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
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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
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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
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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
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