Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
04060095
CITY OF CUPERTINO ''"' '_ ; BUILDING DIVISION PERMIT ;CONT1tACTOR INF(OORMAUON . BUILDING ADDRESS: A PERFECT CLIMATE PERMIT N904060095 21684 GRANADA AV OWNER'S NAME: PERMIT ISSUE DATE Ah DAVID HOBSON ONE: ''�+, SANITARY NO. CONTROL NO. 408 861-954 i ARCHITEC'VENGINEER: /^ BUILDING PERMIT INFO ] BLDG ELECT PLUMB MECH yOC LICENSED CONTRACTOR'S DECLARATION lob D0scr1 Ilan m 1 by ercnm Thal I am Ilamed undor p vIYons of Chapur 9(comraMcing P Z via Sau 70fIU)o(Division3of NC Busiass apE Pm(cssinv Code,and my license is �•� :�y <<� int anlas.d c Licec, FURNACE CI ACE ADD_A/C� IJe.M t• Dau Convenor C� ARCHITECTS DECR 3$O 1 undcnunJ my P6v shall bo used a Pull c nrtls [ ' . O Licensed Professional OWNER-BUILDER DECLARATION 5�F 1 heaby affirm that I am exempt from be Convector's License law for IN ZOO following reason.(Section 703 LS,Business and PmfeIIlnN Code:Any city of county $ which aqulre a Permit to mount,alter,Improve,demolub.m repair my struclum FZtm prior nam its issuance.also requires be applicant for such permit to rile a signed nesemem < than he is licensed pmsumuothe pmvisionsofthe CmunreaisLicense Law(Chapar9 Sq. Ft. Floor Area Valdanon/ (commencing with Section 70110)of Division 3 oflhe Buminessand Profession.Code)ar / 3$ Nal he u essmpt duafrm and ft basis for Oa all exemption,Any vioiad of Semon 7031.5 by any applicant for a permit subjects the applicmuo a civil penalty of 3597MIQlih�er00 occU cy Type not mfi oa than R.hundred dollars(ML ❑1,As,owner of the property,or my employe"with wage As desirsole eompenudan, will do the work and thesvunme immimended or oaead forsale(Ste.7044.Business and Professions Code:The Committers Lianas law doe rot apply 10 an ownm of Required Inspections property who bu llds or Improves Inemon,end who dues suc h work himsel f or through his own employees,provided that uch Improvements rot net intention oroRered for sale.IL however,the building or improvement is sold within one year of ampledon,the mmar, builder will have Bu burden of Moving that he did oat Wild a Improve for postpone of sale). 0 I.as owner of and preptny,am exclusively contracting with licensed antraeten an covwn Ne project(Sec.7044,Business and Profesiov Cade:)The Con meter's Li. arse law docs not apply An an owner of property who Wild.ter improv"therean,and who contacts for such projects with a conmactor(s)Iltensed pursuant an Bu Contractor's ' License Law. ❑I sen exempt under Sec ,B&P C for 11,11 roan Owner Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury ore of she following decimations: 1 have and will maintain a Ceninate of Cement to selLivua fm Wmker'a Compen- sation. ompetesation.As provided for by Section 3700 of the Labor Code,for the performance of the wank for which Nis prsmit I.issued. ❑I he.and will maintain Workees Compensation Insurance.as required by Section 3700 of the labor Code.for the perfmmance of du work for which Nis Permit is issued. My Worke's Ce PensaBon Inw a c 1tan end Pali m • "- ETI•ICATEO EKEMPfINFROM ORKER ' /�/ COMPENSATION INSURANCE //1(Vr7 mnosection need nm kcompleted If Ju permit b fmoot hundred dollen nIBd) or less.) I certify that in the performance,of the work for which Nis permit is issued.I mall not employ any person In Any Ammar An As m become subject to the Workca'CompeaAmon Laws of California.Data Applicant NOTICE TO APPLICANT:If,after making this CeriOcau of Exemption,you should become subject in the Worker's Compensation previsions of the labor CIM,you must ) .J z forthwith comply with such provisions or this Permit Nall k dcemed revoked. zO CONSTRUCTION LENDING AGENCY (~ Ihereby&(B.that Bum la a annruction lending agency far Bra Merformante of i {1'> the work for which this permit Is issued(Son.3097,Civ.C.) Q landcm lm Nae z UM's Address UI terrify that I have read this application and sou that the above information i. ;•<. correct 1 agree to comply with all city and county ordin sun es and state lawm relning to movengconswcliamand hereby mthoriareoses. Eve of this city to enter upon the LkI move-mentioned property,for indemnify An purposes. (boa)agmt a,eve,indemnify and keep hay in m the City of againina against '3Z inconsequeceofthe Swung and expenses which may in my my meths agtinalsOld City t)z A APPLICANT ND Swung of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL POINT Issued by: D e rg)? G CATIONS. Re-roofs Pplirom/Cenuactor D416 I HAZARDOUS MATERIALS DISCLOSURE Type of Roof o applitem or future building=.Paul mor or handle hsrsNous material the Cupenino Municipal Code,Chapter 9.I2,and Ne Health and Safety s ss53z(a)7All roofs shall be inspected prior to any roofing material being installed. s P Nuthe applicant oof future building uxupant use equipment or devices whichIf a roof is installed without first obtaining an inspection,I agree to remove u]air comemi ems m Jelled by the Bay Arta Air Quality Management all new materials for inspection. QY" XNu I havereW Nec,n Uo MS05,maquiamumt4.lunapQr MifNe Califon die Hak&Safety Calc,Sections !,it.3my mJ 2153q,I toA uifthe Wilding Jana not c ndy naw a unanL Net It u my n.ihillly m notify t xupml of Nc reyulrem w m kmetMdorAni f uauofOcc y. / Signature of Applicant Date wenn comma r<d agent te All roof coverings to be Class"B" or better ' Community Development +) 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 PII NO Fax(408)777-3333 UE Building Department JOB ADDRESS,n U „ 14 ( i Y-a,�,,.A A ;/1� p PERMIT# ©� 062Wat OWNER'S NAME: `� 1 der U T]w PHONE # GENERAL CONTRACTOR FAX # I am not using any subcontractors: Signature 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 J Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �l caner/Contract r Signature ate CITY OF CUPERTINO �5-- FURNACE/AC d " UPEkTINO PERMIT APPLICATION FORM APN # W Date:. Ill U Building Address:21� C yCArtC4_C , f1ve, Owner's Name--pc,,%<f, Phone#: Contrac or �,nn oll Phone: �y p ol� / � License-723 S(9 Contact: 1 ,�� U Phone: b�/ �/ Cupertino Business License#: Usk �S Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech Job Description: IqC5 K, 1a-e-2 CA/LQ � e91G Residential ❑ Commercial For Residential Installations: Attic ❑ I" floor ❑ 2nd floor❑ Adhere to min setback requirement❑ For Commercial Installations: eplacement same weight ❑ Additional weight (structural calcs) ❑ jNew tural Calculations required for new installation ❑ installation PlanningA roval Re uired ❑ of Project: Typ f onsttrruction: Occupafy gro Strapped ❑ On Platform ❑ Bon d ❑ Sq.Ft. Flo New Location ❑ Replacement Qty. if ApplicAlp Fee ID Fee Description Fee Group BENERGY Energy 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 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 �S� , 32.-