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06100191
CITY OF CUPERTINO �T BUiLD[c�G DIVISION � O � 11*0I PERMIT BUILDING ADDRESS: ABC COOLING & HEATING PERMIT No. 06100191. 10016 SPANISH OAK CT OWNER'S NAME: PERMIT ISSUE DATE CRAIG LEE 31845 HAYMAN ST. 10/26/2006 jNE: SANITARY NO. CONTROL NO. (510) 47-1-8181 ARCHITECT/ENGINEER: BUILDING PERMIT INFO P BLDG ELECT PLUMB MECH a 0 o a 18 p LICENSED CONTRACTOR'S DECLARATION Job Description U P 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 =y in full force and e�a�v REPLACE FURNACE AND_ ADD NEW A/C ? License Cl ' 3 F Date07 ARCHI 19C I S DECLARATION/ e. U 1 understand my plans shall be used as public records yO y Licensed Professional V) OWNER-BUILDER DECLARATION 7 1 hereby affirm that 1 am exempt from the Contractor's License Law for the O O following reason.(Section 703 1.5,Business and Professions Code:Any city or county 115 61 <$[9 which requires a permit to construct,alter,improve,demolish,or repair any structure it Z y prior w 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 Sq.Ft.Floor Area u[- (commencing with Section 7000)of Division 3 of the Business and Professions 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 r Occupancy Type not more than five hundred dollars(5500). ❑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 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 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- cense Law docs 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. ❑1 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 Compcn- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. r4164avc and will maintain Worker's Compensation Insurance,as required by Section 100 of the Labor Code,for the performance of the work for which this permit is issued. My Workers ompensation I uran artier and Policy number arc: Carrier: Policy N6-��0 303,01 Ce :rmcATE o EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) 1 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 ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z" 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.) W ALender's Name Lender's Address U Q 1 certify that I have read this application and state that the above information is wcorrect.I agree to comply with all city and county ordinances and state laws relating to (DV building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (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 V Z in consequence of granting oDhis ►^� APPLIC NT ERST ILL CO Y WITH ALLNO -POINT Issued by: Date �f, Z- SOURCE ais-.q�fa _�� iQ Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes g1o__ 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 materials for inspection. District? ❑Yes QNo 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SafctyCodc,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the requirements which¢fstbemet p'orto ccofaC from ofOccupan . Signature of Applicant Date God All roof coverings to be Class"B"or better Owner or au oitrmc ag Date Community Development 10300 Torre Avenin i Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 C TEI�TINO (,�jo)S-3 a - 32 8 2 - "F)o a NI' Building Department JOB ADDRESS:`CV/4 ani D ct-A Com' PERMIT# OWNER'S NAME: PHONE # 6 - 7 3 GENERAL CONTRACTOR: Zle C FAX # • c I am not using any subcontractors: . ��Z�/0 6 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 �C Roofing Septic Tank Sheet Metal Sheet Rock , Tile Owner/Contractor Signature Date CITY OF CUPERTINO y �m 2 of 3 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 34232075 . 00 DATE ISSUED. . . . . . . : 10/26/2006 RECEIPT # . . . . . . . . . : 36577 REFERENCE ID # . . . : 06100191 SITE ADDRESS . . . . . : 10016 SPANISH OAK CT SUBDIVISION . . . . . . : CITY CUPERTINO IMPACT AREA . . . . . . OWNER CRAIG LEE ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : BONITA JENKINS CONTRACTOR GERALD UNRUH LIC # 24643 COMPANY ABC COOLING & HEATING ADDRESS 31845 HAYMAN ST. CITY/STATE/ZIP . . . : HAYWARD, CA 94544 TELEPHONE . . . . . . . . : (510) 471-8181 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 12 , 000 . 00 1 . 20 0 . 00 1 . 20 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 . 94 0 . 00 176 . 94 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL rJ Q-Iing osuaotrl ssoutsng DI'ISflg JNIgY�tfl Id oo j uzolsXS 2uidid SUD SvDdg JNIQ'IIflg aa3 �VQU Weld ?IHDNV'Idg JNIQ'IIflg saa3Iiuuad 419 HH3MUS JNIgWfl'ld anssl Iiuzuad�Iutquznid H93,LIWN9dd 'IVDINVHDUW aouunssl Iiuzzad WOW gg3.I.Iwwadw 'IHDRI.LDH'IH aouunssl Ituzuad oaig HHd.LIww9dH JNQI'IIflg iBio.zauzuzOD otuzsms WODIINSIHSg JNIQ'Ilflg s321 aa3 otuzsps UNDIWSIHSg livolw LDH'Ig slatln0 V gol!mS `lldoa2l IdHDg2II UNS 'IVDINVHDHW uzlo 000 `OI => sliufl D/V MVMIVWH2Ig 'IVDINVHDIW U0 000`01 <Iiufl D/V 2IHAODVWH'dg 'IVDINVHDEIW aouuzn j Nwf lAwgwu JNIQ"IIflg sonuH ADWINHg dnoj0 oad uotlduosaQ 3a3 G100A aiquoiiddd ji -XIO IuauzaouidaZl /© uotWooH m3m :ua.zd.zooid 'l3'bS papuog uzIo31uid u0 ❑ poddu.zlS Ano z ouednoo0 mozlonzlsuoDIo adf 1, pa :;aafo.id jo jsoa ❑ pa.zinba-d iUnoiddd Sutuuuid uotluii'elsut m3N El uozluiiulsut mou.zol pwtnbw suotluinoiuo iu.mlotuiS ❑ (soiuo iu.mlotuls) Ig2!3m iuuotllppV ❑ lopm ouzus luauzaouid3-d :suoiJUJIVISUI ILI;)Jatutuoa JOA Iumwinbai jouq jos uiw of a.zagpv ❑.zooil puZ ❑ Jooil is' ❑ 0111V :suoijuiiiu,;sul julluappag 10A ❑ lu!ojauzuzoD C�61 lVtluapisaZl —. -0 Y t4�r :uoidpasaQ got 11031/v �� quznid —� Ioaig ElPig :olul Ituzuad 2uipimg :#asuaorj ssouisng outpadna uogd :107eluoD :#asuaoiH a d z010101luoD Lfi : auouzUN s zaunn0 # qd :ss3jppV 2utpiing 9 CP1 d7 r/ moa KoliVaTrlaaV iui�IM:4d ©N11�1 D �o :)V/ 4DV.NXfl.J 1 bl (:)Di�o oNisx:Iana ao Bila Lill