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06020005 CITY OF CUPERTINO • BUILDING DIVISION PERMIT v�N"l.R� R�11� M�.114N• '� . BUILDING ADDRESS: CONDITIONED AIR PERA1R N0'06020005 10931 LUCKY OAK ST IFEWS NAME: PERMIT ISSUE DATE TAMMY GALVEZ 1701 LITTLE ORCHARD ST 02/01/2006 PHONE: SANITARY NO. CONTROL NO. (408) 291-2220 ARCHITEC(ENGINEER: BUILDING PERMIT INFD BLDG ELECT PLUMB MECH i�s l:n it =1 atop LICENSED CONTRACTOR'S DECLARATION JJ,��N:v`•r' UM 1 hereby affirm Nal 1 am 14ensd under provisions of Chapter 9(commencing lob Les�rlptl o4 ; �1 NN Section 7000)O1'Division m Pm nn 3 ofthe Business mfcss ons Te Code,And my ens 4 n imm�fammamefrea 4REPLACE FURNACE © �j Dam Licens CU3 O3 Camrurarr((p''�pyy51 '`?R EOO� ARCHrrEcrs DECLARAT 1 I understand my plans shall he coed u public meet&Dwu OWN, �j/ ppp l5 ;o Licensed Professional N )( tU�WN, G Oat I am exempt from DECLARATION ConTION �:.� LLL��� u Z O I hereby•Hens that 11. exempt f am he Conlns Co License Law at far the ZOO following mason.(Section IIB not Business and Nofesaluos Cade:Any city of county $Pi which rtquia Issuance,permit re etmis the aper,hnpmsu h permit t fi repair any ummem 2 4 7 S _zr pdarmits enedpalsu requires the Applicant forthe Commucmi's Liceseo file Law(ed sammal FF Nulmis encing WpSecdnterthe pmvivisNnftimCaatnnessaniconshaw(Coca)w Sq.Ft.Floor Area Valuation y+�$ 'ham he (commencing Section 70ndth Dosis n 3Im ofthe alBed ess exemption, Any iCode)m - .. Net he 4 asumpt therefrom and Om buts fm the alleged eMmption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant As a civil penalty of r Occupancy Type Out more than five hundred dollen($500). 0 I,As owner of the property.Or my employees with wages u their sale compensation, will da the Mark,and the atruclues is not lmmnded m offered for sale(Sec.76th,Business Required Inspections and Perfessiana Code:The COntracmr4 License Law arca Mal apply m an owner of tl p property who builds or Improves Neuron,and who does such work himsel f or thereat his own employees,provided that such Improvements Me nal Intended oroRered ferule.If, however,the building or Improwment is sold within one you of compledon,the owner. Wilder will have the Widen of proving that he did not Wild or improv for purpose of sale.). ❑1.as Owner of the property,am exclusively contracting with licensed conoacmrs to construct the project(Sec.7Wa,Business and ProfeWoos Code:)The Commam's U. came Law dace not apply m an manor of property who Wilds or improve,demon.and who contracts for such pmjccM with a comm ter(O licensed peammu mthe COMlnemda License Law. ❑1 am exempt under Sec. .B k PC for th4 mason osr Dam WORKER'S COMPENSATION DECLARATION 1 hereby,affirm under penally of perjury arc of tins following declarations ❑Ihaw And will maintain aCeNfiam of Comm mulFWum fm Worker's Compen. andon,u provided far by Section 3700 of the labor Code.fm the performance of she work for which this permit is issued. 1 have and will maintain Workers Compensation bunrantt,u acquired by Section 37M of the LAbm Code.for Ne perfonnanc of the work for which this permit is issued. My Worker's Compensation WMmm artier and Policy number .a'rt Comer.�`7T-f CAl�-tLEMPIION FROMOR1CW FJIS' COMPENSATION INSURANCE (This sedan need trot he completed truth,permit 4 Wants hundred dollars($100) or leu) I"reify that to the performance of the work for which Nis permit u issued.l Shall not employ any person In any manner an As m became subject on Ne Worken''Compmuatian Laws of California.Data Applicant NOTICE TO APPLICANT:If,after making this Cerdfieste of Exemption,you should become subject m the Worker's Compeosation provisions of the LAW Circe,you most oO forthwith comply with such provisions or this panel,shall W domed revoked. .Z„r~rNCONSTRUCTION LENDING AGENCY (ti Ihemby alrnm Net Northacoostnmdnn mnding agercy fnrtheperformancef u !