09090105 CITY OF CUPERTINO
BUILDING DIVISION PERMIT � � Z� � TX� �
BUILDING ADDRESS: PERMIT NO.
10184 PARISH PL DRAEGER CONSTRUCTION INC 09050109
OWNER'S NAME. PERMIT ISSUE DATE
- ROMER—I Q1112R M — s A CONTROL NO.
')NE:
(408) 536-0420
ARCHI7ECf/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
a p LICENSED CONTRACTOR'S DECLARATION Job Description
U I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business and Professions Code,and my license is
�$d in full force and effect i�l7 p SHINGL SIDING REPAIR
_Z License CI Li•N—
'n F Date Contractor
AR HITECPs DELLA A ON
a l understand my plans shall be used as public records
DWU
L C y Licensed Professional
y OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractors License Law for the
COO following reason.(Section 7031.5,Business and Professions Cafe:Any city or county
which requires a permit to construct,alter,improve,demolish,or repair any structure
prior to its issuance,also requires the applicant for such permit to file a signed statement
?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
WyY ts-� (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 975
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(M). 31644036 . 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 dots not apply m ns an owner of q P
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements we 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 die 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 Ilse Contractor's
License Law.
❑I am exempt under Sec B&P C for this reason
Owner Dare
WORKER'S COMPENSATION DECLARATION
I hereby afrirm under penalty of perjury one of the following declarations:
1 have and will maintain a Certificate of Consent to self-insure for Worker's 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 Policy Workee Com�pe on nce carrier and Policy number am:
Carrier S No.71W CI L I4 Y
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section recd not be completed if the permit is forone hundred dollars($100)
or 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 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 Code,you must
Z, forthwith comply with such provisions or this permit shalt be deemed revoked.
Z OCONSTRUCTION LENDING AGENCY
[�tom1 1 hereby affirm that there is a construction lending agency for the performance of
Ix 5 the work for which this permit is issued(Sec.3097,Civ.C.)
W Q Lender's Name
aL.endees Address
U 0 1 certify that I have read this application and state that the above information is
Vm► cored I 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
>"a above-mentioned property for inspection purposes
(We)agree to save,indemnify and keep harmless the City of Cupertino against
In liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit.
t--r
APPLICANT UNDE DS AND WIL MPLY WITH ALL NON-POINT Issued by: Date
S s. n s U
6
Re-roofs
rgu7re of Applicant/Contractor Da
n
HAZARDOUS MATERIALS 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
Will the applicant or uwre building occupant use equipment or devices which If a roof:s installed without first obtaining an inspection,I agree to remove
i hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
strict? 0
[3 Yes
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor•
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
does not currently have a tenant.that it ism responsibility to notify the occupant of the
rc 'rem whit be met prior to' c of a C ate of Oc aney. Signature of Applicant Date
N" n �' q All roof coverings to be Class'W'or better
O er or orized agent D
Ys,
CITY OF CUPERTINO
CITY OF
CU PEf TINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# c� Date: 1
Building Address: )U f g-L( P" -, k
Mailing Address(if different from building address): I— r
Owner's Name: Phone#:
)-� V-L S,� kar-+� 2
HOA: (Exterior work only) Yes F1 No
❑ 6�'
If yes, provide letter.from HOA
Contractor: Phone: 1-
Ofq e -e,/ ` c"t&L 'L vim• Fax: U y
Contra for License#: 617 6'/0
Cupertino Business License#:
Contact: „ems CX-N Phone:
Fax:
Residential Commercial ❑
Job Description: S k&yj�( P� St
Building Permit Info:
Bldg X Elect ❑ Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type: 2,
1-A, 1-B ❑ II/IIIN-A ❑ II/111 B, IV-HT, V-13
Valuation: �; Squar ootage:
Project Size: Express ❑ Standard ❑ Large [:1 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.buildit reen.or
Revised 02/05/09
CITY OF CUPERTINO
CUPE TINO GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
PARTITION WALLS
1PARTICONIM Partition :nterior Commercial B IPARTICOMM
1 PARTIR Partition :nterior 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
1RETSP10 Special Design, over 10' high(up to B
50'
IRETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
I RETCRB> Gravity/C rib Wall over 10' high(up to B
50 ft
SIDING
ISIDEST/BK Siding, Slone&Brick Veneer B
interior/Exterior
1 SIDEOTHER Siding all other B
G
SKYLIGHTS
1SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1 STAIRS Stairs-first flight/ea addt'l 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
1of5
I
'•* . .•. * SIM
Fly
Cupertino .Vil-lage
Parish Place
.... ..__. .:....... 10202
10194
N
-�� w t�v OCW) 101930) 0192
10191 - -
10121 10123
_.L swimming Pool i u 1 t3`+
10113! 10131 w -
o 10-181 coo 14182
t -1011-1 10`133 -----
m �, -. --- o o a 10173 1 0.174
� -!0141 � o - ------_-
10103 m ._ w , 10172
w
LAO
1 10143 -- — -_ X10171
Parish PIace 10164
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E
1
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i
May 15,2009
i
{i
1
City of Cupertino Building Department
10300 Torre Avenue
Cupertino,CA 95014-3202
Re: Building Permits for the Cupertino Village Homeowners Association i
10101 - 10251 Parish Place, Cupertino,CA
Authorization for Draeger Construction. Inc. to obtain Permits on our behalf
To Whom It May Concern:
The Board of Directors of the Cupertino ViliagE-Homeowners Association hereby authorizes
Draeger Construction,Inc.,605 Commercial Street, San Jose, Ca 95112,to obtain permits for
miscellaneous remedial repairs to be performed in the common areas of our complex as
referenced above. !
;
Should you have any questions,please do not hcsitate to contact me.
1
Ve txuly yours, I
i
Diana Johnson
Association Manager (Aq 10,r 47,c lk q)
Cupertino Village HOA
i
I
i .
i
CITY OF CUPERTINO
0.
BUILDING DIVISION PERMIT �.:�i 41 � � �
BUILDING ADDRESS: PERMIT NO.
10193 PARISH PL DRAEGER CON STR TI0905010
OWNER'S NAME: PERMIT ISSUE DATE
TAN TCF—WAN FT AT 605 120 MRR.CIAT. ST
INE: S X MYA RY CONTROL NO.
(408) 5? 6-0420
ARCHITECI7ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
app LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
with Section 70W)of D'Z�s
'' sincst and Professions Code,and my license is
=y in full force and effect {/ SIDING STUCCO REPAIR .
v�2 License Class K•N
n y- Date ntractor ��((,�
g DECLA A O
J o used as public records C-
1 understand my plans shall he
�yU
Orn Licensed Professional
y�. OWNER-BUILDER DECLARATION
' I hereby affirm that 1 am exempt from the Contractor's License Law for the
CO O following reason.(Section 7031.5,Business and Professions Code:Any city or county
K m 0! which requires a permit to construct.alter.improve,demolish,or repair any structure
yZ} prior to its issuance,also requires the applicant for such permit to file a signed statement
=O that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation
F$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $975
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
net mere than five hundred dollars($5=. 31644012 . 00
❑I,u 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(Sex.7044,Business Required ired Ins ections
rs
and Professions Code:The Conuactoes License Law donot apply to an owner of q P
property who builds or improves thereon,and who does such work himself or through his
own employees,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 Professions Cade:)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 contractors)licensed pursuant to the Contractors
License Law.
❑1 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 declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compcn-
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 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 Workers ompe aeon/Insurance carrier and Policy number are:
Cartier. Aw Polity No 1 w `�3"�
CERTIFICATE OF EXEMPTION FROM WORKERS'
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 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 Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
z R CONSTRUCTION LENDING AGENCY
F~-r I hereby affirm that there is a construction lending agency for the performance of
(x> the work for which this permit is issued(Sec.3097,Civ.C.)
W Q Lender's Name
.0,lz Lender's Address
U 0 I certify that I have read this application and state that the above information is
LL" correct.I 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
W above-mentioned property for inspection purposes
a (We)agree to save,indemnify and keep harmless the City of Cupertino against
►F-h to liabilities,judgments,costs and expenses which may in any way accrue against said City
V Z in consequence of the granting of this permit. Date
�. AFR,�J]
A�UL
TANDS AN ILL COMPLY WITH ALL NON-POINT Issued b,
S NS. \ /fQ
V ( Re-roofs
Si atumo pplicant/Conuactor Date Type Of Roof
MATERIALS DISCLOSURE
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.
r]Yes R10
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
it hazardous air contaminants as defined by the Bay Area Air Quality Management all new r laterials for inspection.
-rsuict?
❑Yes /�No
1 have read the hazardous materials requirements under Chapter 6.95 of Ute Califor-
nia Health&Safety Codc, 'orts 25505,25533 and 25534.1 understand that if the building
not ntly h tenant.that it is my responsibility to notify the occupant of the
q re wh' tsar be met prior trance of a Certificate of oc t Signaturf:of Applicant Date
U All roof coverings to be Class'n"or better
wnc r authori d agent 112te
CITY OF CUPERTINO
C�
CUPERTINO GENERA=L BUILDING
PERMIT APPLICATION FORM
J APN# qo 1 ,3 Date: slg/o I
BuildWd sS S
Mailing Address (if different from building address):
Owner's Name: Phone#:
K. M� + cel ��yy U� 777
HOA. (Exterior work only) Yes ❑ No ❑
If yes, provide letter,from HOA
Ly
Contractor: Phone: 4/(f r--
®fat�C, Fax:
Contracf6r License#:
Cupertino Business License#:
Contact: L— .� U Phone: J�lU CS —C
Fax: — �
Residential ] Commercial F]
Job De5 ._S4-tv. cc O
Building Permit Info:
Bldg Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type: k —�
1-A, 1-B ❑ II/11IN-A ❑ 11/III B, IV-HT,V-3
Valuation: Square Footage:
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.buildit r�,-en.or
Revised 02/05/09
.. .. ..
Tull%.L.
Cupertino .Village
Parish Place
.._ ..__._. . . .:_...... 10202
0201
`,� - - 10194
0
Ul
w
to �'N o' -10193 ..... _ -_. ..
w � - 7:t
0192
_ 10191 — -
. 10121R- FIN
2:
n� I 1018:37 �~
_._ OwlrrZcning 1-10,01 _._....._ l U1 b4
0 10113 10131 �, ___
@ 10182
10111 . 10133 -
0 0 0 10174
10103 10141 0 10173 ------ -
cn rn `l
10172
1 a1(�i 10143 _ _ . _ 10171
Parish PIace 10164
i
I
c
f
f
;
I
May 15,2009
t
i
City of Cupertino Building Department
10300 Torre Avenue
Cupertino,CA 95014-3202
Re: Building Permits for the Cupertino Village Homeowners Association
10101 — 10251 Parish Place, Cupertinc,CA
Authorization for Draeger Construction,Inc. to obtain Permits on our behalf
To Whom It May Concern:
The Board of Directors of the Cupertino Village Homeowners Association hereby authorizes
Draeger Construction,Inc.,605 Commercial :Street, San Jose, Ca 95112,to obtain permits for
miscellaneous remedial repairs to be performo i in the common areas of our complex as
referenced above.
Should you have any questions,please do not hesitate to contact me.
i
Ve truly yours,
lQ�n6i
Diana Johnson j
Association Manager (,4e1.e,7+
Cupertino Village HOA
i
i
I
i
CITY OF CUPERTINO
� ;i GENERAL BUILDING APPLICATION
PEkTINO FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
G 1STUCOAP Stucco Al-plications (up to 400 so B
o additional stucco application
1 WINREP Replacem.-nt windows/sliding glass B
door ea windows
1 WINMEWSTR New Window-structural shear B
walUmasc nr includes plan ck fee
IEPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
1 ELCPLNCK Stand Alc ne Electric Pln Ck(hourly) E
IMECPLNCK Stand Alcne Mechanical Pln Ck(hrly) M
1PLMBLNCK Stand Alcne Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check(when no E/M/P) B
when not over counter) hourl -stand alone
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Seismic I-esidential B
1BSEISMICO Seismic Commercial B
ITRAVDOC Travel&Documentation B
1BUSLIC Business License B
5 of 5
CITY OF CUPERTINO
�' or GENERAL BUILDING APPLICATION
CUPSINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Des,:ription Fee Permit Type
Group 1GENRES or
1GENCOM
PARTITION WALLS
1PARTICOMM Partition [nterior Commercial B 1PARTICOMM
1PARTIR Partition [nterior 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
IRETSP10 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
1 SIDESTBK Siding, S lone&Brick Veneer B
interior/oxterior
1�J SID EOTFIER Siding al other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight treater than 10 sf or B
structural
1STAIRS Stairs-firA flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage F_acks 0-8' high (up to 100 so B
1 SRACKS>8 Storage Lacks over 8' high(up to 100 B
st
4of5