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07080184 CITY OF CUPERTINO BUILDING DIVISION PERMIT ( RMAU • PERMIT NO. BUILDING ADDRESS: 20087 SOMERSET DR A PERFECT CLIMATE 07080184 OWNER'S NAME: PERMIT ISSUE DATE BACHTEL ARTHUR R AND 8375 BRENTWOOD BLVD STE R 08/20/2007 SANITARY NO. CONTROL NO. 14LIT T 7 AIDUMLI (408) 8E1 9545 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB METH ce z LICENSED CONTRACTOR'S DECLARATION o Job Description w� I hereby affirm that I am licensed under provisions of Chapter 9(commencing z with Section 7000)of Division 3 of the Business and Professions Code and my license is REPLACE; FURNACE, ADD AIR CONDITIONING I.<*. in full force andcffecC �tQ� v�z License CI s l11300 Lic.# t o Datc Contractor a ARCHITECTS DECLA i a Q I understand my plans shall be used as public records :yU L,t Licensed Professional 1 OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the I p O following reason.(Section 703 1.5,Business and Professions Cote:Any city or county -9 which requires a permit to construct,alter,improve,demolish,or repair any structure Z r prior to its issuance,also requires the applicant for such permit to file a signed statement Ft. Floor Area Valuation _ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq F, (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $10267 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of �Number Occupancy Type not more than five hundred dollars(5500). 3 6 9 3 0 0 C'1 0 I,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 Required Inspections and Professions Code:The Contractor's License Law does 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 arc not intended or offered for sale-If, however,the building or improvement is sold within one year or completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). 0 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors Li- cense 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 Contractors License Law. 0 1 am exempt under Sec. B&P C for this reason .Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. )FORave and will maintain Workers Compensation Insurance,as requited by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker Co pensation Insurance carrier and Policy number are: ) Carrier: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I ceni( that in the performance of the work for which this permit is issued 1 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 Worker's Compensation provisions of the Labor Code,you mast Oforthwith comply with such provisions or this permit shall be deemed revoked. Z' CONSTRUCTION LENDING AGENCY Fr CA I hereby affirm that there is a construction lending agency for the performance of r7 the work for which this permit is issued(Sec.3097,Civ.C.) Lt7 Q Lender's Name z Lender's Address U C) I certify that I have read this application and state that the above information is CL. correct.1 agree to comply with all city and county ordinances and state laws relating to 0U building construction,and hereby authorise representatives of this city to enter upon the W ahove-mentioned property for inspection purposes. a (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. Date Ze; ►. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b'�: SOU EGULAno . '-)0"9_7 Re-roofs Signature of Applic t/Conu acto Date AZA US MA RIALS DISCLOSURE Type of_Zoof Will the applic or future building occupant store or bandle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roof: shall be inspected prior to any roofing material being installed. 0 Yes I EffN. 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 -.nit hazardous air contaminants as defined by the Bay Area Air Quality Management all new I naterials for inspection. District? 0 Yes I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that.if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the requiremen h must be met prior w' trance of a Ccrtiftcatc of Occas S ignatur°of Applicant Date cry. All roof coverings to be Class"B"or better Owner or authorise gc-17 Date - CITY OF CUPERTINO 8 ITEMS OF 28 PERMI" RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Bl}.: Lot: APN 36030001. 00 DATE ISSUED. . . . . . . : 08/20/2007 RECEIPT #. . . . . . . . . BS0)00002431 REFERENCE ID # . . . : 07080184 SITE ADDRESS 20087 SOMERSET DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER BACHTEL ARTHUR R AND ELIZABETH ADDRESS 20087 SOMERSET DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3131 RECEIVED FROM ED'9ARD GREGORY CONTRACTOR SMCTH, BYRON E LIC # 21144 COMPANY A ?ERFECT CLIMATE ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513 TELEPHONE (4 )8) 861 9545 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 BREMFURN NO UNIT 1. 00 14 .31 0 . 00 14 .31 0 . 00 BREMRECEPT NO. OUTLETS 1 . 00 1.20 0 . 00 1.20 0 .00 BSEISMICRE VALUATION 10, 267 . 00 1. 10 0 .00 1.10 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 176. 84 0 .00 176.84 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- --------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OFCUPERTINO &I, - FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM APN# 130 �� Date: �y�z -(9 ,7 Building Address: Owner's Name: Phone#: Contracto : Phone: / �,S Yr License#: el__r Contact: / Phone: Cupertino Business License#: Building Permit Info: Bldg ❑ Elect Plumb Mech Job Descri tion: G / vro�«. Residential A Commercial ❑ For Residential Insttallations: Attic ❑ 1"floor X51. 2"d floor❑ Adhere to min set back requirement For Commercial Installations: Replacement same weight ❑ Additional weighs: (structural Elctural calcs) Structural Calculations required for new installation New installation Planning Approval Required ❑ Cost of Project Type of ConsTon: Occupancy group: s�=/� /V,Zb 71 � Strapped ❑ On Platform Lg"-' Bonded EF Sq.Ft. Floor Area: New Location Replacement Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Relocation of Furnace MECHANICAL BREMACOVER A/C Unit> 10,000 cfm MECHANICAL 1 BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL / BREMRECEPT Rec tl, Switch&Outlets ELECTRICAL / BSEISMICRE Seismic Fee Res BUILDING / EPERNIITFEE Elec Permit Issuance ELECTRICAL MPERMTTFEE Mech Permit Issuance MECHANICAL PPERMTTFEE Plumbing Permit Issue PLUMBING BPERMFEE BldgPermit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 rUPEkTINO Building Department JOB ADDRESS: PERMIT # $ -7 -V-?o e-0 63"1 OWNER'S NAME: c, PHONE # 410 - YYb- OkO'`— GENERAL CONTRACTOR: FAX# oA I am not using any subcontractors: J)— ignature �— Date Please check applicable subcontractors and complete 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 Owner/Contractor Signature Date