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07100147 CITY OF CUPERTINO ` ' ' BUILDING DIV1510N PERMIT ���� ��Q� ����������� ° ,:. : ,. ,. .: _ : :n: ..::.:;> ..._.... ..._.. ... . PERMIT NO. BUfL a �3�� ES �OMESTEAD RD #224 DRAEGEF: CONSTRUCTION INC 07100147 . PERMIT L55UE DATE .JER'S NAME: HOMEOWNERS ASSOCIATION 605 COPIMERCIAL ST � 10/19/2007 SANiTARY NO. CONTROL NO. PHONE: ARCHIT'ECI7ENGINEER: BUILDiNG PERMIT INFO REMV & REPLACE LIKE FOR LIK BLDG ELECf PLUMB MECH L� � 0 O i p Q LICENSED CONTRACTOR Decuxar�oN Job Description � v� � hcrcby a[Grm that I am licenscd umicr provisions of CAaptcr 9(commcncing ; z W wi�h Sccdon 7000) of Division 3 uf ihc Busincsc and Profcssiuns C�, and my liccnsc is :� y in full force and cffec � .(� � v� Z Licensc Ciass �M• � + �,,, r p Dam � Contractor -� —�- � r AR HCfECTS DECLARA lON j a a 1 undcrswnd my plans shall bc uscJ as public records )yU ' u. F' Licenscd ProCcssional � y � OWNER-BUILDER DECLARATION 1 t�crcby alTirm �hat I am ezempi Gom ihc Contraccors Liccnsc Law for ehc � p O following rcason. (Scction 7031.5, Busincss and Profccsians Codc: Any ciiy or county �^�i which requitcs a pcimit to consuvct, aNcr, impmvc, dcmolish, or repair any sUUCture priar ui i�s issuancc, also rcquircs ihc applicant for such pertnit io file a signcd sutemcm Valuation -?< that he is liccnscd pursuant lo thc pmvisions o[ thc Conuacu�r's Li��cnsc Law (Chaptcr 9 ;�q. Ft. Floor Area r F� (commcncing wi�h Scction 7000) of Division 3 of Ihc Busincss and Profcssions Codc) ar i�� that he is ezemp� thcrefrom and Ihe bssic [or the allcgcd exemption. Any violauon af Section 7031.5 by arty applicant for a permit subjecu We applicant to a civil penalty af APN Number Oeeupaney Type not morc than five hundrcd dollars (SSOOZ ❑ 1, as owncr o[ ttie property, ar my employces with wages u the'v snlc compensation, wil! do thc work and �he suuctwe is not intenCcd or ofteced for salc (Sec. 7044. Business Required Inspections and Protessions Cadc: The Conuactor's License Law does not apply to an ownu of property who builds or improves thercon, and who does such work himself or Uuougd hu own emplayccs. providcd that such improvemen�s are not in�ended ar allered Cor sala If, however, the building or improvemen� is sold within one year oC complction, d�e owner- builder will have the burden oC proving Wa� he did not build ar improvc for purpox of sakJ. � I, as owner of the property. am uctusively contcacting wi�h Iiansed contract�s W construct the penjea (Sec. 7044. Business and ProCessions Cade:) The Coauxwrs Li• ccnse Law docs not apply to an owner of property who builds or impmves the�eon, and . w6o convacts tor such projec�s wi�h a conuactor(s) Iicensed pursuant to �he Convactars r icense Law. ' am ezempt under Sec. , B& P C for this reasoo ..wner Date _.. -. WORKER'S COMPENSATION DECLARATiON I hereby affitm under penalty of pc�jury onc of the foUowing declarations: ❑ I h:ve and will maintain a Certifipte ot Conscnt to self-insum Cw Workcrs Compen- sation, as provided far by Sec[ion 3700 af the Labor Code. for �he performance oC Ux work for which ihis pertnit is istued. ❑ I have and will maintain Worke�s Compcnsation Insunnce, az mquired by Scction , 3700 of the Labor Code. Cw the performance af Ux work for which this permit is issued. My Work r's Compyisaaon Insurancc carticr and Policy numbe I uc t : 'I ' `O � Cartier. � L �� Policy No.: ��� Z I( 0 CERTIFICAI'E OF EXEMPI'ION FROM WORKERS' COMPENSATIONiNSURANCE (7liis secGon nccd noe bc complc�cJ i! the permit is !or onc hundred doltars (5100) or IcssJ 1 cenify Ihat in thc performancc af Ihc work for which �his pertni� is issucd, I shalt noc employ any person in any manncr so as to bccomc subject �a the Worlccrs' Compensation Laws of Califomia. Date APP�icant NOTICE TO APPL.ICANT: if, aftcr making ihis Ccnilicatc of Ezcmption, you should become subject to the Worker's Compensation provisions of ihe labor Cade, you muu � O (ortAwith comply with such provisions or this pecmit shall bc dccmcd ccvokcQ z ""' CONSTRUCTION LENDING AGENCY (. � I hcrcby affirm Wat thcm is a constcucuon Icnding agenry for thc performa�c o( . a� the work for which this permit is iuucd (Sec. 3097, Civ. C.) W Q Lendcr's Narnc a z L.cnder's Address V � 1 certify �hat 1 havc rcad ihis application and siatc ihat thc a6ovc infocmauon is w � corrcct. I agree w camply with all city md county ortiinances and state laws rctating w � U building conswc�ion, and hcreby authomt reprcsen�ativcs of ihis city to cntcr upon �hc � a abovc-mcnlioncd property for inspccuon purposes. (Wc) agrce to save, indemnify and kup harmlcss the City o( Cupertino against N � liabiliti 'udgmcnts, osts and eapenscs which may in any way acrnu against said City V z ia co cc th ling af Ihis permit. �+ APPLIC U R ANDS AND WILL COMPLY WITH ALL NON-PO Issued by: Date O-I��G SOU E ON � � v Re-roofs � Signat fApplitanUConuazwr �a� T of Roof HAZARDOUS MATERIALS DISCLOSURE }�� Wi11 ihc applicant or future building occupant storc or handle ha•rardaus matcrial Jcfincd by the Cupenino Municipal Cadc. Chap�cr 9.12, and eNe Hcalth and Sa(ay _� SecUon 25532(a)? All roofs �hall be inspected prior to any roofing material being installed. �y� ❑No Will thc applicant or Cuturc building occupant usc cyuipmcnt or Jcviccs whicd If a roof i� installed without first obtaining an inspection, I agree to remove emit ha•rardous air contaminan�s az dcfincd by the Bay Area Air Quality Managcmcnt all new m aterials for inspecr.ion. �su���� ❑ Ycs ❑ Nu I havc rcaJ the h ardcws ma�crials rcquircmcnrs undcr Chaptcr 6.95 of �he Cali[or- nia Hcal ry C , Scctions 15505, 25533 and 25534.1 undcrstv�d that if �hc 6uilding docs not u n y ha tcnant, �hat it is my responsihility m noufy thc occupant of ihc rcyuirem ich me� priorw issuance o[ a Ccnifica�c of Occup �r. Signature of Applicant Date 1° '� All roof coverings to be Class "B" or better Owncr o uthorircd agcnl �� �.= � CITY OF CUPERTINO �� � `' �"� � �� a � CUPER`TINO PE�IT APPL�[CATION FORM APN # �� r _ � ^ � � 1 �. Date: `p �'( Building Address: Mailing Address (if different from building address): o I-�oM�S�i�� IZo�� J��r 2z�f Owner's Name: Phone #: � Contractor: License #: � 1� R.q - b�� ��l.s f"�'u1 �"(`c ��J ��! c. . � ��7 (�J � i� Contact: Phone: y-o3-2'►�t-S6 y� Cupertino Business License#: � I��o � N�n�4�o �c z— F�: 4 0�3 -5'� b -o�fL . � a `� Building Permit Info: Bldg Elect ❑ F'lumb ❑ Mech ❑ Job Description: ��'''`�� � �"�� ''L�l� �� Lt ��L- �+n- �-�'��- Residential � tL-a � c � � �1 -� � Go� T ��. , Commercial ❑ Sq.Ft. Floor Area: � 3 � S Q Sq.Ft.: Cost of Project: Occupancy Group: S �� � — Type of Construction: Please check this box if th project is a second-stor addition: Project Size: Standard ❑ Large ❑ Major ❑ Quanti Fee ID Fee Descri tion Fee Grou BAPPLOTHER Other Appliances MECHANICAL BBOILERI Bo- ler <= 100,000 Btu MECHANICAL BBOILER2 Boile -> l 00K 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 1:onstruction Tax BUILDING BCONSTAX Inc VOff/Comm/Quasi BUILDING BCONSTAXBQ Co l. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Co�istax - Resi/Mobile BUILDING BELEC 1000 El�:c 600V <= 1 OOOA ELECTRICAL BELEC1001 E lec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= ZOOA ELECTRICAL BENERGY Energy BUILDING BENERGYADD �;nergy Add Multi BUILDING BINVESTIGA [nvestigation fee BUILDING 1 of 3 .� � � ` CITY OF C'UPERTINO �►n�f pERMIT APPLJ[CATION FORM CUPER�TINO Quanti Fee ID ]?ee Descri tion Fee Grou BMISCELL l�[iscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME Nf;w Comm Electric ELECTRICAL BNUCOMMM Nev� Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLLTMBING BOVERTIME In;pection Overtime BUILDING BPBACKFLOW At�nospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE E�ld Permit Fees BUILDING BPFIXTURE Pbl Fixture PLUMBING BPGAS Ga� Piping System Fee PLUMBING 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 Lav� n Sprinkler/Backflo PLUMBING BPSTORM �torm/Rain Water PLUMBING BpTRAp Kitchen Trap PLUMBING BPVENT A.t ofDrain & Vent PLUMBING BPWATER Inst:ilUAlter Water Pi e PLUMBING BPWHEATER V� ater Heater/Vent PLUMBING � BPWSVCS M ain Water Service PLUMBING BREINSPECT JZeinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI .�ppliance Install MECHANICAL BREMBUSWAY F,emodel Busways ELECTRICAL BREMFIXT J�ighting Fixtures ELECTRICAL BREIVIFURN Re location of Furnace MECHANICAL BREMFURNOV Rel�� Furnace > l OK btu MECHAI�TICAL BREMHEAT �[eater Installation MECHANICAL BREMINHOOD In stallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BRE1�rINRAFP Rerr. Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Pow��r Device/A aratus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT R�;pair/Alter Heating MECHANICAL BREMRESAPP Rer.lodel Res Appliance ELECTRICAL 2 of 3 � ;� � � CITY OF C'UPERTINO CuPE� ��� PERMIT APPL=[CATION FORM Quantity Fee ID Fee Descri tion Fee Grou BREMSIGNAD Rmcll Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR The atrical Lighting Fix ELECTRICAL BREMVENFAN Ve�it Fan Sin le Duct MECHANICAL BREMVENSYS VE ntilation S stems MECHANICAL BSCBLVD `�cb Specific Plan BUILDING � BSEISMICOM Se: smic Commercial BUILDING BSEISMICRE ;3eismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimmin Pool BUILDING BTEMP Tem orary Power ELECTRICAL BTEMPPERM Tem ora Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Itusiness License BUILDING ELECTRIC ]�lectrical s foot ELECTRICAL EPERMITFEE Elf c Permit Issuance ELECTRICAL MPERMFEE N echanical sq. foot MECHANICAL MPERMITFEE Me�:h Permit Issuance MECHANICAL PPERMITFEE Plu�nbin Permit Issue PLUMBING PPLBG Ph�mbing Fee sq foot PLLTMBING PLLONGRNGC Plannin LR Comme/ Multi-Fam PLANNING PLLONGRNGR Plannin Lon Ran e Residential PLANNING 3 of 3 CITY OF CUPERTINO 3 ITEMS OF 36 PERMI".' RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN ......... 32E�59999.07 DATE ISSUED.......: 10,'19/2007 RECEIPT #.......... BS()00003036 REFERENCE ID # ...: 07:_00147 SITE ADDRESS .....: 22_�30 HOMESTEAD RD #224 SUBDIVISION ....... CITY .............. CUPERTINO IMPACT AREA ....... OWNER ............: HOI4EOWNERS ASSOCIATION ADDRESS ..........: 44�E FIRST ST #1 CITY/STATE/ZIP ...: L0:3 ALTOS, CA 94022 RECEIVED FROM ....: DRi�EGER CONST. INC. CONTRACTOR .......: DR:�EGER, JOHN EDWARD LIC # 21895 COMPANY ..........: DR�EGER CONSTRUCTION INC ADDRESS ..........: 60.'> COMMERCIAL ST CITY/STATE/ZIP ...: SAIJ JOSE, CA 95112 TELEPHONE ........: (4�)8)536 FEE ID UNIT QUANTITY ,�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 126.36 60.65 0.00 60.65 0.00 BPERMFEE VALUATION 5,800.00 126.36 0.00 126.36 0.00 BSEISMICRE VALUATION 5,800.00 0.60 0.00 0.60 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 187.61 0.00 187.61 0.00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 101 FOUNDATION 102 PIERS 103 UFER 104 REBAR 105 ANCHOR BOLTS 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL 204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FR.AME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL Community Development ' °��, .' 10300 Torre Avenue , �: Cupertino CA 95014 � Telephone (408) 777-3228 CIIY OF Fax (408) 777-3333 CUPEt�,TINO Buildin De artment JOB ADDRESS: PERMIT # O .� (� O l � 23? a r'l - i G� 7� �Z� � OWNER'S NAME: � PHONE # o� --�3 fo-o� GENERAL CONTRACTOR: � �2 t �liT FAX # �{' °�3 -- -�' �, — o �-2�' I am not using any subcontractors: 1- ° -d 1 Si ture Date Please check a licable subcontractors and com le followin information: SUBCONTRACTOR BUSIPJESS 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 J _ j ��(�."o� Owne /Contra or Si ature Date