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07100151 CITY OF CUPERTINO *, T '` ' ` BUIL�ING DIVISION �ERlvii l ����� ���� ����`��� ' : ;;. ...: .:.. < ,:, _ .:: BUIL PERMIT NO i RD #314 DRAEGEF CONSTRUCTION INC 07100151 . . NER'S NAME: PERMIT LSSUE DATE HOMEOWNERS ASSOCIATION 605 COD�'IERCIAL ST � 10/19/2007 PHONE: SANITARY NO. CONTROL NO. ARCHIT'ECi'lENGINEER: BUILDING PERMiT INFO REMV & REPLACE LIKE FOR LIKE e�DC ELEGT PLUMB MECH � 0 � 0 i p � LICENSED CONTRACI'OR'S DECLARAT[ON IOb D2SCilptlOil � V� 1 hcrcby affirm that I am IicensM undcr provisions a( Chaptcr 9(commcncing ; z, � wi�h Scction 700U) of Division 3 of ihc Busincss and Profcssiuns Codc. and my liccnse u �� y in futl Corce and eCteq (� t�1 /� `� v� Z Licensc Class 1 Lic. M vi / vi � —���.0 �1 : F �p pa� � Conuaclar � �a ARCHITECI"S DECLARATiON 7 a 6 I undcrstanJ my plans shall bc uscd as public rccords )yU ° u. y Licensed Profcssional � y � OWNER-BUILDER DECLARATION 1 hcrcAy alTirm lhat 1 am cxcmpt trum ihc Can�raciors Liccnsc Law for itic � p O Collowing rcason. (SccGon 7()3I.5, Busincss and Profcssiont Calc: Any city or rnunty �,°, Pi which requires a permit to conswct, alter, imprnve. demolixh, or iepair any svucture ° Z} pnor w i�s issuance, alw requires �he applican� far such permit to file a signed sta�emen� �. Valuation -< �hat hc is liccn:cd pursuant to thc provisions of thc Conuacwr's Liccnsc Law (Chaptcr 9 ,,q. Ft. Floor Area � t �(commcncing wiih Scction 7000) of Division 3 of ihc Business and Profcssions Codc) or y�� that he is e�eempt therefrom and the basu Cor the ailegrA eumption. Any violaGon o( Secdon 7031.5 by arry applicant for a petmit subjecu the applicant to a civil penalty of ppN Number Oceupaney Type not more than fivc hundred dollars (5500). ❑ l, as owncr oC ttie property, ar my employces with wages u We'v solc compensauon, wilt do thc work. and the swcture is not intendcd or offeced (arsalc (Sec. 7044. Business Re uired Ins CCtIOIIS and Pro(essians Code: The Conuactor's License Law docs not apply to an owircr of 9 P propeny who builds or imptoves thercon, and who does such work himselCar Ihrough hia own employces, providcd that such improvemenls are not imm�ded or oQered for sala I[. howevu, the building or improvemen� is sold within one yesr of compleGon, ihe owner- builder wiU have the burden oC proving Wat he did not build or impmvc for puryase of salc J. ❑ I, as awur o[ the property, am exclusively conuuting wi�h (icensed conuac�ors W constmct the ptojen (Sec. 7044. Business and Ptofessions Code:)1Tte Coavutot's Li- ccase Law docs not apply to an owner of property w6o builds or improves thueon, md . who convacts Cor sucA pmjects with a conuactor(s) licenaed pursusnt to �he Cantnctnr's License Law. I am uempi under Sec. , B dc P C for Utis muon wner Date _.. _ WORKERS COMPENSATION DECLARATION 1 hereby atTirm under penalty of pery'ury anc of the following declaratians: ❑ f hsoe and will maintain a Cenifiwte oCConsenl to self-insurc for Workcrs CanQen- sation, as provided for by Sectian 3700 ot the Labor Code, for �he performance of the work tor which this pertnit is issucd. ❑ I havc and will maintain Workcr's Compensation Insurance, as �cquired by Scction 3700 0( thc Labor Cadc. Cor thc performancc af �he work for which U�is permit is iss�d. My Worker's Com Insurance carticr and Poliry number azc: Q 0 . Carrier. �� V"� l b N Poliry No.: 1�� G� 2�� O�J CERTIF[CATE OF EXEMPfION FROM WORKERS' COMPENSAT[ONINSURANCE (This scction need not bc complctcd if the permit is ku onc hundred dotlars (5100) or lcss.) � I cenify that in thc performancc of thc work for which �his permit is issucd. I shall not employ any person in any manner so as to become mbject to ihe Worlcers' Compensazion Laws of Califomia. Datc Applicant NOTICE TO APPLICAN7': I(, aftcr making this CcniGcatc of Faccmption, you shoukl become subject to ihe Worlcer's Compensation provisions of the Lahor Codc, you must � O forthwi�h comply with such provisinns or this pccmi� shall bc dccmcd awokcd. z "" CONSfRUCTION LENDING AGENCY [.�-� ►�-� I hcreby aftirtn Wat thcre is a conswction Icnding agcncy for thc perfortnancc of , (� � �hc work Cur which U�is permit is issucd (Scc. 3097, Civ. CJ W Q L.endcr's Namc ' � � Lcnder's Address V � 1 certi(Y Ihai I have rcad this application and sialc tha� Ihc abovc informatiun is w �' correct. 1 agrce to comply with all city and county ordinances and sute Iaws relating w rJ U building conswction, and hcreby authori�e reprcsentativcs of this city to cntcr upon Nc � W ahovc-mcniioncd propcny (or inspcction purposes. a (Wc) agrce to save, indcmnify and kcep harmless thc Ci�y of Cupertino against �.�'� � liabilities, judgmcn�s, cos�s and ezpenscs which may in any way accruc against said Gty V,'� in conuquenc C thc g ting o( this permit. Date �� �( � L�j � APPLICA N NDS AND WILL COMPLY WI'ft{ ALL NON-POIM' Issued by: SOURCER UL N ( "— ( �' ° Re-roofs ��� Sign turc P�� u a. D9 c Type of R�of HAZAR S TERIALS D[SCLOSURE Will �hc applicant ar futurc building accupant storc or handle ha•rardous matcrial lefined by lhe Cupenino Munici al Codc. Chap�cr 9.12. and the Hcalth and Sakty nlc. Scnion 25532(a)? All roofs :�hall be inspected prior to any roofing material being installed. ❑ Ycs No Will thc applicant or futurc building occupant usc cyuipmcnt or dcvicrs whicb If a roof i: installed without first obtaining an inspection, I agree to remove - cmi� hazardous air conwminan�s as dcfined by the Bay Area Air Qualiry Managemcm all new m�terials for inspection. Dfsv;ci? ��/ ❑ Ycs J�rvu 1 havc rcad the ard<ws maicrials requircmcn�t undcrChap�cr6.95 of ihc Califar- nia Hcalih afct C, ctions Z5505, 25533 and Z5534.1 undcrstand �haz itthc 6uilding docs no� cu nlly a a nan4 lhat it is my rcspoasibility w noufy Uic a:cupant a( �he rcyuircmcn whi m �������«oraca,;rrca�aro���r. Signature �fApplicant Date m ' 4 `� ? All roof coverings to be Class "B" or better Owncr or a horizcd agcnl �,� � � �..,� CITY OF C'UPERTINO � � � � �� � r ��TM�F pERMIT APPL=[CATION FORM CUPEF�TiNO APN # �� / _ � (� `� � + 1 � Date: �.�� l Building Address: Mailing Address (if different from building address): 2''� 3 0 +^� -- S A� �� t,�✓ r T 3 l Owner's ame: Phone #: � D !�r- �f Q�-3 - -r b - o �{-zo Contractor: License #: I� Qo, �, lo �,�2 (,o � S T'Z► 17 � o'J �� C� • (� l � �j ( � ontact: Phone: � d 8-�a g- S� y Cupertino Business License#: v �}�►?��`'J�ILL Fax: �F° � -S7 4, --o`fZS" Building Permit Info: Bldg Elect ❑ F'lumb ❑ � Mech ❑ Job escription: 12� n�t °vl't-/ �r�.�14 �� 'G.; � �L� �o �, �-I �IZ, Residential ❑ �a►Z.'f � � ` '� I "�t S � 7 I �(� � Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: r �, � fl � Occupancy Group: Type of Construction: Please check this box if th project is a second-stor addition: Project Size: Standard Large ❑ Major ❑ Quanti Fee ID ]�ee Descri tion Fee Grou BAPPLOTHER ()ther Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boile�� > 100K to SOOK Btu MECHANICAL BBOILER3 Boilf;r > SOOK to 1M Btu MECHANICAL BBOILER4 Boile: 1M to 1.75 M Btu MECHANICAL BBOILERS B��iler > 1.75M Btu MECHANICAL BCONSTAX ('onstruction Tax BUILDING BCONSTAX Inc/Off/Comm/Quasi BUILDING BCONSTAXBQ Coii. Tax for BQ Zone BUILDING BCONSTAXH :3ote1 and Motel BUILDING BCONSTAXR Cor.stax - Resi/Mobile BUILDING BELEC 1000 ElE c 600V <= l 000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA lnvestigation fee BUILDING 1 �f 3 �� CITY OF C'UPERTINO ; ��n�F pERMIT APPL][CATION FORM CUPER 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 Ne� Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLIJMBING BOVERTIME In,;pection Overtime BUILDING BPBACKFLOW Atrnospheric Vacuum PLiIMBING BPCESSPOOL Cesspool PLLJMBING BPERMFEE B ld Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK J'lan Check Fee BUILDING BPLANCKADD Plai Check Add Multi BUILDING BPLANCKREP Plaii Check Repeat Fee BUILDING BPREPIPE R�� i e Of Fixtures PLUMBING BPSEWAGE � ewa e Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn Sprinkler/Backflo PLLTMBING BPSTORM Stonn/Rain Water PLUMBING BPTRAP Kitchen Tra PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER Insta 1VAlter Water Pi e PLUMBING BPWHEATER W ater Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT F:einspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHAI�ICAL BREMAIRHAN A/C :Jnits <= 10,000 cfin MECHANICAL BREMAPPLI t,ppliance Install MECHANICAL BREMBUSWAY Remodei Busways ELECTRICAL BREMFIXT I,ighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relc Furnace > l OK btu MECHANICAL BREMHEAT H eater Installation MECHANICAL BREMINHOOD In� tallation of Hood MECHANICAL BREMMISC Vlisc Apparatus ELECTRICAL BREMNRAFP Rem Non-Res Appliance ELECTRICAL BREMPOLE Po] e/Platform Fixture ELECTRICAL BREMPOWER Power Device/A aratus ELECTRICAL BREMRECEPT Rc il, Switch & Outlets ELECTRICAL BREMRELOCA Rr,location of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Rerr odel Res Appliance ELECTRICAL 2 �f 3 = i CITY OF C'UPERTINO CU + PE TINO PE�IT APPL:[CATION FORM � Quanti Fee ID E'ee 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 Vf�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 Tem orary Power ELECTRICAL BTEMPPERM Tem orar Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC liusiness License BUILDING ELECTRIC �lectrical sq foot ELECTRICAL EPERMITFEE Elf�c Permit Issuance ELECTRICAL MPERMFEE 1V:echanical sq. foot MECHANICAL MPERMITFEE Mezh 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 ? of 3 CITY OF CUPERTINO 3 ITEMS OF 36 PERMI�' RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: BlJ:: Lot: APN ......... 32t;59999.11 DATE ISSUED.......: 10,'19/2007 RECEIPT #.......... BSI)00003036 REFERENCE ID # ... 07:_00151 SITE ADDRESS .....: 22:i30 HOMESTEAD RD #314 SUBDIVISION ....... CITY .............. CU]�ERTINO IMPACT AREA ......: . OWNER ............: HOIZEOWNERS ASSOCIATION ADDRESS ........... 44�E FIRST ST #1 CITY/STATE/ZIP ...: LO:i ALTOS, CA 94022 RECEIVED FROM ....: DR:�EGER CONST. INC. CONTRACTOR .......: DR��EGER, JOHN EDWARD LIC # 21895 COMPANY ..........: DRI�EGER CONSTRUCTION INC ADDRESS ..........: 60.'i COMMERCIAL ST CITY/STATE/ZIP ...: SAIJ JOSE, CA 95112 TELEPHONE . . . . . . . . : (4�)8) 536-0420 FEE ID UNIT QUANTITY ��MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 83.16 39.92 0.00 39.92 0.00 BPERMFEE VALUATION 1,800.00 83.16 0.00 83.16 0.00 BSEISMICRE VALUATION 1,800.00 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 SCR.ATCH COAT 313 ROOF NAIL