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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