B-2018-0936 CITY OF CUPERTINO BUILDING PERMIT
13UILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0936
22475 RANCHO DEEP CLIFF DR CUPERTINO,CA 95014-3964(356 02 032) ELECTRIC TECH
CONSTRUCTION INC
CONCORD,CA 94520
OWNER'SNAME:ELHAK HANY YOUSEF AHMED LAMA AND TAWFIK NOU DATE ISSUED:08/03/2018
OWNER'S PHONE: PHONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class A,B.C-29 Lic.#897792
Contractor ELECTRIC TECH CONSTRUCTION INC Dale IQ/3112019 X BLDG—ELECT_PLUMB
I hereby affirm that I am licensed tinder the provisions of Chapter 9(commencing —MECH_RESIDENTIAL X COMMERCIAL
with Section 7000)of Division 3 ol'the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
ATT-MODIFICATIONS;SWAP(9)ANTENNAS,SWAP(6)RTU,
I hereby affirm under penalty of perjury one of the following two declarations: INSTALL(6)RRU AND(2)SURGE SUPPRESSORS ON EXISTING
n. 1 have and will maintain a certificate of consent to self-insure for Worker's STEALTH MONOPTNE SITE
Compensation,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 Workers Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work fur which this
permit is issued. Sq.Ft Floor Area: Valuation:$20000.00
APPLICANT CERTIFICATION
I certify that I have read this appllcatlon and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Oewpancy Type:
and state laws relating to building construction,and hereby authorize 356 02 032 A(Tenant Improvements)
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IIP WORT{IS NOT STARTED
may accrue against said City In consequence of the granting of this permit. WITIIIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cupertino
Municipal Code,Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION.
Signature
1 hereby affirm[fiat I inn exempt from the Contractor's License Law for one of the RE-ROOFS
following two reasons: All reoi's shall be inspected prior to any roofing material being installed.If a roof is
t. 1,as owner of the property,or my employees with wages as their solenstalled without first obtaining an'nspection,I agree to remove all new mnterials for
campensatien,will do the work,and the structure is oot intended a,offered for inspection.
sale(Scc.7044,Business&Professions Code)
z. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:08/03/18
1 hereby affirm tinder penalty of perjury one or the pinowbng three declarations: ALL ROOF COVE121NGS'I'O BE CLASS"A"OR BETTER
t. I hove and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
z. In...and will maintain Worker's Compensation Insurance,as provided t'or by I have rend the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this Cultural.Health&Safety Code,Sections 25505,25533,and 25534.1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. I certify that in the performance of doe work for which this permit is issued,l Health&Safety Code,Section 25532(x)should I stare or handle hazardous
shall not employ any person in any manner so as to become subject to the material.Additiunully,should I use equipment or devices which emit hauwdous
nir contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California.IF,after making this ccrlificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,l become subject to the Worker's Compensation provisions ofthe the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent: �'
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is Issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for Inspection purposes. (We)agree Lender's Name
to save Indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against sold City in Lender's Address
consequence of the granting of this permit.Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
SignatureLicensed
Date 08103118
Professional