08020132 CITY OF CUPERTINO fir' d°3*aWst.�tiekvrY- �'*?='
PEMTaFILDIryURM31�T.�'�I7"
*cOtvlswN , N
....p�S`1"f4OMESTEAD RD #114 DRAEGER CONSTRUCTION INC PERMIT 08020132
41rR'S NAME: PERMIT ISSUE DATE
HOMEOWNER' S ASSOCIATION 605 COMMERCIAL ST 02/21/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHI7ECT/FNGINEER: BUILDING PERMIT INFO
RMV/RPLC DMGD RAIL WALL SDNC BLDG ELECT PLUMB MECH
0 0 0 0
roc LICENSEDCONTRACTOWSDECLARATION IobDescription
rd F I Maeby affirm WI 1 am iI and un&r pmvisim of Clupmr 9(commencing ^^"^^ ` —^^"` ^�•^
with Section 7000)ofDivision 3 ofthe Busineaand Prafnsiam Code,and my lwertte is
z
Z in full floe and cI(tt
License Cim Lie.Y '
Dem Corot EKAR_ g�p.�s��,� «�•
RCNrtECI'S DECLARAWO�—
y i undentsnJ my plans doll he amid a public records
��U
g sed Licensed Professional
5 OWNER-BUILDER DECLARATION
Z I hereby aiTinn that I am ucimpi from the Conuanoes License law for the
i.
00 following moon.(Section 7G3 1.5,Business and Profossion Code:Any city or county
3 9 which requires•permit to onrtaYreL alter,impmw,denoolbh,m repair any s asctum
prior at its issuance,also requires the applicant forsuch permit to file a signed statement
< the he is licensed puauam to the pmadomaf the Contractor.umuse Law(Chapter 9 Sq.Ft. Floor Area Valuation
sig (commencing with Sermon 7000)of Division 3 afthe Businessad Pmfcssinn Code)or .
^ dot he is exempt therefrom and the buss for Vte alleged exemption.Any violation of
SecVon 7031.5 by any appnwnt for.permit subjects the applicant to a civil penally of APN Number Occupancy , e
mat mom than Ow hundred dollars(M). P y `Tryl P
1,as owner of Ve property,m my employes with wigs u theirsole compenmma.
willdo th vork,and the location Isnmimented at offered flatus(See.704q Business
and Prat aion Cade The Canasmrs Liwme law dam act apply as an owner of Required Inspections
prop aywho build,orimpoism thereon,and whodoessach workhimselfor through his
own employes,provided that such Improvements;me not intended oroRnad fm We.1f.
however,the building or Improvement i,sold within ane year of completion.the owner-
builder will have Ne hurdrn of proving that he did rot WI4 ar improve for purpose of
ale.).
❑1.as awrcr of the property am eulusively contracting with licensed conu¢mn m
wntrum the pmjed(Sec.7044,Business and Profession Cade:)M Colossuses U.
Mme law don not apply an an owner of property who builds or improv Nemon,and.
who wntruu for such projects with a wnuaemr(s)Boosted parent in the Commences
License law,
❑lam,crept undo Set ,B&PCfarNiamaon
nr Data
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ism of doe following doelruiorm
O lWwand willmunuine Cernfiwu of Consenua self-Ware farwarker,Compcn- -
sedan.as provided fur by Science 37100 of the labs Code,fm the performance of the
work for which out Permit is issued.
0 1 have ad will nes maul Wo laces Compensation I.,u immure by Section
3700 oftic labor Cade,fm the performance close wart fm which this permit is issued. '
My Workees ompwwen/1��zi�Y�l1matereus1ce camierand Polignumbera♦tme.:�, /s
Grtier. OlI'�I V✓ Polity No.:�l k)G f 21 / %o l
CERTIFICATE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
(Tills sepia cared motbeeamplemd If the Permit is fmaae hundmddo0an(5100)
or less)
I cc dfy W.in the perfmasem of the..,it for which this Pemmit is issued,l shall sat
employ any pecan in ay normal an as to became abject to Vie Workers'Campenadon
Lam of California.Data
Applicant
NOTICE TO APPLICANT:If.after making Nis Gnifiwu of Exemption,you should
become subject as the Wolter,Component previsions of the Labor Cede.you mut
,J O forthwith comply with such Provision or Nu permit shall be domed invoked.
? v'" CONSTRUCTION LENDING AGENCY
►)•" Ihereb aB)rm Vast then b a wnunetia lending. for die Y g Fm3' performance of
Dt ,7 the work for which this permit Is laced(Sm.3077,Civ.C.)
W 0 Lcndch Nrnc
.a7. Z Lenders Address '
L)0 I testify that 1 have rend this application W fast,the the allow infomssdua is
I2.r•^ correct 1 agree as comply with all city and county ordinances and slow In"misting to
-0`SJ' building conwmtion.and hammy mobrrine repreanutim of this city in awe upon the
W shove-mentioned PmN for inspection Purpolm
(We tee m a ,indemnify and keep hrmlw the City of Cupertino gain.
y liabilities, d nu,c and expenmia which may in ay way erne against said City
V Z In comma a the ting of this permit.
w. APPLIC D NO AND WILL COMPLY WITH ALL NON-POINT
SOU Issued by: Date
Re-roofs
gnu APp cant/ mRZDOmU MATERIALS DISCLOSURE Data Type of Roof
Will thcappli for(alt uildingaecupanUmremhandle heamous mawrial -
OusOned by the Cu 'cipal Cade.Chapter 9.12.and the Health and Suety -
Section25532(an All roofs shall be inspected prior to any roofing material being installed.
❑Yat PNa
Will the applicant or future building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
,milt haiaamus air contaminants a dchned by the Bay Arta Air Quality Management all new materials for inspection.
Desai.
❑Yat DYIa
Ihs althe muerials mquimmemb under Cluprm5.95 ofilm Califon
raw Health nyC ,Section25505,75533 and 25534.1 undcnwd distillate bolding
doctor ac.c ht aW=k Wt1.wmy=Wmibllitymnodfythe=upatofthe
mquiremcn h est metpriormivuanceafaCmif�te2 C Signature of Applicant Date
ser ath a Date All roof coverings to be Class"B"or better
CITY OF CUPERTINO
ITEM 8 OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32659999 .114
DATE ISSUED. . . . . . . : 02/21/2008
RECEIPT #. . . . . . . . . : BS000004000
REFERENCE ID # . . . : 08020132
SITE ADDRESS . . . . . : 22330 HOMESTEAD RD #114
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HOMEOWNER'S ASSOCIATION
ADDRESS . . . . . . . . . . : 444 FIRST ST #1
CITY/STATE/ZIP . . . : LOS ALTOS, CA 94022
RECEIVED FROM . . . . : DRAEGER CONSTRUCT
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
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1DECKRAIL EACH 1. 00 . 428 . 00 0. 00 428.00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 428'.00 0. 00 428 . 00 0. 00
ID o
CITY OF CUPERTINO
ZV
• CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
Building Address:
22330 H0Mj55rj&40 ao Ustr 114
Mailing Address (if different from building address):
Owner's Name: Phone#:
140m"ulfc—rs Assocw-na �j. POMw1c, P"I Wa( o- q17- 9911
Contractor: Phone: OeS _ *36-ow2.0
A2L1t UV-2,"L U04MIt-c1c11aJ jkjL Fax: Y06 - 5-36 -0YZ5
Contractor License#: (pI 16 10
• Cupertino Business License #:
Contact: Phone: q0S. .- Zoq -S(ay4
L-00 t4rc nla.)he,- Fax: 405 - 5S6- 0+7-5
Residential Commercial
Job Description: 12eHpvElQIGPIF>fc� 0APjA(0K-!2 7z41L- UjAtA,
StDlj(1 A^» 'f-fu"�atT�� r�efd � �e4^� tE Srilbs.
uIIKt� X02 L1k,� .
Building Permit Info:
BldgZ Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-lHR ❑ 11, 111, 1V V-N V�
Valuation: a Square Footage:
300
• Project Size: Standard Large ❑ Major ❑
CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BTEMPPER Temporary Building Permit(good for B
30 days)
1 BBOILERI For the installation or relocation of ea M .
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h 29.3kw
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption ss over 100,000 Btu/h
1BBOILER3 Installation/relocation ofea M
boiler/compressor over 15 horsepower
to & inel 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
IBBOILER4 Installation/relocation ofea M
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1 BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
IELECINSP Other Electrical Inspections (per hour) E
1MECHINSP Other Mechanical Inspections (per M
hour) •
1PLMBINSP Other Plumbing& Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
• CUPEI�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
IFENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1FLAGPOL>20 Flag pole (over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1PILEDRN Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group ]GENRES or
l GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
IRETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
1RETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1 SIDEST/BK Siding, Stone &Brick Veneer B
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
ISKYL<10 SF Skylight less than 10 sf B
ISKYL>IOSF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ca addt'1 B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
cam, l e a2 L_�
4 of 5
a
CITY OF CUPERTINO
CUPEf� GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 WINREP Replacement windows/sliding glass B
door ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
IEPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P
I STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
IBSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
IBUSLIC Business License B
5 of 5
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
l UPERTINO
Building De artment
JOB ADDRESS: #-- PERMIT #
Z O oM sav w-o . I I j)S026( ?
OWNER'S NAME: PHONE # 405 -5316 -0 't7,0
GENERAL CONTRACTOR: bX4i (j r-WIJ;• [- FAX # 40 b - 53 6 -0't ZS
I am not using any subcontractors-. -2, -2-1 -C &
Si a Date
Please check applicable subcontractors and corn a 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
0 V 4. 'Z-21-0
er/Con c or ignature Date