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06080098 (2) CITY OF CUPERTINO BUILDINGDIVISION PERMIT xCL1IRACTQRI 'OI2M/�TIO.N :- . BUILDIN ADDRESS: BAGHDASARIAN SYLVIA AND VAOTTO06080098 22757 STEVE OWNER'S NAME: PERMIT ISSUE DATE 13AGHDASARIAN SYLVIA AND VA OUJ ONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECTPLUMB MECH 0 0 0 0 OZ' LICENSED CONTRACTOR'S DECLARATION lob Description W 1 hereby affirm that,1 am liansvd under provide"of Chip.9(onmmcncing P SZ to with Section 7").Mivision3afiheBasin.and ProfeuiuvCod,Mdmylicense I, « inmRfaraandeffeet DEMO SWIMMING POOL FOR SFDWL in? Licenac Clm La.A •F❑ Datc CO-1—too1 ARCHITECTS DECLARATION i e 1 underatand my plans shall be used as public records iau LLH Licensed Professional '03 do,I am exempt fr DECLARATION Canumeo l<S I hereby reaso.(Tent Nal I I.S.exempt(rent the Cavum,Co e:Any Law for the :20 following retina.Permit t TID serL.[Mr. and Pmfde i demolish, Cade:Any city or wanly 5.61. which require a Permit re cnnswc,alxr,ll fm ser,dcmch hrott or repair any suucsum $150 _I„ priarmiu censeci.alw In toithe thovisios;offer Crourarmilx cense Law(Cha mem < IhmheinrinifmdpunuammNcpmviviomofNcConuxandcvetawalCourtt9 Sq.Ft. Floor,Area Valuation ��$ (cat he 13 ing with therefrom 7 and M basis r of lW Business ediumpl Professions Code)or that he u exempt Ihercfmm and Mc basins fa dm alleged campus..Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of r UU Occupancy Type not more Nan Ow hundred dollars(5500). I,as owner of pmpeny,or my employees with wages as their sale eompewdon, 11yy,,rr���' pp will do Na work and the suumure tinotimendedarancred forsale(Sec.7041,Business Re eCtlOns and Professions Code:The Contracxrs License Law does nal apply b an owner of MM a s peopeny who builds or improvesthercon,andwhodueasuch work himself or through his howinvoever.Me building or i provematriarch.tis wrmentsarene ear red!ocm0lfcrM for Match, �} Wilde".Ne building arimprowmving Ma d didnot year of completion,Ne owner- 6n$� builder wiB have Irk burden of proving Nat he did not build m improve(a purpose of �r�� const SCJ ''T MI.as Owner M rite propeny,am uclusively conuazting with licensed mnuacturs to 0(� contract the or (Sec.7044,Buswm,or and.y who Code)The C,item..U. 000 cense raw dues noupplr ban owner of protons who builds or improves thereon,and 6 who contracts for such projects with a antrauor(s)Raved pursuant in the COnuactoh License law. ❑loin uempt under a Bk PCfor this mown ZZAD Owner Imo` .'SCO F97s Date o//1 WOR 'S COMPENSATION OECIARATION e ((�� 1 hereby a1Brm under penalty of perjury one of Mc following dedantiav: ING 1 have and will maintain aCuuftate of Constantin self-insure for WorkcraCompen- crown,as provided for by Section 37M of the labor Code.for the pcfformana of IW work for which this permit is beeml. 1 have and will maintain Wolfer(Compensation Insurance,as required by Serum 3700 of Mm Labor Cone,for Ne performance of este wink for which Nu pe.I,is usued. My Workers Compensate.her.artier and Policy number art: Carie, Policy No.: , CERTIFICATE OF EXEM MON FROM WORKERS' COMPENSATION INSURANCE mrissection Iced Out bccompie¢d if the pconit a foram.hundred talion($IM) or less) 1 wrofv Nat in thC performance of the work for which this Permit is Imurri l shall not employ any person in any manrcrx az o became xbjen la the Workui ComPc.aon Laws of Califamia•D '/ Applicant V NGnCETOAPPUC Nr:If afmr making Nu Cen ricam of Esc ption, ou should become subject to Ne Workers Compensation provisions of Ne Labor Code,you most ,J z foMwith comply with such provisions or this permit shall W deemed mvokcd. z CONSTRUCTION LENDING AGENCY F 1 hcmby affirm that Nue is a construction lending agency for Mm performance of t� Ne work ror which Nis permit is issued(Sec.3097,Civ.C.) W Q Lenders Name 7 z Lender,Address ' U Q 1 certify that I ban mad Nix application and Mutt that the above information is correct.I agree to comply with all city and county ordinances and sera laws relating to �U Wilding consumetion.and hereby authartrz representatives of this city to enter upon the r W above-mentioned properly for inspection purposes. (We)agree to saw,indMou fy and keep harmless the City of Cuper ino against Imbilides.judg...U..osu and..tenses which may in any way..me against said City U in consequence of the gmming of this Permit. '-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 3� SOURCERE LAnZfNS 4/- ,° L' - At��bb Re-roofs Signature 01APPI15tionComrstrun HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Me applicant or future building occupant stow or handle hvarcous material az deRncd by the Cupertino Municipal Code.Chapter 9.13.and Me HaIN and Safety cma.Suction, Eppszss32(a)? All roofs shall be inspected prior to any roofing material being installed. 41 ❑res Will the applicant or future Wilding occupant use equipment or dcvima which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the,Bay Area Air Quality Management all new materials for inspection. District? —/ p Ycs Yom° I hart roaJ the hvarNws materials requimmew under ChaPar h.95 of dm Glifor ..Health&Safety Cone,Sceuav25505.35533md25534.lwdcnwdthvifdm building does not currently have a Innen,that it is my responsibility m notify the aLca,.,of Ne mgaimmcntawni ma met mm1.a m nncLmrmamoraLaP^Ly. Signa tureofApplicant Date 6 owner or authorize gent D,a All roof coverings to be Class 'B"or better OWNER-BUILDER VERIFICATION 1. (Check one) I or my/immediate family (parent,spouse or child) will perform: • A. ✓ All the work authorized by this permit B. _ A portion of the work C. None of the work :If B or C is checked,complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City Phone # State License # Type of work to • 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City Phone Number Type of work to be performed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (reverse side). Property Owner's Signature: V '/I�� /�W��u—� Date: Job Address: 22757 S'AytoKf /L ES �cr/1Gi+�kOCA Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. City of Cupertino Building Department CITY OF 10300 Torre Avenue• C 1 I P E kT I N 0 Phone: (408)777-3228 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself,you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,woikers' compensation insurance,disability insurance costs,and unemployment compensatice contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S. Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, • City of Cupertino t Printed on Recycled Paper Community Development e 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPERTINO Building Department JOB ADDRESS: PERMIT # 2-2--757 sfe i/ek s Clye Alv4 , O O OWNER'S NAME. r u v,i+ PHONE # Sa- 95 Z GENERAL CONTRACTO : FAX # I am not using any subcontractors: Signature bate 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 CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 34212028 . 00 DATE ISSUED. . . . . . . : 08/15/2006 RECEIPT # . . . . . . . . . : 35624 REFERENCE ID # . . . : 06080098 SITE ADDRESS . . . . . : 22757 STEVENS CREEK BLVD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : BAGHDASARIAN SYLVIA AND VAROUJ ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5628 RECEIVED FROM . . . . : VAROUJ BAGHDASARIAN CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : BAGHDASARIAN SYLVIA AND VAROUJ ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5628 TELEPHONE . . . . . . . . : • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - - - - - - - - - - ------------- ---- - - ---- ------- --- -- - - - - - --- --- ------- ---------- BPERMFEE VALUATION 1, 000 . 00 83 . 16 0 . 00 83 . 16 0 . 00 BSEISMICRE VALUATION 150 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- -------- - - -------- -- TOTAL PERMIT 83 . 66 0 . 00 83 . 66 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ---------------- - ------------ ------------------ CHECK 83 . 66 3691 TOTAL RECEIPT 83 . 66 VOICE ID DESCRIPTION VOICE ID DESCRIPTION --704 DEMO • CITY OF CUPERTINO OF �,,/ DEMO a0006`, 6 CUPEkTINO PERMIT APPLICATION FORM ' APN# -3 026 Date: p © 6 Building Address: D 'L -? S s-hoveOs Cre_e� Owner's Name: Phone#: V s. vct LtdaSaY nq6� -� S2?d�83 Contractor: I License #: Contact: 'I / Phone#: Varou -� a kJmorr, �4h Applicant/Contractor: B_ ' ing Permit Info: 1 ect lamb ec Job Description: � Residential: Commercial: Sq.Ft. Floor Area: $/Sq.Ft.: ArchiteWEngineer: Valuation- L/ ov Type of Construction: ' Occupanf3 Group: Qty. if A ]icable Fee ID Fee Description Fee Grou M BPERFEE BldgPermit Fees BUILIDNG BSEISMICOM Seismic Commercial BUU-IDNG BSEISMICRE Seismic Residential BUILIDNG BPLANCHK Plan Check Fee BUILIDNG BUSLIC Business License BUILIDNG S.A.B. Electric, Inc. Billing Statement 4544 Samson Way _ . ._ . Billing To: Varouj Baghdasarian S.an Jose,.CA 95124, _.. -,. _. .._ ._ . . -. . .: . 22757_Stevens.Creek _ d one/Fax;.(408)445-9545 _. .. .-... _. .. ' _. Cupertino, CA 95014 License.#:827990 _._.. .._. . .. . . .. __Phone: (408):996-7662. BILLING DATE 09/12/2006 Invoice No. 229 . PO#: 22757 DATE DETAELS CHARGES PAYMENTS ➢Check Small Electrical Panel located next to Main Electrical Panel outside.b a e wall ➢There is no power in the Small Electrical Panel. All wires gontR out from the Small.Electrical Panel are not connected in any locations.All wires'end in the garage under the Small Electrical Panel Total Materials&Labor: $85.00 $0.00 New Balance: $85.00 F1 I Please pay this amount: $85.00 Customer's Signature Technician's Signature f'r r- t':FJV]ED SEN 1 8 2006 U, Str 1 8 2006