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06080137CITY OF CUPERTINO ` 'BUILDING DIVISION PERMIT C01�I7CR.T(1T.i.ik�Fk'C)RM.t�..'.XQl . BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT"°'06080137 22475 RANCHO DEEP OWNER'S NAME: PERMIT ISSUE DATE RANCHO DEEP CLIFF HOA 605 COMMERCIAL ST ng/iR/2nne NE: - SANITARY NO. CONTROL NO. (408)536-0420 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH j LICENSED CONTRACTOR'S DECLARATION lob Description 1 hcrtby affirm Net I am licensed under provisions of Chapmr 9 (commencing with Section ?Q30) orDividen 3 ofthe Bear.. and Profusions Cede, and my license e In fell mrcaandeffeot. !O REMOVE 3 TO 4" OF TILE, FELT & BATS. INSTALL NE Z 1 - Z Lkense!EC Contractor (,r Date � �Comreckr ANTI -POUNDING , FELT & BATS. ROOF REPAIR. ARCHITECTS DECLARATION 1 understand my plans shall be used as public rwords J n Licensed Professional ION S OWNER -BUILDER DECLARATION Cmw I hcrchy mlTam that 1 a.1. exempt from the Contractors Anyc Law for the : a Code: Any city o following mason. (Sedan ](131.5, Business andProfessions 0 structure Which requires a permit m cnmwcn, slur, impmw, demolish. or repair any saunum improve, moll primmitscensed ealmrequirce thevisio of for Contrctoitmfiense Law(Cha mem tofile aeignedsmmcnL piomnt for Contractor's permit licensed rsuamkths the applicant <thatr e is R) its pter 9 Sq. Ft,Floor Area Valuatior}208 (commencing with Section 7000) of Division 3 of the Business and Profcuinns Code) or $ Net he u exempt thvefmm and the basis for be alleged exemption. Any violation of PN Number Occupancy Type Section 78313 by any applicant for a permit subjects the applicant to a civil penalty of not mom Nan fin hundred dollars ($5007. �q 3 5 602032.00 D 1, as owner of the property, or my meploycen with wage as their sole compensation, Required Inspections 9 P will do th..&-and the someone is not intended oroRead(orsale(Sec.]044, Beiimss and Professions Code: The Cmdescmr's License Law does ret apply m an owner of property who builds oded thavethimprOvcmcnu1 oenouchendedomselforthmugh Itis f. mwever, the buip ing or nopproat himpmwmwtsmenet ear of .unpicored foe ida.own , however, Uee building or improvement is sold within one year of complcton, the owner - F L F' builder will have the burden of proving teat he did not build or improve for purpose of s.m . ❑ I, as owner of the property, am exclusively connecting with licensed Contractors in construct the (Sec. 7044. Business and professions Cade:) The Codtracmr'a U. ^ f ! project thercdn. d, case law does not apply to an owner of property who builds or improves an / I' who concocts for such projects with a Contracmr(s) licensed pursuant to the Contractors C)I Ve Law. • Dlam memsept undo Bee ,B&PCfor this reason al r L NG Owner Osie _IN WORKER'S COMPENSATION DECLARATION I hereby am. under penalty of perjury arse of the following decant ns: 1 have and will maintain a Cenificak of Consent he selFWum for Worker's Compen- sation, as provided for by Section 3700 of the tabor Code. for Ne performance of tri work for which this permit is issued. ja-rga'w and will maintain Worker's Compensation Insurance, m mquhad by Section 3700 of the labor Code forthe performance of the work for which this permit issued. My Worker's Compensators be, coca,. dPolicy number am: Cartier Policy Nd.: :1 '70111 C RTI ^ A F EXEMMON PRO WORKERS' COMPENSATION INSURANCE' (This section need not he completed dust permit Is farm. hundred dollars ($100) or Icss.) I certify, that in the performance of the work for which this permit is issued. I shall not employ any person in any mennersa as or become subject to the WorkersCompensation Laws of California. Date Applicant NOTICE TO APPLICANT: If. after making this Certificate of Exemption, you should become subject in lie Worker's Compensation previsions of the Labor Code, you must Z forthwith comply with such provisions or this permit shall he dccmed revoked. - 0 ' yCONSTRUCr10N LENDING AGENCY l herebyalllrm that there iso Construction lcndingageney for the performmma.f > the work for which thus permit or issued (Sec. 3097, Civ. C.) a Lenders Name Lender's Address z, 'J 1 certify that I have read Nis application and sum Nat the above information is E~ correct I agree to comply with all city and county ordinances and seem laws relating to J building construction, nod hemhy authmire mpscneneetives of this City to crier upon the 4[7 ah.,C-mant.ncd propcdy for impaction purposes. - (We) agree to save, indemnify and keep hornless the City of Cupertino against liabilities, judgments, Costs and expense which may In any way we= against said City Z in consequence of Ne of this G granting Permit. '+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date AT Re -roofs Type of Roof - diameterDam HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant akm or handle hvardous material ;10mol'Appliean derided by the Cupertino Municipal Code, Chapter 9.11, and the Health and Safety de, Section 25537(x)? NuWill All roofs shall be inspected prior to any roofing material being installed. ❑Yes a roof is installed without first obtaining an inspection, I agree to remove the applicant or future building Occupant use equipment or devices whichIf it hazasdnus air conlaminanu u defiocd by the Bay Area Air Quality Management all new materials for inspection. trict? 'LIN. Dy. 1 hart mad the himadous materials requirements under Chapmrb.95 of the Califor. nia Hcahh&Safety Code. Sections 25505,25533 and 25534.1 underseend thmiflhe building does not currently haw a union, Nm it is my responsibility to notify the occupant of the mqu mcnuwhic t der �mamofOccupancy. Signature of Applicant Date l -Q �- All roof coverings to be Class "B" or better Owner or authonyed agent Data W10 of 10 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35602032.00 DATE ISSUED ....... :'08/18/2006 RECEIPT #.........: 35683 REFERENCE ID.# ...: 06080137 SITE ADDRESS ..... SUBDIVISION ......: CITY .............: IMPACT AREA ...... OWNER ............: ADDRESS ..........: CITY/STATE/ZIP ... 22475 RANCHO DEEP CLI DR CUPERTINO RANCHO DEEP CLIFF HOA u OPERATOR: amyw COPY # : 1 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 QEE ID UNIT ----------------------- BENERGY PERMIT FEE BPERMFEE VALUATION BSEISMICRE VALUATION TOTAL PERMIT METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : 0 QUANTITY AMOUNT ---------- ---------- .115.56 55.47 5,000.00 115.56 4,208.00 0.50 ---------- 171.53 AMOUNT ------------ 1715.30 1715.30 ISRM015AP�9.1&M021� iMOM 047 0.00 55.47 0.00 0.00 115.56 0.00 0.00 0.50 0.00 0.00 171.53 0.00 NUMBER ------------------ 123214 r� Cl� OF CUPERTINO CITY OF CUPERTINO M�0I 3-7 PERMIT APPLICATION FORINT ir N# �W— Vf- ll'J Fee Description Date: C&1125 KXD Building Address: 2 (Z�,iY cho Mailin C�\ �jddress (if different from building address): Owner's Name: ►Zp�l, o poep Cli4 W0A Phone #: -22-U-03o0 Contractor: WQ ( ongramon inc,.LicensU11 ,O CSq Contact: Phone:976 • 313-D100 Cupertino Business License#: FJ'I C IO WIlSVi6Lq Fax: BBOILER4 2J eq Building Permit Info: BBOILER5 Boiler > 1.75M Btu Bldg Rlel0fi0q. Elect ❑ Plumb- PMech ❑ Job Description: feyviel 3tp '1 1 le, BCONSTAX - t Residential BCONSTAXBQ Commercial ❑ Sq.Ft. Floor Area: BCONSTAXH Sq.Ft.: . Cost of Project: 4,a- I BCONSTAXR Occupancy Group: Type of Construction: BELEC1000 Please check this box if the project is a ELECTRICAL BELEC1001 second -story addition: ❑ o'ect Size: Standard R"'� Laze ❑ Major ❑ BELEC200 Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > IOOK 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 BMVESTIGA Investigation fee BUILDING • 1 of 3 i� a CUPERTINO CITY OF CUPERTINO PERMIT APPLICATION FORM ri 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 Gas PipinE 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. WaterHeater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfrn MECHANICAL BREN AIRHAN A/C Units <=10,000 cfrn MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREWIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Fumace 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 A Bance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/AA aratus ELECTRICAL BREMRECEPT Re ti Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT R air/Alter Heatin MECHANICAL BREMRESAPP Remodel Res Ann]* ELECTRICAL 2of3 CUPEkTINO CITY OF CUPERTINO PERMIT APPLICATION FORINT Ouantitv 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 0 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 MPERIvIFEE 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 • 3 of 3