The URL can be used to link to this page

07110153 CTTY OF CUPERTINO , ° ``: ` BU[I;DING DIVSSION PERNIIT :: �Cl�]�,�:�CT� �� ,. :. : ... . ..::.. .. _ .;z ..::: . . . _ .: ...: .: BUILDING ADDRESS: PERMIT NO. 1194 ELMSFORD DR A PERFECT CLIMATE 07110153 . VER'S NAME: PmMIT LSSUE DATE FRED BANDY 8375 ERENTWOOD BLVD STE�B 11/27/2007 PHONE: SAMTARY NO. CONTROL NO. (408)861 9545 ARCHI'IECC/ENGINEER: BUfLDING PERMTC [NFO BLDG ELECT PLUMB MECH 0 � � � y o p UCENSED CONfRACCOR'S DECLARATION JOb D8SCr1pU0I1 � v I dcrcby �rm that I am licensed undcr provisions of Chap�cr 9(commcncing z � wilh SecGon 7000) of Division 3 of ihc Business and Pro[cssions Codc ane m ��ccnsc ia REMOVE / RE P LC E FURNAC E SAME LOCAT I ON �� y in full force and effect G_�D � �,� � j � Z LicenscQ a�s Lic.1i y F ;, � Dam `� ` �� e ARCH1TECi'S DECLARATION �C �< 1 understanJ my plans shall bc used u public rccords a 4 p y Liccnud Rufcssional y � OWNER-BUILDER DECLARATION � `� I hcreby affirm U�at 1 am excmpt Crom �he Contractor's �iccnsc Law for �hc p o Collowing rcasoa. (Scction 7031.5, 8usincss and Prafcssians Codc: Any city or rnuniy �,° Pi which requims a permit to construct, altcr. impmvc. dcmol'tsh. or �epair any swcm�c y Z� prior w i�s issuancc, aLw requiccs thc applican� for such permit ta filc a signed sutcmcnt _< thai Nc is liccnxd pursuanl to thc pmvisions of thc Conuactor's Licensc Law (Chapicr 9 Sq. Ft. Floor Area $ 4 6 3 3 Valuation y F- �(commencing wi�h Scction 7000) of Division 3 of Ihc Businets and Profcssions Cadc) or y �.. thal he is exempt themtrom and Ihe b�sis for �he allcgcd exemption. My violation of Secuon 7031.3 by airy applicant (or a pe�mit subjecu the applicant to a rivil penalty of Number Oeeupancy Type not more �han fiw 6undrcd dollan (SS00�. 3 6 2 0 9 0 0 3� 0 I. u owner o[ the property, a my employcea with wages u their so� compensadon, will do thewark, �nd �he at�unwe ia not intended or of[eced forsalc (Sec. 7044. Business Re uired Ins ections and Peotessians Code: The Conuacwr's I.icense 1.aw doo noi sppiy a an owner o� q � pmperty wha builds a improves thereon, and who daes such work himulf m ttwugh Ais own employca, provided Wat such improvemen�a are not inanded ar offered for sala I[. however, �he building or improvement is sotd within om year o[ compktion, the ownu- builder wiU have the burden of proving �hat he did not build or improvc for purpoee of sakJ. � 1, u awnec of the property, am exclusively conuuting wilh licensed crontrutors W construct ihe p�nject (Sec. 7044. Business and Professions Cade:) The Coavactor's Li- cense Iaw docs not apply to an owner of propeny who builds or improves thereon, and , who convacls for such pmjecu wi�h a conuactor(s) Iicenxd pursuant to �he Convacrors Licenae Law. � I am exempt under Sec. , B& P C for thia reaaon ner Date WORKER'S COMPENSA770N DECLARATION I hereby aCtirm under peualry o[ pe�jury one of the folbwing declaraGons: ❑ I hsve and will mainuin a Certificate of Consent to self-insure fw Workcrs Compen- ution, as provided for by Section 3700 ot the [abor Code. [ar �he perfortnance of �hc work for wAich this pertnit is issued. I have and will maintain Worker's Campensation ]nsurana, as required hy Scction 700 of thc Labor Codc, Cor Ne pcdormance of �he work for which this permit is issued. ' My Workers mpensaGon lnsurance carticr and PolicYnumber a�c: Gmer:��/'�'�.G� PolieyNo N �� Z� �� CERTIFICA7E OF EXEMPI70N FROM WORKERS' COMPENSAT70NINSURANCE � (7Lis section necd not bc completcd if t6e pecmit is for anc hundrcA dollacs (S 100) o� Icss) • 1 cenify that in thc performancc of We