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07100146 CITY OF �'UPERTINO < ' , , BUILDING DIVISION PERMIT ���'T�2A�;�C)�;:I�����'T���1 ; aui � rr �� a ��� ES �OMESTEAD RD #312 DRAEGE,R CONSTRTTCTION INC P � R 07100146 itJER'S NAME: PERMITLSSUEDATE HOMEOWNERS ASSOCIATION 605 CC�MMERCIAL ST 10/19/2007 PHONE: SANiTpRY NO. CONTROL NO. ARCHITECT/ENGiNEER: BUILDING PERMIT INEO REMV & REPLACE LIKE FOR LIKE BLDG ELECT PLUMH MECH 0 � � O + O p LICENSED CON7RACTOR'S DECLARATION � v� [ hcrcby afGtm that I am licenscd unJcr provisions of Chaptcr 9(mmmencing Job Description : z� with Scction 7000) of Division 3 of ihc Busincss and ofcssions Codc, and my liccnse is '� y in futl force and effect. �.� i'� ? Licensc Class Lic. # � F p DaLC � Contraclar — "\.� � � .�,� ARCHITECI'S DECLARA ON ;� U 1 undcrswnd my plans shall bc used as public records ,a � o y Licensed Profcssional � y � OWNER-BUILDER DECLARATION � Q� 1 hcrcby aCflrm Uiat 1 am exempt Crom ihe Conuactors Liccnsc Law for Ihc ` p O Collowing zuon. (Sccuon 7031.5, Busincss and Profacsions Co�1c: My city or rnunty ��� which �cquires a permit to conswct, altcr, improve, dcmolish, or repair any swcture _ Z �, prior ui iLS issuancc, alsu rcquires thc applicant Cor such pertnit w filc a signcd sutemcnt ;= o that hc is Iiccnscd pursuant to thc provisions of thc Convacror's Liccnsc Law (Chaptcr 9 Sq. Ft. Floor Area Valuation � �- $ (commencing wi�h Scction 7000) of Division 3 of Ihc Busincss and Rofcssions Cadc) or L �.. that he is exempt thcrefrom and Uie basis Cor the altegcd exemplion. Aoy violauon o( SecGon 7031.5 by a�ry applicant for a pertnic subjccts ihe applicant to a civil penalry of APN Number Oeeupancy Type not more tMan five hundred doilars (SS00). ❑ I, as ownu ot ttie properry, or my employces with wages az the'v sak compensation, will do the work, and �6e struduie is not intended or ofTered for sale (Sec. 7044, Business and Professions Code: The Conuacwr's License Law docs not apply m an owner o( RCC�ll1iCd IIIS�CC�IOi1S propeny who builds or improves �heccon, and wha does such work himselCor tlwugh his own employces, providcd �hat such improvemenls are not imended or otfered fw sa1e. IC, however, the building or improvement is sold within one year of compktion, tde owneo- builder will have the burden of proving Wa� he did not build or improvc far pmpose of salc.). ❑ I, as avner of the property, am exclusively contracting wiW licensed convactors w constn�ct the projen (Sec. 7044. Busineu and ProCessions Code:)'Ibe Ca�uxanr's Li- ccnse [aw docs wt apply �o an owncr of propeny who builds or improva We�eon, and , who contracts Cor such pmjecLt wiih a con�cactor(s) Iicensed pursuant to We Conuacrors License Law. I am aempt under Sec. , B dc P C fw �his rcason , �vner Date WORKER'S COMPENSATION DECLARATION - � _ 1 hereby aflirm under penalty o( petjury one of the follawing declantians: ❑ I hsve and wil! mainiain a CertiGcate of Consent to sel(-insurc for Worker's Compcn- - sation, u providcd for 6y Section 3700 oC che Labor Co�, for the perfarmancc a( the work for which this permit is issued. ❑ I havc and wil! main�ain Worker's Compensation Insurana, az�cquired by Scction 3700 of �hc labor Codc, Cor �he performance ot �he work far which �his pem�it is issued. ' My Worke�s Cgm� aGon Insur�nm carricr and Policy numhCi azc� ����� � u � i� Carrier. � Poliry No.: E CERTIFICA'fE OF EXEMP7'IOIV FROM WORKERS' COMPENSATlON INSURANCE (This secUon necd not hc camplc�ed if tf� pertni� is !or anc hundred doUars (S 100) or Icss.) 1 ceni(y �hxt in the pertormancc of thc work fw which U�is pertni� is issucd, 1 shatl no[ employ any person in any manner so as m become subject to the Workers' CompensaGon Laws of Califomia. Datc