Loading...
07050027t00 7VWj :z Iy 7 )v�Z �[-W .4 i ,, LQ LQ U. W H 0 N.4 a < o� u^u -ZY QFC i ^ �� Z CITY OF CUPERTINO Cd�T`1E�TQR BUILDING DIVISION PERMIT BUILDutTDpgEssRIVERSIDE PERMIT07050027 DR A PERFECT CLIMATE OWNER'S NAME: PERMIT ISSUE DATE WEI—SHEN HUANG 10570 S DEANZA BLVD 05/03/2007 )NE: SANITARY NO. CONTROL NO. (408)86119545 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is REPLACE A / C - 5 TON 13 SEER AT REAR YARD in full force and effWL T7 License Class C•f,�3 L _ Lie. M v Date Contractor A CHYI'ECTS DECLARATIO 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7(Y31.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License law (Chapter 9 3q. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the Section 7000) Division 3 of the Business and Professions Code) or $5398 (commencing with of that he is exempt therefrom and the basis for the alleged exemption. Any violation of 35603039 A Number 8 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more man eve hundred dollars (x500). . ❑ I, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work and the structure is not intended or offered for sale (Sec. 7144, Business and Professions Code: The Conuactoes License Law dots 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.). ❑ 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 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. ❑ I am exempt under Sec B & P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I 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. ❑ 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 Work�eess Compensation Insurimee carrier and Politynumber Carrier. WtifC V «L SMT * Policy No.: ��0 _ CERTIFICATE OF EXEMPTION FROM WORKERS' 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 • forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I 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.) Lender's Name Lender's Address I certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against j liabilities, judgments, costs and expenses which may in any way accrue against said City ' in consequence of the granting of this permit. y APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCE REG1JLAnONS. _A '1 �f 3 e- 07 Re -roofs Type of Roof Signature of Applicant/Contoctor Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cuperno tiMunic' al Code. Chapter 9.12, and the Health and Safety Code, Section 25532(a)7 All roofs! hall be inspected prior to any roofing material being installed. ❑ Yes o 0YWill If a roof is installed without first obtaining an inspection, I agree to remove the applicant or future ilding occupant use equipment or devices which omit hazardous air contaminant fined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes Nu I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Codc, 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 requireme nrnustbem or to a Certificate of Occupancy Signature )f Applicant Date All roof coverings to be Class "B" or better Owner or authorized ag t Date CITY OF CUPERTINO 6 ITEMS OF 12 PERMIT' RECEIPT Sec: Twp: Rng: Sub: B1}:: Lot: APN ......... 35603039.00 DATE ISSUED........ 05'03/2007 RECEIPT #.........: BS000001202 REFERENCE ID # ...: 07050027 SITE ADDRESS .....: MCA RIVERSIDE DR SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............. WE=-SHEN HUANG ADDRESS .......... CITY/STATE/ZIP ...: CUPERTINO CA, OPERATOR: patg COPY # : 1 95014-3960 RECEIVED FROM ....: REC:EIPT INTERFACE CONTRACTOR .......: SMZTH, BYRON E LIC # 21144 COMPANY ..........: A PERFECT CLIMATE ADDRESS ..........: 10570 S DEANZA BLVD CITY/STATE/ZIP ...: CUIERTINO, CA 95014 TELEPHONE ........: (408)86119545 FEE ID UNIT QUANTITY !LMOUNT 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 5,398.00 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 VOICE ID DESCRIPTION -------- ---------------------------- 303 ROUGH MECHANICAL VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL MAR -09-2007 01:23 PM Mary Kurtis 415 276 2304` 4�� `l P.01 %-urCK,i imu K L` A%IV X A t1l A LdL%..li A iV,lI i' VX%aT.1 APN # — a� Date: Building Address: BREMFURN Owner's Name: i ' Phone #• Contractor. Phone: License #' Contact: � Phone: Cupertino i Iingss License #: GL}} Building Pa tilt Info: MECHANICAL Bldg 0 Elect Plumb Racpd, Switch & Outlets Job Dercri.fion. r Residential Commescial ❑ S3ismic Fere Res For dentisEI ttom: V � BSEISMIC©M Attic 10 floor 2rA floor BUILIDNO Adhere to min set back ent Eve Permit Issuance For Commerce! IttetapatRons: 1 Replacement same weight 0 Additional weight (structural calcs) 0 MPERMTTFEE Stntctu ml. Calculations required for new installation MECHANICAL Now installation Pl aval R c fired PlumbinPexmit Issue Cost of Project Type of Constrw:tion: Occupancy up: Strapped On Platform Bonded Sq.Ft. Floor Axes: New Location Replacement Plan Check Fee Qty. if Avolicable Fee ID Foe Description Fee Group BENER.GY Biergy Bier BUILDING BREMFURN Fumace MECHANICAL BREMACO'VER AIC Unit > 10,000 cf n MECHANICAL BREM,AI tHAN AIC Units <=10, 000 cfm MECHANICAL BREMRECEPT Racpd, Switch & Outlets ELECTRICAL BSEISMICRE S3ismic Fere Res BUILDING BSEISMIC©M S usmic Commercial BUILIDNO EPERMUM Eve Permit Issuance ELECTRICAL MPERMTTFEE M ech Permit Issuance MECHANICAL PPE;RMTI"FEfi PlumbinPexmit Issue PLUMBING BPERNOW B'dg .Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC B isiness License BUILDING CITY OF ',UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: ," PE #OZA�'? OWNER'S NAME: PHONE # c , - GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Kt,,4 ZS ignature Date Please check applicable subcontractors and complete the following information: Owner ontractor Signature Date 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 ontractor Signature Date