The URL can be used to link to this page

06040163 CITY OF CUPERTINO BUILDING DIVISION PERMIT ,X,ONTRACTORINFORMATION BUILMNG ADDRESS: VALLEY HEATING & COOLING PERMIT"°06040163 7928 WOODLARK WY FENAME: PERMrf ISSUE DATE R'S LIM 1171 N 4 TH ST 04/26/2006 PHONE: SANITARY NO. CONTROL NO. (408) 294-6290 ARCHISECfYENGTNEER: BUILDING PERMITINFO BLDG E E (�LECT PLUMB MECH 0 0 ?op LICENSED CONTRACTOR'S DECLARATION Ib Description m+F 1 hereby affirm NOaSCrLp at 1 am licensed under provisions of Chapter 9(commencing lzu, with Section]OM)of Division 3 of the Butlixcs and Profession Code,and my licensee +�„ in full farm and effea REPLACEMENT OF FURNACE AND ADD AC License Class Lic.I y Date Contractor AAA ARCHITECTS DECLARATION IN�® S W 1 uadcrsand my pima shall E used u Public recordsL e FED o t; Licensed Professional OWNER-BUILDER DECLARATION <� 1 hereby alum that 1 am ecmpt from the Contractor's License Law for the 111110729 p lt� a g0a.,a p O following reason.(Section T(n 1.5.Business and Professions Cade:My city or county /1'9 IVf`7 L IY'4afal <m which requires a Permit us mummer.a@r.improve,demolLah,or.pair any mucture 8 CJ 0 0 prior to its issuance,also requites dan applicant for such Permit to file a signed statement Nat he is licensed pursuant o the provision of the,Contractor's Limine Law lChaptor 9 Sq.Ft.Floor Area ep6i��s j (cammenciagwith S,csion7O00)of Divbion3o(lhe Businessand Profession Cad,)w Nat he is exempt therefrom and the bee fm do alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects an,applicant to a civil penally of not mor,Nan five hundred dollars(5500). _ CCl1paRC ❑I,eowwrof the prope+sY•wmY emploYca with wagesa the'v sole eompeaadon, wad do thewons ante:he ctweiecates unause La does net apply Required Inspections Nd property professions ldsorcodemprowas Canaaeb/a and who res doe mala apply lf as owner Of q p ownenYwbo Wiprovi im that tsuhmmprove who m notihwohhoofrfar Waugh he ownemploy.,providedthinsuchimps mid wiitartns year dmmanead fm silo t. t. howls,the building or i sm of provin is halt within arc year electroplated.ovfor the ownmf build.will have the burden of proving that K did mat Wild m improve for purpose of salt.). ❑I,as owner of the PropenY•am exclusively contracting with licensed contractors an construct the project(Sec.7014.Business and Profession Cade)Tlse Comsactor's U. . mom Law does not appy to an owscr of property who builds or improves theoean.and. who cones for such projects with a contractor(s)licensed pursuer to the Comnctnr's Leese Law. ❑1 am eacteptunder See ,B&P C for Nis on Oats WORKERS COMPENSATION DECLARATION J 1 herby a i m uadcr pee ay of perjurymm of de following dr tem : o ///�� V v, ❑ds.at and will far ettles 37M ofGnee tosel6iaum(e Worker'sCompen- worltf r Provided fPe mi Section 3)00 of de labor Cade.for the perfomuna of du work for which this permit is issued. f ❑1 have and will maintain Workc's Compensation Inurana,a required by Section 37M of the Labor Cade,for the performance of the work for which the peratu is issued My Worker's Compensation Insurance artier and Policy,number me: Cartier. Polity No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE mus comm need no laccmnple cd if 0e permit bforenc hun raddollars(Sim) r nr less.) 1 antify Net in the performance of the were:for which this permit is issued,l shall trot employ any person in any racecourse as to become subject to the Workers'Compensation Laws of California.Data Applicant NOTICE TO APPLICANT:If,after making this Certificate of Ema pilon.you should become subject us the Worker's Compensation provision of the labor Cod,you mum .J O roMwith comply withsuch protrude.or Ne Permit Nall I e domed revaked. 'z Vy CONSTRUCTION LENDING AGENCY (—s Ibe.by afRnn that Nem is a coruusedon leading agency for the suforanarm of i5$^ the work for which this permit is issued(Sec.3097,Civ.C.) aLender's Namc =z Leedets Add. U O 1 ecnrty dul 1 have mad Nis."Imadon sad sato Na the above in(..d o.in U. Fcorset.1 agree to comply with all city and county on inanas and sate 1..]sting to O U building construction.and hereby authoris¢preacnmives of this city to enter upon the AboveMentioned judgments. iuncd pmperst forand which may (~ W (We)acme to ave,indemnify and keep harmless the City of Cupertino against Z inconea utuacofthemssand cxpcaemitch mayN any way acaa againtsait City U z m APPLICANT of Negranting SNisD WILL APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. (a Re-roofs HAZARDOUS Stgnmurt of O Data AppliaHAZARDOUS MATERIAL$DISCLOSURE Type of Roof Will than applicant,aruniWilding orhandle laceardoesmaurial a defNm by ad Cupertino Municipal Code.Chapter 9.12,and thHealth and safety .Section 255324)7 ❑Yu ONa All roofs shall be inspected prior to any roofing material being installed. Will she Applicant in=Wilding occupant as If a roof is installed without first obtainingan inspection,I agree to remove PP 8 P Area Air Qu m UMana which pe mar ice? us air contaminants u defined by N,Bay Arta Air Quality Management all new materials for inspection. District? DYa ON. I have mad the hmaodead matostae mgNremmn under Chapter 6.95 afthe Calif.,. .is Health&Safcty Code.Scm.25303.25533 and 25534.1 undcrmand not if the Wilding docs act currently have a unam,Wt it b my msponsibilitY be ratify the occupant of the mquiremens which most be met prior In issuance of a Cemricate of Ocapanry. Signature of Applicant Date Owner or authan,cd agent Dato I All roof coverings to be Class"B"or better ITY OF CUPERTINO CONTRACTOR INFORMATION, BUIL6INC DIVISION PERMIT r ' M. .».,,rY3!£.,h:.T, '„2ix". . ,$. BUILDING ADDRESS: VALLEY HEATING & COOLING PERMIT NG06040163 79d 8 kx,oam ER'S NAME: PERMIT ISSUE DATE HEESON LIM 1171 N 4 TH ST 04/26/2006 HONE: SANITARY NO. CONTROL NO. (408) 294-6290 AR CHTTER/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 ;Op LICENSED CONTRACTOR'S DECLARATION - Job DOSCrIpt100 x 1 hereby affirm that 1 am licensed under provisions of Chapter 9(Comm...I., tial with Section 700C)of Division 3 of to Business and Profccsions Code,and my license is t<6 Mfullfmm WelfaL -�� REPLACEMENT F FURNACE AND ADD AC >vyz LiR.x aur Ln.a Dean Conuacmr ARC I�fiECl'S DECLARATION / 1 1 understand my plans shall he used as public mcoms aau �(n Licensed Professional ] 3 OWNER-BUILDER DECLARATION 2<I 1 berehy air,.that I am exemptm from the CornconrNe s License Law for e O following mason.(Section 1051.5.Business and Pmkssinu Code:Any city or county $8500 e m ff which mquires a Permit w cant.alter.improv.dcmmish,or repair any wrumuro °—ot prior to its issuance.elan requires the applicant for such Rmit to Ole a signed ssement -�< Its,Ito is licensed moseant to the provisions of the Contractors U,..Law(Chapter Sq.Ft. Floor Area Valuation [H e (commencing with Section 7000)of Division 3 of tit.Business and Professions Code)or `C Nal he is exempt therefrom and the buss for Ne alleged esemp ton.Any violation of Section 70314 by any applicant for a perturbs subjects the applicantto a civil penalty of eru U Occupancy Type not mom than ER hundred dollars($500). Luue worL and propmy,amyemploye with wagesuale((See eampewness will Pr due wadL and Ne9 ctm is not U cd or offered Taal.(Sec.n.Business and Professions cads The Con0x0rs U.law doer mel apply m an.sumo of Required Inspections own em wed builds viimprat web mpr and who aesuc tend,himselforth rsade bis awn employe,provided that such improvements are not intended aroRemd forsme.lf. however.Ne Wilding or improvement u hall within oR year of improve for led owe of builder will have tk WNen of proving Nu W did ret Wild w improve far purpose of wk.). 0 1,as owner.1 the Property,am com1wively tom octu,with licensed comnctors to couuuct de pmjem(Sec.7004,Busitmss and Prafeasions Code:)The Cmmcmrs U. cemx law done,not aPP1Y to m owner of property,who Wilds or imRvw Nemon,and, who contracts for such projects with a eonoramor(s)licensed pursuant w the Conuacmts Licenm Law. 0 1 am exempt under Sec. B A P C for this moon Date WORKER'S COMPENSATION DECLARATION I hereby affloo under pera ty of perjury nR of the following declamations: 0Ihave and will main tainetion3nx of ConsenttoCarlo.for Own WortehCompen- wod(f which fPe mi Salon 3'100 of Ne Labor Code.far six Rrfomance of the work car whim thio Permit is issRa. 0 1 haw and will maintain Workers Compensation Insurance,an m4uimd by Section 3700.