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05080065BUILDING DIVISION PERMIT BUILDING ADDRESS: A PERFECT CLIMATE PBRM" N0.05080065 10901 WTT.VTM9QN AV NER'S NAME: PERMIT ISSUE DATE OW MARIE GATTO 10570 lop NE: SANITARY NO. CI 408) 861-9545 ARCHITEC (ENGINEER: BUILDING PERK BLDG ELECT 300 LICENSED CONTRACTOR'S JobDescri tion rd d I thereby affirm that I un Ikeaud under penvisioM of Chapter 9 (commencing p 4 with Section 700f) of Division 3 of the Business std Professions Code. and my license is InfuBln ecnd 3 571 INSTALL A/C 211 eine 1 Ix. Dau Contractor ARCH "In use D DELLA TIO a i undersunJ my plain shalho used As public reenNs g s Lkenu1 herebyProfeslapel GW NER-BUILDER DECLARATION r�• ZOOhereby affirm Net 1 1. exempt from he essinnofs License Law for the �1 D o following moron. emit i 7031.5, Business and Rof.asluu Cade: Any oily or county 5 S which Acquires • Permit Ac consuthe slur, improve, h Permit in ri mash try micmcsumnamt % '] pdm 70 its issuance, pursuant also W the the Applicant for smh permfuo cense Lac (Chaps cm �< Net mis enti gwit S 70 0) of Dislom of theta Business essand License o,c)m Sq. Ft. Floor Area aluation S (Com a is remwiN Section 70nd basis f r th the aged exe pt on. An laM Cd,on of — that o r .tempt thcmlrom and or aper it them alleged currant to Any violation of tJ Section hah five airy applicant far a permit ubjem the applicant to a Neil peahy, of OC arty T not mort then five hundrtd dolrrs (t300). and Profession Code: The Communes License Law does not apply 0 an owner pmpmy who builds orimprov thereon, and whoduessuch work ldnuadfor Waugh builder will have she burden of proving Wt he did rot build ar Improve for purpose of sale.). ❑ 1, As owner of the propert,& am exclusively connecting with licensed carmwrs m contract the project (Sec. 7044. Business and Profesdam Cade) The Conlrcwr's U. ceue law tlau not appy to in owner of property who builds or improv thereon, end who cc mincis for such projects with A conuaccm(al licensed pursuant 70 the Conmetoei License law. ❑ I am exempt under Sec. ,B k PC for this mason Owner Data WORKERS COMPENSATION DECLARATION 1 hereby Alarm under penalty of perjury Are Aides following Ceelant70tes 1 have and will mainuln a Canifiateof Consent to ulf-Imum for Warkse.Canpcn. salon, As provided for by Section 3700 of me labor Cade, for the performance of use Antis for which this permit is issued. _ Co have and will malnuln Worker's Compensation Insurance. As tequimd by Section end Policy number art: __.., 1414114 U $ 2 - film; section need notho completed IfiW Peron is forme hundred dollars I$ lop) nr leas.) 1 unify, that in the performance of the work for which Nts Permit is issued, l Nall am employ any person In any manners u to become subject to tato Workeri Compmsm on Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Ccnificam of Exemption, you should become Subject to the Worker'. Compensation provisions of th) labor Cade, you muss ,J O forthwith comply with such provWnM or this permit shall ho dmmed re d. z CONSTRUCTION LENDING AGENCY (r4 1 hemhy AM. that them Is a construction lending agency far the performance of ai > the work for which this permit is issued (Sm. 3097, Co. C.) 0.Q lendch Name z Lendels Addrepe U O 1 certify that 1 lave read this application and sum Lau the above Information is Dr E corms I sarin he comply with ell City SAW County ordinances and state laws palming be 0 SV' building convection, and hereby ambodre representatives of this city in enter upon tM W &hove -mentioned Property for inspection purposes pyo (We) agree m save, indemnify and keep harmless the City of Cupertino agalnm i..i (n liabilities,Judgments, emu and expenses which may In any way ccrm against said City U 2� in consequence of the grunthl; of this permit APP IC/CIQANT UNDERSTSA�NDS AND WILL COMPLY WITH ALL NON -POINT SO Q RQi�,ONA-��.y_Lu� Signature of ApplicanUContnctor Dow NA2ARDOUS MATERIA ISCLOSURE Will dm applicant or (rune building occup&ntstorc or handle hasandoa material cau deflned by th) %)oIm Municipal Cade. Chapter 9.13, and the Health and Safety t. Section 25x32(01 ❑Yea u Will the applicut or f win burin occupant use equipment m device which It h.uNew .Ir contsml nu domed by the Bay Area Air Quality Management DlaufeR ❑Yea No 1 have read thehassedna materials requirements undcrChipur6.95 orlhe Califor. nia Hcaithik Safcty Coda, Sectors 25505.25333 and 21534. I understood thmifthc building date not curcmly have a tenant, last It is my mspomlbility to tify the occupant of lac requmcnu which most ho met p�immrauat�A ofa Ceninu of Occaponey. Required Inspections Issued by: Re -roofs Type of Roof Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. , .pplican t YDate All roof coverings to be Class "B" or better a Community Development 10300 Torn Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department OB ADDR SS: (r --f PERMIT # Q, I ) g o �o0 6S" OWNER'S NAME: PHONE # - . Z. GENERAL CONTRACTOR:' Cj Ci FAX # Ik I am not using any subcontractors: �Aaq Signature Date Please check applicable subcontractors and complete the following information Owner/Contractor Signature Date 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 L-A t ITY of CUPERTINO -CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM 6 pv IV --0 KSS APN # D te: Building Address: D c 03 w� i Kivc,SzD-, �/✓P C� �6a Owner's Name: �i�� P ne #: c. _rasa tor: - License #: . .tra t✓ MECHANICAL Contact: Cupertino Business License #: Building Permit Info: BSEISMICRE Bldg ❑ Elect Plumb ❑ Mech ❑ Job Description: Elec Permit Issuance ELECTRICAL MPERMITFEE Residential Xr Commercial ❑ MECHANICAL For Residential Ins llations: Plumbing Permit Issue Attic ❑ ls` floor 2nd floor ❑ BPERMFEE Adhere to min set back requirement[] BUILDING For Commercial Installations: Plan Check Fee Replacement same weight ❑ Additional weight (structural calcs) ❑ BUSLIC Structural Calculations required for new installation , ❑ BUILDING New installation Planning Approval Required ❑ Cost of Project: Type of Construction: Occupancy group: Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location / Replacement El Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/C Unit > 10,000 c&n MECHANICAL BREMAIItHAN A/C Units <= 10, 000 cfrn MECHANICAL BREMRECEPT Rec tl, 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 �q> / "/' _—)