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11020055CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10394 GLENVIEW AVE CONTRACTOR: PAPPAS ELECTRIC PERMIT NO: 11020055 OWNER'S NAME: RICHARD J DENESHA 7377 THAYER CT DATE ISSUED: 02/15/2011 O"-" VER'S PHONE: 4082570542 GILROY, CA 95020 PHONE NO: (408) 846-5204 LICENSED CONTRACTOR'S DECLARATIONF PLUMB License Class CI-10 Lic. # BUILDING PERMIT INFO: BLDG ELECT F F r Contractor IrP��5 , L 6 e7-0` ICDate 2 j 1� MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: PANEL UPGRADE 100AMP TO 200AMP (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $1000 1 have and will maintain Worker's Compensation Insurance, as providedVbySection 3700 of the Labor Code, for the performance of the work for whpermit APN Number: 36911021.00 Occupancy Type: is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above informa correct. I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply the Cupertino Municipal Code, Section 2 with all non-point source regulations per Issued by Date• /-5�- %% 9.18. Signature Date � � r RE-ROOFS: OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain Compensation, as provided for by Section 3700 of the Labor Code, for the compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & performance of the work for which this permit is issued. Safety Code, Section 25532(a) should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance, as provided for by Additionally, should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code, for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Owner o u Tori d t: Compensation laws of California. If, after making this certificate of exemption, I Date: become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued (Sec. 3097, Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter Lender's Address upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION cr and expenses which may accrue against said City in consequence of the L g of this permit. Additionally, the applicant understands and will comply I understand my plans shall be used as public records. wr... all non-point source regulations per the Cupertino Municipal Code, Section 9.18• Licensed Professional Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST J JOB ADDRESS: 1 b 3 `/ Y G le V'/ C w PERMIT # OWNER'S NAME:ck, 0 E,/V 14, PHONE # qej&" — i-5-%'' U 5-'Y.)- -YGENERAL GENERALCONTRACTOR: BUSINESS LICENSE # 7�;-&Va ADDRESS: 7 3 �77 e,, c CITY/ZIPCODE: ��/�� c *Our municipal code requires all businesses working in the city to have a City of Cupertino'business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Pa 0 PC, ale C. 7`v i C - Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date go CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 10394 glenview dr. DATE: 02/15/2011 REVIEWED BY: bobs. UNITS APN: BP#: *VALUATION: 1$1,000 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or DuplexPENTAMATION USE: Amps 1REAP2 PERMIT TYPE: WORK 200 amp service upgrade SCOPE supI?/. 11x 1) I' ' :' APPLIANCE / EQUIP TYPE FEE ID P t _d ,>, f,c,, J; QTY UNITS BP FEES Elec. Permit Fee: IEPERMIT Services 1 ERT<200 Other Elec. Insp.0.0 hrs $42.00 100 Amps $42 1'cr'inji supI?/. 11x 1) I' ' :' PME Unit Fee: $42.00 PME Permit Fee: $42.00 COnt i}'dff`non 1tn Work Without Permit? 0 Yes E) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: IBSEISMICR NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resohition 09-051 E,('. T"I/10) ,1, /1 t o-. P t _d ,>, f,c,, J; Elec. Plan Check 0.0 1 hrs $0.00 F r, Elec. Permit Fee: IEPERMIT sllp17/. P(l, t "L>Y,F Other Elec. Insp.0.0 hrs $42.00 .1�1�x,' ��; 1 .•�_ f'.4 r'-� t<�; , t. ,�., l�.lec. Irtt�� <<..�:. NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resohition 09-051 E,('. T"I/10) FEE QTY/FEET MISC ITEMS Plan t'li c1,(( t�cc. 'A sllp17/. P(l, t "L>Y,F PME Plan Check: $0.00 1'cr'inji supI?/. 11x 1) I' ' :' PME Unit Fee: $42.00 PME Permit Fee: $42.00 COnt i}'dff`non 1tn Work Without Permit? 0 Yes E) No $0.00 Maiming Vcc . Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $127.50 $0.00 TOTAL FEE: ; $127.50 Revised: 01/15/2011 CITY OF CUPERTINO 5 ITEMS OF 6 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36911021.00 DATE ISSUED.......: 02/15/2011 RECEIPT #.........: BS000012716 REFERENCE ID # ...: 11020055 SITE ADDRESS .....: 10394 GLENVIEW AVE SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............: RICHARD J DENESHA ADDRESS . 10394 GLENVIEW AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: DEAN S PAPPAS CONTRACTOR .......: DEAN PAPPAS LIC # 28835 COMPANY ..........: PAPPAS ELECTRIC ADDRESS . 7377 THAYER CT CITY/STATE/ZIP ...: GILROY, CA 95020 TELEPHONE ........: (408) 846-5204 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 1,000.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BELEC200 METERS 1.00 42.00 0.00 42.00 0.00 1BSEISMICR VALUATION 1,000.00 0.50 0.00 0.50 0.00 1EPERMITFE FLAT RATE 1.00 42.00 0.00 42.00 0.00 1TRAVDOC FLAT RATE 1.00 42.00 0.00 42.00 0.00 TOTAL PERMIT ---------- 127.50 ---------- 0.00 ---------- 127.50 ---------- 0.00 VOICE ID DESCRIPTION -------- ---------------------------- 103 UFER 505 FINAL ELECTRICAL VOICE ID DESCRIPTION -------- ---------------------------- 304 ROUGH ELECTRICAL CITY OF //DA CITY OF CUPERTINO GENERAL BUILDING CUPERTINO PERMIT APPLICATION FORM APN # / �02 Date: Building Address: Mailing Address (if different from building address): Are Hazardous Materials being used as part of this project? Yes ❑ No HOA: (Exterior work only) Yes ❑ No W If yes, provide letter from HOA If Residential is house an Eichler? Yes ❑ No [9� If yes, needs planning approval. Owner's Name: Dic-k 0Eli lis �� Phone #: ,., el, -x 5 7-0 5 , Contractor: {� y�/� S L� �� 2/ Phone: �' _ Y� - 77 3 6' �! `'�l �v Fax: 7�.� - 3 Contractor License #: Cupertino Business License #: Contact: �p�s Phone: �/�� - `��-' '7936 Fax/e-mail: Residential Commercial ❑ Job Description:Q vp C ra dL Building Permit Info: Bldg ❑ Elect Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ IUIII B, IV -HT, V -B Valuation: Square Footage: J,/, Project Size: Counter UL Ex ress ❑ Standard ❑ Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.builditgreen.org Revised 12/06/10 Xr, Arl —f