The URL can be used to link to this page

06090208CITY OF CUPERTINO ..�•'' BUILDING DIVISION PERMIT,CrUIN`FR:A.CTOR1!TFURNIATIO auIL01NC ADDRFss: CONDITIONED AIR PERMIT NO. 06090208 10730 LA RODA D OWNER'S NAME: PERMIT SSUEDATE LA POINTE ROBERT 1701 LITTLE QRCHARD AT ng/91/9,006 NE: - SANITARY NO. CONTROL NO. (408)291-2220 ARCHTECT'ENGINEER: BUILDING PERMIT INFO PLUMB MECH BO O LICENSED CONTRACTOR'S DECLARATION Job Description 1 hareby affirm that 1 am limned under provisions of Chapter 9 (cammcnclna wits Scotian 70r1U) of Di•Imon Snide: Bmineo mod pfarcaelalm Code. sad my license is in fail forceandeffem 45I C-fid REMOVE & REPLACE FURNACE Llnenm Clore Lm.0 �,<-eta - Datcp yr,, Cam"I'm � AA1'ION ARCHTECfS DECL I andemand my Pope "I be urea u while rncaNa Licensed Professional OW NSR-BUILDER DECLARATION I herchy aRrm that I am caemPl form the Cannanore, License Law for the fallowing mason. (Section 701.5, Business and Profentinns Calc: Any city at county $2400 which acquires a permit on construct. after. improve, dcmohah, nr repair my someone Sq. Ft. Floor Area prior m its issume. alse requhm to applicant (err such permit m file a ligned mommem conuacmea lJmnse aw(chapter 9 that he is licensed pursuant to dm provisions of the that (commenting wits Senior, 7000) of Division 3 of the Basireo Alm Profession, Code) or We be is Accept m-•^ftms and the bash for the alleged emmption My violWan of r u v Occupancy Type Section 7031.5 by any applicant far a permit abjecu m: appliant to a civil penalty of am Acme than Ron hundred dollars (5500} D I, u owner of the property, or my cmplaynes with wage, As their sale emnpema0an, nst Required Inspections q P will do the work and me snuctuse la rot Intended or offered for ask (Sec. 7014, Beeixu and Profefaioes Cade The Cmtrcmes Lkx law alma orapply or an owner of property who builds orimpraves Ihercan.cdwha doessuchwadthur elfortimrough his awnem,thebuildin ded Inch impsowmcuate ort oraSmeL oy ear of Weaalelr, building err improvement h mid within are year a(cmpletim, me awriu. bowevm, or builder MB haw the burden of pmNng that k did ort build Or Improve for purpose of mak.). D 1. Ac awns of the pmpeny, me eselmively cmuaming with Densed enoacmn in construct the pmket (Sec. 7014, Seem= and Profession Cade:) The Commamoe, Li. cases law dam not apply ja an owner of progeny who deltas or improwa thereon, and, apply he Wilds oamntorme C wlmaemhsoterty caconumet; for such Cance, ad License Law. D 1 am Acept under Sec. . B At P C far dei: rmson Owner Dam WORKER'S COMPENSATION DECLARATION 1 hereby saints under p"ll, of perjury one of the following aocisationc ham and wBl alnmin aCeNRon of Coueem m self-imurt fa Workees Compen- 1 m sad., as provided for by $=don 3700 of the Inbar Cade. for w performance or on work for which this permit is issued. D 1 hive and will maintain Weinces Compensation Insutanee, As required by Section 3700 of tie labor Code, for me perfarmuce of the wart far which this permit is found. My Worker's Compensation Inwrauce prier and Policy number arc: Cartier.AhQft `nI;PkbPolicy No.:OIiXQt`ES6L6-OtSI CE �CATE OF EXEMPTION MOM WORKERS' COMPENSATION INSURANCE UhhsecOm need an, be completed from permit is form hundred dollam ($100) or lese.) I century that In the performance of that work fm which this permit is intend. 1 shall not employ any person in any manner amu to became subject to the Workeri Compensedm Law, of California. Data Applicant NOTICE TO APPUCANT. IC afar making this CcmResu of Ea:mpdan. you should become subject be the Woheea Comperwtine provisions of the labor Code ye, mum foMwits comply with such provisions murk permit mall M decmed naked. CONSTRUCTION LENDING AGENCY 1 hereby me mere h e nn lending agency far Ne perfarmanun of d (So,. theLe wars fur which orb perch ie Intund (Sec. 7097, Civ. C.) which s Lender's Name Lcndeh Md^.