08020137 CITY OF CUPERTINO
BUILDING DIVISION PERMIT .. CONTRAC" (TRINE�f}IZNIAZ�IO
PERMIT NO.
BuaplldciApga HOMESTEAD RD #213 DRAEGER CONSTRUCTION INC 08020137 ,
LRL'S.5NA5MUE: PERMIT ISSUE DATE
HOMEOWNER' S ASSOCIATION 605 COMMERCIAL ST 02/21/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHTTECTIENGINEER: BUILDING PERMIT INFO
RMV/RPLC BLCNY CTNG BO O O O
30, LICENSED CONDUCTOR'S DECLARATION JobDescri [ion
V 1 hereby affirm Nal 1 an lixnscd under provisions of Chapter 9(commencing '^"-•-••^� ^� ^•^•^^ P
wiNSecdon7=)of Divlskn3of Ne Businmudfeuiun C
Gom1 .�nd myliccneis
^ � in full rom ane CRea
j y'Z Lkenso Cam Lk. -
tS Dam
ARCHITECTS DEC DECLARATION
1 undersoonJ my plain N411 he used a public rcoNs
JyU
yuan Licensed Profcssionel
j OWNER-BUILDER DECLARATION
n0 1 hammy.Bran m 1 am tempt from an Ne esuramora c:Any c law for the
0 4 following reason.(Section 703 1.5.Busmen and ere,d dons Cade:Any oily or county
9lei which requires•Permit re cores lat altee Improve,demolish,fi repair any aroctum
pd.mits iuwna.alw requires the 4Pplinmfor such permit mfileasigneB wmmenr
ppssi Nat he is licensed pursuant to to provisions of the Conuacmr'a Li¢nsc Law(Charter 9 S q.Ft. Floor Area Valuation
yF (wanna ncingwiNSccd..7 W)nf Div].ion3af Ne0u,inm=d Profmions Co )Or
g 5lg this he u exampt therefrom and Be basis for the alleged association.Any violation of
Section 7031.5 by arty applicant for a permit subjects the applkam he a civil penalty of APN Number Occupancy e
not mom than Bw hundred dollen(5300). p y Typ
❑I,uowresofthepropvly.mmymploymwith apsu Ne wleoompem on,
willdo thewoak,sed the =to.]..at intended oaolfcmd for sale(Sec.]OH,Business Required Inspections
sead
d Prepame,Cade:The ConuacmU.Ys WLaw does set apply m e ns an owner of Q P
property who builds or improves thereon,and bodoes such work sionvi r v through his
own employees,provided door such improvements arc not intended era@red fws4k.If.
howewq the building or Impmwment is sold within one year o(compleuon.One owner.
Wilder will have the burden of proHng that he did wt build or improve for purpose of
sale.).
❑1.as owner of Be property.am conclusively contracting with Ikvued roseumn a
coutrwT Ne project(San.TON,11"Wea and Pmfeashms Cods:)Th Cootraemh U. _
cam law doe,not apply at an owner of property who Guilds or improves demon,sed
who contracts for such prefects with a conuscmKs)licensed pursuant m Be Commctoes
License Law.
❑IameonptunderSec ,Bk PCfm Nis.
v Data
WORKER'S COMPENSATION DECLARATION
1 hereby alrrno under Penslry of perjury can of Ban following declarations:
❑I mea wd will mainuin a CatiOamo(Camenuo selN..roc Workues Compen-
union,an paovidcd for by Section 37M Of Use labor Code.far Be perfarem.Of the
work for which this permit is issued.
❑1 haw sed will maintain Workers Campeusdw Imuran.a mqulrtd by Section .
)TOO of the labor Cojok,,For an Performance of Ne work for watch
h¢this
�pe/r rmit is harrow. ,(b
MY WarkersFor6b V 1 Szou PoI cy NoY nu rt W V ' 4 V a7 a '
Cori �/�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Ords scedon wed not bc<mnplemd trusts permit].(mese hundred dollars(SIM) '
or leu)
I certify Out,in the Perfurn.or the work for which this Permit is lamed.I shall nes
employ any person in soy m=wrm as be become subject to Bm Workers'Compensation
Laws of California•Dam
Applicant
NOTICE TO APPUCAND If.after making this Ccnifiam of Exemption,you should
bwome subject to the Worker's Compensation previsions of the labor Coda,you must
O forthwith comply with such pwomme;or Nu permmabe
it ll darnrevoked.ed oked.
z'71 CONSTRUCTION LENDING AGENCY
[r IMreby aRnrn No,them is a coruwctinn lending agency for the Perform==or
Ix i the were ter which itis permit].iuwd(Sec 3097,CW.C-)
W� Q latuck",Name
z Lenders Add.
U Q 1 worry that I Tuve reed this wpikati=ane sum rho the above Information is
IL F correct.l agree m comply with all city and county aNinances and sum laws elating to
DU building construction,and hereby aurbodm repmsemtims of N].city m enter upon Bm
W show-mcn. had Property fro inspection Purposes.
P. (W gree m indemnify=d keep barmen Oe City of Cupertino gala
W liabilitiu.J mevts.c N dexpenses which may In=y soy socme against mid City
V z in eanseq the rang of Nu parse t.
^r APPLICA DE STA S AND WILL COMPLY WITH A NO -POINT Issued by: Dale
SOURCE G A N S
2 2� ta v. Re-roofs
At[hatu or p Data ARD SM ALS DISCLOSURE Type of Roof
apCowm an M ng aaupapt Bort erh=dk haurtlans mamri4l
defined y tite Cupertino Municipal Code.Chapter 9.11,and tim Health=d Safety
Section 255324)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu V(No
Will the applicant or future building occupant on equipment or devise which If a roof is installed without first obtaining an inspection,I agree to remove
emit hvsrdnus air contaminants as defined by the Bay Ams Air Qualby Management all new materials for inspection.
D strc7
t]Ycs No '
1 haw mal the bund/oust materiala reeuiements under CTupmrb.95 ofNe Cdifm-
niaHcalthk IyC 1SS05,T11am12434.1unrkasund Nmiftite building
does not c m h a L But it k mY mapnulbility m sedl'y Ne Occup=r Of Ne
acqulrtmem w It t * m orscTidnar2 .(e, Signature of Applicant Date
sew , tsar, n. N
Data All roof coverings to be Class"B" or better
• CITY OF CUPERTINO
ITEM 4 OF' 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32659999 .213
.DATE ISSUED. . . . . . . : 02/21/2008
RECEIPT C . * . . . . . . : BS000004000
REFERENCE ID # . . . : 08020137
SITE ADDRESS . . . . . : 22330 HOMESTEAD RD #213
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
IDECKWOGD EACH 1 . 00 428. 00 0 . 00 428. 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 428. 00 0. 00 428 . 00 0. 00
•
J :
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
SO
CITY OF Fax(408)777-3333
uUPERTINO
Building De artment
JOB ADDRESS: PERMIT #
v n srt�n5 �o�n Zl3 20137
OWNER'S NAME: 1„jJ(6 e,s o- PHONE # qUa , 57,1 6 _o }z.o
GENERAL CONTRACTOR:-Dg4 ( JYT7 /&I(, FAX# 40 6_o LS
I am not using any subcontractor . Z-z(—0
Signa a Date
Please check applicable subcontractors and com le di followin information:
SUBCONTRACTOR BUSINE AME 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
T'
Lo J (-k -Z-2,1 -o Zj
\Owner/Contracto ignature Date
CITY OF CUPERTINO
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
2-21-0 `6
Building Address:
ZZ-13 '0 'Zo ad WIT-
Mailing
]T-Mailing Address (if different from building address):
Owner's Name: Phone#:
D )onIueC j PKofM tTY /-14AIAL i I- L
0r1jF.oLJ'►rL5 4Cv0r,1D-1-c0J luso -41'1- q 0111
Contractor: Phone: Lt 0% _ 5.3 ra_64 20
p s �1o1'tJ2- l�vsCjzvt,�n�l ('%/ G Fax: t+0Q, _S36-Q%+7,
Contractor License #: (p 1'1 (o( p
• Cupertino Business License #:
Contact: Ph �{'one: L}o g -20 9 _ f 6 `q
L O tI I 1 fc «+
. 4'J7�2_ Fax: 40% _5 3 6 - o`f y!r
Residential Commercial
Job Description: V-EMt0cjC- I34tL'o-j-�1 " 0-r( &J(j
L.I e-('E r07— LI IE W I rAk M I t-jO 2 C4 W-rMJ7-1t T-
T,-,,
T,-,,f V--I I_ r-1ac,-EI v
Building Permit Info:
Bld Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, I IFR ❑ 11, 111, V-lHR ❑ 11, 111, lV V-N
Valuation: -Z000 Square Footage:
�=-
• Project Size: Standard Large ❑ Major ❑
CITY OF CUPERTINO •
CUPE(,TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1GENCOM
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
1BBOTLER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
abso tion sys over 100,000 Btu/h
1BBOILER3 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
1BBOILER5 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) •
S Inspections P
Other Plumbing& Gas Ins
1PLMBINSP P
(Der hour
IMEETINGIHR Application Meeting B
alF
CITY OF CUPERTINO
CUPitF GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
1ACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
ICHIMNEYR 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
IMODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast.in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
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CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION •
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1 GENCOM
RETAINING
WALL(CONCRETE
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 13
1SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ca addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 so 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�1//11
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(W
CITY OF CUPERTINO
cuPEr� T`wo GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 WRMEP 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
IPLMPLNCK 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
IBSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel &Documentation B
IBUSLIC Business License B
•
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