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06050022 CITY OF CUPERTINO �� "^` " ` •''- °�"' BUIIAING DIVISION PERMIT kc�NTT,",G"�OTN R� w,�'I�R�Mr�7'Tf1N BUILDING ADDRESS: PACIFIC COAST MECHANICAL PERMIT NO. 06050022 21050 MC CLETIAN RD OWNER'S NAME: FER1.025M DATE - WALT S HOEFLER TRUST 247 SUNOL STREET ng/02/2006 EI SANITARY N0, CONTROL NO. (408) 365-7004 ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 app LICENSED CONTRACTOR'S DECLARATION Job Description 4 I hereby&Mrm that I am Baud under provision of Chapter 9(commencing with Send.1")of Division 7 ofthe B ramess ad Prol-mi-ru Code.and my license r + „ inmluomeadenea 374�� REPLACE EXISTING HVAC UNITS LiC"' Clus Lle.P _ n 7 Dem -� CS DECr ��jj r� p /R p 7W ARCHITECTS DECLARATION ^,(��Njf�t ""IN M /psa �� f I undctmnJ my plans shall h used u public records �H`aNrNeA'iEl�r+'\i' y� CTD BI a ped�a Licensed Pm(nsional 3 OatIam BUIMERexempt id CLARATION ZOO hertby.film(Sec that 1 1. .Bumps from the Contractor's Co License Law for the JUN " � v1806a p O which following moon.(Section 7031.5.Business and Improve, do obi Code:Any city or county IIIV / Ur V ZOO which mquea issuance.perm[n eti s tit alms,hnpmw,demolish,err repair ny uroetum 9 6 _Zi "the instsensedprsa requires theappliamformchpemitto Ole aaigad statement f(�G this hetslkend pumunttothep(Maionsofde Canuactorsllauc io(Chipun9 Sq.Ft. Floor Area ;tion 9 (co he is exempt Lhmf n 7 and th Division r of the B ed 4ndexempt Profession Cde)per tic' S— Net o ta 1.5 btaemfrom and de aper it the allsubjects Cut exemption.to Any l Pennon of Secdan 70315 by any red dont for a parol[objects dm applicant a civil pantry of i CCUpanCY p oat mart dun Ow hundred dolma(55007. ❑1.ao ofthepropeny,umyemployeawlNwagnuteirnlecampenudon, will duthework.ndthesuuctme snot Nmndedoroffemd fanalo(Sec.'rof4.Businea Required Inspections Nd Professions Cade:The Contractors Liaise Taw does act apply n n owner e a( q P property,who buildsaimproma thmnn,adwho doessuch workbimseffor through his own employes,provided that such improvements m nntinmdd oro@ted forsde.If, however.the building or Improvement rsold within one year o(compbedon,the owns. builder will hew de burden of proving dost he did at build or Improve for purpose of stk.). 0 1.as owner of the propeny,am exclusively conducting with livened nnuemn to 44 Consumer tae project(Sec.70 ,Bunineu and Probations Code:)The Contractors U. «ve law doss On,apply in an owmr of property who WiW3 or Improves du rcon,and, who contacts for such projeeta with a conuacur(s)licensed Person[to the Conuamoes License Law. ❑ 14m exempt under See .B k PC for this wan e Data WORKERS COMPENSATION DECLARATION 1 hereby afBno under penalty of perjury one of the following declaatiou: ❑1 have and will maintain aCertiOcamof Comm to self-invert fa Wadmrs Compos. nation.an provided for by Section 3710 of the labor Cde,for de perfnmmce of Can work for which this permit is lured ❑1 have and will maintain Worhh Compcuadon Insurance,u required by Sohn 3700 of the labor Code,for the performance ofthe work for which this permit la Issued. My GrMWeor.*e^f'Conummoutiom insurance Carl d Poll ry breN7/ Nr?' Policy N CEOFEXEMPf10ROMWORKERS LCCQ 2- COMPENSATION INSURANCE (Thrsea)m tied rrolM completed If the permit Is farone hundred dollars(SIM) or less.) I anify thus in thc performance of the work for which this permit Is issued.I"I not employ any person in my manner an as in become subject to As Worked Compcudon Laws of California.Dam Applicant NOTICE TO APPLICANT:If,after making this CeniRum of Exemption.you Should become subject in the Workeh Compensnlon provisions of the labor Cade,you most Oforthwith comply with such pro mmund W this permit shill be deemed revoked. Z CONSTRUCTION LENDING AGENCY [r4 l hereby 41lrm that Nem rex construction lending agency for the perfurmatx:e of 6i> the work for which Nr permit Is issued(Be..3097,Civ.C.) QLanders Nurse .7 z Ledces Add= U Q I Certify that 1 ban read this application and m e that de above Information is It,!' COMM I afore to comply with all city umy ardbnncu ad stsm laws misting to Q building conswction,and hereby an macnosriwa of this city to enter upon the GT1 shorn-nmotiuned provany forits n u sea. a (We)agree to pew,indc if and ice p humins,the City of Cupertino against ,.r(n biabilidesjudgmenu.eom red wM h may In my way accrue against said City U"�, incometi.dthegrander ( uPeir" r Z�• G APPLICANT UNDER STA S ND'W L COMPLY WITH ALL NON-POINT Issued by: Date _7 SOURCE REGULATIONS. Re-roofs Signature of Appbiam JOm Dam HAZA MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupmtstore or handle hazardous mamrrl u deRud by de Cupertino Municipal Cade.Chapmr 9.12.and the Health and Safety Section 2"32(')7 All roofs shall be inspected prior to any roofing material being installed. ❑Yrs �Na Will We applicam or future building occupant use equipment ordevies which If a roof is installed without first obtaining an inspection,I agree to remove emit haxaQwhkm insnu u defined by the Bay Ara Air Quality Management all new materials for inspection. Disoict7 Oyu ($Nu IhmamriLsmquimmcnuundcrCMpwri95ofdm Calif.. maHulthSavons255D5.25533nd25534.1udemnddmifdc Wilding does rotecum that It r my oupouibility to notify the Occup ct err thc requlmmcbe met pdorwissumen ofa Certifeaeof Occupancy. Signature Of Applicant Date owner cur nman.ed agent Dom All roof coverings to be Class"B"or better CITY OF CUPERTINO I• 1 of 1 PERMIT RECEIPT OPERATOR: Buem COPY # 2 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 35905133.00 DATE ISSUED. . . . . . . : 05/02/2006 RECEIPT #. . . . . . . . . : 34218 REFERENCE ID # . . . : 06050022 SITE ADDRESS . . . . . : 21050 MC CLELLAN RD SUBDIVISION . . . . . . . CITY . .. . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : WALT S HOEFLER TRUST ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . . . . : WALT HOEFLER CONTRACTOR . . . . . . . : TORRISI, MARK LIC # 18612 COMPANY . . . . . . . . . . : PACIFIC COAST MECHANICAL ADDRESS . . . . . . . . . . : 247 SUNOL STREET CITY/STATE/ZIP . . . : SAN JOSE, CA 95126 TELEPHONE . . . . . . . . : (408) 365-7004 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW HAL . __________ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 9,600.00 169.56 0.00 169.56 0.00 BREMAIRHAN NO.UNITS . 1.00 10.26 0.00 10.26 0.00 BENERGY PERMIT FEE 169.56 81.39 0.00 81.39 0.00 BSEISMICOM VALUATION 9, 600.00 2.10 0.00 2.10 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 378.42 0.00 378.42 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 378.42 VISA TOTAL RECEIPT 378.42 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 • o v � I e IQ ' a w � � a L� cC. d J 1 J� o a� © i ^ y V.I 4f O � m W o N p n � � � � �� .E � acs cE •" g � ' �L W W Li (il U i 4 CL ' Zoe N .L1 q C] , I .�• C p C • C O 1v�1 mN QRZ n3."cro p � mv ZCL W va s.3E= � Z Wcci C.r l 'd Ell 'ON H93W iMD Ol d l9tld W z l 900b 'l 'AN MAY. 1. 2006 3:21 PM PACIFIC COAST MECH N0. 213 P. 3 • rZ fall ���za Community Development 10300 Tone Avenue Cupertino CA 95014 Telephone(408)777-3228 UnCIIOF C�TIA'O Fax(408)777-3333 rC 1 '�I Building De artment JOB ADDRESS: PERMIT# d o c o Cv °o C�7 6a s o, a z--t OWNER'S NAME: k( tTS, PHONE 4k(-OW _ o GENERAL CONTRACTOR c o ( L FAX # Yo c) 0 9 I am not using any subcontractors: Vz s- L a(, Signa&t6W Date Please check applicable subcontractors and complete the following information: 21 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 �alF CITY OF CUPERTINO CUPEI�TINO PERMIT APPLICATION FORM ()�b5� � N# Jsf Date: 2. 06 Building Address: Mailing Address (if different from building address): 2- 1 OS D Mc Cc cc a 12013,o v riern° Owner's Name: Phone#: crS � UJI O Vyl Contractor: a licens6#: Fb a- ro a 6337Y Contact: Phone(IN)36. -- ?Wy Cupertino Busl ess License#: Fax: o(,) % oZ Building Permit Info: E�fpcjNc Axl j,VC MVAC va%rf Bldg ❑ Elect ❑ Plumb ❑ Mech Job Description: Residential ❑ Commercial Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupanc Group: Ebb Y -3 Type of Construction: Please check this box if the project is a AWNL Za2 I second-story addition: ❑ Project Size: Standard ❑ Laze ❑ 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 BELCC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elee Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING Akh BINVESTIGA Investigation fee BUILDING qW 1 of3 a�'mn CITY OF CUPERTINO CUPEI�TINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. 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 Check 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 ofFumace 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 d, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT I Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 CITY OF CUPERTINO CUPERTINO PERMIT APPLICATION FORM uantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR 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 Inspection BUILDING BSWIM 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 Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • 3 of 3