The URL can be used to link to this page

04120140 CITY OF CUPERTINO rrr+ �«�,.�„ -"''"* _ •_`''P" ''. BUILDING DIVISION -' PERMIT- -`' >C0NTRAtT0RINF0RMATI0N - - v BUILDING ADDRESS: AIR QUALITY HEATING & AIRC EptMIT"°04120140 751NEIt'S NAME:3 HEA V WPERMIT ISSUE DATE - NEHA & VIVEK DESAI 1233 PEDRO ST jI NE: SANITARY NO. CONTROL NO. (408) 293-7138 ARCHITECT'ENGINEER: BUILDING PERMIT INFO - ILDG ELECT PLUMB MECH +>-aop LICENSED CONTRACTOR'SD LARATION - + : sub,err.mat 1 fm BmmW.neer foom.fcn.ple,9(...caring lob Description i with n70(KhmDivision3 ofdm Businuss fusiam Code.and]ny lM.is ^� immnf came eet S/i REPLACE DUCTWORK D jqK Lie Class -Lie.p 1r;7�r�+�,\ nk-w Date Contractor- -• - L'1' RCHDECI-S DECMRA (DN (' -P ii g< I..do.. my piens shell be used as puhli cards DaU - t-nL io y I.Mcmcd Prc(cvsimul - . OWNER-BUILDERDECLARATION /��-� I hereby ul'firm that 1 am exempt from the Contractor's License Law for the 2�n�J p O following reason.(Section 703 1.5,Business and Pmfcxsiuns Code:Any city of County - �� ys)(I n K m which requites a Permit to emoVocl.Jeer,impmw,demoliahir an .Or repay suuctme 1�< {( 11 fj r, terms' prior to its issuance.also mquirm the applicant for such Permit to file a signed suormot 1l 1 that he is licensed pursuant me provisions of the Connector's License Law(Chapter 9 Sq. FI. Floor Area �\JJ II .`+ r7t�� FValuahon -- - WI--0 (commencing with Section 7")of Division 3 of the Business and Professions Cme)or - V�h i met M is exempt themfmm from de has,for the alleged exemption.Any violation of �.oq� Section 7031.7 by fury,applicant fora parmit subjects the applicant m a civil penalty of nrv[nQ'Uacr40 - - Occupancy Type -----'-- ._ not mom than fiw hundred dollars(5500). ❑1,az owner of she ProPa+tY,m my cmploycm win weg¢az Heir solo compcnvtion, _ will do the work.and the structure is not inundedi unaltered finee.(See 7044,Business Required Inspections - and Profanation,Code:The Conuacmr,License Law doss not apply m an owner of 9 p property who builds or improves thereon,andwho does suchwork himselfor through his -. own employees,provided that such impm rnmms rte not intended oroRemd forset,If, - _ however.the building or improwmens is sold within one year ofeempletion.me owner- . builder will now the burden of proving that be did not Wild or improve for purpase of - sale.). O I,as Owner of the proper•am exclusively contracting with licensed Marooned;to consumer the project(Sec.7044,Business and Professions Code:)The Contracmts Licome Law arms not apply to an owdcr oflumperty who Wilds or Improves Owned,and, who earners far such projects with a canuacmr(e licensed lumuetn in the Cmunim Ys -- - - License law. I am exempt under Sec. .B B P C for suis mason -. -_ water Dae __ ____ WORKERSCOMPENSATIONDECURATIOFI - r. I berth,aRrm under Penalty of perjury dm of Ne following daclastomm: - `- •` Ihsw and will maintain a Certificate of Contenuoself-insure for Wmkets COmpem sation.az provided for by Section 3700 of the Ichor Code,for the performanm of the _ work for which suis permit is issued. .. ❑1 haw and will maintain Worker's Compensation insurance,as required by Section ll00 of the laWrCme.for Ne pedormanceef the work fm wieh that permit is issued. cts Co Pe don I fierce c nice and Policy num ram: er Polio '`/ ERTI TOF ENSAEXEMPTION RA WORK OMPENSATION INSURANCE (Tit,secrinn need not W completed iftbe permit is force hundred dollars($100) -Or less.) I cenity that in the pe,formanm of the,work for which this Permit,issued,l shall nut ' employ any person in any manner so az mhmome subject o the Workers'Compensation Laws of California.Data Applicant NOTICE TO APPLICANT:If,after making this Certificate,of Exemption,you should become