Loading...
05070167 CITY OF CUPERTINO x tial '^�'* "� n ' BUILDING DIVISION PERMIT COI I -- I 'OR INJOQRMATION ' T»y BUILDING ADDRESS: A PERFECT CLIMATE PERMrrNO.05070167 99t;29 poppy ng NEWS NAME: PERMIT ISSUE DAIS RON W C NE: SANITARY NO. ONTROL NO. 408 861-9545 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH It NI t� l� 300 LICENSED CONTRACTOR'S DECLARATION Job 1 hereby amm,Nat 1 am IicemN under Provitiats of Chapter 9(cemmencingtestNAUU with Batson 7011U)of pivWon laf the Budrca and PrO(caioa Code,ad my Ikense 4 imm'm�prn�eese cao31ST' INSTALL A/C 3gz o. L I s �y ARCHI'TECT'S D RAT N '1\lQ_ ZOOJ LKonsed Professional I4a shall nrN BUILDING OWNER-exempBUILDER und ft ATION BUILDING 2 M O I hereby.Rion the 11. exempt tram d r Comracrors License Law for Ne EMO O following mason.(Section 700 construct,sines and ve.denni Calc:Any city m comity 5$ which mquima•,.also re resthellq impmw,demolish,orrepaira signed structure ement _zry^ prior mits issuance.also requires applicant for ContrannitmMusse Law(Chapter < thathelicensedPSeaanitoNcofDialoaofNeConuinessaUwnofeado Code)or Sq.Ft.Floor Area Valuation eRg (ham els axe pttheral 70M)ofDivision oftheeged Business endon.Any Code)or Q�., Nat be la exempt tMrefrom and the buts for Ne alleged exception.Any violation of Section 7031.5 by airy applicant for a pem It subjects the applicant an a civil penalty of 3AP&24A6er00 Occupancy Type not mom than five hundred dollen(5500). ❑Lu owner Ofthe property,or my employers with wages as their axle compensation, will do the work,and theswclum is not Intended Oroffered fonaie(Sec.7044,Business Required Inspections and Professions Code:The Conmcar's License LAw does not apply to in Owner of q P property who build,or improves Nercon,and who does such work himself or through his own employees,provided that uch lmpmwments are not intended or offered for ale.If, however,the building or Improvement Is aid within one you of completion.the owner builder will have slue burden of proving that M did Out Wild or Improve for purpose of ale.). ❑1,a owner of rte property am mu lMd ly conuacdng with licensed conmcmn in - construct Ne project(Sec.7094,Business and Professions Code:)The Contractors U. cense Law does not apply m an owner of property who Wilds or improve thereon,and, who coronets for such projects with a cotuactods)licensed pursuant in the Consumes License Law. _ ❑I em exempt under Sec. - .B&P C for this mann ter — - Dam WORKER'S COMPENSATION DECLARATION - '" -- - - 1 hereby alarm under penalty of perjury one of he following declantiom - ❑I haw and will maintain a CeNncam of Consent to elf-InsumforWorkeraCompen- ame.as provided for by Section 3700 of the ober Code,for no performance of rte work for which this permit is issued. ❑1 have and will maintain Workers Compensation IaWaom.as inquired by Section 3700 of the ober Code.for the per(ormana or the work for which this pumit is issued. My Workers nCom^pe�nati^o�n�Inanrme carrier and Polly number art: p Cartier. I I�J Polity No.'�51 t4(1J2 CERTIFICATE OF E%EM MON FROM WORKERS' COMPENSATION INSURANCE (fhb section need notheeompleted lithe permit is farome hundred dollus(5100) or lav) 1 certify that in the performance of the work for which this permit is WrOod,I shall nm employ any person In any manner an a to become abject to the Workers'Compeaadan Laws of Califomla.Dam Applicant NOTICE TO APPLICANT:If.after making this Certificate of Exemption,you should become Subject in the Worker's Compensation provisions of the(Aber Code.you muss .,O fmNwith comply win such provisions or this permit shall w doomed revoked. Z CONSTRUCTION LENDING AGENCY [—t Thereby affirm Lost Nem Is a construction lending agency for the performance,of IYa> the work for which this permit is