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07050241?Oo ,mp :UU BUILDINL DIVISION PERMIT PERMIT NO. 7tiffMINBOW DR ATLAS-TRILLO HVAC 07050241 OWNER'S NAME: MANI RAMASWAMY NE: ARCHITECT/ENGINEER: 1965 KY. -,E PARK CT (408)286-8931 PERMIT ISSUE DATE 05/23/2007 SANITARY NO. CONTROL NO. LICENSED CONTRACTOR'S DECLARATION ,Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section�fD3 Business and Professions Code, and my license is R & R F� IRNACE, ADD 3 TON A/C UNIT in full force LicenseLic.S;n/DateContractorItuY `�CTS DECLA A I N I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the 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 to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (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 not more than five hundred dollars (S50W). 0 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 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.). 01. 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- 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. 0 I am exempt under Sec. B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION �O zR R. A az UO O �a Uz I hereby affirm under penalty of perjury one of the following declarations: 64 have and will maintain a certificate of Consent to self -insure Cor Workei s Compen- sation, as provided for by Section 3701 of the Labor Code, for the performance of the work for which this permit is issued. iJtave and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Work ' Cam nsatio nsurance carrier and Polity numbe am: Cartier. Policy Na.: _L CERTIFICATE OF EXEMPTION FROM RK RS' COMPENSATION INSURANCE (rhis section need not be completed if the permit is for one hundred dollars ($ 100) or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workcrs' 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 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (W o save, indemnify and keep harmless the City of Cupertino against liabiliti , j94SdlFnL4costs and expenses which may in anyway accrue against said City in con ifince o c granting of VzOermit. APP ANT� ERSTA D WILL COMPLY WITH ALL NON -POINT SOU E REGUL T N5� Signature of Applicant/Con Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Mu ' ' al Code. Chapter 9.12, and the Health and Safety Code, Section 25532(a)? 0 Yes Will the applicant or fu re building occupant use equipment or devices which 1cmit hazardous air contaminants fined by the Bay Area Air Quality Management District? 0 Yes 1 have read the hpddousrnmerials requirements under Chapter 6.95 of the Califor- nia He Safety , Sections 25505 533 and 25534.1 understand that if the building does t cu nt ve a tenanL, that ' hs m esponsibihty w tify occupant of the re rem h must be met r w issuanf a Cch(G yf w eancy- Owner or authorize agent v _ Dare 0q. Ft. Floor Area 36224001pg8JNumber Issued by: Re -roofs Type of Roof BUILDING PERMIT INFO valuation $8500 Required Inspections occupancy Type Date -J-' --D- ----) All roofs ;hall be inspected prior to any roofing material being installed. If a roof i; installed without first obtaining an inspection, I agree to remove all new aterials for inspection. �13 Signature of A ate All roof coverings to be Class "B" or better 8 ITEMS OF 16 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk. Lot: APN 36224001.00 DATE ISSUED.......: 05/23/2007 RECEIPT #.........: BSC00001448 REFERENCE ID # ...: 07C50241 SITE ADDRESS .....: 75E7 RAINBOW DR SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OWNER MMII RAMASWAMY ADDRESS .......... CITY/STATE/ZIP ...: CUPERTINO CA, OPERATOR: patg COPY # : 1 95014-5235 RECEIVED FROM ....: ATLAS-TRILLO CONTRACTOR TRILLO, STEVE LIC # 4269 COMPANY ATLAS-TRILLO HVAC ADDRESS ..........: 19E,5 KYLE PARK CT CITY/STATE/ZIP ...: SAN JOSE, CA 95125 TELEPHONE (408)286-8931 FEE ID UNIT QUANTITY RMOUNT 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 8,500.00 0.90 0.00 0.90 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 ----------- 176.64 ---------- 0.00 176.64 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 353.38 --------------- 353-.38 VOICE ID DESCRIPTION -------- ---------------------------- 301 ROUGH PLUMBING 304 ROUGH ELECTRICAL 507 FINAL PLUMBING REFERENCE NUMBER -------------------- #8706 VOICE ID DESCRIPTION -------- ---------------------------- 303 ROUGH MECHANICAL 505 FINAL ELECTRICAL 508 FINAL MECHANICAL 9101 CUPEkTINO CITY OF CUPERTINO FU NA-CEAC PERMIT APPLICATION FORM DqDC300-te-1 I APN # - cx�1 Date- Building Addre Building Rai,VL- BREMFURN Owner's N e: Yxo�UAAX-- Phone # 3-1 Co Itractor: Phone: ,�C ��' - l License : l 2 ContacL. Phone: Cupertino Business License #: V1 MECHANICAL Buil ing Permit Info: R(:cptl, Switch & Outlets Bldg ❑ Elect Ed/" P lumb �� Mech Job Description:,� /P-,rj.Z a C� 0K 44- Residential Commercial ❑ Seismic Commercial For Residential Installations: ❑ ❑ ❑ EPERMITFEE 2nd floor 1St floor Attic ELECTRICAL Adhere to min set back requiremen M ;ch Permit Issuance For Commercial Installations: _eplacement same weight ❑ Additional weight (structural calcs) ❑ PPERMITFEE Structural Calculations required for new installation PLUMBING New installation Planning Approval Required ❑ Bldg Permit Fees Cost o ro'eet: Type of Construction: Occupancy group: Ub QZ—W �L 3 Strappe ❑ On Platform ET Bonded Sq.Ft. Floor Area: New Location R lacemen BUSLIC Qty. if A licable Fee ID Fee Description Fee Group BENERGY Er. ergy BUILDING BREMFURN Furnace MECHANICAL BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10, 000 cfin MECHANICAL BREMRECEPT R(:cptl, Switch & Outlets ELECTRICAL BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILIDNG EPERMITFEE El -,c Permit Issuance ELECTRICAL MPERMITFEE M ;ch Permit Issuance MECHANICAL PPERMITFEE PI--ambing Permit Issue PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPLANCHK Pl;m Check Fee BUILDING BPGAS Gas Piping System Fee PLUMBING BUSLIC Business License BUILDING