The URL can be used to link to this page

07050110 CITY OF CUPERTINO BUILDING DIVISION, PERMIT PERMIT NO. BUILDIN ADDRESS: 2485 RANCHO VENTURA ST DOVE' S SERVICES INC 07050110 PERMIT ISSUE DATE OWNER'S NAME: ALICIA WRIGHT 1695 SA3EWOOD AVE 05/14/2007 SANITARY NO. CONTROL NO. NE: (510) 37'0-6543 BUILDING PERMIT INFO ARCHITECTIENGiNEER: BLDG ELECT PLUMB MECH p C LICENSED CONTRACTOR'S DECLARATION Job Description U C I hereby affirm that I am licensed under provisions of Chapter 9(commencing z m with Section 7000)of Division 3 of the Business and Professions Code,and my license is ADD AIR CONDITIONING IN REAR H in full force and effect. Z Licensee LIC.# rp DatD Contractor, ARCHITI TION i C< l understand my plans shall be used as public records >yU C H Licensed Professional OWNER-BUILDER DECLARATION ja I hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following mason.(Section 7031.5,Business and Professions Code:Any city or county <$Q which requires a permit to construct,alter,improve,demolish,or repair any structure —y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 iq.Ft.Floor Area 2 t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $3600 that he is exempt therefrom and the basis for the alleged exemption.Any violation of �t Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3570107 9 AEU Number Occupancy Type not more than five hundred dollars(5500). ❑f,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 offend for sale(Sec.7044,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 We.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- 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. ❑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: J I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for 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 Workees��c,o,,,m�►►pp�eePsadon Insurance carrier and Policy number are: Carrier. �TF'<1'c � Policy No.: 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,1 shall not employ any person in any manner so as to become subject to the Workcrs'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 ,J forthwith comply with such provisions or this permit shall be deemed revoked. O z, CONSTRUCTION LENDING AGENCY HrA I hereby affirm that there is a construction lending agency for the performance of {Y+> the work for which this permit is issued(Set:.3097,Civ.C.) W Q Lender's Namc az Lender's Address V 0 1 certify that I have read this application and state that the above information is L4 0,1 correct.1 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. CL (We)agree to save,indemnify and keep harmless the City of Cupertino against V) liabilities,judgments,costs and expenses which may in any way accrue against said City fJ Z in consequence of the granting of this permit. Date ►'� APPLICANT UNDERSTAND A WILL COMPLY WITH ALL NON-POINT Issued by S URGE GULATIONS. 1 U1 Re-roofs tareof ApplicatrDam HAZARDOUS e of Roof HAZARDODO Type 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 Cede,Section 25532(x)? All roofs shall be inspected prior to any roofing material being installed. C]Yes [3 No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. District? ❑Yes O No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sectio 5.25533 and 25534.1 understand that if the building doe not currently have a tenon that A is my responsibility to notify the occupant of the re vire itis hick must be m prior«*issuance of a Certificate of Occ pan Signature of Applicant Date a All roof coverings to be Class"B"or better Owner or authorized agent Da ' CITY OF CUPERTINO Vit\ AC,E/,,,k,C CUPER`T1NO PERMIT APPLICATION FORM APN# -3-52 / 0 N I Date: Building Address: 22L485 PinC,tl0 Owner's Name: Phone#: Contractor: License#: DO&s �6 50C12- Contact: 5 37� _ �y 3 Cupertino Business License #: Building Permit Info: -Bldg ❑ Elect ❑ Plumb G Mech C�- Job Description: d 4A C Residential in Commercial ❑ For Residential Installations: Attic ❑ I' floor E:1 2°d floor❑ Adhere to min set back requirement 99 For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required Cost of Project: Type of Constru,-tion: Occupancy gr up: POO Strapped On Platform Bonded Sq.Ft. Floor Area: New Location Replacement ❑ Qty. if Applicable Fee ID Fee Description Fee Group BENERGY —Energy BUILDING BREMFURN kelocation of Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfin MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfrn MECHANICAL BREMRECEPT Rec tl, Switch& Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING 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 BUSLIC Business License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPEi�TINO Building Department JOB ADDRESS: PERMIT# ` -,-da V L� OWNER'S NAME: 7 " PHONE# l c� O 1 - 2 > I GENERAL CONTRACTOR:, e -s Sep-v", FAX# I am not using any subcontractors: �Lait�, - Signature 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 S-iq , c7 Owner/Contractor Signature Date