• r 1 certify that 1 have mad mis application and sum that me show information is " cormct. I agree or comply with all city and county ordinances and sun laws mladng or Wilding construction. And hereby endocrine represcmatives of this city to enter upnn me ainavc.mendaned for impaction purposes. ld pamay (Wal) a&= in saw, indemnify and kip harmless me City of Cupertino against IIlaNlltmajudgmenu.cam and expenses which may in my way aocrue against mid City I in consegunme of the Starting of this permit. 7 APPLICANT UNDERSTANDR AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SO • REGULATIONS. `1 OC AsQU Re-roofs si rcerr Appik.hkrAtushmma, Dam HAZARDOUS MATERIALS DISCLOSURE �----' Type Of Roof Will oe applicant or future building a Pamnorc or handle hmsdous material u deMad by 0e Cupertino Municipal Cade. Ompmr 9.12. and the Health and Safety Corn. Section 25532(41 �� ✓✓✓ ❑Y. All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will me applicant or future building Occupant use equipment of devices which mit ha.mr. air contaminants as deRaed by the Bay Ara Air Quality Memlement all new materials for inspection. District? Dyes 4 u I haw mad me hoaNmw material requirements under Captor 695 or the Cali for -is Hcalmh SefmyCode, Ss. 25505,25533 and 25134.1 understand mm if the building does not curtently hew a unam, mm It At my .Pp hility se notify dm occupant of that requirements which mat W met prior n iasuAnun or a CCMflCate Of OCC uPateY, Signature of Applicant Date B roof coverings to be Class 'B" or better ow ,,maria<a ,erns Data &m 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36934041.00 DATE ISSUED.......: 09/21/2006 RECEIPT #.........: 36142 REFERENCE ID # ...: 06090208 SITE ADDRESS .....: 10730 LA RODA DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: LA POINTE ROBERT ADDRESS ..........: CITY/STATE/ZIP ...: , RECEIVED FROM CONTRACTOR ... COMPANY ...... ADDRESS ....... CITY/STATE/ZIP TELEPHONE .... 0 E ID UNIT QUANTITY OPERATOR: amyw COPY # : 1 CONDITIONED AIR RICHARD READ LIC # 22334 CONDITIONED AIR 1701 LITTLE ORCHARD ST SAN JOSE, CA 95125 (408)291-2220 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 2,400.00 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 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ OTHER 164.78 ------------------ VISA. TOTAL RECEIPT 164.78. VOICE ID DESCRIPTION VOICE ID -------- DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING -------- 303 ---------------------------- ---------------------------- ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM APN # Date: BUILDING Building Address: C Furnace li 1 A/C Unit> 10,000 cfm I MECHANICAL Owner's Name: Phone #: MECHANICAL BREMRECEPT 9 IF 1' Contractor: Phone: License I., i BUILDING BSEISMICOM Seismic Commercial BUILIDNG Contact: Phone: Cupertm iBusiness License #: MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING Building Permit Info: Bldg Permit Fees BUILDING Bldg ❑ Elect ❑ Plumb ❑ Mech i ❑ . BPGAS Gas Piping System Fee i PLUMBING Job Description: (� � e C9� Business License BUILDING Residential CE�- Commercial ❑ For Rg�Wential In all qns: LJ ❑ i Attic 0 floor 2'" floor i Adhere to min set back requirement ❑ or Commercial Installations: Additional weight (structural calcs) ❑ eplacement same weight ❑ E3 Structural Calculations required for new installation ew installation PlanningApproval Required Cost of Project:„ , 1,,0 Type of Construction: Occupar. y group: n % Strapped EF On Platform Bonded -O Sq.Ft. F 'or Area: New Location ❑ Replacement ❑ Qty. if A 1' bl Fee ID Fee Description Fee Grou ica e 1 BENERGY Energy BUILDING BREMFURN Furnace I MECHANICAL BREMACOVER A/C Unit> 10,000 cfm I MECHANICAL BREMAIRHAN A/C Units <=10, 000 cfm MECHANICAL BREMRECEPT Recptl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res i BUILDING BSEISMICOM Seismic Commercial BUILIDNG I 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 Piping System Fee i PLUMBING BUSLIC Business License BUILDING