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05100159 CITY OF CUPERTINO BUILDING DIVISION PERMIT C,ONTRACTaR INF�RMATIO.N "°? BUILDING ADDRESS: WARREN HILL CONSTRUCTION PERMIT N0.05100159 10177 MYFR PT, INS NAME: PERMIT ISSUE DATE SKANDALIS CHARLES D ROSER PHONE: SANITARY NO. CONTROL NO. (408) 836-4988 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECTPLUMB MECH I� � I� X00 LICENSED CONTRACTOR'S DECLARATION mF 1 emby affirm Net I am licensed under provkdons of Chapter 9(commencing Job Description ,ZTj with SCction7")of Division 3of NC Buxom and Professions Code.and my license is n« Wrmuomtande L BATH REMODEL LIKE FOR LIKE NON-STRUCTURAL WAL ;p= Leer la_ L.ic.a 735 3(0 tA Dam comaetel REMOVED, ENLARGE SHOWER ARCHITECTS DECLARATION wy w I undersand my plans shall he usea ds d public re Uit Licensed Professional `05 OWNER-BUILDER DECLARATION +� y 1 hereby affirm Net 1 am exempt from We Contractors License Law for the –OO following reason.(Section 1031.5.Business and Pmfeaihm Code:Any City or county which requires a permit to cnnswcM,alar,impure.demolish,or repair any swan. prior n its issuance.also requires the applicant for such permit to Glc a signed statement S< that he is licensed pursuant to the previsions of Ne Contractor's License Law(charter 9 Sq.Ft.Floor Area Valu41D5000 Yk'O (Commencing with Section/000)of Division 3nfde Business and Prokatiora Qstle)or 'd $ that k is exempt therefrom and We basis for tk a11cgW exemption.Any violation of Section 1031.5 by any appnum for a permit subjects We applicant to a civil penally of APN Number not more Want fn hundred dollars 4500). Occupancy TyPe 01,aowncr ofdm propeny.mmy employmea with wagesaNcir sole compensation, 31623051 . 00 will do Newark.and Ne he Con is not s Lndns or Law do sonata(Sm.70,W,Business and doProfessionswork code: structure ctunuators License law aces not apply man owner of Required Inspections proper(who Wi Ids or im proves Merton,and who does suc h work himse If or through his own employees,provided that such improvements art nolinmoded or offered formic.If, however,Ne building or improvement is sold within one year of completion.Ne owner- a / builder will baro We border of proving Nat he did not Wild or improve for purynse of ale.). ❑1.ru twrer of a Sec.7 y,am Business and concocting with:)The eeC Canmmars t- / Construct a dw es not ply.o an Business and nywhoPreftmr Wilds ds or i prows,the son. rad cense law docs not man owner of proper(who builds rs improves Nerehn,and who me Lacta for projects with a conmactor(s)liccrtsed pursuant to the Contractor's C Liccme law. ^ [_]I am exempt antler Sec. ,B k P C for this moon we, TIO WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penally of perjury one of the following declarations: 1 bate and will maintain a Certificate of Consent o self-insum for Workers ComXu- ration,as provided for by Section 3700 of Om labor Code,for the performance of Ne work for which Nis permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 37W of the labor Code.for Ne performance of the work for which this permit is issued. My Workers ComPeosation humborm Cartier and Polity number arc: Cartier. off? r— F Policy No.: _ ERTIFIC OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (this section need not bo completed irthe Permit is forone hundred dollars($10() or less) 1 Cefdfv Nat in We performance of Ne work for which this Permit is imued,I shall not employ any person in any manoerso at w keomc subject to the Workea'Cowper adon Laws of Califomia.Dam Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should became subject W Ne Worker's Compensation provisions of Ne Labor Cutlet you meet .J O forthwith Comply with such provisions or this permit shall be dimmed revoked. Z CONSTRUCTION LENDING AGENCY [-+ Ikmby alErm Nat Were is a comtfssotino lending