04040032 CITY OF CUPERTINO ,ri „ ` T, , '«�" O ".
BUILDING DIVISIONPERMIT
aa r
BUILDING ADDRESS: THERMAL CONTROL PERMIT NO.04040032
•OWNER'S NAME: PERMIT ISBUB DATE
GEORGE)NE: SANITARY 0 All NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDGO O PLUMB MECHO
u p p LICENSED CONTRACTOR'S DECLARATION Job De nn' /w,
Z 1 he fRrm then 1 am litcnud under provisions of Chapter 9(commcndng R R,� v\L E D
with Sectsre (,,Division Sof thesed mad,pr renshapter 9(mylicenuia 1tVLJ r'�'
infullfort eerce PLACE FURNACE & ADD A C
5 n? Licenu ase Lk.R
qF Dau \\ � ContreMar
a stand y plans shell M u�acJ uEpuhlR a OCT t 2004
DyU
Liccnu0 Pnafcmionel
3 OWNER-exempt
DE CLARATION BUILDING
■ ■I ®I
+� I hereby alOrm that I em exempt from the Conlracmfa License Lew for the •DJ U
MOO following mason.(Section WIT 1.5.Business and Professions Cade:Any city or county
,29 which w,,deas a passed W emtsuuct,alter.improve,demolish,or repair my somehow
m;0 m prior m i6 isffiftsuance,also m4ones the applicant for such Permit to file a signed slakmenl
£L"�i do he is licensed purmant to the provisimu of the Contractor's License law Chapter Sq.Ft.Floor Area Valuan
m� (commencing with Section 7")of Division 3 of the Business and Panfeaaions Code)or
g R..$ that he is exempt therefrom aid the one for the alleged exempdan.Any viohtlon of rA,B AT�g�,.,�
Section]031.5 by any applicant for a pewit subjects Ne applicant to s civil penalty or 3 O�YkalyuPber 0 0 Occupancy Type
not more thm five hundred dollen(5500). O� 1YlY"i'9
1,as owner of the property,or my employees wish wages AS theta sale campenulon,
will do the work and lheswcame is not intended car offered fo...I.(Sec.7044,Buslaess Required Inspections
and Prefecture Code:The Crenate is LLicensee Law dues not apply to an owner of q P
Property who builds or imprmes thereon,and who does such work himself or through his
own employees,provided that such improvements art notimended"offered formis.if,
however.Jen building or Improvement is sold within mm year of completion,me ownef-
builder will have Bre burden of proving that be did not build or improve for purpose of
sak.).
1,as owner of the properly,am exclusively conhxling with licensed mnaacWn W
convect the project(Sec.7016,Business and Professions Cade:)The Comnetola U.
come Law docs not apply W an owner of propeny who Wilds or improves domains,and,
who contracts for such pmjects with a contractor(s)licensed pursuant to the Conranloh -
Licenm Law.
❑l am exemplars.Sec. ,B&PC for this moon
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby of ire under penalty of perjury au of the following declarations:
1 have and will maintain a Certificate of Consent self-inure for Warkerl Coarsen.
astiun,m provided for by Section 3]011 of Ne labor Code.for doe perfoammum of the
work for which this permit is issued '
❑I have and will maintain Workor'a Compensation Insurance,c required by Section
3]00 of the labor Cade,for Ne perfowmce of the work far which this permit is issued.
My Wmrkcrs Comps sent p Incur c carrier and Policy number arc:
C er. Poliry Na.: 2 rL
ERTIFI ATE OF EXEMPTION ORA
COMPENSATION INS NCE
(Thu section need notlo:comple ed if she Permit s formic hundred dollars($101)
M loss.)
1 certify shat in We performance of she work for which this permit k lead,l still not '
employ any person in any manneru as W become subject W dm Workers'Compensalion
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making this Cenificale of Exemption,you should
become subject W the Worker'&Compensation provisions of the labor Code,you must
Q,`z forthwith comply with such provisions in this permit shall W deemed evoked.
z O CONSTRUCTION LENDING AGENCY
[—, I hereby a Rum that them laacomn.fien lending agaay for Ne Performance of
a r7 the work for which this Permit is issued(Sec.3097,Civ.C.)
W A Lenders Name
.7 z lander'.Address
V Q I certify that 1 have mad this application and auto that the above information is
0.F cmrrmcl.I agree no comply with all city and county ordinances and amu laws relating no
Q V Wilding comwetion,and hcebymWoriu represenWlives of this city lm enter upon tic
r shove-memion.proPcny for inspection purposes.
