06080155 (2) CITY OF CUPERTINO
6UILDID.';�DIVISION PERMIT "CON MCTnR INF�,ORMATION BUILDING ADDRESS a DRAEGER CONSTRUCTION INC PERMIT NO.06080155
10870 KESTER D
OWNER'S NAME: PIItMR ISSUE DATE
ft RANCHO DEEP CLIFF HOA 605 COMMERC
NE:
SANITARY NO. CONTROL N0.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDGO ELECTO PLUMS MECHO
00 LICENSED CONTRACTOR'S DECLARATION IOb Description{ 1 hcmby afOrm that 1 am licensed under provisions of Chapter 9(commencing
w, inulsfortsm�cffctt i°tri°°'arNe Businw arta Proressiwn,Cnde..ndmylicenxu REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE
__ Dam !Cla Con or f(� ANTI-POUNDING, FELT & BATS . ROOF REPAIR.
Dam �TE Contractor
ARCHITECTS DECLARATION
i I undcnunJ my plans shell W used as public records
zyU
'Qt� Licensed Professional
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OWNER-BUILDER DECLARATION
S 1 Wmhy.(Sere Nat 11. ,Bump,hum the Cssions Cc License Law for tW
p O following ocean.(Section 703 1.5, tainess and ve thuuns Cod°:Any city or county
fZ'1$voo which myus u n eeral ii m cnnswct,alter,improve,h permit
t or mash any structure
11_Z} pnaIWits IEuaM4al5a(Cgalmsthe applicant far such pefmllmrile aslgneJ abutment
eonthat
thatWislicensed pursuanttothe provisions ofthe Connector's UmmeLow(Chapmr9 Sq.F FFloorArea ValuatiOd208
(commending with Section 7")of Division 3 of the Business and Professions Code)or
f $
that be u exempt therefrom and the bash for Ne alleged exception.My violation of
Section]031.5 by any applicant for a permit sub*us the appOu
cano a civil penalty of qPN Number Occupancy Type
not more Nan five hundred dellen($%Oo 3 5 602046 . 00
❑I.in owner of the property,army..pl.yc.with wage,as then.1.compensation,
will do thewurk,and the stmaure is not intended oronesed forsde(See 704a,Businw Required Inspections
and prou ftmamCode:The Conasemr,License law does wont e ns apply N an owner of 9 P
property who Wilds crimproves themon,and wh tdas,uch work himulfmthrough his
own employes,provided that such improvereems are not intended or offered forme.IL
however,the building or improvement is sold within aro year of completion.Ne mand,
builder will have Ne hurden of proving Na he did not Wild or improve for purpose of
salt.).
❑1,as owner of the property,am uduadvely muorc,ing with licensed mnuutars W
comuuct the project(sec.Rude,Businm and Profwiam Cade:)The Cmunduars U.
come law does not apply to an owner o'progeny who Wilds or improves thereon.and.
who contracts for such projects with a e°nuacmr(s)licensed persons,in the Connectors
License law.
❑I am exempt under See. ,B&P C for this mason
Owner Dam
WORKER'S COMPENSATION DECLARATION
40 1 hereby air.under pcmlty,of perjury aro of the fallawing declesair m:
t3-Posve and will maintain a CustiOcate of Consent 1.self-insure for Werkee.Compcn-
mount.as provided for by Section 3700 of the labor Cade,for the performance of the
work for which this permit is issued.
)T T—Nive and will maintain Workers Compensation Imuran,.a requited by Section
37W of tho labor Cade.for thepertormand,Of Ne work for which Nu w
is prom, ised.
My Warkch CompensaYon insure dirtier and Policy number am:
Cartier. Policy No.:
CERTIFTCA OFEKEMPION FROM WORKERS'
COMPENSATION INSURANCE
(This seaiaw reed no,W completed if the permit is routine hundred mfl.($100)
or less)
1 etnJy that in the pwromanee or the work for which this permit is issued,l,hall not
employ any parson in any manner so as W become subject to the W°rlem Compernadon
Laws of Caltromia.Dam
Applicant
NOTICE TO APPLICANT:IL after making this Cmdricam of Exemption,you should
become xbjen to the Worim's Compcosetion previsions of the labor Code,you most
.J 0 forthwith comply with such provisions or this Permit shall W deemed nevnkcd.
z'-" CONSTRUCTION LENDING AGENCY
[—t 4 I hemh,.1irm that Nem is a construction lending apacy for the performance of
(Y. > the work for which this permit is issued(Sec.3097,Civ.C.)
W 0 Lenders Name
z lenders Addmes
U O 1 ccnify that I have mad this application and stem that dm above information is
ly F coned.l agree to comply with all city and county ordinances and mile laws misting to
0U building construction,and hereby authorise mprescroatives of this city to enter upon the
Lt3 movc-mentioned property for inspection purposes.
Fgy
(We)agree to arc,indemnify and keep harmless the City of Cupertina against
py
liabilities judgments,costs and expenses which may in any way aacmt against said City
Uz in consequence of the gmnung Of this fermis
'-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
EGU ONS.
Re-roofs C71'
Sigulture of A,,Imxf memos Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding Occapattstom at handle hamrdous material
adefined by the Cupertino Chapter
o Municipal Cade. 9.12, oil Health and Safety
Code.Section 25532(.)? All roofs shall be inspected prior to any rood Nroofing material being installed.
❑Ym
Will the applicant orfomm Wildingaeupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haammis air contamimnu as defrod by Our Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes --g-N.
I have mail the haaNas materials requirements,under Chapter 6.95 or the Califor.
nice H..I"Safcsy Code,S.6.m M5.25533am125534.I.&k dthaifNc Wilding
dam mai curmmly haw s tenant,Nu it u my rcmmunhility w notify the Occupant of one
Oupite x riarmiauataanctn;BeamorOccupancy. SignatureofApplicant Date
-� Alroof coverings to be Class"B"or better
Ownfror authorized agent Dam
CITY OF CUPERTINO
�m 8 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # .1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35602046 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . : 35685
REFERENCE ID # . . . : 06080155
SITE ADDRESS . . . . . : 10870 KESTER 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
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CITY OF CUPERTINO
(�¢00d15�
CUPEI0F PERMIT APPLICATION FORM
N# Date: pe)I X(2) 10 U
Building Address Mailing Address (if different from building address):
Imnr
Owner's Names ,^' ,te a CT /*4b p Phone#: ,{� =p a3c
Contractor: �1 1 License #:
Contact: Phone: Cupertino Business License#:
Fax: 2-639-5
Building Permit Info:
Bldg 0`000 1 Elect ❑ Plumb ech ❑
Job Description: -5-M fi 1 4i
Residential E -V Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: 'Ls�LJ Please check this box if the project is a
second-story addition:
o'ect Size: Standard •B� Laze ❑ a'or ❑
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/Comin/ uasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A 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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CITY .OF CUPERTINO
C PERaol- O PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Grou •
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 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
BPVENf 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 cfin MECHANICAL
BREMAHUiAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Fumace MECHANICAL
BREMITURNOV 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 Appliance ELECTRICAL
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CITY OF CUPERTINO
CUP*TrlINQ PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Group
BREMSIGNAD Rmd] 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
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special hisection 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
EPERMITFEE 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
Ilk PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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