03090112 (2) CITY OF CUPERTINO .�--
BUILDING DIVISION PIiRMl` 'CONTRACTOR INFORMA N ,
BUILDING ADDRESS: """"03
ERMIT"03 0 9 0112
106C17 10HAN2RN DR
-R'S NAME: PERMIT ISSUE DATE
PHONE. SANITARY NO. 36 Z 2 CONTROL N0,
ARCHMICI7ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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fop LICENSED CONTRACTOR Eeomx of hap
ON
wp 1 hereby arfrm that 1 am licensed enter rnvixmnx nr cnamdo v(<nmmenang Job Description
�z with SCclionA ))nf Division 3 of the❑uviI .andPdo.'inns J yliccnxis
wlrnra n rr<n f,�'�- REVSION--IN HOUSE USE ONLY
License CI Lin.K
-rc Dam cumm<wr NO NEW PERMIT ISSUED/ORIG. #03070079
•S Q ARCHITECT'S DECLARATION
I a understand my plans shall x used as public records
lyU
C G Licensed Professional
OWNER-BUILDER DECLARATION -
.t a E . 1 hereby arfrm that I am emmpl from the Cnmractor's License Law for the
Ho following reason.(Section 703 1.5,Business and Profession Code:Any city or county
i m which rcquias a permit it,construct,alter,improve,demolish,Or repair any strac rre
pnono its issuancc.also requires the applicant for such permit to file a signed statement
azp mat he is licensed pursuant to minme pm.iaOf Coamdmrs License Law(Chapter 9 Sq. Ft. Floor Area Valuatiq�l07
2 - (commencing with Section 7")of Division 3 of the B usiness and Professions Code)or
that he is exempt memfrum and the basis for the alleged cmirgd on.Any violation of
Section 7031.5 by any applicant for a Permitsubject,me,applicant to a civil penalty of 3'AON�"tzrOO
not mom man five hundred dotter= Occupancy Type
-- - -
❑I.as owner of the pmpeny,Or my cmploydss with wages u their sole compensation,
will do me work,and me spot is nal intended or offered for sale(Sec.7044.Busi=a
and rosiest ions
mdocs
ion:Code:The Coactors License Law not apply to an owner of Required Inspections
property who nilds or improves thercun.and who dors such work himwronhrough his 101 — FOUNDATIUN ^.
own employees.provided that such impromemeou;are not intended or offered for sale.If. lO2 — PIERS
however,me building or improvement is sold within one year of completion.Be owner-
builder will have die burden of proving mat he did not build or improve for purposd of 103 - OF ER
01. 104 - REBAR
1,as owner of the property,am eadusiv<ly concocting with licensed contractors to
untrua the project(See.7044,Business and Pro¢ations Code:)The Conmacmr's 13. 105 - ANCHOR BOLTS
cense Law does not apply to an owner of progeny who wilds or improves thereon.and 106 - SEWER & WATER
who eommdt,for such pmjccn with a somata r(s)licensed pursuann,me Contractors
License Law. 202 - UNDERFLOOR PLUMBING
1 am exempt under Sec. .B&PC for this reason
203 - UNDERFLOOR MECHANICAL
Date204 - UNDERFLOOR FRAME
WORKER'S COMPENSATION DECLARATION "'-"-
Ihereby affirmcodes Pcrally ofpedid,moe of inemuowmgd¢amitimis: 205 - UNDERFLOOR INSULATION
Alban and will maintain acanmamoremtsemmselfheard for WortraCompon. 301 — ROUGH PLUMBING
cation,ss provided for by Section 37W of the Labor Code.for she performance of me 302 - TUB. & OR SHOWER
work for which mix pmmil is issued.
❑I have and will maintain Worker's Compcnation Insurance,is required by Section 3 03 - ROUGH MECHANICAL
37W of the lormonsCode.for and gerformance of me work for which mix Permit is caused. 304 - ROUGH ELECTRICAL
My Worker Cor�penstinnmavmntt canter andPolicyna,tymge����v^�- 305 - FRAME
Ca`a SCE IFICADeOFEXEMPI'IOIvWOMWGORKERS' 306 - HOLDOWNS
COMPENSATION INSURANCE 307 - INSULATION
Inmsi)
(This section odea not w completed it the Permit is mound hundred dollars($IQB 308 - SHEETROCK
309 - EXTERIOR LATH
e m ploy mm or me performance mann of sa work ort whim this permit is issued,1 xhau ren
employ 310 - INTERIOR LATH
Laws of California.Dam 311 - SCRATCH COAT
Applicant
NOTICE TO APPLICANT:If,at making this Centrax of Exemption,you should 313 - ROOF NAIL
become subjcn to the Worker's Compensation provisions of the Labor Code,you must
] Z mnhwimcomplywithsuchpmvislonsotthispdrmitshallwdeemedovoked. 501 - FINAL ELECTRICAL ENERGY
z CONSTRUCTION LENDING AGENCY 502 — FINAL PLUMBING ENERGY
I hembyamrm thatthereisaconoucfinn leadingagency fnrshct,crformanmof 503 - FINAL MECHANICAL ENERGY
Z the work but which this pcdmu is issued see.3097,Civ,C.)
