The URL can be used to link to this page

07010028 lx: CITE'OF CUPERTINO RMA.'Ir BUILDING DIVISION PERMIT PERMIT NO. BUILDING ADDRESS: RAINBOW7669 DR AL " PERMIT LSSUE DATE OWNER'S NAME: 551 INDUSTRIAL RD 01/04/2007 FEYOZ SHABVANI SANITARY NO. CONTROL NO. ONE: (650) 622-0330 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH O p LICENSED CONTRACTOR'S DECLARATION Job Description m 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing z with Section 7000)of Division 3 of the Business and Professions Code,and my license is REP LAC I N 3 8 WINDOWS LIKE FOR LIKE ' H in full force and effect. r Z j ? License Class Lic.8 3 t- Date SL Comractar z ARC rTECL'S DECLARATION a-t I understand my plans shall be used as public records �yU G H Licensed Professional n yr OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county Kms,9 which requires a permit to construct,alter,improve,demolish,or repair any structure Z Y, prior to its issuance,also requires the applicant for such permit to rile a signed statement �; .Ft.Floor Area Valuation F x G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $4075 y F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 1. that he is exempt therefrom and the basis for the alleged exemption.Any violation of Q j� Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 36224011 .�17V not more than five hundred dollars($500). 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 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 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 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: 0 I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the Wf which this permit is issued. have 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 Workers Compensation Insuranj carrier and Policy number are: Carrier�'I Citi C Ui1. I• r Policy No.: CERTIFICA OF EXEMP ION FROM WORKS COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in thc 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 Compcnsadon provisions of the Labor Code,you must Z forthwith comply with such provisions or this permit shall be deemed revoked. Z O CONSTRUCTION LENDING AGENCY F~t►�.. 1 hereby affirm that there is a construction lending agency for the performance of �i> the work for which this permit is issued(See.3097,Civ.C.) W Q Lender's Name 04 Z L.cndees Address t certify that I have read this application and state that the above information is LUL" correct.1 agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,costs and expenses which may in any way accrue against said City r/ V Zin consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WIL COMPLY WITH ALL NON-POINT Issued b): SOURCE REQVLATION / EJ/ O O• Re-roofs Sig ature of Applican11Contractor DAC T Of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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)7 All roofs shall be inspected prior to any roofing material being installed. 0 Yes 644 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 Area Air Quality Management all new r laterials for inspection. District? '/ 0 Yes dko I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.1 understand that if the building does not cuWtly have a tenant.that it is my responsibility to notify the occupant of the re 'rem hich ust be met ri issuance of a Certificate of Oce an qw-� � p `y. Signaturt;of Applicant ate C'w ,� �Itqf'�� All roof coverings to be Class'B or better Owner or aur onzed agenta�tc CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36224011 .00 DATE ISSUED. . . . . . . : 01/ )4/2007 RECEIPT #. . . . . . . . . . BSO)0000139 REFERENCE ID # . . . : 07010028 SITE ADDRESS . . . . . : 7669 RAINBOW DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : FEYOZ SHABVANI ADDRESS CITY/STATE/ZIP . . . : CUFERTINO CA, 95014-5236 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : JACEK PASTERNAK LIC # 24829 COMPANY ALIBRAND WINDOWS ADDRESS . 551 INDUSTRIAL RD CITY/STATE/ZIP . . . : SAY CARLOS, CA 94070 TELEPHONE (6`_ 0) 622-0330 FEE ID UNIT QUANTITY ].MOUNT PD-TO-DT THIS REC NEW BAL __ ___ ---------- ---- ------------- BENERGY PERMIT FEE 115. 56 55 .47 0. 00 55 .47 0. 0 BPERMFEE VALUATION 4, 075. 00 115 .56 0. 00 115 .56 0.00 BPLANCHK PERMIT FEE 115 .56 154 .21 0. 00 154 .21 0. 00 BSEISMICRE VALUATION 4, 075. 00 0 .50 0. 00 0_50 ------0_00 ------ TOTAL PERMIT 325 .74 0. 00 325 .74 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 325 .74 VISA --------------- TOTAL RECEIPT 325 .74 Community Development w +, 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 ''UPEIkTINO Buildh�i De artment JOB ADDRESS- PERMIT # 7 010c9-2- OWNER'S NAME: s2 s 117 PHONE # GENERAL CONTRA OR E 11tVP0J L � .,� ��✓-� FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followinginformation: 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 Date Owner/Contractor Signature Iv�Gi.r x, i X. LOO L7 �� 7 5 J 1 2- 140 PRbVEED IN ACCORDANCE WITH THE CITY Ot CUPERTINO CODES AND ORDINANCES DATE `�lu"J�f1 This set of plans and specifications MUS. N? kept on the job at ail times and it is un a4"'lul t() make any changes or alteration, orj sa; f5 avithywt written permission fron D^pt., City of Cupertino. tI slam��in�;of th;s plan and specification I O L N,'),` be he'd to pe.reit or to be a, Ox '�j � �z !vwval of the violation of any provisio, C� 70111, l k A 1, fes' %CF �� CITY OF CUPERTINO PERMIT APPLICATION FORM CUPEkTINO CPN# Date: Buildin ddress• / MAI' Address (if different from building address): Owner's Name: P License #: Contact: Phone: ,�� 4fl;)''� 9 Cupertino Business License#: J4c.,�4 ; Fax: Building Pe it Info: Bldg C Elect ❑ P lumb ❑ Mech ❑ Job Description/ Jo .,s •rte J �� ( I; h " " Residential Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 7 Occupancy Gr up: Type of Construction: Please check this box if the project is a second-story addition: El lroject Size: Standard [Ir"'- Large ❑ Maj:)r ❑ Quantity Fee ID ]Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Bol'ler<= 100,000 Btu MECHANICAL BBOILER2 Boiler-7>71 0 KK to 500K Btu MECHANICAL BBOILER3 Boil,-,r> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX I-'onstruction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Co lstax—Resi/Mobile BUILDING BELEC1000 El--c 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD 13nergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING J of 3 ', . CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO Quantity Fee ID Fee Description Fee Grou BMISCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME I aspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE BldR Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD P.an Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE l2e i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK L,-.wn SprinklerBackflo PLUMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER In,,:tall/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER AIC Unit> 10,000 cfm MECHANICAL ggEHp,N A/C Units <= 10,000 cfin MECHANICAL BR ,, MAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN P elocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> IOK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP R:m Non-Res Appliance ELECTRICAL BREMPOLE ?ole/Platform Fixture ELECTRICAL BRE MPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rtl, Switch & Outlets ELECTRICAL c BREMRELOCA Relocation of Hood MECHANICAL BREREPALT Repair/Alter Heating MECHANICAL M BRERESAPP Remodel Res Appliance ELECTRICAL M 2 of 3 CITY OF CUPERTINO aClWF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rr1dl Signs Add Branch ELECTRICAL BREMSIGNS Re odel Signs, Marquee ELECTRICAL BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS -Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP rernporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Faro PLANNING PLLONGRNGR Plannin g Long Range Residential PLANNING ZADDCHG Address Change BUILDING of 3