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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 1of3 ( r 7 6 � *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 2of3 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 3 of 3