08020140 CITY OF CUPERTINO '�^ =,rh•,�^t•f�x ""''
BUILDING DIVISION PER 'r#CQ1�T�TRACT(TR I.NFQRMpT,,-I�'„ Nf'
PERMIT NO.
au1Lgln'n'd`E%ME STEAD RD #215 DRAEGER CONSTRUCTION INC 08020140
ER'S.3NAME: PERMrr ISSUE DATE
HOMEOWNER' S ASSOCATION 605 COMMERCIAL ST 02/21/2008
71HRCC'
NE: SANITARY NO. CONm%OL N0,
HITECT(ENGINEER: BUILDING PERMIT INFO
RMV/RPLC BLCNY CTNG 7BLDG lO PLO O
'Loo
LICENSED CONTRAC`IVR'SDECLARATION Job Description
4 V I hreby affirm dat I we licensd under provisions of Chapter 9(commencing
with Section 70M)of Divtsian3of Mm Business and Professions Code,and m(91 y license is
I"
full forte and all
3 i License Ctm Lic.I
Dam ARCHMCTS DECLARATION
ht i understand my plans shall be used As public Iavrds
�6
k C Licensed Pmfessianel
S N Oe,I am umDER DECe Cmur ON
C O E heresy.(Sero Nm i am eaempt from the Contracmh License Law for the
p O fallowing massa Peron t ]0713,Business and Professions Codc:Any city st county
$N`i which requires a peals.m cnnstre%alcor.improve,demolish,nue mpalr any structure
F;y
,Her m its censed e.purse nt to Me t nvisio ard s.1'lar suchPermitw Reese gild mmmem
that he it licensed pursuant wthcprovivisioa.f Beat wra License❑w(Chapmr9 $q.Ft.Floor-Area Valuation
3 (commenriy with Seton]000).l DivisionJaf the Business and Professions Cede)or
.. that he is exempt therefrom and the bub for to alleged exemption.Any violation of
Seton 7031.5 by cry appnunt for.permit subjttu the applicant in•civil penally of APN Number Occupancy Type
Imt mare than ff e hundred dolufs($.5001.
Q 1.u owner of the pmp ny.or my employee with wage u theirwle eompemdon,
wiRdathework,andthesaunurtuIwtIntendedrofremdforule(S .]Ora,Burmese
and Prof.sdons Code:Tha Conuacwrr Llacnse Law dose not apply b w awry of Required Inspections
property who bunds or impwvn tmrmn,and who does inch work himself or through his
awn employm,provided thst such improwmenu see not intended of offered for We If.
however.Ne building or impmvemmt Is sold within one year of Completion,the owner.
buildm will have Are,burden of proving trot he did not Mid or improve for purpose of
sale.).
Q 1,A owm of the property.am eclusively contracting will licenced rnhacAra An
amst tact the pAjen(Sec 7014.Budness.M pro(eWens Cade:)The Contra us's U.
run law it.not apply to An..of property wive builds or improve themon.and
who contracts farsuch projects wiN.canwnor(s)licensed pursuant in Me C rarsowra
Lions Law.
Q I am uempt under See. .B h P C far Nis mown
410- Das
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declauuimme
Q I haveand will maintain aCenificamof Consnttoulf-Insum ler Workers Compen.
scion,an provided for by sedan 37M of the labor Code.for the performance W the
week for which Isis pewit is issued.
Q 1 have and will maintain Workm's Compensation Insurance,As required by Seton
3M.(the Iabm Code,for the performance of the work for which Asir permit is inroad.
My Wmkef�Ch�a smapeO ao�n lnvsu�y'mtinier and Policy rom�ner ares: q 1 ' OI
Card.. WL VI V�/ Pinky No.:J )W&1tj
CERTIFICATE OF MEM MON FROM WORKERS'
COMPENSATION INSURANCE
('dile union amid ant be crnplcwd little Permit is fm000 hundred derima(S(OD
rIt .)
I certify tum in the p erforman.of the wart for which this Permit in issued.I shall nor
employ any person in Coy mannerw u at become subject to the W011mi Ca er(unaton
maws of California.Dam
APPlicer
NOME M APPLICANT:If,spur making Nu CemiOcam of Exemption,yen should
become subject to the Wanes Compensation previsions of Ne Lahr Cade,you most
.JO forthwith comply with such Millions are this Permit Mall W dmmM mated.
z CONSTRUCTION LENDING AGENCY
I..h4 1 herhyafnrm Nat there is a construction lending agency for the pmformarcc of
Col w>„ Om work for which this permit is issued(Sec.3097,Civ.C.)
