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06020018rs0 in n�Z JyU aLLt; 05 oo Y�C 0 z z N a� �z UO_ OF U F� U 4 CITY QF CUPERTINO �" �'+ �'r . ��c "M.-g,gy m - BUILDING DIVISION PERMIT CONTRACT®RJNFORMATI0N ,R LDINGAOORFss: ALLIED AIRE SERVICE INC PERMIT N0.o6(]2(](]18 1841 SAN FERNANDO AVENUE F NER'S NAME: PERMITLSSUEDATE STEVE WHITEHILL 661 SINCLAIR FRONTAGE RD 2 2006 IE: SANITARY NO, CONTROL NO. (408)934-8844 ARCHITEC (ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 LICENSED CONTRACTOR'S DECLARATION Jb Description o Cbepmr 9 (comencin 1 hcmby affirm that I am licensed ureter .,Won M m g with Semion7(XX))of Diviaion3ofdm mi and Professions Code. and mmlicense is in fullforec 75 ((++ES pp andT C�� / Liccnl' �� Lrt.R �Y 4�O _�j REPLACE 2 EXISTIN t�,1HH�{�J 60, 000 BTUS ��a® DOLL• e0nlDECL - ARCHTIECTS DECLARATION I understand my Plans Shall be used u public mcnrds —�� FEB -1I- 1006 Llcnxd Pri(easio..l OWNER -BUILDER DECLARATION I bemhy.(Sere that 1 exempt f License Law for lW exempt Wm the Cessions (Sarson ]101.5, ad 1. shot, and de ooli Cade: Any city os mumy - regmama. which re construct. improve, fie repair requires a Perme, $2500 prior mestheeller, pnoraits Issuance,raserequireslhoapplicant for men Ginse signed also for n permit t ed staterorimom thuhois licensed pursuant lothc the Contractor's lJcensclaw(Ch.pmr9 Sq. F[. Floor Area Valuation ofProvisions sion( (commencing with Sermons of Division 3 of the Business exc and Calc) or W on, Myons that be V exmpt Ihortfmm aM lho Eesti fa lbe alleged esempuan My violation of I Occupancy Type Section 7031.5 by airy applinnt for a permit subjects the applicant he a civil penalty of mot ream man live hundred dollars ($500). ❑ 1. as owner of the properly, or my employees with wag. as thou sole compansation, Required Inspections will do the work, and the structure Is not Intended of Offered for Sale (See,. 7040, Business end Prudent.. Code: The Contractor's License law don not apply m a owner of property who Wildtartimprovcs theram,adwho doesmchwork himxlforthrough his own employees. provided that such improvements art notimaded proffered forsale, if, however, me building or improvement is mid within one year of completion, the owner. Wilder will have On, Widen of proving that ho did not Wild or improve for purpose of sale.). 1, n owner of the prepare , am exclusively contracting with licensed coouaaors to construct the pmjcm (Sec. 7(104, Business; and Professions Code:) The Conuacurh Li - cc sa law docs ret apply m an owner ofpre,enywho Wilds or improves there., and, who counters for such projecs with a eonuxmr(s) licensed pursuant in the Convenors License Law. O I at exempt under Sec. . B k P C for this wason Owner Dam WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury, one or the following declaKtions: 1 have and will maintain. CeniGnte or Consent in self-mam for Wotkcrs Compcm noun, as provided her by Section 37W of dm Labor Codc, for the performance of the work for which this permit is ismed. have and will maintain Workers Compensation Immense, as required by Section 37W of the labor Code, for dm pcormmance of the work for which this permit is issued. My Workers tion Insu can. ad Policy number J /t�Wa Cartier: f'E' �i_.JQ Policy No.iiXi%S��F/ ' •rj CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Tbu section need Out W compined if the Permit is (mons hundred dollen(3100) or las) I certify that in me performance of Ne work for which this permit is issued, I shall not ecaploy any Person In my matter se u w become abject to the WorkeR Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Ceniacme of Exemption, you should become subject in the Workers Compensation provisions of me Ia mr Codc, you must Forthwith comply with such provisions Or the Permit shall W d,emW rooked. CONSTRUCTION LENDING AGENCY I hereby affirm that mere is a consomedon lading.p ne, for the perfurm ons, of the work for which this Permit is issued (Sec. 