Loading...
05010043 CITY OF CUPEWFINO _ PEAT .rYn"AF.s a N#_T '.S ACTbRBUILDING DIVISION RINF FOR?'IIK" JON" z �vYa."'[R$d'SZMw, dv'4d6 ` BUILDING ADDRESS: CHARLES SKKANDALIS PERMITNO05E0043 0122 MYRI? PT, NER'S NAME: PERMIT ISSUE DATE CHARLES SKKANDALTS ,1117.12 Il PHONE: SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELELT PLUMB MECH rC20 op LICENSED CONIRACfOR'S DECLARATION £ F 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing e ❑ llon <W with Seelion 7")of Division 3 ofthe Businusand Professions Cmk,and my he...is j = in full mine and errea` REMODEL KITCHEN/WISSTEM Liento Class Lic.r t„p Dam Coronets, ARCHITECrS DECLARATION tau I understand my plans shall W used as publicrecords Ee�U� VI .)IZ(IC PAR I (_1,196 °u.y Licensed Professional 7 g OWNER-BUILDER mDECLARATION 2 a g 1 masa affirm that 1 oro exempt from the Convenor's License Law for the 4 59O following massa permit t 71131.5.Business and PimprOve. a moll Codc:Any city or county m whichitsisesnpermit mconstruct,alter,It forsuch demolLsh,me a&imcdtatemem -Z„ thither its lensed Palwrcgatthe thovisios or for Cont tmitmflc=LaNnammanl EOG that WislittnuJ pursuanuotbe provisi�nsafthc COmnaur's Lima=taw(Chapter Sq. F[. Floor Area Valuation Lt-$ (twoomming with Section 7(1W)of Division3 ofthe Bminesaand Professions Code)or _ that he As aaonpt therefrom and the Buis for the alleged exemption.Any violation of li Section 7831.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fie hundred dollars03 1A&$3I51er0 0 Occupancy Type 1,u owner ofine property,or my cmploycu with wages As their sole co rrouration. will do the work.and the,loomm is not intended or Offered fonale(Sec.IDM,Business and Professiarts ss no Code:The Contractor's License Law dot apply to an divorce of Required Inspections Property who builds or improves themon,and who does such work himselfor through his own employees,provided Nat such improvements are not intended or offered for sale.If. howeler.the building or improvement is said within ane year of completion.Ne owner- builder will have the,burden of proving Nat he did not Wild or improve for purpose of soled. ❑I,as awrcr of the proprity.am caclusively contracting with licensed contmnars to ` construct the project(Sec.7804,Business and Pretensions Cade:)The Contractor's Li ecom Law docs not apply m an owner of property who Wilds or improve themon,and who Contractssfata such projects with a eontmaoKs)licensed pu rams the Commdots I.QI asn Law. crop oder See .Bh PCfor Nis recon - 0 1 l� W00.KER'SCOMPENSATION DECIAR ION I hereby eTo.un@r penalty of pc jury ane or mclollowing declarations: ❑1 haw and will maintain a Cenifcate of Comms to self-insum but WorimesComp rt- sation,As provided for by Section 37W of me tabor Code,for the Omformance of the work for which this permit is issued. ❑I bars and will maintain Workers Compensation Insurance,As requited by Section 37M of the labor Cale,for the Performance ofine work for which this petmil is issued. My Wei Compensation lnsurana envier and Policy number art: Cartier. Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section teed rot W complcmd lane rcounit is forme hundred dollars(SIM) less.) I ceni(v that in the of the work for which this Permit 4 issued,I shall not - employanypersoninany a nerve mtlmomA subject Into,Workers'Compensation Lews of Califs 4ipp}r 117,0 April�.m NorItE]Q APPLICANT:If,after making this Cemfmam of Eacmption,you should br dhjea to the Workcrb Cam pemation provisions of the IsWr Code,you must D forthwi th comply with etch pmvisiam or this permit shall he dcemcd¢mked. ti'O CONSTRUCTION LENDING AGENCY I herebywhich chmi that them is s construction lending agency far to,terfurmancc of the work for which Nu permit is issued(Sec.7897,Civ.CJ 1 Lendcra Namc D z Lenders Address ].7 0 1 certify that 1 have mad this application and slam that Ne above information is / y F CO eel IagcetOcomplyWith altCity and County oNine ansand star laws relating to buiI, J C.) ng Lomwetion,end hereby Authorizemprimotaives of this city to enter upon Ne h amc-mentioned protc costs for inspection purposes. a IWO agree to save,indemnify and keep harmless de City o(Cutenim against ;JzZ inemnsequudgmcn0.cm6and of thismmit. may in any way aauc againsfsaid City in conuquencc of the granting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOUR EREGULATIONS. __ppi tj JA f L) L I U ti Re-roofs St Iitm Of ApplmamJCantrautor Dam a .�h HAZARDOUS MATERIALS DISCLOSURE---7 Type of Roof Will meapplicantmfuture Wildingoompanumre orhandlehar ousmaterial as di by the Cupertino Municipal,Code.Chapter 9,12,and th<`W alth and Safety Code,Section 25532(¢)7 2ND All roofs shall be inspected prior to any roofing material being installed. Ya Will the applicant or future building occupant use equipment ordcvicu which If a roof is installed without first obtaining an inspection,I agree to remove emit hanrdnus air contaminants As dcGned by the Bay Area Air Quality Management District? all new materials for inspection. ❑Yea [! - I have mad the huamdous materials mimmemer.under Chapter 695 ofine Caliror- nia Health dt Safety Code,Secuon,i,lM,25533 aat 25534.1 understand the tribe Wilding docs not currently haw a tenant,that it is my marommility to notify me cumPom or me not, eats whmhmus`he mm or qt issuance ora Cehtifcate of Occup cy. i` CJ t Signature of Applicant Date own raothoriscdagcn D„e All roof coverings to be Class"B” or better CITY OF ClNO zrer�r 0 134 BUILDING DrvlsloN PERMIT CONTRAC�'TURaINFORMATION• y ILDINGADDRESS: CHARLES SKKANDALIS PERMIT NO 05010043 NER'S NAME: PERMIT ISSUE DATE CHARLES ONE: SANITARY N0. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH !oo LICENSED CONTRACTORS DECLARATION O O O O Lw 1 hereby affirm that I.m licensed under provisions of Chapter 9(commencing Job Description `Z� with Se .5 Division Sof NC Brommasand Prufessitms Code.and my license is <a Ldefm" REMODEL KITCHEN/WINDOWS/ELECT. SYSTEM License full force and Lic,p =Fp Da¢ C.mmcter n f r} ARCHITECTS DECLARATION I w 1 ula understand my pns shall W reed as public memda U n e G Licensed P dessimn.l c ,5 OWNER-BUILDER DECLARATION a y I herchy affirm that I am exempt from do Cn ilmetor's License Law for the 00 following mason.