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07050229 CITY OF CUPERTINO �� { I�YtTIf3N: BUILDING DIVISION PERMIT PERMIT•NO. 3D4 b BUILDf§ p 'E HELMSFORD DR A PERFECT CLIMATE 07050229 �$ PERMIT ISSUE DATE OWNER'S NAME: 05/22/2007 CHIK ANNIE 10570 S DE�NZA BLVD SANITARY NO. CONTROL NO. .)NE: (408) 86119`_45 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH reo o LICENSED CONTRACT'OR'S DECLARATION Job Description :I— I hereby affirm that I am licensed under provisions of Chapter 9(commencing z U with Section 7000)of Division 3 of the Business and Professions Code,�ad my license is ADD A C .5 TON 14 SEER t=u0j. in full force and eff l7� ? License Class Ci Ltc•7i p Date Contractor t w AR HITECTS DECLAR N y a 1 understand my plans shall he used as public records )yV u.H Licensed Professional O< OWNER-BUILDER DECLARATION aI hereby affirm that 1 am exempt from the Contractors License Law for the O op� following reason.(Section 7031.5,Business and Professions Code:Any city or county $(i which requires a permit to construct,alter,improve,demolish,or repair any structure u'y prior m is issuance,also requires the applicant for such permit to rile a signed statement S F.Floor Area Valuation - a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $4995 t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i that ne 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 3752205 7 E Number not more than five hundred dollars(5500) 0 1,as owner of the property,or my employees with wages as their sole compensation, Required Inspections will do the work,and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law docs not 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.). 0 1,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. cerise 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 Contractor's License Law. B 8t P C for this reason 0 1 am exempt under Sec OwnerDate WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: sation1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- ,as provided for by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. 0 1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the labor Code,for the performance of the work for which this permit is issued. My Worker's Com;pen4sauLio&nu a 'r. Iicy num Cartier. 4- °� No.:CKATE OF EXEMPTION FROM S' 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 Workers Compensation provisions of the Labor Code,you must 2 forthwith comply with such provisions or this permit shall be deemed revoked. z O CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of Q�✓ the work for which this permit is issued(See.3097,Civ.C.) Lia Q Lender's Name .7 z Lender's Address U C) 1 certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to 0Ubuilding construction,and hereby authorize representatives of this city to enter upon the - U above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City U z in consequence of the granting of this permit. 1 Date 1, APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE GULATIONS. (�, / Re-roofs Signature of ApplicanUf;011 racto Date T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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)? S All roofs aha]1 be inspected prior to any roofing material being installed. 0Yes e " If a roof is in;tailed 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 Arca Air Quality Management all new mate)ials for inspection. District? 0 Yes No 1 have read the hoz ors materials requirements under Chapter 6.95 of the Califor- niaHealth&Safety Code. ons 25505.25533 and 25534.1understand that iCthe building does not currently have a tenant.that it is my responsibility to notify the occupant of the Date requirements which must be met priorAV a Certificate of Occupancy. Signature of Applicant All roof coverings to be Class"B"or better Owner or authoriz agent Date CITY OF CUPERTINO 7 ITEMS OF 22 PERMIT RECEIPT OPERATOR: kiersaw COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 37522057 . 00 DATE ISSUED. . . . . . . : 05/22/2007 RECEIPT # . . . . . . . . . BS000001432 REFERENCE ID # . . . : 07050229 SITE ADDRESS . . . . . : 18346 CHELMSFORD DR SUBDIVISION CITY CUPERTINO IMPACT AREA . . . . . . OWNER CHIK A\TNIE ADDRESS 18346 "-HELMSFORD DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM A PERFECT CLIMATE CONTRACTOR SMITH, BYRON E LIC # 21144 COMPANY A PERFECT CLIMATE ADDRESS 10570 S DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE (408) 86119545 FEE ID UNIT QUANTITY AMOUNT 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 BREMRECEPT NO. OUTLETS 1 . 00 1.20 0 . 00 1 .20 0 . 00 BSEISMICRE VALUATION 4, 995 . 00 0 . 50 0 . 00 0 .50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 .37 0 .00 38 .37 0 . 00 MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 .00 PPERMITFEE FLAT RATE 1 . 00 38 .37 0 . 00 38 .37 0 . 00 ----- ----- ---------- ---------- ---------- TOTAL PERMIT 161 . 93 0 . 00 161 . 93 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ----- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL 0-f-05 odofl MAR-09-2007 01 :23 PM Mary Kurtis 415 276 2304 P. 01 %-vrcki IrytJ K L' 1%1!'11 1 ALX 1 Ll%..ti 1 1tJl14 X V1%lrl AI'N# o?o?— OS�' Date: 15 Z�—O Building Address: Q A, LM< V `T10 C , . Owner's Name: Phone#: 409 Contractor.- Phone: *72-„3 �s$ Contact: f� Phone: Q5 Cupert�©Bu i License#: • Building Peru Info: B1d �1 Elect Plumb �'' Mech Job Description' _ „Z•s Residential '19 Commercial ❑ For 9WdentW) Dations: Attic uu I"floor U To floor Adhere to min set back ent For Commercial Inst�ttons: Replacement same weight ❑. Additional weight(structural calcs)D Structural Calculations required for new installation New installation Pl&ming 6pEng—R—OcLu—ftad Cost of project: [�, Q t'0 Type of00111! �,`oti; ups P� Strapped On Platform Bonded Sq.Ft. FIoor Area: New Location i% R laeement Qty, if licable Fee ID Fee Description FeeGrou BBNERGY En BUILDING BREMFUItN Fwne ze MECHANICAL BREMACO'VER AJC Unit} 10,000 cfn MECHANICAL BREMAXItHAN AJC Units¢= 10, 000 cfm MECHANICAL BR,EAMCEPT Rood,Switch&Outlets ELECTRICAL BSEISMICRB Seismic Fee Res BUILDING BSE1SMICOM Seismic Commercial BUILIDNO EPERMrI7EE Bloc Permit Issuance ELECTRICAL MPERMITFEE Meeh,Permit Issuance MECHANICAL PPERMPITFEE Plumb n Permit Issue PLUMBING BPERtvWEE Bldg Permit Fees BUILDING BPLANCHK Plan l'lack Fee BUILDING HPGAS Gas)living system Fee PLUMBING BuSLIC Business License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "WEI�TINO Building Department JOB ADDRESS: PERMIT# OWNER'S NAME: PHONE# ,z� GENERAL CONTRACTOR: 4vti FAX# I am not using any subcontractors: 12-AN -2 Z-"27 Signat ure Date Please check applicable subcontractors and com letE the following information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owne Contractor Signature Date