09050090 777777777= 77_7��
CITY OF CUPERTINO
BUILDING DIVISION PERMIT � �
PERMIT NO.
BUILDING ADDRESS:
10141 PARISH P1, DRAEGE CONSTRUCTION INC
PERMIT ISSUE DATE
OWNER'S NAME:
- S CONTROL NO.
'N :
(408) 536-042Q-.
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
0 0
a p OZ LICENSED CONTRACTOR'S DECLARATION Job Description
m I hereby affirm that I am licensed under provisions of Chapter 9(commencing
z with Section 7000)of Division 3 of the Business and Professions Code,ayes my license is
=y in full force and eff (�,� U SIDING STUCCO REPAIR
? License Cl Contractor
F Date RCHICECTS DECLA ON
a< 1 u my pl shall be used as public records /
7c6 Y�
ic y Licensed Professional
h 3 OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
e 2 V which requires a permit to construct,alter,improve,demolish,or repair any structure
y",4 prior to its issuance.also requires the applicant for such permit to< file a signed statement $qValuation
-z that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 .Ft.Floor Area
YF (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
y that he is exempt therefrom and 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 of APN Number Occupancy Type
not more than five hundred dollars(S500)• 31644023 . 00
❑I,as owner of the property,or my employees with wages as their sole compensation,
will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,Provided that such improvements ate not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and.
who contracts for such projects with a contractor(s)licensed pursuant to the contractor's
License Law.
❑1 am exempt under See. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a Certificate of Consent to self-insum for Workers Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Workers Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued
My Workers mpertrn 10ssurance carrier and Policy-um(Ier am: 2
Cartier: �f/ IL`_j Policy No.: 1 k-I f 6
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section reed not be completed if the permit is for one hundred dollars($100)
or ICss.)
I certify that in the performance of the work for which this permit is issued I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Workers Compensation provisions of the Labor Code,you must
❑z forthwith comply with such provisions or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
a the work for which this permit;s issued(Sec.3097,Civ.C-)
W A Lender's Name
Z Lenders Address
U O 1 certify that I have read this application and state that the above information is
V.t-r coeecL 1 agree to comply with all city and county ordinances and state laws relating to
0 Vove-
building construction,and hereby authorize representatives of this city to enter upon the
W abmentioned property for inspection purposes.
CL (We)agree to save,indemnify and keep harmless the City of Cupertino against
„Fy rn liabilities,judgments,costs and expenses which may in any way acme against said City
U Z in consequence of the granting of this permit.
►� AP IC STANDS AND)U41.COMPLY WITH ALL NON-POI Issued by: Date
U E U
S. r—t� z � .5 6 Re-roofs
f Applicant/Conuactor 8
rat oe
HAZARDOUS ATERIALS DISCLOSURE Type of Loof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes ONO
Will a roof s installed without first obtaining an inspection,I agree to remove
ill the applicant or future building occupant use equipment or devices which
it hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
-,strict?
❑Yes ONO
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sections 75505,25533 and 25534.1 understand that if the building
docs not rmnty a tenant,that it is ponsibility to notify the occupant n the
y ire wh'h est be met prior a Certificate of Occup Signature of Applicant Date
All roof coverings to be Class or better
wner or orizcd agent Date
q o Ccs
i CITY OF C UPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
J APN 4
Date:
Building Address:
Mal* A dre s (if diffekent from) building addre -
fes. '
14 Ow 's Name: Phone#::`
ryxYerio ork onl Yes No ❑
H A: (E y) ❑
If es, provide letter from HOA
Contractor: Phone: if —"
Fax:
Contrac r License#: GO
Cupertino Business License#:
Contact: a—C L -e�,rv.-Ur--1, Phone: '�l
Fax: — J
Residential Commercial ❑
Job De5r --st tX.0 O P,e�a�r
LL
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type: tt
1-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT,V-B
Valuation: Square Footage:
Project Size: Express❑ Standard ❑ Large ❑ Ma-or ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable,include in plan set&the sheet index.
