05120088 CITY OF CUPERTINO is.
BUILDING DIVISION PERMIT ,
)aCO RACTQRjNFO1iMATIO
v a+kvs
BUILDING ADDRESS: A PERFECT CLIMATE """No.05120088
OWNER'S NAME: PERMIT ISSUE DATE
RICAHARD LAM 10570 S DE 12/15/2005
NE: SANITARY NO. CONTROL NO.
408) 861-9545
ARCHITER/ENGINEER: BLDG B LECr'.0g PLUMB MECH
0 =f d.}�t� 0
X00 LICENSED CONTRACTOR'S DECLARATION f
8 I kreby affirm that I am licensed under provisions of Chapter 9(commencing Job Description As
with Sudan 70110)of Division Sof the Busies and Profession,Cede,and my license is
n 10fuBmrceade - r$ REPLACE FURNACE & A/C
j n z Licenm lase Lk.I
n Data Conuumr ✓�
Qq Clic CA DEC LA ATI N
I undcrwnd my plane shall be used as public recordsle
1��;�•)
sed Licenced Pndoaainnal
5 OWNER-BUILDER DECLARATION
I I berehy affirm on 1 em exempt from du Contractor's License Law for the
i p O following mason.Section]BSL;Business and me,de one Cade:My city or county
rsi$ which requires a permit re eonewe4 attic.Impmw,h Permit t ore a sig any structure '* 3
primminscewnm,almarequires Ileapplicatfthe Cor ier',.Ole asignedmumcm
F C dwkellmnseJpunuauothe M)ofDisiovofthcConundPadmuLaw(Chapur9 Sq. Ft. Floor Area Valuatio
3�� .,(ced.hecncing with SectionTOM)and
of Division r of the Bud.eexempt on.my ne CnOe)ur
— that io is 31.5 b nor applicant
li and the nub for ube ctsfor exemption.my violation of
Santac th I.5 by atry red mil for a permit abject des Applicant to•civil pevltY of
not mom dun Ow hundred dollen(f300). r L7CCUpanCy Type
❑I,nown"ordu property army employees withwaguud¢trsak compenadon,
will the work.end lneawnure is notorcaded oraffered forade(See.70".Business Required Inspections
and P.I.Mi ut Code:The Comrators License Law does not apply to an owner of q p
property who builds or improves thereon,a nd who does ouch work himself or thmugh his
own employees,pmvidcd that such imprommems au mAinunded reoffered for Sale.If, '
however,she building or improvement Is sold within ane year of completion,the owner.
builder will haw the burden of proving that he did not Wild or improw for purpose of
ale.).
❑1,as owner of the property,am ex luiwly cnnuuaing with licensed mmracton to
construct the Project(Sec.70414,Business and ProfcWam Cade*The Contractor's U.
cause law does not apply to an awner of Property when befIN or Inform thereon,and
who conusevs for such project with acontractm(s)licensed P.,to the Contractors
License Law.
❑1 am exempt under See. .B k P C far this moan
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby affim under penally of pedury arc of the following declarations:
I ham and will maintain a Certificate of Consent to self-Imam for Worme.Compen-
Allan,u provided for by Section 5700 of the Labor Code.for the performance of the
Zwork! whichti.permitisiss d.
w and will maintain Workers Compensation Inmuarmce,u required by Section
5700 of the IAkrCode,for the p 6mmace of the work for which this permit A noued.
My Worker.Compensation lnmraem carrier and Policy number tie:
Cartier:�') �i Policy No.: e A��Q
CERTI EATEOF E%EM PION FROM ORKW ERS'
COMPENSATION INSURANCE
The sectian need outbeceradcu l If the permlt Is forane hundred dollars(SIM)
or less)
I certify that in the performance of the work for which this permit is Vaud,I shall not
Lm
pemommanymanerau became aubkcuo tM Wor 'Compensation
Laws of Ca la.ffm a IT
Applical ��
NOTICE TOXPPL� WF.Ii.afu�l ing this Cenifiau of Exemption,you should
become subject to the Worker's Compensation provisions of the Latour Code,you am
vJ 0 forthwith comply with such Provisions or Nis permit shall be domed mated.
,z.A 14
CONSTRUCTION LENDING AGENCY
[n I kreby allied chat dart n
is a contraction loading agency fm du performance of
CQ�
the
work for which the Permit is issued(Sec.5097,Ci,C.)
W�Q Lenders Nun,
z Lenders Add.
O Q 1 certify that 1 haw mad this application And mu that the am.infomatiun e
L4(~ cotton.l agree to comply with all city and county ordinances and sou laws minting to
Q C.j buildingcmearmlan,And hemby normal.ropmamatiws of thiscity to enter upon the
�a above-mentioned property for impaction purposes.
(We)ague to axe,indemnify and keep harmless du City of Cupertino eg cast
mF—m h Ilabliitin,Judgmenu,eau adespcous which may In ay way acauagainst aid City
in
APPLICANT cof the onsequence
UNDERSTANDS Aof mND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Signaturt of Appliea��US MATERIALS DISCLOSURE Daa Type of Roof
Will the applicant or future Wilding occupant seam or handle haurdous material
As deRad by the Cupertico Municipal Cade,Chapter 9.12.and the Health ad Safety
Code,Secdun 25572(a)7
41 ❑Yes �Na All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
craft heradnu sit contaminants u dcMcd by the Bay Ams Air Quality Management all new materials for inspection.
