Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
04020061
''CITY OF CUPERTINO "" BUILDING DIVISION PERMIT y,CONTRACTORINFORMATION ;A' BUILDINGADDRESS: GOSAL HEATING&AIR CONDITIO MYo04020061 OW NER'S NAME: PERMIT ISSUE DATE ALEX UMIN 114 NE: SANITARY NO. CONTROL N0. 510 441-2318 BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION Job Description w I bemby affirm that I am licensed under Provisions of Chapter 9(commencing <� with Seetimn,7000)a(Dlvlsion 3 of NC Bund a the Predication,Code.and MY licence is in mnse Cl and—free:. FUNAn E© 5'q? uecmmr6ea r'.2.n uc.x 6 VIC `Is/ REPLACE FURNACE & ADD A/C t!— U�iJ fib Ceramists, Gn SAL Ah L ✓ — s )ARCHITECTS DEC1Dk ATIOIT N L understand my plans 0.11 bo used as public ttOld, F E g 12 2004 7yU 30t Licensed Profcuional OWNER-BUILDER DECLARATION I hereby affirm Nat 1 em eacmpt from the Comoseme,License Law for the 1��'�®�pp� �p o following Mason.(Sashed 03IS,Business and professions Code:Any city at county BUILDING CtlI K$ff which requires a Permit to construct,ether,repave,drmmlksh.or repair any structure w�'^ prior m its issuance.also ratio.tM applicant for such permit to file.signed stawmcnt that the is licensed pursuant P the Previsions of NC Conuacwr's lJcrnu Law (Chapter 9 Sq.Ft. Floor Area Valuation m (commencing with Section 7")of Division 3 of the Business and Professions Code)or ou Nat he u exempt thertfrom and the basis for the alleged exemption.Any violation of . Section 9031.5 by any applicant for a permit subjects tW applicant in a civil penalty of 32W414'4l"cr00 Occupancy Type nm mom Nan five hundred dollars($500). ❑1.as owner ofthe property,or my employees with wages as Noir sale compensation, will da the work.and Ne swctum a not intended or offered forsale(Sec.7061,Buddes, and Prodessimu aewra Crude:The CaarLlano Law den,Out apply in as her of Required Inspections propeny who bands or improves theman,and who does such work himselfor through his own employees,provided thatsuch improvements art collateral or offered for sale.If, however.the Wilding or improvement is sold within one year of completion.the ownm- builder will have the Wrden of moving Jut M did her Wild ar improve(or purpose of sale.). ❑1,as an,of the property,am exclusively convecting win licensed commeters w chat Inor I dm Project(See.7014.Business and Pro(esaions Cade:)The Contractor'.actori V. ' nen law does not apply to an owner of Maturity was bolds or Improves Jwmon,and who contracts for such projects with.icon elor(s)licensed pursuant 10 the ConmiCtOra License Law. ❑ I am aempt under See .B&PC far this mean Owner Dam WORKER'S COMPENSATION DECLARATION I Mreby aRmm under penalty of perjury ane of the following daloatioru: - 1 have and will maintain a Cedificae of Consent to self-manam for Worker's Co est en- 737]"W ion,as provided for by Section 3700 of the Labor Cod,for the Performance of the rk for which this permit is issued. 1 have and will maintain Workers Compensation Inaurana,as required by Section ofNC labor Code,for the o formarec of the work for which this permit is issued.y Worker's�Coma p�eru�auon�l{ryVu,+na canter endfPolicy�mWrUm:ZrmYr Work;';C CER FICATEoM%EM PVTJVN FROM WOR KERS' COMPENSATION INSURANCE.7/.Q y mass mmol tared net bocamplewd i(the Permit is form=hundred dollars($100) or less.) - 1 codify that in the performance of the work for which this Permit as issued.I shall not employ any prison in any manderm as to become subpct in rho Wmrktrs'Com,cmNon Laws of California.Dau Applicant NOTICE TO APPLICANT.If.star making Nis Cedifcare Of Exemption.you should taco m,subject w NC Worker's Compensation provisions of Our,Labor Cade,you muse forthwith comply with such provisions or this Permit&halt be deemed revoked. Z O CONSTRUCTION LENDING AGENCY I hereby arms that Vert is a construction lending agency for the Performance of CZ 7 the work fur which this permit 6 issued(Sec.3097.Civ.C.) W Q Lender's Name D. Leal Lender's Md. V Q 1 codify that I have read this application and sow Nn the above inforaddim is [f.H correct.1 agree to comply with all city and county ordinances and sure laws minting to O v building construction,and hereby avthorio representatives of this city to enter upon NC a above-mentioned Property for inspection purposes. (sac)agree m says,indemni(Y and teem hammless Ne Ciry of Cupertino.gains F' V) liabilities,judgmcas,casts esewa laid expenses which may in any y accrue against said City , U Z in consequence of the granting of this Permit. APP CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SO GULATIO S. -0/er 2:0—OL/ Re-roofs Si nuureof Applica tsr Data HA]IRDOUS MATERIALS DISCLOSURE Type of Roof W II Nc applicant to furore building occupant store or hudlc haaardeus material ax defined by the Cupenion Municipal Code.Chapter 9.13,and the Health and Safety AjOLCodc,Section25533(a)?Y. W111. All roofs shall be inspected prior to any roofing material being installed. ❑wn Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit herardous air conuminarm m defined by Me Bay Area Air Quality Management all new materials for inspection. DisuicR ❑Yes No I have read the hvardnus materials requirements under Chapterb.95 of the Califon nu Health&SafayCedc.SCcuwu 35505.25533 am125534.I understaM thatifJw Wilding does not currently have a tenam.Nat it is my responshilay to edify the occupant of the cnu which must be met priwmasticatr eNficaweroOmwey. Signature of Applicant Date .O `� wncr or authomsd agent Dam All roof coverings to be Class"B"or better t �C CITY OF CUPERTINO FURNACE/AC v � oa o 66 OF UPERTINO PERMIT APPLICATION FORM APN #326 /, — 036 Date: a 9 - 0 Building Address: 7 Owner's Name: MINA Phone #: V61T -57/7�7 If It L Contractor: G L Phone: sj� _ `f\4 1 23 8 License#: ' 6 W- 9 Contact: Phone: Cupertino Business License #: Building Permit-Info: Bldg ❑�� Elect ® Plumb ❑ Mech m ,J9 b�escript i o n: /2 " A-_I)D f L 0��C er-!a-.�-4 � Uu'� � Res dentia] -7 Commercial ❑ For ResitiffitialInstallations: Attic 5Q I" floor ❑ 2"d floor❑ Adhere to min set back requirement❑ or Commercial Installations:—_ eplacement s weight ❑ Additional weight (structural calcs) ❑ Structural culations required for new installation ❑ New ins lation Planning Approval Re uii 'E] Cost o Project: Type f Construct n Occupancy oup: �/'7S� Strappe O Bonded Sq.Ft. Floor . New Location ❑ Replacement Qty. . A ca 1 Fee ID Fee Descri tion Fee Group BENERGY Energy 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 BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE I Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING