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06080107 (2) CITY OF CUPERTINO /•r��s �7 u pa r P �'j "` (� `BUILDING DIVISION PERMIT BUILDING ADDRESS: A PERFECT CLIMATE PERMIT NO.06080107 1042 OWNER'S NAME: PERMIT ISSUE DATE VINCENT WONG 10570 S D NE: SANITARY N0. 1 19CONTROL NO. (408) 86119545 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG EO PLO MEOCH o p LICENSED CONTRACTOR'S DECLARATION Ib Description �s 1 hereby affirm that I am Oen licensed under provinces of Chapter 9(commencing P with Secuan 701N)of Division 3 of the Business and Pmfessusm Code,and my license is ; y in fullformandeffect. -j. (3Z3[S x ADD A/C TO "HOME Z License CIEl 0 Dam x Lk.g i +31 t- Contrumr P C [+C (•. red o qqqqARCHITECTS DECLARATION i e "i I transmutedmy plans shall he used as public records ' 8t; Licensed Professional •ph� OWNER-BUILDER DECLARATION 1 1 hereby alum Not I am exempt form the Commuters License Law for Ilrc- _ O C following reman.(Section 7031.5.Business and Prefeuinx Cade:My city or county 5$ which requires a permit to coesuus,alcor,improve,demolish,or repair any ebuduno •Zm prior to its issuance,also requires the applicant(orauch permit to file a signed comment that he is licensed random to the provision of Me Contractor'Liana Law(Chapter 9 Sq.Ft.Floor Area Valuation SSB (commencing with Section 7000)of Division 3 of Ne Business and ProlminnsC#1 or dot he b exempt therefrom and Ne bob fat the allcgcd exemption.Any violation of Section 7031.5 by any applicant for a permit easiness the applicant m a civil penalty of r u u Occupancy Type not marc than five hundred dollars($500). ❑I,as owner of the property,or my employes with wages as their sold eampettotion, will do the.,it,end to swcuue is net intended or offered forsale(Sm.70x4,Businw Required Inspections and Profeoloa Code:The Conuactnrs Liana Law data not apply m nce an owr of 9 P property who build,or improves thereon,and who does such work himself er through his hMan owever, ens,provided or i Nm ndunt irovem within arc not you moRered far ala o- builder Ne Buildingorimpaprovinualt edidnmmyearorImproefartlmowoer- builder will have the burden of proving Net he did not build a improv fa purpose of sold.). ❑1,a owner of ct property..B sness and contracting with licensedeCcenaxwsa U.construct dproject(See.7044,Besiwsand Proftao Wilda Cade:)The=themrand (� cele law dos not apply je an owns of property ecuu(s who sed p err improve Unman.and, o wed convects for such projects with a rnnvxmrta)IkenxO pursuant m the Contractors Lkeae Law. [I 14M exempt undo See .BkPC you itis mown / Owner Dole Oj WORKER'S COMPENSATION DECLARATION �O 1 hereby affirm under penalty of perjury now of the folldwin;decbmtioo: .I ham and will mainuin a Certificate of Consent to self-Wum for Workee,Comped- action,a provided for by Section 3700 of the labor Code,for the performance of Ne work for which this permit is issucd. - ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 37W of the labor Code,far Ne performance of the wmk for which this permit is issued. My Wore rear, C�ompesaupin Iaua m esrier and Polity number art: Carrier. /'M I 4:"I e Polity No.:1 frU 9,54 0 Vt3 7- O 7 0 SU C CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This account need not becompieted If to permit is farone hundred dollen(SIM) or Inns) 1 cen0y that In the performance of to wad for which this permit is issued,l shall not , employ any person in any manncrso as m become subject to the Workers'Compensation Iowa of California.Dam Applicant NOTICE TO APPLICANT,IL afar making this CeNficate of Exemption,you should become subject to the Woder's Compensation provisions of the labra Code,you most z faMwith comply with such providona of N0 pmeth,holl W darned rewked. z ti CONSTRUCr10N LENDING AGENCY f'+ I hereby alrrne that there is a construction leading agency l'or the Performance of Cli > fin work for which this permit b issued(Sec.3W7,Civ.C.) �W Q Lenders Name a z Lcedera Address U Q 1 certify Nu 1 have read this application and sum that the above turnaround is D, F~- correct.l agree in comply with all city and county ordinances and sok laws misting to CV building construction,and hereby authorize representatives of Nis city to enter upon the Uahwc-mentioned property far inspection purposes. (We)agree to save,indemnify and keep homeless the City of Cupertino against o-E"r fn liabilities,judgments,costs and expenses which may in any way see=against said City in consequence of the Standing of this permit. •+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date I -cfL. 5 U CE REGULATIONS. .7 -1G"V"6 Re-roofs Signature of ApplicanteConuaclor Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant sore or handle hamrdous tenurial u defend by the Cupertino Municipal Cann.Chapter 9.11,and she Health and Safety Code,Section 15533(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes llaiNa Will the applicant m future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit hazardous air codtaminxnts as defend by the Bay Area Air Quality MMaSemedh all new materials for inspection. District? ❑Yes Nu I haw read the hevarduus materials dequlromcxs under Chapter 6.95 of the Coffer. .is Health&SafctyCode,Section 25505,25533 and 15534.1 umlerstand Nal if the building dos a h current y haw a tenant Net it is My responsibility n unify the occupant of Ne rem crus which i hssuanceuraCeaifcamofOccupancy. Signature of Applicant Date All roof coverings to be Class "B"or better GAtder or authorized agent Dam" CITY OF CUPERTINO !m 1 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32641083 . 00 DATE ISSUED. . . . . . . : 08/16/2006 RECEIPT # . . . . . . . . . : 35641 REFERENCE ID # . . . : 06080107 SITE ADDRESS . . . . . : 10423 CHISHOLM AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : VINCENT WONG ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : A PERFECT CLIMATE CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 10570. 5 DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408) 86119545 �EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BREMAIRHAN NO.UNITS 1 . 00 10 . 26 0 . 00 10 . 26 0 . 00. BREMRECEPT NO. OUTLETS 1 . 00 1 . 20 0 . 00 1 . 20 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BSEISMICRE VALUATION 4 , 550 . 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 161 . 93 0 . 00 161 . 93 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL • Community Development 10300 Torre Avenue altoTelephone Cupertino CA 95014 (408) 777-3228 CITY or Fax(408) 777-3333 GVUPEkTINO Building Department JOB ADDRESS: PERMIT # y33 AV. OU0801O7 OWNER'S NAME: W p vi 9PHONE # yD S GENERAL CONTRACTORer q ; vn c FAX # Q,,$"/�/ I am not using any subcontractors: / �-P;yl, ` / ��iiv/.moi & d'" o 6 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 CITY OF CUPERTINO FURNACE/AC OUPEkTINO PERMIT APPLICATION FORM APN# 32tp1 u ,.t^(;72 Date: I' A Building Address: —[ 1 O t-1AV Owner's Name: Phone#: ,v� e- -- w 08- X73 -/s33 frac r: I Phone: License #: ecvec.� C,\ rv�w+� '(D� �(�( 9 y� X33/ SFT Cont Phone: Cu ertmo B siness License#: It:-). � -4u � � r� S a� �(� � 45�/� 01I1q� Building Permit Info: Bldg ❑ Elect Er Plumb 0' Mech-t Job Description: ctdd ,41c e Residential( Commercial ❑ For Rgg�idential Ins allations: Attic n I" floor 2nd floor❑ Adhere to min set back requirement 4OFor Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required Cost of Projecct: O Gd Type of Con$t�n� Occupancy group: Strapped 00 On Platform BondedZ 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 A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Recptl, 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