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07050245 777=17 CITY OF CUPERTINO BUILDING DIVISION PERMIT PERMIT NO. BUILDJN6e p�ESCARVER DR NATIONAL CONSTRUCTION 07050245 UU b bb PERMIT ISSUE DATE OWNER'S NAME: KARAM GERGES & SAMIA GERGES 15319_ CHAT:WORTH ST 05/24/2 SANITARY NO. CONTROL NO. ,NE: (818) 221-6C57 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH p a LICENSED CONTRACTOR'S DECLARATION Job Description v t= I hereby affirm that I am licensed under provisions of Chapter 9(commencing ;ZU with Section 7000)of Division 3 of the Business and professions Code,and my license is TEMPORARY POWER POST INSTALLATION r,4 c. in full force and effect. v�Z License Class Lic.# i t- Date Contractor � ARCHITECT'S DECLARATION j z a 1 understand my plans shall be used as public records )0.0 win Licensed Professional O a OWNER-BUILDER DECLARATION a1 hereby affirm that 1 am exempt from the Contractor's License Law for the p o following reason.(Section 7031.5,Business and Professions Code:Any city or county Q.9 which requires a permit to construct,alter,improve,demolish,or repair any structure fl Valuation u'H prior to its issuance,also requires the applicant for such permit to file a signed statement S F Floor Area $3 5 0 -?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 e.t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or Q 5 that he is exempt therefrom and the basis for the alleged exemption.Any violation of �pOCCU Occupancy Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 37532016 .V Number P Y Type not more than five hundred dollars($500). ❑1,as owner of the property,or my employees with wages as their sole compensation, Required Inspections 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 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.). I•as owner of the property.am exclusively contracting with licensed contractors to constmct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- ccnse 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. B&P C for this mason ❑�� Sec �AI�IONDEC O I hereby affirm undr penaltyo[perjuryone of the fofiowing declarations: ❑1 have and will maintain a Certificate of Consent to self-insure for workees Compen- sation,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 Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('Phis section need not be completed if the permit is for anc hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any to become subject to the Workers'Compensation Laws of C- o Applicant NOTICE TO APPLI Certificate of Exemption,y should become subject to the Worker's Compensation provisions of the Labor Code,you must ,z forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of R! the work for which this permit is issued(Sec.3097.Civ.C.) W A Lender's Name az Lender's Address U 0 1 certify that 1 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 O Ubuilding construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. f\\ CS. (We)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,costs and expenses which may in any way scenic against said City U z in consequence of the granting of this permit. ( Date ►� APPLICA NDE S AND WILL COMPLY WITH ALL NON-POINT Issued by: ONS. _ -�- o Re-roofs Sig ore of Appire. tort Date Type of Roof HAZARDOUS MATERIALS DISCLOSURE YP 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)? All roofs shall be inspected prior to any roofing material being installed. Yes 14,No Will the applicant or future building occupant use equipment or devices which If a roof is in:;talled without first obtaining an inspection, agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new mates ials for inspection. District? Cl Yes ek. I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Hcalth&Safety .Sections 25505,25533 and 25534.1 understand that if the building docs not curter a tenant, y responsibility to notify the occupant of the Date requirements ustbeML to of accrtificatcofOccupancy. Signature of 1�pplicant S Z VA All roof coverings to be Class"B"or better 0wner aur Date- CITY OF CU?ERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: christya COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN 37532016. 00 DATE ISSUED. . . . . . . : 05/24/2007 RECEIPT # . . . . . . . . . : BS000001454 REFERENCE ID # . . . : 07050245 SITE ADDRESS 10668 CARVER DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KARAF GERGES & SAMIA GERGES ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : RECEIVED FROM . . . . : KARAk GERGES CONTRACTOR . . . . . . . : NATICNAL CONSTRUCTION RENTALS LIC # 22537 COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS ADDRESS . . . . . . . . . . : 1531S CHATSWORTH ST CITY/STATE/ZIP . . . : MISSION HILLS, CA 91345 TELEPHONE . . . . . . . . : (818) 221-6057 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------- ------ ---------- ---- ------ -------- BTEMP FLAT RATE 1. 00 62 .10 0. 00 62 .10 0. 00 EPERMITFEE FLAT RATE 1. 00 38.37 0.00 38.37 0.00 ----------- ---------- ---------- ---------- TOTAL PERMIT 100.47 0. 00 100.47 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- •-------------------- CREDIT CARD 100.47 MASTERCARD --------------- TOTAL RECEIPT 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------- 103 UFER 304 ROUGH ELECTRICAL INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO PERMIT IrfVOICE OPERATOR: christya Sec: Twp: Rng: Sub: B--k: Lot: APN 37532016. 00 INVOICE DATE. . . . . . : 05/24,'2007 REFERENCE ID # . . . : 07050245 SITE ADDRESS . . . . . : 10668 CARVER DR SUBDIVISION . . . . . . . CITY CUPERPINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KARAM GERGES & SAMIA GERGES ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CONTRACTOR . . . . . . . : NATIONAL CONSTRUCTION RENTALS LIC # 22537 COMPANY . . . . . . . . . . : NATIONAL CONSTRUCTION RENTALS ADDRESS . . . . . . . . . . : 15319 CHATSWORTH ST CITY/STATE/ZIP . . . : MISSION HILLS, CA 91345 TELEPHONE . . . . . . . . : (818) 221-6057 FEE DESCRIPTION DUE FOR AMOUNT DUE PAID BALANCE --------------------------- ---------------- ---------- ----- TEMPORARY POWER PRINTING PEFMIT 62 .10 0.00 62 .10 ELEC PERMIT ISSUANCE PRINTING PEFMIT 38. 37 0_00 -----38_37 ------ 100.47 0. 00 100.47 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -- ---------------------------- 103 UFER 304 ROUGH ELECTRICAL -� CITY OF CUPERTINO c TEMP POWER CITY OF CUPERTINO PERMIT APPLICATION FORM APN# 0 / Date:S 2� Building Address: � L 0 66 8 CaVU 6�-/ U Eia o Owner's Name: Phone#: V � A s M� � c � z� ,o _ 92s_ 4 ( CA Contractor: i Phone: License #: NA--loNi�oo- S2- _6 -a ) .Z 681 ( (60 Contact: Phone: Cupertino Business License#: Afi o - 2-t (32 2-15 1�77 Building Permit Info: Elect U-- Job Description: ,7 70 v)0- Residential Residential K Commercial ❑ Cost of Project: .- 35o Qty. if Applicable Fee ID Fee Description Fee Group BTEMP Tem 3orary Power ELECTRICAL EPERMITFEE Elect. Permit Issuance ELECTRICAL BUSLIC Business License BUILDING Community Development 10300 Torre Avenue ;x Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -UPERTINO Buildina Department JOB ADDRESS: PERMIT# OWNER'S NAME: / 4 y1n S AA,,(',4 E C-a (:i z-S PHONE #& GENERAL CONTRACTOR: o 0 A- L FAX # I am not using any subcontractors: 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