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07050028 -777777. 7 7777 CITY OF CUPIERTINO BUILDING DIVISION PERMIT C1R9 OTQ ItT��r1 BUfLgiNGgO/4ESYALM AV A PERFECT CLIMATE PERMIT07050028 OWNER'S NAME: PERMIT ISSUE DATE JOHN CHOW 10570 S DEANZA BLVD 05/03/2007 AE: (408) 86'-19545 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 � 0 i p p LICENSED CONTRACTOR'S DECLARATION Job Description UP I hereby affirm that I am licensed under provisions of Chapter 9(commencing Zm with Section 7000)of Division 3 of the Business and Professions Code,and my license is REPLACE A/C 5 TON 14 SEER h�w in full t? forcend License Cl V Date AR HITRCleDCLAR N 1 understand my plans shall be used as public records )�U ,a a Licensed Professional y OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county <%0! which requires a permit to construct,alter,improve,demolish,or repair any structure Z y prior to its issuance.also requires the applicant for such permit to file a signed statement =o that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ,t,hq.Ft. Floor Area $5098 Valuation L3 t-$ (commencing with Section 7000)of Division 3 of the Business and Proressions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of �p]�j Number Occupancy Type not more than five hundred dollars($500). 3 5 7 0 4 0 64 1:t��1 I,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,Business Required fired Ins echo ns and Professions Code:The Contractor's Licerhse Law does not apply to an owner of 9 P 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 I,as owner of rhe 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 contractor(s)licensed pursuant to the Contractor's License Law. Q I 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: L]I have and will maintain a Certificate of Consent to self-insure for Workefs Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the wo or which this permit is issued. 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 Worke�es Compensation Insurance Insurance carrier and Policy a ber are: � e_7�^ Carrier l�il b4kt L Policy No.: 3 V l TCERTIFICATE OF EXEMPTION FRO WO ERS' 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 Codc,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z'" CONSTRUCTION LENDING AGENCY (~� 1 hereby affirm that there is a construction lending agency for the performance of p; the work for which this permit is issued(Sec.3097,Civ.C.) WIz,A Lender's Name a z Lender's Address U 0 1 certify that 1 have read this application and state that the above information is V.'r 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 W ahove-mentioned property for inspection purposes. LL (We)agree to save,indemnify and keep harmless the City of Cupertino against hF"y liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE • ULATIONS. nax�� " 9 5,.'7�� Re-roofs Signature of Applicant/C actor Dare 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 ode.Chapter 9.12,and the Health and Safety Cede,Section 25532(a)? All roofs,hall be inspected prior to any roofing material being installed. ❑Yes u Will the applicant or future b'ding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants fined by the Bay Area Air Quality Management all new materials for inspection. District? QYcs No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 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 requirements which mustprior to rarhceofa r, leofoecupancy.� Signature AApplicant Date S's All roof coverings to be Class "B"or better Owner or authorized agent YY CITY OF CUPERTINO 6 ITEMS OF 12 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 35704064. 00 DATE ISSUED. . . . . . . : 05/03/2007 RECEIPT #. . . . . . . . . : BSC00001202 REFERENCE ID # . . . : 07C50028 SITE ADDRESS . . . . . : 22374 PALM AV SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER JOIN CHOW ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2710 RECEIVED FROM . . . . : REC'EIPT INTERFACE CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY A PERFECT CLIMATE ADDRESS 10_`70 S DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE (4( 8) 86119545 FEE ID UNIT QUANTITY 1,MOUNT 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 BSEISMICRE VALUATION 5, 098. 00 0. 60 0. 00 0 . 60 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 160. 83 0. 00 160.83 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 321. 66 #30710, PERFCT CLIMAT --------------- TOTAL RECEIPT 321 . 66 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF CUPERTINO BUILDING DIVISION PERMIT Q� �.} M`ITI�N PERMITNO. BUILL iVjjkl(� b 6' ARKW00D DR AVERY CONSTRUCTION 07050142 OWNER'S JNAME: r PERMITISSUEDATE GLENBROOK APTS 130 E;iST D,NA ST 05/16/2007 NE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO REPLACE WINDOWS LIKE FOR BLDG ELECT PLUMB MECH C] D O D Ar? 6I.ENWE)OD 100 LICENSED CONTRACTOR'S DECLARATION ,- _ -,Try Job Description V 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, nd my license is in full force and j ? License Class Lic.ff y Date ARCHITECTSRATION Ca 1 understand my plans shall be used as public records �yU u.H Licensed Professional `- OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the C O following reason.(Section 7031.5,Business and Professions Code:Any city or county Z 0� which requires a permit to construct,alter,improve,demolish,or repair any structure U Z> prior to 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 >�] 4 t- (commencing with Section 7000)of Division 3 of the Business and Professions Codc)or y `� that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars($500). ❑I,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,Business Required Ired Ins eCU0i1S and Professions Code:The Contractor's License Law does not apply to an owner of q p 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.). ❑I,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- cause 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. ❑I 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: ❑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. ❑1 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 Workeel.SpinpensaLion Insurance carrier and Policy9number am: 6 b Carrier.. �"� Polity o.:�V y CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This 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.Dale 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 dcemed revoked. Z O CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of R! > the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name ] Z Lender's Address U 0 1 certify that I have read this application and state that the above information is 11. correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding consuuction,and hereby authorise representatives of this city to enter upon the W above-mentioned property for inspection purposes. a (We)agree to sav 'ndcmnify and keep harmless the City of Cupertino against liabilities,judgments,c and expenses which may in any way accrue against said City U,Z in consequence of th nun of this permit. -, APPLICANT WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU TI .011.1 �`.. '(6 a 7 Re-roofs Signature of A icant/Contractor Dam Type of R sof HAZARDOUS MATERIALS DISCLOSURE 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(x)? All roofs:;hall be inspected prior to any roofing material being installed. ❑yes No If a roof i:;installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contamin as defined by the Bay Area Air Quality Management all new m iterials for inspection. District? ❑Yes I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&,W C ,Sections 25505,25533 and 25534.1 understand that if the building d currently ve a nt,that it is mypansibility to notify the occupant of the re uircmcnts hssuanccnfaecrifhcateofOgnpancy. Signature of Applicant Date l/— ( 66 All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO 4 ITEMS OF 56 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 32627037. 07 DATE ISSUED. . . .. . . : 05/16/2007 RECEIPT #. . . . . . . . . BS000001350 REFERENCE ID # . . . : 07050142 SITE ADDRESS . . . . . : 10110 PARKWOOD DR SUBDIVISION . . . . . . CITY CUEERTINO IMPACT AREA . . . . . . OWNER GLENBROOK APTS ADDRESS . . . . . . . . . . : 10100 MARY AVE CITY/STATE/ZIP . . . : CUEERTINO CA, 95014-1502 RECEIVED FROM . . . . : BRIAN AVERY/MATT CONTRACTOR AVERY, BURT LIC # 12134 COMPANY AVERY CONSTRUCTION ADDRESS 13C EAST DANA ST CITY/STATE/ZIP . . . : MTT VIEW, CA 94041 TELEPHONE . . . . . . . . : (9E0) 961-8330 FEE ID UNIT QUANTITY TMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 147.96 71.02 0.00 71. 02 0. 00 BPERMFEE VALUATION 7, 785.00 147. 96 0.00 147. 96 0. 00 BPLANCHK PERMIT FEE 147 .96 197.45 0.00 197.45 0. 00 BSEISMICRE VALUATION 7, 785 .00 0. 80 0.00 0. 80 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 417.23 0 . 00 417.23 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 101 FOUNDATION 102 PIERS 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH