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07060164 CITY OF!CUPERTINO777. BUILDING DIVISION PERMIT � ' 'RAGTC�R IN }RMAT�fIN• BUIL f G ESS: PERMIT NO. � �� RED FIR CT A PERFECT CLIMATE 07060164 OWNER'S NAME: PERMIT ISSUE DATE JADHAW CHETAN AND MOHINI 10570 S DEANZA BLVD 06/19/2007 TONE: (408) 86119545 SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 i p 0O LICENSED CONTRACTOR'S DECLARATION Job Description j Ut hereby affirm that I am licensed under provisions of Chapter 9(commencing Z m with Section 7000)of Division 3 of thc Business and Professions Code,and my license is REPLACE FURNACE AND AIR CONDITIONER y in full force and effect j Z License Class Lic.N 3 F w Date (p � 0-�Contractor ARCHITECTS DECLARAT161i aa 1 understand my plans shall be used as public records )yL) n.l- Licensed Professional H OWNER-BUILDER DECLARATION } rise Law far the 1 hereby affirm that I am exempt from the Contractor's Lice 0 O following reason.(Section 7031.5,Business and Professions Code:Any city or county e which requires a permit to construct,alter,improve,demolish,or repair any structure a Z y prior it)its issuance,also requires the applicant for such permit to file a signed statement s s o that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area $4347 Valuation aF- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or L 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 �p�Number Occupancy Type not more than five hundred dollars($500). 3590506 8 ❑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 docs not apply to an owner of q p 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.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractoes 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 Contractor's License Law. ❑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 workces Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑1 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 WorkeessCCo`mpe tioon Insurance carrier and Policy number are: Cartier: .eft a►\� Policy NoA50 !8891 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is forone 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z , CONSTRUCTION LENDING AGENCY [~- rA 1 hereby affirm that there is a conswction lending agency for the performance of LY. > the work for which this permit is issued(Sec.3097,Civ.C.) ALender's Name a Z04 L.ender's Address U O 1 certify that I have read this application and state that the above information is LL '-' correct.I agree to comply with all city and county ordinances and state laws relating to C U building construction,and hereby authorize representatives of this city to enter upon the W ahove-mentioned property for inspection purposes. LY (We)agree to save,indemnify and keep harmless the City of Cupertino against tF.a 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 LL COMPLY WITH ALL NON-POINT Issued b): SOURCE REGULATION Re-roofs Signature of Applicant/Contractor Date t HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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 roof Will the applicant or future building occupant use equipment or devices which .s installed without first obtaining an inspection,I agree to remove -mit hazardous air contaminants as defined by the Bay Area Air Quality Management all new r laterials for inspection. District? ❑Yes 75e 1 have read the hazardous materials requirements under Chapter 6.95 of thc 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 requirements w&must be mel . to issuance of a certificate of Occupancy. Signaturt of Applicant Date L"V'% All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CL PERTINO 8 ITEMS OF 31 PERMIT FECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 3590EO68 . 00 DATE ISSUED. . . . . . . : 06/1S/2007 RECEIPT # . . . . . . . . . : BSO00001699 REFERENCE ID # . . . : 0706C164 SITE ADDRESS . . . . . : 2105E RED FIR CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JADH7.W CHETAN AND MOHINI ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : SUNNYVALE CA, 94087-4605 RECEIVED FROM . . . . : A PERFECT CLIMATE CONTRACTOR . . . . . . . : SMITE:, BYRON E LIC # 21144 COMPANY . . . . . . . . . . : A PEF.FECT CLIMATE ADDRESS . . . . . . . . . . : 1057C S DEANZA BLVD CITY/STATE/ZIP . . . : CUPEF.TINO, CA 95014 TELEPHONE . . . . . . . . : (408) 86119545 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 4, 347 .00 0 . 50 0 . 00 0 . 50 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 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL CITY OF C+UPE(RTINO FURNACE/AC.. CUPEkTINO PERMIT APPLICATION FORM � 7a bo 6 APN# Date: Building Address: Owner's Name: Phone#: Contractor: phone: License #: �,Ae�k 'yc�,$- ":j6t-- S,5 1 2�_3 tS—� Contact: Phone: Cupertino Business License#: Building Permit Info: Bldg ❑ Elect I'lumb Mech 14 Job Description: (� n cwc f u,r r c,,r.,'- -k Y ' r �r�K�4:, me r Residential `Z Commercial ❑ For Residential Installations: Attic ❑ 1" floor 9 2nd floor❑ Adhere to min set back requirement 19 For Commercial Installations: Zeplacement same weight ❑ Additional weight(sijctural calcs) ❑ Structural Calculations required for new installation New installation Planning Approval Required ❑ Cost of Project: Type ofC/onstruction: Occupancy grou Strapped ❑ On Platform U-" Bonded - Sq.Ft. Floor Area: New Location Replacement Qty. if Applicable Fee ID Fee Description Fee Group BENERGY Energy BUILDING BREMFURN Fumace MECHANICAL BREMACOVER A'C Unit> 10,000 cfin MECHANICAL BREMAIRHAN AC Units <= 10, 000 cfm MECHANICAL BREMRECEPT R,-cptl, Switch& Outlets ELECTRICAL BSEISMICRE Soismic Fee Res BUILDING BSEISMICOM Soismic Commercial BUILIDNG EPERMITFEE E ec Permit Issuance ELECTRICAL MPERMITFEE Mech Permit Issuance MECHANICAL / PPERMITFEE Plumbing Permit Issue PLUMBING BPERMFEE B:dg Permit Fees BUILDING BPLANCHK Plan Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC B isiness License BUILDING 7777777777777 CITY OF CUPERTINON. BUILDING DIVISION PERMIT . UMW.-I4�N~ BUIL1 G IfEsnEDONDO CT QUALITY WINDOW & DOOR M8158 PERMIT ISSUE DATE OWNER'S NAME: PACHARUI, LAU AND PREETI 3597 HOMESTEAD RD 06/19/2007 SANITARY NO. CONTROL NO. 'NE: (408) 77'7-9090 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH (� 0 p p LICENSED CONTRACTOR'S DECLARATION Job Description w I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing REPLACE WINDOWS LIKE FOR LIKE z U with Section 7000)of Division 3 of the Business and Pro cssions Code,and my license is r y in full force and effect tD�Y 3 7 ? License Cl az Lic.ff !� [ C Date Contractor ARCHITECTS DECLARATION i a< 1 understand my plans shall be used as public records )yU ' U.H Licensed Professional < OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors Liccnsc Law for the :C o following reason.(Section 7031.5,Business and Professions Code:Any city or county %m which requires a permit to construct,alter,improve,demob h,or repair any structure z y prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area $9987 a t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 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 3562101 3Number Occupancy Type not more than five hundred dollars($500). 0 1,as owner of the property,or my employees with wages az 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 0 1,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 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: ❑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. 0 1 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 Workers CompensationI urance rc carrier and Policy number a : Carrier. f r�Te a -' Polity No.: /3 y-/s 20 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 certify that in tate performance of the work for which this permit is issued,I shall not employ any person in any manner so az 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 H1 hereby affirm that there is a construction lending agency for the performance of t�> the work for which this permit is issued(Sec.3097,Civ.C.) W A Lenders Name Z L.cndees Address U 0 I certify that I have read this application and state that the above information is correct.I 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 Wabove-mentioned property for inspection purposes. Q. (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 G U,Z in consequence ranting of this permit. Date - ►•+ APPLIC UND STAND AND WILL COMPLY WITH ALL NON-POINT Issued by (� A?, a- SOUR REGUL O ' Re-roofs 2-- Signature of icant/Contracar Das Type of Roof HAZARDOUS MATERIALS DISCLOSURE 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 LJ no.. If a roof 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 Arca Air Quality Management all new rr aterials for inspection. District? ❑Yes o I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety C ctions 25505,25533 and 255 34.1 understand that if tate building docs not currenLIY4 ravci tenant,that it is my responsibility to notify the occupant of the rcquiremen hick ' ante of a Certificate o 7 Signature of Applicant Date All roof coverings to be Class"B"or better Owner or au orized agent Date