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07100145 CITY OF CUPERTINO <: ' � BUILDING DIVIS�ON PERMIT �� ,,. ,.:. '.z:::.; PERMIT NO. aui � cu �� es �OMESTEAD RD #310 . DR.AEGER CONSTRUCTION INC 07100145 . ER'S NAME: PE[tMIT LSSUE DATE HOMEOWNER ASSOCIATION 605 CONMERCIAL ST � 10/19/2007 PHONE: SAMTARY NO. CONTROL NO. ARCHIT'ECT/ENGiNEER: BU►[.DING PERMIT INFO REMV/REPLACE LIKE FOR LIKE BLDG er.ECr PLUMB MECH 0 0 � 0 i p p LICENSED CONTRACI'OR'S DECLARATION � v� ! hcrcby aCfirm �hat I am licenscd undcr provisions oC Chaptcr 9(rnmmenciny Job Description ; z W with Secuon 700U) of Division 3 oCihc Busincss and Profcssiuns Codc, and my liccnsc is �� y in full (orce and eCfec /� � v� z Licensc C1ass Lic. k � � �,,, p Datc �� Conuactnr '� ARCH(TECI'S DECLARATI i d 4 I undcrstand my plans shall bc uscd as public records )aU ' u. y l,iccnscd Pcufcssional � y � OWNER-BUILDER DECLARATION � �� 1 hercby a1Grm that 1 am exempt Crum the Camracrors License L.aw fac �t�c p o toilowing rcazon. (SccGon 7031.5, Busincss and Profcssians Catc: Any ci�y or rnuniy < m�i which requires a pertnit to cnnswct, alter, improvc, dcmolish, or repair any swawc ° Z} prior w i1s issuance, alsu requires the applicant for such permit io file a signed stalrment < that hc is liccnscd pursuant to thc pmvisions of ilrc Conuacmr's Lic�cnsc Law (Chaptcr 9 S q. Ft. Floor Area Valuation r F� (commencing wi�h Section 7000) of Division 3 of �he Business and Professio�s Code) ar L�� that he is exempt thcccfrom and the buis Cor eAe allcgcd exemption. Any violatioa a( Secuon 7031.3 by arry applicant Cor a petmie subjecu ihe applicant to a civil penalry of APN Number Oceupaney Type not more than five hundrcd dallars (5500). ❑ I, as owncr o[ ttie property, ar my emplayces with wages as the'v solc compenvtian, will do ihc work, and the scruaure is not irtiendcd or offered for salc (Sec. 7044. Busineu Re u ired Ins eCtIO11S and Professions Code: 77�e Conuactor's License Law docs not apply to an ownet of Q P property who 6uilds a improves thercon, and who does such work himselCor thcougd his own employccs, providcd that such improvements are not intended ar offered for sale. I!, however, the building or impcovement is sold within one year ot compleuon, tlie owmo- builder witl have the burden oC proving �Aa� he did not build or improvc for pmpose o( sakJ. ❑ I, as owner of the property, am uclusively conlracting with licensed rnnuaciors b construct the projea (Sec. 7044. Business and Profcssions Cade:) The Con�rutors Li- ccnse Law docs not apply to an owner of propeny who builds or improves We�eon, and , w6o contracts for such projects with a comractor(s) Iicen:ed pursuant to �he Convactors License L.aw. '-' t am uempt under Sec . B dc P C fw this ¢awn .er Date WORKER'S COMPENSATION DECLARATION "� � I dereby sfCirtn under penalry of perjury onc o( �Fx following declarationx ❑ 1 hsve and will maintain a CertiGcatc o[ Consent lo ult-insurc !or Workers Compen- sation, at provided for by Section 3700 of the [abor Code. [ar �he performanoe ot the work far whic6 ihis prrmit is issued. ❑ I havc and will mainlain Workcr's Compensation Insunnce, u rcquired by Scpion 3700 0( �he l.abor Code, fw �he performanee of �he worlc for which this permie is issued. ' My Warke s Compen�on In�sur nce cartier and Policy number are: / . ^� �� Cartier. � v �"� Policy No.: a�� v� v ( I CERT(FlCA7'E OF EXEMP'CION FROM WORKERS' COMPEIVSATION INSURANCE � ' (This scction nced not Ac comQlc�ed it the permit is for onc hundred dollus (5100) or Icss.) • I cenify that in thc perCormancc of �hc work for which Ihis permi� is issucd, l shall �rot employ any person in any manner so as io beeome wbject ta �he Workers' Compensa�ioa Laws of Califomia. Datc Applicant NO'TTCE 7'O APPLICAM: If, aftcr making �his CeniGcatc of Excmption, you should bccome subjcct to the Worker's CompcnsaGon provisions of the L.abor Codc, you mua � O forthwith comply with such provisions or this permit shall hc dccmcd revokcd. z '"'' CONSTRUCf10N LENDING AGENCY �►�-� I hcmhy afGrm U�at thcre is a consuuctinn Icnding agcncy for thc per(ormar� of R! � �hc work for which this pertnit is issucd (Sec:. 