The URL can be used to link to this page

05070044 CITY OF CUPERTINO BUILDING DIVISION PERMITCONTRACTORINFORMATION .: BUILDING ADDRESS: A B S HEATING & AIR COND 1E111N905070044 6360 MYRTI-EWOOD DR OWNER'S NAME: PERMIT ISSUE DATE ANk NOBUNGA DEAN AND ALYSSA 334 SHAMROCK 14 NE: SANITARY NO. CONTROL NO. (408) 238-7178 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 'oo LICENSEDoatIonONIRACmR'SDECLARATION onsofCap JobDescri tion wF 1 ion 7 affirm Net 1 am Licensed under previsions of Chador 9(commencing p i,y withlltomn]defec Dnviaian3of Nc Buainm and Professions Code,and mylicenmu incense "and effect. (� fV R & R EXISTING FURNACE AND A/C jhZ License us (��7lJ Lica f//� /� Daro ✓ Conlranar 44 ARCHITECTS DECLAA!)�- W< I MoCrUand my plans shall be used u public records Dau C� Licensed Professional 5 OWNER-BUILDER DECLARATION a 71 q 1 hcrchy affirm Nem t I acarmct pt from Ne CmuaoYs License Law for the �7 S `�Y`. D O rellowing moon.(SeeMm]1131.5,Business and Profession Cale:Any city or county L K$ which mh m.a permit m rnnstmct,alter,improve,demolish,or repair any muctue ymi print in its issuance.clan requires Me applicant forsuch permit to rile a signed statement Out bw is monsed pursuant to Me prevision of Else Conmaurr's License Law(Chapt" Sq.Ft. Floor Area ��/ // r WiValuation x Fgg (commencing with Section]000)of Division 3 of tic Business;and Professions Code)or y� Nat he is exempt ticmfrom and the basis far the alleged exemption.Any violation of J /( „Q n Section]031.5 by sexy applicant for a permit subjects the applicant to a civil anal)y of .nP+,v not mart Nan Oro hundred dollars(5500). vU�Gl7CCllpan0y Type ❑Lu owner ofthe pmpeny,ntmy employees with vngcuthcir sole eompensstion, v l`� will do the work,and On structure u not intended m.1fened farsak(Sec.7044,Budness and Professions Cade:The ContOeme,Licence law dors an,apply to an owner of Required Inspections property who builds or improves thercom.and whodoessuchwork himselforthrough his Own employees,provided thalmi improvements see not intended oroRered forsale.If. however,Ne building or improvement is mid within one yeas of completion,Ne owner- builder will have the burden of proving,tit he did not Wild or improve for purpom of role.). 0 1,as owner of the ropen,on exclusively contracting with licensed contractors to construct Ne project(Sec.7044,Business and Profeasiou Code:)The Conuacmfs I.I. comm law does not apply to an owner of property who WHO;or improves Orman.and. who contracts for such projects with 4 eo^vaclar(s)licensed pursuant a tic Conuxmfs License law. 0 1 am comp,under Sec. ,B&P C for this won Owner Data WORKERS COMPENSATION DECLARATION I hereby ff..under penalty of perjury ore of Ne fallowing declarations: I Its and will maintain ACcnifiam of Cement to self-iuum for Worker'+Compen. catch,u Pm MW for by Section 3700 of Ne labor Code.for Ute arformana of the work for which Nis permit is issued. 0 1 have and will mainoi^Workers Compensation Inrni as required by Scedon 3700 of Ne Labor Code,far the performance of Ne work for which Nis permit is issued. My Worcres Compensalion inn ananim and PO num rare: Carrier. 5%�' /g/ PoId lie �✓ CERTIFICATEOFEXEMPIION FROMWORKERS' ' COMPENSATION INSURANCE (Ticure ns seneed not he completed if the Permit is for one hundred dollars IS IM) or Lt.) I sonify Nm in the performance of Ne work for which this Permit is issued.I Mail not employ any persen in any manner an as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If.after making this Ccnificale of Eacmption,you should become subject in Ne Workei s Compensation provisimn of Me labor Code,you mus, .JO forthwith comply with such Provisions or this permit shall k deemed evoked. Z CONSTRUCTION LENDING AGENCY [+ I Insibywhich this Nat Ncrt is aeol(See3nl,Ch, .) for the performana of D: La work for whicM1 Nis permit u issued(Sect l09],Civ.C.) Q Undoes Name =z LeMels