agency far Ne performance of a.moi Ne work for which Nis pari,is issued(Sec.3D97,Co.C.) Undoes Name Z lenders Address U Q 1 mnify that 1 have read Nis application and show Na,the above Information is ly F CoeaaL 1 agmc to Comply with all city and county ordinances and sum laws relating to �U Wilding construction,and hereby authorize repreanhotiws tar Nis City to Cnwr upon We W shove-mentioned property for imPection purposCa LL (We)agree to saw.indemnify and temp brimless the City of Cupertino against fn liabilitim,judgmets.Chau and capemm which may in any way am=against said City IJ ,Z in consequence of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date n SOURCE REGULATIONS. /o -x 0-0 5- Re-roofs Signature of ApplicanUComrator Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will We applicant of future building occupantstme or handle hazardous material 0 defined by to Concision Municipal Code.Chapter 9.11,and le Health and Safety .Section I5533(a)9 [Dye. Cq2,.,1(+'4'a All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I Will dw applicant or future building aceupam tux equipment or devices which g agree to remove P emit hazardous air contaminants as defined by the Bay Arta Air Quality Management all new materials for inspection. District? ❑Yea YNy In vemol the hmardnusmawriab mquimmenu under Chapwr6.95 of de Califor- niaHCnl"SafetyCode.S.O.o S 5.25533ad2534.1undersandthmifde Wilding does not cunemly haw a tenant Chad 1,u my responsibility w notify We exupat of Nc requirements which must k me,prior or issuance of a CcMfieam of occupancy. Signature of Applicant Date Owner m:athhdacd agent Dam All roof coverings to be Class"B"or better CITY OF CUPERTINO Fz MM79w ` � = BUILDING DIVISION PERMI4 'CO'NTRAC�'OR, NF®RMA.1' BUILDING ADDRESS: WARREN HILL CONSTRUCTION & PEamrr No.05100159 OWNER'S NAME: PERMIT MUG DATE SKANDALIS CHARLES E E: SANITARY NO. CONTROL NO. 408) 836-4988 ABUILDING PERMIT INFO RCHITECT)ENGINEER: RLDGO ELECTO PLO MFCHO 3o p LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Socdon 7")of Divialon S of the Business and Prole shms Code.and my license r, in fall fares and e t. BATH REMODEL, LIKE FOR LIKE, NON-STRUCTURAL WAL Liz Dead re lam c mmn, s 34 REMOVED, ENLARGE SHOWER 9 ARCHITECTS DECLARATION 1 understand my plans shall be used as public records � U ;4.o Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affnm that I am exempt farm Ute Contractors License Law for the ,p o following moon.(Sedan 703 1.5,Busineu and Profedum Cade:Any city or county $ which requlrns a permit trs construct,altee improve,demolish.or repair any structure iy prior in its issuance.alsorequiret tWapplicam forsuch Pun itto file asignedsutement that he is licensed pursuant to the provis mmof the Cmanater's Umnu law Oberon9 Sq.Ft.Floor Area V8u 1��000 F$ (9mmeneing with Sudan 7000)of Division 3 of lM Bushousand Professions Cade)ar Net he is exempt therefrom and dte basis for the alleged exemption.Any violadon of Sedan 7031.5 by any applianl for a permit subject dte applkam ID a civil penally of APN Number Occupancy Type ant mom than five hundred dollars(s5W1 31623051 . 00 0 1,as owner of die props ny,or my employees with Mages as their sole usepenpllon, win do the work end theawctme is not intended.roffemd far sale(Sec.7044,Business Required Inspections and Pmfemions Code:The Contractors Licence law does not apply m an owner of q property who builds or impravo t thereon.end wha does such work himself or through his own employees,provided that such improvement on not maradrd oroffemd formic.If, however,the building or Improvement is sold within one year of compledon.the owner. builder will have dte burden of proving that be did an,Wild or Improve far pugose of ark.). ❑I,as Owner of the property,am exclusively contracting with licensed contractors to construct