(Section 7131.5,Business and Professions Code:Any city or county <$ which¢quirts a permit to consumer.alter,improve,demolish,or repair any svuaure prior to its homine..alsu requires the applicant forsuch p.rmiuo fie a signedsmtement aro that n,islicensed pursuanunNcpmvisiros.111mCmaraauraLicense Law(Chapmr9 Sq. Ft. Floor Area Valuation 2a (commencing with Section 1000)of Division 3 of the Bu.inessand Professions Code)or v $ that he Is exempt therefrom and be,basis for the alleged exemption.Any violation of Section 7031.5 by eM apPliant for.pc.I,subjects the applicant I...ivil crudy of Occu ane TYPeam more man five hundred dmlrs(ssmk 3Y 3p3Uer00 Q I,as owner of the property,or my employees with wages as their olc compensation, will do the work,and the swcsum is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractors License Law docs not apply to an owner of Required Inspections Property whobuilds or improves ftmon.and whodees such work himselfor brought his cur.the building provided that r such improvements are not eroded or neem.for aide.If. owne employees, o e buildingde improvement is old within one Kte o(completion.offered be ownet. builder will hew the burden of proving that he did not build or improve for puryou of QslcI.).w cownepr roof dm(p consbe ocp1ny,em exclusively contracting with licensed contractors,to 04 , Business and Professions Code:)The Convxcor's Li. O cave hw docs not apply m an owner of property who Wilds or improvss durcon,and who conafor such proje Lcs with a contnmor(s)licensed pursuant to the Convector's / Law.w. .m eximp ndla`'r Sec. ,BkPC�for this Sazon WORKER'S COMPENSATION D[CLAR ION I Mmby eRrm under pcnahy of perjury oro of the laWo,declarrumns: 1 have and will maintain a Cenincam of Continua Self-insure for WOrkersCompen- sation,ss provided for by Section 37W of the Labor Cock,for the performance of the work for which this pamrit is iaued. Q 1 have and will maintain Worker's Compensation Insurance,a rcquimd by Section 3700 of the Labor Cod..for me performance of the work for wbieh this permit is issued. My Worker's Compensation Insurance carrier and Policy number am: Cartier: Policy No.: _ CERTIFICATE OF EKEMMON FROM WORKERS' COMPENSATION INSURANCE (Thuaection recd reel beeomplewd if[be permit is fvorc hundred dollars(SIOt1) or less.) 1 Mni(v dot in meof thew k for which this Permit u issued.I shall not mpinyanyperonidany .ro o me subjeel to the Worker;Compensation libinLawsonsond 1e 7�0S NET] E APPLICANT:IL atom making this Cendlefficof of Exemption,on,you should �Ohung bjeet y the Worker s Comas of this provisions ofd a Labor Code,you mum foMwith comply with such provisions or this Permit W tl..mcd revoked. z h CONSTRUCTION LENDING AGENCY I h.rcwh ch affirm that them is s construction d(Sec0 lending agency for performance of Y� be work for which this permit u issued(Sec.Joni Civ.C.) YQ IsndcrName 5 z Lender's Address 1 ..7 Q 1 eenee rem 1 have read this city and c un county o fins that Be above information is Ucoemy Wilda.l ogre to comply with all city sad county oN fives or and abo laws r upon t e Wilding cottoned mxriyhereby author p reprexnusiws of this oily reenter upon the C ahovomentinneents.costa rot dex,nows purposes (We)agme to save,indemnify adl keep harmless the City of Cupcnino against h inconsequne of the cossantl kxpcnusmit. they in any way secret againsfsaid City J z in consequence of be granting of this permit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Sou E EG LATIONS. L t 0 ^ Re-roofs Si sere of Applicam/COmracor Dao a HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant ser future building Occupant store vb and ha ca dotsmaterial fined by the Cupertino Municipal Code,Chapter 9.12,and the Ire and Safely .Section 25532(a)? ❑r.a (yrit All roofs shall be inspected prior to any roofing material being installed. 