08020138 CITY OF CUPERTINO �r-+au'*�am�d
BUILDING DI'JISION PERMITA. ONTRAC"T R.'INF.�U�'IA'TI®N �y
PERMR NO.
.... gYIp3D�FEsslIOMESTEAD RD #212 DRAEGER CONSTRUCTION INC 08020138
R'S NAME: PEP34T ISSUE DATE
HOMEOWNER' S ASSOCIATION 605 COMMERCIAL ST 02/21/2008
PHONE: SANITARY NO, CONTROL NO.
ARCHTI ECITENGINBER: BUILDING PERMr1'INFO
RMV/RPLC BLCNY CTNG BLDG
O PLUMB
O 0
M LICENSEDCONfRACrOR'SDECLARATION Job Description
td I hmcby option tint 1 am licamo l uCr provisions of Chip.,9(commcncing """"""" "' """""
x wiNSecYon7gMBaf D1 A.0.1'WBusinwaM of tum and my lkcnx is
in full forte aM eRett � 'J
g Z Llcena CI , Lie.R '
31„ Dee Conuutar_
q EC15 DECLARATION
un
V I dersand my Plans"shalI he useJ as;public records
k Licensed Professional
5 a OWNER-BUILDER from
DECLARATION
COO 1 hereby.(Sec Jeal 11. exempt from the positins Cot License tow for the
i.o o following naso.. octal,t 7113 LS,1.Business and Proimprove.
der ore Coe:Any city or woure
S$ which acquires a permit re carom the alar.W for such
demniW.OF a pair any twmure
x�
prior uita isswnce.ahurequires thevision at for COwu rmi,eia aaLAW(uumem
< that M h licensed prraantt.the provision of the ContracoMilJanse law(CNpm9 Sq.Ft.Floor Area Valuation
$ (commencing with Section 7000)of Division 3 of the Businev and Pm(euians Coca)or
thu W is esemp,Jnnfwn out the hula far the alleged exemption.Any violation of
Session 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more Nan Rve hundred dollars($500).
0 1,as owe,of I&property,a my employees wW wages as Neo into compnwdon. .
will o are wok and the structure Is not intended or offered for ale(Sex.7W,Business
and Ptofeviar Cade:The Comms m's Lkunse low dose Out apply or a.velar of Required Inspections
property who builds orimprovesthmexim al whodoessuch work himself.,through his
awn employees,provided thatsuch Improvements are not intended aroRerM fa We.R.
however.the building of Improvement is sold within ane year of completion,the Owner.
Wilder will have the burden of Proving that he did at build or improve for purpose of
ateJ.
0 1,a.war of the Property,am cowcowly convauing with licensed conbacmn to
cons,nct the project(Sec.70W,Business and Profesdom Corfu)Tie Contraamts U.
cense low,dose not apply to an owner of property who Wilds or improves thereon,and,
who contracts fa such projects with a contractor(s)licensed punwnt as We Conuactofa
License law.
❑I am exempt under See ,B h P C for this noon
Dau
WORKER'S COMPENSATION DECLARATION
1 hereby afRm under penalty of perjury ata of the following decimations:
sa I t.a and will.amain a tion 37 te of Content Code,
far
Workea Campeo-
anon.r provided(pe mi Section 37000(the lobo,Code,for the performeao of Jct
work for which this permit is issued.
0 I haw and will maintain Worker's Compensation Insurance,u required by Section
3700 of the Labe Code,for the paniamance of the work for which Nit permit h lamed.
My Worker's ompanon mamas carrier and Policy number art:
Geier. J PolicyNo.: �1 I U G Iti I ic 3 o g/
I177 TEOFEXEMPTIONFROMWORKERS'
COMPENSATION INSURANCE
(Thhscscon road notocompleted lithe Permit is Forane hundred dollen($100)
or lea)
1 anify the,In the performance of the work fa which this ferrets is issued.I shall trot
employ anypcown in any manners as to become abject is use Workers'Compenadon
Law,of California.Dora
Applicant
NOTICE TO APPLICANT.IL after making this Cenifiae M Eaempton,you shwa
become subject b the Worker's Compensation provision,of tht Lobar Cad.,you most _ ..
.,O forthwith comply with ach provision Nit or permit shallm
k deemed reveled.
i CONSTRUCTION LENDING AGENCY
ErI hereby affirm that Jure i,a construction lending agency for duperformanaof
E -
�: ftwork(or which this commit is ivad(Sec.3041,Civ.C.)