work fw which �his permit is iuucQ 1 shall not e�nploy any person in any mann r s becp� wbject to the Workecs' Compensalion Laws of Califom�tc o Applicmt �-• p�� N077CE TO APPLICANT: If, afYcr making Wis cniGcam of Excmption, you should become subject to �he Worlcer's Compensation provisions of Ne Lstwr Code, you must , O fonhwilh comply with such provisions or this pecmit sha1L he dccmcd n.woked. Z "" CONSI'RUCTION LENDING AGENCY �- ►�,+ I he�cby �rm Ihat there is a consuvcunn Icnding agency far thc performance u! p; � ihe work for which this permit is iuued (Scc. 3097, Civ. CJ W� Q Lendc�s Namc ^ a z L.cnder's Addtcss V � I certity ihal I have rcad ihis application and sutc thst Ihc a6ove info�mation is � �" corten. I agece w comply wiih all rity and counry ordinances and sute Iaws mlating to 0 U building conswction, and hercby autharia ccpresenuGvcs of �his ciiy to enmr upon ihe � w atrovc-mcntioned propcny for inspecuon purposea (Wc) agcce to save, indcmniFy and kecp I�amiless the City oC Cupertino against �� (iabililiu, judgmcnis, costs and expenscs which may in any way ucn�e againsl said City / � V z in conseque�e of the granting of this permi� y Date ��" �� "� APPLICA UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued t: � SOURCE LAT[ON 1 �' a �"v'� Re-roof> /� Signature of Applian�Contnclor Dale " HAZARDOUS MATERIALS DISC SURE Type of Roof Wilt the applicant or future building oaupant store or handle harardous matcrial defincd by �he Cupertino Munictipal Code. Chap�cr 9.12, �nd the HcalU� and Sa(ety �. ScMion 25532(a)? All roof s shall be inspected prior to any roofing material being instailed. ❑ Ycs �ko '� If a rool' is installed without first obtaining an inspection, I agree to remove Wiil thc applicant or fuluec building accupant usc equipmcnt or devices which emit hazatdous air contaminants az dcfincd by lhe Bay Acea Air Quality Managcmcn� all new materials for inspection. Disuict? O Ycs '�IVo 1 havc rcad the hvardau matcrials requi�emenu under Clup�cr 695 of Ihe Califor- ^ nia Heal�h dc Safery Cade, Sectio�s 25505.25533 and 25534.1 unekrs�and �hu iCthe building I �� X _ --- `l '... `� 7 Q� docs cwrcntly havc a icnan�, ihat it is my responsibility io nodfy thc occupant of ihe my ' �swhich x�� •��;�� r��ara��. Signatwe ofApplicant Date �C -�a J7 All roof coverings to be Class "B" or better Owncr or authoriacd c �� . � - �:�. CITY OF CUPERTINO FURI��ACE/AC CuPE� �NO PERMIT APPI�ICATION FORM D / APN # Date: � � pv .�� - � %� Building Address: `l �� l� s � � �r , � � Owner's Name: Phone #: �re �.( � a.�. c( y � � �� 6 �� / Contractor: Phone #: y � �_ � b /- 9� �� — ��, r ,_.� �-� C; ��-. �� 6 Fax #: L1� �- b'b l—�.s y Contractor License #: Cupertino Business License #: �� S � ��y� Contact: Phone #: ��.r��_ �6 /- �O c� �, ,�W,��r S,� �1�� Fax #: Building Permit Info: Elect ❑ Plumb ❑ Mech Job Description: � '� e �JVt °� I `��' �s�e �'' / �n 4l �_ �c•'..� ��c��'�,� Residential Commercial For Residential Installations: � Attic ❑ 1 St floor � 2" floor ❑ Adhere to minimum setback re uirement ❑ For Commercial Installations: Replacement same weight ❑ Additional weight (structural calcs) ❑ Structural Calculations required for new installatior� ❑ New installation Planning Approval Required ❑ Cost of Project: Type of (;onstruction (Usage Class): y� .:� _� Strapped On Platform Boncled New Location Replacement Valuation: � �� .` Green Building: Must attach Gre��n Building Check list to this application CITY OF C UPERTINO � FURN��CE/AC CuPE� iNO � FEE SCl3EDULE FURNACE: Qty. if A plicable Fee ID Fee Descri tion Fee Grou Permit T e � MCRAA Furnace M FURN/AC MCREPALT Commercial Mech Repair/alt/add M MCSUSHTR Commercial Sus��end WalUfloor M Heater PGASCOM New Gas Piping System 1-4 Outlets P Commercial BSEISMICO Seismic Comme��cial B M� Residential Mecli Repair/altladd M MRSUSHTR Residential Suspend WalUfloor M Heater �/ BSEISMICRE Seismic Residential B MFLRFURN Install/relocate F loor Furnace M MECPLNCK Mechanical Plar: Check M MFR=<100 Furnace Syst <1 �Ok BTU M MFRN>100 Furnace Syst > l OOk BTU M MRAIRHAN Comm/Res < 1 C Ok BTU M / EPERMITFEE Electric Permit ]iee E � � MPERMITFEE Mechanical Pennit Fee � BREMRECEPT Electric Recept��cles E PGASRES New Gas Pipin�; System 1-4 Outlets P Residential BPGAS Gas Piping System 5+ Per Outlet P t TRAVDOC Travel Documentation B l � BUSLIC Business Licen.�e B ; CITY OF CUPERTINO �� FURl�rACE/AC cuPE�iNO FEE S(�HEDULE AIR CONDITIONER: Qty. if A plicable Fee ID FeeDescripti��n Fee Grou Permit T e BCAIRHAN Commercial A/C Units <= lOk CFM B FURN/AC MCRAA Commercial N:ech Repair/alt/add M SEISMICOM Seismic Comniercial B BREMAIRHAN Residential A/ � units <= l Ok CFM B M��, Residential M�;ch Repair/aldadd M BSEISMICRE Seismic Resid�ntial B EPERMITFEE Electric Permit E MPERMITFEE Mechanical Pf;rmit M r PPERMITFEE Plumbing Pennit P BREMRECEPT Electric Rece��tacles E PGASCOM New Gas Pipi zg System Commercial P 1-4 Outlets PGASRES New Gas Piping System Residential P 1-4 Outlets BPGAS Gas Piping S}�stem 5+ Per Outlet P TRAVDOC Travel Docunientation B BUSLIC Business License B Community Development � ' F, ' ° 10300 Torre Avenue �: Cupertino CA 95014 � :� Telephone (408) ?77-3228 Fax (408) 777-3333 CITY OF CUPEl�TINO Buildin De artment JOB ADDRESS: PERMIT # / �y �/� g ��'� �� {>`� � � � � .�.� OWNER'S NAME: � � e d 1��. � PHONE # t o�-- a'93�- 7/y GENERAL CONTRACTOR: � ,�-(� �yrvwq7� FAX # � � -- c��l— �t3'�`� I am not using any subcontractors: _ �� Signature Date Please check a licable subcontractors and com lete the followin information: SUBCONTRACTOR BUSIPJESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating 2 r Y�t ��'�" �✓' w�� v� Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile �� Owner/Contractor i Date CITY OF CUPERTINO 6 ITEMS OF 6 PERMI'P RECE._T_pT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blic: Lot: APN ........ 36�09003.00 DATE ISSUED.......: 11/27/2007 RECEIPT #.........: BS000003341 REFERENCE ID # ...: 07110153 SITE ADDRESS .....: 1194 ELMSFORD DR SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ....... OWNER ............. FRED BANDY ADDRESS . : 1194 ELMSFORD DR CITY/STATE/ZIP ...: CL;PERTINO, CA 95014-3946 RECEIVED FROM ....: ELWARD GREGORY CONTR.ACTOR .......: SN:ITH, BYRON E LIC # 21144 COMPANY ..........: A PERFECT CLIMATE ADDRE5S ..........: 8_'75 BRENTWOOD BLVD STE B CITY/STATE/ZIP ...: BF_ENTWOOD, CA 94513 TELEPHONE ........: (�08)861 9545 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ----------- - -------- ---------- ---------- -- --------- -- 1MCR.AA LTNITS 1.00 122.38 0.00 122.38 0.00 BSEISMICRE VALUATION 4, 633.00 0.50 0.00 0.50 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 RATE 1.00 40.79 0.00 40.79 0.00 TRAVDOC FLAT R.ATE 1.00 40.79 0.00 40.79 _ ----------- ---------- ---------- - TOTAL PERMIT : 286.04 0.00 286.04 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------- CREDIT CARD 286.04 MC --------------- TOTAL RECEIPT : 286.04 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ---------------------------- 113 SLAB 301 ROUGH PLUMBING 303 ROUGH MECHANICAL � 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 506 GAS TEST 507 FINAL PLUMBING 508 FINAL MECHANICAL