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07080208 CITY OF CUPERTINO BUILDIfiG DIVISION PERMIT �a 'r7777 7777777777777 77777777777 �.CTox INPQM�'TI�1�t' PERMIT NO. BUILDINGA1502 POPPY WY DDRESS: A PERFECT CLIMATE 07080208 PERMIT ISSUE DATE OWNER'S NAME: HUNTS JAMES L AND COLLEEN A 8375 BRENTWOOD BLVD STE B 08/22/2007 SANITARY NO. CONTROL NO. NE: (408) 86:_ 9545 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELS PLUMB MECH 0�Z LICENSED CONTRACTOR'S DECLARATION Job Description O vP: I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z 8 with Section 7000)of Division 3 of the Business and Professions Code,and my license is REPLACE FURANC E y in full force and cffec S$ ? License CI s----�-� Lic.# Date ^��--Contractor � ARCHITECTS DECLARATION ia< 1 understand my plans shall be used as public records iyV U.H Licensed Professional O a OWNER-BUILDER DECLARATION Ia 2 I hereby affirm that t am exempt from the Contractor's License Law for the :00 following reason.(Section 7031.5,Business and Professions Code:Any city or county :-ff which requires a permit to construct,alter,improve,demolish,or repair any structure t N prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft.Floor Area Valuation Z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 (1 $4560 t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or ? - that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ( Number not more than five hundred dollars(5500). 366101-11 " C]I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law docs not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sate.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that be did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractors Li. cense taw docs not apply to an owner of property who builds or improves thereon,and, who contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law. ❑1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: �I I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Workers Compensation insurance,as required by Section X700 of the Labor Code,for the performance of the work for which this permit is issued. my Worker' o �nation Insurance carrier and Policy number are: Camey. PolicyNo.:t Q4Q3Z4J?0 CERTIFICATE OF EXEMVIION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or Icss.) 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Z forthwith comply with such provision or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY E...c.. I hereby affirm that there is a construction lending agency for the performance of (]�> the work for which this permit is issued(Sec.3097,Civ.C.) (Sa Q Lender's Name Li. Gender's Address I certify that I have read this application and state that the above information is LUL O correct.1 agree to comply with all city and county ordinances and state laws relating to U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against to liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. Date APP NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b-r: SO EGULATIONS. ZZ r�- Re-roofs Signature o pplican ontractor Dare Type of hoof AZARDOUS MATE S DISCLOSURE YP Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)7 All roof:;shall be inspected prior to any roofing material being installed. Yesru. If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or ilding occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? 0 Yes I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Section 25505,25533 and 25534.1 understand that if the building docs not cu y have a tenant,that it is my responsibility to notify the occupant of the require. s h must be met prior i suanc,of a Certificate of Occu ancy.2 Signature of Applicant 'r Date All roof coverings to be Class"B"or better Owner or authorize agent Dat, - CITY OF CUPERTINO FURNACE/AC CUPEI�TINO PERMIT APPLICATION FORM o7 68 ,0 Zt APN# 3 (0( it q Date: �a Building Address: /S- �—o Z p 9 Owner's Namf Phone#: Contractor: Phone: License#: ere� C1,4�41(� !eoe- 961 5� � 7Z -3l Contact: Phone: Cupertino Business License#: Building Permit'In o: Bldg ❑ Elect L7 Plumb Mech Job Description: I 19,-e Residential v Commercial ❑ For Residential I s llations: Attic ❑ l"floor 2nd floor❑ Adhere to min set back requirement For Commercial Installations: Replacement same weight ❑ Additional weight(structural calcs) ❑ Structural Calculations required for new installation ❑ New installation Planning Approval Required ❑ Cost of Project: Type 7�_ Type of nzction: Occupancy group:15� S < ,3 Strapped ❑ On Platform ❑ Bonded 0� Sq.Ft. Floor Area: New Location ❑ Re lacement Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Enemv BUILDING BREMFURN 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 BSEISMICRE Seismic Fee Res BUILDING EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE :Mech Permit Issuance MECHANICAL PPERMI TFEE ?lumbin Permit Issue PLUMBING BPERMFEE :31dg Permit Fees BUILDING BPLANCHK Man Check Fee BUILDING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue a Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF `,UPEkTINO Buildin De fartment JOB ADDRESS: PIT # OWNER'S NAME: r PHONE # �! - 2J Z' VV > GENERAL CONTRACTOR: FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSIrIESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing l Heating ( ¢ `��" c, l Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile owner/Contractor Signature Date CITY OF CUPERTINO 5 ITEMS OF 21 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk.: Lot: APN 36E10114.00 DATE ISSUED. . . . . . . : 08/22/2007 RECEIPT #. . . . . . . . . . BSC00002456 REFERENCE ID # . . . : 07080208 SITE ADDRESS 1502 POPPY WY SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER HUPITS JAMES L AND COLLEEN A ADDRESS . . . . . . . . . . : 1502 POPPY WY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5307 RECEIVED FROM . . . . : EDWARD A GREGORY CONTRACTOR . . . . . . . : SM==TH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 83'75 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BR]!NTWOOD, CA 94513 TELEPHONE . . . . . . . . : (408) 861 9545 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ------ ---------- - --------- ---------- BENERGY PERMIT FEE 1. 00 34 .86 0. 00 34 .86 0. 00 BREMFURN NO UNIT 1. 00 14 .31 0. 00 14 .31 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 171 .54 0. 00 171 .54 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