Points Achieved:
For help,contact Build it Green at www.buildit reen.or
Revised 02/05/09
CITY OF CUPERTINO
CUCITY
TYor �O GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Des,:ription Fee Permit Type
Group 1GENRES or
1GENCOM
PARTITION WALLS
1PARTICOMM Partition Interior Commercial B 1PARTICOMM
1PARTIR Partition Interior Residential B 1PARTIR<=30
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard(up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSPI0 Special Design, over 10' high(up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
1 RETCRB> Gravity/Crib Wall over 10' high(up to B
50 ft
SIDING
ISIDESTBK Siding, Stone&Brick Veneer B
interior/:xterior
1 SIDEOTHER Siding al I other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>1 OSF Skylight greater than 10 sf or B
structura
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage hacks 0-8' high (up to 100 so B
1 SRACKS>8 Storage hacks over 8' high (up to 100 B
st
4of5
F
CITY OF CUPERTINO
-� GENERAL BUILDING APPLICATION
CUPERJINU FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
2 1STUCOAP Stucco Applications (up to 400 so B
J additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 3 windows
1 WINMEWSTR New Win low-structural shear B
wall/mascn (includes plan ck fee
IEPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alcne Electric Pln Ck(hourly) E
1MECPLNCK Stand Alcne Mechanical Pln Ck(hrly) M
1PLMBLNCK Stand Alcne Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard:'Ian Check(when no E/1\4/P) B
when not over counter) hourl -stand alone
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
1BUSLIC Business;_icense B
` of 5
4
IMIN
}.
Cupertino Village
--
Parish Place
__. .._._._. .... _. .:-.... 10202
_ - - '10201
LI
10194
wNN o o 10193 1 0192
10191 ---
10121 F F 10123
101
837
-- '-• -•- J YY 111 t 1 111 E i t�- t''U U l ' '-"""'- .D I U 1 t3 4
0 10113- 10131 �, ---
N 10-182
< 10111 . 10133 ----- _..-- — - ----- --- ._
> _
o a41 10173
10174
10103 CD010 ----_--
1
10172
10101 1- 101743 -- — 10171
Parish PIace 10164
.. I
s
1
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May 15,2009
i
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City of Cupertino Building Department
s
10300 Torre Avenue
Cupertino,CA 95014-3202
I
Re: Building Permits for the Cupertino Village Homeowners Association
10101 — 10251 Parish Place,Cupertino,CA j
Authorization for Draeger Construction Inc.to obtain Permits on our behalf
To Whom It May Concern:
The Board of Directors of the Cupertino Villag:Homeowners Association hereby authorizes i
Draeger Construction, Inc.,605 Commercial Street, San Jose,Ca 95112,to obtain permits for
miscellaneous remedial repairs to be performer in the common areas of our complex as
referenced above.
Should you have any questions,please do not b esitate to contact me.
4
E
Ve truly yours,
Diana Johnson
Association Manager (Aq en+
Cupertino Village HOA
i
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CITY OF CUPERTINO �6*1
BUILDING DIVISION PERMIT
BUILDING ADDRESS: PERMIT NO.
10143 OWNER'S NAME: PERMIT ISSUE DATE
IN SAN CONTROL NO.
ABUILDING PERMIT INFO
RCHITECIlENGiNEER:
BLDG ELECT PLUMB MECH
SHINGLE SIDING REPAIR D D 0 O
u O p LICENSED CONTRACTOR'S DECLARATION Job Description
0,E
I hereby affirm that I am licensed under provision of Chapter 9(commencing
ith Se
Z trod with 7000)of Division 3 of the Business and Professions Code,ar�'Ry license is
in full force and�ef �/2 (�L;cenacLle•8DateContractor
CTS DECLARATION Y`-
3, 1 understand my plans shalt be used as public records
4 C in Licensed Professional
n 3 OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the
00 following reason.(Section 7031.5,Business and Profession Code:Any city or county
y$ which requires a permit to construct,alter,improve,dcmolLah,or repair any stnrcto
prior to its issuance.also requires the applicant for such permit to file a signed statement
Gthat he is licensed pursuant to the provision of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
Y.t-0 (commencing with Section 7000)of Division 3 of the Business and Profession Code)or
that he is exempt therefrom and 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 of APN Number Occupancy Type
not more than five hundred dollars($500).
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work and the structure is not intended or offered for sale(Sec.7044.Business Required Inspections
and Profession The e Contractor's Lune Law does not apply to an owner of q P
property who builds or improves thereon,and who does such work himself or through his
own employers,provided that such improvements arc not intended or offered for sale.If.
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044.Business and Profession Code:)The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
❑I am exempt under Sec. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declaration:
I have and will maintain a Certificate of Consent to self-insure for Workefs Compen-
.,ation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Worker's C pensa n b carrier and Poli number are:
Carter
Policy No.:
C RTIFICATE OF EXEMPTION FROM ORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less)
I certify that in the performance of the work for which this permit is issued.I shall nes
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Codc,you must
Z, forthwith comply with such provision or this permit shall be deemed revoked.
