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07050058 CITY OF CUPERTINO CQ) Tl +�r � 'jN• BUILDING vIVISION PERMIT .............. PERMIT NO. BUIL�rl�G5TtE'hSTLETON ST STANFORD PLUMBING HEATING 07050058 4 PERMIT ISSUE DATE OWNER'S NAME: GREGG VENT 19 6 5 KYLE PARK COURT 05/08/2007 RYNO. ----- SANITARY NO. CONTROL NO. 'NE: (408) 286-8931 BUILDING PERMIT INFO ARCHTCECf1ENGINEER: BLDG� ELECT� PLUMB MECH [=3 cd Z LICENSED CONTRACTOR'S DECLARATION Job Description p I hereby affirm that I am licensed under provisions of Chapter 9(commencing ur Z c8 with Section 7000)of Division 3 of the Business and Pr 'ns arum icensc is REPLACE FUR VAC E, ADD A IR CONDITIONING y in full force and eft L v�Z License Class Lre•M p Dam Contractor t w CTS DECLA y� 1 undo sta d plans all be used as public records �U 4 G ti Licensed Professional OWNER-BUILDER DECLARATION H I a� I hereby affirm that 1 am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county $ which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation t-y prior to its issuance.also requires the applicant for such permit to file a signed statement S F[ Floor Area ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $10000 i t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of d Number Occupancy Type Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of[35=62004=6 not more than five hundred dollars($500). 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 for sale(Sec.7044, nenes� Required Inspections and Professions Code:The Contractor's License Law docs not apply to an 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 U. cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractors)licensed pursuant to the Contractor's License Law. B do P C for this reason 0 I am exempt under Sec Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have;and will maintain a certificate of Consent to self-insure for Worker's Compen- sat) 'provided for by Section 3700 of the Labor Code,for the performance of the ork for which this permit is issued. I land will maintain Worker's Compensation insurance,as required by Section 37 f the Labor Code,for the performance of the work for which this permit is issued. M Workers Cm pens tion Ins nee carrier and�tolieY number e: Cartier. /l�T No.: F EM ON FRO O COMPENSATION INSURANCE (this section need not be completed if the permit is for one hundred dollars(S 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 CONSTRUCTION LENDING AGENCY (t 1 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.) W Q Lender's Name az Lenders Address U 0 1 certify that I have read this application and state that the above information is V4 correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the Gla ahovc-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and ex nses which may in any way accrue against said City V z in conseque rantin is permit. Date 6 tart APPLIC D S A:N:�WEAtc ON-POINT Issued by: Sc SOURC RE Re-roofs Signature of App tcant/Conuactor T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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 XN..budIf a roof is ins:ailed without first obtaining an inspection,I agree to remove Will the applicant ding occupant use equipment o or devices which all new materials for inspection. emit hazardous air comam' ants as defined by the Bay Arca Air Quality Management District? O Yes ° 1 have read the hazardous aterials requirements under Chapter 6.95 of the Cali for- nia Health&lafeLy Code,Sc 25505,25533 and 25534.1 understand that if the building does not cuntly have a ant.that it is my responsibility a noti the occupant of the Date require n .h met • to ora oc Signature of Applicant Date r All roof coverings to be Class 'B or better '.c Owner or auth d agent CITY OF CUPE',RTINO PERMIT RECEIPT OPERATOR: suew 8 ITEMS OF 8 COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35620066 . 00 DATE ISSUED. . . . . . . : 05/08/:2007 RECEIPT #. . . . . . . . . : BS0000 )1241 REFERENCE ID # . . . : 07050058 SITE ADDRESS . . . . . : 21594 CASTLETON ST SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER GREGG VENT ADDRESS . . . . . . . . . . : 21594 CASTLETON ST CITY/STATE/ZIP CUPER7INO CA, 95014-4703 RECEIVED FROM RECEIIT INTERFACE CONTRACTOR TRILLO, STEVE LIC # 4269 COMPANY STANFORD PLUMBING HEATING &AIR ADDRESS 1965 KYLE PARK COURT CITY/STATE/ZIP SAN 08 OSE, CA 8931 95125 TELEPHONE FEE ID UNIT QUANTITY AMOITNT 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 1.00 1.20 0 .00 1 .20 0 .00 BREMRECEPT NO. OUTLETS 0.00 BSEISMICRE VALUATION 10, 000 :000 00 0 38:37 0 .00 38 .3700 0 . 00 EPERMITFEE FLAT RATE MPERMITFEE FLAT RATE 1 .00 38 .37 0 .00 38 .37 0 .00 PPERMITFEE FLAT RATE 1.00 38.37 ---- 38 .37 ------0_00 TOTAL PERMIT 176 .74 0 . 00 176 .74 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE-NUMBER - -- -------- ----------------- CHECK 176 .74 E698-ATLAS/TRILLO --------------- TOTAL RECEIPT 176 .74 VOICE ID DESCRIPTION VOICE ID DESCRIPTION-- ---------- _ __ 304 ROUGH ELECTRICAL 303 ROUGH MECHANICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF CUPERTINO FURNACEAC '10ofTIOI®T �oRM � oS ' CUPE(,TINO PERMIT APPLICATION _PN # Dater Building Address: 259 Owner's Name: Phone#. 3 A 0 S PTO Contact: Phone: Cupertino $usirness License#: Building Permit Info: / Plumt, �! Mech_ Bldg El Elect I� Job Description: I / C Residential Commercial ❑ For Residential Installations: Attic ❑. 1St floor ❑ 2nd floor , Adhere to min set back requirement For Commercial Installations: placement same weight E] Additional weight (structural talcs) ❑ otructural Calculations required for new installation ❑ New installation Planning Approval Required ❑ WedU Type of Comction: Occupancy grOn Platform Bonded 19' Sq.Ft. Floor Area: New Location Replacement E Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/C U zit> 10,000 cfm MECHANICAL BREMAIRHAN A/C U-lits<= 10, 000 cfin MECHANICAL BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seism:c Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech?ermit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg F ermit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Businoss License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 `'UPEkTINO Buil din Department JOB ADDRESS: PERMIT# ;L1 S-C? 94 -. OWNER'S NAME: C fi PHONE # GENERAL CONTRACTOR: a FAX # I am not using any subcontractors: Si e to Please check ap licable 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 ate