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CITY OF CUPERTINO�!
BUILDING DIVISION PERMIT
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' nNTRACTORINFORMATION '
wa._,,`%::,Ar.•,,...e.°.�,. •w&`k 3. tAi, r`^ eh u -Y<
PFAMITN°.06080148
BUILDING ADDRESS:
DRAEGER CONSTRUCTION INC
11023 CANYON VISTA D2-
OWNEWS NAME:
PERMIT ISSUE DATE
RANCHO DEEP CLIFF HOA
605 COMMERCIAL
NE:
SANITARY N0. CONTROL N0.
(408)536-0420
ARCNITECr/EN0INEER:
BUILDING PERMIT INFO
BLDG ELECTO PLUMO MO
LICENSED CONTRACT'OR'S DECLARATION
Job Description
hereby affirm that I am thousand onlar provLd.m of Capter 9 (commencing
with Section TOM) of DiAsion 3 of the Bummood Prefmakns Code, and my license is
in full fame Ind affect.
REMOVE 3 TO 4" OF TILE, FELT & BATS. INSTALL NE
o0- ;en —c Nr
ANTI -POUNDING, FELT & BATS. ROOF REPAIR.
ARCHITECTS DECLARATION
1 understand my plans mall W used as public maria
Licensed Prafenla0ai
OWNER -BUILDER DECLARATION
1 amby anirm that I em exempt Isom the Convectors License Law for the
fallowing moron. (Sayan 7031.5, Business and Profemons Code: My city or aunty
.
which requires a permit to common, slie, hopmw. demmlmh. or repair any svuctum
prior w he issuance, also (equims IW applicant forwah Permit o file a signed comment
Liam! Law(Chapter9
SQ. f'[. F100[Alea
Valuati�14 2 0 8
that he is licensed prmuentto the preASI-ns of the Commerce'
(commendng with Secvon 70001nf Oivulon7 n(thc Busmen xM Proleuiam Codc)or
that he is tempt thcmfmm and the bull for the alleged exemption. Any vloladon of
Number
Occupancy Type
Section 7031.5 by any sppllant for a permit objects the aPPlkat M a civil Penslty of
not mom Nan Bw hundred mllan (3500).
R,5 yyppN
3 .D b 28041.00
wi L u owns of 1W property, m with wages tai( com.emam.,
Required Inspections
q p
Is r eco. 111
will do On worit.cion
of
trawrs License Law dose not apply lf an owner of
.d. nmmuml, tam'intended., Lkanerea s Act apply to -0 0.00,
and Pro(esslons Cade: Ta
progenywW WTMs ns lfm Waugh his
amasuchwded
i ed that sutirzreom,andwW
awn oro intense. IL
poashimprowmauerenotIntendedmphomn.ffered
bonen. the building m unprovement 4 told wlNk one year of ampkdon. the awner-
m.th building
I ���
bullmr will arc the burden of proving that he did mat Wild m improve far purpose of
eek.).
❑ 1, as owner of the property, w sxelusinly coaaacting with licensed WhImm om to
Code:) The Conemrs Li-
the (Sec. 7044. Business and Pmfesamu m
j a]
� rsi'I but
construct project
cense Law deal not apply to an owner of property who Wilds or impmva thereon. and,
' J t�
who coned for such pmjea0 with a conmstor(s) Ronald pursuant to the Con raemr'm
lam sereno, undm Sa ,
1wwr Law.
BUILDING
0 DaBkPCfmthisreuon
Owns( u
N
WOR KBRS COMPENSATION DECLARA770N
I hereby affirm under penalty of perjury, one of lW following declaaaum:
and will mainum a Cutifiai of COMA, to self-insum far Workers Compen-
sation, as provided for by Section 3700 of Ne Labor Cade, for to Perfomanm of the
woh for which this permit is issued.
1 haw, and will maintain Workers COMI.MLIM Inmratice, Is reyvired by Section
37W of the Labor Code. for the performance of the work for which that permit is blued.
My Workers Compenavon lmua artier and Paltry number are:
Carrier.,_%- ..tA,r��
CERTIFl N FltAN WORKERS'
O E%TION
COMPENSATION INSURANCE
CO I
'
(Thu inion mea noted completed if the permit is forone hundred dollar, ($100)
or las.)
'
1 cenify that in the perfarmenee of the work for which this permit Is blood, ) mall not
employ any person In my mater an as an become subject to W Wohcm' Compensation
Laws of Califarnh. Dal.
Applicant
NOTICE TO APPLICANT: If, after making 036 Certificate of Exemption. you should
become subject rc the Workers Compcnation proisiam of fee Labor Code, you must
forthwith amply with such previsions or this permit shall W deemed rented.
i
CONSTRUCTION LENDING AGENCY
I hereby affirm Nat Nem Is construction lending agemy for the performance of
s
' work far which this permit b issued (Sec. 7(197. Civ. C.)
Le Name
-
I<nmrs Aaere.
I..&?,
j I cenify that I ban read this almilmsun and sum that the aeon Information Is
' comct. 1 agree to comply with all city and county ordinances and mm laws relating to
Wilding construction, and hereby authorise mpmsenutins or this city to cnmr upon the
ahovc-mcntiuned pmpcny for inspection purposes -
(We) agree to an, indemnify and keep hernia. the City of Cgrcnina !gains,
j Iiahlliaa.Judgmcnm,cosb dna mpemm which rosy In any way accrec against ala City
' in consequence of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date - -az
sON
Re -roofs
Type of Roof
:�'5� -21-6C,
Dau
Signatum ofAirplicamlConittemor
HAZARDOUS MATERIALS DISCLOSURE
Will sae appliam m future Wilding aavpantstore mandle haaardous rudmial
u defined by the Cupertino Municipal Code. Chapter 9.11, and Use Health and Safety
Cam. Secti..15531(a>7
All roofs shall be inspected prior to any roofing material being installed.
[:3 Y. Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will Na applicant or future building Occupant use equipment or mvicea which
MAIL hmudous air contaminants to de0(md by Ne Bay Area Air Quality Management
all new materials for inspection.
District?
0 y $Nff—
I ban mad the intentions materials requirements under Chapter 6.95 of the Califor.
nil Heal" Safety Cam, Sections 15505,25533 and 15534,1 undem sed that if go Wilding
does net CuR.ndy Ilan I nab Mat It Y my Impam ldllty to eadfy the maga, of the
requimme him. ,b melpnarwi.amleaaraeerdneamafOccupancy.
Signature of Applicant Date
- 1 -O(n
�- '
All roof coverings to be Class "B" or better
Ownerw euNo agent Date
VF 1 of 10
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 35628041.00
DATE ISSUED........: 08/18/2006
RECEIPT #.........: 35685
REFERENCE ID # •.. 06080148
SITE ADDRESS .....: 11023 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
(WCOF
CITY OF CUPERTINO agoec lqg
PERMIT APPLICATION FORM
N#
-
I Date:
1 0B 18 O
Building Address: Mailing Address (if different from building address):
ViStn
110,93 Tk—
Owner's Ne:
Phone #:
BBOILERI
6G
Contractor:
License #:
Urq rn 1rc.
Conwo
Contact: Phone: 825'313-0100
I a�Ol 1 A Fax:
Cupertino Business License#:
ZI
Building Permit Info:
Bldg Er'RCOfi Elect ❑ Plumb ❑ M h ❑
Job Description: Ve,
Residential [Er Y'Commercial ❑
Sq.Ft. Floor Area:
Sq.Ft.:
Cost of Project: 11�4 �Q
D
Occupancy Group:
Type of Construction:
Please check this box if the project is a
BCONSTAX
second -story addition: ❑
o'ect Size: Standard Laze ❑ Major ❑
BCONSTAXBQ
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 > IM to 1.75 M Btu
MECHANICAL
BBOILER5
Boiler > 1.75M Btu
MECHANICAL
BCONSTAX
Construction Tax
BUILDING
BCONSTAX
Ind/OfFComm/ uasi
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
CUPEkTINO
(Wl'
CITY OF CUPERTINO
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
as 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 rinklerBackflo
PLUMBING
BPSTORM
Storm/Rain Water
PLUMBING
BPTRAP
Kitchen 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 cfm
MECHANICAL
BREMAMIAN
A/C Units <= 10,000 cfm
MECHANICAL
BREMAPPLI
Appliance Install
MECHANICAL
BREMBUSWAY
Remodel Busways
ELECTRICAL
BREMFIXT
Lighting Fixtures
ELECTRICAL
BREWURN
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
CUPEf�F 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
W111k]