Z O CONSTRUCTION LENDING AGENCY
E r►�-r I hereby affirm that there is a construction lending agency for the performance of
11�+ the work for which this permit is issued(Sec.3097,Civ.Q
W Q Lender's Name
04 Lender's Address
U 0 1 certify that 1 have read this application and state that the above information is
fL" correct 1 agree to comply with all city and county ordinances and state laws relating to
0 V building construction,and hereby authorize representatives of this city to enter upon the
U above-mentioned property for inspection purposes
(We)agree to save,indemnify and keep harmless the City of Cupertino against
rF.r liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the ung of this permit. Date
■" A 1C U E ANDS WILL COMPLY WITH ALL NO? POI Issued btr:
OU G ONS. r—� s r
V Re-roofs
S' nu f Applicanl/Conuac Dare
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety
Code,Section 25532(a)? ' / All roofs shall be inspected prior to any roofing material being installed.
[:]Yes No
Will If a roof is installed without first obtaining an inspection,I agree to remove
ll the applicant or future building occupant use equipment or devices which
t hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
_strict?
❑Yes kNu
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&SafetyCode,Sections 25505.25533 and 25534.1 understand that if the building
does�hbc
at i�tssu
A�rC
o notify the upant of the
irioreate of a p C,�ignaturn of Applicant Date
/ All roof coverings to be Class'n"'or better
er othorized agent Da
vqa
CITY OF 4"UPERTINO
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Lf o,-;p . -� k-:�) Date:
Building Addr -
P��
Mailing Address(if different from building address):
Ownelr's Name: `I11 Phone#:
HOA: (Exterior work only) Yes ❑� Yio ❑
If es,provide letter.from HOA
Contractor: Phone: y U e-- 1-
lz�fC,a �t "S, Fax: �'f U�- 5 3 (P U L/
Contra for License#: 6-17 67 Q
Cupertino Business License#:
Contact: �"� � � C� Phone:
Fax:
Residential Commercial ❑
Job Description: S
Building Permit Info:
-Bldg 9 Elect ❑ Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type: �_-3
-I-A, 1-B ❑ II/IIIN-A ❑ II/III B, IV-HT, V-3 ]
Valuation: f _F Squar ootage:
Project Size: Express ❑ Standard ❑ Large Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable,include in plan set&the sheet index.
Points Achieved:
For help,contact Build it Green at www.builditgr.-en.org
Revised 02/05/09
CITY OF CUPERTINO
CLiYU° GENERAL BUILDING APPLICATION
CUPE�TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
PARTITION WALLS
1PARTICOMM Partition Interior Commercial B IPARTICOMM
1PARTIR Partition Interior Residential B 1PARTIR<=30
RETAINING
WALL(CONCRETE
OR MASONRY
1RETSTN Standard(up to 50 ft) B
IRETSP310 Special I>esign, 3-10' high(up to 50 `) B
1 RETSP I O Special Design, over 10' high(up to B
50'
1RETCRB< Gravity/ ,rib Wall, 0-10'high (up to B
50 ft
1RETCRB> Gravity/ ;rib Wall over 10' high(up to B
50 ft
SIDING
1 SIDEST/BK Siding, c tone&Brick Veneer B
interior/_-xterior
a 1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>1 OSF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'1 B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 so B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st
4of5
rr
WVW-
Ctl ertino vil-lage
Parish Place 10202
- _
'10201
• -.'. o o LoN-
7
N•A � O -IO193
.-1 .N .._._ -10'192
.46
. .._ -- _''
4 10121F 10123
10184
Swimming Po.oI
o 103- ---
_ I 'i 0131 t 0'f f31 0 10182
< 1011j 10`133
m -- _ -A. 10174
�' 10141 o 10173 --
10103 cv to - --` - -----
C 10172
. W _
L,a1oi �0�43 _ -- .. _ 10171 ---------� -
Parish PIace 10164
i
i
,
i
I
May 15,2009 j
i
i
i
City of Cupertino Building Department
10300 Torre Avenue
Cupertino,CA 95014-3202
Re: Bui1ding Permits for the Cupertino Village Homeowners Association
10101 - 10251 Parish Place, Cupertino,CA j
Authorization for Draeger Constructior,,Inc. to obtain Permits on our behalf i
To Whom It May Concern:
The Board of Directors of the Cupertino Vilial e Homeowners Association hereby authorizes
Draeger Construction,Inc.,605 Commercial ;,treet, San Jose,Ca 95112,to obtain permits for
miscellaneous remedial repairs to be performed in the common areas of our complex as i
referenced above.
Should you have any questions,please do not hesitate to contact me.
I
Ve truly yours,
Diana Johnson 1
�o�+
Association Manager )
Cupertino Village HOA
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