the project(See.7044.Bmioas and Profession Code)The Commotion's Lb cone law does not apply to an owner of propeny.who Wilds or improves(hereon,and who contacts for such Project with a comor mr(s)licensed pursuant W to Convectors 3l -/`- License Law. ❑I on escmpt under See .B&P C gar his reason /J Own, Date /9/ WORKER'S COMPENSATION DECLARATION O 1 hereby dram under penalty of perjury one of the following deelsmtion: 1 ham and will maintain a CeNBate of Conenuo ul6insum for Wmkah Compen- winn.as provided far by SenlOn 3700 of the labor Code.for its perfmmana of the work for which this permit is Issued. ❑1 have and will maintain Workers Compensation Insurance,u required by Section 37W of Na Labor Code,for the performance of the work forwhich this permit is Issued. My Workers Compensation Insumna carrier and Policy number am: Caller. Policy O ERTIFlCA OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Qbls section road not hecompbmed iT the permit is fm one hundred Milan(5100) or lax.) 1 madly that In the performance of ate work for which this permit k Issued.I shall not employ any person in any manner so as On became subject to the Wori eri Compensation Laws of Calilomh.Date Applicant NOTICE TO APPLICANT:If.after making this Ccri ficate of Exemption,you should become subject to the Workers Compensation previsions of be La Wr Cade,you mol ,JO forthwith comply with such provisions or this permit shall W deemed misd e. rte~+ CONSTRUCTION LENDING AGENCY 'rr I hereby affirm that there is a constructinn lending agency for tW performance of fYi> the work for which this permit Is word(Sec.3097,Civ.Cd W�Q Lenders Name c.7 z :enders Address U p 1 cenify that I ham mad Nis application and stem that the above infmmalion Is cancer,I agree to comply with all city and county ordinarms and state laws relating to building convection,and hereby authorize mprnenudva of this city to enter upon the W ahovomcnliuned preperty for inpecdon purposes. 0. (We)agree to ave.Indemnify and keep farmlad,the City of Cupcnino against H h liabilities,judgment,costs and expenses which may in any way accrues agaimlsaid City V rzin" APPLICANToUNDERSTANDSof be gaming of IAtND WILL COMPLY WITH ALL NOWPOINf Issued by: Date SOURCE REGULATIONS. ,S /�► X/�` 10 -10-05- Re-roofs Y Signal..of ApplimdVCon mx%.1 Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dmf applicant or future Wilding Occupant mom or handle hawalous material as darned by Ne Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Coda.Sudan25532(a)7 2/'' All roofs shall be inspected prior to any roofing material being installed. Y Will the applicant or future building occupant use equipment or devices which If a roof Is Installed Without first Obtaining an Inspection,I agree to remove colt hamr❑des J�Ya nus air contaminants as defined by the Bay Area Air Quality Management all new materials for Inspection. District? ❑Yes 177+4 1 hive mad the ho ndmas materials requirementumkr Chapter6.95 fthe Califoo- nia Health&SafciyCodc,Sections25505.25533 and25534.I t rulcmimnd the ifthe Wilding does not emrenlly ham a tenant,that it is my mspensibility ed notify dm occupant of the requimment which must W mel prior to issuance of a Certificate of Occupancy._ Signature of Applicant Date 0-09 All roof coverings to be Class"B"or better Owner ser avlh.aoxal agtot Date ;( OTY OF CUPERTINO �� f C=, arro PERMIT APPLICATION FORM CUPEkTINO N# O�3 /4, 3 O Date:� Building Address: Mailing Address (if different from building address): 10 1 -1 -1 c Owner's Name: Phone#: Contractor: License#: b wp-rrt o 7 3 s 3to D Contact: Phone: 4 o a -8 3L-`l t 8 8 Cupertino Business License#: (.Marr¢vt Fax: L• oH-1$crs2-6 �- Building Pemlit Info: Bldg ® 1 1 Elect ® n Plumb I9 Mtech E& Job Description: qY ^�y .. V- .,)4I — k�l-. r,er 1 kQ �lbn srr�.� a( ww�l_ Yew b✓c Residential EB-( kc . U( - eh r k�vcr Commercial ❑ Sq.Ft. Floor Area: q.Ft.: S s 4-1 Cost of Project:dt2 S, 00(> Occupancy Group: Type of Construction: Please check this box if the project is a 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> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> IM 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 > 1000A ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 i`l 0ITY OF CUPERTINO CUPEIZF PERMIT APPLICATION FORM QuantityFee 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 BNUCOMNT New Conon 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 rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUM31NG 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 cf m MECHANICAL BREMAIRHAN A/C Units<= 10,000 cfin MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BRENIFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood NIECHAMCAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP 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 AMkk BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 •ITY OF CUPERTIN• CITY OF Ef�TINO PERMIT APPLICATION FORM. CUP CUPFee ID Fee Description Fee Group Quantity 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 Insection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary BldgPermit BUILDING BTEMPSVCS Temp Dist Svcs " ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL =PPERAE TFEE Mech Permit Issuance MECHANICAL TFEE Plumbin Permit Issue PLUMBING G Plumbing Fees foot PLUMBING RNGC Plannin LR Comme/Multi-Fam PLANNING RNGR Plannin Lon Ran a Residential PLANNINGCHG Address Change BUILDING • 3of3 CITY OF CUPERTINO >� 1 of 2 PERMIT RECEIPT OPERATOR: kiersaw COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31623051.00 DATE ISSUED. . . . . . . : 10/20/2005 RECEIPT #. . . . . . . . . : 31674 REFERENCE ID # . . . : 05100159 SITE ADDRESS . . . . . : 10177 MYER PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . _ OWNER . . . . . . . . . . . . : SKANDALIS CHARLES W AND ROBERT ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2336 RECEIVED FROM . . . . : WILL WARREN CONTRACTOR . . . . . . . : WARREN HILL . LIC # 27024 COMPANY . . . . . . . . . . : WARREN HILL CONSTRUCTION & ADDRESS . . . . . . . . . . : 999 LAKESHIRE COURT CITY/STATE/ZIP . . . : SAN JOSE, CA 95126 TELEPHONE . . . . . . . . : (408) 836-4988 4RE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL __________ _____________ __________ __________ __________ __________ ---------- VOICE ID DESCRIPTION VOICE ID DESCRIPTION 101 FOUNDATION ==102-== PIERS_______________________ 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL a0s FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL 501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY 503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY 505 FINAL ELECTRICAL 506 GAS TEST 507 FINAL PLUMBING 508 FINAL MECHANICAL 509 FINAL GRADE 510 FINAL PLANNING 514 FINAL PUBLIC WORKS • L4 1 fto 161 is 1 7 - - -------- ------- J J f ol I f CD O L'. C14 (D c) 7 �j 00- IL N -T -------- ---- L 00 .Opp all CUPERJINO Assessor's Parcel Number: Nameofowner. C_,AF S <a aS' S Project address., 0 1 7 -7 M Y P l a Contact person. W a r re Ori\\ Phone. Fax. 4 o A-- 2L t D -5'1s z Net square footage of lot. Existin Proposed Square footage: First floor: Second floor: Garage: TOTAL: • Are there at least two 10 foot by 20 foot clear spaces inside the garage? N Is privacy protection planting required for the project? Y U On what floor(s) is work being done? s d SC o Brief description of work,. 1 b alk v-e" Aa l -- k'016-e �-o 1 .� C�> ba�U rew..,cQ.a ` - !H� etc c JI.o,..eu• � 12 .M . +�- iv01A Sfr�c��.. t wa ,l Code editions:2001 CBC (D N)2001 CFC Y)N)2001 CMC 2001 CPC (Y -14)2001 NEC (r N) Effective 11/1/02 Plan Review Process Work Book Page-B-Revised 4/28/04