Wood(Sec.3097,Civ.C.) ' QLenders Name .7 z Lender's Address U Q I certify that 1 have mad this application and sate that the be.Information is correct.I agree to comply with all city and county ordinances and sum laws relating to Q lrJ' building construction.and hereby authorlm representatives of this city to cncr upon Nc L57 about-mendoned Property for ImPeNon Pugmas a (We)egret to ave,indemnify and keep harmless the City of Cupertino against Ilabllides,judgments,eau and expenses which may In ay way accme against said City U 7 in consequence of the gaming of this Permit. rte• APPL ANT UNDERSTANDS AND WILL CO LY TH ALL NON-POINT Issued by: Date SOU p REGULATIONS, 9 A _ lel&n(I,(- /- Re-roofs Signature of ApplinnUConusctor Dem HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding Occupant Brom or handl haArdous material as defined by Ne Cupertino Municipal Code,Chapter 9.13,and Ne HesIN and Safety .section 255324)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant o uwm Wilding=opem use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit lux"noa sir conuXN.. dc0ncd by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes T haw roW rtehaeda.. nu under Chap1r6.95 of rte Glifor. nb Halth&Safety C.k.Secdau35505, 33 25534.IundenteMnaifOa Wilding doesnol curmmly haw a tenal.Nat It my res aibility m notify Ne accupat of the m�q��``nu which mug be incl p�eiom l�ssu�ce fa Grtifka of Occup Signature of Applicant Date a kj / All roof coverings to be Class"B"or better Owner tar amhodrted agent Dom CITY OF CUPERTINO 3 of 4 PERMIT RECEIPT OPERATOR: euem COPY # 3' Sec: Twp: Rug: Sub: Blk: Lot: APN . . . . . . . . : 34212004.00 DATE ISSUED. . . . . . . : 07/26/2005 RECEIPT #. . . . . . . . . : 30520 REFERENCE ID # . . . : 05070167 SITE ADDRESS . . . . . : 22529 POPPY DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RON WONG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0802 RECEIVED FROM . . . . : A PERFECT CLIMATE CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 10570 S DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 • TELEPHONE . . . . . . . . : (408) 861-9545 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 4, 066.00 115.56 0.00 115.56 0.00 BREMAIRHAN NO.UNITS 1.00 10.26 0.00 10.26 0.00 BENERGY PERMIT FEE 115.56 55.47 0.00 55.47 0.00 BREMFURN NO UNIT 1.00 14.31 0.00 14.31 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 BSEISMICRE VALUATION 4, 066.00 0.50 0.00 0.50 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 311.21 0.00 311.21 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL • Community Development 10300 Torre Avenue OCIFCupertino CA 95014 Telephone(408)777-3228 �DC�TIAIO Fax(408)777-3333 rC 1 '�1 Building De artment JOB ADDRESPERMIT# OP.529 S�tvoq- i pS 0? � / 6 ? OWNER'S NAME: PHONE oZS - GENERAL CONTRACTOR: CU Q,c FAX# Q I am not using any subcontractors: �&jd(Le, 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 FURNACE/AC •UPERTINO PERMIT APPLICATION FORM 567��10 APN # 3W2 I tZ Date• -r3-as Building Addres aa� O er's Name- hone #: c 05 - 78 A a tor: Phone: ticense #: -72-31 S �ntact: Phone: Cupertino Busme s.License#: WIKC4 l$ Building Permit Info: Bldg ❑ Elect K Plumb ❑ Mech Job Description: C� Residential Commercial ❑ For Re idential Installations: tttic LJ I"floor E:12nd floor❑ Adhere to min set back requirement For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction: Occupancy group: D1i?G� Lv Strapped ❑ On Platform El Bonded ❑ Sq.Ft. Floor Area: New Location zr Replacement ❑ Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Relocation of 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 BSEISMICOM Seismic Commercial BUILIDNG EPERMTTFEE Elec Permit Issuance ELECTRICAL MPERMTTFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING