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07100013 CIT�' OF' CUPERTINO � ` 7 �� {� ` BUILDINC DIVISION PERMIT 1�:��T��f��"`��T��E : <.:: _ ,.. ,:: .. BUILD N ADDRESS: PERMIT NO. ��741 SANTA LUCIA RD AAA FUF�NACE & AIR 07100013 . OWNER'S NAME: -- PERMTT LSSUE DATE ERIC CARLTON 1712 `;TONE AVE 1 1 2007 iNE: SANITARY NO. CONTROL NO. ARCHITEGT/ENGiNEER: BUILD[NG PERMITINFO RMV WALL FURNACE, INSTL HLDC E�cr PLUMB MECH � � � 0 � o o LICENSED CONTRACTOR'S DECLARATION ' JQI�.D�sGra,ption : V � [ hcreby affirm �hat I am licenscd undcr provisions oC Chap�cr 9 (commcncing � �^�^ -- ^ • •• ^ ^ ^ ^ ^ ^'_' • _ ; z� with Scction 7000) of Division 3 of ihc Business and Prafcssions Code, and my licensc is ;? y in full Coree and f� � v� Z Licensc Class � � �. * ; F � Dacc Contracw a RCHiTECI'S DEC R i a Q 1 undcrstanJ my ptans shatl bc uud u public rccords ,�G >yV ' u. y Liccnscd Pn�fcssional ' � a OWNER-BUILDER DECLARATION j�� I hcrcby alTirm that 1 am cxcmpt Crom ihc Cantractor's Licensc Law for the . p o Collowing rcason. (Sccuon 70315, Busincss and Profcssions Cafc: Any city ar county �,°, � which requims a pemiit to consuuct, alter, impmvc, dcmnlich, pr �epair any uructure � Z y prior w its issuancc, also rcquires thc applican� for such permit w filc a signcd sta�mcni Valuation -< that he is licenscd pursuant to thc provisions of �hc Contractor's Lii:cnse Law (Chaptcr 9 ; iq. Ft. Floor Area 4 t �(commencing wiih Section 7000) of Division 3 of the Businccs and Professions Cade) or �� hat he is ezempt thcrcfrom and tAe basis Cor t6e allcged eumpdon. Any violauon o[ Section 7031.5 by arry applicant for a permit subjects ihe applicant w a civil pcnalty at ppN Number Oeeupaney Type not morc than five hundred dollars (5500). ❑ I, as owncr of tfie pmperty. or my employca with wages u their solc compensation, will do thc work, and the stcuame is notintendcd or of[ered forsale (Sec. 7044. Busiixss Re uired Ins eCt1011S and Ptofessions Code: 'll�e Contrxtor's License Law docs not apply to an ownu o[ q p prapeny who builds w imptoves thercon, and who does such work himself ar through his own emplayces, provided tha� such improvemen�s are not intended or oRereA (or sak. I[. however, the building or improvement ia sold wit6in one year of complcdon. �he owner- builder will have the burden ot proving Wat he did no� build or improvc [or puryose af saleJ• ❑ I, as owner o[ the property, am ezclusively conUUting wi�h limnsed rnnvactars m construct �he project (Sec. 7044. Business aad Professions Cade:) The Contnctars Li- cense Caw docs not apply to an owner o( propeny who builds ar impraves iheceoa. �nd , who conuacts for sucd pmjecu with a convactar(s) licensed pursuant to the Contrutor's License Law. ❑ 1 am exempt under Sec. . B& P C for this reuoa Owner Daie WORKER'S COMPENSAT[ON DECLARATION I hereby affirm under penalty of perjury one of the follawing declaralions: ❑ I hsye and will maintain a Cenificate of Conum to self-insure for Workcrs Canpen- sation, az provided for by Section 3700 of the Labor Code, for �he perfocmance o[ the work for which Ihis permit is issued. ❑ I havc and will maintain Workers Compensation Insurance, az myuired by Scction , 3700 oC ihe Labor Codc, Cor thc performance of the woric tar which this permit is issued. My Worker's Comp Insunnce cartier and Policy number are: Cartier. �` d1`P Policy No.: �1��/ ERTI CA O EXEMPITON FROM WORKERS' COMPENSAT[ON INSURANCE (This scctlan nccd irot bc completed if the permit is for onc hundred dollazs (5100) or IcssJ � I ccnify thxt in thc performanec of �hc work for which ihis permit is issucd. I shall not employ any person in any maancr so u to bccomc subjcct to �he Workcrs CompcnsaHon Laws of Califoq�ia. Datc Applicam /�1 NOTICE TO A PLICANT: f, ahcr making ihis Ccrti[ica�e of Ezcmption, you should become subjcct a thc Workcr's Compensation provisions oC �Ac LaAor Codc, you must � O forthwilh camply wi�h such pmvisions or this pecmit sha116c dccmcd revokcd_ z "" CONSTRUCI'ION LENDING AGENCY (—�i � I hereby atTirm that there is a constructian Iending agency for the performance oC , C1� � thc work for which this permit is issued (Scc. 309'1, Civ. C.) W A Lendcr's Narnc ' � z L,cnde�s Address U � 1 certify tha� I havc read this app(ication and sia� ihat the above infocmation is �►�" cortcc� 1 agree to comply wi�h all city and county orelinantts and sute laws relating to 0 U 6vilding conswction, and hcreby authome rcprescntativcs of lhis ci�y to cn�cr upon tAc . � a ahovomcn�ioncd property for inspccuon purposes. (Wc) agrce to save, indcm�ify and kecp hartnless ihc Ci�y of Cupcnino against �� liabilitiu, judgmcn�s, costs and expcnscs which may in any way accruc agains� said Gty V z in consequence oC the granting of this permit. Date �"'� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. Re-roofs Signawrc of ApplicandConvacWr �� T of R�of HAZARDOUS MATERIALS DISCLOSURE }�� Will �hc applicant or Cuturc building occupant storc or handlc harardous matcrial as dcfined by Ihe Cupertino Municipal Codc, Chaptcr 9.12, and the Hcal�h and Safety c«��, Section 25532(a)? All roofs :�hall be inspected prior to any roofing material being installed. � y� �'I No , Will thc applicant or f ure Euilding occupant use equipment ot Jcviccs arhich If a roof i:; installed without First obtaining an inspection, I agree to remove cmi� harardous air conwminanct as cicfincd by the Bay Arca Air Quality Managcmcm all new m�terials for inspeciion. Districc? � Ycs �Nu 1 havc rcaJ the ha�ardws maicrials reyuircmcnLS undcr Chapter6.95 of thc Califor- nia Hcalih & Safcry Codc, Scctions Z5505, 25533 and 25534. I undcrstand thaz if �c building docs not curtcntly havc a �cnan4 �� it is my responsibiliry w rroufy thc axupant of �he myu men�s which must bc me� prior w issuancc o( a Cenifica�c of OccupancY• S 1gIlatUie Of APPI1CSIlt Date /�� —, ��—d-,� All roof coverings to be Class ��B" or better Owncr or authori•r.c agcnt Datc _ ��' O� � �J�ER�"I�� `�7 � � o c� 13 ��..,�: �� k�� :� � �_��: ��,(��-. ,- _ .._. �..,.,�. ��T��o PE I� APPLI��'�"I�I� �O Date: �� I� �c� �o'� • 7 Building Address: /� Q �vC � � �Co o�� Owner's Name: Phone #: � _ ��_� C__ ��,e � r=��,�J -- — — ��" ' y��-� � ia �s � ,. )'j,� � 1,iCC:ns�,�: �,��r,�� t ,� . >>�te,: j - �UiU� �i�� '✓` - • _ ' f�� 7/ . Coi� act: � Fhone: �upertino �usiness -License #: � � �_ �a _ �cJ .S � Buildin Permit Info: Bldg ❑ Elect Plumb ❑ Mech Job Description: yo�eO .� li �`m , � 4 � ` e�?�T` f Resi ential ❑ Commercial ❑ For R sidential Installations: Attic � 1 St floor � 2 flool' � Adhere to min set back requirement For Commercial Installations: �' eplacement same weight � Additional weight (stnictural calcs) � �tructural Calculations required for new installation C� New installation Planning Approval Required ❑ Cost of Project: Type of Construct on: Occupancy group: � � �P Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location � Replacement � Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Enf;rgy BUILDING BREMFURN Fuinace MECHANICAL BREMACOVER A/C Unit > 10,000 cfin MECHANICAL BRE1VIp,IRHAN A/C Units <= 10, 000 cfin MECHANICAL BREMRECEPT Re�;ptl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Ele c Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Blc g Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Ga> Piping System Fee PLUMBING BUSLIC Bu>iness License BUILDING CITY OF CUPERTINO 8 ITEMS OF 14 PERMI'[' RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Bl.c: Lot: APN ......... 34:?17091.00 DATE ISSUED.......: 10i01/2007 RECEIPT #.........: BS)00002845 REFERENCE ID # ...: 07L00013 SITE ADDRESS .....: 10'741 SANTA LUCIA RD SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OWNER ............: ERCC CARLTON ADDRESS ..........: 10'741 SANTA LUCIA RD CITY/STATE/ZIP ...: CU:?ERTINO CA 95014 RECEIVED FROM ....: JII� RANDO CONTRACTOR .......: R.A]1D0, JIM LIC # 8050 COMPANY ..........: AA.� FURNACE & AIR CONDITIONING ADDRESS .. ........: 17:L2 STONE AVE CITY/STATE/ZIP ...: SAIJ JOSE, CA 95125 TELEPHONE ........: (4)8)293 FEE ID UNIT QUANTITY .�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1.00 34.86 0.00 34 .86 0.00 BPGAS OULETS 1.00 5.40 0.00 5.40 0.00 BREMAIRHAN NO.UNITS 1.00 10.26 0.00 10.26 0.00 BREMFURN NO tTNIT 1.00 14.31 0.00 14.31 0.00 BSEISMICRE VALUATION 13,838.00 1.40 0.00 1.40 0.00 EPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 MPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 PPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 188.60 0.00 188.60 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 INVOICE INVOICE INVOICE INVOICE I:JVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO PERMI'P INVOICE OPER.ATOR: patg Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 34?17091.00 INVOICE DATE......: 10/01/2007 REFERENCE ID # ...: 07L00013 SITE ADDRESS .....: 10'741 SANTA LUCIA RD SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OWNER ............. ER:CC CARLTON ADDRESS ..........: 10'741 SANTA LUCIA RD CITY/STATE/ZIP ...: CU:?ERTINO CA, 95014-3939 CONTRACTOR .......: RA]JDO, JIM LIC # 8050 COMPANY ..........: AA;� FURNACE & AIR CONDITIONING ADDRESS ........ 17:L2 STONE AVE CITY/STATE/ZIP ...: SA]J JOSE, CA 95125 TELEPHONE ........: (4�)8)293-4717 FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE --------------------------- ---------�------- ---------- ---------- ---------- ENERGY APPLICATIc)N 34.86 0.00 34.86 GAS PIPING SYSTEM FEE PRINTING :?ERMIT 5.40 0.00 5.40 A/C UNITS <= 10,OOOCFM PRINTING :?�RMIT 10.26 0.00 10.26 FURNACE INSTALLATION PRINTING :?ERMIT 14.31 0.00 14.31 SEISMIC FEE RES PRINTING :?ERMIT 1.40 0.00 1.40 ELEC PERMIT ISSUANCE PRINTING :?ERMIT 40.79 0.00 40.79 MECH PERMIT ISSUANCE PRINTING :?ERMIT 40.79 0.00 40.79 PLUMBNG PERMIT ISSUE PRINTING :?ERMIT- 40.79 0.00 40.79 ---------- ---------- ---------- 188.60 0.00 188.60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL � � �� v _�� , �� s,...e "�'� . r�,. -�� `'�--+ � q� \� � 3 �` , ! 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