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07100212 CITY OF CUPERTINO ' (`� ` j #7� BUILDING DIV1S10N PERMIT �� `�`�� *' '. ... ; , , , ,>. ..- ,. ., >;: : _ . . _ . . : . PERMIT NO. BUILD �� ESS OAKCREST CT CONDITIONED AIR 07100212 . PERMIT LSSIIE DATE �ER'S NAME: TENOLD STANLEY E AND MARGO L 1701 LI`�TLE ORCHARD ST� 10/30/2007 SANITARY NO. CONTROL NO. PHONE: (408) 29:L-2220 BUILDING PERMR INFO ARCHTCECTIENGINEER: BLDG ELECT PLUMB MECH � 0 � � i p Q LICENSED CON7RACTOR nec�.nRanoN Job Description i U� I hcreby affcm that [ am licenud undcr provisions of Chaptcr 9(commencins ;z � withSccuon7IXl0)afDivision3ofthcBusi �' �'��s REMV &:zEPLACE FURNACE� ADD A/C �� y in full forec and sftec� Z Licensc CI s L�. # : � � Da�c Conu r � �"� � pR ITECI'S DEC ATION i a a 1 understand my plans hall be used az pu6iic reeords )yU ' u. y Liccnsed Pn�fcsaianal � y � OWNER-BUILDER DECLARATION >' 1 hcrcby atTrm that 1 am excmp� Crom thc Convaaors l.iccnac Law far thc j p O [ollowing rcason. (Sccuon 7U31.5, Busincss and Profcssions Codc: Any ci�y or county �°„ � which rcquires a permit to consuuc4 81tcr. imlxovc• dcmolish, or icpair any stn�cture prior ui i�s issuancc, also rcquires thc applicant Cor such permit to filc a signed s�alcmcn� �; Ft. Floor Area Valuation � s � ihai he is liecnscd pursuant to thc provisions o! thc Comraetor's Li��cnsc law (CAap�cr 9 • $1717 5 � h (commencing wiih Scction �000) of Division 3 0( Ihc Busincss and Profcssions Cadc) or ��.. U�at he is exempt thcccfrom md the buu Cor the altegcd exemption. Any violuion o( Sectian 7031.5 by arty applicant [or a pertnit subjecu the applicant to a civi] penalty oC 3 4 2 4 8 0 0�� Number Oceupaney Type not more than five hund�ed dollars (5500). ❑ 1, az owner oC tt�e propccty. or my cmployces with wages as their solc compensstioa. wili do the work, and the suuctuce is r.ot intended or etLead for sale (Sec.7044. Busiaess Required Inspeetions and P�vfessions Code: 'fhe Conuacwrs License Law docs not apply w an owner of property wha builds or improves thercon, and who daes such work himseltor tivong6 hia own emplayces. provided ihat such improvemen�s are not in�ended or a[fered for sak. I[, however, the buildiag or impmvement is sotd within one year of compiction, ihe oa�er- builder will have the burdco ot proving ihat he did no� build or improve Cor pmpoae of salc.). Q I, as owner of �he property. am accfusively conuacting with littnxd rnnuactors a conswct the projea (Sec. 7044. Businas aad Pcofessions Cade:) The Conuxtor's Li- cense [aw does aot applY �o an ownec of propeny who builds or improves Ihe�eon. and . who convacts [or such projects with a conuactor(s) licensed pursuam to ihe Convanors License Law. ' am uempt undu Sec. , B& P C!or �his reason _ ., ner Date _ WORKERS COMPENSATION DECLARATION 1 heccby aflirm under penalty of perjury onc o[ U�e folbwing declaratioas: ❑ I hsve and wilt mainuin a Cenificate of Consent to self-insure (or Workcfs Comprn- sation, u provided for by Section 3700 of the Labor Code, for �he pedormancc oi ide woric for which Ihis permit is issued. ❑ I havc and will maintain Workcr's CompensaUon Insunna, u required 6y Scction . 3700 0[ the Labor Code, fw �he performance of We work for w6ich this permit is issued. Camet/��dY / � n !/�G �" / � Policy N ry /D/�� / / � CER7'IFICA'C6 OF EXEMPRON FROM WORKERS' COMPENSATION [NSURANCE � (Chis scction m:cd not bc completcd if the pecmit is for onc hundrcd doltars (5100) or IcssJ 1 cenify thxt in the performance of ihe work for which �his pertnit is issucd, I shall na amploy any person in any manncr so az w bccomc subject ta ihe Workcci Compcnsatian Laws of Califomia Datc Applicant N077CE'f0 APPLICANT: If, aftcr making this Cenifica�c of Excmption, you should become subject �o lhe Worlcer's Compensation pmrisions of Ihe Labor Code, you muu � O forthwith comply wi�h such provisions or this permit sAall be decmed revoked. z ""' CONSfRUCI70N LENDING AGENCY (. ��-+ I herehy atGrm ihat thcre is a conswcuon knding agcncy for thc per[ortnanex of - (� � �hc work for which this pertnit is issucd (Scc. 3097. Civ. C.) W A Lendcr's Narnc � z Lcndet's Address V � I ccrtify Uiai 1 h rcad this application and sutc �hu �hc abovc informauun is w � corrcct. 