04040011 (3) CI'PY OF CUPERTINO
nulLmNCDrvlsloN PERMI GCINTRAGT RINkO �VIAT = thy '
BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMITNO.O4040011
OWNER'S NAME: PERMIT LSSUE DATE
IRVINE APARTMENT COMMUNITIIS605 COMMERCIALn4/14/2004
E: SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER:' BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
X00 LICENSED CONTRACTOR'S DECLARATION Job r tl n
C 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing FI��L
en with 5eorcean effecOivixion]of NC Business end Pmfcasinns Codc,end my license is
in mu rmme dna arrear STAIR REPAIR
j�? License Clazx Lic.p
�pp p ED
Datc Cim"Anwr
ARCHITEa< I underamnd my pr'n,.h.1 he us d.DECLARATION records
OCT 2004
So: Licenses Pntfessinnel
S OWNER-BUILDER DECLARATION
BUILDING
a I naso affirm on I am exempt from the Contractor's ;Any,Law for my
m Off, followingreason.a permit
IDnstr Businessand improve.
demolish.
h.oc:Any city or county
Which requires a permit na cnnsvum,eller,improve.demolish,nr repair any arucwu
iy
Poor RL its issuance,ahu myuirevht.,tcant I.,such permit to file a signed statement 57892
< that he is licensed parsonal to the previsions or the Contractors Licause Law(Chapter 9 Sq. Ft. Floor Area Valuation
as (commencing With Section 7")of Division]of the Business and Professions Code)or
y
that he is czcmpt Barabm and d¢basis for the alleged exemption.Any violation of
S,ctl.0031.5 by any Applicant far.p.it subjccu he Applicant to a civil penalty of 3 A01 fMer OO Occupancy Type
nolmorothan Rvehundred delta.(ss0o).
El 1,as owner of the property,of my employees with wages As their sole compcnsetlna,
will dothework.endo: awqumisnotintended mow does
A(Sec.1044,Business
end ertywhiobu Cade:The wsflemora Licenseand
Lew aces or appy to an owner or Required Inspections
own em who buildsorimproveschimpr,and who Are not
himaelredor through his
own employcbuilding or i sM1m such improvements are not iear o intended mplemcd for reconnect.builder ,Ne buildingb r improvement is sold within one year of improvtif r the owner
builder will have the burden of proving Net he did not build or improve for purpose of
salt.).
�.es owner of the property,am exclusively contracting wish licensed contractors to
ons met the pmjcct(Sec.7W,Business and Professions Code:)The Contractor's Li-
cense law docs not apply in an owner of property who builds or improves th ro on,and, -
who contracts for such pmjccu with a cont actor(s)licensed pursuant to the Contractor's
License La
of.. In n Sec. ,B&PCfor did o
Ow Data
O Eft' OMPENSATION DECLARATION
the y ssm er nally of perjury one of Ne following deelafatim n
Iheveandwi maintaina Ceniricm,of Conscnttoulr.insumfor Worker's Compete
cation,As provided for by Section 3700 of she Labor Codc,for the performance Of the '
work for which Nis permit is issued.
1 have and will maintain Worker's Compensation Insurance,.s required by Section
3000 of the Labor Code,for the performance of the work for which this permit is issued
My Worker's Compensation Insurance carter and Policy number ea:
Cartier: Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
ITIL'Seclloe need not he COMPICtcd if tote permit is forms,hundred dollars($100)
n less.)
I certify that in the performance of the work for which this permit is issued,I shall not
employ any person in any manner se As An become subject to the Workers'Compensation
Law.of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Ce tiEcem of Exemption,you should
become Subject to the Worker's Compensation provisions of the Lance Code,you must
.JO forthwith comply with such provisinm or this permit shall be deemed invoked.
z.,r"a CONSTRUCTION LENDING AGENCY
ti
[--� I herebywhich
that N,re is sued(S
ee.
i(Fo,Civ.
agency for performance Of
(Yi the work for which this permit is issued(Sec.JU9),Civ.C.)
W� Q Lener's Name
z
Lenders Address
V 0 1 certify that 1 have read this application and sate that the about information is
w f~- correct.I agree to comply with All city and county ordinances and state laws relating to
Ct, building construction,and hereby submits repfesenmtives of this city to enter upon the
W shovommnioned property for itmpecdon PurPeus.
LL (We)ague to save,indemnify and keep harmless the City of Copc(ino against
fyh Iiabilitiesjudgmcnts,costs and expenses which may in any way accrue against sold City
U z in conuyuencc of th 6rami 11 of this Permit.
APP A T E NDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO TI
Re-roofs
Signature f Pplic C n actor am
HAA OUS MATGRIALS DISCLOSURE Type of Roof
Will caPP uwrc building occupant store or handle havalloux material
As refined by the Cupeni no Municipal Code,Chapter 9.12,and the Hcal th and Safety
Code,Section 25532(.)? All roofs shall be inspected prior to any roofing material being installed.
OWill the applicant or Ind- nftmlmilmng ner:want Asc,yeipm.nl or d,.ie,a wni,h If a roof is installed without first obtaining an inspection,I agree to remove
IL honrdous air contaminants ax defined by the Bay Area Air Quality Management all new materials for inspection.
Oistria? r�asy/,C,
OYea
I have mad the hmallous mamrialsuquimmenu under Chspmr 6.95 of the Califor-
nixHealth&Safety Code,Secdmns25N)5,25533nd Z55J4.lundcn dtholifthe building _
Jm¢ of v ml Svc a run tr Na it is my rn mnihility m nodfy thn mcupnl of thc
n
Tey r rats hmust ntpdonulssuccm.Cerifca¢oroccup ,. Signature of Applicant Date
O. tar „ ri,eda ant „e All roof coverings to be Class "B" or better
OITY OF CUPERTINO
CUPEkTINO PERMIT APPLICATION FORM �u v
N# Date:
316-06-032, 316-06-037 March 31, 2004
Building Address: . (Building 1110 ) 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 lett ❑ Plumb ❑ Mech ❑
Job escription:
Residential ❑ Commercial ❑
Sq. t. Floor Area: S/Sq.Ft.:
Cost of Project: Occupancy Grou I
$ 57,892.24
Type of Construction: Please check thi ox i the projec 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
BBO.LER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler> 500K to 1M Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILERS -Boiler> I75MBra 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 <= 1000A ELECTRICAL
13ELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<= 200A ELECTRICAL
BENERGY Ener BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUII DING
BMITIGATC Comm. Housin Mit. Fee BUILDING
# s�
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�ITY OF CUPERTINO
CUPEf�TINO PERMIT APPLICATION FORM
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 Pb1g 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 Fumace> I OK btu MECHANICAL
BREN=AT 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
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
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*CITY 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 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
ZADDCHG Address Chane BUILDING
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