3097, Civ. CJ � Q L.endcr's Namc • � Z Lcnder's Address V � 1 certify �hat 1 havc rcad ihis application and sta�c tha� thc a6ovc informa�ion is w ►-� cortect. ! agrce to comply with all city and county oniinances and sta�e laws relating �v � U building conswction, and hereby authori�e representatives of U�is ci�y to enler �pon tAc � � W abovc-mcnuoncd property for inspccuon purposes. (We) agree to save, indcmnify and kecp hartnless the Ci�y of Cupertino against �� liabiliuu, judgmcn�s cosu and expcnscs which may in any way accruc against said Ca�y V z in conuquence oC �h ranting of ihis permit. �+ APPLI ANT N STANDS AND WILL COMPLY WITH ALL NON-POII�lI' Issued by: Date U.- 1 9� SOU E RE NS. � � '� � � � Re-roofs Sign rc of lican ontractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Ro �f Will �he applicant or future building occupant store or handle harardous ma�crial �fincd by thc Cupenino Municipal Codc. Chapicr 9.12, and the Hcalth and Safay z,Sccuon25532(a)? All roofs st�all be inspeeted prior to any roofing material being installed. Q Ycs ❑ No Wi11 thc applicant or fuwrc building occupant usc equipmcnt or Jcviar which If a roof is .nstalled without first obtaining an inspection, I agree to remove • cmit harardous air contaminan�s as ckfincd by the Bay Arca Air Quality Managemem all new ma� erials for inspection. Disttict? ❑ Ycs ❑ No 1 havc ccad Uu ardous matcrials requircmceuc undcr Chap�er 6.95 0( �6e CaliCor nia Hca & Safcty C , Scctions 25505, 25533 aru125534. I undcrstand that iC�hc huildinb does n u tly h a tenan4 Ihat i� is my rcsponsibitity w notify the ace�ant of the rcyuire n�s hich u � bc mel prior to isauancc of a Ccrtificam of Occupancy. S ignature o E Appl icant Date r� Ow r rau .c agcnt p„� All roof coverings to be Class ��8�� or better .: � CITY • F CUPERTIN� � �' �� - ��F PERMIT APPLICATION FORM CUPEI�TI�'JO Date: APN# �� - �n �� lo-tq�o� `� Ivlailin Address if different from buildin address Building Address: � g �� g �' 223 O M^sf�a' Qo�� l��t-I 3l �� Owner's Name: Phone #: 1-� M o t,�1a K--� A ss o c,� 4 rt �•J y�od _ S b-D `� Z� Co tractor: License #: 1��4 r�k,�,� t�as �rulc,�oJ ��1 �. (�I� l� Contact: Phone: 4 - r� Cupertino Business License#: - �.oJ 1�1�-�2�Jp,J.��z- Fax: �{oQ, -i3 b •0 33 � � '" �`� Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Description: ��Nto��/e�r►k►c.� !.�►k1E. � �-��'�_ Residential q� � .•� �- S�vi��-1 • Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: �� C'i Q, 0 C� '� Type of Construction: � Please check this box if the project is a �X,��rLto �, ��J IS Ik�C-,S . second-sto addition: Project Size: Standard Large ❑ Maj �r ❑ Quanti Fee ID l?ee Descri tion Fee Grou BAPPLOTHER Uther Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boile�� > 100K to SOOK Btu MECHANICAL BBOILER3 Boilf;r > SOOK to 1M Btu MECHANICAL BBOILER� Boile -> 1 M to 1.75 M Btu MECHANICAL BBOILERS B��iler > 1.75M Btu MECHANICAL BCONSTAX (;onstruction Tax BUILDING BCONSTAX IncUOff/Comm/Quasi BUILDING BCONSTA.XBQ Co�i. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Coiistax - Resi/Mobile BUILDING BELEC1000 Elf;c 600V <= 1000A ELECTRICAL SELEC1001 EJ ec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL r BENERGY Energy BUILDING BENERGYADD F-nergy Add Multi BUILDING BINVESTIGA :nvestigation fee BUILDING 1 of 3 � t g� CITY OF CUPERTINO * ��n �� pERMIT APPLI CATION FORM CUPER�TINfl Quanti Fee ID I�ee Descri tion Fee Grou BMISCELL N iscellaneous Fee BUILDING BMITIGATC Corrvn. Housing Mit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNLTCOMMP N�;w Comm Plumb � PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atrlospheric Vacuum PLLIMBING ; BPCESSPOOL Cesspool PLLJMBING BPERMFEE Bld Permit Fees BUILDING BPFIXTURE Pbl Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLLTMBING BPLANCHK l'lan Check Fee BUILDING BPLANCKADD Pla�i Check Add Multi � BUILDING BPLANCKREP Plari Check Repeat Fee BUILDING BPREPIPE Rf: i e Of Fixtures PLUMBING BPSEWAGE S ewa e Dis osal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLLJMBING BPSTORM Storm/Rain Water PLUMBING gp'I'�p Kitchen Tra PLLTMBING BPVENT Alt of Drain & Vent PLIIMBING BPWATER Insta IUAlter Water Pi e PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT �;einspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHAI�ICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI l�ppliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT I,ighting Fixtures ELECTRICAL BREMFURN Re: ocation of Furnace MECHANICAL BREMFURNOV Relu Furnace > l OK btu MECHANICAL BREMHEAT F:eater Installation MECHANICAL BREMINHOOD In,�tallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL B��,ZN�pp Rem Non-Res Appliance ELECTRICAL BREMPOLE Po �e/Platform Fixture ELECTRICAL BREMPOWER PowE�r Device/A aratus ELECTRICAL BREMRECEPT Rc �:1, Switch & Outlets ELECTRICAL BREMRELOCA R�location of Hood MECHANICAL BREMREPALT Rf:pair/Alter Heating MECHANICAL BREMRESAPP Reniodel Res Appliance ELECTRICAL 2 of 3 ��. �� CITY OF C UPERTINO � � �� pERMIT APPLICATION FORM CUPERTINO Quanti Fee ID F'ee Descri tion Fee Grou BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remc►del Signs, Mar uee ELECTRICAL BREMTHEATR The;�trical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Sin le Duct MECHANICAL BREMVENSYS Ve �tilation S stems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Sei �mic Commercial BUILDING BSEISMICRE ��eismic Fee Res BUILDING BSPECIAL S��ecial Inspection BUILDING BSWIM ;>wimming Pool BUILDING BTEMP Tem orar Power ELECTRICAL BTEMPPERM Tem �orar Bld Permit BUILDING BTEMPSVCS 'remp Dist Svcs ELECTRICAL BUSLIC E�usiness License BUILDING ELECTRIC �;lectrical s foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE M echanical sq. foot MECHANICAL MPERMITFEE Mei:h Permit Issuance MECHANICAL PPERMITFEE Plulnbin Permit Issue PLUMBING PPLBG Phimbing Fee s foot PLUMBING PLLON�RNGC Plannin LR Comme/ Multi-Fam PLANNING PLLONGRNGR Plannin Lon Ran e Residential PLANNING :� of 3 CITY OF CUPERTINO 3 ITEMS OF 36 PERMI7' RECEIPT OPER.ATOR: patg COPY # : 1 Sec : Twp : Rng : Sub : B11�:: Lot : APN ......... 32E59999.05 DATE ISSUED.......: 10/19/2007 RECEIPT #.........: BSC00003036 REFERENCE ID # ...: 07]00145 SITE ADDRESS .....: 22=30 HOMESTEAD RD #310 SUBDIVISION ....... CITY .............. CUF'ERTINO IMPACT AREA ....... OWNER ............: HOr[EOWNER ASSOCIATION ADDRESS ........... 449 FIRST ST #1 CITY/STATE/ZIP ...: LO.�. ALTOS, CA 94022 RECEIVED FROM ....: DR�.EGER CONST. INC. CONTRACTOR .......: DR�.EGER, JOHN EDWARD LIC # 21895 COMPANY ..........: DR�.EGER CONSTRUCTION INC ADDRESS ..........: 60_` COMMERCIAL ST CITY/STATE/ZIP ...: SAI� JOSE, CA 95112 TELEPHONE ........: (4C8)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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1,867.14 #132881 --------------- TOTAL RECEIPT : 1 ,867�.14 � .