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07010076129 1290 m =zUA o<a Z z e2e�t� jWU �0< ny—t eco tm� � � y ESC CITY OF CUPERTllVO � BUILDING DIVISION PERMIT BUILDING ADDRESS: 7626 NEWCASTLE DR OWNER'S NAME: NADER SHAMMA ARCHITECTIENGINEER: FM E 1370 DAPHNE DR (408)315-1135 PERMIT NO. PERMIT ISSUE DATE )1/12/2007 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO AT nn FLECT PLUMB LICENSED CONTRACTOR'S DECLARATION Job Descnptlon I hereby affirm that I am licensed under provisions of Chapter 9 (commencing INSTALL OUTLET AT GARAGE CEI LING LOCATION vith Section 70f1V) of Division 3 of thc Business and Professions Code, and my license is n full force and effect. .icensc Class Lic. S )arc Contractor ARCHITECTS DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, 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 and Professions Code: The Contractor's License Law dohs not apply to an owner of property who builds or impmves thereon, and who does such work himself or through his awn 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 satcJ. 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. ❑ 1 am exempt unSec /I B & P C for this mason der .7 O Z r.. w ~ aQ az UO w F. OV a Uz Owner Date I hereby affirm under penalty of perjury one of the following declarations: -1 1 have and will maintain a Certificate of Consent to self -insure for Worker's Compen- ation, as provided for by Section 3700 of the Labor Code, for the performance of the vork for which this permit is issued. ] I have and will maintain Worker's Compensation Insurance, as required by Section 1700 of the Labor Code, for the performance of the work for which this permit is issued. Ay Worker's Compensation Insurance carrier and Policy number arc: :arrier.Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('This section need not be completed if the permit is for one hundred dollars ($100) 3q. Ft. Floor Area 36617084. it less.) certify that in the performance of the work for which this permit is issued. I shall not :mploy any person in any m n, s as aeomc to i to the Workers' Compensation ..aws of California Doc Applicant NOTICE TO APPLICANT: If. after making This Certificate of Exemption, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Namc Lender's Address I certify that I have read this application and state that the above information is correct I agree to comply with all city and county ordinances and state laws relating to building conswction, and hereby authorize 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 may in any way accrue against said City in consequence of the granting of this permit APPLICANT UNDERSTANDS AND I COMPLY WITH ALL NON -POINT SOURCE REGULATIONS. HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Munici 'Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? ❑ Yes o Will the applicant or future building occupant use equipment or devices which ..At hazardous air contaminants as defined by the Bay Area Air Quality Management District? � ❑Yes �Nu 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 currently have a tenant, that y responsibility to notify the occupant of the rcquirc cn ich must et Ito h uance of a Certificate of ianZ/ Z /// Owner or authorized agent Date Issued b -i: Re -roof: Type of Goof $145 Required Inspections Valuation occupancy Date All roof; shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant All roof coverings to be Class "B" or better Date CITY OF "WEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Buildi:nDepartment JOB ADDRESS: '7 2-L N SC S ��'_ PERMIT # �. �l C�16�`76, OWNER'S NAME: Gz ,, PHONE # D - 3 - 777 GENERAL CONTRACTOR: K WU-ti Kowtfi _ FAX # I am not using any subcontractors: . ac- Si,-pature Date 'Dl--".-- A-Ao a»lkrnni-rari-nrc anti rnmt)lete the following information: 1 1G r UA i1�Vl - ✓ ...rv_r -__- ----- ----- BUSINESS NAME BUSINESS LICENSE # a ets & Millwork rCemeUBCONTRACTOR XFinishing Electrical Excavation Fencing _ Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating _ Insulation Landscaping Lathing Masonry _ Ornamental Sheet Metal Painting / Wallpaper Paving X_ Plastering Plumbing Roofing _ Septic Tank Sheet Met4/ Sheet R Tile Date 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN 36617084.00 DATE ISSUED.......: 01/12/2007 RECEIPT #.........: BSC00000204 REFERENCE ID # ...: 07C10076 SITE ADDRESS .....: 766 NEWCASTLE DR SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OWNER ............. NM)ER SHAMMA ADDRESS .......... CITY/STATE/ZIP CUPERTINO CA, OPERATOR: aMYW COPY # : 1 95014-5221 RECEIVED FROM ....: RECEIPT INTERFACE CONTRACTOR .......: KWAN-SOO KANG LIC # 22540 COMPANY ..........: FM ELECTRIC CONTRACTOR ADDRESS : 13'70 DAPHNE DR CITY/STATE/ZIP ...: SK4 JOSE, CA 95129 TELEPHONE ........: (4)8)315-1135 FEE ID UNIT QUANTITY z\MOUNT PD -TO -DT --------- THIS REC ---- NEW BAL _ _------------- BREMRECEPT NO. OUTLETS ---------- 1.00 --- 1.20 0.00 0.00 1.20 0.50 0.00 0.00 BSEISMICRE VALUATION 145.00 1.00 0.50 38.37 0.00 EPERMITFEE FLAT RATE ---------- - ---- - ------0_00 ---------- 40.07 0.00 40.07 0.00 TOTAL PERMIT METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 40.07 --------------- 40.07 VOICE ID DESCRIPTION -------- ----------------------- 304 ROUGH ELECTRICAL 505 FINAL ELECTRICAL REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- --------------------------- 501 FINAL ELECTRICAL ENERGY CC I OF CUPEkTINO CITY OF C'UPERTINO PERMIT APPL[CATION FORM O1ol OZyf(0 _ CPN # 3cap. n -c@ q Date: ! (� 2DC' 7- Building Address: Mailin N ca S 4-1 ,e- D r - C4 i e r Address (if different from building address): �� 14 Of -';-n � 2 % eJw MECHANICAL Owner's Name: h Phone #: S 11_ g _ -7777 �O�S' - T Contractor:_ F tl j Gfr i C- License #: 7q 3g I' o Contact: %� Phone.90 - Cupertino Business License#: Building Permit Info: Boil -,r > IM to 1.75 M Btu Bldg ElElect El Mech El Job Description - Residential Residential Commercial El Sq.Ft. Floor Area: Construction Tax Sq.Ft.: Cost of Project: c f �� 0-0 IrLdlOff/Comm/Quasi Occupancy group: Type of Construction: Con. Tax for BQ Zone Hotel and Motel Please check this box if the project is a ❑ Qi2 Constax — Resi/Mobile second -story addition: BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 11'lec 600V > 1000A ELECTRICAL C", A -A F► T nrff.- I-1 Maior F - Elec Svcs 600V <= 200A Energy ELECTRICAL BUILDING Irl vJcLL OIGC. ULCul- Quantity Fee ID BAPPLOTHER Fee Description Other Appliances Fee Group MECHANICAL BBOILERI Bailer <= 100,000 Btu MECHANICAL BBOILER2 Boil(;r > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to lM Btu MECHANICAL BBOILER4 Boil -,r > IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX IrLdlOff/Comm/Quasi BUILDING BCONSTAXBQ BCONSTAXH Con. Tax for BQ Zone Hotel and Motel BUILDING BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 11'lec 600V > 1000A ELECTRICAL BELEC200 BENERGY Elec Svcs 600V <= 200A Energy ELECTRICAL BUILDING BENE, RGYADD BINVESTIGA Energy Add Multi Investigation fee BUILDING BUILDING 1 of 3 2 of 3 I CITY OF CUPERTINO OF pERMIT APPLII�ATION FORM CITY CUPE6�TINO Quantity Fee ID Fee Description Miscellaneou�ie Fe Fee Group BUILDING BMISCELL BMITIGATC Comm. Housing t. Fee BUILDING ELECTRICAL BNUCOMME New Comm Electric New �omm Mechanical MECHANICAL BN[JCOMMM New Comm Plumb PLUMBING BNUCOMMP Ins-)ection Overtime BUILDING BOVERTIME BP LOW Atmospheric Vacuum PLUMBING PLUMBING BPCESSPOOL Cesspool B Permit Fees BUILDING BPERMFEE .d Pbl Fixture PLUMBING BPFIXTURE Gas Piping System Fee PLUMBING BPGAS BPINTERCEP Ind Waste Interceptor PLUMBING BUILDING BPLANCHK flan Check Fee Plan Check Add Multi BUILDING BPLANCKADD Plan Check Repeat Fee BUILDING BPLANCKREP Rc i e Of Fixtures PLUMBING BPREPIPE c, posal PLUMBING BPSEWAGE PLUMBING BPSEWER s Lavir/Backflo PLUMBING BPSPRINK SWater PLUMBING BPSTORM Trap ZI PLUMBING BPTRAP A & Vent PLUMBING BPVENT Instater Pipe PLUMBING BPWATER V ister Heater/Vent PLUMBING BPWHEATER Main Water Service PLUMBING BPWSVCS Reinspection Fee BUILDING BREINSPECT A/' Unit > 10,000 cfm MECHANICAL BREMACOVER BREIVIAIRHAN A/C Units <= 10,000 cfin MECHANICAL MECHANICAL BREMAPPLI Appliance Install ELECTRICAL BREMBUSWAY ,Iemodel Busways ELECTRICAL BREMFIXT Lighting Fixtures MECHANICAL BREMFURN R. -location of Furnace Relo Furnace > lOK btu MECHANICAL BREMFURNOV Heater Installation MECHANICAL BREMHEAT Installation of Hood MECHANICAL BREMINHOOD Misc Apparatus ELECTRICAL BREMMISC Rem Non -Res Appliance ELECTRICAL p F'ole/Platform Fixture ELECTRICAL BREMPOLE BREMPOWER Power Device/A aratus ELECTRICAL ELECTRICAL BREMRECEPT Rc tl, Switch &Outlets Relocation of Hood MECHANICAL BREMRELOCA repair/Alter Heating MECHANICAL BREMREPALT R -.model Res Appliance ELECTRICAL BREMRESApp 2 of 3 I �--c ZTWYO F CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Tee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR The Arical 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 Te!n)orary Bldg Permit BUILDING BTEMPSVCS 'Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC I?lectrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Meeh Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Plannin LR Comme/ Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING I ZADDCHG .Address Change BUILDING 3 of 3