06040005 CITY,OF CGPERTIND.
BUILDING DIVISIONPERMIT C0NT"CTnR4INP'0RMATI0117 °:;
tLr .s-arc sato d?+�iv$,:`�=: 'fid....
BUILDING ADDRESS: PERMITN0.
890 BRENT AV
NER'S NAME: PERMITLSUEDATE
WILLEVER HARRY A AND THERESA D10570 S DEANZA BLVD 04/03/2006
PHONE: SANITARY NO. CONTROL N0.
(408) 861-9545
ARCHITECTrENCINEElt: BUILDING PERMITINFO
BLDG EI P!T PLUMB MECH
0 0
300 LICENSED CONTRACTOR'S DECLARATION Job DeSCfIpUOn
I herby of m Nat 1 am nasrd under prvvidma of Clupur 9(commrncint
wlNSatlmTIXp)afOivlaias]oftto Busir card Prafadma Code.artlm Ike�u F���LE®
. fLbSca¢a tl ) r Y FURNACE REPLACEMENT
2�z Lkenc Cls: Lk.�'
p Dare Cantata
S<] ARCH]EC'S DEC'URA ON
I unocw my Plana Wall be Lath u pubic rcmOs
oLI,orr,m turcviaoal APR 2006
OWNER-BUILDER DECLARATION
I hcrto,aET.Nu I am cacmpt from tY C..'w.LIana law for Eo
A o fc lkwing woo.(Section 7(n 1.5,Btdtuv sad Psfc ti Code:My coy or caa,ry jj� J\JM2 6 6 0
$ wbjcb toqulrea a permit 1.cmurun,aicr,impio e.dvnmLW.or icpur any a t.
_z ,xior to its CattanCe.ab,,,rtquima do'Pi.rorwch permit to Bk.sitnd sutrmrnt
< dad bo U llccnsad pursuant to Nc ptavtsom of tht Contracts',I]cenm law CUP=9 Sq.Ft. Floor Area NblWibn
F�C (caomercNg with Satlon]0DO)ookwim Sof the Bumtev arta Pofcnlau Cade)or
$ tbt,W ia acmp(Nvefror.all thr Iwo for the 440.,ddlm.Any A ktlon M
Sad.M31.5 by alry.ppiunt for a peroit vbjeeu Ne applkant W.riv0 penahy of umber Occupancy aJ
oat mac Nan circ hundrtd dollar($5001 T�(e
01,vawns of the popfny,a my omplysea wW w.ry u Nco sok can pe n.
will do Nc Woh am tbemuc W 1c 11 not IntenEcd or oQerod for We scoc.7044,Busircu -
and Ptoresdmu Codc TW ContsatoYs Lkrns:law data ant apply to an or rc of Required Inspections
ptopwy wbo btdltlam Jnoro heeun,andwhn dews W war WtovRar Waugh hu
own emNoYrca,pmvidcd Nat snob lmpmrtments arc mtina7tdcd mo cml for sale v,
hn.c.er,
the Wiring or hopo.1 Is rob wIW n me yea Mcampktion,the owtrr
W lka will naw tk Wda of proving thu tr Ela 11or ddM a uttpvotc far puryoa d
vk.).
I,oa owrta M the property..B esr]tuiroo a cvo ng With licenarcmvu tb,'.
catu La the psjaa(Sec o an B of and Pmfessk,u ds or
The Caouador'a nd
come Law Eou va apply W an amt of prtgcrty who Willa ar Impsaea tbeapn.arta
wbofm sum pojau with a anu.nm(s711¢11xd Pursunt W tic CmtranpYo
L cone.�LaEw..
❑ lam eaemp urge See .Bk PC for 11da rosin
net Dau
WORKERS COMPENSATION DECLARATION
�. 1 hereby arthro unto,paW ty a perjury me of 1W following declatabna:
1ha.s and will malnuin.Ccrd0.a Conoco,to xlf-b"'—fa Wor .CMNR-
utkn,as psvldcd for by Salon 37W of the labs Cade,for tit petfmmana of tW
work for which W.pemlt it[riots
❑I have and WiB maintain Wurkel.Compensation Inwrarta,u tapdrW by Section
3700ofW fabur Code,fa the puformanaofthe w fawbich this permit ISiao .n
My Worker.Cmpeotatimmm.Em Poky oumbc,arc:
Carrier1pa ;S [, MyNo:18"5-
016I
CERTIFICATE OF EXEM ON FROM WORKERS
COMPENSATION INSURANCE
ffnl,aaOm ttcW uta bccoropkud if tit pvmh 4 torso Auodmd ENIm($100)
or ku)
1 m fy Nm In ft perform.e of Nc work for wtirS OU Nail Is iaucd.I Nall nor
employ any person in any mvrcr v u to bemrm subject W the Workrn'CornpuvEan
law,of Callfomla Dau
Applkatu
NOTICE TO APPLICANT:If,after making th11 Ccldfivac of Faanptim yin sMoki
become aubjw to tltc Wohet'a CaopetuWon psvlsiau of the labor Codc,you muv
�Z forthwith comply with such prmistas or Nis rami,shall he dermad revoked.
ZN CONSTRUCTION LENDING AGENCY
I b rbny air.that tine 4.rnwrucixc klding r,,rc for the perfomw¢Ed .
(Yi> rite wort fa which Nit p h 11 is,um(Sa.31H7,Civ.C.) .
ALeMer'.Nano .. .
o z IraECYS Add.
