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08100033 CITY OF CUPERTINO - r BUILDINGDIVISIOA PERMIT NFORMATIaN BUILDINGADDRESS: PERMITNO. 22663 WOODRIDGE CT KESTER HEATING AND AIR 08100033 OWNER'S NAME: PERMIT ISSUE DATE BEDELL HARRY W JR AND CAROL A 4351 GLENPARK DR 10/07/2008 VE: (408) 265-1103 SANITARY NO. CONTROL NO. ARCHTIEC(ENGINEER: BUILDING PERMIT INFO BLDG0 PO MECH0 "Oo LICENSED CONTRACTOR'S DECLARATION b DaSCn (lOn u I herby affirm unen that I am licensed der provisions of Chapter 9(commencing Job P ^1 Uwith Section 70("of Division 3 of the Business ark Professions Code.and my license is RPLC ERT FURNC @SAME LOC in full forte andcffam. v bt.7 License Clan C­2Le.P a- DaM Camrar e g CHRECfSxlDECLARA790 C 2 1 understand my plaru shall le used as public:records yCr^ Licmtxd Professional . g Oat I am exempt from m Ce ConomON His 1 hereby.sero o n I am exempt from U r Contractors !Any c law for the y O O following reason.(Section 7031.5,Bushtess and Pe.dkon,l Cade Any city s county $� whirb mqusu n Permit h vires the Plus.improve de Permit t,m e a sig any unelum ZY priomiucansule.alman,W ft theappfaant for such permit mfilea Law(ummem thnstruccgwith Sudan 7(l)(1) pmviAooso of thft e BuumrSLJmvcl�w(Chapm9 Sq.Ft. Floor Area Valuation g5g (cameiscogwiNScctishotofDasesfroftheBusircnarp6mfmyviCrEe)of $2400 — Natio ls eumprany,atherefrom and the basis far the alleged applies to Any it Penalty of Section 7031.5 by any,applimntfar aPermit abjeeu the applicantto arivilpcoalty of that mammanfive mkmddollars(S5M. 34215074 - Occupancy Type ❑1,u ewnu aide proprsty,M mY emploYcu with wage u that ale compemadon. will Prdmsim's Code,- rte Cont Tarsals I tend Wawdo mart ,,I, sec .o] and err.he bat code The Gantrxtors n ke law ach rot aPplr ff an awmu is Required Inspections propenywW builds mimpcowslhermr and who aresauchwark MmaeredWough his own employees.however. theWiproNdr i that rem improvements am not ear oft a pletio .far ala If. Wildne id building o improvement is old did arc year of i m rmfw the pwnm- Wiku will have th badeo of proving Nat k ria rot WiM o improv lar pocprsm of ale.). ❑1.u owrcr of Om Property.am exclusively mnusting with Ikensed contractors to com arm the project flee roan.Bmmea and PrefesUam Code:)Tln Conaamars Li. cannot law does not apply he son owner of property who builds or improves Nmmn.and. who mnuacts far,such projects with a eonractor(.)licensed parmant to the Commodes Lleeme law. I rm e¢mpt under See .B A P C tar Nis reason Owner, Dom WORKERS COMPENSATION DECLARATION 1 bemby affim under Foully of perjury one or the following declwdrns: lave and will maintain aCeruBesm of Cement b alr-io ren for Wortcrseompm- amen.ss provided fm by Sectme 31M of the Labor Code.far the part...of the work for which this Permit is issoea. ❑I have and will maintain Wofkces Compensation Insurance,as mgkmd by Section 370(1ar the Mbar Cade.far the perfarmanz of to work for which this Permit u lssrcd My e1 ' Wacker.C-�ompenudonn�Imunnce carrier and Policy numbcs one; �j Carriers p k A)L fy1,04 Policy No.: t'KLI )5�a CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This actin nand not W complemd iflhe permit is foam,Wndmk sofas(SIM) or leu) 1 certify Out in the pecfoonance of the wart far which this permit is issued,l Shall rot employ any pecan in any maorcr an as m become abject to the Wordue Compensation Laws of California.Dem Applicant NOTICE TO APPLICANT:IL alter making this Ccmfficam of Exemption,you shonld beeeme tubj=to the WorheYf Campemedan proYi9arr of the IAW,Godo you am .J O fathwids comply with such Provisions or Nu permit shall W deemed ravelled. 'E y EN CONSrRucnON LENDING AGCY [..m.. I Wmhy affirm can them ls a command. agency far the perfamarcc of E WC work fm which NY PCmhl Is ISaKd(Sm.3097.Civ.C.) !A 0 lenders Name z alders And. U O 1«tory Nal 1 have mea W.mHoden and.um that the above W.U.I, ty E trona 1 agree m.plY with N city and county arthro and sum lar.hung m 0 V^ building construction,and herby mNari¢representatives or this city to untrupo the above-mentionedpe pmnY for inspection purpaea CL (We)agree to ave,indemnify and kup ha emus the City of Cupertino again (V) liabilities,jedgeunu.costa ana experts which may m my way atone againu.ud City U z in unscgmrce of the granting of this permit. ti APPLICANT UNDERSTANDS 4ND WILL COMPLY WITH ALL NON-POINT Issued by: Dale SOURCE REGUUT IO "�— Re-roofs Signuum of ApplicanUContacmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applinnt or forum bolding aceupantnom or handle bared..armaial as defiocd by th Cuperam Municipal Code.Chapter 9.12 and the Health and Safety Code.Section e� zss3z(.)7 t]Ym All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding oc upant tea equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove t havaknm air camumimnu as defmrcd by the Bay Area Air Quality Management all new materials for inspection. sat et4 ❑Yes GNU I have,mad Ne,hanardom materials mquhemcw ander Chapmr6.95 of Ne,Glifor- nuHealthA SafmyCode,Sections 25.505.25533 mdn534.1 uLLmund thniftW Wilding dens,not c..fly have a root Nu it is my rapomi6ility as maty the acenWt of the requirements which m,. crop be martpoor m issuance mat Certificate or OunpaneY. Signature of Applicant Date V `T—— IV.^ 1 Owner or amhod ag Dow All roof coverings to be Class'%W`or better CITY OF CUPERTINO • 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34215074 . 00 DATE ISSUED. . . . . . . : 10/07/2008 RECEIPT # . . . . . . . . . : BS000006287 REFERENCE ID # . . . : 08100033 SITE ADDRESS . . . . . : 22663 WOODRIDGE CT SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BEDELL HARRY W JR AND CAROL A ADDRESS . . . . . . . . . . : 22663 WOODRIDGE CT CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2676 RECEIVED FROM . . . . : DAVID KESTER CONTRACTOR . . . . . . . : KESTER, DAVID M LIC # 22101 COMPANY . . . . . . . . . . : KESTER HEATING AND AIR CONDITI ADDRESS . . . . . . . . . . : 4351 GLENPARK DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95136 TELEPHONE . . . . . . . . : (408) 265-1103 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --- ------------- ---------- ---------- ---------- ---------- - --- 1BSEISMICR VALUATION 2 , 400 . 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 1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00 ---- --- ---------- ---------- TOTAL PERMIT 224 . 85 0 . 00 224 . 85 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 224 . 85 VISA --------------- TOTAL RECEIPT 224 . 85 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ---------------------------- -------- ------- -------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Community Development 10300 Torre Avenue S Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 WUPEkTINO Building De artment JOB ADDRESS: PERMIT # OWNER'S NAME: R PHONE # 9% - 3,T03 GENERAL CONTRACTOR.' gryz FAX# I am not using any subcontractors: to) -11 n 'gIFAure 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 Owner/Conactor ignature Date v � 33 ' d CITY OF CUPERTINO FURNACE/AC •CUPERTINO PERMIT APPLICATION FORM APN# 3 y o2 50-7y. v v Date: Building Address: -Z(0(0 S ujc 7n '- Owner's Name: Phone#: /�,4 AP (3i-.61L - 3SL>3 Contractor: Phone#: • H 2--I2-2Z Kc$ Fax #: 12 /Sd Contractor License#: Cupertino Business License#: Contact: Phone #: j(49— Fax 49—Fax #: Building Permit Info: Elect ®/ Plumb ,®._--- Mech [�— Residential I Commercial Job Description: For Residential Installations: 10 Attic ❑ I" floor [�� 2"a 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 Re uired ❑ Cost of Project: Type of Construction (Usage Class): Strapped D On Platform Lj Bonded El New Location ❑ Replacement Project Size: Ex ress ©�Standard ❑ Large ❑ Major ❑ Valuation: Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Revised 6/16/08 CITY OF CUPERTINO CD- FURNACE/AC 5 " CI OF CUPEI,TINO FEE SCHEDULE • Quantity Fee ID Fee Description Fee Permit Type Group FURNACE FURN/AC 1MCRAA Commercial-Repair/Alteration/Add to M ea heating appliance,refrigeration unit, cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MCREPALT Commercial for the repair of alt/add to M ea heating appliance,refrigeration unit,cooling unit,VAV boxes, absorption unit or ea heathing, cooling absorption,or evaporative cooling sys, incl install of controls regulated by this code. 1MCSUSHTR Commercial Install/Relocate ea M suspended heater,recessed wall htr, or • floor mounted unit heater. 1PGASCOM Commerical for ea gas piping System P 1-4 outlets 1BPGAS For each gas piping system of 5 or P more per outlet. 1MCAPPVNT Commercial for the install/relocate/ or M replacement of ea appliance vent installed &not incl in an appliance permit. 1BSEISMICO Commercial Seismic B IMRRAA Residential Repair/Alteration/Add to M ea heating appliance,refrigeration unit, A cooling unit,absorption unit,or ea heating,cooling,absorption or evaporative cooling system,incl installation of controls regulated by this code. 1MRSUSHTR Residential Install/Relocate ea M suspended heater,recessed wall htr, or floor mounted unit heater. 1MRAPPVNT Residential for the install/relocate/or M • replacement of ea appliance vent install &not incl in an appl permit. Quantity Fee ID Fee DescriptionFee Permit Type Gr u n