The URL can be used to link to this page

11030083 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7903 AUGUST LN CONTRACTOR:COMERFORD'S SERVICE PERMIT NO: 11030083 EXPERTS OWNER'S NAME: RICHARD PAPASM 6984 SIERRA CT DATE ISSUED:03/16/2011 (" NER'S PHONE: 4082572802 DUBLIN,CA 94568 PHONE NO:(925)273-3468 T LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class C Z-C7 Li,.# S 10 5 7 P S Date_4L6/ MECH r- RESIDENTIAL COMMERCIAL Contractor �O V14M Fviz. / I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REPLACE A/C,COIL,SAME LOCATION IN YARD (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$9857 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:36212011.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Issued b�= �------� Date 9.18. Z Signature Date > LE /1 RE-ROOFS: ER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Owner or authorized agent• Compensation laws of California. If,after making this certificate of exemption,I Date: 1 become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, a^xpenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION f this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. w,t.,4i,...,n-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date CITY OF CITY OF CUPERTINO FURNACE/AC CUP'ER7INO PERMIT APPLICATION FORM APN # I ( Date: 3 /� Building Address: 1, 790 > A06051 L,^•) E Owner's Name: y Phone#: 21 C_"A20 P4 sic g -7-57 Z-902- Contractor: �p�E-jZ F�Z:J��s Sr-jt J jL� �i��r�Z-r e Phone#: q,>5 Z73 -3 y 6 69g q 51CR-R-A G'►. DLJ i i i,J i C4 - `7,4 S(, Fax M 125 - !556 - 1067- Contractor 06lContractor License M 3 I o5 71 Cupertino Business License#: Contact: �� F� Gf iZ, C v Phone#: cl zs_ 2-'73 - 3 �4 C q Fax#: Building Permit Info: Elect Plumb [`�'� Mech 1Z Residential Dq Commercial Job Description: �"t'LA Ge A- l G i C-Gi c,/ 5 �✓`1 [-oe-A 7,p ,J For Residential Installations: Attic ❑ I"floor 2"d floor ❑ Adhere to minimum setback 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 of Construction (Usage Class): 19,85 -2 v= Strapped On Platform ❑ Bonded New Location El Replacement Project Size: Ex ress ❑ Standard ❑ Large ❑ Major❑ Valuation: 1 41 0? 5? 6 Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Revised 01/07/09 CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36212011. 00 DATE ISSUED. . . . . . . : 03/16/2011 RECEIPT #. . . . . . . . . : BS000012922 REFERENCE ID # . . . : 11030083 SITE ADDRESS . . . . . : 7903 AUGUST LN SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : RICHARD PAPASIN ADDRESS . . . . . . . . . . : 7903 AUGUST LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JEFF RAINEY CONTRACTOR . . . . . . . : TROY THOMAS LIC # 32138 COMPANY . . . . . . . . . . : COMERFORD'S SERVICE EXPERTS ADDRESS . . . . . . . . . . : 6984 SIERRA CT CITY/STATE/ZIP . . . : DUBLIN, CA 94568 TELEPHONE . . . . . . . . : (925) 273-3468 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 9, 857 .00 1. 00 0. 00 1 .00 0. 00 1BREMAIRHA NO.UNITS 1 .00 63 . 00 0. 00 63 .00 0. 00 1BSEISMICR VALUATION 9, 857 .00 0. 99 0. 00 0 .99 0. 00 1MPERMITFE FLAT RATE 1 .00 42 . 00 0. 00 42 .00 0. 00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0.00 42 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 148. 99 0. 00 148 .99 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 148 . 99 VISA --------------- TOTAL RECEIPT 148 . 99 VOICE ID DESCRIPTION VOICE ID DESCRIPTION_ -------- ---------------------------- -------- ---------------------------- 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL