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06080046 (2) CITY OF CUPERTINO _? + .�aa*t BNLQINC DI'�R61ON PERMIT 6 Cd)N�TRACT(iR INFORMATION Al dSlt=..g,t.... a'+,!I{•A:R hl< f,..,a 9�'&v'b „i6»"f BUILDING ADDRESS: PERMIT NO. ANDERSON RADIANT HEATING 06080046 10920 KF.,qTFR DR OWNER'S NAME: PERMIT ISSUE DATE REYNOLDS 355 E H9QL1NCY__LN STT�, T4 .08108120119 NE: SANITARY NO. CONTROL NO. (408) 378-3868 ARCHITEC rENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 loo LICENSED CONTRACIDR'SDEC ATID Job Descrition I di 1 hereby sfRrm Nn I am Iimmad under pno ora of C mer 9(commencing P qwith Smdan]IX10)ol inion of Nc Busin,e r dmyl' is i Lft, to eand,ff u g REMOVE AND REPLACE HYDRONIC BOILER F D GanleMbf ARCHITECTS OEC N i 1 uad rstaninJ my plashall he red. bl' sdV G Licensed Professional OWNER-BUILD DECLARATION io I heathy.(Tree Nm 11. nae t fmm the Contracted Lic,nu Law for the 22 follwhich requires Permit ]e ter .,irm rve. io demolish,.,ag ycity or county 5$ which mquitas a permit re can alcor,improse, armttcare a sig any swaum $8900 _Z< thiormiu lensed p,akuntto ft theapplicantof thnuchpcnmilm NnasLawJ mmmcm Nehciscingwiis pursuant to ft of Dislonsof tits Conwnessnd LicenseLaw(ClaspersCron)or Sq.Ft.Floor Area Valuation eF (commencing with Section 7")of DivisionJaf Na Business and Professions Cam)or ' Nat he is aempt therefrom and the basis far the alleged asempdar,My violsuon of Section]031.5 by any applicant for a permit subjects the applicant to a civil penally Of r Occupancy Type not mom Nen five hundred dollars(6500). ❑1,as owner of the property,or my employeer with wages as theirsoleeampensadon, will do thework.and the structure not intended oraRered forsam(Sec.10",Business Required Inspections and Professions Cade:The Conergoon's Liana Law doe Out apply to e an Owner of 9 P property who builds orimpromea Neeson,and who duessuchworkhimself or through his own employ=.provided that such improvements are not intended oraRered for sale.If. however,the building or improvement is sold within aro year u(completion.the owns, builder wRl have the harden of proving Nat he did no,build or Improve for purpox of sola.). ❑1.u owner of she pmRny,am eulusiv,J,contracting with licensed mnuacmm to mnstmcl the project(Sec.7044.Business and Profetdmm Code)The Cmtrutors Li- mner Law dean sot apply to an owner of property he Wilds or Imp..Nataon,and, who contracts for such projects wish a mnuaaor(s)licensed pursuant to the ConuaaaYs Licesure law. ❑Iomeaempiunder See ,B&PCIer Nismason Owner Data WORKER'S COMPENSATION DECLARATION 1 totally of iso under Xnasty of perjury,am of the following declmulom: 1 have and will..Irwin a Certificate of Camenuo self-inure far Worked Compete. nation,an provided far by Section 3700 of the Labor Cade,for Ne performance of Ne work(a soh Nis permit u heated.have and will maintain Workers CompemNon Insurance,as required by Section 37M of to Labor Code,foperformance of the work for which this Permit is legend. r, My Wor �V_ilcrd Policy qur�cym� /� J Cartier. (��� /NFROMWORKERS' SURANCE (This=arm need int he completed if the Permit is forms,hundred rollers($I0)) or lett) I coolly Nat in the performance of the work fm which Nis permit is Wood,I shall not employ any person in any mommru as to become subject to Ne Warkcn'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after ting his Ccniacate of Exemption,you should become mhmt to the Workers C patent m provisions of Ne Ltlaor Code,y.0 mus, Mith comply with .J O lowgentian crew is peemit shall be dmmcd tawkcd. z CO RUCfI LENDING AGENCY Ih,uhy a?umN dam Lsac traction lending aCcnry far Ne perfurmana of !Yi w>i the work for which Ni ermit is Le d(See.3097,Ci,C.) Q Landers Name , z Lcnfctiod e U Q at 1 have nd this applieadon and soon that the above info,muion is Lf. P conto nom with all city and county ordinances and state laws relating to C Wilaio d hereby authorim represenmives oftis city to enter upon Ne momNrly for inspection purposes. me to save,i nt and keep harmless Ne City.