4rUnder',Name 504 - FINAL BUILDING ENERGY
Lcndcr'sAddmss
Z)z. 505 — FINAL ELECTRICAL_
1 codify that I have read this application and some that did above information is 506 — GAS TEST
.L Coneet.1 agree to comply with all city and county on inances and stale laws relating to
building construction,and hereby arthoom representatives of this city to enter upon the
�U abmomemomedpmpcny far inspection proposes. FIN PLUeIN
ago,
v<,indemnify and keep harmless me City of Cupertino against FI L
N su andcsperdses which may broad,way accede agai0 i staid City
J z anting of this peropi 5%
1Z
^ STAND AND COMPLY WITH ALL NON-P01 Issued by: Date
S Re-roofs 4 NAL PUBLIC WORK
S' amrc or APPlic UCom Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will theapplicantm future building e.Chaptscoreor handle Health anmaterial
az donned io the 32(a)?nn Municipal Code.Chapter 7.12,ant the Health and Safely
fwd,o er2ss3z(a)? All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or fmurcubuilJing occupant use equipment or obviates which If a roof is installed without first obtaining an inspection,I agree to remove
mit horaNnus air contaminant,as dcfncd by the Bay Area Air Quality Management all new materials for inspection.
District? ��//��
[3 Yea �u
I moo dm<hararJnusmamrialsayviamcnu under Chapmr 695of me Califon
nia Hmhh& tyCode Sccdom 25505.2V33 and 25534.i undcrsmnd ma if me wilding
does ad,/y5dy have a tcnan that it citify responsi hility m nastily the Intupan of me
which am,,, I or sxuadeeoracdNfua urOcdrn Signature of Applicant Date
D �J-
er ser solhonmd or, am All roof coverings to be Class "B" or better
=pePOPA ENGINEERS Inc.
STRUCTURAL ENGINEERING CONSULTANTS
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GOLDEN VALLEY OFFICE CENTER
2542 South Bascom Avenue • Suite 102 • Campbell, California 95008
Phone: (408) 559-4202 • FAX: (408) 559-3628
CITY OF CUPERTINO
Ite 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp : Rng : Sub : Blk: Lot :
APZV . . . . . . . . : 37537065 . 00
DATE ISSUED. . . . . . . : 09/16/2003
RECEIPT 4 . . . . . . . . . : 23160
REFERENCE ID # . . . : 03090112
SITE ADDRESS . . . . . : 10697 JOHANSEN DR
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . :
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : DAVID & JUDY CANO
ADDRESS 10697 JOHANSEN DR
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : IBRAHIM YILMAZ
CONTRACTOR . . . . . . . : LIC #
COMPANY . . . . . . . . . . .
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
• TELEPHONE . . . . . . . . :
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- - - - - - ------- --- --- - - -- - --- - ---
BPLANCKREP HOURS 4 . 00 222 . 00 0 . 00 222 . 00 0 . 00
TOTAL PERMIT 222 . 00 0 . 00 222 . 00 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
-------------- --- ---- -- - - ---- - -- ---- - - -
OTHER 222 . 00 VISA
TOTAL RECEIPT 222 . 00
• C ts�"r�. x'03 0 7(, o 7
S 1 � �ITY OF CUPERTINO
CU CITY OF NO PERMIT APPLICATION FORM b2—
e
APN # 375 - 57 -eq& j Date:
Building Address:
I DroF=-�7 PE Rry NO, CA 9 S 104-
Owner's Name: Phone #:
17aVv4 ,aJDY cAt4G (4o&� 49(0 - 0767
ContractorN. License#,
Contact: Cupertino Business License#:
Building Permit Info:
Bldg E ❑ Plumb ❑ Mech ❑
Job Description:
Residential rg G- Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: Occupancy Group
Type of Construction:
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBLDGFEE Bldg Permits . foot BUILDING
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
BMITIGATC Comm. Housing Mit. Fee BUILDING
Iof3 � � �
OITY OF CUPERTINO
CITY OF PERMIT APPLICATION FORM
CUPEkTINO
Quanti Fee ID Fee Description Fee Group
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL
BNEWMULTI Multifamily Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BNUMULTI New Multifamily Res PLUMBING
BNUSFD New Single Family Res BUILDING
BOVERTDAE Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE" Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 WaterHeater/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 cf n MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
2 of 3
r C IkITY OF CUPERTINO*
On°F PERMIT APPLICATION FORM
CUPERTINO
Quantity Fee ID Fee Description Fee Group
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
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 Swinuning 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 Issuance PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
•
3 of 3
:kKlGiuliani & Kull , Inc. .
San Jose - Oakdale - Auburn
November,2003
Job No. 03285
Ibrahim Yilmaz
IMT Group Builders, Inc.
141 Thyme Avenue
Morgan Hill, CA 95037
Subject:: 10697 Johansen Drive, Cupertino
This letter is to confirm in writing that Giuliani & Kull Inc., provided construction
staking for the property corners located at 10697 Johansen Drive, in the unincorporated
portion of the City of Cupertino. In addition, we also checked the foundation form work in
relation to the property lines. The results of that survey are as follows:
Front building corner: 20.51 feet to property line
Right side building corner: 5.00 feet to property line
Left side building comer: 7.48 feet to property line
Rear building corner: 12.41 feet to property line
If you have any questions please do not hesitate to contact our office.
Sincerely,
GIULIANI & KULL, INC. �SS�ePpIALHF0oG�G
o 'er 'yF<
��� '4- NO 7078
Mark A. Helton, P.E., P.L.S. f,Pi1!
T9T.�or CCN
•
4880 Stevens Creek Blvd., Suite 205 San Jose, CA 95129 (408) 615-4000 Fax (408) 615-4004