District?
❑Yu q<-
I haac mad the huardau mau ialsicyuimment undcrChapi r6.95afthe Cdifor-
nia Healdik tyCada Soctiaer 25505,25533aml253Jl l undemaM that ifthe Wilding 11
does Amt carte t he s mumu.t it a my repo inility b atify da aceup I of
Call nch Bbemetp toiaaanoor c,mresaoroop�ayy� SignatureofApplicant Date
Owner arsuthorizod a em 0 D�-f—a0--r�7 All roof coverings to be Class"B"Or better
Community Development
10300 Torre Avenue
r' ✓' Cupertino CA 95014
Telephone(408)777-3228
�
CITY OF Fax(408)777-3333 UPERTINO •
Building Department
JOB ADDRESS: PERMIT#
oaaiq �AJ so oS Z,668�
OWNER'S NAME: , PHONE #
GENERAL CONTRACTOR FAX # 86
I am not using any subcontractors:
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
DEC. 5.2005 5:05PM INDS ORNS FIN/HR 140.655 P.12
SBC-
ust
rywart
Industry Markets
430 Bush St.,3''Fir.
San Francisco,California 94108
Far#415-956.4150
I
r t (. L iTv
Fax Cover Sheet
DATE:>0'
"RA ? �� I Q
PHONE-
l ( FAX: �g
UJT
RE: ('��,hp �01 ,�, '13U iii{)
• A-Mfpva l Lt---r14-Lr
Number of pages including cover sheet: 2—
Messag®: -4 , uQ,y�2� '(Ce , ��v� C 72 *�-G
From: �(2 n� .-1 acme a �=� A4- 202zq kl-� k Gds T' SQ
Mike Cunningham (415)774-1989 Don Morrison (415)774.1983
Howard Duff (415)774-1881 Botty Soo Hoo (416)774-1873
Raymond Hebert (415) 7741969 Michelle Smaney (415)774.1986
Kim Hines (416)7741991 Lou Torres (416) 774.1975
Debbie Jang (415) 774-1967 Bonnie Toy (415)774-1977
Dar Karen Toy (415) 774.1965
Rich Lam (416 774.197 Rosemarie Von usa (416)774.1978
Gloria an oza (415) 774-1988 Tina Wong (416)774-1987
16EC.,, 5.200586.5:06PM4085INDS OPMS FIN/HR NOR7F30INT HOA N0.655 P.2/2 GE 92
DEC. 2.2m y10:36* INDS CPN6 Fl" NO.645 P,2/2
Dcoembct 1,2005
TO: 2 HOmeOwmr Asseoialioa Board
20880 , otth OW Way,Cuperdno.CA 95014(408)996..3734 Fax(408)996 2026
From Ricbark Y.em
Northpoint Flomeovmee of 20229 Nordrwct Square
CVCRI,u% Ca 95014
S Raqu Approval far IDSWIatioA of Air Conddu*S Ueit within Backyard
Bmdary
Deet Nmdtpuim Homeovmer Associa m Board; -
'This is to"quiet approval,for the pkumsm of a Two Model?dt.110 2.5 Toa
roadaaeiug tutlt,modal no,(2TTM030A)Air Coalitioner unit within the cam6ru of tae
pado/bac"M area of 6m eboveute dmad addram.The*=&do=Wait bas an I 1
SM Of patteot Crimes Aft TO ant MIftam welt iastallad by a o0el cmw Som
Cttpmao,ca 95014 g and e.it CConMoWne, locoed at 10570 S.De Atm Blvd,
and 9 to all code and permit ragalremeots of doe
City ofov"o.
The air ocnditton r ivdt is lone Fmxok and wql be situated clone to the patio doer on the
d&side of rho b&Jgwd.The emit will be wt illy Meld by to eommm fence slog Ste
beak and side yard aliadneting my rd&egmme&m the outside.
Phone review pad provide below a favorable WOW£or the kabUsdon of the a tL
Thank you ft your consiftifim sad mepeDarioa w
Be1 .0
st rt�da,
z,.Ltc;��
1�Dh>ad��am
Ow=of 20229 Narthwast Square
G4apnatmo,CA 95014
OTco:(415)7741971 Fme(415)9564150
Em dl:Mard.Lam(c sr com
Northpoint Hd lecw Anxidon Board
.NameID l
.L_�j �1 Date;12t�a�D �
CITY OF CUPERTINO
FURNACE/AC ��� Z
CUPEkTINO PERMIT APPLICATION FORM
APN #
?! � 3 � °s Date:
Building Address:
ao2.a9 Nor es S
Owner's Name: Phone #:
av, , C�arcQ SIS-77q -197 (
Contractor: � � License #:
Contact: Cupertino Business License #:
Building Permit Info:
Bldg ❑ Elect Ltd Plumb B' MCC LCA
Job Description:
Residential Ip/ Commercial ❑
For Resi ential Installations:
Attic 1" floor ❑ 2"d floor❑
Adhere to min set back 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 P jec : Type of Congructio Occupancy oup:
/®3i r vN0.c e £ l9 L L/
Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor ea:
New Location ❑ Replacement
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 Qnits <= 10, 000 cfm MECHANICAL
BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL
BSEISMICRE Seismic Fee Res BUILDING
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
BUSLIC Business LicenseBUILDING