Address U Q I cantly Nal 1 have rand this application and some Nat the move information is uw P Corm-1 agree to comply with W city and county o d irwues and stale laws relating m OU Wilding construction.and hereby outcomempresentativu of this city to enter upon the [Ll above-me Ends property,for inspection which ms p, (Wc)agsa so cave,indemnify and kap harmless the City of Cupenino against V z liabilities ents,costs anJexpenses which may Nanyway accrue against said City in consequence of Ne granting of Nis permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITHRe-roofs AL NON-POINT Issued by: Date SOURCE REGULATIONS.`/ or J 1©} Signature of ApphcanuCor DateHAZARDOUS MATERIALS DISCLOSURE Type Of Roof Will the applicant no forum building occupant ata.1 or handle Incautious material _ u defined by the Cupertino Municipal Code.Chapter 9.12,and Ne Healthth ananJ Safely Code.Section 25532(a)] ❑Yes CNo All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove sit havardous air comernmer ts as defined by Ik Bay Arca Air Quality Management District? all new materials for inspection. ❑Yes CNu I have mad the harardnus materials requirements under Chapter Q95 of Ne Califor- his Health&SafclyCode,Senium 25505.35533 and x5534.1 understand Nu if Nn Wilding dors nut currently have,a toria2Lj4t it u my maponsihilily in notify tW acup.,of the requirements which in et or to Issuance of a CenlOcam of Occupancy. Signature of Applicant Date Owner Orunion. D,m All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue al , Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 4�UPERTINO Building De artment JOB ADDRESS: /�1'RTGE1�l�� /M PERMIT# So-7vo �c OWNER'S NAME: PHONE # -ZS-5 ,!', GENERAL CONTRACTOR FAX # I am not using any subcontractors: Signature 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 CITY OF CUPERTINO *em 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # 3 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36919012 . 00 DATE ISSUED. . . . . . . : 07/07/2005 RECEIPT # . . . . . . . . . : 30264 REFERENCE ID # . . . : 05070044 SITE ADDRESS . . . . . : 6360 MYRTLEWOOD DR SUBDIVISION . . . . . . : CITY CUPERTINO IMPACT AREA OWNER NOBUNGA DEAN AND ALYSSA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4625 RECEIVED FROM . . . . : ROBERT HALL ABS HEAT CONTRACTOR ROBERT HALL LIC # 22481 COMPANY . . . . . . . . . . : A B S HEATING & AIR GOND ADDRESS . . . . . . . . . . : 334 SHAMROCK DR CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 238-7178 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ------- --- BREMAIRHAN NO.UNITS 1 . 00 10 . 26 0 . 00 10 . 26 0 . 00 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 9, 000 . 00 0 . 90 0 . 00 0 . 90 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 175 . 44 0 . 00 175 . 44 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER -- --------------- ------------ ------------------ CHECK 175 .44 2319 TOTAL RECEIPT 175 .44 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • oso-4-04t CITY OF CUPERTINO FURNACE/AC • CUPERTINO PERMIT APPLICATION FORM APN# 3&913— i —oI oL Date: Building Address: Owner's Name: Phone #: z 3 -- 8�3 Contractor: License #: oh Contact: Cupertino Bus' ,sJLicense #: Building Permit Info: Bldg , ❑ Elect 91-/ Plumb ❑ Mech Job Description: Residential Commercial ❑ For Re ' ential Installations: Attic l" floor ❑ 2nd floor❑ • Adhere to min set back re uirement❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural talcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: ;�/ �a Type of Construction: Occupancy group: Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location ❑ Replacement Qty. if A licable Fee ID Fee Descri tion 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 tl EPERMITFEE Elec Permit Issuance ELECTRICAL / MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK PlanCheck Fee BUILDING BUSLIC Business License BUILDING