The URL can be used to link to this page

07030050 CITY-OF CUPERTINO BUILDING DIVISION PERMIT 3G7�+QRERM�ITI(3N; PERMIT NO. BUILDING ADDRESS: 1451 POPPY WY CONDITIONED AIR 07030050 PERMIT ISSUE DATE OWNER'S NAME: RAYMOND PON 1701 LITTLE ORCHARD ST 03/08/2007 SANITARY NO. CONTROL NO. )NE: (408) 291-2220 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG EO PLUMB MO i p p LICENSED CONTRACT'OR'S DECLARATION Job Description Lu p 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing z UW with Section 7000)of Division 3 of the Business and Professions Code,and my license is REMOVE AND REPLACE 2 FURNANC E, ADD ON A/C t e o. in full force and effect, I ' 6_L Lic.A E•-Z License Class�i L2 rp Date '+ Contractor .a ARCHITECPS DECLARATION d j a I understand my plans shall be used as public records )IU ay Licensed Professional G a OWNER-BUILDER DECLARATION aI hcrchy affirm that I am exempt from the Contractor's License Law for the p O [ollowing reason.(Section 7031.5,Business and Professions Cade:Any city or county <m which requires a permit to construct,alter,improve,demolish,or repair any swcture —H prior to its issuance,also requires the applicant for such permit to file a signed statement Sq.Ft.Floor Area Valuation ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 $11075 it= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Q 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 A��l Number not more than five hundred dollars(5500). 36615022 V U ❑1,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 does rmt 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 sale.If. however,the building or improvement is sold within one year of completion,the owner. builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law does 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 affum under penalty of perjury one of the following-declarations: Cl I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn- 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 Worker's Compensation Insurance,as required by Section of the Labor Code.for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number are: Carrier: C) ( r 1 g1[h((Y tC Polity No.: -�I D D(U S L A EX PITON FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I 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 ,J O forthwith comply with such provisions or this permit shall be deemed revoked. z r-. CONSTRUCTION LENDING AGENCY E o rte-+ I hereby affirm that there is a construction lending agency for the performance of CY,> the work for which this permit is issued(Sec.3097,Civ.C.) (Sa A Lender's Name _ L.endees Address U O 1 certify that I have read this application and state that the above information is L> E' correct.1 agree to comply with all city and county ordinances and state laws relating to rJ Ubuilding 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 rn liabilities,judgments,costs and expenses which may in any way accrue against said City U 2 in consequence of the granting of this permit. Date -> t-- APPLICANT UNDERSTANDS AND WILL C MPLY WITH ALL NON-POINT Issued f y: SOU REGULATIONS. tG Re-roof Sign of Applicand o tractor Dae Type of Roof HAZARDOUS MATERIALS DISCLOSURE 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)? 1 All roof's shall be inspected prior to any roofing material being installed. 0]Yes No If a zoo 7 is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑Nu s 1 have read due hazardous at materials requirements under Chapter 6.95 of the Califor- nia Health&Safcty Codc,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the Date requirements which m t be met pri uancc of a Certificate of Occupancy. Signature Of Applicant G All roof coverings to be Class"B"or better or authorized agent Date CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: kiersaw COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36615022 . 00 DATE ISSUED. . . . . . . : 03/ 8/2007 RECEIPT # . . . . . . . . . BS030000631 REFERENCE ID # . . . : 07030050 SITE ADDRESS 1451 POPPY WY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER RAYMOND PON ADDRESS . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5316 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : RICHARD READ LIC # 22334 COMPANY . . . . . . . . . . : CONDITIONED AIR ADDRESS . . . . . . . . . . : 17C1 LITTLE ORCHARD ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (4C8) 291-2220 F FEE ID UNIT QUANTITY FMOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- --- ---------- -- -------- ---------- ---- BENERGY PERMIT FEE; 1.00 34 . 86 0 . 00 34 . 86 0 . 00 BREMAIRHAN NO.UNITS 1 . 00 10 .26 0 . 00 10 .26 0 . 00 BREMFURN NO UNIT 2 .00 28 . 62 0 . 00 28 . 62 0 . 00 BSEISMICRE VALUATION 11, 075 . 00 1.20 0 . 00 1 .20 0 .00 MPERMITFEE FLAT RATE 1.00 38 . 37 0 . 00 38 .37 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 113 . 31 0 . 00 113 .31 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------------ CREDIT CARD 113 . 31 VISA --------------- TOTAL RECEIPT 113 . 31 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ----------------------------- -------- --- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL r CITY OF (;UPERTINO 0FURNACE/AC4 000 CUPEIJINO PE RMIT APPL[CATION FORM APN# Date: 3 66- 1� - d2Z 3 Building Address: 4 5 ° �� Phone#• ' Name: cl �er s N �(Q en Licse i Con' ctor: Phone• _ 4 4 S1 62, Phon : Cupertini ol Business License#: Building P it Info: Bldg, ❑ Elect :Plumb ❑ Meth Job Description: Residential Commercial ❑ For Rg idential In tions: Attic U 151floor r2!t floor la Adhere to min set balk requirement❑ For Commercial Installations: Replacement same weight ElAdditional weight(s�ctural talcs)❑ Structural Calculations required for new installation New installation Planning Approval Required El Cost of Proje t: Type of Construztion: Occup y group: �� des Strapped On Platform LJ Bonded Lr, Sq.Ft. F1 jor Area: New Location ❑ Replacement Qty.if Fee Description Fee Group A livable Fee ID BENERGY l,ner BUILDING z BREMFURN Furnace MECHANICAL BREMACOVER AJC Unit> 10,000 cfm MECHANICAL BREMAIRHAN iJC Units<= 10, 000 cfin MECHANICAL BREIVIRECEPT 1,,ecptl, Switch&Outlets ELECTRICAL BSEISMICRE seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE I'slec Permit Issuance ELECTRICAL MPERMTTFEE bTech Permit Issuance MECHANICAL F'lumbin Permit Issue PLUMBING PPERMITFEE BUILDING BPERMFEE Feld Permit Fees BPLANCHK flan Check Fee, BUILDING BPGAS (jas Pi in S stem Fee PLUMBING BUSLIC 13usiness License BUILDING