3D97, Civ C.) larder's Name L.Weh Add•.s 1 certify that 1 have t.d this application and sum that the above information is ' concck I agree u comply with ata city ad county ordinates and sol laws relating to Willing comsr4climn, and hereby authonre tepicamma ea of this city to enter upnn the shove-menlidproperly for inspection pugwxs (We) agree m save, indemnify ad keep ha rmlw lbe City of Copertino.geinsl costs ad whim may in any way eccmc against said City inconsequJudgments,the in cansequcncc of the granting of this permit. of this. APPLICANT UND STAN S��jDDDIIIs-W ILL COMPLY WITH ALL NON -POINT Issued by: Date soujc rl / .-yQ , Re -roofs Sign te of ApnlicaV�Canuaomr`/��_y Dem HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant none or handle harvdous numeral as defined by f Cupertino Munidpal Code. Chapter 9,11, ad me Health ad Safety cote.0y.1ss31(e)? )415 Yes All roofs shall be inspected prior to any roofing material being installed. Will the a licat or future building Occupant use equipment nn e q 'pmat or devices which If a roof is installed without first obtainingan inspection, I agree to remove P narardnus air conmminants u d,fine0 by the Bay Arca Air Quality Manaeemcnt , all new materials for inspection. Disuim? ❑Yes f1Mo 1 have mad me hags hmss materials requirements under Chapmr6,93 of the Califor. nia halm k Safcly Cad,, Sauces 25505.25533 and 25530.1 ad,rndM then ifft Wilding don mu currently haw a tensa, that itis my mspomibility u notify the occapsm of due ret)y n w W ppat�myss 0 aceniG.m r r. ��O6 Signature of Applicant Date All roof coverings to be Class "B" or better 0 rronol Dow CITY OF CUPERTINO 0 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # : 3 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 37515040.00 DATE ISSUED.......: 02/02/2006 RECEIPT #.........: 33060 REFERENCE ID # ...: 06020018 SITE ADDRESS .....: 21841 SAN FERNANDO AVENUE SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: STEVE WHITEHILL ADDRESS ..........: CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: ALLIED AIRE SERVICE CONTRACTOR .......: STEINER, ARNOLD R LIC # 19207 COMPANY ..........: ALLIED AIRE SERVICE INC ADDRESS ..........: 661 SINCLAIR FRONTAGE RD CITY/STATE/ZIP ...: MILPITAS, CA 95035 TELEPHONE ........: (408)934-8844 - SE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW HAL BSEISMICRE VALUATION 2,500.00 0.50 0.00 0.50 0.00 BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 EPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 PPERMITFEE 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 150.47 __________ __________ ---------- 0.00 150.47 0.00 METHOD OF PAYMENT AMOUNT _________________ NUMBER ------------ CHECK 150.47 __---_---_---___-- 17653 TOTAL RECEIPT 150.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Id CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM Oma UDI 6 APN # 3 7-S - /S — d y Q Date: Build' Address: 7� BREMFURN r / V I MECHANICAL Owner's Name: sA ve Phone #: 6 ��6 �ti,// BREMAIRHAN Contra tor: hone: License #: Contact: hone: 2536 A67145 C 8 610 ,1811 Cupertino Business License #: Building Permit Info: BSEISMICRE Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential O� Commercial ❑ BUILIDNG For Residential Installations: 01 floor ❑ ❑ Elec Permit Issuance 1s' 2"d floor Attic ,t Se/l1P dhere to min set back requirement[:]or J MPERMITFEE Commercial Installations: k MECHANICAL eplacement same weight ❑ Additional weight (structural calcs) ❑ Plumbing Permit Issue Structural Calculations required for new installation ❑ BPERMFEE New installation Planning Approval Required ❑ BUILDING Cost of Project: Type of Cons ction: Occupancy group: '�(' may_ ,icei4Ge.S BPGAS Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location ❑ Replacementx Business License Qty. if Applicable 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 BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL J 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