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 it ha'urdous air contaminants an defined by the Bay Arca Air Quality Management all new materials for inspection. ,.vitt? C]Yes IJ nu 1 have read the,hmardnus materials requiremew under Chapter 6.95 of the Cali foe nia Health A Safety Cmle,Sodov 25515.25533 and 25534.1 understood that ifthe Wilding does not currently have a emnt,that it is my mspansibility In fury IW racupenl or the mqui c9LswhicIf Wmet r isuancco(accruncaoOnOcmp ley. Signature of Applicant L Dale Own rauthorixsdagent Dale All roof coverings to be Class"B" or better C . o vo e N • APPROVED o5 o W17H 7H .CITY tN ACCORDANCF� AND R tN.AP ccl EL CIIpR71N0 C AT iMicrowave SIGNED y 23zs32'wlde ecitications MUST Fridge This set ofan• all times and it is un De kept on In.-Mat mchanges or, alteration4 lawful tom ' I-witten permission from r on same v @m > of Cupertino. r the buildir ,°r s plan The U"", ty Is plan and specrfications SNAII N4411 d to permit oc to be an ®PProval ��olation of any proY1 't enY Mance.oC State�� m in 4"Sheetrock Wall —m F o tall cabinet _-- - - a - a 5. (up to granite) c o v a - _ o-" ata �,N D b' ?QQJr O _ o c m m 71 -17 12 m ,.,,a,�.-..-��:C.-._-.N .-fn-^1�_. N � _. -•-ter'_^��. ._. � D Ea OJ Ul c R{ �q O N e _ moV 2 val —M ' ' u is Q 2 Zi O cv n F I i a y F o p 0� 0 m ao � om m �o £ ao O J o O.F6 3 O ou. d 0 O N N 3 i o m q'4"'.;hpptrmk Wall N , - o � N p m y N N N q Bl-fl m (1... M - 4 O V � cl 00 W � � W � eyg C a N �O S�. Q lD`-� I O N 9 N �,,-at-- r,.-- -.�r10-O=.Sheetrock-Wall-, m ?3 J-4 0 � g 2 ' C�a y A tt� `.x'x�h4�"krlk4a Y-�y• ..ynkF...0'�..� ��k e N - 4• .Oe.\ � c Ito°' 4�. -hpT iw• JeVV�r • ;�a a - - - -- :- Q o o f o o o o o o a0 w. w a' o'o- p C 0 w w • - 3 0 m �° OD c �. ¢In x - _ key p, t . "ted f�d', . ,ei• � �tf 'kv�•` u 0 00 N p s (1 Op ro y o - m 0 1 { : �(H a� V s o m a m 0. o n Ll ..°o 0 m 0 3 o a p n S w c O O 0n v w w d p a �. F - o' sno C00 o rn rn 3 a ° m ° S o 14 �PIC m n af� r r ruS tt a: npiY M�'Alk c3y�5.: (d' �2..w;•_"fib. 11 6 �'� ,r��j�`J�? •ate . . p 5 w a C -0 0 .+ o 6, O Z. 0- cn • o D Ll m c x O o0 o m w ,� O a a 3 m c �. w s 0 3 s G1 N ,w. — w w 3 m (1 O O O <. OD 3 0- oo N > O 3 o0a v O O O J 0 m co r W a r, b ���T4 ✓ "t� P t Y 14 t�lgw` k � Y fi Z.. yn. ni t �` r l PROJEGT LOCATION: < 10177 MYER PLAGE z Q • WHEAT N DR STEVENS GREEK BLVD I PLAN LOCATION MA NOTH SCALE: NONE APPLICABLE CODES O 2001 CALIFORNIA BUILDING CODE O 2001 CALIFORNIA MECHANICAL CODE • O 2001 CALIFORNIA PLUMBING CODE O 2001 GALIFO AL Iff 6 O 2001 NAT RC GOOE O 2001 CALIFORNIA FIRE CODE 1. A.P.N. 316-23-051 2. OGGUPANGY TYPE: R 3. ZONING DESIGNATION - RESIDENTIAL 4. SGOPE OF WORK: GREATE AN OPENING IN A NON 'SHEAR SHEATHED' INTERIOR WALL BETWEEN KITCHEN ! LIVING ROOM Doorway nn ni g for SED aaey� Roberta& Charles SkandalisP4 ° 10177 Myer Place, Cupertino, CA 95014 uy(Nyllbl@ � 0 ��� m�cC 388 Telephone: (408)255.1819 19952 Homestead Road • Cupertino, CA 4 Date: 11/17/04 Tele:(408)257-8500 Te1eF=(408)257-8844 9g 2- CF C (E) LIVING ROOM �---r- Z F(E) KITCHEN O VIEW "B" w � I PLAN. PARTIAL PLAN NORTH SCALE: 1/4' = Y- 0 (E) D L TOP PL TO REMAIN (N) 51MP50N FC4's II II (N) 4x12 OF #2 HEADER " II w/ FC4's, TOP AND BOT " ALL FIN15H TO BE GYPBD 0 MATCH ADJACENT, TYP. (N) 2x4 DF STUD w/ TRIMMER I I II II II II ASE OPENING WITH G/TRIMS TO MATCH REMOVE 2 x 4 STUDS AND BOTTOM " PLATE AT SUBFLOOR (DASHED) DJACENT OPENING'S II II 36' WIDE OPENING - VERIFY II I I (N) 2x4 OF STUD w/ TRIMMER I II II II 0 I O I (E) FLOOR JOISTS AND SILLS `4 *SGALE: REMAIN UNDISTURBED ) SIMPSON FG4's, TYP. " II II FE-ROUTE U 5 REQUIREPLYWD SUBFLOOR REMAIN " II II II OCK SOLID 1 JOIST BAY EAG LI _LI E OF (N) OPENING 2SSTORY GONG FOUNDATION D SILL PL TO REMAIN UNDISTURBED I I , ,P. B. vlEw � SCALE: 1/2- = 1'-0" 2 of 2 DQOr nav OQoni__n�p�far MC Roberta& Charles Skandalis piNE c 10177 Myer Place, Cupertino, CA 95014 SOME 0 A70 � 889 Telephone: (408)255-1819 19952 Homestead Road • Capertino, CA 9601 Dote: 11/17/04 Tele (408)257-8500 Tek Faz.•(408)257-8844 0?q�k124`4,�P f orcNd� a ter CITY OF CUPERTINR o • CUP TYOF NO PERMIT APPLICATION FORM APN # 3( / 3 0� Date: r Building A(� ss: Mailing Address (if d' erent o building address): I o l"t—1 1 lY Pc Owner arae: Phone #: CK-r�rzt�5 SKa,.t� 2• 4o9- Zss Ig l9 Contract ' License#: Dwnev �Uu�l&e.v Cont t: -ReQrA°a, Ph e: Cupertino Business License#: SI Oht- Fa4og-256-1819 Building Perm, fo: Bid Elect Plumb Mech ❑ Jo' escription: j .�J Residential Elo erc al U C/ Sq.Ft. Floor Area: i $/ . O� Cost of Project: / Occ ancy roup: ype of Construction: Please check this box if the prolec is a second-sto addition: ❑ Project Size: Standar ❑ 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> 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> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <--200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 . o vo e N • APPROVED o5 o W17H 7H .CITY tN ACCORDANCF� AND R tN.AP ccl EL CIIpR71N0 C AT iMicrowave SIGNED y 23zs32'wlde ecitications MUST Fridge This set ofan• all times and it is un De kept on In.-Mat mchanges or, alteration4 lawful tom ' I-witten permission from r on same v @m > of Cupertino. r the buildir ,°r s plan The U"", ty Is plan and specrfications SNAII N4411 d to permit oc to be an ®PProval ��olation of any proY1 't enY Mance.oC State�� m in 4"Sheetrock Wall —m F o tall cabinet _-- - - a - a 5. (up to granite) c o v a - _ o-" ata �,N D b' ?QQJr O _ o c m m 71 -17 12 m ,.,,a,�.-..-��:C.-._-.N .-fn-^1�_. N � _. -•-ter'_^��. ._. � D Ea OJ Ul c R{ �q O N e _ moV 2 val —M ' ' u is Q 2 Zi O cv n F I i a y F o p 0� 0 m ao � om m �o £ ao O J o O.F6 3 O ou. d 0 O N N 3 i o m q'4"'.;hpptrmk Wall N , - o � N p m y N N N q Bl-fl m (1... M - 4 O V � cl 00 W � � W � eyg C a N �O S�. Q lD`-� I O N 9 N �,,-at-- r,.-- -.�r10-O=.Sheetrock-Wall-, m ?3 J-4 0 � g 2 ' C�a y A tt� `.x'x�h4�"krlk4a Y-�y• ..ynkF...0'�..� ��k e N - 4• .Oe.\ � c Ito°' 4�. -hpT iw• JeVV�r • ;�a a - - - -- :- Q o o f o o o o o o a0 w. w a' o'o- p C 0 w w • - 3 0 m �° OD c �. ¢In x - _ key p, t . "ted f�d', . ,ei• � �tf 'kv�•` u 0 00 N p s (1 Op ro y o - m 0 1 { : �(H a� V s o m a m 0. o n Ll ..°o 0 m 0 3 o a p n S w c O O 0n v w w d p a �. F - o' sno C00 o rn rn 3 a ° m ° S o 14 �PIC m n af� r r ruS tt a: npiY M�'Alk c3y�5.: (d' �2..w;•_"fib. 11 6 �'� ,r��j�`J�? •ate . . p 5 w a C -0 0 .+ o 6, O Z. 0- cn • o D Ll m c x O o0 o m w ,� O a a 3 m c �. w s 0 3 s G1 N ,w. — w w 3 m (1 O O O <. OD 3 0- oo N > O 3 o0a v O O O J 0 m co r W a r, b ���T4 ✓ "t� P t Y 14 t�lgw` k � Y fi Z.. yn. ni t �` r l PROJEGT LOCATION: < 10177 MYER PLAGE z Q • WHEAT N DR STEVENS GREEK BLVD I PLAN LOCATION MA NOTH SCALE: NONE APPLICABLE CODES O 2001 CALIFORNIA BUILDING CODE O 2001 CALIFORNIA MECHANICAL CODE • O 2001 CALIFORNIA PLUMBING CODE O 2001 GALIFO AL Iff 6 O 2001 NAT RC GOOE O 2001 CALIFORNIA FIRE CODE 1. A.P.N. 316-23-051 2. OGGUPANGY TYPE: R 3. ZONING DESIGNATION - RESIDENTIAL 4. SGOPE OF WORK: GREATE AN OPENING IN A NON 'SHEAR SHEATHED' INTERIOR WALL BETWEEN KITCHEN ! LIVING ROOM Doorway nn ni g for SED aaey� Roberta& Charles SkandalisP4 ° 10177 Myer Place, Cupertino, CA 95014 uy(Nyllbl@ � 0 ��� m�cC 388 Telephone: (408)255.1819 19952 Homestead Road • Cupertino, CA 4 Date: 11/17/04 Tele:(408)257-8500 Te1eF=(408)257-8844 9g 2- CF C (E) LIVING ROOM �---r- Z F(E) KITCHEN O VIEW "B" w � I PLAN. PARTIAL PLAN NORTH SCALE: 1/4' = Y- 0 (E) D L TOP PL TO REMAIN (N) 51MP50N FC4's II II (N) 4x12 OF #2 HEADER " II w/ FC4's, TOP AND BOT " ALL FIN15H TO BE GYPBD 0 MATCH ADJACENT, TYP. (N) 2x4 DF STUD w/ TRIMMER I I II II II II ASE OPENING WITH G/TRIMS TO MATCH REMOVE 2 x 4 STUDS AND BOTTOM " PLATE AT SUBFLOOR (DASHED) DJACENT OPENING'S II II 36' WIDE OPENING - VERIFY II I I (N) 2x4 OF STUD w/ TRIMMER I II II II 0 I O I (E) FLOOR JOISTS AND SILLS `4 *SGALE: REMAIN UNDISTURBED ) SIMPSON FG4's, TYP. " II II FE-ROUTE U 5 REQUIREPLYWD SUBFLOOR REMAIN " II II II OCK SOLID 1 JOIST BAY EAG LI _LI E OF (N) OPENING 2SSTORY GONG FOUNDATION D SILL PL TO REMAIN UNDISTURBED I I , ,P. B. vlEw � SCALE: 1/2- = 1'-0" 2 of 2 DQOr nav OQoni__n�p�far MC Roberta& Charles Skandalis piNE c 10177 Myer Place, Cupertino, CA 95014 SOME 0 A70 � 889 Telephone: (408)255-1819 19952 Homestead Road • Capertino, CA 9601 Dote: 11/17/04 Tele (408)257-8500 Tek Faz.•(408)257-8844 0?q�k124`4,�P f orcNd� a ter CITY OF CUPERTINR o • CUP TYOF NO PERMIT APPLICATION FORM APN # 3( / 3 0� Date: r Building A(� ss: Mailing Address (if d' erent o building address): I o l"t—1 1 lY Pc Owner arae: Phone #: CK-r�rzt�5 SKa,.t� 2• 4o9- Zss Ig l9 Contract ' License#: Dwnev �Uu�l&e.v Cont t: -ReQrA°a, Ph e: Cupertino Business License#: SI Oht- Fa4og-256-1819 Building Perm, fo: Bid Elect Plumb Mech ❑ Jo' escription: j .�J Residential Elo erc al U C/ Sq.Ft. Floor Area: i $/ . O� Cost of Project: / Occ ancy roup: ype of Construction: Please check this box if the prolec is a second-sto addition: ❑ Project Size: Standar ❑ 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> 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> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <--200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3