The URL can be used to link to this page

07050240 CITY OF CUPERTINO � I }R1 �j€ N• BUILEANG DIViCION PERMIT PERMIT NO. BUIUTV�QDit hSTLETON ST ATLAS—TRILLO HVAC 07050240 y L� PERMIT LSSUE DATE OWNER'S NAME: GREGG VENT 1965 KYLE PARK CT 05/23/2007 SANITARY NO. CONTROL NO. 'NE: (408) 286-8931 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH ee Z LICENSED CONTRACTOR'S DECLARATION Job Description 0 Up I hereby affirm that i am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division Ufthc Business and Professions Code,and my license is R & R FURNA I E, ADD 4 TON A/C UNIT '4 l. H in full force and effeb1 � v�Z License Lic.# p Datc Contractor t tit ARCHITECTS DECLARATIO d< 1 understand my plans shall he used as public records �V U.H Licensed Professional o a OWNER-BUILDER DECLARATION -2 1 hereby affirm that 1 am exempt from the Contractor's License Law for the In Or� following reason.(Section 703 1.5.Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure Z; S prior ur its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $10000 F (commencing with Section 7000)of Division 3 of the Business and Professions Cade)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 35620 0 46 .t� f Number 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.7041,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.). 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- ccnse 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. 0 I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION bereby affirm under penalty of perjury one of the following declarations: ave and will maintain a Cerfiricate of Consent to self-insure for Worker's Compen- sai provided for by Section 3700 of the Labor Code,for the performance of the w r which this permit is issued. ave and will maintain Worker's Compensation Insurance,as required by Section 37 of the Labor Code,for the performance of the work for which this permit is issued. Workees,Comp nsauon gsurance carrier d Policy her are: Carrier. P61icy No.: LV RH CERTIFICATE OF EXEMPTION FROM WO ERS' COMPENSATION INSURANCE (This section need not be completed if the permit is foronc 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 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 O CONSTRUCTION LENDING AGENCY F.s►�– 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 QLender's Name az Lender's Address i certify that I have read this application and state that the above information is V.O correct.I agree to comply with all city and county ordinances and state laws relating to 0U building consuuction,and hereby authorize representatives of this city to enter upon the ahove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,costs and expenses which may in any way accrue against said City lJ z in consequence of the grantin of this permit. ►" APPLI UNDER S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date OUR ULA NS 5bt)hn Re-roofs Sign ur actor Dam Type of Roof HAZARDOUS M ALS DI CLOSURE yP Will the applicant or future building occupant store or handle hazardous material as defined by the CupertinoFu. I Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall')e inspected prior to any roofing material being installed. 0 Yes If a roof is instilled without first obtaining an inspection, agree to remove Will the applicant oilding occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management a] ew materials for inspection. District? .� 0Yes o! I have read the hazards s materials requirements undcrChaptcr 6.95 of the Califor- niaHeal�Se5533 and 25534.1 undcrstand that if the building lJ docs noy responsibility to notify the occupant of the requiuance of a e_ ate er apaney. Signature of Applicant D e All roof coverings to be Class"B"or better Owner or authorized agent ate CITY OF CUPERTINO 8 ITEMS OF 16 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 3562004:6.00 DATE ISSUED. . . . . . . : 05/23/,:007 RECEIPT #. . . . . . . . . : BS0000O1448 REFERENCE ID # . . . : 07050260 SITE ADDRESS . . . . . : 21594 CASTLETON ST SUBDIVISION . . . . . . . CITY CUPERTLNO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GREGG JENT ADDRESS : 21594 '-ASTLETON ST CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4703 RECEIVED FROM . . . . : ATLAS-TRILLO CONTRACTOR . . . . . . . : TRILLO, STEVE LIC # 4269 COMPANY . . . . . . . . . . : ATLAS-TRILLO HVAC ADDRESS : 1965 KYLE PARK CT CITY/STATE/ZIP SAN JCSE, CA 95125 TELEPHONE (408) 286-8931 FEE ID UNIT QUANTITY AMOLNT PD-TO-DT THIS REC --NEW-BAL- ___ ------------- ------ ------ BENERGY PERMIT FEE 1. 00 34 .86 0. 00 34 . 86 0. 0 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 10, 000. 00 1. 00 0. 00 1. 00 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 :-76 .74 0. 00 176 .74 0. 00 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 CUP ERTINO` U NACI.VAC CUPEQ INO PERMIT APPLICATION FORM APN# Dat 35;O— a0-01kLo �Z. Building Address: 1<5q I-- ,2= _ Owner's Name: % P�j�l,. _��I? - - --- 6)T,1647�--- — 1� Coll c Phone- Licens 8- Contact, Phone: Cupertino Business License#: Aa(o� Building Permit Info: Bldg ❑ Elect Plumb C Mech Job Description: ct Residential Commercial ❑ For Residential Installations: Attic ❑ 1St floor ❑ 2nd floor❑ Adhere to min set back requiremen For Commercial Installations: _eplacement same weight E] Additional weight (structural calcs) El Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ C st of Project; Type of Construction: Occupancy group: rM Strapped ❑ On Platform Bonded TT Sq.Ft. Floor Area: New Location Replacement Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN 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 BSEISMICOM Seismic;Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piling System Fee PLUMBING BUSLIC Busine,;s License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ''UPEkTINO Buildin Department JOB ADDRESS: PERMIT#O`� G S O ��rl OWNER'S NAME: PHO d{ -a..q GENERAL CONTRACTOR: V �' FAX# I am not using any subcontractors: �--- Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS5 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 ile ntrac or Signature bate