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06080150 CITY OF CUPERTINO PERMIT BUILDING DIVISION PERMIT BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT NO.06080150 10913 CANYON VISTA DR OWNER'S NAME: PCItMT[ISSUEOATE RANCHO DEEP CLIFF HOA 605 COMME rTAT. CT O SANITARY N0. CONTROL NO. NE: (408) 536-0420 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH iOC LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby affirm the 1 Am im ewd under provisions,of Chapter 9(corommaing Zwith Section 7000)of Division 5 of the Business aha Professiana Code.and my lice-1 in full fame andCffML REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE i.= Lice nss99,,Clas ContractorLle•g!- 17� em N^x5r0 ANTI-POUNDING, FELT & BATS . ROOF REPAIR. D — ARCHITECTS DECLARATION I understand my plana shall he used As public month s LWanxJ Professional 'y 5 OWNER-BUILDERFo mDECLARATION 1 hereby alum Not I am exempt t from Common'sumr's Lienee Law for the CC following masa^.(Section 7131 Business and Professiaa Calc:Any city of county 5 g E which acquires a permit to eoaus s.a1e6 improve.dam ilah,or upoir any Water m ra Prior or its issuance,a1W requires the applicant far such permit to file asigned summer, Valuatort 2 0 8 -�� Nn he u licensed partasnl to ftpmvislana of the,Commcmrs ucewe Law(Chapm9 Sq.Ft.Floor Area sf$ (commencing with Section IOM)a Division 3 of ft Business anal Pnormiona Code)or Nat he isca mpl Naefmm and the hams for tM alleged sr .ameth Any viOlmfan of Panel'Section 7031.3 by any Applicant for Panel'subjects the epplcant W A civil penalty of r Occupancy Type not mart than five hundred dollar($500). agas ❑L u owner of lie Impanel.army employees with wagesu their ole asopenaatim, r. will do lhework.and the structue in,motlmmnded oranemd fmsale(Sac.70th,Bananas w Required Inspections and Profholona x Code:The Comw/s Lt..Law dos not apply m an owner of Z -!I^ (1 p property who builds orimpmva duman,and who doessuch work MmselforNmugh his �/ awn employees.provided that such improvements are not intmded or oReredfnrsale.if. t 49 however,the building or improvement is old widuA an you of Can Plans.Ne mvmr- builder will haw Ne haa dof proving that Ire did not build a improve(Or purpose of ssre.I. �� ❑1.a owner of tire property am exclusivelyo contracting mch licensed nn uomto r cc.LA rite pmjm(Ste.70th. of and Profeamaw Code:) pr Cmwctan,LI- Genu IAw does sot apply je ts roarer of property,who Wilds or antWws Norton,and, Lwho ine.Law.for such Projects NN•antrororls)Ilcewed Pursuant o rite L'alltrxlar. 0lmme ❑lam escmpt under See .Bk PC for Wes reeWn Owner Dam WORKER'S COMPENSATION DECURA71ON 1 thereby affirm under penalty of perjury ata of Ne following declaration. haw and will maintain a Cerdfiare of Cousentloulf-Insure far Wakr's Comere p "I.,as provided for by Section 57M of die Labor Code,far the performWce of the work for which this permit is issued. OTrave and will maintain Worke's Compenaation Innsmnx,as required by Section 5700 of the Labor Code.for the performance of tM work fm which this Fruit u loved. My worker'.Compemniae Woven a aria and Policy number art: Grtier:,< PolicyNo.:A 713/S71222 t)s - FlCA7E OF^XEMPnON FROM WORKERS' COMPENSATION INSURANCE (rain,section need not W completed if IM Permit Is foram hundred dollar,(SIM) or less.) I certify that In the performance of the work for which this permit is issued.I shall not employ any person in any manner An an in became object w the Worleeri Compensation Laws of California.Dale Applicant NOTICE TO APPLICANT:IL after making this Cenifl are of Exemption.you should bceame subject W Ne WanerY Campanian proni ions of the LAW Coda,you muse foMwiN amply with such provamas a this permit shall be daemon mated. z CONSTRUCTION LENDING AGENCY (—i IMreby.M.Nu arms,I...amroctim lendingagemy for the perfmarman of tan the work far which Nis Permit Is issued(See.3097,Civ,C.) W Q Lender's Name D, Leader'a Md. U Q 1 certify that I have read this application and mare that the above information is U. Hcorrect.1 agree to comply with all city end county ordinances and auk laws relating to U building construction.and hereby aulhorix representatives of Nis city to enter upon the W ah.va-mamit ned property for Impaction purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against tiqliabilities,judgments,costs and expenses which may In my way accrue agalnatsaid City V Z in consequence of the granting of this permit '('(/LA' ^ APPLICANT UNDERSTAN S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date E -` - Re-roofs Signs.of ApplctuaXonuactur Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will NC applieanlor(uuup building attupot Rart or handle hvardaw material ss d fined by the Cupertino Municipal Cade.Chapter 9.13,and the Health and Safety Cade,Section 25552(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes •-L --' Will the applicant or future Wilding acubam iso equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove _malt hmardna air canuminanm u delmd by Ne Bay Area All Quality Management all new materials for inspection. District? ❑Ya — I hew mad the hvudassmamrlalsmquimmentsunder LTapter6.95 afNe Califar me HalNk Safcty Cada,Savo^25505,25557 and 75534.l understand dentition Wilding Joe.not rBat •ren W4 Nu It u mY rcipoosihility w notify 5!r:;2e aceupot of the mmalI emu whleher be 'orwiuusmcefsccmrwgteof Ocapvcy. Signature of Applicant Date � 'S j-� All roof coverings to be Class"B" or better Owner WNorixcJ�fg1J Daw' CITY OF CUPERTINO m 3 of 10 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: B1k: . Lot : APN . . . . . . . . : 35628008 . 00 DATE ISSUED. . . . . . . : 08/18/2006 RECEIPT # . . . . . . . . . : 35685 REFERENCE ID # . . . : 06080150 SITE ADDRESS . . . . . : 10913 CANYON VISTA DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RANCHO DEEP CLIFF HOA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : DRAEGER CONSTRUCTION CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21895 COMPANY . . . . . . . . . . : DRAEGER CONSTRUCTION INC ADDRESS . . . . . . . . . . : 605 COMMERCIAL ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 536-0420 •EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- --- ------- ---------- BENERGY PERMIT FEE 115 . 56 55 . 47 0 . 00 55 . 47 0 . 00 BPERMFEE VALUATION 5, 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00 BSEISMICRE VALUATION 4, 208 . 00 0 . 50 0 . 00 0 . 50 0 . 00 ---------- ---------- ---- ------ ---------- TOTAL PERMIT 171 . 53 0 . 00 171 . 53 0 . 00 • �an CITY OF CUPERTINO 0(M150 CUPEf�TINO PERMIT APPLICATION FORM 1015U3 l�tota �_ -ae —009 N# ate: OS Ig Ol0 Building Address: `/; Mailing Address (if different from building address): loqj3 Tk- Owner's N V Phone#: Contractor: License#: 'DT r pn 1Y-C. CoQU10 Contact; �} Phone:g25'313-Q00 Cupertino Business License#: an 0 ZaO► I a Fax: ZI Building Permit Info: Bldg Er9CQ(JN Elect ❑ Plumb ❑ M h ❑ Job Description: e Residential Er 1('Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: 4 L1 �D Occupancy Group: Type of Construction: D Please check this box if the project is a second-story addition: ❑ o'ect Size: Standard 2'� Laze ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILER1 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 B 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 CITY OF CUPERTINO �. CUPER,TINO PERMIT APPLICATION FORM Quantity Fee 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 BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFI_OW Atmospheric Vacuum PLUMBING BPCESSPOOL cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPIN ERCEP 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 BPSTORMStorm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water HeaterfVent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 din MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace 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 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 2of3 CITY OF CUPERTINO CUPEI�TINO PERMIT.APPLICATION FORM uantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Sips Add Branch ELECTRICAL BREMSIGNS Remodel Sips, 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 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 Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chan e BUILDING • 3 of 3