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06020013 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT 4NONTAXOTORANE0RMATION <. BUILDING ADDRESS: VALLEY HEATING & COOLING PE14MRNO'06020013 5914 SUTTON PARK PL OWNER'S NAME: PEIMITI SUEDATE CHOW JOHN CHI-BUN AND WINN E W1171 N 4 TH ST 02/02/2006 NE: SANITARY NO. CONTROL NO. (408) 294-6290 ARCHITEC ,ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 °09 LICENSED CONTRACTOR'S DECLARATION �� 1 hereby alfum Nall am limned under pmviCom of Chapter 9(commencing Job Description with SmImO70WB of Division Sof the Business and Pmfcssions Codc.and my licctuc u is Nfullfmmand fr SYCj REPLACING EXISTING FURNACE AND A/C LiCen Claza Lk.Y =p Datc Co.I.in YY ARCHITECTS DECLARATION a...�� C 1 understand my plans shall be used a public records IgGDy7ra''- Jye g G� Licensed PreNtomnal 3 OWNER-BUILDER DECLARATION 1 hereby effort that I am exempt from ftCont min's License Law for thep o following reason.(Section 7131.5,Business and Pmfessiom Code:Any city or county K$ which rcquims a permit to concoct,alcor,improve,demolish,or mpair any structure FF7nne $7000 yai prior m its issuance,also requires the applicant for such Permit o file a signed statement i< Out he is licensed P..an((.On ravism.ofthe Contractor's Lee.Ltw(Clepter9 Sq.Ft. Floor Area Valuation xI$ (commencing with Scction 7000)of Division 3 of the Business and Pmfessiom Code)in `i Nat W is exempt therefrom and the basis for the alleged exemption.My violation of no Seedon 7031.5 by tory applicant fora permit subjects the applicant to a civil penalty ofAPN not mom Nan five hundred dollars(5500). r cy Type ❑I.uowner o(Ne propmy.mmy employes with wages atic'v sole eompenution. will do On work,and Nc swcture isnot Intended monered for We(Sec.7014,Business and Pmfmsions Cade:The Commem's License Law dao not apply in an owner of Required Inspections property who bulldsor improves dmrenn,and who doessuch work himmiforthrough his own employees,provided Netsuch improsemenuare notion ndcd oro@red for We.If, however.On building or improvement is sold within one year of mmplction.no,mwmn- builder will have the burden of proving Nat he did not build or improve for purpose of uk.). D I,as owsmr of the property,am exclusively eonuacting with licensed conuacmrs he construct On Project(Sec.7044,Business and Professional Code:)The Contractors Li- . came law docs not apply to in owner of pmpcnywho builds or improves rheram.and who contracts for such Projects with a contractor(s)licensed pursuant or the Cenuaemri Licence law. D l am exempt under Sec ,B h P C for Nis reason Owner Dam WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declanlume 1 hive and will mainuin aCenifteate ofCnment m self-imum fa WorkeriCompen- ution,as provided for by Section 37M of the labor Code,for NC performance of the work non which Nis permit is issued. D 1 have and will maintain Workers Compensation Imursna,as required by Section 3710 of the labor Cook,for the performance oI work for which this permit is issued. My Wmrkrc�rs Compensation Insurance carrier and Policy number are !/'/ Cartier:ZR.e-e' t4 Policy NQD r��O NS! CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (i'Lu section need not BC comphand if the permit is forone hundred do lars(5100) Or kss) 1¢nify Nat in the perfaminum of the work for which this Permit is issued.I shall net employ any person in any manner an as in become subject to the Wmker3'Compemadon Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this CcniEeate of Exemption,you should become subject to Ne Worker.cent co pion provision of the Lahr Cede,you must .JO forthwith comply with Such provisions or this Permit shall be dccmW minded. Zn CONSTRUCTION LENDING AGENCY 'p. I thereby affirm NV them is a construction lending agnit y for the perrurm umn of lY the work fur which this permit is issued(Sec.309'f,Civ.C.) dQ Landers Name . z LCMers Add. U Q 1 ccnify Nat 1 have read this application and sone don the shove hili m itiun is IL F correct.I agree In comply with all city and county ordinances and tum laws relating in C U building construction,and hereby eurhmis mpresenrsrivu of this city to outs,upon the FC[1 above-mentioned pmperty for inspection purposes. 