°� �� _ Community Development ��-, 10300 Torre Avenue �� ' �� Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: PERMIT # o ,� 4�r�� 3r� �� IOoI � OWNER'S NAME: E-t- L� PHONE #�f o�— S3 b_o �t zv GENERAL CONTRACTOR: l�Q1� �(�� (�otls 1 � U FAX # � o � — �'3 c. _o -t z � I am not using any subcontractors: � v � � p-1°I - o'l ature Date Please check a licable subcontractors and co ete the followin information: SUBCONTRACTOR BUSIrJESS NAME BUSINESS LICENSE # Cabinets & Mill�vork Cement Finishing Electrical 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 '�� ,(�t�o? Own r/Contracto gnature Date o� c �� CITY OF I�UPERTINO ' �,�oF pERMIT APPLICATION FORM CUPEf�TINO APN # ��P S� 1 l 1 A�� Date: O �� _ O-1 Building Address: Mailing Addr s(if different from building address): 2233 fl�-lo ►^'►I��'A� �d cJsi T�s 2oz � z o Owner's Name: Phone #: H a t..� o�-�3 co -C� �-f� z- ° Contractor: ��' � ` � o � �� License #: � �� ` U ,I� 12� � � �.,� ontact: Phone:�1-�8 -Z>>°1-�6� Cupertino Business License#: ��/��1�-L Fax: y� - s� b-o� z� Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job escription: �K-'"'��-/�k. p�� uC; � r=� ��- L � �� Residential Wityd�2. S��v P) woo'� n� C�-� - Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: � t-�- Q S Cost of Project: Occupancy Group: �d�a'_ Type of Construction: Please check this box if the project is a second-stor addition: � Project Size: Standard Large ❑ M�jor ❑ Quanti Fee ID Fee Descri tion Fee Grou BAPPLOTHER Other Appliances MECHANICAL BBOILERI B�iler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to SOOK Btu MECHANICAL BBOILER3 Bo.ler > SOOK to 1M Btu MECHANICAL BBOILER4 Boi er > 1M to 1.75 M Btu MECHANICAL BBOILERS 3oiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Iid/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR C �nstax - Resi/Mobile BUILDING BELEC 1000 �;lec 600V <= l 000A ELECTRICAL BELEC1001 :Elec 600V > 1000A ELECTRICAL BELEC200 ElE c Svcs 600V <= 200A ELECTRICAL � BENERGY Energy BUILDING - BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 � CITY OF I�UPERTINO ` ��n�F pERMIT APPL,ICATION FORM CUPEI�TINO Quanti Fee ID Fee Descri tion Fee Grou BREMSIGNAD Rrr�dl Signs Add Branch ELECTRICAL BREMSIGNS Rernodel Signs, Marquee ELECTRICAL BREMTHEATR TY eatrical Lighting Fix ELECTRICAL BREMVENFAN V��nt Fan Sin le Duct MECHANICAL BREMVENSYS `"entilation S stems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM S �ismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP 'Tem orary Power ELECTRICAL STEMPPERM Te�n orar Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Vlechanical sq. foot MECHANICAL MPERMITFEE M ech Permit Issuance MECHANICAL PPERMITFEE Ptumbin Permit Issue PLUMBING PPLBG F'lumbing 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 PERMI7' RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: B1}:: Lot: APN ......... 32E59999.23 DATE ISSUED.......: 10i19/2007 RECEIPT #.........: BS( �00003036 REFERENCE ID # . ..: 07]00156 SITE ADDRESS .....: 22_30 HOME5TEAD RD #202,204 SUBDIVISION ....... CITY .............. CU�'ERTINO IMPACT AREA ....... OWNER ............: HOr[EOWNERS ASSOCIATION ADDRESS ..........: 444: FIRST ST #1 CITY/STATE/ZIP ...: LO:� ALTOS, CA 94022 RECEIVED FROM ....: DR��EGER CONST. INC. CONTR.ACTOR .......: DRI�EGER, JOHN EDWARD LIC # 21895 COMPANY ..........: DRI�EGER CONSTRUCTION INC ADDRESS ..........: 60`� COMMERCIAL ST CITY/STATE/ZIP ...: SAZI JOSE, CA 95112 i TELEPHONE ........: (4(18)536 FEE ID UNIT QUANTITY E�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BENERGY PERMIT FEE 83.16 39.92 0.00 39.92 0.00 BPERMFEE VALUATION 1,000.00 83.16 0.00 83.16 0.00 BSEISMICRE VALUATION 1,000.00 0.50 0.00 0.50 0.00 ----------- ---------- ---------- ---------- TOTAL PERMIT : 123.58 0.00 123.58 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 FRAME 306 HOLDOWNS 307 INSULATION 308 SHEETROCK 309 EXTERIOR LATH 310 INTERIOR LATH 311 SCRATCH COAT 313 ROOF NAIL