06080128 CITY OF CUPERTINO x !
&ITLDING'DIVISION PERMIT CC11 7C'TZAC QI�.I�Tk`C RMATIONt
> ,.
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT N0.06080128
22306 RANCHO DEEP CLI DR
OWNER'S NAME: PERNUi ISUEDATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
NE:
SANITARY N0. CONTROL N0.
(408) 536-0420
ARCHITEC17ENGINEER: BLDG BUILDING PERMIT INFO
MECH
ELECT PLUMB
1=] t� 0 0
o o LICENSED CONTRACTOR'S DECLARATION
1 wmby affirm Nat I am lianacd under provisions of Clupwr 9(commcwing lob Description
with Section 7000)of Divieion 3 oftha Bus nesaand Professions Cade.and my]icon=is
! gin fullfowe.ndcffan. REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE
t$Z License Class Lk.p (,fe l
'eDaw � Contractor License FELT Se BATS . ROOF REPAIR.
ARCHITECTS DECLARATION
i [understand my plans shall w used as public records
)yU
G Licensed Professional
OWNER-BUILDER DECLARATION
1 hereby affirm Not 11. exempt from On Contractor's License Any c Law for the
❑O whichfollowing mason. encdun 7!131.5,Bminesa and Professions Code:Any tiny or county
$ which its issu n permin requires
the alter,improve,h permit t or mash any strucumm um
•iy prior to its issuance.also requires the applicant Branch permit tilt aaigncd auwmcm
that he is licun=d pursue,to the previsions of Nc Contractor's License hw(Chapmr 9Sq.Ft, Floor ArValuat"208
LF$ (commencing with Section 7000).(Division 3of Ne Bualnessand Profesuinns Code)m
.- Net he u exempt Ne of ant and the basis for the alleged eumptlon.Any violation of
Section 7031.5 by any applicaatfor a permit subjects the applicant=a civil penalty of pKN Number Occupancy Type
not marc Nan Eve hundred dollars($300k 3 5 6 0 2044 . 00
❑Las owner of Ne Property,or my employees with wages=their sole compenation,
will do the work,and t1watrmturc is notintended m.ffered forsale(Sec.7044.Business Required Inspections
and Professions Cede:The ConuMwrY License Law does not apply w e an Owner a( q P
property,who W ildaar improves thereon,and who dos wch work himself.,through his
however.
ebuiprovided than such improvements are not ear of completion.m oRcrtd torula. r, �/
however.Ne building Orden of proving hat he did owynr ofprovfor the owner- $p ;
builder will have the burden of proving that he did wt build or improve for purpose of "•ar
sale.).
❑1,as owner of the property,am exclusively contracting with licensed comments to
construct tw project(Sec.7044,Business and Professions Code:)The Conuacwr's Li.
cove law danot apply w m owner of property who builds or unproven daemon.and [/
whocomeactn far such projects with a conwactor(s)licensed pursuant w dm COmmems's
License Law. qs O
❑lam..a."under Sec .B&PCfm this reason V�
Owner Data 1
WORKER'S COMPENSATION DECLARATION
hereby aR�under penalty of perjury one of to following declamations:hsve and will maintain a Canifiaw of Consent to self-insure for Workcr's Common. -
sation,As provided for by Section 3700 of the labor Cade,for the performance of the
work(r''hieh this permit is issued.
I have and will maintain Worker's Compensation Insurance,a required by Secdon
3700.(Iw labor Code,for the performance of the work for which this peank is lssmd.
My Worker's Compensation Insumna artier and Policy number am:
Carier:,STa-4E��ff.l'l',,CC••.na Den a•(-ard�Imy N.OF :1713 15() 7.110
{-li�.S11 JCERTIFlCA7�PENSATIONTINSURANCE ON OORKERS'
musaw ion wed not wcomplewd if Ne permit is Bmow hundrcddoilare($100)
or cas.)
I certify that in tits perfomtamw of to work for which this permit is issued,]shall not
employ any person in any mannerm w to become subject to the Workers Compenation
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this CeniEcaw of Exemption,you should .
became subject w Ne Worker's Compensation provisions of de tabor Code,you must
.,O forthwith comply wit such provisions or this Permit shall w deemed revuked.
z^ CONSTRUCTION LENDING AGENCY
[•e 1hemby farm that there iso construction lendingagemy for dw performance of
CYi 7 the work for which this pemtit is Wood(Sec.3097,Civ.C.)
fA QLender's Namc
gl,] z lenders Address
U Q 1 cenify Nat I have mad this application and raw thn the above information is
VL (~ arect.I agree In comply with all city and county ordinances and ante laws minting to
0U Willing conuwction,and hereby authorise mpmscnutives of this city to cmc,urm the
L$7 above-mentioned property for inspection purposes.
y (We)agree to save,indemnify and kap hornless the City of Cupertino against
,s rA liabilities,judgments.costs and expenses which may in any way acorea against mid City60
U APPLICANT U Nc PANDS AtND WILL COMPLY WITH ALL NON-POINT Issued by: Date 4/--d
S RCE R
- - Re-roofs �L--�
Sig
net=ofA ican ontmcter - Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m future building oecupwtswrc or handle hmardaus material
As deGwd by the Cupertino Municipal Code,Chapter 9.12,and 0w Health and Safely
Cade,Section I5572(a)?
❑ All roofs shall be inspected prior to any roofing material being installed.
41 Yes No
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 haaardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District,
C]Yes Nu
I have mad the h arena weariats tequimmenm under Chapter 6.95 ofthc Calif.,
ria Health&SafetyCoce,Sectiam 25505,25533 and 25534.1 understand Nat K0M Wilding
dere luck a tenant t u my rcaPanfhility l wor cc acupant rf Nc
m mentswhmhmn — .rtinawaraapanay. Signature of Applicant Dale
"— � All roof coverings to be Class "B"or better
0 rauNori'rcd agent Dow'
CITY OF CUPERTINO
�m 1 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35602044 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT 4 . . . . . . . . . : 35683
REFERENCE ID # . . . : 06080128
SITE ADDRESS . . . . . : 22306 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 # 21895
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
•
DRAEGER / c�
CONSTRUCTION
CA LICENSE#617610
August 18, 2006
NV LICENSE#0050111
AZ LICENSE#ROC 196924 TO: City of Cupertino
INSURANCE REPAIRS
RECONSTRUCTION
RE: Authorization to Procure Permits-;,—` � „,�„ra.`•;
PROPERTY MAINTENANCE
Hilario Bastida is currently e1yed'witfi Draeger Construction 3nc. as
Superintendent for the East By Regional:Office' and4s authorizes to procure
permits for Draeger Construction-Inc.e Ws"projects,�Y.
. ,�.. M�_ �, >.,,�1; P Iv,
Should you have any questions or regmre�additional=information,pleaseti
contact me at our office (925) 313 '0100;,,r I
Many Thanks
r a
JP
Maria
Mazia Da Mazen
i hti Grf
Internal Operations & Mazketing.Manager r "'
Martinez& Sacramento Regions r''�
Draeger Construction Inc. ° 6r - S`-'
`.;
0ORPORATE & SOUTH BAY EAST BAY REGIONAL NEVADA OFFICE SACRAMENTO REGIONAL ARIZONA OFFICE
REGIONAL OFFICE 137 MASON CIRCLE 2139 INDUSTRIAL ROAD 1875 DIESEL DRIVE, SUITE 11 2266 S. DOBSON ROAD
605 COMMERCIAL STREET CONCORD, CA 94520 LAS VEGAS, NV 89102 SACRAMENTO, CA 95838 SUITE 200
SAN JOSE, CA 95112 MAIN 925-313-0100 MAIN 702-547.6667 MAIN 916-646-6400 MESA, AZ 85202
MAIN 408-536.0420 FAX 925.675-6465 FAX 702.547-9020 FAX 916-646-6457 MAIN 480-775-5138
FAX 408-536-0425 FAX 480-775-5187
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
•CUPEI�TINO
Building Department
JOB ADDRESS: PERMIT #
1Z ndh� C1 iff o dos as o 1-8 to oymaca-
OWNER'S NAME: 90 oQ-t HOArPHONE #
GENERAL CONTRACTOR 21 Cj FAX #
am not using any subcontrac _ CYI t7
( _ Signature Date
Please check applicable subcontractors and complete the following information:
60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring. Carpeting
Linoleum/ Wood
• Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date
CITY OF CUPERTINO aaolz
CUPEf�F PERMIT APPLICATION FORINT
04-52 Date:C&III&IOIO
Building Ad ress' 3\U 'T Mailin dress (if different from building address):
2 . ro-onc o DoEp
Owner's Name: Phone#:
�gn�'lu Cli{�r kloA �-22Fo'3300
Contractor:VQ 0,0n< 1�t�CW)y1 If)C' License n ! c C S9
Contact: W Phone:'12•313-DWO Cupertino Business License#:
f-1" orlo W'90Gi01 Fax: 21£39
rp
Building Permit Info:
Bldg RIe�illq Elect ❑ Plumb Mech ❑
Job Description: 3to " "r1 e t
Residential Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project:4�-I
Occupancy Group:
Type of Construction: Please check this box if the project is a
second-story addition: ❑
oject Size: Standard R"�' Laze ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI 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/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V <= IOOOA ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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amCITY OF CUPERTINO < . .
CUPEI�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous,Fee j' BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
;BNUCOMMP i . 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 rinklerBackflo PLUMBING
BPSTORM Stomi/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 cfrn MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfni MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Fumace> 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
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CITY OF CUPERTINO
CUPEf�TINO INT
PERMIT APPLICATION FOR
' 4..
Q uantit
y Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marque(, 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
Am PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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