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04040041 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: BECKS HEATING AND AIR CON ITIO o 04040041 0gon Mr rT.RT.T AN RD 1 OWNER'S NAME: PERMIT 1551TH DATE RECTOR NE: 4 1SANITARY OL NO. ARCHI'IECDENOINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o o LICENSED CONTRACTOR'S DECLARATION a I hereby&truer that 1 am licensed under provisions of Chapter 9(commencing Job Description ¢sem LSf with Section7")of Division Tar the Business and Prufeesinm Code,and my license I. pmmILltA� �/kk F,tispasizi OEM ?Orn in full force and effect Y ■J�(�X� 5�z Li...Class Lt..Is FORCED AIR HEATER & 'A/C �� 27- 2004 t Deto Contractor Y ARCHITECT'S DECLARATION Y 1 understand my plans&hall be used as public records 3ro, Licensed Professional 5p0 OWNER-BUILDER DECLARATION 3<f 1 hereby affirm that I am exempt tram BUILDING the Contractors License Law for the e0 following masan.(Section 71131.5,Business and Professioes Code:Any city or county a}m which requires a permit to construct,alter.improve,demolish,or repair any structure HZi prior to its issuance.also requires the applicant for such Permit to file a signed sentiment < that he is licensed pursuant to the provislonsnfthe Contractor's License Law(Chapter 9 Sq. Ft. Floor Area Valuate n as (aommcnc(ng with Sectiion]000)nl DivisionJnf the Budwesand Professions Cotle)ur that he la exempt tharefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by my applicant for a permit subjects the applicant to a civil penalty of 3rj9��IgI�er00 Occupancy Type not mom than rise hundred dollars($500). ❑L as owner of the property,in my amplayse with wage as their sole compenmdan, will do the work,and she structure is not intended or offered for aria(Sec.7W.Business and Profession,Code:The Contractors License Law does not apply to an owner of Required Inspections propenywho Wildsor improav thereon,and whodoessuch workhubmIfmtmough his own employees,provided that each improvements am not intended orolrered forsele.If. however,the building or improvemen,is sold within one year of completion.the owner- builder will have this burden of proving Nat he did not Wild or improve for purpose or rale.). ❑1.as owner of the property,am exclusively contracting with licuued cart erns to construct the project(Sac.7014,Business and Professions Code:)The Contractors Li. centra law does not apply to an owner of property who Wild,or improves thereon,and, who contracts for such projects with a connections)licensed pursuant m dm Contractor, License Law. l an exempt un ec .B&PC for this meson er Dau '/ OR 'S COMPERMTION DECLARATION I h7will mt under penalty of perjury one of the fall declaration.I Iowaintain&CaNflcouofConsentto Warker,Compen- satlon,as or by Section 3]011 of the labor Code,far the performance of the work for wpermit is house. ❑I haveaintain Workers Compensation Insurance,az expired by Section 3]00 of Node,for the performance of du work for which this permit is issued. My Workers Compensation Insurance canter and Policy number am: Cartier. Policy No.: CERTIFICATE OF EXEMFI70N FROM WORKERS' COMPENSATION INSURANCE (Thissection need nut beeompleted if the permit is forauehundred dollars($100) or Was.) I certify that in the performance of the work for which this permit is homed,I shall not employ any person in any matter an az to become subject in be Workera'Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:if,after making this Certificate of Exemption,you should become subject to the Worker's Compensation previsions of the labor Cde,you must .JO forthwith comply with such provisions or this permit shall tic deemed revoked. 'Z' CONSTRUCTION LENDING AGENCY [+� I lenity affirm that them 1.a construction leadingagsncy faiths perfurmana of !Yi> the work for which this permit is issued(Sec.TOW.Civ,C.) Wh Q Lenders Nmna r7 z Lenders Address U Q I cert![,that I have mad this application and auk Net the above information is ";: correct.1 agree to comply with all city and county ordinances and suite laws relating in - Qv building construction.and hereby authodre npresenutive,of this city to entorupnn the W &hove-mentioned property for initiation;purposes. C (We)agree to eve,indemnify and keep harmlem the City of Cupertino against m liabilities.judgments,costs and expense which may in any way see=against mid City U in consequence of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE RE LATIONS. �1 Re-roofs C li Contractor Data HAZARDOUS MATERIALS DISCLOS Type of Roof applicant m factum Wilding a:cupem&tete or herdic heaardous mamdd the Cut Municipal Code,Chapter 9.12,and the Health and Safety n 25532(a)? All roofs shall be inspected prior to any roofing material being installed. n Nue applicant or future builtling accupenl use cyuipment ar devices whichIf a roof is installed without first obtaining an inspection,I agree to remove us air contaminants az defend by Ne Bay Area Air Quality Management all new materials for inspection. s E 1 have mad the hnaNrms materials mq.ioopams under Ch;pkr6.95 of the Califor- .iaHealth&Safety Cade,Sectio,25505,25533 and 25534.Imnderctsnd thatifthc Wilding dors not currently have a tenant that it u my responsibility to rusty ft occupant of the mqui men stbcmetpriorwimuanccoraCcnificate r cupancy. Signature of Applicant Date �� o erarammarieedagent Da All roof coverings to be Class"B"or better ti Community Development 10300 Torre Avenue Cupertino CA 95014 1 Telephone(408)777-3228 Fax(408)777-3333 CITY OF fffkTINO Building Department JOB ADDRES . PERMIT #O [ Q O / O e CSL OWNER'S N ;t �—(�� ,4-c ONE # Y - z - Y 1,64 GENERAL CONTRACTOR I am not using any subcontractors: � Signature Date Please check applicable subcontractors and complete the following ' onnation: 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 AD Tile Owner/S2 lc a or Signature Date CITY OF CUPERTINO / 4 FURNACE/AC UPERTINO PERMIT APPLICATION FORM rBuilding PN # Date: Address: 20 R z O Cit-'fit-[A+J d� Cu p�P �v Owner's ame: Phone #:� ,51-f LL l7� S '� Contractor oJCa s�ll�eo u� PhonoB�v�0 arm- L'css9laetA,i5 G �d Cont �,lPhone: Q S,7i� Cupertino OBusiness License#: Building Permit Info: T Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Job Description: /j�T�G��CN/2G�� r A-e&P AF, 12-- Residential ❑ Commercial ❑ For Residential Installations: Attic 0 1"floor ❑ 2nd floor❑ Adhere to min set back requirement[Ior Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installation El New installa 'on Planning App2gyal Required ❑ Cost of Pr t:5,— / Type of Construction: Occupancy grou Strapped Platform ElBonded ❑ Sq.Ft. Floor Area: New Location El Replacement ❑ Qty. if ADOlickablp, Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Relocation of Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10, 000 cfrn MECHANICAL BREMRECEPT Rec tl, 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 BUSLIC Business icense BUILDING d J