06080132 CITY OF CUPERTINO + as4o uew -
_ BUTLDINGD.fV,SION PERMIT C�NTRAa.. L'()zRINFO,,RM ION„
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT NO.06080132
22355 RANCH() DEEP M-1 DR
OWNER'S NAME: PERMIT LSSUEDATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
NE: SANITARY NO, CONTROL NO.
(408) 536-0420
ARCHITEC TEN°INEER: BUILDING PERM"INFO
BLDG ELECT PLUMB MECH
t� 0 0 0
loo LICENSED CO6r1EACIDR'S DECLARATION Job DSSCrI IIOn
�s C I WoU,affirm that I em licensed under pmvbians of Chapter 9(commencing P
bb with Section 7000)ofDiviaian 3 offt Suannv and Profevrium CoM,and my license
MH krallroceandenecs. REMOVE 3 TO 411 OF TILE, FELT & BATS . INSTALL NE
t Z Licens�r Cl azs Lk.as A 17 61 D
o D.wX—' _contrswr ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
ARCHITECTS DECLARATION
i Iundersund my plans shall he used az public records
tyU
LLo Licensed Professional
OW NERBUILDER DECLARATION
1 hcmhy alErm Not I em exempt from the Centrector's License Law rot Eric
:00 following mama.(Section 7031.5.Business and Professions Cade:Any city or county
j§9 which inquires a permit m continues.alter,improve,demolLsh,or repair any gromum
.Ziprior to its issuance.also requires the applicant for such Permit o file a signed smwmem
that he is licensed pursuant to Use provisions of the Connector's License Law(Cliapter 9 Sq.Ft. Floor Area Valuati$)d 2 0 8
`v $ (commencing with Scotian T000)or Division 3 of the Busneaa aM Prafe.W.E.Codd or
3 .. that he u exempt therefrom and the basis for the alleged esemplion.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant 10 is civil penalty Of APN Number Occupancy Type
not mom than five hundred dollars(SSW). 35602039 . 00
❑1,as Owner of the pmpeny,or my employees with wages as their salt compensation,
will da the wart,and theswcturt is not intended Or Offered for ask(Sec.J044,Business Required Inspections
sod Professions Code:The Committees License Law does not apply w an owner of q P
prepeny who buildsorimproves thereon,and who doessuch wink himsel(Or,Waugh his
own employees,provided that such improvements art net intended unaltered for rale.If.
however,the building or improvement is sold within one year o(compledon.the Owner.
builder will have the burden of proving that he did Wt build ar Improve for pmp Tse of
sale I.
s
❑1,as owner of the Set10Property,.Business exclusively conuaming with:i Th eC mbaanton . �/�
construct the es not (Sec.in an wnofand Professions Code:)The Cminewrb Lid ��
cense Law tlons not apply w an owner of property who sed p ra improves thereon,and &D
whoLA
ts for inch projects with a mntrxwr(s)licensed purwam w that Conuaclor's
0
License wit Taw.
❑I ore exempt under Sec .B k P C far Nis maven
Owner Dan
WORKERSCOMPENSATION m DECLAMa, ppm
40 1 hereby efasunder penalty of perjury ane of Ne following
dedam0ona:TT
■yUUL�pIp/■DIM;
fd5t�. i.
have and will for by
a tion 37M of C e Latioo oce.far far Performance
S ce of the I/�s/®/I re
ratite,as provided for by Sudan 37W of the labor Cade,ser the pcnfarmana of the �,V/
work far which this permit is Wood.
,fffhavc and will maintain W Wkeri Compensation Insurance,as required by Sectio
37W of the labor Code.for Jw performance of the work for which this porn is issued
My
Carrwicaokefs� + earnriennd Palicyrumyberam:
7�irS
dPolicy No.
CERTIFICATE EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu seetion need not w coreplmcd if the permit is for enc hundred dollen(31M)
or least)
1 unify that in the perfmU men Of the work for which Nis Permit is issued.I shall Out
employ any pence in any mmrrcrm as in become subject to the Workers'Compensation
Laws Of California.Doc
Applicmt
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worko's COmpeormon provisions of the labor Coda,you mug
.,O forthwith comply with such provisions m this permit shall be deemed revoked.
z CONSTRUCTION LENDING AGENCY
f".�.. 1 hereby spion Nat there its cmuvuctinn lending.,me,for the per(urmanm of
6i r7 the work for which this permit is issued(Sec.3097,Ci,C.)
Qlender's Name ,
7 Z fandefs Addm..
U C I m tify that I have road this application and sum Nat the above information is
U.H torten.I agree to comply with all city and county eminences and state laws relating to
.JU building construction.and hereby authorize representatives of 0iseity to enter upon the
r W above mentioned property for inspection purposes.
CL (Wo)agree to save,indemnify and keep Eremitical the City of Cuperuno against
h 1l
rF"y abnt ilitiea,judgmenss,costs and expenses which may in my way seem against said City
U Z in consequence of the granting of this permit.
^" APPLICANT UNDERSTAN S AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2 t
S RE ATTON
- Z -)I-nG Re-roofs
nFlt'
Sign—mum pplicanUConuacwr Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or forum building occupant store or handle hmamons material
as deRmd by Bre Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Coda,Section25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
pyo -ia—
Will the applicant or futon building mcupant tax equipment Or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hmamnus air..=Icanss as&food by the Bay Arca Air Quality Management all new materials for inspection.
DisaicR
❑Yes
I have mail the hae.door mmcrisb requirements under Chapter 6.95 of the Calier.
ria NoalthhSafcty CaM.Smtimts 25505,25533 am115534.1 mJcrsmnd thoirW building
docs net currently have a wnmL that It u my responsibility w nodry,the occupant of the
mquim nis chmav mapnartoismmmnfacemricawaracum . Signature of Applicant Date
' J•
owner an cera reg t naw. All roof coverings to be Class"B"or better
CITY OF CUPERTINO
5 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35602039 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . : 35683
REFERENCE ID # . . . : 06080132
SITE ADDRESS . . . . . : 22355 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
SEE 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
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CITY OF CUPERTINO
CUPERTINO PERMIT APPLICATION FORM
'N# o(0-✓!vc�c it Mfg Date:
C&I`&IO(D
Building Addres : n 11^� Mailing dAress (if different from building address):
Owner's Name: U 1 {Phone #:
. Mrx ho D& 41Eff RDA -33-
Contractor: Q n nnqrumOn ink License#:
Contact: Phone:'IT•313-DI00 Cupertino Business License#:
�y
1- iOrK.) WSt0&1 Fax: 218q
Building Permit Info:
Bldg S3**1ejCDfiK7q Elect ❑ , Plumb Mech ❑
Job Description: -PUAT KA%f
Residential Commercial E]
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
-4-
Type of Construction: Please check this box if the project is a
/ second-storyaddition: ❑
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> 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 <= 1000A ELECTRICAL
BELEC1001 Elee 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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CITY OF CUPERTINO +
CUPEf�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee ; - BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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 as 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 cfm MECHANICAL
BREMAPPLI A liance 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 Ap2liance ELECTRICAL
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CITY OF CUPERTINO
CUPER`F INT
PERMIT APPLICATION FOR
uanti 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
E BSEISMICRE Seismic Fee Res BUILDING
BSPECLAL 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
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