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07110104 CITY OF CUPERTINO ��« BUILDING DIV1510N PERMIT :, :: . _.< :: .. . . . . . PFRMIT NO. 9UILDING ADDRESS: 7552 ERIN WAY AAA FURVACE & AIR 07110104 . PERMIT LSSUE DATE .,+JNER'S NAME: RAJ GUR 1712 SPONE AVE � 11/19/2007 SAMTARY NO. CONTROL NO. PHONE: (408)293-4717 BUILDING PERMff INFO ARCHI'IECC/ENGiNEER: BLDG ELECT PLUMB MECH � � � � u p p LICENSED CONTRACfOR'S DECLARATION JOb DeSCiIpLlOi1 � I hcrcby affirm Wat 1 am liccnscd undcr provisions of Chap�cr 9(commcncins � Z� wi� Scction 7000) of Di�ision 3 of thc Business and Protcasions Code, and my iicensc is RE P LC F URNAC E 1. � �� BTU & ADD A/ C� 4 T ON n< a �n full Corce and /� "� v � Z Licenac C Lic. N n l - p Da1C ^ ConVaclo� C � ARCHITEC!'S DECLARA O ��< ! undcrstand my plans s6a11 be uscd u public rccords ��(/ m 4 O y Licensed Pcufcuional OWNF,It-BUi[,DER DECLARATION ,'� e� 1 hcrcby alTirm ttiat 1 am racempt from ihc Conuaaor's Liccnsc Lnw for the L O O following rcacon. (Scction 7(Y3I.5, Busincss md Profcssions Cafc: Any ciry or county K$ Pi whicd requiccs a permit m conswc4 a�lcr. improvc• demalLth, or repair any swcwrc '� "'^ prior w i�s issuance, also rcquires U�c applicant for such permit to file a signed su�emcnt Ft. Floor Area Valuation —?< that he is licenscd pursuant to thc pmvisions of thc Conuactor's Liccnsc [�w (Chap�cr 9 S�] • � 7 9 � � Y t� = - $(commcncing wi�h Scction 7000) of Division 3 of �fic Busincss and Profcssions C�dc) ur y� that he is uempt the�efrom and �he basia Cor the slleged eumption. My violauon ot Secuon 7031.5 by �ny applicant for a permit subjecu ihe appiicmt w a civil penaity af �� Number Oecupancy Type not mwe than fiw hundmd doliazs (5500)• 3 5 9 2 1 �� ."" ❑ I. as owner ot tlu ptopercy. ar my employces with wages u the'v sole compensadon, w illd o U k warkandihestcucwmisnotimm�dedoro[ferodtorsale(Sa.m�t.Busircas Required Inspections and Professiona Cade: The Conuaztar's License Law docs nat appiy a an owner of property who builda a improves thercon, and who docs sucA wort himael[ar through his own empbyces, providcd tha� such improvemrnts are not in�ended or olfercd for sala I[. however, the buiiding or improvement is sold within one yesr of compledon. the ownu- builder will have the burde� of pcoving Wat he did not build or improvc for purpose af sak.). ❑ 1. u owner o[ the properry. am wcclusively contracting wi�h licensed rnnusanrs w conswct the projea (See. 7044. Business a� Professions CodeJ The Contruwrs Li- ccnse Iaw does not appiy to an owner of property wha buiids or improves Ihe+eon, and , who conuac�s for such pmjects with a contnctor(s) licensed pursuant to ihe Contrurors ' 'cense Law. l am exempt under See. . B& P C for �his reason Uwner Dale WORKER'S COMPENSA770N DECLARA770N I hereby aflinn under penalty ot perjury one o! the tollowing declarations: ❑ i hsae and wilt mainuin a CeniGcate of Consent to self-insure Cor Workcrs Compen- sarion, as providcd for by Section 3700 of the Labor Code, far the pedormance oC thc worfc for which Ihis permit is issued. ❑ I have and will m�intain Workcls Compensation Insurana, az �equired hy Scction , 3700 of �he Labor Code. Cor the pedormance of Ihe wrorlc for which �his permit is issued. My Workers o pens 'on unnce cartier and Policy number are: �a; Poliry No.: s � `� CgRTIFt F EXEMP'I'ION FROM WO KERS' COMPENSATION INSURANCE (7Lis seetion need rrot bc comple�cd i( the permit is for onc hundred dollars (5100) or Icu) I cenify �hat in ihe performance o! the work fw which this permil is issued, 1 shal! not c�nploy any person in any manncr so u to bcrnmc subject to the Workcrs' Compensation Laws oC Califomia Da�c Applicant NOTICE TO APPC.ICAM: If, a(icr making �his CcniGwtc of ExempGon, yau should become subjcct a �hc Worlcu's Compensation provisions of �Ac l.atwr Codc, yau must , O(orthwilh comply with such provisions or this pecmit shall be decmed revoked. � '"'' CONSTRUCf10N LENDING AGENCY �►.�� ► hcroby sRirm Unt thcre is a consuuction Icnding agcncy !or thc perfortnancc uf . (1� � ihc wrork for which this permit is issued (Scc. 5097, Civ. C.) , W Q I.endcr's Namc � � Lcnder's Addm,ss I cenify ihat 1 havc resd tltis application and sutc ihu thc above infarmadun is w� correc� I agree w comply wi�h �II city and county orciinances and sute laws celating to 0 U building eonsuuction, and hercby authoria ccpresentativcs of ihis ciiy to cntcr upon thc W ahove-mentioned properry for inspection purposes a (We) agree to save, indcmnify and keep harmlest ihe Ciry oC Cupectino against �„ � liabiliuu, judgmenls, cosLS and expenses which may in any way acecue against seid Ciry / V`Z in consequence of the granting o[ this permi4 Date (�� ' � �"� APPLICANT UNDERSTANDS AND W1LL COMPI.Y WITH ALL NON-POINT Issued by: SOU E REGULATIONS ,t-.�r ��c�� Re-roof:� rc o Appliant/Contractor � T of Roof HAZARDOUS MA'fERIALS D[SCLOSURE YPe Will thc applicant or futurc building acupant uorc or handlc hanrdous matcrial kfincd by the Cupectino Municipal Codc. Chapter 9.12, and �he Hcalth and SaCety ,.�, s��uo� zss3zca)? - All roof � shall be inspected prior to any roofing material being installed. ❑Ycs o �11 thc applicant or uwre �ilding occupant use eyuipment or dcvices which If a roof is installed without first obtaining an inspection, I agree to remove cmit ha air conisminants u dcfincd by the Bay Area Air Qualily Managemcn� all new naterials for inspection. ��5�;�� ❑ Ycs Nu � havc rca�i the hv ma�crials requircments un�icrChaptcr6.95 of i6e Califor- nia tkalih & Safc�y Codc. 'ons 75505, 25533 anc125534. l undctsmnd ihaz iC ihe building dacs nat cwren�y havc a tenan4 � it ia my responsibili�y m notify tlu occupant of ihe rcyui n�s which must 6e me� prior w issuance oC a Ccnifua�c of Occup Signatut e of Applicant Date � p All roof coverings to be Class "B" or better wner or authari� agcn� CITY OF CUPERTINO 8 ITEMS OF 8 PERMIZ RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk.: Lot: APN ......... 35�21030.00 DATE ISSUED.......: 11i19/2007 RECEIPT #.........: BS(�00003277 REFERENCE ID # ...: 07110104 , SITE ADDRESS .....: 75`_�2 ERIN WAY SUBDIVISION ....... CITY .............. CUl'ERTINO IMPACT AREA ...•••• OWNER ............. R.A�T GUR ADDRESS . : 75.'i2 ERIN WY CITY/STATE/ZIP ...: CU:?ERTINO CA 95014 RECEIVED FROM ....: JI]�I RANDO CONTRACTOR .......: RAJDO, JIM LIC # 8050 COMPANY ..........: AA� FURNACE & AIR CONDITIONING ADDRESS . : 1712 STONE AVE CITY/STATE/ZIP ...: SAV JOSE, CA 95125 TELEPHONE ........: (4�8)293 FEE ID UNIT QUANTITY AMOUNT PD-TO THIS REC NEW BAL ------------- ---------- ---------- - --------- ---- BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 BREMAIRHAN NO.LTNITS 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 7,900.00 0.80 0.00 0.80 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 : 183.80 0.00 183.80 0 .00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- CHECK 183.80 VISA --------------- TOTAL RECEIPT : 183.80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL O �7// �/ v�/ CITY OF t�UPERTINO w � , � . �I..T�.l��.��.�' CUPEf�,TINO PERMIT APPL�ICATION FORM Date: APN # �� `�� ) � ��- � Building Address: �s � �. ��- //U �v,o �� Owner's Name: Phone #: � /� � �j � !�. ---- ----- �D�1� - � 7�� -- �;_ ___ ---1-`-- �------- — C�ntracta�-: �'hone: ��icense �: �i�c �� Ya�°� �s�7� ��i Contact: � Phone: Cupertino Business License #: j' �v -z �.c, ' D� � / o SO Building Permit Info: Bldg ❑ Elect Plumb � Mech Job Description: .� m p -� � y TairJ Reside ial [� Co ercial ❑ For Residential In t llations: 4ttic � l st floor � 2" floor � _dhere to min set back requirement For Commercial Installations: Replacement same weight ❑ Additional weight (:;tructural calcs) � Structural Calculations required for new installation � New installation Planning Approval Re uired ❑ Cost of Project: Type of Constn�ction: Occupancy oup: 7 �v S �' -� Strapped On Platform Bonded C Sq.Ft. Floor Area: New Location � Replacement u Qty. if Applicable Fee ID Fee Descri tion Fee Group BENERGY l?nergy BUILDING B��Ug� ]iurnace MECHANICAL BREMACOVER ,�/C Unit> 10,000 cfin MECHANICAL BREMAIRHAN ,�/C Units <= 10, 000 cfin MECHANICAL (' BREMRECEPT �ecptl, Switch & Outlets ELECTRICAL BSEISMICRE 3eismic Fee Res BUILDING BSEISMICOM �eismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE vlech Permit Issuance MECHANICAL PPERMITFEE 'lumbing Permit Issue PLUMBING BPERMFEE 31dg Permit Fees BUILDING BPLANCHK ?lan Check Fee BUILDING BPGAS Gas Pi ing System Fee PLUMBING BUSLIC Business License BUILDING Community Development "� *, , 10300 Torre Avenue �s� � ; `��;� : Cupertino CA 95014 Telephone (408) 777-3228 C(TY OF Fax (408) 777-3333 CUPEf�TINO Buildi.n De artment JOB ADDRESS: PERMIT # ,��-� � /� �iL� L�j�! �� `7 (' C l3 l � � OWNER'S NAME: /1 ,j ' u/' PHONE # ' D�- 7 7� - 07 �. GENERAL CONTRACTOR: �� FAX # I am not using any subcontractors: �-h` /�r19 �� S .gnature Date Please check a licable subcontractors and com lete the followin information: SUBCONTRACTOR BUSI]vESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Fuushing IIectrical 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 Owner/Contractor Signature Date