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07100045 CIT�' OF CUPERTINO � ': ' ' n BU;LDING D:VISIOiV PERMIT �-+��'�� ` :;. :: _:;_. . ,.: BUIL A RESS: PERMITNO. ��4� WATERFORD DR VALLEY HEATING & COOLING 07100045 . OWNER'S NAME: PERMIT LSSUE DATE ALBRIGHT GARY 1171 N 4 TH ST 10/04 2007 NE: SANITARY NO. COMCROL NO. (408)294-6290 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 0 0 ; o o LICENSED CONTRACTOR'S DECLARATION JOb DeSCI'lpt1011 : V� I hcrcby affirm that I am licensed unJcr provisions of Chaptcr 9(commencing ; Z� wiU� Secuon 7400) of Division 3 of �hc Business Protcssiuns Codc. and my licensc is RE PLAC E FURNAC E& ADD A/ C �� y in full Corce and cffect /� � � ? Licensc Class - z '-/�-�• � ; F , � Datc 'L Contractor � ARCHITECTS DECLA TION i a a 1 undcrstanJ my plans shall bc uscd as public recorcls )yU ' u. y Liccnscd Prt�fcssionai � � � OWNER-BUILDER DECLARATION I hcrcby aCfirm ihai 1 am cxcmpt Crom ihc Contractors Licensc Law far thc � p o Collowing reuon. (Scction 7031.5, Busincss and Profcssions Codc: Any city or county �,°, � which requircs a pc�mit to conswc� altcr, impmvc, dcmolich, ar repair any stcucturc `? Z y prior w i�s issuancc, alsu rcquires ihc applicant for such permit �a filc a signcd sta�emcn� Valuation - < that hc is liccnscd pursuan� �o thc provisions o( thc Contrutur's Liccnsc Law (Chaptcr 9 S�. Ft. Floor Area r�� (commencing with Section 7000) of Division 3 of Ihe Business and Professians Code) or $ H 6 S 1 y�� that be is ezempt thcrefrom and the buis for ihe allcgcd exemption. Any violaGun o( SecGon 7031.5 by a�ry applicant for a permit subjccu �he applicant w a civit penalty of Number Occupancy Type not morc than fvc hundred dollars (5500). 3 6 6 17 � 8 5�� ❑ I, u owner oC tlie properry, ar my employces witti wages az the'v solc compensation, will do thc work, and Uu swctuce is not intended or afkred for sale (Sec. 7044. Business Re uired In s eCtlOI1S and Professions Code: 11u Conuactor's License Law docs not apply to an owner of q p property who builds or impcoves thereon, and who daes such worlc himxlf ar tlwugh his own employees, provided that such improvements are not intended or o[feced for sale. If. however, the building or improvement is sold within one yeer of completion, tl�e owner- builder will have the burden oC pcoving Uiat he did not build or improvc for purpau of salc.). ❑ 1, u owner of the propeny, am ezclusively conuscting wild licensed convactors W consuuct �he pmjett (Sec. 7044. 8usiness and ProCessions Code:)'[he Conuactors Li- cense Law does aot apply to an owner of propeny who builds or improves �demon, md , who conuacts for such projects with a comractor(s) li«nsed purswm to �he Comneror's License [aw. ❑ I am ezempt under Sec. , B& P C for this reazon Ownu Date _ .. _: WORKERS COMPENSAT70N DECLARATION I heccby aHirm under penalty o[ pujury one of the following declara[ions: ❑ I hsvc and will mainuin a Certifiptc of Consent to self-insme for Worke�s Compen- sation, u provided for by Secdon 3700 oC the Labor Cade, for the pedormancc a[ the - work for which this permit is issued. ❑ I have and will maintain Worker's Compensadan Insunnce, as tcquircd by Scction 3700 oC thc Labor Codc, for thc perCormance of the wwic (or which this pe�mit is iswed My Worke mpensation In cancc carticr and Policy nu ber azc: Grtiu: Policy No.• G — ERT TE OF EXEMPf[ON FR WORKERS' COMPENSATION [NSURANCE (Ihis scction necd not bc complctcd if the permit is for ane hundred dallazs (5100) or Icss.) � I cenify tAat in thc perfortnancc of ihc worlc for which �his permit is iscucd. ► shatl not employ any person in any manncr so as w beeomc subjcct ia �he Workcrs' Compensation Laws af Califomia. Datc Applicant NOTICE TO APPLICAM: If, aftcr making Uiis Ccrtificatc of ExcmpGon, you slauW become subjcct to the Worker's Compcnsauon provisions of Nc Ls6ar Codc, you must � O fenhwi�h comply with such pravuions or this pe�mit shall be deemed rcvoked. z '"' CONSTRUCfION LENDWG AGENCY H ►�-� 1 hcrcby af[irm Wat thcre is a consuuctian �nding agcncy Cor the perfortnancc o[ _ p�„ � thc work Cor which ihis permit is issued (Sce:. 