06080156 CITY OF CUPERTINO
a�ILtn;va DIVISION PE
RNIIT <_TOR"
,BUILDING ADDRESS: DRA GER CONSTRUCTION INC PERMIT"°'06080156
10901 KESTER DR
OWNER'S NAME: _ PERMIT ISSUE DATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL ST QR/18 /2006
NE: SANITARY NO, CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PERMfr INFO
BLDG ELECT PLUMB MECH
u o j LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby affirm Nm Il
at 1 am under provbi...of Claims,9(commencing p
^� nuth ll roses and effect ection 7")of ivuian3of Ne Busi as And 4,177_' unn Codc.aM my license is REMOVE 3 TO 4" OF TILE FELT & BATS . INSTALL NE
qz user�eg,claes Lk.a .fi(7(o..(� ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
;—p
Data �r Conlrazwr
tARCHrrECrS DECLARATION
�y < 1 undeniand my plans shall be used As public rtcnr&
;QU Licensed Professional
OWN ER-BUILDER DECLARATION
I hereby AM.Not It exempt form dm Conu tmor9 License Law for the
00 foluwing mason(Sadao IID I.S.Business and Profetinm Cede:My city or county
3 E E which requires a permit in envo,alter.bereave.demnitvh,or mean any so ecome
_I< our us itsiasuance.Arm onion es the applicant far such permit..file A signed stamment
pia
that he is licensed pursuant to Nc provisions of this Comment's License Law(Chapter 9 Sq.Ft. Floor Area Valuate&2 0 8
y (commencing with Section 70M)of Division 3 of the Business and Professions Cade)or
Q $ that he ts exempt therefrom and the bests far the Alleged exemption.Any violation of
Section 7031.5 by any applicant for A permit subjects the applicant to a civil penalty ofypN Number Occupancy Type
not mart Nen five hundred dollars(SIM). 323021 . 00
�O
D I.As own of the property,or my employes with wages As Nen sale compemadon,
will do thewoM1,and theswusum is not lnm ued oraffeted for ask(ga.7Ms4,Business Required Inspections
end Pmfesalons Cade:The Commemes LKaRY Law does not apply to an owner of 1 Y
property who build,or improves thereon.and who does such work mansel f or through his
awn employees,provided that such ireprovemenu arc not Inmeded oroRered formic.If,
however.the building or improvement is sold within ane year of cempledon,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
Ask.).
D 1,as mvnes of the propmY.am excluoycly...amusing with Ilemou d mnuecwn m
constmct the project(Sec.7044.Business and Professions Cade*The Commend U.
cane Law does not apply at m owner of pmpeny who builds or house.Nemon,and
who contecu for each projects with a con ractor(s)licensed pursuant to tie Contractors
License Law.
D l Am exempt under See .B&P C far this meson
Owner Data
WORKER'S COMPENSATION DECLARATION
VI hereby allhanunder penalty of perjury aro of the following d lmilons:
ia is and will maintain A canines.of cement m self-imam for wmacea cant
Action,m provided far by Section 3700 of de Labor Code,for the performance of the
work for which Nis permit is issued.
F_Ll—and will maintain Warkeh Campewtian I...As required by Section
]011 e(the Libor Code.for the performance of Ne winds far which this Permit is issued
My Workers Comrensauan Insure esrricr end Policynumber am:
Cartier. 1 Polley No.:
CERTIFI OF XEMPTION FROM WORKERS'`
COMPENSATION INSURANCE
Mussectow used nothecampli m i Vice permit Y forme hundreddallue(Skil)
.,less.)
1 certify that in the performance of the work for which this permit is Issued.I shell tet
employ any pecan in my manner an as to became subject to the Wahcn'Compensation
Laws.f C.1ifiand.,Dau
Applicant
NOTICE TO APPLICANT:If,after making this Cettincam of Exemption.You should
became subjm in the Workers Compctssatme mweisioes of Ne IAhv Code,you meat
.J O forthwith comply with such provision or this permit shall W deemed revalued.
„zry CONSTRUCTION LENDING AGENCY
[-+ Ihereby.from that there I.....=do.lending Agenry,to,on,Perfurmamn of
Ci Ne work for which this permit ti issued(Sec.3097,Civ.C.) '
ILIQ Lender's Name
e7 z Lande.Address
U 0 1«reify that 1 have mad this application and sum that the be.information u
Ly fii entreaL 1 agree to comply with all city and county on inames and sok laws rearing m
Obuilding construction,and hereby•uthorira mpmenheives or Nis city to enter upon the
Ualmow-menti.ned Property for inspection purposes.
0. (We)agree to save,indcmni fy and kap humless ftCity of Cupertino agaiest
N liabohles.judgmenu.costs and experum which may in any wayaa]ueagamol aid City
U mcoruequestce of the granting of Nis permit.
SPPLIIC �'A I
NT UNDERSDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date <P 2 K— !�
_ 53-51 -01 Re-roofs
Signam,of Applican✓Conuetor Data Type of Roof
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant orfuture building dumpant team or Nnulc haallous co enol .
as deRned by the Cupertino Municipal Cade.Chapter 9.12.and the Health and Safety
Cotte.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes u
Will the applicant or future holding ounpant use equipment W devices which If a roof is installed without first obtaining an inspection,I agree to remove
_ emit harardnus air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
DYes zm_
1 have mal the haxmdnus materials homimmems under Chapmr 6.95 of the Califor-
nia Health&Safety Couse,Smuoes 25505.25533 and 25534.1 under and t airthe building
dna net currently haw a amant,that It is my reepomiM1Olity to notify dm comment of de
a cements nab nm d winmma.ncttufica,of Occupancy, Signature of Applicant Date
HAI
ownerr or aamanumd agent Data All roof coverings to be Class"B"or better
CITY OF CUPERTINO
9 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35628021 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . : 35685
REFERENCE ID # . . . : 06080156
SITE ADDRESS . . . . . : 10901 KESTER DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RANCHO DEEP CLIFF HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : DRAEGER CONSTRUCTION
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
OEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ----------=-- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 115 . 56 55 . 47 0 . 00 55 . 47 0 . 00
BPERMFEE VALUATION 5 , 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00
BSEISMICRE VALUATION 4 , 208 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 171 . 53 0 . 00 171 . 53 0 . 00
TINO
act CITY OF CUORM 0���`
CUPE(�TINO PERMIT APPLICATION
N4
Date: ub I �� I O
Buildingddre ss: LU V r Mailing Address (if different from building address):
09
Owner's' IIN�m : I- O Doe _N:4-
M + Do 4 . Phone#:
Contractor: License #:
Contact: Phone: Cupertino Business License#:
Fax:
Building Permit Info:
Bldg �6C)0 Elect ❑ Plumb Nech ❑
JobDescription: 1V 001mifelt 1 1q '
Residential E / + Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: ^� Occupancy Group:
Type of Construction: !s-�L Please check this box if the project is a
second-story addition: ❑
likoject Size: Standard Ql� Lar e ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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I - CITY OF CUPERTINO
cuPERTiNo PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Grou
BMISCELL Miscellaneous Fee i BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP : New,Comm Plumb PLUMBING,
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheiic Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPIN'TERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Maim Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREMARUTAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMFURNOV Relo Fumace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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CITY OF CUPERTINO
CUPEf of INT
PERMIT APPLICATION FOR
Quanti Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Ternp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
Ask PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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