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07020107 -7777777. CITY OF CUPERTINO BUILDING vIVISION PERMIT PERMIT NO. BUILDING ADDRESS: 988 CRANBERRY DR PELLE HEATING & AC INC 07020107 PERMIT ISSUE DATE OWNER'S NAME: ROBERTA DUNLAP 3728 C CHARTER PARK DR 7 SANITARY NO. CONTROL NO. NE: (408) 97:3-7060 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 i e p LICENSED CONTRACTOR'S DECLARATION Job Description III F 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing z w with Section 7000)of Division 3 of the Business and Professions Code,and my license is REPLACE FURNACE I''w in full tote and effect. (� r vn z License Class _ Lam• c Dam Comractor �/aP ARCHITECTS DECLARATION 7 a< 1 understand my plans shall be used as public records >yU 7.H Licensed Professional c OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city or county <m ff which requires a permit to construct,alter,improve,demolish,or repair any structure n prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation "?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 3q.Ft.Floor Area r t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $4960 i that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of �Number Occupancy Type not more than five hundred dollars(5500). 36202005 ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale(Sec.7044.Business Required Inspections and Professions Code:The Contractor's License Law dors not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner. builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li. cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. ❑1 am exempt under Sec. B&P C far this reason Owner - Date WORKER'S COMPENSATION DEZLARO.TION- I hereby affirm under penalty of perjury one of the following declarations: iI I have and will maintain a Certificate of Conscnt to self-insure for WorkeesComPCtl' cation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation carrier and Policy number are: Carrier. Policy No.: 03,2c, CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making d»s Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J 0 forthwith comply with such provisions or this permit shall be deemed revoked. Z" CONSTRUCTION LENDING AGENCY [~�CA I hereby affirm that there is a construction lending agency for the performance of (Y > the work for which this permit is issued(See.3097,Civ.C.) (7a Q Lender's Name jz Lender's Address U 0 1 certify that 1 have read this application and state that the above information is (1. correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorise representatives of this City to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against �.q liabilities,judgments,costs and expenses which may in any way accrue against said City ✓f U Z in consequence�UNDERSTA, f the granting of this mit. ►- APPLICANT S WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE LATIO -74 Re-roofs Signatu App icant/Contractor Datt HAZARDOUS MATERIALS DISCLOSURE Type of F.00f Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building occupant use equipment or devices which If a roof s installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes u I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it Is MY responsibility to notify the occupant of the requirements whiclLgt be m. nor t t once of a Certificate of Dec pancy. SlgnaturE Of Applicant Date ? All roof coverings to be Class"B"or better Owner or au o •red agent D tc CITY OF CUPERTINO f 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: B1.{: Lot: APN . . . . . . . . . 36202006 . 00 DATE ISSUED. . . . . . . : 02 /22/2007 RECEIPT #. . . . . . . . . : BS)00000506 REFERENCE ID # . . . : 07 )20107 SITE ADDRESS . . . . . : 983 CRANBERRY DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : R0:3ERTA DUNLAP ADDRESS . . . . . . . . . . : 983 CRANBERRY DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : STEVE PELLE LIC # 27593 COMPANY . . . . . . . . . . : PE:jLE HEATING & AC INC ADDRESS . . . . . . . . . . : 378 C CHARTER PARK DR CITY/STATE/ZIP . . . : SAA JOSE, CA 95136 TELEPHONE . . . . . . . . : (4 )8) 978-7060 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1. 00 34 .86 0. 00 34 .86 0. 00 BREMFURN NO UNIT 1. 00 14 .31 0. 00 14.31 0. 00 BSEISMICRE VALUATION 4, 960. 00 0.50 0. 00 0.50 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 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 38.37 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 164 .78 0. 00 164.78 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 164 .78 VISA --------------- TOTAL RECEIPT 164 .78 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ------ ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL CITY OF CUPERTINO CUP TING PERMIT APPLICATION FORM APN # Date: Building Address: Owners Name: Phone #: `tL �LArAl Contractor: License #: Contact: Cupertino Business License #: -' 3 Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech Job Description: Residential Commercial ❑ For Residential I llations: Attic ❑ 1St floor 2nd floor ❑ Adhere to min set back 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 ct-> Type of Construction: Occupancy group: Strapped ❑ On Platform ❑ Bonded Sq.Ft. Floor Area: New Location ❑ Replacement ❑ Qty. if Applicable 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 BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING EPERMITFEE Elec Permit Issuance ELECTRICAL l MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbin Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING