maintain a Certifcme of Consent m self insure for Worker'sCompen-
cation, u provided for by Sutton 3700 of the LOW, Code, for the p Mo... of the
work for which Of, permit is issued.
1 have and will maintain Worker's Compensation Insurance, as "uimd by Section
37W of the Labor Code, for Ne p.rf.onim a of the work for which Nis pconit is issued.
My Worker's Compensation Insurance artier and Policy number am:
Cartier, Policy No.:
CERTIFICATE OF E%EM MON FROM WORKERS'
,
COMPENSATION INSURANCE
(TTh swim reed not be completed if the permit is for.. hundred dollars (SIM)
or los.)
I ttmfy this in the performance of the work for which this permit is issued. l shall not
employ any person in any manner m as to became subject to 1W WorkersCompensation
Laws of Calif.mia D.
Applicant
NOTICE TO APPLICANT: If, dor making Oil CcniOcatc of Exemption, you should
become subject in the Worker'a Compensation previsions of Ne Lems, Code. you must
Forthwith comply with such provisions or Nis permit shall be deemed mvnked.
)
CONSTRUCTION LENDING AGENCY
I hereby effort that there is a conswctin t lending agency for she perfunnince of
' the work for which this permit is issued (Sec. 3(197, Civ. C.)
Lender's Nome
/ 1
Iembeis Address
I certify 1 have read this and dart Nat salve mus misting is
mocn. I once m comply with all city and county ordinances es and sant laws
0 c city and coup and ng
r up e
building consmumiva and hereby authame mnreunutiwa or Nis city to toter upon the
3 ahovc(We)aned an
veo for
lice, hs.
to save demnify Ne City of Cupertino against
(We) agree l0 save, indemnify and kith he,
j liIIiI! ,judgments. Coss and capenscs which may in any way acerae against said City
to an
' in ca ucnce of Nc graining ofthis pc.it.
'
' APP 1 UNDERSTANDS AND ILL COMPLY�WI ALLINT
Issued by: D
[ON
SOU UL DN g i6
Re -roofs
m of ApphewsufC.Mosetro
HAZARDOUS MA IALS DISCLOSURE
Type of Roof
Will thc applicant or forum Wilding Occupant Mom or handle hascWous material
as dcfncd by d¢ Cupertino Municipal Code. Chapter 9.12. and thee Health and Safety
Cale. Section25532(a)?
CYes Nu
All roofs shall be inspected prior to any roofing material being installed.
knell
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicaneor future Wilding occupant use, equipment or devices which
havardous air contaminants as defined by the Bay Area Air Quality Management
all new materials for inspection.
[:1 Y. Nu
1 eroadthe Wcndous materials mquimmcns under Chapter 6.95 of the Califon
nia Hcal & dety Code,Sbons25505,25537and25534.1undcm=dNatiftW Wilding
does no Cu rely have a tcmm. Not " is my re,mrsoldit y p notify do acuprns of one
prioui arae.faCerti eateof'cep
melon, Annual Wmmn
Signature of Applicant Date
, I
All roof coverings to be Class "B" or better
own r r aamoriaca ascot D„
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # : 3
Sec: Twp: Rug: Sub: Elk: Lot:
APN ........: 36224036.00
DATE ISSUED.......: 07/16/2004
RECEIPT 4.........: 26320
REFERENCE ID # ...: 04070083
SITE ADDRESS .....: 1192 CRESTLINE DR
SUBDIVISION ......:
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: LARRY & LISA ARONOVITZ
ADDRESS ..........:
CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-5035
RECEIVED FROM ....: LISA ARONOVITZ
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
%E ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
BREMAIRHAN NO.UNITS
1.00
10.26
0.00
10.26
0.00
BREMRECEPT NO. OUTLETS
1.00
1.20
0.00
1.20
0.00
BENERGY PERMIT FEE
1.00
34.86
0.00
34.86
0.00
BSEISMICRE VALUATION 3,750.00
0.50
0.00
0.50
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
__________
161.93
__________
0.00
__________ ----------
161.93
0.00
METHOD OF PAYMENT AMOUNT
_________________
NUMBER
------------
CHECK 161.93
-----_________---_
3519
TOTAL RECEIPT 161.93
VOICE ID DESCRIPTION
VOICE ID
DESCRIPTION
303 ROUGH MECHANICAL
304
ROUGH
ELECTRICAL
505 FINAL ELECTRICAL
508
FINAL
MECHANICAL
CITY OF
UPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDR SS:
Cre-SHIne Dred
PERMIT # o
OWNER'S N ,C i� ovtp„i
PHOW# $ , 461 . 9
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
Date
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
Date
--
0CIIv uI
CUPEkTINO
L]
0
CITY OF CUPERTINO
FURNACE/AC
PERMIT APPLICATION FORM
APN # r 0
Energy
Date:
Building Address:
1112 (2yf &
0q -
Owner's Name:
I Lrsc. Av-lovl4„c-tt
BREMACOVER
Phone #:
408 — $61 — Ysa
Contractor:License
A/C Units <= 10, 000 cfm
#:
e r
Rec tl, Switch & Outlets
ELECTRICAL
BSEISMICRE
Contact:
AvC�PR�
BUILDING
Cupertino Business License #:
Building Permit Info:
ELECTRICAL
Bldg ❑ Elect ❑ Plumb
❑ Mech ❑
Job Description: II 00nn p
1
I h S't� C� Gl.i✓
can cLr�nnvf
Residential 5QCommercial ❑
Bldg Permit Fees
For Residential Ins allations:
BPLANCHK
Attic 1:1151 floor 2nd floor ❑
BUILDING
Adhere to min set back requirement Q`I
Business License
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural
talcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required F1
z
Cost of Project: Type of Const
Occupant gr "
Strapped On Platform Bonded
Sq.Ft. Floor Area:
New Location ElReplacement ❑
A�tliclple
Fee ID
Fee Description
Fee Groun
BENERGY
Energy
BUILDING
BREMFURN
Relocation of 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
Business License
BUILDING