01070034 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS PERMIT NO.
21125 SEVEN SPRINGS DRIVE DRAEGER CONSTRUCTION INC 01070034
ogNE�sNME: 605 COMMERCIAL ST 07/10/2001
i
PHONE: (408) 536-0420 SANITARY NO. CONTROL NO.
C m Z ARCHIHEC'VENGINEER: BUILDING PERMIT INFO
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BLDG ELECT PLUMB MUCH
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Z LICENSED CONTRACTOR'S DECLARATION Job DOSCr]pI10❑
oz-oIhon7000).1Diuthat in3otpicdaoderprovisions
sionsCde.anomm=neing
nse CHANGE EXTERIOR SIDING
Fte Fm with Full;on]OWI of Drvi' Sot mdusinets:mJ Pmfessians Cudc and my license
xs ;scefad lass anderceet.3 � � 6(f7
¢ a License Class sZ Lic.N
Oc.U Date Contractor
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so 3 Ice CTS ARCHITEDECLARATI
C a D, I understand my phos shall he used as public records
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a.O ce Licensed Professional C`
OW NER�BUILDER DECLARATION /
e tier I hereby olFrm that I am cnempt from the Cornmelm's License Law for the I
z following mason.(Section 70315,Business and Professions Code:Any city or county $809 60
E x o which requires a permit to comwct,alter,improve,demolish,or repair any stricture
to�ze -prim tot .als 9 th pplicant for such permitt 11 a.g edtlammWl. - ---
thmhlsl' 'dpun no the pr .inns of meCommemr L< scl (Chap¢r9 ,-,c�. _-1'381OC37��s6�a- ' `s '••,, -, Valu ion
(comm< 'ng with Sect 7000) f Division 3 of me Business and Professions Cadet - . ,. ., ..- -( y .:J'._•I:{! 1 . -
or that he is exempt therefrom mW 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
inntnt more man rate nanared aounrs ssom. l 01APN NP 7AMAT I ON Occupancy Type
❑I,as owner of the propcny.or my employees wllh wages as Meir rale mmpensahnn. 102 PIERS
will an the work,arae the structure is not intended or offered for sale(see.Tau, 103 — UFER Required Ins ections
Business and Professions Code The Cmuracmr's License taw does not apply to as (] p
owner of property Who builds or improves thereon,and who does such work himself 104 - REBAR _
lir mrougb his own howevercarployeei( provided that such improvements of arc not intended or
-complroc Sale B.hbtaildethell have tnrimenofprotn sola hedid not year or ...... -105 - ANCHOR BOLTS'- f, . . . . ._ . ... . . . - . _.
inmptadfor the Puoseo-badeaer w;u have me ba,J<o of proving that he did not na0d or 106 — SEWER & WATER i
mpmvc Purpose
01 as owner of the property.ame.cI.unwely contracting with licensed commmntsm 202 '- UNDERFLOOR- PLUMBING
- consumer the project(see.70.44.Business and Profmstons Code:)The Contractors 203 - UNDERFLOOR MECHANICAL
License Law does not apply to an owner of property who builds or improves thereon.
andi ocartract,for such projects with a emilounim.)licensed pursaam to he -2 04 - UNDERFLOOR- FRAME -- - - - '- - - - -
Contmntore License law. ,.
❑I am exempt trader Ses. - -':B'&PC for this mmon 205 - UNDERFLOOR' INSULATION
Ow62r nate 301 - ROUGH PLUMBING
WORKER'S COMPENSATION DECLARATION 302 - TUB & OR SHOWER
I hemby erecta under penapy of perp,one of me munwa,declarminns: 303 _ ROUGH MECHANICAL
❑ I have and will maintain Certificate of Consent to mlf-mare for Workers 304 ROUGH ELECTRICAL
Comprn.sation, as provided for by Seaton 37W of the Labor Code. for the 305 — FRAME
performance of the work for which this Permit is Issued
❑1 haveated will maintain Worker's Compenerionilromarear
on,acquired by Section 3 06 - HOLDOWNS
37011 of the labor Coil r the
dominate f the work for which this perm t t 3 07 — INSULATION
iso cd hfy W lane,C ser n In:umnc J Pal y be arc
3081= SHEETROCK
ca Policy Na, Wr309 !-%EXT'ERIOR _-
s'�.CENTIpICA'TION OF E%EMPTION PROM.WORKfiRS�
„rJ? "LATH I:
COFIPENSATION INSURANCE s;' --. .. --- ----.-310----INTER-IOR—LATH ' -' --- --- - --- -
mtis seedon need no,ec completed inne pi is frozen.handrai dWlart 311 - SCRATCH COAT
4.311%Il nr Iess.1
333.-. ROOF.-.NAIL.....
1 certify thin in the perrnnnance bf thv work for which his permit is ixsaw'l
501 - FINAL ELECTRICAL ENERGY
shill ma employ any parson in any manner m as m become subject to,he Workers
Compemadnn caws nrealimmla.Dam
ApPhcan( _ 502 FINAL .PLUMBING ENERGY
._ ..
"'TICCTOAPPLICANT 11.after making this Grit fitinte of Escruption,you should 503 — FINAL MECHANICAL ENERGY
zh become nub/ my i CONSTRUCTION LENDING ittier,Corropen,,limi iofthe Labor Code,you mull
hsnhwimcnmplywimsasnpm ;amnsarmksprmdshort xaamearesnked. 504 - FINAL BUILDING ENERGY
Z
— AGENCY 505 - FINAL ELECTRICAL
1 hereby affirm that there is a construction lending agency for the peAanwnce
a onl,e work for which this permit is ,,.,d(See 3097,Cm.C.. 506 — GAS TEST
y.q L'enJcraName ' .. _ - 507. ..- . FINAL - PLUMBING - . . . . _.... . .
.�..Z Lcndei%Address -
- U'-O
I'crtify that I have mad thik application and state that the above information % 508 - FINAL MECHANICAL
Ls. E.. correct.I agree to comply with al1,city and county ordinances and irate laws relating 509 — FINAL GRADE
_ O U m buildingeoustrualon,and hereby authorize mpm,catelivesof this city to emeraP"" 510 - FINAL PLANNING
the above-WPAZAR�U
pony for inspection par,n c,
F� .y pv ;indemnify and keep haritheCity ofcopettmnagainst 514 - FINAL PUBLIC WORKS
Z liabilities, cs and expenses which may in any way accrue against said
U Z City'n eue-rating of this Permit.
— SOU! CEA. DS AND N'ILL COMPLY WITH ALL NO - NT Issued by:
Squat i montract �tc �• Re-roofs
ARDOU MATERIA!,DISCLOSURE
Will mi applicant or future W;IJinp acupam nom or handl<hazmrlous material Type of Roof
iv,di by the Cupertino Municipal Cade,Chapter 9.12,and the Health and Safety
Co dc,Scnion 25532(u1'! .I'.4. .I, (i,R`'4. t }, , , ., '' • 'N'. a:' "' s ser-: sA
❑Yes •u^ _ ❑No ... f 1, . :'
: .. . . .All.roofs shall.be inspected prior.to any roofing material-being installed. . . _._.
pWili theapplicantor future building occupant use equipment or devices which If a roof is insiAlledwithout first obtaining an inspection; I agreeto remove
emit hazardous air contaminants as defined by the Bay Area Air Quality Manngemen,
District?,om_ - oN all new materials for inspection. Applicant understands and will comply with. .
all non-paint r regulations.
t 1 ha d the hazardous mduis requirementsd Chapter 695 of the
Calf a He hh&Safe,,Cad Siwari 25505.25533 ad 255U I midersound 4.w,
- fjhm boil 'ng as 4.c dyh t rat Chet in myth pone brei notify the �, ` l� D
4.K upam f t rem ms whish must be met prnr m nzuunce o!a enilipme of
c1c tpunc (/ _ - Date',
.. -
p .p Ignature of Applicant
Owthnri:ends=rat Date All roof coverings to be Class "B" or better
..- .c'. .. ... t
_ - OFFICE