(Wc)agme to save,indemnify and keep harmless the City of Cupertino against
rat Iiabilillex.judgments,costs and expenses which may in any way scant against mid City
U7odur
cc of c liEdrined
well
GT RST COMPLY WITH ALL N -P Issued by: Date
wl:111�710V
Ng. Q -
Re-roofs
AN,a Dau
TERIALS DISCLOSURE Type of Roof
the applicant or ing occupant stow or handle hasa dour material
y the Cupertino Code,Chapter 9.12,and du Health and Safety
n 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
the applicant ording occupant um cyuipmenl or Jcvices which If a roof is installed without first obtaining an inspection,I agree to remove
nus air commiIsined by the Bay Area Air Quality Management all new materials for inspection.
District? ������tttsss
El Yes O Nu
I have mad the hicaknua materials mqummorm under Chapter 6.95 of the califor-
nA� Sly Code.Scc' 255 5533 md25534.1 understood thuifthc ildinp
Jy hf¢:e L N i s mymsponsihiliq W notify tic atop tofIhmun t imaancemraCenincatear drop Signature of Applicant Date
mer ora at� All roof coverings to be Class "B"or better
Wily A MANM SsMxk Is »
IMYOIrrA a-
* _
Aheatingand cooling system
made up of individual parts.And,even t
though each component is separate. '.
they're all deaittned and engineered '
to work together as a system.A
perfectly balanced system is the best
way to get the highest comfort and
exciency.when you match an XRII
air conditioner with a Trane high
efficiency gas furnace,or an=l 1 heat
pump with aTmae air handler,you
can rest easy knowing you've installed
a system that can have an efficiency
rating up to 11.50 SEER *,h
...._,.:nom„ . ...
TI F:IS.LGer Sw S
FOR YOUR CO?601cr NFEOS.
iyhen buying a home comfort system, ?CRL1 Ant CortnmoNEa
selecting the right size is crucial,For
instance,an air conditioner that is too directly affect system size.This is K
w.
large will cool your home quickly but the,best way to help you select a
you still may not feel comfortable.It system that tits your particular 2r1R10I&A 13' 18,000 26 20 19 00-034
will satlgfy the thermostat before it can lifestyle and home comfort need-. 2TIR1024A 20 24000 2e. 20 19
remove sufficient moisture from the air. 2t1'R1030A 2.f 30,000 2b 29 26
Act asystemthatis a 2MI036A 3.0 86.000 26' 29 26
Syou Might expe
A TKADmoN OF NNOYA110N. 2ir8.1042A 3.5 42,000 29 29 26
too small just cannot get the job done. YIT8104811 29 29 26ff 33 33 30
N.
Your local independent Trane Comfort innovation and expert engin ' A 0, 31 89 30
Specialist"dealer can help you have been a hallmark of'1'r n
determine the right size system fors
ince 1931 when our sound XEill f1EA'r f'u6s
your home comfort needs with an Reuben Trane patented the
energy analysis Of your home• company's first air conditioning
Your dealer will measure your system.from that time ov; ;
windows,doors,walls,1100r,check the Trane has been a leader in the 2TWRI018A L$ 18,000' 26 29 26 11,insulation,ductwork and building advanc t eats and air 2fWR1024A 2.0 24,000 26 29 26
materials,Plus other things that can conditi 2.f 30000 29 29 26 3.0 36,000 29 29 26
l 3.5 42,000 32 33 30
IN4.0 44M 33 33 30
APR 0 7 2004 2TWR1660A 5.0 60,000 33 37 34 r
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- 05"02/00 08:17- -Pd.\ 406 395 VfV ' ins 11C " '-
,ARCffiTECTUR.AL APPLICATION
Name of Association:
Name of Ctwner(s)! e o e
Address of Uait: 8 r 4
� / unn� 2 - 7F-e .
