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08010031 (2) BUILDING DIVISION- PERMIT ✓�� s4V''T� Y��,'�`a=^`""� �� q�p^ ' BUILD D RESS: PERMIT NO. �.�g SCOTLAND DR - 'A PERFECT CLIMATE 08010031 OWNER'S NAME: PERMIT ISSUE DATE DE, MARCOS MOIRA " 8375 BRENTWOOD BLVD STE B 01/07/2008 E: SANITARY NO. CONTROL N0. ARCHTIECT/ENGINEER: BUILDING PERMIT INFO REPLACE FURNACE 8OK BTU BLDG ELECT PLUMBMECH 0 0 0 0 uesEDON�AtpovCoofChapI hemby aRres mTnder provision hate9(commnmmng Job Description with Sectim,700D)afOivision 3 afthe Bestows,and Professimu Cade.and my license is .ow in full force and eRmt aA /S ,,aaZ Licensc lase `'�1 Lk.g :F o Dam r III Conenato qq A CHTECTSDECLARATION i W 1 undersand my plans shall he used as public retards a H Licensed Pnonssional _ 3 OWNER-BUILDER DECLARATION f I hereby affirm Nat 1 am exempt from No Contractors License Law for she 00 following rumor.(Section 7031.5,Business end Profted..Cade:Any city or..in, IRE! which"u nes a permit to construct.ether,improve,demolish.or repair my s arcaure -zy prior to its issuancc.alm requires the applicant for such Permit to file a signedawommt :Z< that he1.licensed pu..Itothe pmvisionsofth,Canlrmter'Li...Law Chapter 9 Sq. Ft. Floor Area Valuation eH (commencing wish Section 7000)or Division 3 orthe Businemand Prafessinm Code)m that he is exempt aherc6om and the basis for Me alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant in a civil Penalty of APN Number Occupancy Type oat mom than ftva hundred dollars(550(). P Y YP do en wMkafthe fleauty,nomyemntended withwagesRshebsule W,Bmmer will daProfesion ande:The ttum unn.Licdad aroRcmdformlepplya an Bueness Required Inspections and property Cade:The eanOacmis and Law uch rot apply lf rt owner is q P property who bis itch car improves thereon,and who area rah work himself car through M1 f. - howsam ver,th ses,building provided that rahimprovementsare not earoedmpletied possum.B, however,the building orimprowment remit within one year or mprovefor the o res of builder will haw the burden of proving Nat he did not Wild a improve for proposes of mkJ. ❑1.as owner of the property,am exclusively contracting with licensed covuusars in construct the project(Sec.7044,Business and Professions Code:)The Contractors Li. cave Law dem art apply in an owner of property who builds or improver themm,and, " who contra for such projects with a conusictur(s)licensed pursuant m ate Comnicu fs License Law. ❑IamexemptunderSec. ,B&PCforthisreamn Owner Dam WORKERS COMPENSATION DECLARATION -' I hereby".under penalty of perjury..of the following declarati.. have and will maintain Iifi aCmcehe of Cammattoself-imute for Warker,Camper, an,ss providrd for by Section 3700 of the Lab"Code,for Ne peeannanm of rhe work for which this Permit is Extend. have and will maintain Werkefs Compensation Isssurence,as mquimd by session ]00 of the tabus Code.far Ne performance of Ne work for which this permituissned. ' My Work�o°1m�'pevation lvumncr artium Iity//g�strry5b-vver are: � .^.',v Cartier.L�.tidr/re,rsC u. Policy No.:t,dl�(7J O V/ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu sects s need net hecanplemd lithe permit is fmone hundred do0ua(5100) or less) I certify Net in the performance of de,work for which this Permit u issued.l shall oat employ any parson in my monster so m to became subject he the Workers''Campettwion Laws of Califaroix.Data Applicant NOTICE TO APPLICANT:If.after making this Comficam of Exemption,you sbouw become subject m the Wotier'a Compensation provisions of the labor Cade,you mom ,J O forthwith comply with such provuinv or this Permit shall he deemed revoked. „ z a" CONSTRUCTION LENDING AGENCY [-+14 I herchy alOrm Nat Nem is a covtroctimn kr ding agemT for the perfurmanm of a > she work fur which this permit is issued(Sec.3077,Ci,C.) W Q Lender's Name z Lenders Address U Q 1 certify Nat I have read this application and=Mc Nat Ne shove information is f^ correct.I agrm in comply with all city and county ordinances and sate laws miming to (� building construction,and hereby aushmirz mpresctr tivv of this city to enter alms the shovo-mcmioned Prolcrty,for inticctionlusPoscs. W (We)agree to save,indemnify and keep harmless the City of Cupertino against N liabilities,judgments,cera and expenses which may in my way accrue against said City V z APPLICANTAND thisof Me grousing of Permit. WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Signature of ApplinData Re-roofs HAZARDOUS US MATERIALS DISCLOSURE Type of Roof Will Ne applicant m(umm building acupanumro car handle Health w s Safety m defined by the Cupertino Municipal Code.Chapter 9.12 and the Health and Sa(tty Code,Section 35513(a)? ❑Yes All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Handing a upant am gaipnhent car devices wh b "If a roof is installed without first obtaining an inspection,I agree to remove hazardous air eonaouremss ss dcOs al by the Bay Ama Air Quality Managmtmt all new materials for inspection. ❑Yes 1 have matt the Enormous materials mquiremuus umlcr Chapter 6.95 of the Califor- niaHealth&SafetyCom.Scctimu 25505.35533 and 25534.1 undersand that iftlte building d of curmmly hmc a Imam than it u my msNmihility m notify the=ce c of the nu whim um be et eonaissu Ce niBcmearaeuparcT. _ Signature of Applicant Date -7-00 Owner oraathori,.e ,gent Dam All roof coverings to be Class "B"or better okol 0031 CITY OF CUPERTINO sm FURNACE/AC ®CUPEkTiNO . PERMIT APPLICATION FORM APN # �(PO�A Wo 1 Q () Date: Building Address: I / jl 3 � Q tJ co fL awC �r (9 Owner's Name: Phone#: aT0S 7 92 (o Contractor: Phone#: � �- � � Q �e Yoe— d26/— 9SYs— 2✓7 e G Fax #: YO(F- Contractor License#: Cupertino Business License#: 72 3 /.5- F C— 2J Z i/ yv Contact: L 1 / Phone#: yod2- d'6/-5 ej- 401 5�� S4,% 75C�f /re (� Fax #: Building Permit Info: Elect ❑ Plumb ❑ Mech Job Description: eo K I37—V i �-2/� �4 c 2 /�✓ �vl 4 c GG Residential/ Commercial For Residential Installations: Attic ❑ I" floor 2nd floor ❑ Adhere to minimum setback requirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction (Usage Class): Strapped On Platform Bonded New LocationEl Replacement Valuation: n Green Building: Must attach Green Building Check list to this application A CITY OF CUPERTINO FURNACE/AC CUPER,TiNO FEE SCHEDULE FURNACE: Qty. if Applicable Fee ID Fee Description Fee Group Permit Type MCRAA Furnace M FURN/AC MCREPALT Commercial Mech Repair/alt/add M MCSUSHTR Commercial Suspend Wall/floor M Heater PGASCOM New Gas Piping System 1-4 Outlets P Commercial BSEISMICO Seismic Commercial B MRRAA Residential Mech Repair/alt/add M MRSUSHTR Residential Suspend Wall/floor M Heater BSEISMICRE Seismic Residential B • MFLRFURN Install/relocate Floor Furnace M MECPLNCK Mechanical Plan Check M MFR=<100 Furnace Syst<100k BTU M >100 Furnace S st> l OOk BTU M MFRN Y MRAIRHAN Comm/Res < 100k BTU M / EPERMITFEE Electric Permit Fee E MPERMITFEE Mechanical Permit Fee M BREMRECEPT Electric Receptacles E PGASRES New Gas Piping System 1-4 Outlets P Residential BPGAS Gas Piping System 5+ Per Outlet P TRAVDOC Travel Documentation B BUSLIC Business License B aio CITY OF CUPERTINO FURNACE/AC •CUPERTINO FEE SCHEDULE AIR CONDITIONER: Qty, if A licable Fee ID Fee Description Fee Grou Permit Type BCAIRHAN Commercial A/C Units<= 1 Ok CFM B FURN/AC MCRAA Commercial Mech Repair/alt/add M SEISMICOM Seismic Commercial B BREMAIRHAN Residential A/C units <= l Ok CFM B MRRAA Residential Mech Repair/alt/add M BSEISMICRE Seismic Residential B EPERMITFEE Electric Permit E MPERMITFEE Mechanical Permit M PPERMITFEE Plumbing Permit p BREMRECEPT Electric Receptacles E PGASCOM New Gas Piping System Commercial P 1-4 Outlets PGASRES New Gas Piping System Residential P 1-4 Outlets BPGAS Gas Piping System 5+ per Outlet P TRAVDOC Travel Documentation B BUSLIC Business License B CITY OF CUPERTINO ® 5 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: . APN . . . . . . . . : 36228015 . 00 DATE ISSUED. . . . . . . : 01/07/2008 RECEIPT #. . . . . . . . . : BS000003624 REFERENCE ID # . . . : 08010031 SITE ADDRESS . . . . . : 1136 SCOTLAND DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER DE MARCOS MOIRA ADDRESS 1136 SCOTLAND DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : EDWARD A GREGORY CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY A PERFECT CLIMATE ADDRESS 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513 TELEPHONE (408) 861 9545 ® FEE ID UNIT QUANTITY - AMOUNT... - PD-TO-DT THIS REC NEW BAL --------- ------------ ---------- ----------- ---------- ---------- ---------- 1BSEISMICR VALUATION 2, 657 . 00 0. 50 0. 00 0.50 0. 00 1EPERMITFE FLAT 'RATE 1. 00 40.79 0. 00 40.79 0. 00 1MPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00 1MRRAA UNITS 1. 00 61.19 0. 00 61 .19 0. 00 1TRAVDOC FLAT RATE 1 . 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 184 . 06 0 . 00 184 . 06 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 368 .22 MC --------------- TOTAL RECEIPT 368.22 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 113 SLAB 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 506 GAS TEST 507 FINAL PLUMBING 508 FINAL MECHANICAL Community Development 10300 Tota Avenue Cupertino CA 95014 Telephone(408)777-3228 OPER INO Fex(408)777-3333 Building De artment JOB ADDRESS: 1136 Sc o-f 1ct T-),,, PERMIT# owe � OWNER'S NAME: . 114 q r r' q r?// G i cos PHONE# Yod' Z 7 Y z G GENERAL CONTRACTOR: A 2e dc. FAX# I am not using any subcontractors: 61(/� � �n—� * /— 7- foo J' 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 e� ��f /r:� 4✓e. Z //w Insulation Landscaping Lathing / Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving . Plastering Plumbing C Roofing Septic Tank Sheet Metal Sheet Rock Tile - /— 7- 2oOd' Owner/Contracto i Lure Date