Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
06050005
,CITY QF CUPERTINO t z "'• f ` ''" BUILDING DIVISION PERMIT C�NTRACTO,RINF;O„RNIATTONN BUILDING ADDRESS: AAA FURNACE & AIR CONDITI leff9''UO06050005 22447 SANTA PAULA AV 'ER's NAME: PERMIT SUE DAMMIDDLETON, MIKE 1712 STONE AVE 05/01/2006 PHONE: SANITARY NO. CONTROL NO. (408) 293-4717 ARCHITEC(ENGINEER: BUILDING PERMIT INFO SLOG ELECT PLUMB MECN +Op LICENSED CONTRACTOR'S DECLARATION Job Description I lee eby.(firm Net 1 am IianM under provision of Clapmr Y(commencing at,Section I=,rDivision Softhe Busmen and Prafcvsion Com.md my license is toflifart,and,fec je - 7 ' REPLACE FURNACE AND WATER HEATER s�z Ucenm❑ a t.- Lk.a Q 'o _ r� Dam aCs roctor�, VC, 4 AR NITECTDECLARATION WV 1 und,rwnJ my pan shall be used as public records °p�; Licensed Professional OWNER,BUILDER DECLARATION 1'min,affirm Nat I am exempt from ft Connmmfs License Law for the O O following mason.(section NIS 1.5,Business and Profenioes Calc:Any city or county m which rtquims a Permit m contract.alcor,improve.demolish,or repair my smuclum $4540 prior at its neuanee.also requires lW applicant for such permit m Ele a signed summcnt Oat he a licensed promant to the prevision of me ContricwN Uceose Law(Chaper9 Sq.Ft. Floor Area Valuation [ O (commcncingwith Scaion7000)of Divbion3o(me Buainmmd ProfcaionsCndc)ur y that Im is exempt memfmm and Om basis for dm alleged exemption.My violation of Section 7031.5 by my applinn for a permit subjects do,applicant m a civil pcoalry of r Occupancy Type Int mon Nm five hundred dollars(5500). ❑I,as own,of dm pmpenY•ormY emPloYcn with magna their role compensation, will do the work,and the swctun u Imsmmndnd w offend tarsal,(Sec.7044,Busnev and ProfevTh ion Cade, e Conula actofs Lt. w doesset apply m an owner of Required Inspections pmpeny who builds or Tmprovn mmeon,and who docamch work himselformmugh his ..employ.,pm Tided Eameach improvements are not intended arollered forsalc If. WwdwE.Ove building or imprevemant is mid within arc year of mmpleuon,the ownm- builder will have the burden of proving that W did an,Wild or improve for purpose of salt.). ❑1,u owner of sW property,am exclusively conuacting with liamN mnuacmn an construct the preject(Sec.7064.Business and Profession Cock:)Tim Contractors LF cmtst law don mot apply m an owner of property who builds or impmvn dmnon.sed. / who contracts for such projects with a conumm,(t)licensed pursuant m de,Conuacnrs Liren r law. ❑lam exempt under See .B&PC far anis roamn Dam WORKERS COMPENSATION DECLARATION 1 hereby anon under penalty of Perjury ane of the following declantian: em.so and will marbinaCa 373 ofCe Labor Coda.for far by SECtion 3]00 of tins labor Code.far the performance of the work for which anis permit is issued. ❑I have and will maintain Workers Campermion Insurance,as required by Saction 3700of me labor Coda,for m,pm rearmceaf me work fm which this Ecrmit is issued. My Wmides Compensation Wumr a caner and Polley number am:_ Cartier. � Policy No.: — (4�1rEFk6pTION FROM W04E S• COMPENSATION INSURANCE (This section reed nwbceampl,md if me permit Is(mans hundreddollan(5100) a or less) 1 cenify that in Oc performance of the work for which anis Permit is issued.I shall not employ any person in my mamner an ss m ba<ame subject to the Woftn''Compensation Lama of Califomia.Dan Applicant NOTICE TO APPLICANT.TL Erle,making oris CeniEcam of Exemption,you should became subject b she Wahcr's Compcnation provision of to,labor Cod%you most .,O foMwith comply with such Provision or mu Permit mall oc domed revoked. Z”" CONSTRUCTION LENDING AGENCY (—ice (hereby affirm On then u acmuvuctinn leading spacy far the perfurmanaaf a ti Ne work for which this permit In issued(SEC.309].Civ.C.) ' lender's Name U z Unde/s Add. U O 1 certify sen 1 have nod this