04040007 CITY OF CUPERTINO �.T" �..y. �s,�
BUILDING DIVISION PERMI "'I �)La� T11a��QA` �
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMITNo.04040007
ERS NAME: PERMITI55UEDATE
IRVINE APARTMENT COMMUNITI IS605 COMMERCIAL2004
PHONE: SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
:00 LICENSED CONTRACTOR'S DECLARATION Job De I
EI herby from that 1 am fdo.Br under previsions of Chapter 9(commencing SIAL E D
with Section 70(xf of Division 3 of the Business and Professions Codc,and my license is
i imm�mmeanaerRa STAIR REPAIR
�n Dole Clens Com
LE� Date TSDECr 3
[ ARCHITECTS DECLARATION /V 7004
1 understand my plana(hall be used as public recnNs a. 1
JyU
oN Licensedrebsainna' BUILDIN
S OWNER-BUILDER DECLARATION
<4 I hereby affirm then 1 our exempt from the Cnmramor's License Law for the
❑O follnwinason.(Section 7031.5,Business and Professions Codc:Any city or county
P7,65
K6 re
m which requires a pctmit m construct,alter,improve.demolish,or repair any stmcum
prior mils ismincc,als.rcyuireafhcaplicant forsuch Imrmiuu file a xi'malintemcm
gg < that he is licensed ninmana In the pr virwr. fth.CWhaetur'sLicense Lav,(Chipter9 Sq.Ft. Floor Area Valuation
z � (commencing with Section 7")of Division 3 of the Business and Professions Code)or
that he is exempt thcmfrom and Ne basis for the Alleged exemption.Any violation of
Stenon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 h(PRO,QMer00 Occupancy Type
not more than five hundred dollars($500).
❑1,as owner of the property,or my employees with wegen ss their sole compensation,
will do the work,and Ne ssmnum is not intended or offered for sale(Be..7014,Business
ani Professions Code:The Comacros'a License Law does not apply to an owner of Required Inspections
property who builds or improves thereon,and who does such work himselfor through his
own employees,provided that such improvements ase not intended oroffered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
salt.).
1,as owner of the property,am exclusively contracting with licensed contractors to
on et the project(See.7W.Business and Professions Code)The Contfacmr's Li.
ecoic law docs not apply to an owner of property who Wilds or improves Nemo and
who contracts for such projects with a cur,Remits)licensed pursuant to the Contmmoes
License La
❑lam ex to or cc. ,B&PC r his re on
latr on
OR R' OMPENSATION DECLARATION
the ya rent oder Ity of perjury one of the following chdamthus:
❑l haveandwlllmainmina ertlfrcate of Consent to self-insumBar Workers Compen-
indent,as provided for by Section 3700 of the Labor Code,for the parfmmance of the
work for which this permit is issued.
❑1 have and will maintain Workers Compensation Insurance.as required by Section
3700 or the Labor Code,for Ne performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number am:
Camey. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed Bthe permit Is for one hundred dollars($IQB
or Ices.)
I certify that in the perrormann,of the work for which this permit is issued,l shall not
employ any person in any manner so as in become subject a the Workcts'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If.after making this Cenific(¢of Exemption,you should
become suhjen m the Worker's Compensation provisions of the Lam,Code.yodmus
.JO forthwith comply with such provisions or this permit shall be deemed mvuked.
„z„ CONSTRUCTION LENDING AGENCY
OG
f I hereby affirm that there is a construction lending agency for the performance of -
Ci> the work ror which Nis permit is issued(Sec.3097.Civ.C.)
W�Q Lender's Name
z Lender's Address
C)Q 1 certify that I have read this application and sum that the above information is
LL,F correct.I agree to comply with all city and county ordinances and state laws relating to
V building eonsu
uction,and hereby authoorm representatives of this city to enter upon the
Oil
ahovomentinned property for inspection purpoxcs.
(We)agree m save,indemnify and keep harmless the City of Cupertino ageinn
.a laq liabilities,judgments,costs and expenses which may in any way scram against said City
U lnannmgnen conegmmingnnMsDWI Issued by: Date'
APPLICA U N SAND WILL COMPLY WITH ALL NON-POINT
SOURCE
Re-roofs
Signamrc o Ap ¢at/ tr t r et
Han R S MATERIALS DISCLOSURE Type of Roof
Will the plicantuComeron ni ipal Code,Chapter
r ate 9.12,
andhanthe
Health
rs and Safety al
As tlefincd by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safely
ode,Section 25533(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Ycs
Will the applicant or future building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants As deoned by the Bay Arca Air Quality Management all new materials for inspection.
District? `/
❑Ycs
I hove read the hazardmu materials requirements under Chapter 6.95 of the Cali for,
nix Health Safmy little,Sections 25505,25533 and 25534.1 understand that if the building
docs not ru a action,that it is my responsibility m nobly the occupant of the
requo-en musstM or I.ixrvmeeof.anificamofaen �r' Signature ofApplicant Date
Owner ar as nr .CJs e t Date I All roof coverings to be Class "B" or better
SkITY OF CUPERTINO'*
CUP
EI ., PERMIT APPLICATION FORM v � o O
APN# Date:
316-06-032, 316-06-037 March 31, 2004
Building Address: (Building # 6 ) 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 Permit Info:
Bl Elect ❑ Plumb ❑ Mech ❑
Job Description:
Residential ❑ Commercial ❑
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Project: Occupancy Group:
$ 55,365.10
Type of Construction: Please check this box if the project is a
second-story addition: ❑
Quanti Fee ID Fee Descri tion Fee Group
BAPPLOTHER Other A11`11— MECHANICAL
BBLDGFEE Bldg Permit sq. foot BUILDING
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/C=ZoueBLULDING
BUILDING
BCONSTAXBQ Con. Tax fBUILDING
BCONSTAXH Hotel anBUILDING
BCONSTAXR Constax- BUILDING
BELEC1000 Elec 600VLECTRICAL
BELEC1001 Elec 600VECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
BMITIGAI U Comm. Housing Mit. Fee BUILDING
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okr
-ErM WITY OF CUPERTINO+
CUPEf�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
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 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 rinkler/Backflo 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 cfin MECHANICAL
BREMAIRHAN A/C Units<= 10,000 cfin MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace 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 Signs, Marquee ELECTRICAL
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CITY OF CUPERTIN(*
CUPEf�TINO PERMIT APPLICATION FORM
QuantityFee 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 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 i
ZADDCHG Address Chane BUILDING
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