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06080157 (2) CITY OF CUPERTINO a` BUILDING DIVISION PERMIT CQNTRAC' (;T�tI TP`Q•RMA' �_N ''` BUILDING ADDRESS: , DRAEGER CONSTRUCTION INC PERMIT No.06080157 10951 KESTER D OWNER'S NAME: PERMIT ISSUE DATE RANCHO DEEP CLIFF HOA 605 COMMERCIAL NE: SANITARY NO. CONTROL NO. (408) 536-0420 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BO ELECT PLO MEOCH u000 LICENSED CONTRACTOR'S DECLARATION Job DOSCilpt100 w❑ 1 booby affirm Nat I am licensed undo,provisions of Chapter 9(commenein{ iU with Section 70M)of Division 3 afthe Busineu and Professions Code.and my license is n<� inrtllfareeameerteet. REMOVE 3 TO 4" OF TILE, FELT & BATS. INSTALL NE j�_ license Clau Lic.N 6�7/ lt7 �� Data7 —o t comrxmr ANTI—POUNDING, FELT & BATS . ROOF REPAIR. illo ARCHRELTS DECLARATION I understand my plans shall be used u public omnis JyU g t; Licensed Professional S OWNER-BUILDER DECLARATION f 1 hereby affirm that I am exempt from Ne Contractors License Law for the no following mason.(section 7031.5,Business and Pm(cssiom Codc:Any city or county SA which requires a permit to canumct alter,Improve,demolish,ar repair any Structure Z y prior tat its issuance,also imports the applicant rorsuch permit m file a signed statement < that he is licensed pursuant to the provisions of the Conbu:tur II3cense Law(Chapter 9 Sq.F FFloor AValuati$ 2 O yZF$ (commencing with Section 7M(y)of Division 3 of the Business and Professions Code)or It there r3 that he exempt from and the basis for the dinged exemption.Any violation of Section 70315 by any applicant for a permit subjects the applicant m a civil penalty of APN Number Occupancy Type on mare than r hundred dollars($500). 35628023 . 00 ❑L,u owner of the property,army employees with wages u theirsok eompe aeon. will do the work.and Nesumose is nnintanded araQered foraale(So..7044,Bviness Required Inspections and Professions Cade:The Contactors License Law does not apply N e an owner of q P property who buildsorimproves lhemon,and who doessuchwark hitmelforthrough his own employees,provided that such improvements tae notin ended oraffered formic.If. however,the building or improvement'msald within one year o(completion.the owner. builder will have tim burden of proving Nn M did nut Wild or Improve for purpose of sak.). ❑1,an owner of the property.am exclusively connoting with licenead conlnetars to construct the prefect(Sec.7044.Business card Professions Code:)The Contactors Li. cave taw dors not apply to an ownm o(property who Wilds or improve themen.and, who contracts for such projects wild anomnnar(s)licensed pursuant to the Contractors License Law. ❑I Sam exempt under See. .B k P C for this mssan Owner Dau 41 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury obo or the following declaration: J rIIhave and will maintain a Cardinals ofeovent m self-insure for Worker's Coupon. Sudan.as provided for by Section 3700 of the Labor Code,for the performance or the we&for which this permit is issued. have and will maintain Workers Compevx0on Insurance,as myvimd by Section 3700 of the Labor Come,far the performance of the work for which this Introit is Issued My Workers Camperssauon Ivo non carrier end Policy number ars: - Cam Policy No.:7(3j5 "O 9OnJ RTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE mitemetion bond not W completed ifthe permit is forone hundmddoihrs(SIM) or leas.) 1 comfy,that in the fulmination of the work for which this Permit is issued,I Shall not employ any person in any mannerso as in became subject to Ne Workers'Compensation Laws of California.Dau Applicant NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you Should become subject in the Worker's Compensation provisions of the Labor Code,you must .J O forthwith comply wit such provisimts or this permit shell W domed uvaked. 'y ^' CONSTRUCTION LENDING AGENCY [r 4 I hereby alRrm Nat them its construction lending agency for the performance of CG.tea the work for which this Permit is issued(Seo.3097,Cie C.) Q Lenticr's Name a z Lentlers Address U 0 i certify that 1 have road this application and sou Nu Ne above information Is correct,l agree to comply with all city and county ordinances and mu laws relating to V building construction,and hereby authorim mpmsenutives of this city to enter upon the Ct7 ahove-mcouuncd property for inspection purposes. g), (We).,me to save,indemnify and keep harNass the City of Cupertino again, tFi rA liabilities,judgments.ousts and expenses which may in any way accrue again,,mid City L)Z in consegec..of Ne granting of Nis permh. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Re-roofs Sigiffluareo App spRData HAZARDOUS xAZARDOUDOUb MATERIALS tm mo handl Type of Roof Will the applicant m future building e.Chapter tume or handle Health an materiel v defncd by tW Cupertino Municipal Code.Chapter 9.12,and the HCSIN and Safety Code.Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Y. 9-Har— Will the applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit haardous air comaminants u defiant by the Bay Amo Air Quality Management all new materials for inspection. Distr ct7 Oyes I have mad the Wa dams matarials reqummunts undcrchapus6.95 of the Califon niafhuhh&,Safety Code Secuov 25505.25533 and 25534.I understand Nuifihe building J bow a octans Nu it u my mspovihility u notify the,occupant of the u'mmcros whit or in announce of a Ceruficau ar Occupancy. Signature of Applicant Date (_19All roof coverings to be Class "B"or better Owner or authomed agent Data' CITY OF CUPERTINO -0m 10 of 10 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35628023 . 00 DATE ISSUED: . . . . . . : 08/18/2006 RECEIPT # • • • • . • • • • : 35685 REFERENCE ID # . . . : 06080157 SITE ADDRESS . . . . . : 10951 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 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 METHOD OF PAYMENT AMOUNT NUMBER - ---------------- ------------ ------------------ CHECK 1715 . 30 123214 TOTAL RECEIPT 1715 . 30 • CITY OF CUPERTINO CUPEI�TINO C1 or PERMIT APPLICATION FORM 411PN Date: ple>IIzIO�D Building Addr ss: Mailing Address (if different from building address): 5 r Owner's N Phone#: hGl�� To=te �'� }�c Contractor: License #: UI-1(.o 10 � Contact: Phone: Cupertino Business License#: Fax: Building Permit Info: Bldg W teZV�iElect ❑ Plumb Nech ❑ Job Description: $'To - 1 1 Residential K' -V Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: Type of Constriction: Ls�LJ Please check this box if the project is a second-story addition: ❑ •o'ect Size: Standard 'B"' Large ❑ 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> IM to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75MBtu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX hid/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 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING • 1 of 3 CITY OF CUPERTINO CUPEf�F PERMIT APPLICATION FORM QuantityFee 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 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 BREMAIlZHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL r BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Mise 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 2of3 CITY OF CUPERTINO CUPS OF 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 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 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 • 3 of 3