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07020164 CITYO 'C UPE BUILLJING DIVISION PERMIT �1NT .G ® 'QRML�TTON« PERMIT NO. BUILDING ADDRESS: A PERFECT CLIMATE 07020164 10407 LAS ONDAS WY PERMIT ISSUE DATE OWNER'S NAME: HESHAM ABUELATA 10570 S DEANZA BLVD 02/28/2007 SANITARY NO. CONTROL NO. .)NE: (408) 86119545 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH Ig, LICENSED CONTRACTOR'S DECLARATION Job Description UF 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 A/C AND REPLACE FURNACE t=c'. in full farce and effec v�z Licensc Class Lam• c Dale Contractor f w ARCHITECTS DECLARATION j aa < I understand my plans shall be used as public records )yU U.I" Licensed Professional C< OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the p or� following reason.(Section 7031.5,Business and Professions Code:Any city or county permit to construct,alter,improve,demolish,or repair any structure which requires a pe u'y prior est its issuance,also requires the applicant for such permit to file s signed statement S Ft.Floor Area Valuation - < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $16840 r F$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or lu that he is exempt therefrom and the basis for the alleged exemption.Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36929041 . Number P Y YP not more than five hundred dollars($500)• ❑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 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 contractors)licensed pursuant to the Contractor's License Law. B&P C for this mason r-1 1 am exempt under Sec OwnerDate 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-insurc 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 3700 of the Labor Code,for the performance of the work for which this permit is issued, My Workeef m easadon Insuratice nrtiSF s)!i Policy�b a �� Carrier 1 (PPo17icY No.; CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for ane hundred dollars($100) or less.) 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 Z forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of a,> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name az Lender's Address U 0 1 certify that I have read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the above-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 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued Ey: SOURC GULATIONS. ,r,��•1 � (S 1-Z� U7 Re-roof; Signature of Appli t/Contractor Dare T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes If a roo.'is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. DistrlCl? ❑Yes 1 have read the hazardous materials requirements undcrChapter 6.95 of the Califor- nia Health&Safety Codc,Sections 25505,25533 and 25534.1 understand thatif the building docs not currently have a tenant,that it is.my responsibility to notify the occupant of the Date requirets hich must be in I r w ssuan c of Certificate of�cc`pancy.✓ Signature of Applicant �L All roof coverings to be Class"B"or better Owner or authorized age t Dat, CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: Blk.: Lot: APN 36529041 .00 DATE ISSUED. . . . . . . : 02/28/2007 RECEIPT #. . . . . . . . . : BS000000574 REFERENCE ID # . . . : 07020164 SITE ADDRESS 102:07 LAS ONDAS WY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER HESHAM ABUELATA ADDRESS . 10,107 LAS ONDAS WAY CITY/STATE/ZIP CU:?ERTINO, CA 95014 RECEIVED FROM RECEIPT INTERFACE CONTRACTOR SMITH, BYRON E LIC # 21144 COMPANY A PERFECT CLIMATE ADDRESS 10/70 S DEANZA BLVD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (48) 86119545 FEE ID UNIT QUANTITY ?MOUNT 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 BSEISMICRE VALUATION 16, 840. 00 1.70 0. 00 1.70 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 PPERMITFEE FLAT RATE 1. 00 38.37 0. 00 -----38_37 ------0_00 ---------- ---------- TOTAL PERMIT 176 .24 0. 00 176 .24 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------ CHECK 176 .24 6818 --------------- TOTAL RECEIPT 176 .24 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ----------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF CUPERTINO TFU RNACE�AC 002 b1 l0 F' PERMIT APPLICATION FORM CUPEiZTINO Date: � APN# 2-- Building Address: Phone#: Owner's Name: ° • ate License#: Phone: Contractor'. � 1M. ';Zb I . M Cupertino Business License#: Contact: Phone: Building Permit Info: Bldg ❑ Elect Plamb ❑ Mech Job Description: �hG Residential Commercial LJ For Residential Installations: Attic ❑ 1' floor ❑ 2°a floor❑ Adhere to min set back requirement For Commercial Installations: ;placement same weight ElAdditional weight(structural calcs)El Structural Calculations required for new installation New installation Planning Approval Required ❑ Occupancy group: Cost of Project: qqov Tyhe of Coc:ion:� Sq.Ft. Floor Area: Strapped On Platform Bonded New Location ❑ Replacement Qty. if Fee Description Fee Group Applicable Fee ID BUILDING BENERGY E:iergy F,zrnace MECHANICAL BREMFURN MECHANICAL BREMACOVER A/C Unit> 10,000 cfin MECHANICAL BREMAIRHAN A/C Units<= 10, 000 cfin ELECTRICAL BREMRECEPT R ec tl, Switch& Outlets BUILDING BSEISMICRE Seismic Fee Res BUILIDNG BSEISMICOM Seismic Commercial ELECTRICAL EPERMITFEE Elec Permit Issuance MECHANICAL MPERMITFEE TZech Permit Issuance pLUMBING PPERMITFEE F lambing Permit Issue BUILDING BPERMFEE Fldg Permit Fees BUILDING BPLANCHK Flan Check Fee PLUMBING BPGAS (Jas Pi ing System Fee BUILDING BUSLIC Business License