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04040005 (3) CITY OF CUPERTINO 'z BUILDING DIVIs1oN PERMI' CONRACT(�R I)YFOItMA , BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT NOD 4040005 19500 PRUNERID ER'S NAME: PERMIT ISSUE DATE IRVINE APARTMENT COMMUNITI S605 COMMERCIAL ST 04/14/2004 PHONE: SANITARY NO, CONTROL NO. (408) 536-0420 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o p LICENSED CONTRACTOR'S DECLARATION {{{{��w�sts�{{{ass�� ppppfvt,,,,v....,,,,QQQQ��'� pppp �Y rd 1 hereby affirm Nal 1 am he Rosiness under provisions of Charter 9(commencing ■ ■• ALE D wishscolion7(1(%1)of DivisionSur Ne Busincaa antivisimaiof harteandmylicense is mmuto=and effeck STAIR REPAIR jgiZ License Class Lick Danc Comrad NOVO 004 'pp ARCH Con DECLARATION v- a 2L a< I undersmnd my plans'hall he used as public records �yU Z o� Licensed hereby affix BUILDING ®I S OWNER-BUILDER DECLARATION ■ir(7 .�0 0 , 1 booby affirm on 1 1. exempt from Nc Contractor's e:Any Law for the p o following reason.permit t 11131.5,Business and improve. d sio li Code:Any city or county K$ which itsisssnpermitm micros alienimprove,demolish,nreasrepair ged suement 7 ]568 _zr thucture e,hor nitscenseee,also imomam1.the lhovisiosOfcant for such Contrarmittoiense Law(Chapter ££zza Nat heislicensedpursuanuunhepmvisinnsnlNeCommemhLicenselsw(CAapter9 Sq.F[. Floor Area Valuation yFp (commencing with Section 700ft)of Division 3 of the Business and Professions Qxle7 ser y Net he Is exempt doref ion and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant no a civil penalty of 3 11,QRqQihBa00 Occupancy Type not more than Eve hundred dollars(SSW). 1,as owner of the property,or my employees with wages as their sole compensation, will do Ne work,and the structure is not intended or offered for sale(Sec.7w,Business antl Professions Code:The Concretion's License Law docs not apply to an owner or Required Inspections property who builds or improves thereon,and who does such work himself or through his n employees,provided that such improvements are not intended or offered for use.IL h wever,the building or improvement is sold within one year of completion,the owneo- builder will have the burden of proving Oat be did not Wild or improve for purpose of sale.). 1,as owner of the propcny.em exclusively contracting wide licensed contractor to Co. ofthe project(Sec.70a4,Business and Professions Code)The Contractors Li. come Law core not apply to an owner or property who holds or improves themon and who contracts far such projects with s contracror(s)licensed pursuant io um Contractor's License Law. ❑lame i on or e. .B&PCfon is re on er d Date lZj 'S CO PENSATION DECLARATION I here affi der a y of perjury one of Ne following declarations: ❑I have and will mail ermficme of Consentto self-insure far Workers Cumpcm smion,a provided for by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. ❑1 bane and will maintain Worker's Compensation Insurance,as required by Section 3700 of Ne Labor Code,far dee performance of On work for which Nis North is Issued. My Worker's Compensation Insurance carrier and Policy number art: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE IThls uctinn..it not W complemd if the permlt is rmin c hundred dollars 091(%3) or less) 1 certify that in the performance of Ne work for which this permit is issued,I shall not employ any person in any manner so ax to become subject no t e Workers'Compcneri im, Caws or California.Delo Applicant NOTICE TO APPLICANT:If,arwr making this Ccdificate of Exemption,you should become subject to the Worker's Compensation provisions or the Lihor Code,you must ,Jz forthwith comply with such provisions or this permit shall he deemed mimed. ya CONSTRUCTION LENDING AGENCY ' Ihereby affirm Nat there is a Construction lending agency for the porrumnance of pi ,> to work for which this rennin is issued(See.3097,Civ.C.) W Q Lender's Name z Lender's Address V Q 1 certify Out 1 have reed this application and stem that Ne soon,information is B, H cmrea.I agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby suburbia representatives of this city to enter upon the a above-mentioned property far inspccuon purposes. (~ (we)agree to save.indemnify and keep harmless the City of Cupertino against y Iiabiitie,Judgmcnls,cosor andcxpenus which may in anyway¢came ageinn said City �` O " in co Iucncc oft cgranting of this permit. r APP A T E 5 ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU L T S. Re-roofs. sisnatu of pylic m` n ¢tor am HA A DOUS MATERIALS DISCLOSURE Type of Roof ZIP Pl 'mum building occupant store of handle havallous materiel as defined by the Cupertino Municipal Code,Chapter 9.11,and the Health and Safety ISection 25532(¢)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yesu Will the applicant or(Mare building Occupant use equipment or dcdces which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District] ❑Ycs I}iNu I have read the he ardouTuss mmancrials requirements under Chapter 6.95 of the Califor- niaHcalub N Codc,Scram¢25Y)5,25533=d25534.tundcm=ddeatir We building does I c rten0y a t na 1.Out it is my responsibility to notify[be occupant of the requi cu mast 1 'rem,of acemncatoof0cae r SignatureofApplicant Date Ownc a ho coda nl Date All roof coverings to be Class "B" or better OCITY OF CUPERTINA cuP TYOF o PERMIT APPLICATION FORM APN# Date: 316-06-032, 316-06-037 March 31, 2004 Building Address: (Building # 4 ) Mailing Address (if different from building address): 19500 Pruneridge Avenue, Cupertino, CA 95014 Owner's Name: Phone #: Irvine Apartment Communities, L.P. Contractor: License #: Draeger Construction, Inc. Contact: Phone: 408-392-4100 Cupertino Business License#: Chris Young Fax: 408-392-4120 Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Description: Residential ❑ Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project: Occupancy Group: $ 77,568.00 Type of Construction: Please check this box if the project is a second-story addition: ❑ Quanti Fee ID Fee Descri tion Fee Group BAPPLOTHER Other A pliances MECHANICAL BBLDGFEE Bldg Permit sq. foot BUILDING BBOILER1 Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler IOOKto 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75MBtu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Qu si BUII_DING 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> I OOOA ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 0 mss- I I of t� �-6 7 , (�o @CITY OF CUPERTINOO c TM o PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group 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 rinkler/Backflo 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> 1 OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNR.APP 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 BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL 2of3 56 WITY OF CUPERTINO* CUP TYOF O PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group 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 Inspection 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 ZADDCHG Address Chane BUILDING i _ . . . i 3 of 3