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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 1 of 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 2of3 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 • 3 of 3