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07080206 CITx OF CITPERTINO � , BUILDING DIVISION PERMIT 7t? ZQRMITI�N` PERMIT NO. BUiLDJN�'i�I RYORKSHIRE DR A PERFECT CLIMATE 07080206 l j, y PERMIT ISSUE DATE OWNER'S NAME: VINCENT JAMES H AND CAROLE L 8375 BR.fNTWOOD BLVD STE B 0 8TARY x0. 2 7 CONTROL NO. NE: (408) 86L 9545 BUILDING PERMIT INFO rARCHITECTIENGINEER: BLDG ELECT PLUMB MECH a zLICENSED CONTRACTOR'S DECLARATION Job Description OVreby affirm that I am licensed under provisions of Chapter 9(commencing n 7000)of Division 3 of the Business and profession Code,and my lice is REPLACE FURNACE ADD AC TO SYSTEM ti in full force and cf—fQ— "J OCA ? License Class Lic.X Date Y_ _`�� Contractor t ARCHITECTs DEC i < I understand my plans shall be used as public records iaV U.ti Licensed Professional O a OWNER-BUILDER DECLARATION a I hereby affirm that I am exempt from the Contractor's License Law for the :p O following reason.(Section 7031.5,Business and Professions Code:Any city or county Pi which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation r m prior m its issuance,also requires the applicant for such permit to file a signed statement !q;Floor Area-za that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $17127i t=– (commencing with Section 7000)of Division 3 of the Business and Professions Code)orthat he is exempt therefrom and the basis for the alleged exemption.Any violation of OCCU ar T e Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36207018Number P Y YP not more than five hundred dollars($500). ❑I,as owner of the property,or my employees with wages az 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 does 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. B&P C for this reason ❑1 am exempt under Sec Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: �J I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,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 of the Labor Code,for the performance of the work for which this permit is issued. y Worker's ompensation Insurance carrier and Policy rnumber are: Carrier: Policy NoAAI A[IN) fad 6 ERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (•Chis 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,I 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 this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z� CONSTRUCTION LENDING AGENCY ( t rA I hereby affirm that there is a construction lending agency for the performance of > the work for which this permit is issued(Sec.3097,Civ.C.) {L1 Q Lender's Name Lender's Address 1 certify that I have read this application and state that the above information is U O correct.I agree to comply with all city and county ordinances and state laws relating to 0U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,toss and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date a ` APPLI UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued t y: SOU ULATIO g' 2 -�7 Re-roof Signature of A ican omractor Dare Type of Roof AZARDOUS MATERIALS DISCLOSURE YP Will plicant or future building occupant store or handle hazardous material as defined by the Cupertino Muni' I Code.Chapter 9.12,and the Health and Safety Cede,section 25532(a)? All roof's shall be inspected prior to any roofing material being installed. ❑Yes o If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant(future building occupant use equipment ordevices whicn all new materials for inspection. emit hazardous air contaminants as defined by the Bay Area Air QualityManagement District? ❑Yes I have read the hal dous materials requirements under Chapter 6.95 of the Califor- nia Heal th&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building docs of c ently have a tenant,that it is my responsibility to notify the occupant of the "Date req nr which must be t pri uancc of a Certificate of Occupancy. Signature of Applicant All roof coverings to be Class"B or better Owncr or authorirc agcdi Dat CITY OF CUPERTINO FURNACE/AC CUPEKTINO PERMIT APPLICATION FORM C�� 26-1 APN# 0 (s Date: 6v— 2z BuildingAddress: �—' yol> 1-le �j�,�/2. Phone#: Owner's Name: G�� VL LC-,� Yi2,9 3 -�3 6�r J Ct"", License#: Contractor: Phone: �� 6l �� 7z jl 5- P Contact: � Phone: Cupertino Business License#: Building Permit Info: Bldg ❑ Elect L�� Plumb C'�� Mech C --- Job Description: S�� ,e 2 �t-e. G4/-VL, le G( � C �O Residential Commercial ❑ For Residential Installations: Attic ❑ 1St floor F 2nd floor❑ Adhere to min set back re uirement For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation New installation Planning Approval Required ❑ Occu anc group: Cost of Project:/.7 /,Z 7 ``le Type of Consti u tio1}: P g Strapped ❑ On Platform C�' Bonded Sq.Ft. Floor Area: New Location Replacement Qty. if Fee Group A licabl Fee ID Fee Description BENERGY --En—ergy 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 EPERMTTFEE 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 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 MCITY Of Fax(408)777-3333 ',UPEkTIN0 Buildin De artment JOB ADDRESS: q�, PERMIT # OWNER'S NAME: PHONE # 336 -- GENERAL CONTRACTOR: - G/; ,(-� FAX # �'J -- 61- I am not using any subcontractors: Si;nature Date Please check applicable subcontractors and com)lete 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 Owner/Contractor Signature Date CITY OF CUPERTINO 8 ITEMS OF 21 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Bl};: Lot: APN 3607018.00 DATE ISSUED. . . . . . . : 08,'22/2007 RECEIPT #. . . . . . . . . : BS000002456 REFERENCE ID # 07080206 SITE ADDRESS 11:39 YORKSHIRE DR SUBDIVISION . . . . . . CITY CU:?ERTINO IMPACT AREA . . . . . . OWNER VINCENT JAMES H AND CAROLE L ADDRESS CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4916 RECEIVED FROM EDgARD 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 ______ ------------- ---------- - --------- ---------- --- BENERGY PERMIT FEE 1. 00 34.86 0. 00 34 .86 0. 00 BREMAIRHAN NO.UNITS 1. 00 10.26 0. 00 10.26 0. 00 BREMFURN NO UNIT 1.00 14 .31 0. 00 14 .31 0. 00 BREMRECEPT NO. OUTLETS 1.00 1 .20 0. 00 1 .20 0. 00 BSEISMICRE VALUATION 17, 127 . 00 1 .80 0. 00 1 .80 0. 00 EPERMITFEE FLAT RATE 1. 00 40 .79 0. 00 40 .79 0. 00 MPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 PPERMITFEE FLAT RATE 1. 00 40.79 0. 00 ---- - ------0_00 - --------- ---------- - TOTAL PERMIT 184 .80 0. 00 184 .80 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --- CREDIT CARD 540.74 MC --------------- TOTAL RECEIPT 540.74 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL