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06100135 CITY OF CUPERTINO +CTR� O Is.} TI�N ` BUILDING DIVISION PERMIT ,.:. . PERMIT NO. BUILDING ADDRESS: A & H HEATING 06100135 7809 LUNAR CT PERMIT ISSUE DATE OWNER'S NAME: YU RESIDENCE 770 CHE SANITARY NO. CONTROL NO. NE: (408)279-0722 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 0 a O p LICENSED CONTRACTOR'S DECLARATION Job Description i U 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,and my license is �y in full force and effecty� REMOVE & REPLACE FURNACE FLUE AND DUCT SYSTEM v�Z License Clads `,. Zv Lic•>r �� Contractor ARCHITECT'S DECLAR O i C< I understand my plans shall be used as public records .a. OI- Licensed Professional ti OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the 3 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 z; prior to its issuance,also requires the applicant for such permit to file a signed statement Sq,Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 I- (commencing with Section 7000)of Division 3 oC the Business and Professions Code)or ? .. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of G 0 0 Occupancy Type not more than five hundred dollars($500). ❑1,as owner of the property,or my employees with wages as thew sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law dors 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.). ❑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- 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: ❑1 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 Worker's Compensation Insurance carrier and Policy number arc: Carier.��IpJ I �1!' . Policy No.: I D?-O� CERTIFICATFOF 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.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 E.r I hereby affirm that there is a constructimn lending agency for the performance of - fY the work for which this permit is issued(See.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 IS.E" correct.I agree to comply with all city and county ordinances and state laws relating to C U building construction,and hereby authorise 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 „F„ liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date ►- APPLICANT UNDERSTANDS A WILL COMPLY WITH ALL NON-POINT Issued by: SO E REGULATIONS. — Re-roofs Signature of Applicant/Contractor Dare Type of Roof HAZARDOUS MATERIALS DISCLOSURE yp Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal C de.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 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 contamina;No s de y the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Hcalth&SafetyCode,Sections 25505.25533 and 25534.1 understand that if Ute building docs not currently have a tenant,that it is my responsibility to notify the occupant of the requimmc which must be met prior w' an of a Ccruftcate Occupancy. _ Signature of Applicant Date All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO .em 2 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36220020 . 00 DATE ISSUED. . . . . . . : 10/18/2006 RECEIPT # . . . . . . . . . : 36483 REFERENCE ID # 06100135 SITE ADDRESS . : 7809 LUNAR CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER YU RESIDENCE ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : DALE PHELPS CONTRACTOR . . . . . . . : PHELPS, DALE LIC # 12079 COMPANY . . . . . . . . . . : A & H HEATING ADDRESS . . . . . . . . . . : 770 CHESTNUT ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95110 TELEPHONE . . . . . . . . : (408) 279-0722 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -- - ---- - - - -- - - --- - ----- - ------ - -- ---------- --------- - ----- --- -- ---------- BREMFURN NO UNIT 1 . 00 14 . 31 0 . 00 14 . 31 0 . 00 BSEISMICRE VALUATION 4 , 450 . 00 0 . 50 0 . 00 0 . 5.0 0 . 00 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 EPERMITFEE 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 MPERMFEE SQUARE FEET 2 , 000 . 00 160 . 00 0 . 00 160 . 00 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 - ----- ---- ---------- ---------- --------- - TOTAL PERMIT 324 . 78 0 . 00 324 . 78 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - - - - ---- - -- --- - -- -------- ---- - ----------------- OTHER 486 . 71 VISA TOTAL RECEIPT 486 . 71 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL .: Community Development 10300 Torre Avenue ' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 '.UPEkTINO Building Department JOB ADDRESS: PERMIT #, OWNER'S NAME: G( PHONE # 2$'— 8 GENERAL CONTRACTOR: !g T FAX # I am not using any subcontractors: 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 Owner/Contractor Signator Date CITY OF CUPERTINO Olt 10os FURNACE/AC ;UPE1NO PERMIT APPLICATION FORM APN # Date: /O (�L,& 1 Building Address: Owner's Name: u Phone #no�5_1 /1953 --j Contr ctor: ..,,� . Phone: License #30 &tY7,X N�1 � Cu ertino Business License i#: Contact: � pRaes J40 5.h.,._Phone: k�G Building Permit Info: Bldg ❑ Elect `YJ Plumb LJ Mech Job Description: `= t6 Residential PC Commercial ❑ � For Residential Installations: Attic ❑ 1St floor ❑ 2nd floor❑ Adhere to min set back requirement❑ ,'?' k~"' S or Commercial Installations: Replacement same weight ❑ Additional weight (stmctural calcs) ❑ Structural Calculations required for new installation New installation Plannin Approval Required ❑ — Cost of Proje Type of Construction: Occup1n grip: Z lam- `C_ J Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location ❑ Replacement ❑ – Qty. if A licable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Relocation of Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BRE 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 BUSLIC Business License BUILDINGP-C _ Dovv_� �t=t. e� S - r 1 � _