06040047 CITY OF CUPERTINO t
Buaornc DIVISION PERMIT RC��NTRAC TQRINFO�MATION
BUILDING ADDRESS: DRAIN DOCTOR PEaMrr no.06040047
21824 BENETT
OWNER'S NAME: PE2Mf[ISSUE DATE
ALY & IMAN ELREFAIE 1775 WINCH
NE SANITARY N0. CONTROL NO.
(408) 370-3082
ARCHiIECl/ENGINEEi: BUILDING PERMR INFO
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;op LICENSED CavrnncllDRSDECLARf CMV Job Description
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COIPENSAnONDECLARAT70N - -
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CERTIFICATE OF EXEA MON FROM WORKERS
COMPENSATION INSURANCE r
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NarICE TO APPL ICANr:If.SVItIdn,car 0e 11we of Fi—Pp at.yw W
braome aubim w w Wwheta Lompcoadon p.vW.wf w L„a Code.ya muR
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z CONSTRUC'nON LENDING AGENCY
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6i> de wart fa obit,Wr permit k blued(Sec.3M.CW.C.)
Qland Name
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bulEin(WOnctim.aM m. autyw rtprtunu the chya wrntu uplmd
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APPLIICC W UNDERtfiq SfAN«AND WILL COMPLY WRN ALL NON-POINT Issued by: Date
MREGULATI - _ _
Re-roofs
slpn.uue«App US MATERIALS DISCLOSURE Dae Type of Roof
WIB Jlc 0000000'car fuwrt bdW 'wmupa t port Or handle ha xdom mawnY
.,xwed by de ewen;no A,vdwipal cox,Cluper 9.17.and de tblm.Id Safety
Cn1e.Sec.25532()7 All roofs shall be inspected prior to any roofing material being installed.
Ely. /Qtio
cabled. N.mllvcr acapan �,a<ywpramt a x.dm If a roof is installed without first obtaining an inspection,I agree to remove
win de Pp luv�
moll ha�udwr air mnumbunu n xlba by Im Bay Ams Air Qu RY Mu V=u all new materials for inspection.
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Jon rol0vrcnlly Nrc a my rtS'l Mlily b m fy ds o¢vW.OF de
whkh muR Ec I wRYAT.ora Cmdfcau car Date
Signature of Applicant
All roof coverings to be Class "B"or better
Owrsr a aulhorvc . - '"' - - Da .
Community Development
10300 Torre Avenue
' J. Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
g UMkTINO
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: ALy-1-1- r-IOZZ PHONE # 1108
GENERAL CONTRACTOR: '�)ral nQo C_ 0r FAX #
I am not using any subcontractors:
afore Date
Please check applicable subcontractors and com lete 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
er/ ontractor Signature Date
I
CITY OF CUPERTINO
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: B1k: Lot:
APN . . . . . . . . : 32649027 . 00
DATE ISSUED. . . . . . . : 04/11/2006
RECEIPT # . . . . . . . . . : 33920
REFERENCE ID # . . . : 06040047
SITE ADDRESS . . . . . : 21824 BENETTI CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ALY & IMAN ELREFAIE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1221
RECEIVED FROM . . . . : IMAN ELREFAIE
CONTRACTOR . . . . . . . : JOHN H. LIM LIC # 24784
COMPANY . . . . . . . . . . : DRAIN DOCTOR
ADDRESS . . . . . . . . . . : 1775 WINCHESTER BLVD
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 370-3082
WEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ---- ---- ----- ----------- ---------- ---------- ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BPWHEATER PER HEATER 1 . 00 10 . 79 0 . 00 10 . 79 0 . 00
PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00
---------- ---------- - --------- ----------
TOTAL PERMIT 84 . 02 0 . 00 84 . 02 0 . 00
METHOD OF PAYMENT AMOUNT -NUMBER
-- - -------------- ---- ------ -
OTHER 84 . 02 MASTERCARD
TOTAL RECEIPT 84 . 02
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------------------------
502 FINAL PLUMBING ENERGY 506 GAS TEST
507 FINAL PLUMBING
•
CITY OF CUPERTINO Q U o*oo4l
WATER HEATER
• CUPEk INO PERMIT APPLICATION FORM
APN# Date: / // I I ( O
3210 - 4q- 02� �7 I
Building Address: 4 , Gj So y
I -2 Bene/-R, a, C hv-
Owner's Name:/I L`/ � I M (1 ' _ Phone#:
7 ..L A N � I re,F=� �
Contractor: Phone: q License#:
Contact: Phone: z e 4, 4 Cupertino Business License#:
Building Permit Info:
Bldg ❑ Elect 10 Plumb Mech E�
Job Description:
Ce
Residential 5( Commerc al ❑
Cost of Project oZ a s
Strapped El On Platform Bonded El
• New Location ❑ Replacement
Qty. if
Apphcab.le Fee ID Fee Description Fee Group
BPWHEATER Water Heater/Vent BUILDING
PPERN4=E Plumbing Permit Issuance PLUMBING
BENERGY Energy BUILDING
BUSLIC Business License BUILDING
I