06040004 CITY OF CUPERTINO : , ' ' y "x "? "a =
BUILDING DIVISION ERMIT CO1�P_,RWCTOR INFURIVTATI®
B ILDINr ADDRESS: PERMITNO.
LI658
W HER'S NAME: PERMIT ISSUE DATE
MIKE ST. CLAIR 10570 S DEANZA BLVD 04/03/2006
HONE: SANITARY NO. CONTROL NO.
(408) 861-9545
ARCHITECT(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O D o O
±op LICENSED CONTRACTOR'S DECLARATION lois Descriptio
�t 1 thereby affirm that 1 w licensed under provisions of Chapter 9(commencing ��&&
with Section 70110 of0lWaion]of um Busineuand Profeainm Code.and license I� ®�® E®
sad
! y FURNACE REPLACEMENT 'OY,■1 L
n=n in full force and effect, ,
n qZ Licensa Clue L"N
;Fp Dem ARCHITECTS DECLARATRIIN UI mWemunJ as plans shall be used public Memoir
APR /v 2006
Licensed Professional
OWNER-BUILDER DECLARATION
if 1 hereby Aran that I am exempt from the ConvanoYs License Law for the
C.0 following mason.(Section 7031.5,Business and Professions Code:Any city or county
$ which requires a permit to construct,amr.Improve,demolish.or repair any structure BUILDIN
-Z>r^ poor At its issuance,else requires thcappliunt forauch permit m file ASigned ssamment
<
that he is licensed PursuentmNepmvislomnfNcConuxter'.0 .Law(Chapter 9 Sq.Ft.Floor Area Valuation
xMomm
E N 3 tint hecming with S"tion]000)af Division3o(the Businessand Re(esaiom Cndc)ar
h exempt urrerrom and the buts for the alleged exemption.Any violation of
Section 7031.5 by arty applicant for a permit ubjects the applicant m a civil Penalty of Number Occupancy Type
not mom than five hundmd dollars(6500).
❑1,As owner of the property,or my employe"with wages u their sole compensation,
will do the work and the "comm is not intended o offered for sale(Sec.7014,Business Required Inspections
and Pmfemiom Cade:The Contractors Liamlaw don rut apply m e an owner of q P
property who builefseT imp cr es thereon,andwho doe isuchwork himsel(orthrough his
own employ=,provided Nacxh improvements are rot intended oro@red for sale If,
however,to Wilding or Improvement is veld within one year or completion.AM owner
builds will have the burden of proving that he did not Wild or improve for purpose of
sale.).
❑1.as owner of the property,am"Abusively contracting with licensed contractor to
construct the pmjeci(See.7044,Business and Pro(eaton Cade:)TW Common'Li.
cense,law does not apply in an owner of property who bolds or Improv"thereon,and, ;
who contractsfor such pmkm
c s with a nussmr(q licensed pursuant"de, nuan
Cooes
License law.
❑14.AmMid..tiro Sec .B&PC(o Nb reuon
weer Dam
WORKER'S COMPENSATION DECLARATION
f Ibereby affluentunder poetry of perjury one of the following declarations.
,O
L]1 As.and will maintain aCeNfi"te of Consent mself-om.fa WorkersConpem
stolon.As provided for by Section 3700 of the Labor Code,for the performance of she
work for which this permit is lamed.
❑I have and will maintain Wmkera Compensation I.e.,as required by sued.
3700 or Ne labor Code,for the performance of Ne work for which this permit is iuued.
My Worker's Compensation Insurance carrier and Policy number ere: p
Cartier.¢OYC PolicyNo.:
AEXEMPTION
FROM WORKERS
COMPENSATION INSURANCE
((itis=,ien need not be completed If red Permit is Toone hundred dollars($101)
or lea.)
I unify that In the performance of the work for which this Permit is Issued.I shall not
employ any person In any manner an As in Wmmesubjcet to the Workers'Compensation
LAWS or Califomla.Date
Applicant
NOTICE TO APPLICANT:If,after making this Corollate of Exemption.you should
become subject in the Workers Compensation provisions of the Ice WrCode.you must
,J O forthwith comply with such Provisions or thh permit mail he dmmcd mvokd
e -
ry CONSTRUCTION LENDING AGENCY
(-i I hereby 4firm that there is a commotion lending agency for the performane,of
gd> the work for which this Permit Is iaued(Sec.3097.Civ.C.)
Landers Name
=2 IaMress
ers Add
U O I cenlfy that I lave read this application sed sea¢the the a WveInformation is
W F cores.l agree to comply with all city and county ordinanns and sum hos relating m
OU building conauuoi0e,and hereby authorise repremmetives of this city to cnmrupon the
W above-mentioned property for inspection purposes.
(We)agree to ave,indemnify and keep hamless unc City of Cupertino against
it
CA liabilities s;anp
judgments, experuwhich may in any my accrue agent said City
U Z In conaequenee of the gsaning of this permLL
APPLIC DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date tr
SOU REG ATIONS.
Re-roofs
ngnourco pplica onmunr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will ism applicant or Nuuc building occupant tom At handle haardous mamdt
As deRned by the Cupenina Municipal Code,Cbapmr 9.13.and the Halm and Safety
Code.See mnzs53:(.r 1 / All roofs shall be inspected prior to any roofing material being installed.
40 ❑Y" I�Ra
Will the applicant or future building=upon,use equipment An devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants As de0ned by the Bay Arca Air Quality Management all new materials for inspection.
District? UPId
❑Y"
I have mad the hanrdduus materials reqmm
uinecunderChepter& the 95 ofCalifon
nil Health&SafelyCode.Scctiom 75505.15533 and 75534.1 understand the if the Wilding
does not curmntl mnL Na It;my responsibility m noufy use occupant of the
rtyuircmen;w rousted et 'ormiuuanceohCcrtifteateo(Qup cr. SignatureofApplicant Date'
owner ed t Date All roof coverings to be Class"B"or better
CITY OF CUPERTINO
em 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36654105 . 00
DATE ISSUED. . . . . . . : 04/03/2006
RECEIPT # . . . . . . . . . 33818
REFERENCE ID # . . . : 06040004
JLime%t 4Nr\ t1Vt-
SITE ADDRESS . . . . . : .1658 biVg ^T
.,,,rte,.,
SUBDIVISION . . . . . . :
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MIKE ST. CLAIR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5141
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 2, 300 . 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 164 . 78 0 . 00 164 . 78 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
204 UNDERFLOOR FRAME 301 ROUGH PLUMBING
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL 514 FINAL PUBLIC WORKS
Community Development
10300 Torre Avenue
t Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
'WUPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #Gd 9,000
171
OWNER'S NAME: PHONE # 3 (o l
GENERAL CONTRACTOR: l FAX # LO $U(- CtSq(p
I am not using any subcontractors: ®�
igna a 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
Community Development
10300 Tone Avenue
Cupertino CA 95014
CITY OF Telephone(408) 777-3228
Fax(408) 777-3333
!U PEkTINO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for.the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• • Landscaping runoff containing pesticides or weed killers; and
Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring ata construction site and will be held responsible for any environmental
damage caused by subcontractors or employees. .
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cui)ertino.org/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL UFFICE
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at htti)://www.amlegal.com/cupertino ca/
• �_._
Greg Casteel
Building Official
APR 0 1 2006
CITY OF CUPERTINO 0004p004
FURNACE/AC
OUPERTINO PERMIT APPLICATION FORM
APN# �)(Q(v JTC i 1 - lob Date: 3lob
Building Address:
Owner's Name: Phone #:
. �6� 3& l f�
Con ctor: Q Phone: License#:
�0� I- otv -7a-31 S�
Contact: n n► Phone: Cupertino Business License#:
I -U Q �=C lit 6�w 3(e lo' I Na"
Building Permit Info:
BI dg 0 Elect Plumb ® �- Mech l
Job Description:—
V tom-
Residential Commercial ❑
For Residential In�s.�,all� 'ons:
Attic ❑ 19 floor �2nd floor❑
Adhere to min setback requirement El
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction: Occupancy group:
a?O-D.W `� e--3
Strapped El On Platform 0 Bonded El Sq.Ft. Floor Area:
New Location ❑ ReplacementKI,
Qty. if
Applicable Fee ID Fee Description Fee Group
BENERGY Energy 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
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
BPGAS Gas PipinE System Fee PLUMBING
BUSLIC Business License BUILDING