(Cupertino against liabm ts.cr andcxpenan which may in any way seems against said City U'Z in cthe amting of this permit. )))APN RSTAND ND WILL OMPLY WITH L�N-POIM' Issued by: Date SOU A IONS. apf Re-roofs Si u pplica on nm Date RDOUS MATERIA S DISCLOS RE Type of Roof Wi Neap ie or future building oceupaat store or handle havandous material mfim y u oina Munic'in otic.Chaptcr 9.13,and sh,Health and Safely Cam, on 53(a)? All roofs shall,be inspected prior to any roofing material being installed. Will th applicant or luta b ilain c use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove amlt heard. sit mmtsm" arca a d, a Bay Area Air Quality Management all new materials for inspection. Diuria? ❑ s I vein Ord, maurialsmquimmcnmunter Chapur6.95ofde Califar nice Heai h l 'ors 355()5.25573 and 35534.1 ummmost one ifNc building does t a nm.that It my taspamNility le miry am^�ant.fthe reggm mono sMmet p' uieuanm cpfuauc U� Signature of Applicant Date 0 er or author cd en, M - Dow All roof coverings to be Class"B°or better CITY OF CUPERTINO !m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35628018 . 00 DATE ISSUED. . .. . . . : 08/08/2006 RECEIPT # . . . . . . . . . : 35545 REFERENCE ID # . . . : 06080046 SITE ADDRESS . . . . . : 10920 KESTER DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . : . . . . : REYNOLDS ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : ANDERSON RADIANT CONTRACTOR . . . . . . . : GLEN WAGNER LIC # 23141 COMPANY . . . . . . . . . . : ANDERSON RADIANT HEATING ADDRESS . . . . . . . . . . : 355 E MCGLINCY LN STE H CITY/STATE/ZIP : CAMPBELL, CA 95008 TELEPHONE . . . . . . . . : (408) 378-.3868 *EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BBOILER2 NO OF BOILER 1 . 00 26 . 19 0 . 00 26 . 19 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BSEISMICRE VALUATION 8, 900 . 00 0 . 90 0 . 00 0 . 90 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 100 . 32 0 . 00 100 . 32 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - - --------------- ------------ ------------------ OTHER 100 . 32 MASTERCARD TOTAL RECEIPT 100 . 32 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 204 UNDERFLOOR FRAME 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL 514 FINAL PUBLIC WORKS . . �_ n ���r�? �OIQ Date: Q ac0 Building Address/- �(�� /v�� Owner's Name 7 (/ Phone#: C one: �/ . d License C to t: Pon : 7 Cupertino Business License#: Building Permit Info: —/ Bldg ❑ Elect ❑ Plumb L7 Mech ❑ Job Description: Residential Commercial ❑ For Residential Installations: Attic ❑ 1"floor ❑ 2"d floor❑ Adhere to min set back requirement❑ For Commercial Installations: Replacement same weight ❑ Additional weight(structural talcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project- n, / DQ Type of Construction: Occupancy group: trapped ❑ ��On Platform Bonded ❑ Sq.Ft. Floor Area: New Location ❑ R lacement ❑ CITY OF CUPERTINO b3W P CUPERTINO PERMIT APPLICATION'FORM �ll`` N# Date: Building Address: Mailing Address (if different from building address): Owner's Name: Phone#: Contractor: License#: Contact: Phone: Cupertino Business License#: Fax: Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: Type of Construction: Please check this box if the project is a second-story addition: ❑ *roje7ctSize: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler>500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Ener y Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of CITY OF CUPERTINO CUPEkTF PERMIT APPLICATION FORM roup —�ft Quanti ty Fee ID Fee Description Fee DIN BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. HousingMit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING EBPCESSPOOL RTIME Ins ection Overtime BUILDING KFLOW Atmos heric Vacuum PLUMBING Cess ool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE PbIg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal— PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING • BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI A2pliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> 1 OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood ZELECTRICAL ANICAL BREMMISC Misc Apparatus TRICAL BREMNRAPP Rem Non-Res Appliance TRICAL BREMPOLE Pole/Platform Fixture TRICAL BREMPOWER Power Device/Apparatus BREMRECEPT Rc t1, Switch & Outlets TRICAL' BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alt r Heating MECHANICAL • BREMRESAPP Remodel Res Appliance ELECTRICAL 2of3 • aF CITY OF CUPERTINO PERMIT APPLICATION FORM CUPERTINO Aiwuantity Fee ID Fee Description Fee Group IRV BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Ternp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fain PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Change BUILDING • j 3 of 3