10060010 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22230 HOMESTEAD RD C011TRACTOR:A&A PLUMBING PERMIT NO: 10060010
OWNER'S NAME: LEFEVRE SUSAN M ET AL 10311 E EL CAMINO REAL STE 248 DATE ISSUED:06/02/2010
OWNER'S PHONE: 4087738906
SUTINYVALE,CA 94087 PHONE NO:(408)738-8878
A 1] LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL 0 COMMERCIAL
< Lic.# J 3 23 PI'.RMITTING AN EXISTING A/C UNIT WHICH WAS
License Class 3� IN STALLED WITHOUT A PERMIT IN THE PAST
Contractor s ��
.,a,J,; Date Z
I hereby affirm that I am licensed under the provisions of Chapter 9
(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 Valuation:$3000
performance of the work for which this permit is issued. Sq Ft Floor Area:
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 At N Number:32651005.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, C�2 'LG
costs,and expenses which may accrue against said City in consequence of the Is sued by: Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section _
9.18. / RE-ROOFS:
i Signature Date Z/ O A I roofs shall be inspected prior to any roofing material being installed.If a roof is
in>talled without first obtaining an inspection,I agree to remove all new materials for
in spection.
OWNER-BUILDER DECLARATION S gnature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
the following two reasons:
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&Professions Code) HAZARDOUS MATERIALS DISCLOSURE
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three ntaintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Ilealth&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's r raterial. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the a it contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. i/ill maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by
the Health&Safety Code,Sections 5533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date:
permit is issued.
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 Worker's CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must hereby affirm that there is a construction lending agency for the performance of
vork's for which this permit is issued(Sec.3097,Civ C.)
forthwith comply with such provisions or this permit shall be deemed revoked. i_ender's Name
APPLICANT CERTIFICATION Lender's Address
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
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
—ts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
ting of this permit.Additionally,the applicant understands and will comply
all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: SylviaM
COPY ## 1
Sec : Twp: Rng: Sub: Blk: Lott:
APN . . . . . . . . : 32651005 . 00
DATE ISSUED. . . . . . . : 06/02/2010
RECEIPT #. . . . . . . . . BSOOOOL0541
REFERENCE ID # . . . 10060OLO
SITE ADDRESS . . . . . : 22230 :10MESTEAD RD
SUBDIVISION . . . . . .
CITY CUPERTCNO
IMPACT AREA . . . .
OWNER LEFEVR3 SUSAN M ET AL
ADDRESS . . . . . . . . . . : 22230 '40MESTEAD RD
CITY/STATE/ZIP . . . : CUPERTCNO, CA 95014-0115
RECEIVED FROM . . . . : A & A PLUMBING
CONTRACTOR . . . . . . . : MIKE FOX LIC # 25401
COMPANY . . . . . . . . . . : A & A PLUMBING
ADDRESS 1030 E EL CAMINO REAL STE 248
CITY/STATE/ZIP . . . : SUNNYVALE, CA 94087
TELEPHONE . . . . . . . . : (408) 738-8878
FEE ID UNIT QUANTITY AMOUJT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ----- ----- ---------- ---------- ----------
1BCBSC VALUATION 3 , 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BREMAIRHA NO.UNITS 1 . 00 53 . 00 0 . 00 63 . 00 0 . 00
1BSEISMICR VALUATION 3, 000 . 00 0 . 50 0 . 00 0 . 50 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 . 50 0 . 00 148 .50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 148 . 50 5993
---------------
TOTAL RECEIPT 148 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
CITY OF CUPERTINO
FURNACE/AC 1 00 (::200/0
CUPCITYEf�TINO PERMIT APPLICATION FORM
_
APN # S
51 -- ODS 2f=-l0
Date:
Building Address:
n
2-L2 3i; / ,,�-i e� r��'�A �' Phone#:
Owner's Name:
Phone#:
Contractor:
ly��, Fax#:
Contractor License#: Cupertino Business License#:
of 3 2 3 2 sy o /
Phone#: aY 7 1.,12 �� 7Z
Contact:
//�G4.- Fax#: 6
Building Permit Info:
Elect' Plumb �— Mech RJ I
Residential Q Commercial ❑
Job Description:
For Residential Installations: 2nd floor ❑
Attic ❑ 1St floor ❑
Adhere to minimum setback requirement [l'-
For Commercial Installations:
Additional weight (structural calcs) El
Replacement same weight ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
Strapped ❑ On Platform Bonded New Location Replacement ❑
Project Size: Express E]--" Standard ❑ Large ❑ Major❑
Valuation:
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 CUP ERTINO
ai FURNACEVAC
CUPEt�TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Unit 3 <= I Ok CFM B
1 MCRAA Commercial Mech Re 3air/alt/add M
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea ga;piping System P
1-4 outlets
1 PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1 BPGAS For each gas piping system of 5 or P
more per outlet. Corrun/Resid
/ 1 BREMAIRHAN Residential A/C units <= I Ok CFM B
I
1 MRRAA Residential Mech Repair/alt/add M
=1BCBSC Cal =Standards ommission Fee B ALL PERMIT
ITYPES
1BSEISMICR Seismic Residential B
1 EPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
I
1 PPERMITFEE Plumbing Permit P
1 TRAVDOC Travel Documentation B
1BUSLIC Business License B
M.Indoor Air Ouaft and Finishes
1•Use LowlNo-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/F lealth pts y=yes 0
3.Use Low/ND VOC Adhesives 3 IAQ/F lealth pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resciroe pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 6 IAQ/F lealth pts y=yes p
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/F lealth pts y=yes 0
7.Seal all EVosed Partidsboard or MDF 4 IAQ/F lealth pts y=yes 0
S.Use FSC Certified Materials for Interior Finish 4 Resoiroe pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resoirce pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/lealth pts y=yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resou-ce pts y=yes 0
2.Use Rapidly Renewable Flooring Materials 4 Resou-ce pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resou ce pts y=yes 0
4. Install Natural Linoleum in Place of Vinyl 5 IAQ/H:alth pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resou ce pts y=yes 0
6. Install Recycled Content Carpet with Low VOCs 4 Resou ce pts y=yes 0
i i t
Total Points Available: 1401 1301 57
Total Points Project Received:1 C Of 01 01
610
G:data/progs/greenbuildnggi idelines/remodelers/greenpointsfinal2.12.04protected.xls
y
COMMUNITY MANAGEMENT SERVICE:i, INCORPORATED
September 29, 2004
Ms. Susan LeFevre-Harvey
222230 Homestead Road
Cupertino, CA 95014
Re: Glenoaks Park Villas Homeowners Ass ociation (Unit OS)
Hearin
Dear Susan and Bruce:
Thank you for attending the hearing before the Board last evening regarding the conduit and
wiring running across the roof of your building to your air conditioning unit on your patio.
The findings of the hearing are as follows:
■ The air conditioner was installed without requesting permission from the Committee or
the Board of Directors as required by the governing documents;
■ The conduit holding the wiring to the air conditioner runs across the roof of the
building in which Unit 05 is located;
The Board has determined the following coursc of action:
■ All wiring for the air conditioner must i un inside your unit, from your circuit breaker
box to the compressor;
■ All conduit and supports must be remo,Ted from the roof of the building and the roof
brought to pre-existing condition;
• If the above is not completed within thirty days, pursuant to the CC&Rs,that is on or
before November 1, 2004, a fine in the amount of$25 per month until completed and
approved by a member of the Board of Directors,will be assessed.
Please contact the undersigned or Barbara Bee:)e, when the above has been completed. Thank
you for your anticipated cooperation.
Sincerel
COl NWNIT MANAGEMENT SERVICiKS
auline M. A. Moore, Senior Association Manager
Glenoaks Park Villas Homeowners Associatl m D
cc: Barbara Beebe, President
1935 Dry Creek Road,Suite 203 ■ Campbell CA • 95008-3631 ■ voice (408) 559-1977 ■ fax (408) 559-1970