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06020026u00C zk i 4 «G �CC –zi te�c 0 � z CITY OF CUPERTINO ' �* '•d. ,�:: K0y, Mist BUILDING DIVISION PERMIT ,kw...:xt +U'4. i; ..i:sa�[..._.:, PgK M: iZ•C�.``ttix $I_r–•AuAa26�is«' BUILDING ADDRESS: PERMIT NO. 06020026 1588 PRIMROSE WY OWNER'S NAME: PERMIT ISSUE DATE ENG EDWARD AND MAY G TRUSTME 02 03 2006 E; SANITARY N0, CONTROL NO. ARCHITECTYENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CON RACIOWS DECLARATION Chapter 9 lob Description P I herchy affirm Nat 1 am licensed under provisions of (commencing with Saaon]IXIU)ofDivisionJof time Bu9ncuand PWfrssions Cod +p my liceise is in full forte and InG /d Lkenu Class Lk.« REPLACE FURNACE AND,ADD A « ♦ r Do,— _ Cun (i•"� DEGLAR CHITF.CI'S DECLARATI� N t� 1 unders my Tans shall W used as public records APR -/f 2006 Licensed Professional OWNER-BUILDERof DECLARATION mpt from the Contractor's License Law for Nc I hcrehy, .(firm that I ore exempt following meson. ](131.5. Business and Code: city as county n, ,emus which Permit t cnmwcL almc W or repair any structure mu a permit po 0 re h Permit t its rat such requites tW applicant for Contrarmiuofile aicense ned Law (Chapter prior to tensed Ne Contsines iLicence law(ChepmrY hatslicensed Sq. FL Floor Area U 1 p,alsu that purstion700) of Divionsof (commencing with Section7000)add of Division J of the dProfusions Co to (cut he am Net he u eumpt thcm(rom and the baso for Ne alleged csemption. Any violation of r Occupancy Type S. doo 7031.5 bym, far a .it Nblccls Nb C applicant a ch,il IF ..Ity of h ndmdldaS that fiby (g5(Ia ❑ 1, m Owner of the property, Or my employees with wages as their sole compensation, Required Inspections will Or the work, end the structure is not intended or offered foraale(Sce. ](As. Rostrum and Pmfessimn Code: The CanvecmYs Lt. law does not apply to an owner of property who build Or impmwes Nercon.and who docasahworkhimselfor Waugh his ownemployms, provided Our such improvements are and intended oroffered foraele. If, Wwewr. the building or improvement is sold within one year of compleuan. the owner. W ildcr will lune the Wrdcn of proving that he did not Wild or improve for purpose of sale.). ❑ 1. as owner of the property, am exclusively convecting with licensed contractors to construct the project (Sec. 7W. Business and Professions Cade:) The Contractor's Li cause law docs not apply to an owner of properwho Wilds or improves themon, and, who contracts for such pmjeets with a conlucmr(s) licensed pursuant to the Contr ctoYs License law. ❑ I am exempt under Sec ,B&P C for this mason Owner Data WORKEWS COMPENSATION DECORATION 1 hereby af0mm under penally of perjury oa of the following declarations: 1 ham and will maintain a Certificate of Conum 1.self-insum nor Workers Compcn- satian, as provided for by Section 3700 of the Labor Code. for the performance of Ne work for which this permit is traded. ❑ 1 have and will maintain Workeea Competseuon Iwrana, as acquired by Section 3700 of Oc Labor Code. for the performance of the work for which this permit is Load. My War ore naatianlnsurana�rtiera nlm� eyolicy Ca er' G I `7 �'L� CERTIFIC 1E OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This acmism need not W completed if Ne Cavett is forone hundred dollars ($law) ar leas) 1 certify that in the perfomuax of the work for which this permit's issued. I Nall not employ any moron in my manner so as to become subject to the Workeri Compensation Laws of California. Data Applkam NOTICE TO APPLICANT: IL after making this Certificate of Exemption. you should become subject to the Worker's Compensation provisions of Yue labor Code, you must faMwith comply with such provisimu or this permit shall W dcemcd mroked. CONSTRUCTION LENDING AGENCY I hemby aRmm that them is a Convection lending agency for the performance of Oc work for which this permit is issued (See. 3097, Civ. C.) Landers Name Under's Address I candy Nat I have read this application and sum that the above infomotum is emseeL I agree to comply with all city and county ordinances and state laws relating Or building convection, and hereby au horim mpresenutises of this city to enter upon the aWvcmemionW property ret inspection purposes (We) agree to save, indemnify and keep harprIM the City of Cupertino against gments.costs antic which may in any wayamuc againstsaid City in in comequ of Ne Brandyy this permit. APPLIC DER$TApt S ANjj���sWILL COMPLY WI ALL NON -POINT Issued by: Date SOURC d 0 . / \ �Z / Re -roofs v \ 07 Smgnatumof Applmcanmncmt /// --7- Dom— HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant more of handle hanNoas material as dcflned by the Cupertino Municipal Code. Chapter 9.11, and the Health and Safety Cnde. Orion 15531(x)? Ye All roofs shall be inspected prior to any roofing material being installed. Will Ne applicant o furore building acupam esu equipment or dentins which If a roof is installed without first obtainingan inspection, I agree to remove P g n hmaMnus air contaminants u defined by the Bay Area Air Quality Management all new materials for inspection. Istria? ❑ Yu u I haw read! soumrudsrcquimnumsundcr Cbapter6.95ofNcCalifor- tions lSNIS,2557JanJ 255Jd.lunderstsnd thuifNc Wiking tenant Nat' my responsibility m omify the accumm, of Nc �:'�.U&dfgycH ustWmet issuanaaraCcrufmcata.' p Signature of Applicant Date Owner or adthorir Data All roof coverings to be Class "B" or better CITY OF CUPERTINO 0 2 of 2 PERMIT RECEIPT .OPERATOR: bethe COPY # : 2 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36615010.00 DATE ISSUED.......: 02/03/2006 RECEIPT #.........: 33079 REFERENCE ID # ...: 06020026 SITE ADDRESS .....: 1588 PRIMROSE WY SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: ENG EDWARD AND MAY G TRUSTEE ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5230 RECEIVED FROM ....: ATLAS TRILLO CONTRACTOR .......: LIC # COMPANY ..........: ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: 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 BREMRECEPT NO. OUTLETS 1.00 1.20 0.00 1.20 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 BSEISMICRE VALUATION 6,000.00 0.60 0.00 0.60 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 176.34 0.00 176.34 0.00 METHOD OF PAYMENT AMOUNT _________________ NUMBER ------------ CHECK 341.12 ___--_____________ 7281 TOTAL RECEIPT 341.12 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL &CIN OF UPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM APN # BENERGY DaterG Building Address: i;` C o JfL� P� rm w BREMFURN Furnace MECHANICAL Owner's Name: / A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN �(L� �S — U �. Contractor: ^ - , S uvG^ e Phonicen�ep./T� 7 BREMRECEPT Contact: Phon / /1 lJ ELECTRICAL Cupertino Business License #: Building Permit Info: Seismic Fee Res Bldg ❑ Elect Plumb ❑ Mech Job Description ISI V�lQ�Ad Cl l y '\/' Q W I C LLYL Residential Commercial ❑ For. Residential I tallations: Attic El sc floor 2"d floor E]N.Adhere Elec Permit Issuance to min set back re uiremen or Commercial Installations: Mech Permit Issuance Replacement same weight ❑ Additional weight (structural calcs) ❑ PPERMITFEE Structural Calculations required for new installation ❑ PLUMBING New installation Planning Approval Required ❑ Bldg Permit Fees Cost of Project:/ D U Type of Construction: Occupancy group: Strapped ❑ On Platform El Bonded ❑ Sq.Ft. Floor Area: New Location '© Replacement 2 Qty. if Applicable Fee ID Fee Descrintion Fvr Rrnnn BENERGY —t—n—ergy 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 j BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG 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 BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING