The URL can be used to link to this page

07100210 CITY OF CUPERTINO yy ! � ` 1k�T ' ` BU[LD[IVG DIVISION PERMIT 4��#�� ` ;: ,<;. ,.:.: . _.::..... _ BU[LD �� RD CARL FA RSAI P 0 710 0 210 . .dER'S NAME: PERMTT ISSUE DATE CARL FARSAI 10106 CARMEN RD � 10/30/2007 PHONE: SANITARY NO. CONTROL NO. ARCHI'['ECT/ENGINEER: BUILDING PERMCI'INFO BLDG ELECT PLUMB MECH � � 0 � i p p LICENSED CONTRACTOR �ECr..nRnr►ox Job Description � v� I hcreby aCGrm �hat [ arn licenscd undcr provisions of Chap�cr 9(commencing ; z� wiw Sccdon 7000) of Division 3 of thc Busincss and Profcssians Code, and my liccnsc is TEMP PO iVER TO NEW METER LOCAT I ON � a a in full foree and effect i � ? Licensc Clazs Lic. # : �, � Datc Con�ractor ARCHTIECTS DECLARATION i� Q 1 undcrstand my plans shali hc uscd as public rccords >aU ° u. N (,icensed Prufcssianal � y � OWNER-BUILDER DECLARATION � 1 hcrcby a1Trm that I am cxcmpt Crum �hc Contractar's Licensc Law for �hc j p O following rcason. (Scction 7031.5, Business and Profc.csions Codc: Any city or county �,°, � which requims a pccmit to conswct, altcr, impmvc, dcmolish, or repair any suucture � z� prior to ilt issuance, alsu mquires the applicant for such permil to file a signed swement Valuation �_ � ihai he is liccnscd pursuanl to thc pmvisions o[ thc Contractor's Liccnsc Law (Chaptcr 9 Sq. Ft. Floor Area � 1 O O 0 � F- �(commcncing with Scction 7000) of Divisian 3 aC thc Busincss and Profcssinns Cadc) or ti �.. �hat he is ezempt the�efmm and the basis Cor the allegcd eumption. Any violatian a[ Secdon 703 t.5 by arry applicant tw a pecmit subjects ihe applicant to a civil penalty o( 3 5 7 0 9 0 6 5��N Number Occupancy Type not more Wan fivc hundred dollars (5500). ❑ I, u owncr oC tl�e propcny, or my cmploycu with wages as their sotc compensation, wi;l do :he woric, and she structure is not insendcd or offered [or sale (Sec. 7044. Business Re uired Ins ections and Professians Codc: The Conuactar's License Law docs not apply w an ownu of q p property who builds or improvcs thercon, and who dces such work himself or Wcougd his own employccs, provided ihat such imQrovemenLC are not in�ended orof(ereA Corsala If. however, the building or imp�ovement is sold within one yesr of compktion, die owner- builder will have the burden of proving that he did not huild or improvc for pu�pose of sakJ. ❑ 1, as owner of the propeny, am ezclusively contracting wiW licensed rnnuactors to conswct Uu pmjett (Sec. 7044. Business and ProCcssions Code:) 77K Coaaactnts Li- ccnse Law does aot appiy w an owner of propeny who builds or improves tl�enon, and , who convacls for such pmjecu with a con�ractor(s) liansed pursuant to �he Conuxtafs License Law. 1 am exempi undei�2c . B& P C tor this reuon _ Nnv Date �Q� _. . OR S OMPENSAT[ON DECLARATION I hereby �mi under penalty a[ perjury one of the following declarations: ❑ I hs.�e and wili mainuin a CertiGcatc of Consent to self-insure for Workc�s Campen- sation, as providcd for by Section 3700 of Uu Labor Code, for the perfortnancc o[ thc work for which this permit is issued. ❑ I have and will maintain Worker's Compensation Insurance, ac �equired by Section 3700 oC �he Labor Code, for the performance of the work for which this pe�mit is issued. My Worker s Compencation Insurance carticr and Poliry number are: Carrier. Poliry No.: CERTIF7CATE OF EXEMPT[ON FROM WORKERS' COMPENSATION 1NSURANCE ' (This scctian necd irot bc comple�ed if the permit is far anc hundrcd doUus (5100) or Icss.) ' I cenify ihxt in thc performancc af thc work for which ihis pertnit is issucd. ! s6a11 not employ any person in any az om t e Workcrs' Compcnsauon Laws of Calitomia Applican� NOTICE 7'O A : f, r m i i cmption, yau shauW bccome subjcct to thc Workcr's Compcnsation provisions of �hc Lsdor Codc, you muu � O forthwi�h cpmply witA such provisions w this permil shall bc dccmcd ccvoked. z """ CONSfRUCI'ION LENDING AGHPICY (. r�. I hercby a[i'irm Uut there is a conswction Icnding agcnry (or the performance u( . �Y., � ihe work (or which this pertnit is issued (Scc. 3097, Civ. C.) W� Q Lendcr'S Namc ' � z L.ender's Address V � I certi(Y ihai 1 have read �his applieation and sia�c ihat thc above infamauun is w � correc� I agree to comply with all ci�y and county ordinances and su�e laws relaung in 0 U building conswction, and hereby authoriie representatives of ihis city to enter upon Uic � a above-mentioned property for inspection purposes. (Wc) agree to sare, indcm�i(y and keep hartnless ihe City oC Cupcnino agai�s� N � liabilitiu, judgmcnts, cosLS and expenscs which may in any way accruc against said City V z in consequence oC thc granting af �his rmit. � APPLICA E jJ4 AND COMPLY WITH ALL NON-POIPR' Issued by Date SOU E Re-roofs �� AP', DOUS MATERIALS D[SCLOSURE i � Type of Roof � WiU Ihc applicant or future buildins occupant storc or handlc harardous ma�crial iefincd by the Cupenino Municipal Code. Chap�cr 9.12, snd thc Hcalth and Sakty .ocic. Scction 25532{a)? All roofs �hall be inspected prior to any roofing material being installed. ❑ Y� �° . �11 �hc applicant or futurc Duilding occupant use equipmcnt or dcvices which If a roof i� installed without first obtaining an inspection, I agree to remove emi� harardaus air contaminants az dcfincd by �he Eay Arca Air Quality Managcmcn� all new m aterials for inspecr.ion. Disvict? � ❑ Ycs � I havc rcacl,the haiardcws ma�crials requircmcnLS unAcr Chap�cr6.95 of the Califor- � , ' nia Hcalth & Safcry Codc, Sections 25505, 25533 and 75534.1 undcrstand �hat if �t�c huiWing �-' docs not curtenUy havc a �cnant,, it ls'my rapo ibiliry to notil'y ihc oecupaet of thc � " rcyuiremc muu �efe issuancc aCcnifica�cof �P . ature o Applica " Date �� All roof coverings to be Class "B" or better •r.cd a cnt �z� � � CITY OF (vUPERTINO �� [ � � � � ��`�� `�1�✓�� J'��. �UPE1�Tl�I� PERMIT APPL[CATION FORNI APN #�� C� � �� 3� U Date: i Q 2 �/ �� t � � Building Address: � ( Q /_ �� tCJ Owner's Naine: �� n � ' � � � Phone � �8 7 `�� 3 � ! - - -- -- ---- -- 1�- � - -- ---- -- ---- -- --- - _ _ - — - -- - --- -- -- - _ _ _ ---------- - � I C��orlh �� Phone: Licc�is� #: �-7�37 Contact: �� D 5 n � Phone�� _ �� ,., Cupertino Business License #: /T�-- /`i- C> Building Permit Info: Elect �' Job Description: � �� -r� ��-- ,� � �, ��,�„ , 'p � c�.�" � o C� Residential Commercial ❑ Cost of Project: i QQ � I Qty. if A plicable Fee ID Fee Descri tion Fee Group BTEMP Temporary Power ELECTRICAL EPERMITFEE Elf;ct. Permit Issuance ELECTRICAL BUSLIC Bl siness License BLTILDING CITY OF CUPERTINO 2 ITEMS OF 2 PERMI'P RECEIPT OPERATOR: patg COPY # :. 1 Sec: Twp: Rng: Sub: Bl{: Lot: APN ....... 35109065.00 DATE ISSUED.......: 10/30/2007 RECEIPT #.........: BS)00003117 REFERENCE ID # ...: 07100210 SITE ADDRESS .....: 10L06 CARMEN RD SUBDIVISION ....... CITY .............. CU?ERTINO IMPACT AREA ....... OWNER ............. CA2L FARSAI ADDRESS ........... 10106 CARMEN RD CITY/STATE/ZIP ...: CU?ERTINO CA, 95015 RECEIVED FROM ....: CAZL K FARSAI CONTRACTOR .......: LIC # *OWNER* COMPANY ..........: CA�L FARSAI ADDRESS ........... 10106 CARMEN RD CITY/STATE/ZIP ...: CU?ERTINO CA, 95015 TELEPHONE ......... FEE ID UNIT QUANTITY .�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BTEMP FLAT RATE 1.00 62.10 0.00 62.10 0.00 EPERMITFEE FLAT R.ATE 1.00 40.79 0.00 40.79 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 102.89 0.00 102.89 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 102.89 AMEX --------------- TOTAL RECEIPT : 102.89 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL Community Development ;`' F°.,� � 10300 Torre Avenue �:�•� '� � ��;�,= Cupertino CA 95014 Telephone (408) 777-3228 CITYOF Fax (408) 777-3333 CUPEt�TINO Buildin De artment JOB ADDRESS: PERMIT # 1aI�� C�2M � �� OWNER'S NAME: �� L.. �1(Z. S�- I PHONE # �� • 7�-7 3�7 GENERAL CONTRACTOR: .� �L � FAX # � -82 � �- ? �,_.... I am not using any subcontractors: ✓� _, ^ � ��°�� 7 i;na e Date Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIl`1ESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linolewn / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile °� - � co/3�%7 - ontr ignature Date