The URL can be used to link to this page

030601611 0Q Z WQ UO_ 0 U U F Uz CI'T'Y OF CUPERTINO BUILDING DIVISION PERMIT .�CONTkACT�OR,INFORMATIO Ou1LDING ADDRESS: KALLIO CONSTRUCTION PERMIT NO 03060161 OWNER'S NAME: 1492 WALBROOK DR PERMIT ISSUE DATE NE: (408) 873-9777 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MF,CH CJ 0 0 -. LICENSED CONTRACnor, Job Description oviCmisof CON 1 hcrchy affirm that 1 am under, provisions Of Chapter 9 (commencing with Scction lIXlll) of Division J of the Business and Professions Cade, antl my license is f0. Bu in full force and affecL HEATER & A/C W/DUCTS License Clans Lic. N Dale Contractor ! � y L.W. L ARCHnECI'S DECLARATION ➢�1 1 understand my plans shall W used as public records - JUL Liccnsed Poo ssional OWNER -BUILDER DECLARATION I hcrchy affirm that I amI. cicmpe from @c Contractors License: Law for the Code: Any city or roomy following rcuoa (Section ) n LS. Business and Cod ny derons which) a permit cnnawm, i improve demolish, ri repair any t 11 stauehine prior us its issuance, atm requin ires she applicant for such permit m file signed smmm.nl its Issuance. re appliafter,cant t for such tement thmairen Sq. Ft. Floor Area ' - Valuation villwitpurswm7")ofDivc,iim of eBuime s adPofit�w(ChaprerY (commencingwith Section nl Division3 of the Business and Professions Cadc)per mat is thcretran antl the aper for the alleged exemption. any of and 35703053.00 Section any it Penalty io 31.5 b pliatto APN Number Occupancy Type P Y YP not more than five hundred dollars (5500). Q h as Owner of she property, or my employees with wages as their sole comperoadma, will do the work, and the snuaure is not intended ar offered far sal. (Sec. 7W. Business 11111 and Professions Code: The Contractor's License Law docs not apply to an owner of AL pmpcny who builds or improves thereon, and who does such work himself or through his 3 0 3 - ROUGH M CHANI ns Own employees, pmvidcd that such improvements ase not intended or offered for sale. If. 304 — ROUGH ELECTRICAL howevar, me building or improvement is sold within one yea of completion, the owner. builder will have me burden of proving mat he did not Wild or improve for purpose of 501 - FINAL ELECTRICAL ENERGY sale')' 502 — FINAL PLUMBING ENERGY owner of the property, am exclusively contracting wit licensed covuactom to wea the project(See.7044, Business and Professions Code:) The Cmimsetori Li. 503 — FINAL MECHANICAL ENERGY aLawdoesnotapplytoanownerofpmpenywhoWildsorimproveamemon.and505 — FINAL ELECTRICAL contracts for such projects with a eo irrmsr(s) licensed pursuant to the COMONC.ram. Law. 507 — FINAL PLUMBING a pt rick, Sec,.B&PCT thi�ny�e ;.fion, 508 - FINAL MECHANICAL /"C4 6 o;5/Oon WORKERS COMPENSATIO ECLA N 1 hercby affirm under penalty of perjury one of me following dacluatiope: have and will maintain a Certificate of Consent to self -insure for Workers Com ion. as provided for by Section 3700 of the labor Code. for the perro mance, of on, work for which this permit is issued. C] 1 hats and will maintain Worker's Compensation Insurance, u n:quired by Section 3700 of the labor Code, for the performance of the work for which lois permit is issued. My Worker's Compensation Insurance carrier and Policy number art: Carrier: Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thr sectim need not W completed if (h permit IS form= hundreddollars (SIM) is, less.) 1 cenify that in %e performance of the work for which this permit is issued. I shall not employ any person in any manner so pe at become Subject o the Workers' Compensation - Laws of California. Dae Applicant NOTICE TO APPLICANT: If. attar making this Ccnifcatc of Exemption. you should become subject o the Worker's Compensation provisions of IM Labor Code. you muse forthwith comply with such provisions or this Permit shall ac doomed revoked. . CONSTRUCTION LENDING AGENCY 1 hcrchy affirm that mere its conauuctinn lending agency rot the, performance of me work fof which this permit is issued (Sol. 3097, Civ, C.) Lenders Name ILndcr's Addicts 1 cenify, that I have read this application and sum that the about infoimilian is correct. 1 agree to comply with all city and county oNiminces and slate laws relating to building construction, and hereby authorim representatives of this city to enter upon the ahbvcmemianed property for inspectioneexpenses purpowwhich (We) agree to saw, indemnify and keep harmlcu me City of Cupenino against rex Costs and Osteouswhich they in any way acerve against saitl City lieconsequcra of of thegranting of this permit. ADJC.& T APP UNDERSTANDS AND WILL COMPLY WITH ALL ON -P INT Issued by:914Date SO RC G ATIONS, r ' Re -roofs azar OfApplicanUContrutoryfiDate HAZARDOUS MATERIALS IJACLOSURE Type of Roof Will he applicant or future building Occupant store or handle ha udous material u defined by die Cupenino Municipal Code, Oxide, 9. 12, and the Health and Safety C. Section 35532(a)? ��JJJ ❑Yet pgNa All roofs shall be inspected prior to any roofing material being installed. Will mea applicant or tutu= building occu equipment rap s tumsaee tofdetractemnt If a roof is installed without first obtaining an inspection, I agree to remove g P g it iartelpardnui air contaminants pe defined by the Bay Area Air Quality Management all new materials for inspection. ❑Yes u I have read the Wmodoussmmaterials mquiremen s under Chapter 6.95 of IW Califon. nix Health &SxfmyCak, Seabirds 35515, 35533 and 35534.1 untleismnd that if the Wilding Ji uis. haw a tenant th race of Carty no IM acupanl n the re ire . tsw nme. bcq¢t yon peama.ofa/CenEcacof� rye, au a Signature of Applicant Date All roof coverings to be Class "B" or better Owner err aahorirsd agent Do, Diu - MY Or CUPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM 0306 a/4/ APN # Energy vavu BUILDING BREMFURN Relocation of Furnace MECHANICAL Building Addresss: p� �j A pt, T Owner's Name: _ BREMAIRHAN Phoge #: 6 3�� ' I e1/G, I BREMRECEPT Rec tl, Switch & Outlets Contractor: S Phone: -3 f BSEISMICRE License #: 76G9e3 Contact: one: 1 EPERMTTFEE Cupertino Business License #: Building Permit Info: MPERMITFEE Mech Permit Issuance MECHANICAL Bld E ❑ Plumb Lam! Mech Job Description: nle,3 a�c, 114c yf -�o a - 1'c w; Residential g Commercial ❑ BUILDING For Residential Installations: Attic ® 1s` floor ❑ 2"d floor ❑ Plan Check Fee BUILDING BUSL C Adhere to min set back requirement ❑ BUILDING For Commercial Installations: _ Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calc ons req for new installation ❑ New installa ' n _inA 1 o al Required ❑ Cost of Pr ject: Type of Constructs Occupancy grou ^ 2 Strapped On orm ❑ Bonded ❑ Sq.Ft. Floor Area:, New Location E]Re " lacemen"t QW. -if A liable Fee M FAP Tlaenr:nfinn i BENERGY Energy vavu 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 f BSEISMICRE Seismic Fee Res BUILDING EPERMTTFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumb in Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSL C J Business License BUILDING I _