4. (We)agree to save,indemnify,and keep harmless the City of Cupertino against h incoexpari of the grassing of this Permit. mayinany way attrne againn said City („),'� m cense ANT of the granting or Nis permit. '—' APPLICANT UN TIONS. AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Zia 6 SOUR REG TIONrs. �I rG'f_A�'- °�-�'-�J Re-roofs �� Sign urnnt�anuanor ..in HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant store or handle hammous maktial az de0ncd by Ne Cupenine Municipal Code,CWP1mr 9.17,and the Health and Safety m1c.Scc4nn 75537(x)7 ❑yes eNa All roofs shall be inspected prior to any roofing material being installed. Will On applicant or future building occupant use equipment at dnvices which If a roof is installed without first obtaining an inspection,I agree to remove ret a9 rdous air contaminants a defined by the Bay Am Air Quality Management all new materials for inspection. DYus ❑Na I have mad the hasfdnus mmcrials requirements iso mrCh rp erb.95of 0w Catlin, .isHealNh Safcty Com,Seedims 25505.25533 and 25534.1undersund thuifdn building does ret currently have a knam Naz it is my responsibility as notify the occupant Of the Zia must e,'let mimtt ssnaraccnirnu•,arOcgrpancy. _ (�, Signature of Applicant Date , Owner or authotiacd agentsem/ DC,re//; All roof coverings to be Class "B"or better CITY OF CUPERTINO l7(��ao�13 FURNACE/AC �Up acloF PERMIT APPLICATION FORM APN # Date: 31S - Building Address: fc�c a( Owner's Name: Phone#: n�oe C ��J .267 Contractor: Phone: License#: Contact: Phone: Cupertino Business License#: 6 ii1�G Building Permit Info: Bldg ❑ Elect I/ Plumb 2111" Mech 9T Jo Description: `e Ca a � %er CI Q ee C Residential if Commercial ❑ For Residential Installations: Attic ❑ -l" floor Z 2nd floor❑ dhere to min set back requirement E WrFor Commercial Installations: Replacement same weight E] Additional weight (structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type of Construction: Occ pancy oup: G72,4,roq,c� � Strapped ❑ On Platform ❑ Bonded ❑ Sq. t. 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 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 BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # 3 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 37535033.00 DATE ISSUED. . . . . . . : 02/02/2006 RECEIPT #. . . . . . . . . : 33051 REFERENCE ID # . . . : 06020013 SITE ADDRESS . . . . . : 5914 SUTTON PARK PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CHOW JOHN CHI-BUN AND WINNIE W ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3531 RECEIVED FROM . . . . : VALLEY HEATING & COO CONTRACTOR . . . . . . . : ATKINSON, THOMAS LIC # 141 COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING ADDRESS . . . . . . . . . . : 1171 N 4 TH ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 294-6290 &E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL __________ _____________ __________ __________ __________ __________ __________ BREMFURN NO UNIT 1.00 14.31 0.00 14 .31 0.00 BENERGY PERMIT FEE 1.00 34 .86 0.00 34 .86 0.00 BSEISMICRE VALUATION 7, 000.00 0.70 0.00 0.70 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 164 .98 0.00 164 .98 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ --_----_____-_---- CHECK 164 .98 14267 TOTAL RECEIPT 164 .98 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL F Community Development 10300 Torre Avenue ' Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 RUPEkTINO Building Ike a.rtment . JOB ADDRESS: PERMIT # S9 /7 S �-�� Pa�� Ocoozoo i's OWNER'S NAME: wjivtAC,e LwW PHONE #aJ 7- GENERAL CONTRACTOR J,,1(21LFAX # L S-,7, `l7 I am not using any subcontractors: lqw Si afore 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 ^ G� Owner/Contractor Signator Date