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09050107 CITY OF CUPERTINO BUILDING DIVISION PERMIT +C�' TRAQRI� ? TENr BUILDING ADDRESS: PERMIT NO. 10194 PARISH PL DRAEGERCONSTRTT( rPTnN TNC 09090 07 OWNER'S NAME: PERMIT ISSUE DATE CHU rte=DI l 2TRN 605 QQ MERGiAln SEP 'NE: S A CONTROL NO. (408) 5_- 6-0420 ARCHI•IECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH o p LICENSED CONTRACTOR'S DECLARATION Job Description v I hereby affirm that I am licensed under provisions of Chapter 9(commencing 7�. with Section 7000)of Division 3 of the Business and Professions Code.an my license is ?=y in full force and effect. SIDING STUCCO REPAIR v�z License Class Lic•X k- Date Contractor HTIECTA N S DECL Cd e I understand my plans shall be used as public records N Ld Dyu L Oy Licensed Professional y� OWNER-BUILDER DECLARATION n I hereby affirm that 1am exempt from the Contractors License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county K Pi which requires a permit to construct.alter,improve,demolish,or repair any structum y Zy 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 lave(Chapter 9 Sq.Ft.Floor Area Valuation x F- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $975 y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(SM. 316440-': 8 . 00 ❑I,as owner of the property,or my employees with wages as their sok compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of (1 P property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements arc not intended or offered for sale.if, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon,and. who contracts for such projects with a contractor($)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 strum 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 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 Co ensau r insurance carrier and Policy number am: Cartier Policy No.- l UJ C- I OL) 2— CERTIFICATE CERTIFICATE F PILON FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is far one hundred dollars($100) or Icss.) 1 certify that in the performance of the work for which this permit is issued,l 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 ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z" CONSTRUCTION LENDING AGENCY [�4 1 hereby affirm that them is a construction lending agency for the performance of �i> the work for which this permit is issued(Sec.3097,Civ.C.) GWi Q Lendces Name Z L.cudees Address U C) I certify that 1 have read this application and state that the above information is LL correcL 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. LL (We)agree to save,indemnify and keep harmless the City of Cupertino against ,t to liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. c ►+ Date APPLICANT UN NDS AND ILL COMPLY WITH ALL NON-POINT Issued bv: S R ATI S. n Re-roofs Sig urc pplicanUContractor Date Type Of ltOOf HAZARDOUS 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. ❑Yes FNo If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building Occupant use equipment or devices which i hazardous air contaminants as defined by the Bay Area Air Quality Management all new r laterials for inspection. .tstrict? ❑Yes PWO 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 t cu tly ha t. is that itmy responsibility to notify the occupant of the re Irec hic m met prior f a¢giGcatc of Gccu Q Signaturf:of Applicant Date C�'ty- ( All roof coverings to be Class',''or better O er or th.67.d agent a D tc ;qo� � � � =� CITY OF CUPERTINO CUPERTINO GENERAL, BUILDING PERMIT APPLICATION FORM J APN# � H o-3 9, Date: Build' g Address: r\Qx,,� Mai Ing Address (if different from building address): Own isCAUN ma�N S` �r Phone#: HOA: (Exterior work only) Yes F] No ❑ -7J `2 If yes,provide letter from HOA _ Contractor: Phone: D�raCW4�� ^ U`L Fax: Contract&License -Cupertino Business License#: Contact: U r-\ Phone: J�' — Fax: – _ Residential Commercial ❑ Job De t4CA —S4_t> .(t O LL Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Type of Construction(Usage Class): Occupancy Type: 73 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT,V-B -- 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-builditjjreen.or Revised 02/05/09 CITY OF CUPERTINO CIT GENERAL BUILDING APPLICATION CUPE�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM PARTITION WALLS 1PARTICOMM Partition I iterior Commercial B 1PARTICOMM 1PARTIR Partition Literior Residential B 1PARTIR<=30 RETAINING WALL(CONCRETE OR MASONRY 1RETSTN Standard(ap to 50 ft) B IRETSP310 Special Df sign, 3-10' high (up to 50 `) B 1RETSP10 Special Design, over 10' high(up to B 50' 1RETCRB< Gravity/Ci ib 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, Stone&Brick Veneer B interior/e,.terior 1 SIDEOTHER Siding all )ther B SKYLIGHTS 1 SKYL<10 SF Skylight le ss than 10 sf B 1 SKYL>l 0SF Skylight g-eater than 10 sf or B structural 1STAIRS Stairs-first flight/ea addt'1 B STORAGE RACKS 1 SRACKS<=8 Storage R,.cks 0-8' high (up to 100 so B 1 SRACKS>8 Storage R�.cks over 8' high (up to 100 B st 4of5 r,. CITY OF �,UPERTINO GENERAL BUILDING APPLICATION CUPEkTINO FEESCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or IGENCOM 1STUCOAP Stucco Applications (up to 400 sfl B additional stucco application 1 WINREP Replacement windows/sliding glass B door ea .3 windows 1 WINMEWSTR New Window-structural shear B wall/masc nr includes plan ck fee IEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanicil Permit Fee M IPPERMITFEE Plumbing Permit Fee P IELCPLNCK Stand Alo:ie Electric Pin Ck(hourly) E IMECPLNCK Stand Aloie Mechanical Pin Ck(hrly) M 1PLMBLNCK Stand Alone Plumbing Pin Ck(hrly) P 1 STPLNCK-(3 Hr Min Standard F Ian Check(when no E/M/P) B when not over counter) hourl -stand alone IBCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1 BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B ITRAVDOC Travel&E ocumentation B 1BUSLIC Business L cense B 5 of 5 TIM-- T- 11 Tr MI - Cupertino Village Parish Place ----- 10202 -110201 10194 - -1 •� _____- N NP -01 co N N N _ -O-I - w W W � . w p 10192 10191 -- - 10121 [7F101 - '2 3 Swimming Pool .a 10J B4 o . 10113- 0 10131 10182 <' 10111 . � 10133 --M _..._ -- �.._.;:.��.__.. - ----- --- •- -1 10174 1014`1 a o 0 0 10173 -- - E.103 m v, .�- ..� w 10172 W L, 10143 _...-_ 10171 Parish Piace 10164 I } f May 15,2009 i 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,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 Village 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 he sitate to contact me. I Ve truly yours, Diana Johnson Association Manager Oct e0 0-r 47�.c lh:�'4) Cupertino Village HOA i I i