application and sum this do shove inforramun is ty F Correa I agree to comply with all city and county ordinances and mate laws relating to 0U building consuuction.and hereby authorise represenuivss of this city to enter upon me aIWw-menuuned property for impaction purposes. (We)ague to ars,indemnify and keep humiea me City of Caperton against Uabili0es,judgmcnu,costs ad..N.which may in any way accrue against said City U z in eonseguene,of the granting of this Permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Ste/-ljs 50 "uRCE REGULATIONS. �,""-' %�a S zS/�( Re-roofs Sig�iun a(Applica / D HAZA HAZARDODO M US MATERIALS DISCLOSURE Type of Roof Will the applicant of furore W al Co occupant r 9.1 or handle h eaAon manna) u de0ned by the Cupertino Municipal Code.Chapter 9.13.and the Health and Same Sceldon 25532(a)7 ❑Yrs MN.� All roofs shall be inspected prior to any roofing material being installed. Will the applkant or to,..building occupant use equipment w dermas which If a roof is installed without first obtaining an inspection,I agree to remove emit hataroOn air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. DimicI7 ❑Yu / ]No I have mad the lurardtm osawriahrequindsom a underCWpmr 6.95 ofdm Cxiifor. nia Health&Safety Ca ,Scetion25505.25533a 25536.lundcnunddwifthc Wilding dans on,Cuncmty hors a arrant,mat it u my msponihility m Modify de occupant Of OC nqu ' menu hichmtwb,m�e�lp��,r mcked.cfa CauficamoroccupaaRY. Signature of Applicant Date �" dwfi¢r or mthoriacd agcn g r f y All roof coverings to be Class "B"or better ag / Oam' e Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 4kUPEPTINO Building D'e artment JOB ADDRESS: A I PERMIT # 00D -5,0 ,50-r OWNER'S AME: PHONE # -,zogP-Oil GENERAL CONTRACTOR: U C FAX # 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 XAto"O -A,-4 L TNG 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 inn 1 of 2 PERMIT RECEIPT OPERATOR: bethe COPY # 2 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 35704054 .00 DATE ISSUED. . . . . . . : 05/01/2006 RECEIPT #. . . . . . . . . : 34200 REFERENCE ID # . . . : 06050005 SITE ADDRESS . . . . . : 22447 SANTA PAULA AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MIDDLETON, MIKE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2715 RECEIVED FROM . . . . : BARBARA MANGAN CONTRACTOR . . . . . . . : RANDO, JIM LIC # 8050 COMPANY . . . . . . . . . . : AAA FURNACE E AIR CONDITIONING ADDRESS 1712 STONE AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408) 293-4717 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL BPWHEATER PER HEATER 1.00 10.79 0.00 10.79 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 BSEISMICRE VALUATION 4, 540.00 0.50 0.00 0.50 0.00 PPERMITFEE FLAT RATE 1.00 38 .37 0.00 38.37 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 175.57 0.00 175.57 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • CITY OF CUPERTINO FURNACE/AC OCUP kTINO PERMIT APPLICATION FORM ObD5�b05 APN # Date: 357-04-054 D -491 Building Address: as s< Owner's Name: Phone#: Contractor: Phone: License #: AMC — Dd Contact: Phone: Cupertino Business License#: (5744 c atv O rD.tv Building Permit Info: Bldg ❑ Elect E Plumb Mech Job Description: v L ✓ Resi enti 1 (' Commercial ❑ For Residential Installations: Attic © I` floor 12' 2nd floor❑ adhere to min set back requirement F]or Commercial Installations: Replacement same weight E] Additional weight (structural calcs) ElStructural Calculations required for new installation ElNew installation Planning Approval Required ❑ Cost of Project: _ Type of Construction: Occupanc?oup: J � 3 Strapped I] On Platform' E) Bonded 0 Sq.Ft. Floor Area: 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 ALC 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 BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING