03050115 (2) CITY OF CUPERTINO »r,-= +' ''%= m 's` '' -
BUILDING DIVISION PERMIT ,CONTRACy ,T.OR IN,1 '.0�.RMA' I,O,N:.
BUILDING ADDRESS: PERMIT NO.
MAHON ROBERT B AND EMILY Y TRU 03050115
u'
AM PERMIT ISSUE DATE
05/23/2003
ONE: SANITARY NO. CONTROL NO.
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
000 LICENSED CONTRACIOR'S DECLARATION
rd U I Mreby.ITtrm lout I am Ikenacd under provpdona of Chapter 9(commencing Job Description
n� with Section?")ofDMAi.Sof he Dudneu.rad Pefesdons Code,and my license is
in full fora and Affect.
LlcenscCWA Lc.x REPLACE FURNACE & ADD A/C FINALED
Dem
ARCH
S DECLARATION
I understand my plana shall be used in public records
p; Licensed Professional JUN 0 9 2003
n
MINER-BUILDER DECLARATION
rayy I hi affirm Nn 1 am caempt from de ContranAM1 License law for the
`p0 followingreturn.(Section7031.5,BualneASandPrvfcuionsCode:Anycityorcounty BUILDING
5$ which requires a Permit m 4 a
cmeh lta,impmw,demmliahtm
,Or repair any acturt
prior to its issuance,else requireathe applicant for such Permit o Glc a signed statement
C that he is licensed pursuant to the provislonsorthe Contractor's License Lie,(Chaplet 9 Sq.Ft. Floor Area $3Nt6tion
(commencing with Section 7")of Division 3 of NProfessions
e Business and Code)or
that heis exempt therefrom and the basis for toe alleged exemption.Any vioh ion of
Saloon 7031.5 by any applicant fon Permit Subjects the applicant to.civil Penalty Of ^y.p�7vt�a�gv 1YP
not more than Gw hundred dollen(5500). 3 7 76+ALU' ro 0 Occupancye
I,u owner of Ilia ProPeny,a my emplOwea with wage u their sole compenAStim,
will do the work,and the structure is not intended or Offered for safe(See.70M,Business 301 - ROUGH R);tjIi&68 actions
and Professions Code:The Conlracmr'a License Law does not apply m an owner of
property who builds or improve thereon,and who doessuch work hlmselrurlhmugh his 303 - ROUGH MECHANICAL
Own employees.provided lost such improwmema me not intended crortered forint if. 30q — ROUGH ELECTRICAL
however,this the building w improvement is cold within ore year of Completion,the Owneo-
Wilder will have lose burden of Pressing mat M did not build or Improve for pu,sm of 505 — FINAL ELECTRICAL
ASIA.).
❑I,as owner of the property,am exclusively contracting with licensed conhKlnrt to 507 - FINAL PLUMBING
construct the pmjcct(Sec.7064.Business and Professions Cada)The COnlnctor's Li- 508 — FINAL MECHANICAL
cense Law does not apply in an Owner of property who builds or improves thereon,and
who convects for such projects with a convacmr(s)licensed pursuant in the Convenor's
Li nm Law.
I Am exempt der Sec. B kP f Nis reason
Owner
WORK is PENSATIONOEC ION
I hereby of rte under penalty of Perjury Ane of she following declarations:
m]I haw and will maintain A certificate or Consent to self-insure for Worker's Compere
sador.AS provided for by Section 3700 of the Labor Code,for Ne performena of the
work for which this Permit is issued
❑1 blow and will maintain Worker's Compression Insmurce,AS required by Section
3700 of the Labor Code,for the performua of the work for which this permit is issued.
My Woheta Compensation Insurance carrier and Policy number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thssecdnn need not becompleted if the Permit m forme hundred dNlus($]M)
ori r)
1 cenify int in the perfnrmam'e of due work for which this Permit is flood,1 shall nm
employ any pe nm any in Cr seas mhaomcSu'aR 3 an'ComPeASaloon
Lava of Calif am
pppl'
NoTI APPLICA fuer making this CetdGcam of Exemption,you should
beco fat to she Worker's Complassi provisions of the,Labor Codd.you most
.,0 forthwith comply with such prevoked
visions or this permit shall An deemed re _
r CONSTRUCTION LENDING AGENCY
F. 1 hereby affirm that there is a construction lending agency for the performance of
CYi the work for which this pe.I,Is Issued(Sec.3097,Co.C.)