(0.LwOl Code.for the pcnormance Club,wok for which this pcnmit is issued ' My Worker Cmdpemadm Inand.artier and Polity numb¢are: Carrier, Policy No.: Z0`7 C6 O RTIFICATE OF EXEMMON FROM WORKERS' COMPENSATION INSURANCE (Thu seam deed nmbe completed ifthe permit isfrroe,humied dollars($100) r loss.) I cewry Nm in the performance of the work fon which this R.I,is issued.I"I not employ any person in any manner.an to become subject to the Wohcrs'Comp.maum Laws of California.Dox Applicant NOTICE TO APPLICANT:If,after making this Cenifiae of Exmpdon,you should baome subject m six Workers C.mRosauon provisions of the L en Code,you muss .J O forthwith comply with such Provisions of this permit shall W domed revoked. Z� CONSTRUCTION LENDING AGENCY [--: 1 hereby affirm Wt there is.Conwuction landing agency for the arfOrmaroc t f CLv one work for which Nis Permit is hound(Sec.3097,Civ.C) 0 Lenders Name , Z)z Landers Address U Q 1 certify Nat 1 have read this application and soon d u the aWv.information is U. F Comm 1 agree ut comply with all city Nd county.Norworns and won laws Rladnp M 0U Wilding construction.and hereby moonrise xprexmuiwC of this city to enter upon the r PWi ,lout-memiumd property nor inspecu m p ti oses (We)ague to sam.indemnify and kap barred.the City or CupeNm against fn liabilities,Judgments,costs and expenses which may in any way accoue Maim,said City U z in e5mlzosd is RmtiL AP - L COMPLY WITH ALL NON-POINT Issued by: Date _ J a Re-roofs of Applic onuactor Data HA L ZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant afore or handle haramdous row rial Lu OCR" by-Cu o CuRnim Municipal Coac.CW'sn 9.13.and the Health and We,y .satin.15532(.)7 �,✓ All roofs shall be inspected prior to any roofing material being installed. 0Ym Ill° If a roof is installed without first obtaining an inspection,I GOP Will the applicant or fuwro building occupant sex cyvipmem err devices which g agree to remove P emit haraNnm air cmuminanu u doll d by the Bay Area Air Quality Management all new materials for inspection. Diwict7 � 0Yes ayx. Iluvcrosltheh andms max'alsmquiremens un delchapmr6.95ofthe Caliror- , nice Hwhba.Safcty Cad.,Sac 505.22333' dZSS3a.l understand thatiflW Wilding demnot curt d h rd t Na,t is my mspomibiliry x notify six Occupant of the mqulremen w , m ' q ,.iss.an..nfacmilkoommampancy. ignatureofApplicant Date o suth edMem ,xI All roof coverings to be Class"B"or better CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36202046 . 00 DATE ISSUED. . . . . . . : 04/26/2006 RECEIPT # • • • • . . . . . : 34153 REFERENCE ID # . . . : 06040163 SITE ADDRESS . . . . . . R SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HEESON LIM ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95074-4933 RECEIVED FROM . . . . : VALLEY HEATING CONTRACTOR . . . . . . . : ATKINSON, THOMAS LIC # 141 COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING ADDRESS 1171 N 4 TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 294-6290 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 8, 500 . 00 0 . 90 0 . 00 0 . 90 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 . 64 0 . 00 176 . 64 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ----------- ------- CHECK 176 . 64 14577 TOTAL RECEIPT 176 . 64 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ________ ---------- 304 ROUGH ELECTRICAL 501 FINAL ELECTRICAL ENERGY 505 FINAL ELECTRICAL Community Development �} ?1 10300 Torre Avenue - Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 OJPERTINO Building De artment JOB AD KESS: PERMIT # 'E r 060 Ya /5 3 OWNER'S NAME: Sayj PHONE # CrG -- GENERAL CONTRACTOR: FAX # I am not using any subcontractors: a Si a Date Please check applicable subcontractors and complete the followinginformation: 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 Irwn erZJgKntractor Signature Date OCCIAo I v3 M (� CITY OF CUPERTINO (moi FURNACE/AC cnvol CUPEKTINO PERMIT APPLICATION FORM AIN# Date: 3 W/.� f. Building Address: �S ZOt�6 1:7) wocxllc:rlL wca Owner's Name: �� r tPhone#: �b Contractor: . � Cz S �• �,fGL11 11 eratt Lo��t License#�S�6SL(C� Contact: Cupertino Business License#: ' 1V lGo 1� j'Yi art Building Permit Info: Bid ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential Commercial ❑. For Residential Installations: Attic ❑ ]a floor ❑ 2nd floor❑ Adhere to min set back requirement . For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs)❑ Structural Calculations required for new installation ❑ - New installation Plannin Approval Required sta Soot:— Type o(C ruction: Occu ancy P' Strapped On Platform Bonded Sq.Ft.Floor Area: New Location Re Replacement ' Qty.if Applicable Fee ID Fee Description. P Fee Group BENERGY Energy BUILDING BREMFURN Relocation of Fumace MECHANICAL BRE COVER 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 EPERMITFEE Flee Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbin Permit Issue PLUMBING BPERMFEE Bid Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING