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06080140CITY OF CUPERTINO 9 *I'a A ae&77YM m -max ray'. BUILDING DIVISION PERM s CON"�CTOA�It\L'OLVY1 Ls L -F; BUILDING ADDRESS: D ER CONSTRUCTION INC 1ERMR110.06080140 11002 CANYON VISTA DR OWNER'S NAME: PERMrf ISSUE DATE RANCHO DEEP CLIFF HOA 605 COMMERCIAL NE: SANITARY NO. CONTROL NO. (408)536-0420 ARCHffEUT/ENGINEER: BUILDING PERMITINFO 'BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description 1 hereby street that l am licensed under provisions or Chapter 9 (commencing with Section 7") of Division 3 Of the Business and Professium Cade, and my ticmum is in full fora REMOVE 3 TO 4" OF TILE, FELT & BATS. INSTALL NE and affect. Llcenrc;g- Contractor GIn Dauer -S�—CamDECL ANTI -POUNDING, FELT & BATS. ROOF REPAIR. DECLARATION As shall W ma 1 undersunJ my plans shall bo usad u public ettords Licensed Frofe signal OWNER -BUILDER DECLARATION I hereby of lm that I am exempt from the Camraaars License Law for the following moan. (Section 7831.5, Business and Professions Code: Any City or Caaaly which requires a permit to construct. alar, improve. demolish, or repair any Mature prior at its issuance, also mquima the applicant retrench permit In file aalgned sulamcntFloor Ulexma lww(Chapter 9 Sq. Ft. Area Valuati$d 2 0 8 dual he u licensed PuMnal to the previlm"of the Ca -=WS (commencing with Sudan 7000) N Division 3 of the Buslrcu and Profauona Cast)ar that he is measure therefrom and the basis for the alleged aemptian. My violation of Section 7031.5 by any applicant for a permit subjects the applkW anl a civil penalty of ppb N Occupancy Type 0 not mom than fin hundred dollars (53001 3 5 6 2 8 8 4 r 0 0 ❑ I,uowner Oohs property, or my employees with"gnu their sale compensation, will do the work, no the someone is nal intended moRered Waste (Sao. 7044,1huninut RegU and Professions Code: The DOalraClael License clean ean not apptY u an Dona of peeportywbo Wilds. impearowthereao, and whodoc mehwork hismelfor through his own employee, provided this such improvements; tie notimeMd WaBaecl foraaln N, howenr. the Wilding or improvmmnt 4 told within oro year of eompledoo. the owrce- buil0ee will Nn the barmen of proving dual he did rot Wild or barren far PurWse of An ! ^�� sale.). 1, u awns M the properly. am =elusively contracting with Ilceued antr lemel to construct La the an jea (sec. a an Business and Profuoom Code:) The Conwmoe. nd cove law doe oat apply u m owner of pmpenY who Wilda arimprone thereon. ucl .[ � Jam' BUILDING far such wakN with a amrulor(s) licensed pursuant m the Combecufs whonse Law. 0 l ablaw. ❑tom exempt underSee .Bh PC fm Nis mason Owner Data WORKERS COMPENSATION DECLARATION 1 hereby s0irm under penalty of perjury dare of the following declaraWu: I ban and will msinuin aCerufieote of Cement m self -Wore far Wortefa C—Pmn- sa0on, an provided fm by Section 37M of the labor Code, for dm perfor mann of the ways for which this permit is issued. 1 have and will maintain Weisser Compensation Insurance. an required by Section 3700 of Na LsWr Code, for the performance of the wart, for which this Permit is Instead. My Workers Compeuatian Wun ce cenicr and Polity number set: Carrier: FIPoliry No.:'7I3f�n Lh 1_4/1-. Co •ATIONI NFRA WORKERS' COMPENSATION INSURANCE OMPE ' (Thu rection need not he completed ifd¢ Permit it foram hundred delan($10(0) or less.) I certify that in the performance of the work far which this permit is issued, l shall oat employ any Parma in any etmnerm an he become subject to the Wdrimelf Compensation Laws of califomis. Dam Applicant NOTICE TO APPLICANT: If. after making this onefiate of EOW.Nion, you aAouW become Subject m the Wori Compensation provisions of the Labor Cade, you mol forthwith comply with such pmvisiom m this permit shall be deemed ranked. CONSRUCTION LENDING AGENCY I herby timet that dune its construction {agency for the performance of 3 7. Ch theLe dark fur which dub permit u issued (Sec. 7097. Civ. C.) jLender's Nuns Lender's Add. 1 certify that 1 ban reed this application and sou that the abort information is career. l agree to comply with all city and county ardinarwu and auk laws misting to building construction, and hereby authorim mpresenutivu of this city to enter upon the a ahs-mentiuned property for inspection pwpoees. (We) agree to un, indemnify and temp harmless the City a(Cupcnino againn liabilit e,judgme ms,cosu and espeues which may in my way acme sSam, said City r in consequence of due {ranting of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT ,r /L (r f' Issued by: Date . Mono _ - -� - , Re -roofs Signature of AppBan✓Comrscmr Dau HAZARDOUS MATMALS DISCLOSURE Type of Roof Will the applicant or fumee Wilding oecupmlrtom or lundle hanmou material U dertmd by um Capone. Municipal Code. Chapter 9.11, and area Health sad Sdcly cane. Section 255324)7 ❑Yu Na 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 Will tis applicant a future building aapant ata equipment a devices which cmll huamants ale communanu u defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yrs aN 1 haw read esu huardous materials requirements under Chapter 695 of the Califor. nu He.]" Safety Code, Sodom 25505.25533 and 25534.1 mdereund Nat ifum Wilding deal not currently ban a Ia1Nt, the It is my reapoemblllly, to 0odfy the accepmt of the M ai mastalpriortoismmceofaCemficsteafOccupanry. Signature of Applicant Date All roof coverings to be Class "Bo or better Owner err aamanvxe.�gmnt Data iw 3 of 10 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35628040.00 DATE ISSUED.......: 08/18/2006 RECEIPT #.........: 35684 REFERENCE ID # ...: 06080140 SITE ADDRESS .....: 11002 CANYON VISTA DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OWNER ............: RANCHO DEEP CLIFF HOA ADDRESS ..........: CITY/STATE/ZIP ...: , OPERATOR: amyw COPY # : 1 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 SEE ID UNIT QUANTITY ---------- ------------- ---------- BENERGY PERMIT FEE 115.56 BPERMFEE VALUATION 5,000.00 BSEISMICRE VALUATION 4,208.00 TOTAL PERMIT 0 AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 55.47 ---------- 0.00 ---------- 55.47 ---------- 0.00 115.56 0.00 115.56 0.00 0.50 0.00 0.50 0.00 ---------- 171.53 ---------- 0.00 ---------- ---------- 171.53 0.00 CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM N # I Fee Description Date: 0615ou Building Address: ViS1� Mailing Address (if different from building address): ooatr Boiler <= 100,000 Btu MECHANICAL Owner's Namf: / MD7t Phone #: I Contractor: DrGI r w on krc. License #: 1-1 LP 10 Contact: Phone: g25-313-LAU Cupertino Business License#: I G1Y10 E09l Ci Fax: 21 Building Permit Info: Construction Tax BUILDING Bldg Rr*9WEiN Elect ❑ Plumb ❑ MijhElp Job Description: BUILDING Residential [ Hotel and Motel Commercial ❑ Sq.Ft. Floor Area: Constax— Resi/Mobile Sq.Ft.: Cost of Project: 1 4 �Q a Elec 600V <= IOOOA Occupancy Group: Type of Construction: Elec 600V > 1000A Please check this box if the project is a BELEC200 Elec Svcs 600V <= 200A second -story addition: ❑ o'ect Size: Standard 2�' Large ❑ Major ❑ Energy Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILER1 Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > I OOK 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/ uasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax— Resi/Mobile BUILDING BELEC1000 Elec 600V <= IOOOA 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 . CUPEkTINO 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 BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg 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 rhWerBackflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitcben Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING . BPWATER Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 efm MECHANICAL BREMAIRHAN A/C Units <=10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFDtT Lighting Fixtures ELECTRICAL BREMEURN Relocation of Furnace MECHANICAL BREMEURNOV 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 CUPEkTF PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group 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 Inspection 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 Chane BUILDING • 3 of 3