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06100120C4 z CC :raP .0 :ZW I�z FC tWt: �Qv N :OC 'Z< ==C CITE' OF CUPERTINO777777=77- �Ck IQMAtTIfYN. +. BUILDING DIVISION PERMIT .: BUILDINGADDRESS: P & J SERVICE I CE PERMIT NO. 06100120 7579 WATERFQRD DR PERMIT ISSUE DATE OWNER'S NAME: YEN, JAMES 1063 NOBL SANITARY NO. CONTROL NO. INE: (408)_926-3688 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 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 Cade, and my license is in full force andef[ect. REPLACE EXISTING FURNACE AND INSTALL NEW AIR License Class Lie " Date Contractor CONDITIONER ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the 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 prior to its issuance, also requires the applicant for such permit to file a signed statement 9 Sq. Ft. Floor Area Valuati 5 p Q that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter (commencing with Section 7000) of Division 3 of 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 any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars ($500). 36617030.00 ❑ 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 oroffered 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 thmugb his own employees, provided that such improvements are not intended or offered for sale. It, 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 contractors) licensed pursuant to the Contractor's License Law. ❑ 1 am exem oder Sec B & P C for this aeon Owner Date WORKER'S COMPE TION DECLARATION I hereby affirm under penalty 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 Workers Compensation Insurance carrier and Policy number are: Carrier. 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 to bee jet the orkers' Compensation Laws of California. Applicant NOTICE TO APQUCANT: If, after makin,rSis Certificate Exemption, you should become subject io the Worker's Comperodion 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 L.cndees Address D I certify that 1 have read this application and start that the above information is correct. I 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 /) liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. �+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -PO Issued by: Date SOURCE R GULATIONS. Re -roofs Sign;luioatif Applicam/Contractor Date v' HAZARDOUS gd'ATERIALS DISCLOSURE Type of Roof Will the applicant or ruturcp6ilding occupant store or handle hazardous material as defined by the Cupertino Municipal Code, 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 )i�No If a roof is 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 contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ YesNu I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Hcalth & Safciy Code, Sections 25505, 25533 and 25534. l understand that if the building docs not currently have a tenant, that it is my responsibility to notify the occupant of th Date rcquints which must be met pmr w' uancc of a Certificate of occupant Signature of Applicant All roof coverings to be Class "B" or better Owner or authorized agent D tc CITY OF ''UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS. `�/ PERMIT # OWNER'S NAME: �,/ �yC,S' PHONE GENERAL CONTRACTOR: FAX # I am not using any subcontractors: - - Signatur Date Please check applicable subcontrac to and complete e following information: 211 -1:1Ze 5; 1 Owner/ C tractor 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 211 -1:1Ze 5; 1 Owner/ C tractor Signature Date CITY OF CUPERTINO _ m 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # : 3 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36617030.00 DATE ISSUED.......: 10/16/2006 RECEIPT #.........: 36460 REFERENCE ID # ...: 06100120 SITE ADDRESS ...... 7579 WATERFORD DR SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OWNER YEN, JAMES ADDRESS .. ....... CITY/STATE/ZIP ...: CUPERTINO CA, CA 95014-5233 RECEIVED FROM ....: JAMES YEN CONTRACTOR PAUL WU LIC # 25427 COMPANY P & J SERVICE ADDRESS 1063 NOBLE LANE CITY/STATE/ZIP ...: SAN JOSE, CA 95132 TELEPHONE ........: (408)926-3688 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW -------------------- BAL ----------------------- 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 BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 BREMRECEPT NO. OUTLETS 1.00 1.20 0.00 1.20 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 0.00 BSEISMICRE VALUATION 7,000.00 0.70 0.00 0.70 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 TOTAL PERMIT ---------- ---------- 176.44 0.00 176.44 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ OTHER 176.44 ------------------ MASTERCARD TOTAL RECEIPT 176.44 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ----------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL amTyr CUPEkTINO CITY OF CUPERTINO FURNACE/AC PERMIT APPLICATION FORM APN # ,�—�� Date: Building Address: rl'►q �� 7'E %"�� BUILDING Owner's Name: / .� �/�- ^ / Phone e - 4::C;, L91 Contractor: eJ �,. Phone (.. 3b License #: 4,2 Contact:/,�� Phone: /y Cupertino Business License #: Building Permit Info: MECHANICAL Bldg ❑ Elect Plumb ET�- Mech Job Description: MECHANICAL Residential Commercial ❑ Recptl, Switch & Outlets For Residential Installations: Attic ❑ I" floor W 2nd floor ❑ Adhere to min set back requirement M Seismic Fee Res For Commercial Installations: Replacement same weight ❑ Additional weight (structuralEl calcs) Structural Calculations required for new installation El Seismic Commercial New installation Planning Approval Required ❑ ✓ Cost of Project: /� Type of Construction: Occupancy group: Strapped ❑ On Platform Bonded Sq.Ft. Floor Area: ❑ Mech Permit Issuance New Location Replacement Qty. if Annlion'kla Fee TT) Fee Description Fee Group r BENERGY Energy BUILDING i� BREMFURN Furnace MECHANICAL BREMACOVER A/C Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Recptl, 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 Piping System Fee PLUMBING BUSLIC Business License BUILDING