3097, Civ. C.) W A Lendcr's Namc ' a z Lender's Address U � 1 certity ihat I have rcad this applieation and siatc thaz the abovc infortnatiun is w � cortcct. I agree to comply wiih all city and county oniinances and stau laws relating to � U building conswction, and hcreby auchori�e rcprescnutivcs of �his city to cntcr ��n Nc � W above-mentioned property for inspecuon puqwses. { � (Wc) agree to save, indcm�i(y and kecp harmless ihe City of Cupertino agains� �� liabilitiu, judgmcnLS, costs and expcnscs which may in any way accruc against said Ciry � U z in consequcnce of thc granting af �his permi� ) �" � � APPLICAN'C UNDERSTANDS W Y WITH ALL NON-POINT Issued by: Date �(�/ ' /'' U SOURCE REGULATIONS � ' Re-roofs Signaturc of Applian on �a� Type of Rc of � S AT'ERIALS DISCLOSURE Will ihc a licant r fuwm building occupant uorc or handlc ha•rardous marcrial � az defincd by Cupenino Municipal Codc. Chap�er 9.12, and the Hea��h and Sa(ety Caic. Scction 25532(a)? All roofs sl�all be inspected prior to any roofing material being installed. � Ycs �o , WiII thc applicanc or future building oeeupant usc cyuipment or dcvices which If a roof is installed without first obtaining an inspection, I agree to remove cmit ha•r.ardous air contaminan�s dcfincd by the Bay Area Air QualilY Managcmcn� all new ma terials for inspeccion. Districi? Q Ycs 1 havc rcacl the haiacdous maicrials requircmcn�t undcrChap�cr 6.95 o(ihc CaliCor- nia Hcalth & Safcty Codc. Sections 25505, 25533 and 25534.1 undcrstand �hu iC Ux building docs no� curtcntly haw a it' res bilily w noufy �hc occupan� nf thc rcyuircmen�cwhich acac��r�a�ora��P��r. SignaturecfApplicant Date � - p �� . All roof coverings to be Class "B" or better Owncr or au�h .ed c �� CITY OF (:UPERTINO _ --_ _ - _ _ _ _ _ _ _ __- . _ _ -- �M.. ° „� -- - ---_. - ___ _ __ _ _ ---FUF��NAC�TAC �� PERMIT APPLICATION FORM �� APN # .r- Q D Date: � � �� rU � . Building Address: ' `� , C '� - Owner's Name: , Phone #: =' � � ~ � �" r / � Co�tractor: � License #�.� � � �- ' � Contact: Cupertino Business License #: � � � Building Pe 't Info: Bld ❑ Elect Plumb L�`�� Mech Job Description: � � �, Q . � Residential Commercial ❑ For Residential Installations: Attic � ls floor �"2" floor � Adhere to min set back re uiremenfi�J— -� For Commercial Installations: Replacement same weight ❑ Additional weight (�tructural calcs) � Structural Calculations required for new installation � New installation Plaimin A roval Re uired Cost of Project: Type of Construction: Occupancy group: � S � �l.� � - � Strapped On Platform Bonded Sq.Ft. Floor Area: New Location � Re lacement � Qty. if Applicab.le Fee ID Fee Description Fee Group BENERGY I:ner BUILDING BREMFURN lzelocation of Furnace MECHANICAL BREMACOVER ��/C Unit > 10,000 cfm MECHANICAL g�Mp,I�p,N ,�/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL _ __ __ f - ---- BSEISNIICRE — —_ _ _ --- _--- -- - Seismic Fee-Res _. _ __ -- -- --- ---- - - BiJILD - --- -- � EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE :vlech Pernut Issuance MECHANICAL PPERMITFEE :'lumbin Permit Issue PLUMBING BPERMFEE :31d Perxnit Fees BUILDING BPLANCHK =?lan Check Fee BUILDING BUSLIC '�, Business License BUILDING CITY OF �UPERTINO 8 ITEMS OF 8 PERMIT RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 36617085.00 DATE ISSUED.......: 10/04/2007 RECEIPT #.........: BS000002893 REFERENCE ID # ...: 07100045 SITE ADDRESS .....: 7645 WATERFORD DR SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ....... OWNER ............. ALBRIGHT GARY ADDRESS ..........: 7645 WATERFORD CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5243 RECEIVED FROM ....: VALLEY HEATING & CO CONTRACTOR .......: ATKINSON, THOMA5 LIC # 141 COMPANY ..........: VALLEY HEATING & COOLING ADDRESS ..........: 1171 N 4 TH ST CITY/STATE/ZIP ...: SAN JOSE, CA 95112 TELEPHONE ........: (408)294 FEE ID UNIT QUANTITY PMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 BREMAIRHAN NO .i7NITS 1.00 10.26 0.00 10.26 0.00 BREMFURN NO UNIT 1.00 14.31 0.00 14.31 0.00 BREMRECEPT NO. OUTLETS 1.00 1.20 0.00 1.20 0.00 BSEISMICRE VALUATION 8,651.00 0.90 0.00 0.90 0.00 EPERMITFEE FLAT RATE 1.00 40.79 0.00 40.79 0.00 MPERMITFEE FLAT R.ATE 1.00 40.79 0.00 40.79 0.00 PPERMITFEE FLAT R.ATE 1.00 40.79 0.00 40.79 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 183.90 0.00 183.90 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 183.90 #16798 --------------- TOTAL RECEIPT : 183.90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL