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06060121 CITY OF CUPERTINO BUILDING DIVISIONe". PERMITC01�FT1ZAC�TOR�ZN1''OR�A`TI,tIV'�. 3n,axLuaGm �' .9. a3;,psa BUILDING ADDRESS: , ECT CLIMATE PEaMrr No.06060121 10947 NORTHSEAL S OW HER'S NAME: PERM"ISSUE DATE SHAH SHARMEELA 10570 S DEANZA BLVD 06/15/2006 NE: SANITARY NO. CONTROL NO. (408) 86119545 ARCHTECr/ENOINEER: BUILDING PERMIT INFO BLDG IS ELECT � 0 t� 3 eD o LICENSED CONTRACTOR'S DECLARATION Jobtrim I hereby affirm that I am Becomes under provisions of Caper 9(commmnciq with Secon70DD)of Division3ofthc BusinessvWpr f em mY llccnm is +� emntorceaMefe fp INSTALL FURNACE & A/C Z License Corractm ,r 1ff ARCHITECTSDECLARA ION LE® ��ppo Du¢ Cos 1 understand my plans shall he used u public meerds G JUL // 2006 sQ� Licensed Professional OWNER-BUILDER axe DER DECLARATION s� 1 hereby affirm(Sect Nat 11. exempt from the Cssimas of Licenser Law for to LOO followingmoan.(Section 7031.5,Business mp ve.drier Coli My City stroomy 119PS$ which requires•pais to epniga4 alar,impow.demnlW,or repair any aWnurc $6039 to prior¢her issuance.abu requires shaapplicam for such permit to Ole a signed settlement pF that he is licensed pursuant to the previsions of the Cmuscmr's Ucena Law(chapter 9 Sq.Ft.Floor Area tion y (commencing with Section 7000)of Division 3 of the Business and Prefeulaa Cade)or does a Is accept therefrom and the bub for Ins alleged remainder.Any vialatlon of Section 7031.5 by any application far a permit subjects the applicants in a civil peaky of Occupancy 1rype nor more than five hundred dolmrs(55W), ❑I,as owner of the Interparty.or my employee with vein as their mlc compnadon, will do the work and the sumento Is not lnerlded arafrered rat arms(Sec.7044.Business Required Inspections and Profeaians Cade:The Cames ire's Usable Law Law donot apply m ownere ns an of q P property who builds or improves demon,and who Maultasch weak himsel f or thmugh his ownemplay es,provided ME such Improvements arc not Intended arortered for sale.If. ' however,de building or improvement is sold within arc year of caopleda.the owm- buildar ,will have the burden of pmNng Wt he did Imt build or impvu for purpose of talc.). ❑1,as owner of the property.am aclusively concocting with licensed coaaclum In coahat the project(See,7044,Business and ProRnions Cade:)The Communes U. cases law does act apply as an owner of property who builds or improves¢omen•and, who contracts fa such pmjeW with a cerntsvmor(s)licensed punuanl to ME,Customers License taw. ❑Iamaceptuader5ee .B@PCforthisnason Owner Data WORKER'S COMPENSATION DECLARATION 1 hereby M.under patty,of prjury as of the Mlowing decimations: 1have and will maintain a Certificate of consent to self-Insure for wnr sCompn- smion,as provided farm by Section 3700 a the labor Code,for da:pr/..of the work for which this permit is issued. ❑I haw and will maintain Worker's Compensation Insurance,u acquired by Section 37W of the labor Cade.for Ne Performance of the work for which this permit is is . My WoraYt p a Insurance carrier and Polity nsu�m�/bp_rf�y�y ,'J�70 tarsier: 6///Sll.�.tz PalkyNa.:(,QJ�L— CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (ThbaNa had netbocompleed if the posh It fororc huntheddanaa(SIM) or las) I unify Wt In the put...of the work for which this permit is issued.I OWI ore employ any person in any manrcrm as as Immune subject mdse Workers'CompeasWan Laws of California.Dae Applicants NOTICE TO APPLICANT.If,after making this Continues of Exemption,you should become subject to the Workers Compnsadan pvbions of the Labor Cade.you must OZ forthwith comply with such provision or this Permit W deemed revoked. Z,m v0 CONSTRUCTION LENDING AGENCY p. I hamny alfum thu mare is a construction lending agency for the performance of Ct:> the work for which this permit is issued(Sec 3097.CIv.C.) QLatell Name =z LendeesAdd. U Q I certify Nat 1 haw mail this applicalia W state Ws the above Information b (r torten.I agree m comply with all city and county and annoes and sate lava Made,In 0 NEW asconsunetion,and heacbyauthorire repremmatives of this city m omm.pn the [37 move-mcmiuncd property far inspection puryoas. Ly, (We)agree to an,indemnify and kap hamdcss ma City of Cupertino against v;y,AA imbilitia,Judgments,casts and expenses which may In any way accrue against said City („) in comealum ce of the gandog of this Permit APPLICA DERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOUR EGUN$iynJ_� ��(/a Re-roofs signet IcanuCOntractcr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupanamm or handle haarden s material as deflated by the Cupertino Municipal Cade,Chapter 9.13,and the Health and Safety Cade,Section 255324)7All roofs shall be inspected prior to any roofing material being installed. ❑Ye Na Will the applicant or future building=upon[use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove mit haardnus air contaminants as de0ned by the Bay Area Air Quality Management all new materials for inspection. District? ❑Ya I haw mid ahaardmts mamixisrequiacmema underCTaPws6.95ormaCtlilm- .1.RealmhkSafmy,Cade,Saca m25505.25533 an125534.1 understand the tide building dace hat c nny new a enanL Net Is b my rcspnslM1llity m nodfY ma aaupant of de requl sena hichmet m asissaenceanccni .moofs7c nm Signature of Applicant Date onarisera tent B Dam' All roof coverings to be Class"B"or better Community Development -• 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 aClTyf Fax(408) 777-3333 OUPEkTINO « f�()60� 'Lo Building De artmentd 6 0 6' 0 "-4 JOB ADDRESS: PERMIT # O O l2 /OS?a 5. DE 4�24 61,vp, 06 o d o OWNER'S NAME: riC, PHONE # GENERAL CONTRACTOR- QrE�Z i C\:n .�cyFy�� FAX # I am not using any subcontractors: ignatuxe7 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 CITY OF CUPERTINO �m 2 of 4 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Elk: Lot : APN . . . . . . . . : 31640022 . 00 DATE ISSUED. . . . . . . : 06/15/2006 RECEIPT # . . . . . . . . . : 34862 REFERENCE ID # . . . : 06060121 SITE ADDRESS . . . . . : 10947 NORTHSEAL SQ SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SHAH SHARMEELA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , 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 WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 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 BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00 BREMRECEPT NO. OUTLETS 1 . 00 1 . 20 0 . 00 1 . 20 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BSEISMICRE VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 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 176 . 44 0 . 00 176 .44 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- -------- ---------------------------- 301 ROUGH PLUMBING 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 507 FINAL PLUMBING 508 FINAL MECHANICAL • ' CITY OF CUPERTINO �`� C,RFURNACE/AC CUP IL INO PERMIT APPLICATION FORM APN# Dater 311P�r/ �02� Building Address: /v q i// „ / / `�' Owner's Name, V Ph c#: Contractor: phone:-�(a/-c�S�S Lioonea#: 023 �5 g Contact: Phone: Cupertino Business License#: Building Pewit Info: Bld ❑ F.lect L� Plumb M� [9 ' Job Description: �GvditrllA A-C f�.o��(/t/ Residential E;,-- Commercial ❑ For R}identlalduos: Attic u 1 a floor is 2"floor❑ J Adhere to min set back rement(�J For Commercial Installations: Replacement name weight ❑ Additional weigbt( o gyral calr_c)❑ Structural Calculations required for new installation Now installation Plannin A nval R aired Cost of Project Q ov Type of Constructron: Oce an°y�rOup' Strapped On Platform Bonded Sq.Ft, Floor Area: New Location R lacement Qty. if Fee Description Fe A licable Fee ID ' Fee Grou BI ,DING BENERdY Ener BREMFURN Fumece MECHANICAL BREMACOVER A/C Unit> 10,000 cfm I MECHANICAL BREMAIRHAN A/C Units 10 000 cfm MECHANICAL BREMRFrFPT Recptl,Switch&Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMTPFEE Elec Pemut Issuance ELECTRICAL MPERMTTFEE Mech Permit Issuance MECHANICAL PPERMTTFEE Plum Yemrit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Plan Check Pee BUILDING BPGAS Gas Piping System Fee PLUMBING }3USLIC Business License BUII.fliNG