Applicm� NOTICE TO APPLICANT: If, afmr malcing �his Ccnificatc oC F�ccmption, you should bccome subject ta thc Workcr's Compcnsation provisions of �c Labor Codc, you must . O fort6with comply wilh such provisions or lhis permil shal) bc dccmcd mrokcd. z � CONSTRUC?ION LENDWG AGENCY (-+ ►-� I hemby affirm ihat ehere is a consuuction lending agency Cor the performance of F: � ihc wurk for which this permit is issucd (Scc. 3097, Civ. C.) W� A L.endcr's Namc = z L.cnder's Address V � 1 certifY Ihal 1 havc read �his application and su�c ihal Ihc abovc info�mauun is � - ( �"" corrcct. I agrce to tomply with aIl city and counry oniinances and sute laws relating �o rJ U building conswction, and hemby authori�e reprexnu�ives of �his city to rnter u�mn Nc � a abovc-mcnuuncd property (or inspccuon purposes. � (Wc) agree to save, indcmnify and kecp harmless thc City of Cupcnino against �� liabititia, judgmc , costs and expcnscs which may in any way accnre against said City U,'� in con ucnce c granting of this pertnit. �"'� APPL A ERSTANDS AND WILL COMPLY WITH AL NON-POINT Issued by: Date �� �`f-rC� SOU S. ( y l '� , Re-roofs ,� urc o Appli I/Conuactor Duc HAZARDOUS MATERIALS DISCLOSURE Type of Rc of �111hc applicant or futurc building accupant storo or handlc harudous ma�crial kfincd by Ihc Cupenino Municipal Codc. Chapicr 9.12, and the Hcalth and Safety �� Scction 25532(a)? All roofs sliall be inspected prior to any roofing material being installed. ❑ Ycs � No Will the a�licant or futurc building occupant usc cyuipmcnt or dcvices whic6 If a roof is installed without first obtaining an inspection, I agree to remove • emit hazardous air contaminan�s as dcfncd by Uic Bay Arca Air Qualiry Managemem all new ma:erials for inspec!ion. a5����� ❑ Ycs � Nu I havc rcad �he haiardous maicrials rcquircmcnLC undcrChapier695 ollhe CaliCar- nia Hcalth & Saf y Codc, Scctions 25505, 25533 and 25534_ t undcrstand Uut iCihc building docs n curtent have a tenan6 Iha[ it is my responsihility m noufy the occupant of Ihe rcyuirc n wn musi x met prior w issuan« of a Ccni�ca�c af Oc ry Signature o f Appl icant Date p � oW ��,,,, ri , ��,,, pa � All roof coverings to be Class "B" or better - � ��1 � � U I `-� � � _. �,� CITY OF CUPERTINO - ���Y�F pERMIT APPLI CATION FORM CUPER APN # 3 - �' , � n � • � / Date: �� �� Building Address: Vlailing Address (if different from building address): 2Z �� �t= S 7�. lln►� fi� l Z Owner's Name: Phone #: 0� �o� _ 53 �o — o`t �- o Contractor: License #: .I�►Zn-�' c� �� f.� t1S �rotJ � �1 � �O � � � � O Contact: Phone: `�' �- z'�'�-S� `''`F Cupertino Business License#: Lov � C J� t� L F ax : 4�� c� � � Building Permit Info: Bldg � Elect. ❑ F lumb ❑ Mech ❑ Job Description: � �''� ° � '��° �°� V' �� �o'z � I►�� Residential 13 {�n r►�l Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: 13� Cost of Project: Occupancy Group: ��d� Type of Construction: Please check this box if t� project is a � �,�� f ��.�S , second-stor addition: Project Size: Standard Large ❑ Major ❑ Quantity 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 Boiler> 1.75MBtu MECHANICAL BCONSTAX ��onstruction Tax BUILDING BCONSTAX In�UOff/Comm/Quasi BUILDING BCONSTAXBQ Co 1. 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 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= ZOOA ELECTRICAL BENERGY Energy BUILDING BENERGYADD I;nergy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 � �� CITY OF CUPERTINO �;,. . ��n ��"' pERMIT APPLI CATION FORM CUPEi�TINO Quanti Fee ID I�ee Descri tion Fee Grou BMISCELL M iscellaneous Fee BUILDING BMITIGATC Com�n. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNLJCOMMP N�;w Comm Plumb PLLTMBING BOVERTIME In:�pection Overtime BUILDING BPBACKFLOW Atrlospheric Vacuum PLtJMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bld Permit Fees BUILDING BPF'IXTURE Pbl � Fixture PLUMBING BPGAS Gas Pi ing System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLLTMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Pla�i Check Add Multi BUILDING BPLANCKREP Plat� Check Re eat Fee BUILDING BPREPIPE RE� i e Of Fixtures PLUMBING BPSEWAGE � ewa e Dis osal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLLTMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Inst<<IUAlter Water Pi e PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT IZeinspection Fee BUILDING BREMACOVER A/C' Unit > 10,000 cfin MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI .�ppliance Install MECHANICAL BREMBUSWAY R_emodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFLTRN Re .ocation of Furnace MECHAIVICAL BREMFURNOV Relc� Furnace > lOK btu MECHAlVICAL BREMHEAT �[eater Installation MECHANICAL BREMINHOOD In �tallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL B���App Rerr Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Powcr Device/A aratus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT R�;pair/Alter Heating MECHANICAL BREMRESAPP Rer.iodel Res Appliance ELECTRICAL 2 of 3 � �` � CITY OF CUPERTINO ���Y�Fj�� pERMIT APPLICATION FORM CUPERT Quantity Fee ID l�ee Descri tion Fee Grou BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Rem��del Signs, Mar uee ELECTRICAL BREMTHEATR The �trical Lighting Fix � ELECTRICAL BREMVENFAN Ver�t Fan Sin le Duct MECHANICAL BREMVENSYS Ventilation S stems MECHANICAL BSCBLVD �cb Specific Plan BUILDING i BSEISMICOM Seismic Commercial BUILDING BSEISMICRE :>eismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM 3wimming Pool BUILDING BTEMP T �mporary Power ELECTRICAL BTEMPPERM Tem orar Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC �:usiness License BUILDING ELECTRIC Llectrical sq foot ELECTRICAL EPERMITFEE Elf�c Permit Issuance ELECTRICAL MPERMFEE 1V:echanical sq. foot MECHANICAL MPERMITFEE Me �h Permit Issuance MECHANICAL PPERMITFEE Plu�nbin Permit Issue PLUMBING PPLBG Pl�zmbing Fee sq foot PLUMBING 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'I RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng Sub: Blk.: Lot: APN ......... 32E59999.06 DATE ISSUED.......: 10/19/2007 RECEIPT #.......... BSC00003036 REFERENCE ID # ...: 07�00146 SITE ADDRESS .....: 22_30 HOMESTEAD RD #312 SUBDIVISION ....... CITY .............. CUI'ERTINO IMPACT AREA ....... OWNER ............: HOPIEOWNERS ASSOCIATION ADDRESS ..........: 44�: FIRST ST #1 CITY/STATE/ZIP ...: LO:� ALTOS, CA 94022 RECEIVED FROM ....: DRt�EGER CONST. INC. CONTRACTOR .......: DR��EGER, JOHN EDWARD LIC # 21895 COMPANY ..........: DR.i�EGER CONSTRUCTION INC ADDRESS ..........: 60`.i COMMERCIAL ST CITY/STATE/ZIP ...: SAI7 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 FR.AME 205 UNDERFLOOR INSULATION 301 ROUGH PLUMBING 302 TUB & OR SHOWER 303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL 305 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCR.ATCH COAT 313 ROOF NAIL Community Development �` � ' 10300 Torre Avenue }� ' Cu ertino CA 95014 �' . .�s�° ` P Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: PERMIT # /' oM�S���7 ��' � '12 �� � C)� l "T'l� OWNER'S NAME: b� PHONE # �a$ -53b --c� Lb GENERAL CONTRACTOR: (Z4 � �p � rL � � 1� V FAX # ° d 53 b, a�Z � I am not using any subcontractors: J —��_� 9 " ° � Si ture Date Please check a licable subcontractors and com �lete the followin information SUBCONTRACTOR BUSIr1ESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Fini.shing Electrical F�ccavation 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 �,, ) t n—( t � er/Contra or S' ature Date