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07080186 CITY OF CUPERTINO 7777777777777—77�� BUILDING DIVISkON PERMIT Q )�A TQ]�I EQRIV�A�TQN• BUILDING ADDRESS: PERMIT NO. 7484 TIPTOE LA A PERFECT CLIMATE 07080186 OWNER'S NAME: PERMIT ISSUE DATE HO SHENG H AND WEI T 8375 BRENTWOOD BLVD STE B 08/20/2007 NE: (408) 861 9545 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O p LICENSED CONTRACTOR'S DECLARATION cwi I hereby affirm that I am licensed under provisions of Chapter 9(commencing Job Description z with Section 7000)of Division 3 or the Business and Professions Code andmylicenscis REMOVE/REPLACE AIR CONDITIONING UNIT a a in full force and IT License C s '� Lic.# 3t p Date - Contractor ' wa ARCHITECTS DECLARATION w a I understand my plans shall be used as public records yU O y Licensed Professional OWNER-BUILDER DECLARATION j a 1 hereby affirm that I am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure } prior it)its issuance,also requires the applicant for such permit to file a signed statement _ that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 Sq.Ft. Floor Area Valuation I- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $5562 .. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of A��N Number Occupancy Type not more than five hundred dollars($500). 35932055 . V U ❑1,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 and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections 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.). ❑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- ccnse 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. ❑I 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: ,J 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as required by Section 37M of the Labor Code,for the performance of the work for which this permit is issued. My Work!eCA Co pensation Insurance carrier and Poli number am: / Carrier d- G Polity No. �A _t7"V1 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is foronc hundred dollars($100) or[us.) 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 Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. z CONSTRUCTION LENDING AGENCY H I hereby affirm that there is a construction lending agency for the performance of C�. the work for which this permit is issued(Sec.3097,Civ.C.) Rwi Q Lender's Name z Lender's Address U C) I certify that 1 have read this application and state that the above information is (y ' correct.I agree to comply with all city and county ordinances and state laws relating to O U building construction,and hereby authorize representatives of this city to enter upon the aabove-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. /^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULATIONS. Re-roofs C7 ��- Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Rc of 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)? [3 Yes All roofs s call be inspected prior to any roofing material being installed. �gNo Will the applicant or fuyn: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 materials for inspection. District? - E3 Yes 1 have aced the hazardous materials 553a requirements under Chapter that i the buiCalif din niaHcalth&Safety Code.Scctions25505,25533and25534.Iunderstand thatifthc building does not curend ave a tenant,that it is my responsibility to notify the occupant of the V requirements is us(be mel pnor to) cc of a Certificate of Occupancy. Signature e f Applicant Date Owner or authorized gc Date All roof coverings to be Class"B"or better CITY OF CUPERTINO 6 ITEMS OF 28 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35932055. 00 DATE ISSUED. . . . . . . : 08/20/2007 RECEIPT #. . . . . . . . . : BS000002431 REFERENCE ID # . . . : 07080186 SITE ADDRESS . . . . . : 7484 TIPTOE LA SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER HO SHENG H AND WEI T ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5819 RECEIVED FROM . . . . : EDRARD GREGORY CONTRACTOR . . . . . . . : SMITH, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PERFECT CLIMATE ADDRESS . . . . . . . . . . : 8375 BRENTWOOD BLVD STE B CITY/STATE/ZIP . . . : BRENTWOOD, CA 94513 TELEPHONE . . . . . . . . : (48) 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 BSEISMICRE VALUATION 5, 562 . 00 0.60 0 . 00 0. 60 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 160 .83 0 . 00 160. 83 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF CUPERTINO FURNACE/AC CUPEkTINO PERMIT APPLICATION FORM D 7ogo18� APN# Date: ? 359- 3a -D55, oc Building Address:71�e -foe- 1-6?k46 Owner's Name: Phone#: Iva Contractor: Phone: �2 License#:.;7Z 31S p Contact: J Phone: Cupertino Business License#: d 6r-eg 0rxf'�f= �6z/ Building Permit Info: Bldg ❑ Elect C' Plumb ly Mech Job Description: Residential Commercial ❑ For Residential In ts�, llations: Attic ❑ 1"floor 19 2nd floor❑ Adhere to min set back requirement For Commercial Installations: Replacement same weight ❑ Additional weighs:(structural calcs) ❑ Structural Calculations required for new installation El New installation Planning Approval Required ❑ Cost of Project- ZS Type of Construc tion: Occupancy grgilp: Strapped ❑ On Platform El Bonded Sq.Ft. Floor Area: New Location ❑ Re lacement/iz� 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 l BREMAIRHAN A/C Units <= 10, 000 cfm MECHANICAL BREMRECEPT Rec tl, Switch&Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING EPERMPTFEE 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 p Community Development s,.,. . . 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 rUPEkTINO Building Department JOB ADDRESS: PERMIT # rN OWNER'S NAME: ; .ti PHONE # -Z 2-- e6 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSI14ESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating ` C Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date