Q Imam's Nurse
z Lmokes Address
U O 1 ratify that 1 have read this Application And sum shout the.bow information Is '
W canon.P agree A comply with all city and county aNinancea and sum law relating to
.O rl'J building construction,and hereby rthorien representatives of this city in cnmr upon Nc
LS7 shove-mentioned property for inspection purpose.
CL e)agrt w save,indiction and lump humless the City o(Cupertim,against
„y ,n liabilid , dg ,cru andeapensa which may In any way SOMAO.galnn Aid City
V z in eo e e gentling of this permit
APPLI N RSTANDS AND WILL COMPLY WITH L NON-POINT Issued by: Date
50 U 0 e
'+ 7! Re-roofs
A. ig t pp- Ken Ar Dam
H DOUS MATFNAIS DISCLOSURE Type of Roof
Will tiro orfumm building occupant nom or handle hezallons material
defloed by tw Cupertino Municipal Code.Chapter 9.12,and No Health and Safely
.Section 25]32(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Ye Na
WIII the applicant or future Wilding occupant us equipment are devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit havuNnu air conuminsnu As de0ncd by the Bay Awa Air Quality M...Lenient all new materials for inspection.
Distim'?
QYns No
Ill read see a u i mdalswquimmenuundcr LLapwr6.95oftm Cali(as
rats Hulth my Sec'tmts25505,25577ana2553d.lundeutsnd thuifthe building
deo not c h ve moan%tut it u my numensibility in wofy the coups of to
require is in be met pdarmiuuance,OfI 'OcamoT wf l cy0 Signature of Applicant Date
IVw�
Dam All roof coverings to be Class"B"or better
CITY OF CUPERTINO
ITEM 1 OF 9 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 32659999 .215
DATE ISSUED. . . . . . . : 02/21/2008
RECEIPT # . . . . . . . . . : BS000004000
REFERENCE ID # . . . : 08020140
SITE ADDRESS . . . . . : 22330 HOMESTEAD RD #215
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER HOMEOWNER'S ASSOCATION
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
•
azz CITY OF CUPERTINO
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
Building Address:
2330 H v fLoc-7 L)JIr zls
Mailing Address (if different from building address):
Owner's Name: Phone#: W P o.n#u� �-
00�Ple ezr.-j PA6AJa to M z—
hr� A00CI4"r0i iso - —q9 Ic
Contractor: ^ _ Phone:
P4, �►L W/JJ'r UTQOAo I'.I V Fax: 4tO s - s3 6 —O`PZ5
Contractor License #: to I-( 10 ( p
• Cupertino Business License #:
Contact: Phone: 40%,ZOQ- C; 6*4
( 0J �rJaJ9c Fax: 401; - 536- 0rf-zs
Residential L Commercial
Job Description: kZ trH
01 Apj dJ 101
Building Permit Info:
Bldg XT Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1 FR, 11FR ❑ 11, 111, V-1HR ❑ 11, 111, 1V V-N
Valuation: 2.000—
Square Footage:
rProject Size: Standard X Large ❑ Major ❑
CITY OF CUPERTINO •
CUPEI,TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES 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
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
1BB0ILER4 Installation/relocation of ea 141
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) •
1PLMBINSP Other Plumbing& Gas Inspections P
(per hour
1MEETINGiHR Application Meeting B
1
CITY OF CUPERTINO
• CUPE�Tirvo GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
YPe
Group 1GENRES or
1GENCOM
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
1 FIREPLMAS 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
1PILEDRIV 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 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RET SP10 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
1SIDEST/BK Siding, Stone &Brick Veneer B •
interior/exterior
1SIDEOTHER 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'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 sf) B
additional stucco application
C..000l 1 lL..- d'' ad •
Loede-- � Do -L 4QM- , 7ceA
4of5
CITY OF CUPERTINO
CUPEt�TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group ]GENRES or
1GENCOM
1 WINREP Replacement windows/sliding glass . B
door ea 8 windows
1WINMEWSTR New Window-structural shear B
wall/maso includes plan ck fee
1 EPERMITFEE 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
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
IBUSLIC Business License B
•
5of5
Community Development
10300 Torre Avenue
P
Cupertino CA 95014
Telephone(408)777-3228
00
CITY OF Fax(408)777-3333
-CUPEt�TINO
Building De artment
JOB ADDRESS: PERMIT#
3 o 01- 1 v ►2047 Z I S p�0 20 / D
OWNER'S NAME: 4/il S 04 PHONE # LtOS -9306 - O Zo
GENERAL CONTRACTOR:ID (D CA Urr 1-J AX # L} u 6 —
I am not using any subcontractors: O%
Signature Date
Please check applicable subcontractors and complete the f information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
lie 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
L° J
Owner/Contractor e Date