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06060057 (2) F8`58 ITY OF CUPERTINO BUILDING DIVISION PER NET `.. 'UNTRALC '�ORI�'FUyuTATTI $k�I rt„ .• "^ LDING ADDRESS: , NEERU SHARMA k SUMIT GAUT "T"°'06060057 E ESTATES DR NER'S NAME: PERMIT ISSUE DATE * NEERU SHARMA & SUMIT GAUT 6 08 2006 E: SANITARY NO. CONTROL NO. ARCHDECf7ENGINEER: BUILDING PERMIT INFO EO EO PLO MEOCH �ta a LICENSED CONTRACTOR'S DECLARATION Ib Description ib"' 1 hereby affirm Nam et I licensed under provisions of Chapter 9(commOCSCTIP encing who Section 7000)ofDiviuon 3 argue Business and Prafeaoons Code.tib my license u In fallraneeandefinet. RELOCATE THE EXISTING WALL (MOVE BY 4 FEET) AND ;'Z ClassLk.R Dow. BUILD A NEW ONE. ALL INSIDE THE HOUSE. PUT i Dou ARCHTTELTSDEC =ON ELECTRICAL OUTLET IN IF NEEDED RELOCATE VANITY I I understand my platy CHIT w used u publicublicATION w s .a Licensed Professional OWNER-BUILDER DECLARATION i a 9 1 hereby.(Tire Not 11. !sumps from Ne Cssions Co Licence Law for mft y .a G following requires a ummit t 703 coons! Business and Improve. Professions Calc:Any city or county i5 whish rets ima n!.also le rim the,ellen wpmve,Nmmub.W mPur any swment prior miu issuame.Wu mquiRatw Cppliunl for such permit us fileasigned statement < than,hculicensed Percent tothat provisions ofthat ConYrcaNsLicame Law(CHpw9Sq.FFl Floor Area Valuation l�0 (cammaming with Section 7000)of Obvufan 3 of the Business mal Profession Coca)or $'4000 $ that he is exempt Ihmfrom and the basis for but alleged exemption.Any violation of Station 7031.5 by any applicant for a permit subjects the applicant an a civil penalty of APN Number Occupancy Type out mom than Rn hundred dollars(5300). ❑Luownerofthepmpwy,mmymPloywwithwgnu Neosolaeompe don, 36924 04P AP will do Neworg,and thaswnure U ret hiuendedo aRertd forsale(Sce.]M4,Bmrcu ' W Pollination Cade Ties Cmuanmh I.irewe Law does ant apply m an owner of Required Inspections property who HllN orimpraves therean,and whodoesamhworkhimself or through his own emplayeu,provided Natauch Improvements are not intended mothered for sale.It. however,the building or improvement is sold within one year of completion.me anent- builder will ban the burden of proving that he did me build or barren ftr purpose ofIg ��, LE® Rle). pp AA I,u owner of the Property,am exclusively contracting Nth Reacted contrec ms m ® � construct die project(Sec.7044,Busimu and ProfessionalsCod:)IntoCmuwmts U. ecru law does not apply to an owner or property,who builds or improves Herren,and whocontracts for such projects with a commar(s)licensed pursuant in the comiactor's License Law. ❑I am exempt under See .B At P C for this mama owner NE WORK SHHRMN Dam 6 D6 ' Ak WORKERS COMPENSATION OECI.ARA am 1 Hmby!frim muter penuity of perjury vertaof de following declamiom 1 ham and will munuin a GartiBne ofConsent m rel(-insure for WoheYs Campen- swon.as provided far by Section 3700 of the Isbm Cads,tar the perfamamx of the work for which Nis Permit is issued. ❑I ban and will maintain Womes Compensation Insurance•as myuimd by Section 3700 of me Labor Code,far the performance of the work far which this permit is leaned. My Worker's Compensation In..nein and Policy number am: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Crldsmealon need ane he compared Ir Ne pcmb bfarane hundred dallas($100) or leas.) - 1 occupy,that in that performance of the cwpobrek for which this perm,Ia named.I shall me employ my Percent in ansubject m e subjethe Wohms'compensation mwsaf Calif Dam Applicant NOTICE TO APPLICANT.T after makingnp Cisinso the Exemption,borCoyoushould Obecome comp y it Wahero Compensation provisions of de lahar Code.You mute fanhwith amply with such provisions or Nu pectic aHll be deemed rented. Z'�; CONSTRUCTION LENDING AGENCY (-i IMreby afore that Nem is a rnMrucOm lending agency for the Performance of a > the wood,far which this Permit is lasted(Sec.3097,Or.C.) - aQ Isndee:Nmc , 7 Lemke 2 Aaamaa . U0 I exactly Nn i Hn road W.application and Nu this the awn Information I, Vs F cormcL 1 agme to comply with all city and county aNinsrew.nd tyle laws relating to 0 U building conswction,and hereby authorize representatives of this city to enter upon Ne W .hove-mcatiuned property for inspection purposes. (We)agree to an.indemnify and,cep heartless;the City of Cupcnino against wF.s y liabilities,judgments.cow and expemw which may In any way accrue against said City UyZ in consequence of to Senting of this pennh. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date (,�— _ SOURCE REGUI.A�S. r'yI a.. (6 /$'O C. Re-roofs Signs=of ApplluR - Dau HAZA HAZARDOO US MATERIALS DISCLOSURE Type of Roof Willy t e Cupertino m future wilding es.Chaptnore rehandle Health material u dennW by the Cupertino Muuidpal Cade.Chapter 9.13.and Oar Health aM Safety Cade.Scene.25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yap nNo Will tthatapplicant or future wse building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it haraNnw air nmmiwnu so darned by the Day Arca Air Quality Managmeat all new materials for inspection. Distrim7 D Yes [i/loo I ban mad the haRrtlnus materialsmquimmenu under Chapur6.95 or the Culler. .is HeethAt SafeeyCode,Sections 35505,25533 and 25534.1 understand this ifthe wilding doer ret currently ham a enanl that It is my responsihllity,in notify me occupant or eve requhemenuwh,c roc be sun pruru iaauanm or.Caufinu of Occvpamy. Signature of Applicant Date �¢os fA�n�, won 6 /g/0 6 Owner ar wNariasdagent All roof coverings to be Class"B”or better Oou' ■■M.■■N.MM■■N■■■M■MMM. M■EM■■■ .■. N■ ■ . ■■■�■■■■M ■■■�■■ . . r ■■■■■■■I ■NMNM ■ • • ■■■■■. ■ MMMmmmm . • • ' ME ME ■■■.■■■■■■■.■■ ■■■. .■■■■.. • . ■■■■ - ■� M■■.■.■■ M.■ MOONME MMEN ' ■ MMMM■M.■■■■ ■■■ mmmm •r: I- i yowl '.r„i m NMN .MMM MMMN MMMMMM M NMM■ ■ II MMMMMMME■■■MM MEMO ■ MMM■M ■NM M■■ ■.:::N:::. CME ..: 0:1: .■NMN■■■�■. ■■■■■ © • MEMO N ■.■■ �■■ ■■ M■ ■MM ■■ ■M■ ■M■ ■■MOON■■MM ■ MEMS ■•■ ■ .n1N �MMOM■.NMMNM MMM■ No M■ MMMM ■ .NM■M MEMO MMMNMMM■Ir Mt M■MMME 0 No 0 ME MEN M■ ■MM■ NONE M■OMM� ■ ■MM ■ ■ NONE N■ME ..N� �.MN ■� .N■MMM■■■No mom ■M. ■ �N No m MM.M MMM ■ M ■ MNM NOMNM ■ MN NAME _ NE£'Rv SHAgfy' A (ldd R N ss g 5 8 G%s* C5'A.-s 1Z5ci J k • c:, tai , c q5c/y GcoFF o F WoRk – RE -LOCNTSNCn �aqm� 1zc a t n�� 13cr1lwoo .. , &,,s- . Pte, 4 'Wines �Q cu 6vJLI i Act aoo I NEC . PHON E - 63l- 6TR 5.99.6 I � sosG�4re - fx;s}� MASTER RED Qoom a3'X I'S ' aotla�.k,�e- Ne�v W I� i I - I ASSESSOR COP M u Ro. 11an,i'>L� �S�ouiesi 1 � > 6yAT A.Q9- s'}n 6.e Fn F I Pao'�'Ot%Fdl, `—' ao AQP bs.o.r.ci.. c`.sc-"� 1 v �j, I BatTnv.,.,,u s Prr,�+' - s�4D.alt,rb 4Qve. � ' o�`'.� � s- d""' UpG foo w-e� r�o 6.e- irnsjn � w`�' S saK� ! 9^E 6 -i OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family (parent,spouse or child) will perform: • A. N'S W All the work authorized by this permit B. X A portion of the work C. None of the work If B or C is checked, complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City. Phone # State License # Type of work to be —�:fo.u.ed • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers compensation must be on file at the City of Cupertino Building Department office. Person/Firm AddresgCity Phone Number Type of work to be erformed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (reverse side). Property Owner's Signature: ��o o L,� Date: �/8 Io 6 Job Address: dime} Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. • City of,Cupertino Building Department CITY OF 10300 Torre Avenue • CU PEkTINO Phone: (408)777-3228 Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,workers compensation insurance,disability insurance costs,and unemployment compensation. contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit,erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,Califon-da 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, • City of Cupertino Printed on Recycled Paper CITY OF ' CUPERTINO Oem 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36924012 . 00 DATE ISSUED. . . . . . . : 06/08/2006 RECEIPT # • • • • . . . . . : 34746 REFERENCE ID # . . . : 06060057 SITE ADDRESS . . . . . : 858 E ESTATES DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NEERU SHARMA & SUMIT GAUTAM ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : NEERU SHARMA CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : NEERU SHARMA & SUMIT GAUTAM ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT. THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 4, 000 . 00 104 . 76 0 . 00 104 . 76 0 . 00 BPFIXTURE UNITS 2 . 00 18 . 00 0 . 00 18 . 00 0 . 00 BENERGY PERMIT FEE 104 . 76 50 . 28 0 . 00 50 . 28 0 . 00 BREMRECEPT NO. OUTLETS 2 . 00 2 .40 0 . 00 2 .40 0 . 00 PPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 BSEISMICRE VALUATION 4 , 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 EPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 . 37 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 252 . 68 0 . 00 252 . 68 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 252 . 68 AMEX TOTAL RECEIPT 252 . 68 Community Development 10300 Torre Avenue s Cupertino CA 95014 " Telephone(408)777-3228 CITY OF Fax(408)777-3333 OCUPEkTINO Building Department JOB ADDRESS: 8 58fi Tshds Q PERMIT# X68 6.00 7 OWNER'S NAME: a� S S PHONE # 01-6 7a 15 59.6 GENERAL CONTRACTOR Ten FAX# I am not using any subcontractors: Tap 6' 7 0 Signature Date Please check applicable subcontractors and complete 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 Owner/Contractor Signature Date 'G CITY OF CUPERTINO MtaVCj, CUPEkTINO PERMIT APPLICATION FORM APN# V,q —)4 �D'n Date: 61-7 )06 Building Address: 4• Mailing Address (if different from building address): 5 4,L -DP-IVF , (VPF1FTTNQ. CA q5o ) q Owner's Name: Phone#: 5 ,59 (, NEE v s Q v � J Contractor: ,TBD License #: Contact: WEGKU SHARMA Phone: 631-672 -(�� Cupertino Business License#: 858 f his D4 V—e Fax: Buil d}'ng Permit Info: Ke--6cilio, tW eic%'S-h^ via , ,z t� y ) nscd n'a, U5-en� ti,vacllo.d-� TA Bldg L, Elect P" Plumb ❑ Mech ❑ Job Description: Residential ❑ Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 41, 000 Occupancy Group: Type of Construction: Please check this box if the project is a 1:3z second-story addition: ❑ ro'ect Size: Standard ❑ Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> IOOOA. ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING leo� 1 of 3 CITY OF CUPERTINO CUPEf�TINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group . 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 Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinklerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING . BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BRENCIT PP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 a0 CITY OF CUPERTINO CUPEI�F PERMIT.APPLICATION FORM • Ouantitv Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel 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 Temporary 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 Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING 3 of 3