�� the wish for which this permit 4 issued(Sec.3097,Civ.C.) QLender's Name . Z)z Lender's Addmas U.0 1 certify that I have mad this application and sum that the above infommtion 4 ir. coned.I agme in comply with all city and county ordinances and sum laws relating to 0U Wilding construction,and hereby authormve mpresentatim or this city to enter upon due W alfow-mentioned pmperty for inspection ImMuss. (We)agree m saw,indemnify and anti,harmleas he City or Cupertino ai inst ra'A liabilities.judgments.costs and eapoasS which may In any way name Almost Mid City U 7 in consequence of the granting of this permit. F7 APPLICANT UNDERSTANDS D WILL COMPLY WITH ALL NON-POINT Issued by:9 Date 1—CSG SOUR REGULAT�IO,N/S. .tat 'u�L � viol to a Re-roofs 1 Smit of Applian an sur Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or fume Wilding oceupram ore m handle MIAMI w neral as dented by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety ade.Somme 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes cv�9O Will the applicant or future Wilding aceupant us equipment or Devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hux4ru air ronumiosnu As dMined by the Bay Arta Air Quality Mmagemmn all new materials for inspection. DismiM7 �.[' Dyes QNO I havemtl the huardnm muerialsmgJmmema uma rChapmri95ofde Califor- nia Hal"SafelyCede.Secdaos 25505.23333 Sm12533e.1 understood!than ifdm Wilding does Ill cummlly haw a IMAM.the It is my responsibility in notify the oaupsnt of the cop nm which most I°�r Murex ofa Comfeam of Occupancy. Signature of Applicant Date , g PP All roof coverings to be Class"B"or better Oar authorized g>' Dam CITY OF CUPERTINO •m 1 of 1 PERMIT RECEIPT OPERATOR: bethe COPY # 3 Sec: Twp: Rng:, Sub: Blk: Lot: APN . . . . . . . . : 32651071.00 DATE ISSUED. . . . . . . : 02/01/2006 RECEIPT #. . . . . . . . . : 33036 REFERENCE ID # . . . : 06020005 SITE ADDRESS . . . . . : 10931 LUCKY OAK ST SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . " OWNER . . . . . . . . . . . . : TAMMY GALVEZ ADDRESS . . . . . . . . .'. : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-0117 RECEIVED FROM . . . . : RICHARD READ CONTRACTOR . . . . . . . : RICHARD READ LIC # 22334 COMPANY . . . . . . . . . . : CONDITIONED AIR ADDRESS . . . . . . . . . . : 1701 LITTLE ORCHARD ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95125 TELEPHONE . . . . . . . . : (408)291-2220 FEE ID ' UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL __________ _____________ __________ __________ __________ __________ __________ BREMFURN NO UNIT 1.00 14 .31 0.00 14.31 0.00 BENERGY PERMIT FEE 1.00 34.86 0.00 34.86 0.00 BSEISMICRE VALUATION 2,475.00 0.50 0.00 0.50 0.00 PPERMITFEE FLAT RATE 1.00 38.37 0.00 38.37 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 __________ __________ __________ ---------- TOTAL PERMIT 164 .,78 0.00 164 .78 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ------------ __--_____--____-__ OTHER 164 .78 VISA TOTAL RECEIPT 164 .78 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL Community Development 10300 Torre Avenue f Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 41UPEkTINO Building De artment JOB ADDRESS: PERMIT # 10 \ LucKy O K D 2000 OWNER'S NAME: —[ PHONE # cbqgi -4 5 GENERAL CONTRACTOR: C , 6 mAFAX # C I am not using any subcontractor . • O G Signa Da Please check applicable subcontractors and complete the followinginformation: SUBCONTRACTOR BUSINESS NAME BUSINESS L CENSE # 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 Sh Metal S eet Rock Wr ile weer/Contrac or ignature Date CITY OF CUPERTINO . « " FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM APN# Date: Building Address: kD % Luck 3 <'o+ Ownerr,Name: �l✓e Phone : a3 `J Contracto : - License #: art dAk m4e j Contact: Cupertino Business License #: q� ' tul V, ((4rlzR� 9 33y Building Permit Info: Bldg ❑ Elect 'a Plumb CF' Mech Job Descripti n lqutlW I D (Ce c S -kC a&Cm 6P Residential 1 Commercial ❑' For Residential Installations: Attic El I" floor V 2nd floor❑ Adhere to min set back 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: �{.7S Type of C sn[I trncti Occupancy group: Strapped ❑ On Platform ❑ Bonded F-1 Sq.Ft. Floor Area: New Location ❑ Replacement Qty. if Applicable Fee ID Fee Description Fee Group ✓ BENERGY Energy BUILDING BREMFURN 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 EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING