08020135 CITY OF CUPERTINO sex 3xf4F .a ' ' '"`�
BI)ILDINO-BIVISION PEBNIIT �^yCOIVTR`t�I.CTQR 4NF`'QA � N
Y"i.#°moi':'s n �ar3,'.ev�°4 €aeFs s '�t:zz n-�,.E. i'r.•,
em1,plNq.Sppa HOMESTEAD RD #208 DRAEGER CONSTRUCTION INC P NO.0800135
LEWS.SNAAMUE: PERMIT ISSUE DATE '
HOMEOWNER' S ASSOCIATION 605 COMMERCIAL ST 02/21/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RMV/RPLC LIKE4LIKE, BLDG e1Fcr PLUMB MECH
uoo LICENSED CONTRACTORS DECLARATION V .-..}qb Description
1 hereby am=Nat I am licenced under provisional of Chapter 9(commencing ^'' ^-^• ^••^^ ^^^^^
_ug with Section 70410)of Division 7 of the Business end Professions Code,end my liters,is
<� in full forte and ell I
gZ_ License Class Lld.
Dew Conl�mr
y�
ARCHITECTS DE ILARATI N
�q I undersand my plans shall be=4 ss public imma
DyU ,
y �n
Lie
used Pmfcmioml
3 OWNER-BUILDER DECLARATION
a� I hereby afrnn that I em campt from dm Conlrano'S Lbscmm Lew for the
E O O following Mean.(Station 707 1.5,Bushes,and Pmfesslons Cade:Any city or county
which requires a permit in contract,dum.Improve.Mmnlish.or miter my swmere
z a print W its Maurice,AIM requiMs ide Applicant rarmeh Permit to file a signed mini
that he is licensed puauam In the Pmvidons of the Conuaaar's Limac Law(Chapr 9 Sq.Ft. Floor Area Valuation
4 (content Business an
encing with Section 7000)ofDivision 7 of the Business Profwians Code)or
$ Net he 4emmpt themfmm end tie basis for the Alleged exemption.Any.violation of
Section 70715 by My applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
Ann mom dun five hundred dollars(1500).
❑1,u owner of the property.in my employees with maga As mile sok cumpewda.
will do the work.and she Muctue 4 not intended or offered for We(Sec.7014,Bushels Required Inspections
end Profession.Cade:The Canueciar's License Law does trot apply m so owns,of 9 p
property who buil ds or i mpmws Nercon,end who da.such work Mnmelf or through his
awn employees.provided that inch Improvements an not intended ora0emd fon de.If.
however.the Wilding ar Impmrr
vemn 4 mid within one year of completion.the owtter-
Wilder .will haw the burden of proving Nat he did net ddld or improve for pmpw of
Ale.).
❑I,as awnu of she property,w exclusively,contracting with licensed mnuaews in
convect Ne project(Sec.7044,Business and Professions Cade:)The Cominsime4 V-
cense Law dons not apply man owns'of property who builds or improves distant.ad
who contracts fat such projects with a conuacmr(t)licensed Pentam to Be Coronations
Lkeme Law.
❑lareemplundesSen .BdPCrwthiareamn
nv Dare
WORKER'S COMPENSATION DECLARATION
1 hereby affnu under pandly or perjury ant of the following declarations:
❑I have and will malmin a Certificate of Canssm la self-imam fur WorteY.Campen-
swan,A provided for by Section 3700 of the labor Code.for the performmme of the
wort for which this permit is issued.
❑1 haw and will maintain Workces Compensation Inmnace,as required by Session
7700 of th,Labor Code,far dm performance of Ne wart fwwbich Nis permit 4 Issued. '
My Worker'1Co�mpa may coria end Policy number ate: O
Cartier: `� ` `7 a•J Polity No.: W 7
CERTIFICATE OF ID EMP TON FROM WORKERS'
COMPENSATION INSURANCE
r7h4Acltan wed at uncompleted lithe permit 1s fwaMWnded dollar($100) '
M tail
1 certify that in the performance of use.,it fon which this pertnh 4 4smd,I shall am
employ any person in my manrcrm As An become subject to the Worlcn'Comparomon
Law.of California.Dam
Applicant
NOTICE TO APPLICANT:If,alter making this;Certificate of Exemption,you should
become subject in the Wohee's Compensation provisions of the Labor Coda you mum
.JO forthwith comply with such provisions w 04 permit Mail he doro
med oked.
'E`� CONSTRUCTION LENDING AGENCY
[-+� I hereby affirm that Nene is a construction lending agency fon dee performance:of
CL tW work for which Nis permit 4 issued(Sec.10)7,Civ.C.)
WMA IsndeYs Neon
z Lcndrea Add.
U O I certify that 1 haw f all this appliatiost and some that the above information 4
ly ^ cones.I agree m comply with all city And county pMnenms and ma,lam mladng m
.O IS.'! buildingconstruction,and hereby auNadze representatives of this city to cuter upon the
rbl ,bow-roationrcd PmPeny forinspection Porpmea
C WE
and keep hannlw the Cily of Cupertino ageinsl
liabilitieswhichtheyinanywysaraagdnstsaiOClty
z in conprnnit.APPLID WILL COMPLY WITH ALL NON-POINT Issued by: Datesou
2/1` (74 d Re-roofs
gam of IranUC R US ATERIALS DISCLOSURE Dad Type of Roof
Wlil tic applicantwf (ding oaupmtstore Or bad].hamdaus ma¢rid
dolims by Om Cupenirw I Code.Chapter 9.12.and the Health and Safely
.Section 25512(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ya yf(
f Will the applicant or future building occupant ux equipment or devices,which If a roof is installed without first obtaining an inspection,.I agree to remove
emit harsrdnw air contaminants as de0ned by the Bay Arta Air Quality Management all new materials for inspection.
Disuict7
Oyer
I haw maul the oes materiAls requirtmem under Chpw 6.95afthc Califon
ria Health Sdctyc Sathm25505,253J7andM5M.1undeatsnd Nmifdsebdtding
dos not c n he ten than it 4 my res ximihlluy m ratify the occupant of the
require w h tprimmissuanccor.certi6rauor omi3O Signature of Applicant Date
r mlhwned agent 2 DAM All roof coverings to be Class"B"or better
• CITY OF CUPERTINO
ITEM 6 OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: B1k: Lot;
APN . . . . . . . . : 32'659999 .208A
DATE ISSUED. . . . . . . : 02/21/2008
RECEIPT # . . . . . . . . . : BS000004000
REFERENCE ID # . . . : 08020135
SITE ADDRESS 22330 HOMESTEAD RD #208
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
---------- ------------- ---------- ---------- ---------- ---------- ---------
1DECKWOOD EACH 1. 00 428. 00' 0. 00 428 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 428.00 0. 00 428 . 00 0. 00
•
MA 0( 24 s
CITY OF CUPERTINO
• CUPE TING
R. GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
2 Z( -o
Building Address:
2233 n 4 r> 0
Mailing Address (if different from building address):
Owner's Name: Phone#:
I ' po�l�alc. PR-a*fEtTr �'Ia•Ja6 r.
r�oMps;oUJ0 .Z1: /as'SoGnrioJ (2ti0_ 917-951 (
Contractor: Phone: 4()?, ,5 3 t, -o 4Z O
4r=(0 -z- �,t�Uir�c.TcvJ IJ v Fax: 4C) LS. -33 (f - 047-5
Contractor License#:
• Cupertino Business License#:
Contact: Phone: �c��j _'Zp q _ C 6 If If
L-0J j&J.0 rZ-Z Fax: O -773 h- `l Z
Residential Commercial
Job Description: Q�r7 olllE� ��p�qG� L1 1✓Ib �� L I C
• S19IJ({ nta';P I-R-IM VAIL- C.--&W .
e n A h 40 lrc'� S JoP07 l r2
I Js-ra �� rr� SJ�,ST✓tca r(� Co x1414 F��sH t J s
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR E] 11, 111, V-lHR ❑ 11, 111, 1V V-N �1 J(
Valuation: Square Footage:
o�
• Project Size: Standard Large ❑ Ma'or ❑
CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1 GENCOM
1BTEMPPER Temporary Building Permit (good for B
30 days)
1BBOILERI 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
IBBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl IS horsepower, or ea
absorption ss over 100,000 Btu/h
IBBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea •
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
1BBOILER4 Installation/relocation of ea 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
IBBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
IBAPPLOTH 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) •
IPLMBINSP Other Plumbing & Gas Inspections P
(per hour
1MEETINGIHR Application Meeting B
antm' 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
1ACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1 CHEVMYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1FENCEMAS>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
CUPEI�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group ]GENRES or
1 GENCOM
RETAINING
WALUCONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 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
1 SKYL<l0 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l 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 so B
additional stucco application
Of AedA_
4 of
CITY OF CUPERTINO
CUPERTINO GENERAL BUILDING APPLICATION
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES 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
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M
1PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check(when no E/M/P) B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
1BSEISMIC0 Seismic Commercial B
1TRAVDOC Travel &-Documentation B
1BUSLIC Business License B
•
5 of 5
Community Development
10300 Torre Avenue
J Cupertino CA 95014
Telephone(408)777-3228
1' IOCITY CRjj'N0 Fax(408)777-3333
IJrC I�1
Building De artment
JOB ADDRESS: PERMIT #
=30 kf0►1tr-s'-rr-A.0 V-069 ZO v o-Z 0�3_f_
OWNER'S NAME: M OUPJ 1L PHONE # 40'9 -, 3 6-O Z
GENERAL CONTRACTOR 2-,-'%.G(p r,-b nl r t#J U FAX # O iS - 53 6 —0 Y 7,5,-
I
I am not using any subcontractors: 2--7,1-os
Signa Date
Please check applicable subcontractors and com let e owin 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
Til
LA 44
er ontr ignature Date