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06080160 CITY OF CUPERTINO ma §s" k % ^+�� ``' "' .6UILD1,C DIVISION PERMIT XIONTRAG�T..C►RR'IN 'ORMATIQN,,•: BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PEBM 'NO-06080160 10940 KESTER D OWNER'S NAME: PERMIT ISSUE DATE RANCHO DEEP CLIFF HOA 605 COMMERCIAL ST 8 2006 E: SANTrARY NO. CONTROL NO. (408) 536-0420 ARCHITECOENGINEEA: BUILDING PERMIT INFO BLDG ELECr PLUMB MECH oG LICENSED CONTRACTOR'S DECLARATION lob DOSCrIphOn F 1 hcmby affirm Wt 1 em limvcd under pmvirioiu of CMpmr 9(mmmcMing ZCGd wWSCcIkM70110)af Dividon 3ofMc Business And Prof.m.Cmd.mid my license is �=y infallfomeandofrat. REMOVE. 3 TO 4" OF TILE, FELT & BATS . INSTALL NE ice? Llccnm fWsa oor s, f 761 n C Dam ANTI-POUNDING, FELT & BATS . ROOF REPAIR. SC�2r —n( core ARCHr1ECTS DECLARATION i 1 understand my phos shall be mel As Public¢codes iyU 4,t; Licensed Pmfcuianal y� OWNER-BUILDER DECLARATION g I Wmhy slErm that I am exempt from the CoMactofs License Law for the 0 0 following mean.scedan 7031.5.Business and Professions Cole:Any city or County which resin.a permit m cowruct,alter.W prow,demolish,or mpah any Micro. prior m its issuance.alsurequires the applicant far such Permit to Ilk a signed Moment Met W is licensed pursuant o Me provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuat 4208 250 (commencing with Section 7000)of Division 3 of Me Business and Professions Codd)or $ But he is exempt thereftam and Lire basis for the alleged emmpdon.My violation of Section 70315 by ury Applicant fm a permit subjects the applicant in a cmil penalty ofWpN Number Occupancy Type nut Come than Ow hundred dollars($500). 3.7 O 2 8O 16 . 0 0 0 1,as awmr Clubs Property,or my employers with wages as Heir sole eompenudon, will de Me.,it.And Meatmem.u our intended or offered roraala(Sec.7014,Business Required Inspections and PmfessIme Cade The Casuanora License Law does Amt apply m an owner e of q P proper who Wilds orimeow thertan,and whodassuchamrk himselfor through his awn emplayces,provided that such improvements and not Intended or offered for.le.if. however.Ne building or improvement la sold within and year of completion.dm owner- builder will haw the burden of proving that W did not Mold or'unprow far purpose of sed. L as owner of Lite property,am exclwivcly conuecOng wide licensed conuamrs to nsouct the pmjea(Sec.7014.Business and Professions Cotler)The Connector's Li. Law does not epply to an owner of property who Wilds or trnprow ft...and, o ed, far such projects with a conuamaKs)licensed purawm in the Contractor's eae Law. I am exempt under See. ,B k P C for this reason Owner Dau WORKERS COMPENSATION DECLARATION 1 hereby afnw under penally of perjury ane of the following declarmlour ave and will mainum iCc ofieten(Consent m.If-Wurc for Warkefs Compen- .tion•u provided fm by Secuan 37M of f Labor Code.for f performance of the work for which this permit is issued. have and will mainum Workces Compensation huurance,as required by Section 3100 of sec lahm Code.for Ne performance of see work for which this permit is issued. ' My Warkefs Cmnpen.tion leu canner aM Policy number am: , Cartiee5'� +e- Policy No.: S v CERTIFICATE OF EXEMP ION FROM WOR)[ERS' COMPENSATION INSURANCE (This sectio need not be completed]film Permit is fm one hundred dollar($100) or less.) I cenih dent in see performance of the wort fm which this Permit Is issued,I shall Can employ any penin in my marmerso as.become subject to the Wormff Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:If.after mustang this Ceninum of Exemption.you should became subject to the Worker's Compensation provisions of the Inbar Code,you muse .� z forthwith comply with such provisions or this Permit shall W deemed mvaked. z CONSTRUCTION LENDING AGENCY (+4 I Wmby strum seat ft.is a coruuuctinn leading agency for the peKarmxace of C„>„ see work for which this permit Is issued(See 3097,Civ.C.) QLender's Name :a z Lendefs Address U Q 1 certify Nat I haw mad Ws application and sum Jw the aWw information u IL correct.l agree to comply with all city and county ordinances and sou law relating m Uhuddling eonsuuction,and hereby authority rrprasen1aivca of this city to enter upon the W above mentioned Pmperty for inspection purposes. gy (We)agree to saw,indemnify Add kapamJess hthe upe City of Crtino against E"cA liabilitiea,judgmemu a.cosand expenses which may In any wyaaruc Against mid Ctry O z in consequence of the granting of this Permit. r^ p ^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Dale SOUR RE LATIONS. Re-roofs Signatum of Ap�UCon"ater Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant at forum Wilding accup.M atom m MMIC h 0=material As dcOned by the Cupertino Municipal Code.Chapter 9.13.and see Health.d Safely Came,Section35533(a)7 All roofs shall be inspected nor to an roofing material being Installed. 0Yes rgaa P P Y g 8 Wilt Ne applicant or future Wilding occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hamstlous air contaminants.defined by the Bay Area Air Quality MlIDagemeat all new materials for inspection. Disuict7 DYes 42 1.— T haw mal dee haraNuos materials rtyuirtmcnu unlet ChaPmr Q95 a(thc Wilding nicesam cu end yDade.Srcvons355115,35533.oembil.lunJcdlythr cCum Willing Jw oat cumcnAly haw a mnanL that h M my mspomihiliry m notify Ibe msupant of sec mqui cuwh' bemet .did artaCIA cooneamaraapanry. Signature of Applicant Date 11 All roof coverings to be Class "B"or better Owner or mite nmd agent perm CITY OF CUPERTINO 3 of 5 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35628016 . 00 DATE ISSUED. . . . . . . : 08/18/2006 RECEIPT # . . . . . . . . . : 35686 REFERENCE ID # . . . : 06080160 SITE ADDRESS . . . . . : 10940 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 IREE 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 • CITY OF CUPERTINO (oo CUPEf�TINO PERMIT APPLICATION FORM. JqPN Date: Ole> loll/ Building Addre s lV Mailing Address (if different from building address): iM r Owner's Na .n o �-?e0 � 1 Phone Contractor: lel I l PlC It License #: Ur f't' lr�. C���► I D C 39 Contact: Phone: Cupertino Business License#: Fax: Building Permit Info: Bldg 5 teOOFiElect ❑ Plumb ech ElJob Descripti�o�n:/ .S-M T1 I Residential L`� Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: J ^� Type of Construction: Please check this box if the project is a second-story addition: o ect Size: Standard •8,**� Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M 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 <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING • 1 of 3 CITY OF CUPERTINO EF PERMIT APPLICATION FORM CUPI� Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee 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 Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pb1g Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP 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 - Stonn/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 Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> 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 H ating MECHANICAL BREMRESAPP Remodel Res App liance ELECTRICAL 2of3 CITY OF CUPERTINO CIT OF PERMIT APPLICATION FORM CUPEIZTINO Quantity 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 Temp 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 PLLONGRNGR Planning Long Range Residential PLANNING ZADDCHG Address Chane BUILDING • 3 of 3