subject In the Worker's Compensation provisions of she Labor Cmc,you most .Jz forthwith comply with such provisions or this permit shall be decreed evoked. Z O CONSTRUCTION LENDING AGENCY I bemhy, from mat there is a construction lending agency for the performance of 5me work fur which suis permit is issued(Sec.3097.Civ.C.) 1x7 LeadeesNamt Z Leader's Aderess V 0 I certify that 1 haw read this application and stn Nm me above information is L5.f" correct.1 agree to comply with all city and county ordinances and suss laws mining to 0U Wilding construction,and hereby ruhorm represcrozoves of this city to enter upon dm U abovcmenio od property fee impec cIn proposes. (We)agree to saw,indemnify and keep harmless the City of Cupenino against req liabilities judgments.costs add expenses which ang tri any way ecce.againe said City V Z in eonuquenec of the granting of this Permit. APPLICA U ERSTANDS AND WILL COMPLY WITH AL NON POI ISsued by: Dale S URCE NS. /) - Y Re-roofs V rgmwW",of rC HAZARDOUS OUS MATERIALS DISCLOSURE Contractor N---' Date Type of Roof Will the applicant of future building docupantemm or handle ha�uus material as defined by the Cupertino Municipal Code,Chapter 9.12.and the Health and Seny me.sectionzss32(a)? -! .All roofs shall be inspected prior to any roofing material being installed. ❑Yee lFi No Will the applicant or future building occupant use equipment ordevicmwhich If a roof is installed without first obtaining an inspection,I agree to remove nis hazardous air ronumidants az defined by de Bay Area Air Quality Management all new materials for inspection. D'suict? ❑Yes '�Nu 1 hnvc Mae the hvardtms metria,mqummen.under Chapter 6.95of Ne Cabin, nice Health k Safety Ccdc,Secduns35505,25533 am 25534.1 undcrsund that ifthc building ddts not cunt ly haw a wnanL that it is my m,pomibility m nndly aro t df thc m -c r muvtbemetPmrtoissuanceofaCerira r Signature of Applicant Date nor ter a t nixed agent 5 acne.a� All roof coverings to be Class"B" or better _tbd — - 1 Community Development 10300 Torre Avenue JCupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building DepIcutment JOB ADDRESS: I PETM�/ 7,0 OWNER'S N PHONE`#1 GENERAL CONTRACTOR: / FAX # I am not using any subcontractors: /2i Zp e Signature Date Please check applicable subcontractors and complete the following information: 60 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 Q( CITY OF CUPERTINO ( 2-01 o CUP TYOF PERMIT APPLICATION FORM APN # _ Date: c� 3S �S' Z . ( Z he o/ Building Addfess: Mfling Address (if different from building address): Owner's Name: Phone #' Contracto(,{,t^rs ` License #: �y[l 61 Contact: Phone: Z73-7( -,? 9 Cupertino Business License#: Fax: Building Permit Info: Bldg ❑ Elect ❑. Plumb ❑ Mech ❑ Job Description: Residential K Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: �� Occupancy Gro Type of Construction: Please check this a project is a second-story addition: ❑ Project Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELECI001 Flee 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD .Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING I of 3 (f (, - CITY OF CUPERTINO CITYOF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Conran. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Cbeck Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace > l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 SICITY OF CUPERTINO CITYOF PERMIT APPLICATION FORM CUPERTINO Quanti , Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL jBREMTHEATR , Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special lnsection BUILDING BS WIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL / MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3