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07110086 CITY OF CUPERTINO ' BUILUING DII�ISION PERMIT �� , , ,.. ...:. .. . : ..: . . . ;: , . .: < .: _ . ..:. pERMIT NO. BUILD ��p�ess��ICE AVE VALLEY ]�EATING & COOLING 07110086 . y PERMTT ISSUE DATE �N+NER'S NAME: . BONDS JOHN M AND LEE P 1171 N�� TH ST 11/15/2007 SAMTARY NO. CONTROL NO. P"o"E: (408)29-�-6290 BUILDING PERMtI'INFO ARCHiTECl7ENGINEER: BLDG EI.ECT PI.UMB MECH � 0 0 � u p Z p LICENSED CON7'RAC1'OR'S DECLARATION Jpb DCSCTI[7UOT1 � v C 1 hcrcby ��m tha� I am liccnscd undcr provisions of Chaptcr 9(commcncing �� wiW SccGon 7000) ot Division 3 of thc Busincss and Protcasions Code, and my Iicense is RE PLAC E FURNAC E �� y in fu0 foice a n d e f f S � ,� ? Licenac CI ' � Conlraclor ± F , Da�c " � ARCHI7'ECI'S DECLA A770N I undcrsunJ my plans shail hc used as public rccords �yU `Q y Licensed Pmfcssional OWNER-BUiLDER DECLARATION � <� I hcrcby alTirm �hat i am excmpt Gum ihc Conuactors Liccnsc Law Cor thc p O following resson. (SecGon 703I.S, Busincss and Profcssions Calc: Any cily ar county y� Pi which requires a pcimit w consuucL alter. improve, dcmolish. or �epair any sWCw�c prior in ils issuancc, alm requires �hc applican� for such permit to �Ic a signed stammen� � Ft. Floor Area Valuation �?< thai hc is IiccnscJ pursuant to thc provisions o[ the Conuactor's liccnsc Law (Chaptcr 9 $ 9 7 5 7 z H�(commcncing wi�h Section 7000) o( Division 3 0( ihc Busincss and Profcssions Cadc) or y�$ that 1�e is exrmpt the�efrom and t6e bssis for �he ailegcd eumption. Any violation o[ Number Occupancy Type Section 7031.5 by a�ry applicant for a pem�it subjecu �he appiicant w a civil penalty of 3 5 7 010 5 2! not more � han fi v e h u n d r e d dollars (5500� ❑ I. u owner of tlie propaty. ar my cmployces with wages u the'v solc compensation, willdo�hework.andthestructweisnotintendedorofCecedforsalo Required Inspections and Pco[asiona Codc: The Conuacmr's License Law docs not apply w an owner of property who 6uilds or improvea thereon, and who does such worlc Aimse�f or thmugh his own employca, provided that such improvemenn ue not imm�ded or oReeed (or sale. lf, however. �he building or impmvemmt is sold within one yev of compleGon. the owner- builder will have the burdan o[ PmWng �6at he did not build or improve [or purpose af saleJ. ❑ 1. u awner of the property. am acclusively contracting with Iiansed rnnuacwrs w ��tnut the p�nject (See. 7044. Business and Pcofessions Code:) The Comrumr's Li- cenx [,w does nol apply m an ow�cer of propeny who builds or improves the�eon, and , who coniracts tor such pmjects with a conuacwKs) ��d pursusnt to �he Convactor's °cenre L.aw. ( am exempt under Sec. . B R P C for �his reuan Uwner Date WORKER'S COMPENSATION DECLARATION I dereby stTirm under penalty of perjury one o( the [oliowing declantions: ❑ I hsve and will mainuin a CeniGqte oC Consent ro se!(-inswe [or Warlmrs Compen- sation, u provided fw 6y Secrion 3700 of ehe Labor Code, tor �he performance of tAc woric for which this pertnit is iuucd. ave and e�ill maintain Workcr's Compcnsation Insurana, as required by Scction , o the labor Code. Cor ihe performance o[ ihe worlc for which rhis peemit is issued. My Workets mpensation Iaso ce carticr and Policy r aze: � Grtier: Poliey No.: CER7'IFICA'I'E OF EXEMP'!'[ON FROM WO ERS' . COMPENSATION INSURANCE (I]�u scction necd not be completcd i( the permit is for onc hundrcA do�lars (f 100) , or less) i r.eni(y �hat in thc performancc of Ihc work far which Ihis permi� is issucd. I shall not c:nploy any person in any manncr so az m bccomc subject to the Workers' Campensation Laws of Califomia. Da�c Applicant NOTICE T'O APPC.ICANT: If, allcr making �his Certificatc of Exemption, you shouW become subject w Ilfc Workcr's Compcnsation provisions of iAc La6or Codc, you muu �,� foMwith comply with sueA provisions or this pecmi� shall be dcemed ecvoked. Z � CONSlRUCTION LENDING AGENCY F � 1 hc�cby aRrm U�al there is a conswcdan Icnding agcncy Co� thc performancc u( � a, � thc work Cor which this permit is issued (Scc. 3097. Civ. CJ . W Q Lendcr's Nunc � z L.ender's Address V � I mtify ihat ! havc read this application and sute �hat �hc abow informatiun is w F cortcn. I agcce w comply wi�h all rity md cowry ordinances and sute laws relaung m 0 U building consuuction, and dcreby authari�e rcprescntaGvcs of �his city m cn�er upon thc � W ahove-mentioMd propcny for inspenion purposes a (�y�) agrce to seve, indcmnify and kecp hum�ess ihe Ciry oC Cupertino against �� liabilitia, judgmcnts, cosu and expcnscs wAich may in any way accnic against said Ciry V z in consequence oC tAc gnnting af this permiL Date ►'" APPLICANT UNDERSTANDS AND COMPLY WITH ALL NON-POINT Issued bJ : SOURCE REGULAT(ONS. Re-roofs Signawre of Applicam/Con wr � T of l Loof H OU A ALS DlSCLOSURE YPe wll Ihc appli t or fut buii ng oavpant storc or handlc hanrdaus ma�crial � dcfined by 1he penina Municip Codc. Chaptcr 9.12, and the HcalU� and Safety c�, s�uo� �ss ca>� All roofs shall be inspected prior to any roofing material being installed. �Ycs ° If a roof is installed without first obtaining an inspection, agree to remove Will thc applicant or fuw ilding accupant usc cyuipmcnt or Jcvices which cmit harardous air conaminants az dcfincd by the Bay Acca Air Quality Managcmcm all new r�aterials for inspection. as��n �Y« o� 1 havc rcad t�e hvardous matcrials requi�cmcnts undcr Chap�cr 6.95 0( �c Califor- nia Hcalth & Satcty Cadc. Sections 25505. 25533 anc125534. i undcrsund ihat if ihc building dacs not curtcn�ly havc a an4 wat it is my maponsibiliry w naity �hc accupant af the Date rt:quucmcn�sw ' melpri_ w� oracJ ara�,a�r• Signatur�: of Applicant �� All roof coverings to be Class "B" or better Owner or thori� ag CITY OF CUPERTINO 5 ITEMS OF 5 PERMI7' RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN ......... 35"01052.00 DATE ISSUED........ 11,'15/2007 RECEIPT #.........: BS()00003248 REFERENCE ID # ...: 07:_10086 SITE ADDRESS .....: 22;590 JANICE AVE SUBDIVISION ....... CITY .............. CU]?ERTINO IMPACT AREA ....... OWNER ............: BO]JDS JOHN M AND LEE P ADDRESS ..........: 22:390 JANICE AVE CITY/STATE/ZIP ...: CU:?ERTINO CA, CA 95014 RECEIVED FROM ....: VA:�LEY HEATING & CO CONTRACTOR .......: AT:�INSON, THOMAS LIC # 141 COMPANY ..........: VA:�LEY HEATING & COOLING ADDRESS ........... 1171 N 4 TH ST CITY/STATE/ZIP ...: SA�T JOSE, CA 95112 TELEPHONE ........: (4J8)294 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 BSEISMICRE VALUATION 9,757.00 1.00 0.00 1.00 0.00 EPERMITFEE FLAT R.ATE 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 : 158.23 0.00 158.23 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 158.23 #16947 --------------- TOTAL RECEIPT : 158.23 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL . . �7�� CITY OF I�UPERTINO _____ _- ---__ _ _ __ _ _ -- -_____ --_ _ � . $� �.; - - -- - - __ -- _ _ -- -_ _- - _ - � - , A�, FU12I�AC�TAC _ _ ,��p�� PERMIT APPI.ICATION FORM APN #„ � Date: �/ S ''. 0 �� '�o/�:J�� O� - / 7 Building Address: � _. ; � l� t� F,� Ow r's Name: Phone #: �` � �°2 - � C ntractor: License � � � Cupertino Business License #: Contact: � ; c� h � � � Building Permit Info: Bld ❑ Elect L�' Plumb C� Mech l� Job Description: � �L� --� Residential Commercial ❑ For Residential Installations: Attic � l floor 0 2n floor 0 Adhere to min set back re uirement � For Commercial Installations: Replacement same weight ❑ Additional weight (�tructural calcs) � Structural Calculations required for new installation � New installation Plannin A roval Re uired Cost of Pr� ct: Type of Constru�tion: Occupancy group: � Strapped On Platform nded Sq.Ft. Floor Area: New Location � Re lacement Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Ener BUILDING B��U� Relocation of Furnace MECHANICAL BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch & Outlets ELECTRICAL __-.__. . _ __ _-- - - -_ _ - -- - _ . . _ __- -- BSEI5MICRE -- --- - --- - - -- Seismic Fee Res BIJIL� ----- - EPERMITFEE Elec Pernut Issuance ELECTRICAL MPERMITFEE Mech Pernlit Issuance MECHANICAL PPERMITFEE Plumbin Permit Issue PLUMBING BPERMFEE Bld Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC � Business License BUILDING