06080133 CITY-OF CUPERTINOn �`
BUILDINCCIVISION PERMIT lo ,ii . '. � -ziNir 'Ib�Na
�a I < ,
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT NO.06080133
22385 RANCHO DEEP
OWNER'S NAME: PERMIT ISSUE DATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
NE: SANITARY No. 2 CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
0 0 0 0
IOC LICENSED CONTRACTOR'S DECLARATION Job Description
U 1 hereby affirm that 1 Am licensed under provisions of Clupscr 9(commencing
with Section 7")of Division 3 orthe Businessand Professions Code,and my license is
in full force and effect. REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE
License Cls La.11(_176,10
Dam ge-71- OTS —Contractor ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
ARCHITECTS DECLARATION
i < 1um)craiand my plans shall W used.public records
iau
s G� Licensed Professional
'ysOWNER,BUILDER DECLARATION
1 hereby AlTirm that I am exempt from the Contrachies License Law for the
.p O following mason.(Section 7031.5,Business and Pm(esslons Code:Any city or county
33 r which mquirrs A permit m construct.Alar.improve,demallah,or repair any swctura
-¢e prior m its issuance,also requires tin,applicant forsuch permit to file a signed sentiment
m that toislicensed pursuanttothe provisions ofNCContractor',License U.(Chapter 9 Sq.Ft. Floor Area Valuatior}208
`FS (commencing with Section 7")of Division S of the Bu¢msmnd Professions Code)in
.. that W is exempt therefrom 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 of APN Number Occupancy Type
nos mom than five hundred dollars($500). 35602037 . 00
1,As owner of me property.or my employees with wages As their sole compensation,
wall do thewark.and the structure is notinanded ter Ofered forule(See.7814,Business Required Inspections
®d Professions Code:The Contractors Liana Law does not apply to an owner of q P
property who builds or im prow thereon,and who dies such work himself or through his
own employees,provided thatsueh improvements no,not intended oraQemd forsah.if.
however,me building or improvement is sold within one year of rompledon.the owner
builder will have the burden or proving drat W did Mt build or improve for purpose of F p®�
sale.). ' "' 4
❑I,as owner of the property,am exclusively contracting with licensed cunmorem to ��
cower dap not (gee.7044.Owner
Business and property
who Wilds
Cade:)The Commoner's Lid
ave law does not apply b an owner of property who Wilda or improves theman,and
whots for such projeca with a mnwaor(e)limited pursuant m the Conuumrs i
Licensense UW.
E] Imre exempt under Sea .B@PC for this mason �• a � /1'?�t�
Owner Date p
WORKER'S COMPENSATION DECLARATION ■
1 hereby aRitm under penally of perjury One of the following declarations: L LNG
405(hare and will maintain a Certificate of Consent to self-Insure far WarkerSCorepem
sation,.provided for by Section 3700 of me labra Code,far the perfomsance of the
work for which this permit is issued.
g-1-have and will maintain Worker's Compensation Insurance,as required by Section
3700 of me labor Cade,for the performance of me work for which this permit is issued.
My Workers Compensation Ins cc carrier end Policy number am:
Cartier. Polity Naj WO f ... y
C RTIFICA EOF EXEMPTION FROMWORKERS'
COMPENSATION INSURANCE
Mus section aced net he completed if the permit is formic hundred dollars($100)
tar less)
I certify mot In the performance of the work for which this permit is issued.I shall not
employ any person in any mannerso As On became aubjecuo the Warkers'Compensation
Laws of California.Dan,
Applicant
NOTICE TO APPLICANT.It,arm,making mu CAr iOcam of Exemption,you should
become subject to the Workers Compensation provisions of me Latour Code,you most
Z faMwith comply with such provisions or this permit shall W deemed revoked.
Z Q CONSTRUCTION LENDING AGENCY
(-w I hereby affirm ren mere is a construction lending agency fm the performance of
tai> me we*for which this permit is issued(Ste.3097,Civ.C.)
WQ Lenders Name
�
ice. z LcnderS Address
U p I certify mat I have mad this application and sum mat me above information is
(; f" correct.I agree to comply with all city and county ordinances and sus laws missing to
�U building consuuctmo.and hereby authome representatives Of this city m cmcr upon the
above-mentioned property for inspection pugwscs,
(We)agree to save,indemnify and keep hartnlass me City of Cupertino against
rliabilities.judgmemA.mu and capons.which may in any way acerae egainsuato city p
U Z in consequence of me granting or this Permit.
�••� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU E6 LATIO
4s-31-o( Re-roofs
St 5aturem pplleaa ontraelcr Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will dn,applicant ter future building occupentstne or handle hrrardous material
As dcened by tW Commit..Municipal Code.Chapter 9.12,and the Health and Safely
Cale,Section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑rs _ 24.
Will she applicant or future building occupant use equipment ter devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit ha>srdoua air contaminants As derined by the Bay Arca Air Quality Management all new materials for inspection.
District] _
❑Yes
I have mad the WcaNswaman,rials mquimmenu under Chapar6.95 afthe Califor-
iia H.Im&SafetyCade,Secon.25511SM33 it 25534.1undenund Matifine building
dws not currently how A tenant.mat it is my ru'resibtlity An moill the aeupmt of the
rcyui mentsw' them 'onuissuance ora CeNO.a or Occupancy. Signature of Applicant Dale
owner oramthomedasent Dan, All roof coverings to be Class"B" or better
CITY OF CUPERTINO
6 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # '1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35602037 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # • • • • . . . . . : 35683
REFERENCE ID # . . . : 06080133
SITE ADDRESS . . . . . : 22385 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
WE 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
•
CITY OF CUPERTINO 000R i S3
CUPEt�TINO PERMIT APPLICATION FORM
WN, ���� b2�11�J� ¢ Date:
C&I V&I Ole
Building Address: Poncho
Mailin ddress (if different from building address):
Owner's Nam fZ^n^,^-o W Crlryli l * �� ` Phone#: LP _ 33C0
Contractor: 1lJY ► �� t�/ ^ '�G License #i—1 1 D C39
Contact: Phone:'12-313-0100 Cupertino Business License#:
f'� I�Gllrl� �QS1"1G�G1 Fax: ZISq
Building Permit Info:
Bldg R1?C0fiK7q Elect ❑ Plumb Mech ❑
Job Description: 3ADv "ft
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-sto addition: ❑
oject Size: Standard 2 Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
- -- BBOILER2 Boiler> I OOK 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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h
CITY OF CUPERTINO
CUPEI�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Grou
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housin 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 Pb1g 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 Dis osal 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 Appliance 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 A liance ELECTRICAL
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CITY OF CUPERTINO
CUPEf�TINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Sips 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 Ternp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITF'EE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . 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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