06080130 CITY OF CUPERTINO '^'• ''
�'lllLIIItl,3,DIVISION
BUILDING s DRAEGER CONSTRUCTION INC PERMIT NO.06080130
22305 RANCHO DEEP
PERMri ISSUEDAIE
OWNER'S NAME:
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
NE: SANITARY NO. CONTROL NO.
(408) 536-0420
BUILDING PERMITINFO
AACHITECT/ENGINEEA: BLDG ELECT PLUMB MECH
100 LICENSED CONTRACTOR'S DECLARATION - Job DOSCrIpUOn
I ua C 1 hereby affirm Nat I am licenced matin provisiana of Clupmr 9(commencing
=y ictus forte andaffea ivision3Of the Business and
Prof—cfssi/um Cnde,and mylicenseu REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE
z License Class Lk.lf to 1 15- 1 6
iha Dale' 2TZr6--Contractor ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
ARCH TEOC1•S DECLARATION
N�< I understand my plans shall M used az public recnrdt
ayU
.� Lice.ed Professional
OWNER-BUILDER DECLARATION
1 hemhy alum Not 1 am esempt from the Cimon ctor'a License Law for the
o O fallowing mason.(Section 703 1.5,Business and Professions Cade:Any city or county
3 m which requires a permit m construct,alter,improve.demaRsh,nr repair any structure
prior m its issuane..also requires tM applicant for such permit to file a signed Soo mens Valnati�A 2 0 8
Z< that he is licensed pursuant to the provisions of the Camracloes License Law(Charter 9 Sq.Ft.Floor Area
e 1-� (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
that he is exempt thererrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty atppN Number Occupancy Type
not more than five hundred dollars(SSW). 3 5 6 0 2 0 4 3 . 00
0 Las owner of the property,or my waployw with wages az their wleeompensation,
willikiftwodt and NeaWctum is not intended oraaered fonele(See.?O1A,Business Required Inspections
and professions Code:The Convectors License Law does not apply man owner of q P
propeny who builds or improves timrcon,and who doss such work himsel f m l er ough his
own employees.provided that such improwments are atintended ar nlTered forme.If.
however,the building or improvement is sold within One year of completion.the owner, /
builder will have the burden Of proving Nat he did trot build m improv for purpose of
sale.). --/
❑I,as awrmr of the p openes
.am chadvely contracting with licensed cunvacton to C--i
construct the pmje.(Sec.TOM,Business and Professions Cad.)TM Condensates Li. '/)
cents Law does not apply to an owner of property who builds or improves Banned.and
who contracts for such project,with a condacatr(s)licensed pursuant m the Contractors /
License law. </ j
❑Iameaemptunder See .BAPCforlhisreason
Owner Data
WORKER'S COMPENSATION DECLARATION
_ I hereby affordunder penalty of perjury one of tate following declarmimu:
1 ham and will maintain aCenifieare o(Comenuo sel5insum for WorkcesCompcn-
.seen,as provided far by Section 37W of one labor Cade.for the performance of ft
work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,az required by Section
37W of the labor Code,for the performance of the work for which this permit is issued.
My Workees Compensation InZ s artier and Policy number am:
Cartier Policy N..71 T, 177_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need notM completed ifflue permit is rotund hundred dollen($I W) r
or Icss.)
1 certify Nat in We performance of dm work for which this permit is issued.)shall not
employ any person in any manneno az he become subject to the Workers'Compensaien
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If, for making this Certificate of Exemption,you should
become subject Be the Worker's Compensation provisions of Ne labor Code,you must
Oforthwith comply with such provisions or this permit shall M deemed revoked.
CONSTRUCTION LENDING AGENCY
E-r I hereby affirm that there is a construction lending agency for the performance of
the work fur which this permit is issued(Sec.IDSL Civ.C.)
Q Lender's Nam.
0 z Lender's Add.
U 1 cenify that 1 have read this application and sign that the above information is
I,, torten.1 agree to comply with all city and county ordinances and aute laws relating to
� building construction,and hereby authorise representatives of this city m enter upon the
Uahove-mentioned property for inin cuon purposes.
(We)agree to save,indemnify and keep harmless the City of Cupenino against
tirn liabilities,judgments,casts and expend.which may in any way seem.against said City
U,'Z in consequence of the granting of this permit. re !�-
�•^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date H
$ffyy��gqeeeexxeeccuu��ATIDtCC7
Re-roofs
Signature of App manUConuactor Deu
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding occupautom or handle Burgundies material
az defined by the Columbia Municipal Cade,Chapter 9.12,and the Health and Safety
Code,Section 255324)? All roofs shall be inspected prior to any roofing material being installed.
Cy. ❑Na
Will the applicant or future building occupant use equipment or Mvims which If a roof is installed without fust obtaining an inspection,I agree to remove
emit haxmdous air contaminants az defined by the Bay Area Air Quality Management all new materials for inspection.
w. District?
❑Y.a ❑No
1 have read the hasardeds materials requirements under Chapter 6.95 of thc Califon
iia Heahh@ Safety Code,SCNord;ZW5,25533 and 25534.1 understand thmifthc building
does not cumemly haw a tent.that it is my responsibility in notify the w.'cupanr Or the
requ remEnRswhichm mmetpdormi.ummo(,Cemri.waf Occupmcy. Signature of Applicant Date
o �u ami hariaed\l agent �_1 I n6 All roof coverings to be Class"B"or better
..
CITY OF CUPERTINO
3 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35602043 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . 35683
REFERENCE ID # . . . 06080130
SITE ADDRESS . . . . 22305 RANCHO DEEP CLI DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RANCHO DEEP CLIFF HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : DRAEGER CONSTRUCTION
CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21695
COMPANY . . . . . . . . . . : DRAEGER CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 605 COMMERCIAL ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 536-0420
OEE 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
•
i - CITY OF CUPERTINO OUD&I50
CITYOF PERMIT APPLICATION FORM
CUPEI�TINO
N# �/� /1 � „i(� Date:
c&l125IOID
Building Address- JJ V f h Mailindress (if different from building address):
22 Iamb r2on ho Cfc
Owner's Na Phone #:
ncho Gtff t 1e+°t - 406 -wav-3300
Contractor: n ® 1�G License#:
W i t�l� 10 C3pd
Contact: Phone:925•313-0100 Cupertino Business License#:
f'MG11-10 W.ESOan Fax: 2JOq15
Building Permit Info:
Bldg Rl eC0 Elect ❑ Plumb Mech ❑
Job Description: - 1
Residential Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.: .
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
second-story addition: ❑
o'ect Size: Standard 2"'� Laze ❑ Major❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
-- BBOILER2 Boiler> l OOK to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to IM Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTA)MQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax-Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V > IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
1 BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
•
1 of 3
Illlllllltt _- --_
CITY OF CUPERTINO
CUPERTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee i BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMIvIM New Comm Mechanical ' MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL I Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interce for PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check R eat 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
BPTR-AP 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 Reins ection 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 Lip-htiniz Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHACAL
NI
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRApp Rem Non-Res Appliance ELECTRICAL
BRENT LE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/ADDaratus ELECTRICAL
BREMRECEPT Rent] Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2of3
CITY OF CUPERTINO
OF PERMIT APPLICATION FORM
CUPEkTINO
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 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 Mechanical sq. foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
•
3 of 3