U O 1 cadry Nat 1 halt rrad tha appieuion am sur tbu the shove w rmalion 11
U.E-' mnea I ague W comply wIN all city and countyoNirumes and awe Iry ,quint to
OU Wilding cpnstructim,and brrchy a athwrin reprevnutires of NU City W car urym Nc
r W .Mvc.mcmmcd property for irtsp co porpaxa
(We)agtce to save,NdemNly and keep Nnnleu the City of CupWim ag.imt
Hti Ila1b1IWmjudjmcnu,ceascdc.,n. whkhmayinanywy=..taiwaud City
U Z in cpnse9uence of the tMtL1•1 of 11111 pmnie
1—' APPLI UNDERSTANDS AND WILL COMPLY WITH ALL NONPOIHT Issued by: Date
SOU _-> CATIONS.
Re-roofs
Signatureo ArdiunuCcfl d
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
wdl the sorra",a forme Wilding cacc pant qac a haMk hvaNtttu m.urial '
u to0and by the Cupenim MUMCIpaI.Codc.Chapscr 9.12 all Ne FIUIN am!Safety
Cork,Sado 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
Yn ✓
Will too.pplicanta,forum building aan,nt.cyttipmatatovieswhich If a roof is installed without firs[obtaining an inspection,I agree to remove
.onh hao r air ronuMwtu n dcfurd by thr Bay Ara Air Quality Mgo,s...I all new materials for inspection.
Diaukt7 / .
❑Yu
Itone toad the by rtarcdals feqpirttneroawvkrehapar695oftheC.lifa-
rda HmIN&SNdy Cato,Sasvu25505.3S511 ad 25531.1 vtldsntd 11m Rth Writing
d¢a ort emreml kraal tna IL u my rtryms Wity b mdfy Ne aaupant of do
tcjuimmc tab er met,:iorWi»omt�tx,cwrtacaroatrp,nry. Signature of Applicant Date
i��� All roof coverings to be Class"B"or better
Owrcr a authorircd a cat ate
CITY OF CUPERTINO
om 2 of 2 PERMIT RECEIPT OF amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36924027 . 00
DATE ISSUED. . . . . . . : 04/03/2006
RECEIPT 4 . . . . . . . . . : 33818
REFERENCE ID # . . . : 06040005
SITE ADDRESS . . . . . : 890 BRENT AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : WILLEVER HARRY A AND THERESA D
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4553
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) 861-9545
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, 660 . 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
--- ----- --- ------ ------------ ------------------
CHECK 329 . 56 024508
TOTAL RECEIPT 329 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
204 UNDERFLOOR FRAME 301 ROUGH PLUMBING
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL 514 FINAL PUBLIC WORKS
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
SCUPEf�TINO
Building Department
JOB ADDRESS: PERMrr #
;� O QYado S--
OWNER'S
OWNER'S NAME: Y PHONE # 401
GENERAL CONTRACTOR _ p FAX # (-ciS
I am not using any subcontractors:
Signature Date uL
Please check applicable subcontractors and complete the followinginformation
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
• :, Community Development
`e 10300 Torre Avenue
Cupertino CA 95014
CITY OF- Telephone (408)777-3228
U P E k1 'NO Fax (408)777-3333
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District control stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife
dependent on our waterways, for people living near streams and baylands, and for.the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt, concrete and paint;
• • Landscaping runoff containing pesticides or weed killers; and
• Any material dumped or spilled into streets or storm drains
The property owner and the contractor share ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section of the City of Cupertino web site at:
http://www.cupertino.org/city government/departments and offices/
environmental services COPY
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• . Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street construction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise levels from complaint site - 65 dBA
For more information on noise control, please see Chapter 10.48 of the Cupertino
Municipal Code, which can bea cWjd- �p://www.amlegal.com/cu�ertino ca/
APR .O 1
• Greg Casteel 2 (76
Building Official._
CITY OF CUPERTINO
PIRP FURNACE/AC
ZOUPEkTINO PERMIT APPLICATION FORM
APN# � h� Date: 1310
Building Address: n Q f N n
Owner's Name: � Phone #:.
r � W� I eU-e.r d �
ContractorC�1t�o�, e: License #:
hon �Op �(QI-qS�(5 A
Contact: Phone: Cupertino Business License#:
r w , lege r asa - 08��
Building Permit Info:
Bldg ❑ Elect 9' Plumb L Mech Q�
Job Description:
uvR
Residential Comm cial ❑
For Residential Mations:
Attic ❑ I' floor 2"d floor❑
dhere to min set back requirement El
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ElStructural Calculations required for new installation
El
New installation Planning Approval Required ❑
Cost of Project: �(DUO Type of Construction: Occupancy group:
Strapped On Platform El Bonded LJ Sq.Ft. Floor Area:
New Location ❑ Replacement
Qty. if
A licable Fee ID Fee Description Fee Group
BENERGY Energy BUILDING
BREMFURN Furnace MECHANICAL
BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL
BREMAIRHAN A/C Units<= 10, 000 cfm MECHANICAL
BREMRECEPT Recptl, Switch & Outlets ELECTRICAL
MIBPGAS
ICRE Seismic Fee Res BUILDING
ICOM Seismic Commercial BUILIDNG
TFEE Elec Permit Issuance ELECTRICAL
ITFEE Mech Permit Issuance MECHANICAL
TFEE PlumbingPermit Issue PLUMBING
FEE Bldg Permit Fees BUILDING
CHK Plan Check Fee BUILDING
Gas Pi in S stem Fee PLUMBING
C Business License BUILDING