05090098 CITY OF CUPERTINO ➢ r !«a «) x R '� �"" .�`�`
BUILDING DIVISION PERMITGONTRA.CTnRINFURMATI,,ON
au1LDING ADDRESS: ALLIED AIRE SERVICE INC PERMRN0.05090098
7506 WA
OW NER'S NAME: PERMIT LSUE DATE
YENGUION LEE 661 SINCLAIR FRN 09/14/2005
ONE: SANITARY NO. CONTROL NO.
(408) 93478844
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BIRO ELECT PLUMB MECH
30o LICENSED CONTRACTOR'S DECLARATION JobDescri [io�i�
1 hereby afnrm that 1 am Raved uNer provistov of Chapter 9(enmmoocing P
with Section 7000)olDivision 3 of the Bu' and Professions Code.md my license is n�
In full force A.
set. S �'a�S REPLACE FURNACE
�_ Llmmc s ��Lie.
9 g Data Convenor 4� ��
RCHI7ELTS DELLA ATION
1 unacrmad my plans still be used As Public rends Da
5O1s,
gLLt; Licensed Professional
3 OWNER-BUILDER DECLARATION
' I 1 botchy afri,m that I am exempt from the Contractor's License Law far the /Jy/
i O o follnwinrequires
reass dun 7031.S,Bminea and Pmfessium Cade:My cit 9 r county `r .per 15 0
5$ which • mats ro cnnm
vm ,alar,iso rate.demolish.or it An auc,um ,J"^
prior to its issuance,also requires the applicant for such permit to rile a signed mammon,
< thathcislicevcdPunumuothepravitiovatdaCantracmr'sLvcnxLaw(Chapter9 Sq.Ft.Floor Area ``Valuation
xFF$ (commencing with Section 7000)of Division 3 of she Business and Professions Code)or
3— that he is exempt sunspot and the bub for the alleged uempllan.Any vloladan of
Schon 7031.5 by Any applicant for a pemlb subjects the applicant m a civil penalty of er U U Occupancy Type
oat more than rico hundred dollars($500).
1,As owner of the property,or my employees with wguas their=to compensation,
will do the woR and the aumctuce bo at Intended or offered for Aide(Sec.7014,Business Required Inspections
and Peninsular,Code:The Canvacmr's License Law does not apply m e ns an owner of q P
Property who builds or i mprows theuon,end who dao such work himself ear thmush his
awn employee,provided that such improvements rte rot Intended coo@res forale.It.
however,the building or Improvement Is sold within am year of completion.the name,-
hmilder MR have the burdan of proving slut he did net build or improte for purpom of
sale.).
❑1,as awrasr of the property,am exch lively contracting with licensed ronuannn in
construct the project(Sec.7014.Business and Professiam Code:)The Contacmr's Lb
cents Law does not apply m an ownu of property who builds or improves dterton.and,
who contracts for such prolene with a comrai Q licensed parswntm the Contractor's
License Law,
❑1 am exempt under Sec. ,B R P C for this reason
Owmr Dam
DECLAR
WORKER'S COMPENSATION ATION
1 hereby a nom under penally of perjury oro of da following declarations,
1 ham dna will mainuln•CeNOcaaof Coventtoelf-insumfor Wark sCommn-
sation,As prmlarA for by Section 3700 of the Labor Code,far du perfomanm of see
work for which this Permit is issued.
❑1 haw:and will maintain Worker's Compensation Ivursna, s required by Section
37W of the Labor Coda for the performam of the work tarwhich digs permit b iauca.
Carrier.
07�d9p WumlrA carrier and polity numPolicy No.: /am: n�
CERTIFICATE OFSAnONI NFROM WORKERS'
COMPENSATION INSURANCE
Obm¢ction wed not becomplemd If the pcmlt Is foromhunarea dollars(SIM)
or ha)
I certify Not In the performance of the work for which this Permit is issued.I shall not
employ any perms In my maomr an As An became subject to the warkcrs'Compensation .
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If.after making this Ceninuu of Exemption,you should
become subject in the Warker's Compensation provisions of the Lahor Code,you mum
.,O forthwith comply with such provisions or this Permit shall he dammed ranked.
z rA CONSTRUCTION LENDING AGENCY
[rIhereby af0am that them is a construction lending agency for the Performmes of
6t the wvvk for which this Permit is named(Sec.3097.Civ.C.)
WM Q Lances Name
Q z Lender's Adams
U Q I certify that I have mad N.applietion And sera the,the am.Information is
correct.I agree to comply with all city and county ordinances and slam laws rebang to
Q building conmvttion.and hereby suthorire repmssautiws of Nb city attract,upon the
W mo.-mendoned property for inspection pugams.
�"py (We)agree In an,indemnify ad keep harmless the City of Cupertino against
r.r y IiabiliUesjudgments,cetsAndexpense which may in Anyway amus agumtaid City
U 7 in consequence of the&ruling of mMR.
�-t APPLICANT UNDERSTAND WILL C PLY WITH ALL NON-POINT Issued by: Date
SO ATI S. /
Re-roofs
nuurt of A"I'm onuacmr .Due
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tiro applicant or future building o¢upant mom or handle hlardoa material
u do B, by the Cup
Municipal Code,Chapter 9.12,and the Health And Safety
de,Scctian 25532(1)7 /,y� All roofs shall be inspected prior to any roofing material being installed.
❑ C
Yes TNU
Will the applicant or rmum building occuparn use equipment a,devices which If a roof is installed without first obtaining an inspection,I agree to remove
It haam rdnair caum rmot a derimd by the Bay Are Air Quality Ma otchana all new materials for inspection.
sviaT
❑Yea
I hoe mW the hanrdmsmamrialsrequimencnts under Chapmr6.95 elite Califor-
Health k Safety Cede.Sections 25505,25533 and 25534,1 undersand thetifale Wilding
7isdox;rot currently haw a mnsne that It b my responsibility m notify the occupantM rixm ni mbcmerp' mAnmarafia r mPAn Signature of Applicant Date
7 O All roof coverings to be Class"B"or better
Ow r or amhorimd uens Dam
Community Development
CpOrt norre Avenue
eo CA 95014
Telephone(408) 777-3228
CI
Fax(408) 777-3333
�UPEI�TINO
Building Department
JOB AD RES : PERMIT#
-*Ng- 0 S"o ?coo
OWNER'S NAME: - ` PHONE # e?S aS
GENERAL CONTRACT R /r e- FAX # pt3 8 O
I am not using any subcontractors:
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
NORTHPOINT HOMEOWNERS ASSOCIATION j
PROPERTY MODIFICATION NOTICE
Please indicate below which modification(s) are planned for your property. Provide
brochure(s), if possible, and copy of any proposal(s) including the contractor's
license number. Any modification not expressly listed herein, or not conforming to
the restrictions and requirements listed herein for that modification, will require an
Architectural Review Application to be submitted to the Grounds and Architectural
Committee and the Board of Directors for approval.
Modification Restrictions and Reauirements
Air-conditioning unit Unit will be designed for quiet residential use. Unit
will be located within the enclosed yard of the
property. There will be no parts of the unit visible to
common areas. Installed by licensed contractor.
Replacement window/ . Must be same size aperture and location of existing
sliding door window or sliding door. Any necessary touch-up
painting is the responsibility of the homeowner.
Installed by licensed contractor. i
_ I Garage door Must be windowless and in conformity with general
architectural style of the complex. Repainting to
conform to exterior color scheme is responsibility of
C,1 a the homeowner. Installed by licensed contractor.
UJ
y Satellite dishlreceiver Specify type and size below and include sketch of
"X`' intended location. Installation of dish in the least
A
type:- visible location to receive signal. Cables routed inside
size: attic, crawlspace, or wall near the dish mounting
to minimize visibility. Other guidelines may apply.
Any damages caused to property as a result of modifications will be the
homeowner's responsibility. All prohibitions, restrictions, conditions, and rights of
the Association enumerated under Article V of the Amended and Restated
Covenants, Conditions and Restrictions of the Northpoint Homeowners Association
are applicable to modifications contained,herein. City permits may be required.
Reese print
Homeowner Name(s): A NI ry E t I TC H E L'---
Property Address: 2iD I a a- N C2TIr-V- TPhone: G 416 -SS`J a(�
Date of Notification:-q - 13 -0 7 Date of Completion: ASA C
Homeowner has six months to complete the designated modifications and is responsible for
notifying management upon project completion.
----------------------------------------------------------------------------------------
Official Use Only—
Notification Received by: D Date:
�o
Completion Verified & Approved by: Date:
FORM ADOPTED 8/10/1989 REVISED 8/00
J
CITY OF CUPERTINO
'm-- FURNACE/AC
CUPEkTINO PERMIT APPLICATION FORM
APN# ?6 / C 6 p Date: ?A/
d
Building Address:
.5- lZ 9Soi/
Owner's Name: Phone #:
Contrac , License #:
1-.2111 eA
Contact: Cupertino Business License#:
u
Building Permit Info:
Bldg ElElect ❑ Plumb ElMech
Job Description: /
0-e4q
Residential 12r— Commercial TD g,4
For Residential Installations:
Attic Ell" floor-' 2nd floor❑
Adhere to min set back requirement❑
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural cales) ❑
Structural Calculations required for new installation ❑
New installation Planning Annrn, al Re wired ❑
Cost of Project: Tyke of Con traction: Occupancy group:
�Yeev rR
Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area:
New Location ❑ Replacement 5r,
Qty. if
Applicable Fee ID Fee Description 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 d, Switch & Outlets ELECTRICAL
BSEISMICRE Seismic Fee Res BUILDING
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
BUSLIC Business License BUILDING