1 agrce to co with all city and caunty adinances and su�e laws rclating �o � U building conswc ' n, d hcrcby auth rcprcsentaiivcs of �his ci�y to cntcr upnn Ihc � a abovc-mcntion pro rty (or inspcc on purposes. (Wc) ree t save, indcm. ' y and kccp harmless �hc Cily of Cupertino against �� liabilitiu. " mcn , cos�s and c which may in any way accnu againsl �d Gty V z in con ce of c granting �his permi� Date i � APPLI UN ERSTA S AND WILL COMPLY WITH ALL N-POI Issued by: - v�' SOU REGUL TIONS. .,i � Re-roofs ,��"� s� � ar ��uc a� ° ie T e of Roof HAZARDOUS MA7FRIAIS D[SCLOSURE YP Will Ihe applicant or future building occupmt uore or Aandle haiardaus material :fined by the Cupenino Municipa� Codc. Chaptcr 9.12. and UK Hcalth and Saftty ..,�, Scction 25532(a)? �,�� All roofs �hall be inspected prior to any roofing material being installed. ❑ Ycs IJ�o . Will the applicant or futurc building occupam use equipment or dcvices which If a roof i� installed without first obtaining an inspection, I agree to remove emi� hazardous air contami/ss dcfincd by Ihe Hay Ama Air Qualily Mana6�� all new m aterials for inspecr,ion. Disvict? ❑ Ycs vc ad the haz matcriaLt rcquirc AcrChapicr6.95 of tiic Gl' w- nia & afctyCodc tiont25505,25533a�u1 .Iundcrs�andihatiCihe ' 6 d cu n�ly ha � an4 �hat it is my res ihiti�y w noufy �hc axup t n[ the �yu' mcn�si ichm hc tpriorwissu rac�,�r�a�or - ' nature of Applicant , , Date pa � _ All roof coverings to be Class 'B or better wncr authorizc gent ; C�� o� ��'I�� p -- 7 � � �� I� � �` �� 1��:i� �_��!�� P��T��o PE�I'�' APPLICA�I'I�I� �O AI'N # Date: 2- �� ?,6�0� (b (z�l�� Building Address: � �� `� C (�� C Z S�-� vt Owner's Name: Phone #: � '�� 4�C _��. CZC� 1. �__ � - �/ ��f �Q 1 1'I�oi�e: 1.�ic,�nse �: I i ��`«��fractor: i . , , . � ,� .- � � . ' � � � �4 � . Contact: Phone: Cupertino �usiness License #: .�{. � ��r, o�a Building Permit Info: Bldg ❑ Elect � P: umb � Mec Job Description: , � - e � �� :..� �-��c � ce A t C Residential� Commercial ❑ For Residential Installations: AttiC � 1 St fl00� 2 flOOr � � dhere to min set back requireme,t�l._ .,r Commercial Installations: Replacement same weight�Additional weight (str�ctural calcs) � Structural Calculations required for new installation �� New installation Planning Approval Required ❑ Cost of Project: Type of C�s,truction: Occupancy group: � 1 �S � �� Strapped ❑ On Platform ❑ Bonded ❑ Sq.Ft. Floor Area: New Location � Replaceme Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Fu rnace MECHANICAL BREMACOVER A/ � Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/ � Units <= 10, 000 cfin MECHANICAL BREMRECEPT Re cptl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE El�;c Permit Issuance ELECTRICAL / MPERMTTFEE Mf;ch Permit Issuance MECHANICAL / PPERMITFEE Pliunbing Permit Issue PLUMBING BPERMFEE Bl�ig Pernut Fees BUILDING BPLANCHK Pl�i.n Check Fee BUILDING BPGAS G��s Piping System Fee PLUMBING BUSLIC Bi.siness License BUILDING Community Development - 10300 Torre Avenue ;� *� ._. _ Cupertino CA 95014 Telephone (408) 777-3228 Faz (408) 777-3333 Cl7Y �OF CUPE�TINO Build:in De artment JOB ADDRESS: PERMIT # �. -�y .n � ��7 6�'Z � 2 -- OWNER'S NAME: �� PHO # Q - GENERAL CONTRACTOR � � C� F� 4�4 ZCl �- ZZ � � � (o ( � l�`� I am not using any sulxontractors: �iigristure Date Please check a licable subcontractors and cotz lete the followin infom SUBCONTRACT'UR BUSINESS NAME SUSINESS LICEN E# Cabinets & Millwork Ceanent Finishing IIectrical Excavation Fencing Flooring. Car�eting Linoleum / Wood Glass / Glazsng Heating Insulation Landscaping Latliing Masonry prnamental Sheet Me Painting / W�PaP Paving Plastering Plumbin Roo ' tic Tank Sheet Metal Sheet Rock Tile Date (�wner/Contractor Signatuz'e CITY OF CUPERTINO 7 ITEMS OF 7 PERMI�' RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: B1J�: Lot: APN ......... 34:?48006.00 DATE ISSUED.......: 10,'30/2007 RECEIPT #.........: BS�)00003119 REFERENCE ID # ...: 07:_00212 SITE ADDRESS .. ...: 22��54 OAKCREST CT SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OWNER ............: TE]JOLD STANLEY E AND MARGO L ADDRESS ..........: 22�i54 OAKCREST CT CITY/STATE/ZIP ...: CU:?ERTINO CA, 95014-0830 RECEIVED FROM ....: COJJDITIONED AIR CONTRACTOR .......: RI�;HARD READ LIC # 22334 COMPANY ..........: CO]JDITIONED AIR ADDRESS ..........: 17)1 LITTLE ORCHARD ST CITY/STATE/ZIP ...: SAJJ JOSE, CA 95125 TELEPHONE ........: (4)8)291-2220 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 BREMAIRHAN NO.UNITS 1.00 10.26 0.00 10.26 0.00 BREMFURN NO UNIT 1.00 14.31 0.00 14.31 0.00 BSEISMICRE VALUATION 17,175.00 1.80 0.00 1.80 0.00 EPERMITFEE FLAT R.ATE 1.00 40.79 0.00 40.79 0.00 MPERMITFEE FLAT R.ATE 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 : 183.60 0.00 183.60 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 183.60 VISA --------------- TOTAL RECEIPT : 183.60 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL