The URL can be used to link to this page

07060248 CITY OF CUPERTINO �T� Yt' BUILDING DWISION PERMIT PERMIT NO. BUILDING ADDRESS: 22434 RIVERSIDE DR AAA FURNACE & AIR 07060248 OWNER'S NAME: CO I ON I NG PERMIT ISSUE DATE RYAN YASUI 1712 STONE AVE nr;/27/2007 SANITARY NO. CONTROL NO. .ONE: (408) 29: -4717 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p Z LICENSED CONTRACTOR'S DECLARATION Job Description m I hereby affirm that I am licensed under provisions of Chapter 9(commencing z with Section 7000)of Division 3 of the Business and Professions Code,and my license is ADD A/C 31/2 TON. =y in ful�i�RCHrMCT`IS nLi•M CnDEC RATIO i a a I understand my plans shall he used as public records �aU u y Licensed Professional < OWNER-BUILDER DECLARATION 1 hereby affirm that 1 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 e E,4 which requires a permit to construct,alter,improve.demolish,or repair any structure ti prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation Z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 (;q.Ft.Floor Area t=- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $5000 that he is exempt therefrom and the basis for the alleged exemption.Any violation of N Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3560200 p Number Occupancy Type not more than five hundred dollars(5500). 0 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 forsalc(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law docs 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.). 0 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- cerise 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 Contractors License Law. 0 1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 1 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(slued. 0 I 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 Compensa' n insurance carrier and Policy number arc: Cartier: e Policy No: CERTIFICATE OF EXEMPTION FRO RKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for rine 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 ',Z' forthwith comply with such provisions or this permit shall be deemed revoked. Z OCONSTRUCTION LENDING AGENCY Er ice. 1 hereby affirm that there is a construction lending agency for the performance of f�> the work for which this permit is issued(Sec.3097.Civ.C.) W Q Lender's Name Lender's Address U C) 1 certify that 1 have read this application and state that the above information is Lt,r- correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the W ahovc-mentioned property for inspection purposes. f1. (We)agree to save,indemnify and keep harmless the City of Cupertino against tF liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date 04 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: v SOURCE REGULATIONS. A,-. 2 Del"�!2 Re-roofs Tignature a A licant/Con for Dae T of Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupantstore 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 ;hall be inspected prior to any roofing material being installed. 0 Yes o If a roof i;installed without first obtaining an inspection,I agree to remove Will the applicant or turc building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0 Yes N zaus o 1 have read the hard materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sed4dons 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant.that it is my responsibility to notify the occupant of the req ai encs which must be met prior to issuance of a certificate of occupancy. Signature of Applicant Date h� All roof coverings to be Class"B"or better mer or aur orizcd agent / Date CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN . . . . . . . . . 35602004 . 00 DATE ISSUED. . . . . . . : 06,'27/2007 RECEIPT #. . . . . . . . . : BS000001822 REFERENCE ID # . . . : 07060248 SITE ADDRESS . . . . . : 22434 RIVERSIDE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . RY�LN YASUI ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-3959 RECEIVED FROM . . . . : JITI RANDO CONTRACTOR . . . . . . . : RATdDO, JIM LIC # 8050 COMPANY . . . . . . . . . . : AAA FURNACE & AIR CONDITIONING ADDRESS . . . . . . . . . . : 17:-2 STONE AVE CITY/STATE/ZIP . . . : SAIT JOSE, CA 95125 TELEPHONE . . . . . . . . : (4()8)293-4717 FEE ID UNIT QUANTITY ;MUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BENERGY PERMIT FEE 38.37 34.86 0. 00 34 .86 0. 00 BREMAIRHAN NO.UNITS 1. 00 10.26 0. 00 10 .26 0. 00 BREMRECEPT NO. OUTLETS 1. 00 1.20 0. 00 1.20 0. 00 BSEISMICRE VALUATION 5, 000. 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 161.93 0. 00 161 .93 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 161 .93 VISA --------------- TOTAL RECEIPT 161 .93 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF C UPERTINO 07v (,o 0,2 + F FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM APN# Date: 35�� a � oL/ () � Building Address: Owner's Name: Phone#: Y__4-_ -- ----- -- — -------- Contractor: Phone. License#: QAC c of-,7�3 7 6AR7i Contact: Phone: Cuperting Business License#: Building Permit Info: Bldg ❑ Elect F lumb EP— Mech Job Description:: Residential NA Commercial ❑ For Residential Installations: Attic ❑ 1"floor P 2nd floor❑ Adhere to min set back requiremen For Commercial Installations: Replacement same weight ❑ Additional weight(st-uctural calcs) ❑ Structural Calculations required for new installation New installation Planning Approval Required ❑ Cost of Project: Type of Construction: Occr_5 group: D 1v� Wit_.__ Strapped ❑ On Platform MI Bonded Sq.Ft. Floor Area: New Location Replacement ❑ Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Fitmace MECHANICAL BREMACOVER A'C Unit> 10,000 cfrn MECHANICAL BREMAIRHAN A'C Units <= 10, 000 cfin MECHANICAL BREMRECEPT R.-c tl, Switch& Outlets ELECTRICAL BSEISMICRE S,;ismic Fee Res BUILDING BSEISMICOM S,;ismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE N ech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE B[dg Permit Fees BUILDING BPLANCHK Van Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING Community Development .' 10300 Torre Avenue M . Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: y3 PERAUT# OWNER'S NAME: PHONE # O,e- GENERAL CONTRA OR: C FAX# �G I am not using any subcontractors: Si:;natlure 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/Contractor Signature Date