0.Q Len 's Namc
z Le LZ
U Q I cenify that 1 haw read this application and seato Nu the show infomtauon is
f' eomea I agme to empty with all city and county on inareesInd tum laws relating Id
0 U Wilding conusuction,and hereby authodw represenuuws of this city in enter Aron the
airove-menuoned PrOPeny for iupei PugromL
(We)agree to low.indemnify and keep harnk u Ik City of Cupertino agdut
fn Iiablliiiu.judgments,costs and expense which may In any way scene ISAWL Said City L
U 2 in consequence of the granting of this permit.
Fl APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURC ULA 0
( � Re-roofs
i um of Appl% Ata Da
AZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building Occupant atom or handle ho W dews material
AS dcrined by the Cupertino Municipal Code.Chapter 9.17,and the Health and Safely
Coag,Section 255324)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ye No
Will the applies or fu a WildiAP occupant uric equipment m dcAcas which If a roof is installed without first obtaining an inspection,I agree to remove
.mit hicAnnu air cm,=%n dcGncd by tin Bay Area Air Quality M....cment all new materials for inspection.
Diurlct7
❑Yrs No
I haw mW Ne hurAd ma mdalsrequimmenounderC Pter6.95ofthc Califor. -
nisHnt g:SdeiyCodc,Seclom75505,15533ud75534,1unaentud Nuifdtc Wilding
does not cu oily haw a¢rent.Nat it h my rorpomihilimy m noulY 1M Occupant of de
require a hichm etpdnrtaisauananr.Ce 'Ocem of[�11g1aJ1 Signature of Applicant Date
ownernnnthnrire en All roof coverings to be Class "B"or better
OWNER-BUILDER VERIFICATION
1. (Check.one) I or my immediate family (parent, spouse or child) will perform:
A. All the work authorized by this permit
B. _ A portion of the work
C. _ None of the work D
If B or C is checked, complete 2 or 3 bel
M rzs2
2. A state licensed contractor will be hired to do: By
A. _ All of the work
B. _ A portion of the work (complete sectio below)
Contractor Address/City Phone # State License # Type of work to
be erformed
• 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or
portions of the authorized work. I understand that I may be an employer (see reverse side). A
Certificate of Insurance covering workers' compensation must be on file at the City of
Cupertino Building Department office.
Person/Firm Address/City Phone Number Type of work to be
performed
.....................................................................................................................................................................................
I declare under penalty of perjury that the above is true and correct. I have read and understand the
Owner-Builder Information(reverse sidre)).�f oI
Property Owner's Signatnr_e: oV"` �` d Date: s, Z3 -D ?j
Job Address:/ l�� For r Ct 4�e-euQ'e,)i1 u d Cy�� Permit#
so
Any hanges to the information provided on this form shall be submitted to the City of Cupertino Build
Department.
• COMMUNITY MANAGEMENT SERVICES, INCORPORATED
Emily Mahon
3005 Mauna Loa Court
San Jose, CA 95132 Re: 10550 Red Fir Court
Cupertino Roundtree Homeowners Association
May 20, 2003
Dear Emily;
The Board of Directors has approved your application to install an air-conditioning unit on the
patio as described in your application. As discussed with you at last night's meeting, the Board's
approval is contingent on the unit conforming to acceptable decibel levels of 55dBA to 65 dBA.
The Bryant model number listed in your supporting materials that meets this specification is
538J.
• Sincerely,
(/ fig lU: LJ
)20 R WERT MAY �U3
Association Manager
cc: Board
File
1935 Dry Creek Road, Suite 203 • Campbell CA • 95008-3631 • voice (408) 559-1977 • fax (408) 559-1970
CITY OF CUPERTINO u3
FURNACE/AC
= CUPERTINO PERMIT APPLICATION FORM
APN# �2 Gj O � ��� Date:
r/ � O
Building Address:
Owner's Name: I Pone#:
Contractor: Phon License#:
Contact: P one: Cupertino Business License#:
I
Building Permit'Info:
Bldg ❑ Elect PluZ M h
Job Description: "
Residential Commercial ❑
For RggA�idential InAa Hations:
Attic U 1s`floor U 2nd floor❑
Adhere to min set back requirement❑
i For Commercial Installations:
Replacement same weight ❑ Additional weight(structural calcs) ❑
Structural Calculations required for new installation ❑
New installa ' n Planning Approval Required ❑ .
Cost of P 5 1 fl� Type of Construction Occup y gro
Strapped LP On Platform ❑ Bonded ❑ Sq.Ft. Flo r-Area:
New Location ❑ Re laceme
Qty. if
AppWable Fee ID Fee Description Fee Group
BENERGY Energy BUILDING
BREMFURN Relocation of Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL
BRENIRECEPT 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
s .