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03060070CITY OF CUPERTINO 7.s -.:+~'*^R<" r .^?st*""C•ryf:? INFORM&IOI�i-5 BUILDING DIVISION PERMIT CONTRAC`T®R -, BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT No. 03060070 OWNER'S NAME: 605 COMMERCIAL ST "E"ym"'5`g%b9/2003 NEI (408)536-0420 SANITARY NO. CONTROL NO. ARCfll= ENGINEER: BUILDING PERMIT INFO BLDO ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION reby affirm that I am licensed under previsions of Chapter 9 (commencing 1 thereby escr Job Di with Section TWO) of Division J of the B.I and Pmfessimns Code. and my licenmh u u in fullfart ma p. 19 SIDING License la Lid. g 11- Darcso�EEGsuyrJ/ JUL 1 5 2003 ARCHITECT1 A IOI�, understood my plana shall be used dirldk records BUILDING Licensed Professional OWNER -BUILDER DECLARATION ' exempt from the Contractors License Law for the I hereby Net 1 from ...(Sire 1. Lord Professions Code: Any Chy or roomy ressoa. 71131.3, ' t, Mass aper. ImpmM, tare sig I rtQlllma a tenpin r structure which re arenas t Cares hdemolish.mia ed poor re the poor us its cenedpscowrcgoitha IM applicant sof for suchPermitm .asignedshapterp the Comsinsssnd Nu the in licensed purtusnt 70th)of Sq. FL Floor Area $2�®Ig�jion Division( the Boniness end Professions CtlM) of (commencingwith Section70M)of Division J Pruflaw(C Code) that he a exempt thertfrem and du buss for da alleged exemption. Any vialetion of that he the 3 }SBI P(hilbbr 0 0 Occupancy � p yr •l� Section 70313 by any apiricant fore permit subjects the applicant to a civil penalty of Out mart the fisc hundred dollars (M). ❑ 1. an oww of the property, ter my employee with wages as their tole eompenssdm, — Inspections will do On work. and theswcaurt is not mooded oroRerad pulse (Sec. 7044, Business and PreftWam Code: Th. Condolences Liam Law does sot apply to an owner of property who Wilds orimprom lheeon,a.d who doestuchwmk hboselfortmough his 3 O 7 — I NS U1.t U LH Nd awn employers, predicted that such ireprovemenuare not intended araffered for salt If, 601 — ROOF TEAR OFF however. the building or Improvement is sold within ore year of completion. the owner builder will bac the burden of proving that he did not Wild or Improve for purpose of 602 -, ROOF PLYWOOD NAIL at•')' 603 - ROOF BATTENS ❑ i, as owner of the property am exclusively convening with licensed contractors e 604 — ROOF IN—PROGRESS construct the project (Sec. 70x4. Business and Professions Cade:) The Comraepo's Lb .rue law does not apply to an owner of property who Wi1N or improm thmann, and, who contracts for such proJecu with a emtrromm(t) licensed potassium to the Cannes. ' License Law. ❑ I am exempt under Sea. . B k P C fm this raaann Data WORKER'S COMPENSATION DECLARATION 1 beeby aBhm under penalty of perjury am of the follewing declatations: 1 haveand will maintain • CCrtlfitle Of COnscdl to self-insue for WOhm'aCompm- sstion, a provided for by Section 3700 of the Labor Coca, for the Performance of the work for which this Permit is Issued. ❑ 1 dive and will maintain Worker's Compemadon Insurance, as required by Section J700 of the labor Code. for the pclfomtanee of the work for which this permit is issued. My Workers Campmuefiara Insunna artier end Policy number are: Cirri S.�a. ,A iLal6I�3. Poli .: CERTIFICATEO �MPTI OM WORKERS' COMPENSATION INSURANCE (The=ft= teed not W canpleled if the permit is (mane budded dollata (SIM) or less.) I certify Not in the performance of the work for which this Fusion is Issued. I shad not employ any person in my mannerm as w become subject de Workers' Compenudon Laws of Caifomia. Doc Applicant NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should become subject to the Worker's Compensation previsions of IW labor Code, you must forthwith comply with such Provisimms or this permit shall be deemed Landed. CONS(RUCDON LENDING AGENCY 1 hereby affirm that idem is a construction lending agency, for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Landers Nam. Lenders Address I certify out 1 have east this application end tart that the move information I, correct. I agree m comply with all city and county eminmaa and sea It" misting m building convection, and hereby means mFremnutim of this city to enter upon Lie ahovamcotioned property fm inspersion purposes in OnCityacre Cupertino (sjuagmemcove. indemnifyandkeep hay liabilities gre in m emu and eapensawhich mayinmy wayaccrueageinsaswig City id City in consequence Of the $13OLOg of this Permit. APPLICANT UNDERSEA D D W COMPLY WITH ALL NON -POINT Issued by: Date SOURCEREGUL Re -roofs Type of Roof I ��� Si aureo p Ca tremor HAZARDOUS MATERIALS DISCLOSURE Will the applicant Or future building aecupamnort or handle hamplous material is defined by the Cupertino Municipal Code. Chapter 9.I2, rest the Health and Safety a a.sc]Yan:ss3z(ay7 '''��� ''' ❑Yu �mvo All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove - Will the applicant of future building Occupant use equipment or devices which lit h•xamnua ter contaminants a denned by the Bey Arm Air Quality Management all new materials for inspection. imin7 ,�y' ❑Yo IF 1 have Land Lie hmamnusmatedah requirement ssndcr Cduper 6.95of the Califon ria Health& Snely Cade, Secdons Z5N15.35533 md25534.I undersuna Nu slope building docs not cunt ho a ismim. that it u my rcepo sibility to ramify de aaupmt of the Lly Latin, 'n betel loam..f.cenifrc.aoroccapmey. Signature of Applicant Date All roof coverings to be Class "B" or better own r tharizea mem Drew m CITY of . CUPERTINO CITY OF CUPERTINO p� o6 6-0 7 PERMIT APPLICATION FORM 'RPKPN # 36 s -S ©p ^-I Date: BAPPLOTHER Other Appliances � 6-vq -cs3 BBLDGFEE Building Address: BUILDING 11 Boiler <= 100,000 Btu Owner's Name: Phone #://;; Boiler> 100K to 500K Btu a &0e Boiler> 500K to 1M Btu Contractor: License #: Boiler> 1M to 1.75 M Btu MECHANICAL 17 0 Boiler > 1.75M Btu Contact: Cupertino Business License#: Construction Tax n BCONSTAX Ind/Off/Comm/Quasi Building Permit Info: BCONSTAXBQ Bldg Elect ❑ Plumb ❑ Mech ❑ BUILDING Job Description: Hotel and Motel Residential Ter Commercial ❑ BCONSTAXR Sq.Ft. Floor Area: $/Sq.Ft.: BELEC1000 aav -.I zv� /o v I Ai BELEC1001 Cost of Project: Occupancy Group: BELEC200 °20 'vim ELECTRICAL BENERGY Type of Construction: BUILDING W Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING 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 ` BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of 3 CITY o CUPFRTINCr CITY OF CUPERTINO PERMIT APPLICATION FORM 2of3 Quantity Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamil Res ELECTRICAL BNUCOM M New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING MIXTURE Pblg 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 BREMAIRHAN A/C Units <=10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFDCT Li&hting Fixtures ELECTRICAL BREMFURN Relocation of Furnace 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 2of3 a'410 CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group 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 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 Insection 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 PPERNIITFEE Plumbing Permit Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3 J I