06080161 CITY OF CUPERTINO ��k��sa,,g(�T s - z�y,�g'�' �g�. -- j�j`�(�`�'
*UILDIM1d DIVISION PLi'g�yyyjy �l 'N'1rj W "ma, '^""' � Z,
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMrr ND.06080161
10950 KESTER DR
OWNER'S NAME: PERMITLSSUEDATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
E: SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITEC(ENGINEER: BUILDINO PERMIT INFO
BLDG ELECT PLUMB MECH
;oat LICENSED CONTRACTOR'S DECLARATION - Job Description
u 1 hereby affirm Nall am licenuderd unprovuiom orchapter 9(commencing
with Scaion]tg10)of Divialon 3 of dm Eu&nnv and Prafessionr Code,arW my license is
n fell rrrea andiffect. REMOVE 3 TO 4" OF TILE FELT & BATS . INSTALL NE
i License lass Lie.11 41`21-10
;�oo Date ,,' f -n�' comrmmr ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
ARCHRECI'S DECLARATION
i d� 1 urWersnnJ my plans shall he recd u public recnNa
iyu
Licensed Pmfossional
3 OWNER-BUILDER DECLARATION
p I hereby.sec Nat 11. exempt theim from the Canummfs :Any c law for the
f p O following reason. emit t ]031.5,Businma and Improve.
de oli Code:Any city ar runty
$ which myui sa n permit m uinaum.alter.impaw,dPermit,or repair any come n
prior its issuance.also squirm the applicant for such Permit us Ola axignaJ sutemam
; o that he is licensed pursuant mthe provisions ofd¢CommentrlLicense Law(Chapter 9Sq.F FFloorArea ValuatiOd208
(commencing with Section]000)of Division 3 of the Business and Professions Cade)or
$ that he a exempt therefrom and me hots for me alleged uempdm.Any violation of
Secdon 7031.5 by any applicant fm s permit subj.m the applicant to a civil penalty of APN Number Occupancy Type
net more than five hundred dollars(55001 35628015 . 00
❑Las ower of the property,re my employees with wages t Ness Sale compmustion,
will domcwores Codeehe Con is not intended Or it hot ask
to a Business Required Inspections
and propa ftywhiom Coda:The Contractor's and
whe Law dors not apply lf rt owner of q P
man brat who ,provided
i d tat suves thereon,and who dneamchwa ed or offered
ed faradsmuth Ito
own ver,th Wilding
mat such improvements art oat our of d re oaend rate axle. r,
however,ec building Orden of pr vin is sold within ane year of mmoloc for Ncpose at
builder will have tite burden of proving that M dM oat build or improve far purpose of
nte.I.
❑1,as owner of the preperty,am exclusively contracting with licensed contracmn to
contract the project(Sec.7044,Business and Profmdam Code)The Cmunmr's Li.
cane law does not apply to an owner of property who builds or Tmpravu daemon,and
who contacts for such pajects with a commitments)Bcmesed pursuant at gas Contractors
s
License law.
❑I am uempwnder See ,B&P C fur this reason
Owner Cars—
WORKER'S
anWORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury nm of the following declarations:
have and will mainuin aCenificate of Consecrate teff-im on far Wmker'sCompete-
motor,u provided for by Secdon 3700 of the labs Code.for the porfmorm s of me
wark for which this permit is issued.
w end will maintain Wokes's Compensation Imuran¢,as required by Scefion
700 of me t.w.r Code,for me pcRormanco of the work for which this permit is laved.
My Worher"Compensation Imumoc canner and Policy number are:
Carrier. Policy No.:7/a'"/ -V� ""'Y
n
CERTIPTC TEOF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu semian need ism becomplcued If the peed,isforons hundred dellua($100)
or loss)
I certify that in the performance of the work for which this Permit is issued,I Shall not
employ my Person in any mannum as m become subject o the Worked Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,spur making this Certificate of Exemption,you should
become subject in the WorkeYa Compensation pavisiom of the Lahr Code.you mut
.J O forthwith comply with such provisions or this permit shall be deemed revoked.
„Z,i ti CONSTRUCTION LENDING AGENCY
1hemhyafftrm then eco isacomuucOnn lending agency for the performance of
a > the work for which this Permit IS issued(Sec.3097,Civ.C.)
QLenders Name
z Lmmus Address
U 0 i certify that I have bead this application and some that the above information is
D.F coned.1 agree in comply with all city and county ordinances and some laws relating to
OU building construction,and hereby authorise representatives Of this city to enter upon the
W shove-mentioned property for inspection purposes.
LL (We)agree m save,indemnify and keep harmless the City of Cupertino ageimn
aFi to liabilitiu,judgments,tosts and expenses which may in my way accrue againstmid City
V Z in consequence of me Swung of this Permit
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU N5.
- Re-roofs �--
Sign ure of ApplitmuConuactor Dau
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or form building occupanlsmre arhandle halm doth material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safely
Cola,Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
C]Yes is'Na_
Will the applicant or future building excupanl use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
mit haraNnus air cmuminmis as defined by the Bay Area Air Quality Management all new materials for inspection.
DisuicG
❑Yen .2No—
I have mad the hermit.materials requirements took,Chapter 6.95 of the caltfm
niaHulth&SafktyCo .Smtiaa25505.25533and29534.lundemundeaiftha building
does tutcm o ally haw a te en at it u my responsibility to redly the occupant of me
Oulu Wc�whtdm n I a rtinu=cofaccrdricamorampmcy. Signature of Applicant Date
Ownner
0.c aml homeo agent
All roof coverings to be Class"B"or better
or Dam
CITY OF CUPERTINO
4 of 5 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35628015 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . : 35686
REFERENCE ID # . . . : 06080161
SITE ADDRESS . . . . . : 10950 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
4EE, 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
•
FCITY OF CUPERTINO
PER
CUPEI�TINO MIT APPLICATION O
JIFN# ' ✓b-2V -Oi5 Date:. Oe)111?5 I O LO
Build in Address: Mailing Address (if different from building address):
i { r
Owners N
Phone#:
Contractor: License #:
Contact: Phone: Cupertino Business License#:
Fax: {
Building Permit Info:
Bldg F, .CCZ 'I Elect ❑ Plumb Nech ❑
Job Description: �3To fi II I '
� L4141
Residential k Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: ^� Occupancy Group:
Type of Construction: I�LJ Please check this box if the project is a
secon -story addition: ❑
oject Size: Standard B� Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERl 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
cuPEr�TiNo PERMIT APPLICATION FORM
QuantityFee 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 Cess ool 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 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 Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREKUWAN 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 Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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t CITY OF CUPERTINO
CUPEkTINO PERMIT APPLICATION FORM
uantity 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 Mechanical s . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE --Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee s foot PLUMBING
PLLONGRNGC Plannin LR Comme/Multi-Faro PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chan c BUILDING
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