WorkPbotm C o 'iz '9`f-F Home Phone: =
Applicant agrees and understands that the application does not foM ail of thecondimuatons as d req Atuirements-for an op
ptoval. In addition to this completed "Architectural Application" form,cationj g d1e nature,kind shap6'height,
hi
Review Committee(and/or Board of Directors)a set of plans and spea6 the
materials and locations of the proposed atrhittxttrral alteration It is was deemed neceso understood sary t applicant
pmake a decision.Vntil
cion must be in writing. There may be additional information required
all information is submitted to the com,mittse,.the application wiill.be deemed to be incomplete and the apptc:atiVi will
stand unapproved.
elaN AI,DE_SCRIPTLON OF
PROPOSED WORK ONCL.'UDE DRAWINGS,IF APPHOPRYAT33)
I V'u. O . ,� • n '-rn3.SE' r1 t', QIe.C
Oh�C
4h $ M acrd.. NB
K 2 1 { 3.o �•a..���=- :1 f
a.v"
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let 1� 5 les
2 rnch Cam .e•- rna{all On /�xh.t kir,-Q�rr, A '
rnodifim4am is approved by du Committee or Board,that they
Apglicaat agrees dal Co d tions" that in the event PF7O special conditions shall
may impose"Special Conditions" of construction and maintenance on rhea ved wO�. any s conditions
of the appwvaL Any deviation from the approved Plans, specifications or Special
be attached and be a part that fatltue to conform
shall cause the permit to terminate and become ttud and YOU Applicant gr=an un ork brought�o conformance to rue with
t these requirements will be attteanatic authorization by pp and.understands that all costs in-
the approved plans, 4xd(iCations, and special conditions. Applicant fuxther aft against a the owner's lot.
carred by the Association as a result of bringing said work into compliance shall be a charge
Such costs shall include costs of construction, reconstruction. administration, fees, attorney fees and reasonable court
costs, if incurred. It is also agreed that no work'w ll be initiated which would be a violation of any of the provisions as annoy-
the Assodatian's Declarations Covenants, incur ion Applii Restrimt ctions to inn a ��tiding est any and
ante t rhe residents. to increase the lost Of insutaace• APP
all aces or claims arising in ainnecdan with the improvement,including but not limited ro any and ail acre,omissions,or
claims arising in connection with the approval,c0omucann, operation,maintenance, repair•use or removal of the im•
at, including attorney fees and vests of litigation in connection therewith. Applicant agrees that, in the event
the alicatitm is approved,all maintenance,repair or replacement of the approved irem will be cite sole reslronsdru7iry of
AP-
the unit owner and fiudter that any expense incurred by the Association that is the direct or indirect result consideration.
the O
proved change shall also be the sole tesponsibility of the unit owner. Ail work should be initiated with rvaOmof
that all necessary permits and approvals from mu-
the grounds, esthetics,time and noise factors. Applicant undmands ro.�of this tip
nicipalities or other}urisdicdons we the sole respoasrbiliry of applicant and that Committee/]3oard app
appy mi nog
all such necessary Permits and apps
-
plication is subiem to the a
Applicant agrees to
the fa "conditions and accepts those conditions as evidenced by the owner's
Date:
Signature:
STAFF USE ONLY: Denied ��- Date
APPROVED:
-------
signed:
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Zd WtlZS:90 700? L0 'UdH GSII-966 607 : 'ON-XdU --- - '�tl'Sh�I1H/IONI-N07I�IS '._WOZL-1
FROM : SILICON INOVATIONS,INC. FAH NO. : 408 996-1159 Apr. 07 2004 06:51911 PS
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x Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB ADDRESS. 1145 rrk / le C,YC /L PERMIT #
I/ / b� D UG3 Z
OWNER'S NAME: -,=,, e0 L &n5ell PHONE bio Z
GENERAL CONTRACT FAX#
1 am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the followin information:
14 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
AM Tile
/ gnature -7�7 D to
CITY OF CUPERTINO
FURNACE/ACC11: IF
SUPERTINO PERMIT APPLICATION FORM
APN K• �� J
Date:
Building Address: V 14,6 , fla
I`�G
Owner's Name: 7 Phone #:
�rqQ ( � , ,02-f7
Contractor: License#: / �)/ p•
Contact: hone: Cupertino Business License#:
Building Permit Info:
BldgElect (� Plumb ElMech
Job Description:
Wee r al
Residential Commercial ❑
For Residential Inst ations: __�n1
Attic ❑ I" floor 2nd floor❑ �p8r Ale'°"�
dhere to min set back requirement❑
or Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ElStructural Calculations required for new installation
New installation Planning Approval Required ❑
Cost of Project: �C�n Type of Construction: Occupancy group:
.7 't de act
Strapped ❑ On Platform ❑ Bonded ❑ A40W APUjf N Sq.Ft. Floor Area:
New Location ❑ Replacement ❑ / ����
Qty •
A abl Fee ID Fee Description Fee Group
BENERGY Energy BUILDING
BREMFURN Relocation of Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 c&n 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
BPER IFEE Bldg Permit Fees BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
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