04040006 CITY OF COPERTINO �
BUILDING DIVISION PE MIT CCINTRACTnR IENk'I)�Mr�; - N '
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMITNO.04040006
19500 PRUNERIDGE AVE
' NAME: PERMIT ISSUE DATE
IRVINE APARTMENT COMMUNITI S605 COMMERCIAL ST 04/14/2004
SANITARY NO. CONTROL NO.
PHONE:
(408) 536-0420
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
300 LICENSED CONTRACTOR'S DECLARATION Job � SLE®
ye�C 1 hereby affirm that 1 am licensed under provisions of Chapter Y(commencing NA
b with seas,]!d effecDivision Sof uta Business and Pmfcssinna CnJc,end mylicensc ie
in mummeanderrea. STAIR REPAIR
lIJ? LueneaClase Lic.N
,_0
Datc Contractor 2004
Ruq',` ARCHITECTS DECLARATION DEC 13F
I understand my plans shall he used as public records
Ru
W Licensed Professional BUIL®I IV
S OWNER-BUILDER DECLARATION
E0 1 herchy affirm that I oto exempt from the Contractor's Code:License Law cot the
Kp o rullowwhich re reason.(..it 1 7(1]1.9.Business and PonwS,de n li h. Any city Stanunty
m� which requires a permit In cnnsuucL alter,improve,Jemolixh,Or repair any xuuctum 5176
prior to its issuance,also requires the applicant for such permit to File a signed stalamcm
EE A that he is licensed pamount tothe pmvisionsof the Contractor's License Law(Chapter 9 Sq.F[.Floor Area Valuation
YH$ (commencing with Section 7")of Division]of the Business and Professions Code)or
y Nm he is exempt therefrom and the basis far de alleged exemption.Any violation or
Section 7031.5 by any applicant for a permit subjects the applicant o a civil Penalty of erOO Occupancy Type
not more,Fan Rve hundred dollars($500). .
❑1,as owner orthe property,or my employees with wages as their sole campensatian,
will do the work,and Ne structure is not intended oroffercd fmaalc(Sec.7044,Business Required Inspections
and Profe.m.Code:The Cmumetcr's License Law does not apply to an owner of q p
property who builds orimproves thereon,and who does such warkhimself orthrough his
own employees,provided that such improvements are not intended orafram d foraala.If,
however,the building or improvement is sold within one year or completion,the owner,
builder will have the burden of proving that he did not build or improve for purpose of
I.).
1,es owner of Be proprrl,am exclusively contracting with licensed contractors to -
eons cttheprojen(Sec.7044,Business and Professions Code:)The Contractor's Li.
cense law docs not apply to an owner of property who builds or improves themon,end
who Can ouch projects with a eontramor(s)licensed pursuant to the Contractors
License Law
❑lam ex pt n c. .B&PCfor this on
I IA Data
WK 1PENSATION DECLARATION
Ihereby affil uncle pc I of perjury one of the following declarations:
1 ban and will maintain a Cenifcam of Consent to self insum for WorkersCompen-
sation,as provided for by Section 3700 of the Labor Code,for the perfam ance of the
work for which this Permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by section
37M of the Ube,Code,for Ne performance of the work for which this Permit is issued.
My Wmas's Compensation Insurance carrier end Policy number am:
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This scctlon need not hecompleted Ethe Food'is faro.hundred dollars III fail _
ar less.)
1 certify,that in the performance of the work for which this permit is issued.l shall not
employ any person in any manner an as sea become Subject o the Wmkaf C(mpart.imn
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making this Camficate of Exemption,you should
become subject to the Worker's Compensation provisions or the Labor Code,you must
.J O`forthwith comply with such provisions or this permit shall he deemed revoked.
y CONSTRUCTION LENDING AGENCY
'prZ) Ihereby affirm that dere is a construction lending agency rte the performance of
p$ r- de work fur which this permit is issued(Sec.]U97,Co.C.)
-r
W� rl Lea date Name
U Z Lender's Address
I,)Q 1 mrree that I have read this application and some that the above iws plaiiun is
0 F bonen.l agree to comply with all city and county ctid ordinances and state laws relating to
�U above-mentioned property
rn.antl hereby mthonprposes.natives of this city menter upon de
W above-mentioned agree[a Sam for men colon keep hu
(We)agmen to save,indemnify and keep hay in an the City accrue
Cupertino against 1
rjj liabilities,#R!
nas,costs lug ex this Permit. mayinanyway ecemue against said City
canaming of this Permit Date ,
ti APPLI AN 5 ANp WILL COMPLY WITH ALL NON-POINT Issued by:
sous
6 Re-roofs
Signature clApplicanVCo cm ata
HA S MATERIALS DISCLOSURE Type of Roof
Will the at can ser urn building Occupant store or handle hmardous material
as de road by the Cape tion Municipal Code,Chapter 9.12,and the Health and Safety
ode,Scoion 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
Ely..
Will the applicant or umreabuilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit harardnus air contaminants as JCOned by the Bay Area Air.Quality Management all new materials for inspection.
District?
❑Ycs )dNu
Ih emaJ thchmaNnus materials rcyuiremenm under Chapmr6.95 o(dc Califnr
nia Heald Safety odc,Sccdon 5505,25533and25534.lundersmndthotifthc Wilding
docs n y e to nL mit is my respanxihilily m nndly the occupant of de
rcgai mace w menthe et aanaofacartr0aamofOcea rte. Signature of Applicant - Date
owner ra ori oda t All roof coverings to be Class "B" or better
i,
OITY OF CUPERTINO " � o
CUPE� NO PERMIT APPLICATION FORM
kT
APN# Date:
316-06-032, 316-06-037 March 31, 2004
Building Address: (Building 11 5 ) Mailing Address (if different from building address):
19500 Pruneridge Avenue, Cupertino, CA 95014
Owner's Name: Phone #:
Irvine Apartment Communities, L.P.
Contractor: License#:
Draeger Construction, Inc.
Contact: Phone: 408-392-4100 Cupertino Business License#:
Chris Young Fax: 408=392-4120
Building ,ermit Info:
Bl Elect ❑ Plumb ❑ Mech ❑
Jo Description: l
Residential ❑ Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: Occupancy Group:
$ 75,176.20 j
Type of Construction: Please check this box-if th❑e project is a
second-stor addition:
NEW
Quanti Fee ID Fee Descri tion Fee Group
BAPPLOTHER Other A--1i ances MECHANICAL
BBLDGFEE Bldg Permit sq. foot BUILDING
BBOILER1 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> 1.75MBtu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/ uasi BUILDING
BCONSTAXBQ Con. Tax for B 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 Ener BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
AdIlk BMITIGATC Comm. Housing Mit. Fee BUILDING
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� *ITY OF CUPERTINO
CUP TYOF O PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIN4E Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE 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 cfrn 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
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Si s, Mar uee ELECTRICAL
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p!,OO CITY OF CUPERTIN�
CUP TOF YO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
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 Swinuning 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
MPERNUTFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
ZADDCHG Address Chane BUILDING
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