07100083 CITY OF CUPERTINO ' ' 7��
BUILDING DIVISION PERMIT ���� ������ '
;: _. ._ :. .
PERMIT NQ.
BUILD Z w � n ��� ss HOMESTEAD RD UNIT #209 DRAEGE� CONSTRUCTION INC 07100083 •
pERMIT LSSUE DATE
OWNER'S NAME: ,
HOME OWNERS ASSOCIATION 605 CO�IERCIAL ST
SANiTARY NO. CONTROL NO.
NE:
BUILDING PERMIT INFO
ARCHITECUENGINEER: REMV � REPL i�. �E WATER DAMAGE BLDG ELEC'f PLUMB MECH
� 0 � �
i p p LICENSED CONIRACTOR oECUeanoN b_D�gscription
� V � I hcrcby aCfirm tha[ I am liccnsed undcr provisions oC Chap�cr 9 (commencing ^ — ^ —• -^ - - -^ ^^ � . .^ , ^ ^ �
; Z� wi�h Scction 7000) of Division 3 of thc Busincss and Profcssians Codc, and my liccnsc is
�� y in fu0 force and e(Cec �� b`�
� v� z Licensc Class � L�. # . �� L
: �, � Datc 1�_(L�— Contractnr
� ARCHiTECTS DECLARATION
j a Q i undcrstand my plans shall be uxd as public rccor�
)qU
° u� y Licenscd Pmfessional
; � < OWNER-BUILDER DECLARATION
� a� 1 hcrcby alTirm lhat 1 am cxcmpt Gum thc Contractors Liccnsc Law far �he
p O following rcuon. (Scctioa 7031.5, Busincss and Profc.csinns Ca1c: Any city or couniy
�°� �i which rcquires a pcimit to conswct, altcr. improvc, dcmoli.eh, or rep�ir any suucture
�" N prior to i�s issuancc. alsu rcquires thc applicant for such permit to filc a signed sta�ement , F[. F]OOC AI'e3 Valuation
�?< �ha� hc is liccnxd pursuanl lo thc ptovisions of lhc CoNtacto�'s Licentc Law (Chap�r 9 �>q
Y t �(commcncing wi�h Scction 7000) of Division 3 of ihc Busincss and Profcssions Codc) ar
y�� that he is ezempt thecefrom and �he buis Cor the allcged eumption. Any violation o[
Section �031.5 by arty applicant Cor a pecmit subjects ihe applicant to a civil penalty of APN Number Oceupaney Type
not more chan five hundred dallars (5500)•
❑ I, u owncr of ttie pcoperty. or mY emP�oycw with wages u Weir solc compensauon,
will do thc work, and the structuce is not inunded or oftem� forsalc (Sec. 7044.8usi�ss Required Inspections
and Professions Code: The Conuactors License Law docs �rot apply to an owner of
propeny who builds or improves tAeccon, and wha does such wort himsel[ or tluough Ais
own employccs. providcd tAat such improvemen�s are not in�ended ar ottered Cm sale. If.
however, ihe building or improvemen� is sold wilhin one year oC complcaon, tlte owner-
buiider will have the burden o[ proving �hat he did noi build or improvc for parposa of
salc.).
❑ I, as owur of the property, am ezclusively convacting wiih ticensed wnvactors to
construct �he pmjea (Sec. 7044. Business and Protessions Code:) Thc Contncwrs Li•
ccace Law docs not apply w an owncr of property who builds or impmves lhereon, and .
who conuacts Cor such projects with a convactor(s) licented pursuant to the Convactors
License Law.
� I am aempt under Sec. . B& P C for this mason
Owner Date _ . -
WORKER'S COMPENSATION DECLARA170N ,
1 hereby �rm under penalty o[ pe�jury onc oC the fotlawing declarations:
�] 1 hsve and will maintein a Certificate of Conscnt to self-inswc for Workers Campen-
sation, as provided for by Section 3700 of tha Labor Code. (or �he pedormance oC the
work [or which Ihis permit is issucd.
❑ I havc and will maintain Worker's Compensation Insuranec, as required by Scction ,
3700 of the Labor Cade, Cor the pedormance of the work for which this permit is issued.
My Worker's Com rancc carricr and Poliry number are: O J �
Cartier.�l�/ �./ �• Policy No.: W G �� 0 v
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATIONiNSURANCE
(fhis section necd not bc completed it the pertnic is for onc hundred dollars (S 100)
nr IcssJ
I cenify that in thc performancc of Ihc work for which Ihis permit is issucd. ( shall not
employ any person in any manncr so az a bccomc wbject io �he Workcrs' Compensation
Laws ot Califomia. Date
Applicant
NOTICE TO APP(1CANT: If, attcr making ihis Ccrtificatc of Excmplion, you should
become subject to the Worker's Compenstition provisions of Ne Labor Cade, yau must
� z fonhwi�h comply wi�h such provisians or this pccmi� shall bc dccmed revakcd.
z � CONSI'RUCTION LENDING AGENCY
(.~.� ►�-. I hcreby alTirm U�at thcre is a consuuctian Icnding agcncy tbr the perfurtnancc uf -
a, � �hc work Cur which this permit is iuucd (Scc. 3097, Civ. C.) ,
W Q Lendcr's Namc
� � L.endet's Address
U � I ccrti[y ihat 1 have read this applieation and sta�c thu �hc abovc in(ormatiun is
w � correct. 1 agree io comply with alI city and counry orciinances and sta�e laws relating �o
� U building conswctioa, and hereby authori�e representativcs of Ihis cily to cmcr upon lhc
� W abovc-mcntioncd property forinspccuon purposes.
a (Wc) agree t save, indcmni(y and kecp harmless the City of Cuperuno against
�,E"�„� � liabiliti �udgmcn costs and expcnscs which may in any way accruc agains� said Ciry
V z in con �q c c oC c ranung of ihis permit. �(� ��'
� APPLIC U E STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date � ��
SOU GU S. 1 1
� �1 t 0- — � Re-roofs
Signa ot pplic Can tor � 'I' of F.00f �
AZ OUS MATERIALS DISCLOSURE YP
Will Ihc ap icant futwc building occupant storc or handlc harardous matcrial
as defincd by �he C no Municipal Codc. ChaQ�cr 9.I2. and thc Hcalth and SaCcty
coa�. SccUon 25532(a)? � All roofs shall be inspected prior to any roofing material being installed.
❑ Ycs .
Will thc applicant or Cuturc building occupant usc cyuipmcnt or dcvices which
If a roof s installed without first obtaining an inspection, agree to remove
emi� harardous air contaminan�t as dcfincd by the Bay Area Air Quality Managcmcnt all new n�aterials for inspeccion.
Disvict?
❑ Ycs [�!�{u�
1 havc rcad the rdous mauerials �cquircmcn�s undcr Chaptcr 6.95 o(U�c CaliCor-
nia Hcal�h & 5 ty C, ctions 25505, 25533 and 25534.1 undcrstand U�u iC ihc building
docs not c n y h a nan4 �hat i� is my rcsponsibility to nodCy thc occupant nf Ihc
myuir mc w' usi me� rior usuancco[a�c�fica�co(Occu;anry• G Signature of Applicant 11 Date
� J � ��' �•� All roof coverings to be Class "B or better
Owncr or authorizcd agcn Da�c '
, ��� a °7i o c� � � -3
. ..
� "� . CITY OF C'UPERTINO
��n�F pERMIT APPL=[CATION FORM
CUPE�TINO
�PN# � � �9 ��9 � �� �j Date: 1�- a�p
Building Address: Mailing Address (if different from building address):
��D r 7 eoA� �� I f 2 D�I
Owner's Name: Phone #:
C� � �s � sS� c, �'r a � G .rr G --�� r � — � �C �
Contractor: License #:
�t�A �—(� �C�2- ��Sf �'tca� 1 J(, �o �"7 C� i O
C�o�n� Phone: 4�0�-�-��-5'�`h4 Cupertino Business License#: G � y S -
tN� t► �'cJZ,�) r� ���Z- Fax: � ° ?� - 5"31 � -� �fi � � 4 `
Building Permit Info:
Bldg Elect ❑ �'lumb ❑ Mech ❑
Job Description: e�HOJ1�, c* 0 Q.��lAGf� �4TE'� b4n4 bC L+!'i� ��'Z- ���_ �°4''t-i'q C.,
Residential s���N 4n17 7�M - c�oa, • Commercial ❑'(' c�;�r- (.��,,,
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupan_�,,y G�up:
��----
Type of Construction: Please check this box if t� project is a
<--� �
LLtV second-sto addition:
.'roject Size: Standard,� Large ❑ Major ❑
Quanti Fee ID Fee Descri tion Fee Grou
BAPPLOTHER Other Appliances MECHANICAL
BBOILERl Bo ler <= 100,000 Btu MECHANICAL
BBOILER2 Boile-> 100K to SOOK Btu MECHANICAL
BBOILER3 Boil:r > SOOK to 1M Btu MECHANICAL
BBOILER4 Boiler > 1M to 1.75 M Btu MECHANICAL
BBOILERS B�iler > 1.75M Btu MECHANICAL
BCONSTAX ��onstruction Tax BUILDING
BCONSTAX IncVOff/Comm/Quasi BUILDING
BCONSTAXBQ Co i. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Co�istax - Resi/Mobile BUILDING
BELEC 1000 El�,c 600V <= l 000A ELECTRICAL
BELEC1001 E lec 600V > 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD �;nergy Add Multi BUILDING
BINVESTIGA [nvestigation fee BUILDING
1 of 3
��:
a g CITY OF C'UPERTINO
- ����� pERMIT APPL=[CATION FORM
CUP�I�TINO
Quanti Fee ID Fee Descri tion Fee Grou
BMISCELL 1�liscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNLJCOMME N�;w Comm Electric ELECTRICAL
BNLTCOMMM Nev�� Comm Mechanical MECHANICAL
BNLTCOMMP New Comm Plumb PLUMBING
BOVERTIME In�pection Overtime BUILDING
BPBACKFLOW At�nospheric Vacuum PLLJMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Eld Permit Fees BUILDING
BPFIXTURE Pbl Fixture PLUMBING
BPGAS Ga� Piping System Fee PLiIMBING
BPINTERCEP Inc!� Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Pla�i Check Repeat Fee BUILDING
BPREPIPE R�� i e Of Fixtures PLUMBING
BPSEWAGE ��ewa e Dis osal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK La� n Sprinkler/Backflo PLUMBING
BPSTORM � torm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLLTMBING
BPVENT A_t of Drain & Vent PLUMBING
BPWATER Inst:ilVAlter Water Pi e PLUMBING
BPWHEATER V� ater Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT lZeinspection Fee BUILDING
BREMACOVER A/C Unit > 10,000 cfin MECHAI�IICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHAIVICAL
BREMAPPLI .�ppliance Install MECHANICAL
BREMBUSWAY R_emodel Busways ELECTRICAL
BREMFIXT ],ighting Fixtures ELECTRICAL
BREMFURN . Re .ocation of Furnace MECHA1vICAL
BREMFURNOV Rel�� Furnace > lOK btu MECHANICAL
BREMHEAT �[eater Installation MECHANICAL
BREMINHOOD In �tallation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREn�INRAPP Rerr Non-Res Appliance ELECTRICAL
BREMPOLE Po le/Platform Fixture ELECTRICAL
BREMPOWER Powcr Device/A aratus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Re:pair/Alter Heating MECHANICAL
BREMRESAPP Reniodel Res Appliance ELECTRICAL
2 of 3
CITY OF C'UPERTINO
Cu�PF T�NO PE�IT APPL=[CATION FORM
�
7uanti Fee ID Fee Descri tion Fee Grou
BREMSIGNAD Rmcil Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Mar uee ELECTRICAL
BREMTHEATR The:atrical Lighting Fix ELECTRICAL
BREMVENFAN Ve�it Fan Sin le Duct MECHANICAL
BREMVENSYS Vc�ntilation S stems MECHANICAL
BSCBLVD :>cb Specific Plan BUILDING
BSEISMICOM Se:smic Commercial BUILDING
BSEISMICRE 3eismic Fee Res BUILDING
BSPECIAL � pecial Inspection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Tem ora Bld Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC ]3usiness License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elr,c Permit Issuance ELECTRICAL
MPERMFEE N[echanical sq. foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plu mbin Permit Issue PLUMBING
PPLBG Pl .�mbing Fee s foot PLUMBING
PLLONGRNGC Plannin LR Comme/ Multi-Fam PLANNING
PLLONGRNGR Plannin Lon Ran e Residential PLANNING
:> of 3
CITY OF CUPERTINO
2 ITEMS OF 4 PERMI7' RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Bl}:: Lot:
APN ......... 32E;59999.00
DATE ISSUED.......: 10,09/2007
RECEIPT #.......... BS(100002948
REFERENCE ID # ...: 07_.00083
SITE ADDRESS .....: 22;�30 HOMESTEAD RD UNIT #209
SUBDIVISION .......
CITY .............. CUl'ERTINO
IMPACT AREA .......
OWNER ............: HOT1E OVJNERS ASSOCIATION
ADDRESS ..........: 22:530 HOMESTEAD RD UNIT 209
CITY/STATE/ZIP ...: CUl'ERTINO, CA 95014
RECEIVED FROM ....: DRi1EGER CONSTRUCT
CONTRACTOR .......: DRIIEGER, JOHN EDWARD LIC # 21895
COMPANY ..........: DRI�EGER CONSTRUCTION INC
ADDRESS ..........: 60!i COMMERCIAL ST
CITY/STATE/ZIP ...: SA]1 JOSE, CA 95112
TELEPHONE ........: (4�)8)536-0420
FEE ID UNIT QUANTITY .�'IOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BP�RMFEE VALUATION 7,800.00 147.96 0.00 147.96 0.00
BSEISMICRE VALUATION 7,800.00 0.80 0.00 0.80 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT : 148.76 0.00 148.76 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 297.52 #132695
---------------
TOTAL RECEIPT : 297.52
• �: �� � . :u
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'��' or�miz� 444 First Street #A (650) 917-9911
�,J��ANRGFn�7ENT LOS FiZtOS C�. 94�2� , F'nx 4l_'7–UUQI
PROMPT, COIIRTEOUS SEI2VICE -- IINIFORM ENF�RCEMENT OF RULES -- TMMACULATE ENVZRONL�NT
UCLOD2r' 2i . L U U! �
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Cupertino,�CA
Re: Balcony Repairs
Woodspring HOA
22330 Homestead Road
Cuper�ino, CA 95014
_— --�ccd'��t3 _B���tITte12�.-�������_ ' --------- ----------- ---
__----- ��@_�.—__ ------------ --------- .. . ---- --------
The Woodspring Condominium HOA :1as contracted with:
Draeger Construction Incor��orated
605 Commercial Street
San Jose, CA 95112
to perform dry rot repairs to trim boards prior to pain�ing. If
dry ro� damage extends int:o structural members, Draeger
Construction is authorized to �erform repairs. Please cooperate
with Draeger Construction foY permits and inspec�ions where
necess y.
Kindly i ours ,
i j
. _ . ._.__. ___.._._____ _._ — � ___
DO INIC FERRARI, Property Manag�r
On Beha f of the Board of Direc=ors
Woodspring Homeowners Associati�n
Community Development
' < � .;
- 10300 Torre Avenue
��� � .� = Cupertino CA 95014
Telephone (408) 777-3228
CI71( OF Fax (408) 777-3333
';UPEt�TINO
Buildin De artment
JOB ADDRESS: PERMIT #
233o H e.oc►� U�tt' ��`� v°�
OWNER'S NAME: 1-� �l5 o c�crTl��• PHONE # yn � -ZOq-S 6 `t µ
GENERAL CONTRACTOR b (.o �[f�1 0� FAX #'f� �- 53 b- o`f� Z-5�
�Uv -
I am not using any subcontractors: ��'�1
Si gna Date
Please check a licable subcontractors and com �lete followin information:
SUBCONTRACTOR BUSIr1ESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
IIectrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
lnJ i-��.�.,J4�1��2- 1 D -q -o �i
Owner/Contrac i ature Date