(rJ Q Loader's Namc
0Z Lc.dees Addrea
U O 1 cenify that I Mw read this application am suss that the move information is
!� cortin.l agra in comply with all city and county ordinances and sou laws relating to
Wilding caw,ation,and hereby authanse npmxnunses of this city to enurupon the
W aovcmentioned propcny for hnpecdon purposes.
C (We agree to ave,indemnify and keep humicas the City of Cupertino against
tincilit.&J mens, cots adesPe.ses which may in my My Kent agaialaid City
U Z in consul of th ling of this permit.
w. APPLIN N R AND NO WILL COMPLY WITH N POINT Issued by: Date Z_ 'L f
SOURCE TI S,
2/ O Re-roofs
sigma ! for Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
o
Yt 1 the applicant.,future Wilding accupanunre or handle haardous manorial
dellax d by the Cupertino Mmd ital Code.Chapter 9.13.and the Health and Safety
.Section 2S532(.)? All roofs shall be inspected prior to any roofing material being installed.
C3 Y. O
Will the applicant or fut.building aaupant sea equipment of devices which If a roof is installed without first obtaining an inspection,.I agree to remove
emit harardnus air contaminants u dcRncd by the Bay Area Air Quality Management all new materials for inspection.
District?
OYes u
I havered he hanrd materials requomcnts order Chapter 6.95 of the Califon
.is Hulth Sofcty .Sectiats15505.95533u 2553d.1andcrstaM dmlFthe Wilding
docs oat c ntlY a tenant,that it h my responsibility m nodify the ocupint of the
nqunlnm whic m WmetpiornissumccfaCc 'RcauofoccuS.n � /� Signature of Applicant Date
,a ret n 'G ed use. r All roof coverings to be Class"B"or better
• CITY OF CUPERTINO
ITEM 3 OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32659999 .212
DATE ISSUED. . . . . . . : 02/21/2008
RECEIPT # . . . . . . . . . : BS000004000
REFERENCE ID # . . . : 08020138
SITE ADDRESS . . . . . : 22330 HOMESTEAD RD #212
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
•
DBoa o 38
Q` CITY OF CUPERTINO
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
�oZ �i - f 2-21 -0(o
Building Address:
ZMail'2-7-37o 'J' tzoAq ✓J / r' 2J2—
Mailing
ing Address (if different from building address):
Owner's Name:
?.hone#:
O�'liJlt�� �R�PE¢-fti' Ma-.1a. cb+L
0Hr�OWJr--Z4 ACSOO-NT-io�J (aso- 91-7- 19It
Contractor: Phone: +o,6 — Gj y 6,o 4 Z O
Fax: OQu — 5-3 6 — 047-5
Contractor License #: (ot 7 �� O
• Cupertino Business License#:
Contact: Phone: t f p$ _ Zoo -,W 6,'{
Lois Z Fax: y. oQ . 53&—o4Z5'
Residential Commercial
Job Description: JZ��'IO� �'�<IGIE ✓�aCLoJ � C-GaT1 'J�
L, ly,(s t'-'ort t-tLIE Wt tt-�o� Cn�pcEvT7cT
't-�-Irl 4I-JV tMOSI-21L �I�cNr� c� r
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11F ❑ 11, 111, V-IHR ❑ 11, 111, IV V-N 3
Valuation: co� 2ooeSquare Footage:—
• Project Size: Standard XL Large ❑ Major ❑
CITY OF CUPERTINO
CUPERTINO 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
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 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
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
tM 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
1ACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1CHIMNEY Chimney B
1 CHIMNEYR 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
IPILECAST Pile Foundation Cast in place concrete B
1PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
CITY OF CUPERTINO
CUPEf�TINO GENERAL BUILDING APPLICATION
FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
1 RETSP310 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
1SIDESTBK Siding, Stone & Brick Veneer B
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1SKYL<10 SF Skylight less than 10 sf B
1SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'1 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 sD B
additional stucco application
PR l
4of5
CITY OF CUPERTINO
CUPEI�TINO GENERAL BUILDING APPLICATION
FEESCHEDULE
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 shearB
wall/masonry includes plan ck fee
1EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
lELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M
IPLMPLNCK 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
1BSEISMICO Seismic Commercial B
1TRAVD0C Travel &Documentation B
1BUSLIC Business License B
•
5of5
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB ADDRESS: PERMIT#
0 140mr",4;r Ao k�on7 Z12 o
OWNER'S NAME: PHONE # `t•o lb -5 3 6—b Zo
GENERAL CONTRACTOR: Pee 1✓(0jr_-je._ C4o.,r. J FAX# Itos - 5 3 6, Z
I am not using any subcontractors 'Z-Z h- o $
Si a Date
Please check applicable subcontractors and com le 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
T'197 n
0 b
er/Contrac r Si ature Date