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07100150 CITY �F CUPF,RTINO ' ' BUILDiNG DIVISION PERMIT ���k� ��:�� �����T ' , , ,.. ,.- _ _.::::. .:_. BUtL a► �� c � ES �OMESTEAD RD # 311 DRAEGEF CONSTRUCTION INC P � R 071 O 015 0 , PfiRMIT ISSUE DATE 1ER'S NAME: HOMEOWNERS ASSOCIATION 605 CONMERCIAL ST ' 10/19/2007 SANITARY NO. CONTROL NO. PHONE: ARCHITECC/ENGiNEER: BUILDING PERMIT INFO RMV ANI� REPLACE LIKE FOR a�oc ELECT PLUMB MECH 0 � 0 0 ; o o LICENSED CON7RACTOR'S DECLARATION ^, �_,,, r _ _„ JOb DeSCilptlOil � V� ( hcrcby �rm that [ am licensed undcr provisions oC Chaptcr 9(cammcncing ; z� wiih Scction 7000) of Division 3 0( thc Busincss and Protcssiuns Codc, and my liccnsc is ;� y in fuli forcc and ef( t /� 1� 6�,p � v� Z Licensc Clasa � Lic. # 1 (/ � - : �„ ❑ Datc Conuacy�r IL_ b�.'V N� � ARCHITECI'S DECLARATION 7 a Q 1 undcrs�an�i my �lans shall be uxd as public rcconls )yU ' u. �"' Liccnud Pro(cssional ` � < OW NER-BUILDER DECLARA'C10N '}� i hcrcby alfirm th�� 1 am cxcmpt from thc Conuaccors Liccnsc Law for �hc � p O Collowing r: ason. (Sccdon 7(Y31.5, Busincss and Profc.ccions Codc: Any city or county t°„ Qi which rcquires a pertnit to conswct, altcr, improvc, dcmolieh, or repair any suuaurc °"' y prior W il� issuance, also ecquires �he applicant for such pertnit to file a signed sta�ement i, Valuation �_< that hc is liccnscJ pursuant to thc pmvisions of thc Conuactor's Lic-�nsc Law (Chaptcr 9 .� Ft. Floor Area r F- $(commencing with Scction 7000) of Division 3 of Ihc Busincss and Profcssions Codc) or y�.. ihat he is exempt the�c(rom and ihe basit (or Ihe allegcd exemption. Any violadon ot Section 7031.5 by a�ry applicant for a pumit subjects �he applicant to a civil penalty of APN Number Oeeupaney Type not more than five hundred dollars (5500� ❑ I, u owncr oC tt�e property, or my employces with wages az their sote compensation, will do ihc wark, and the swctuce is notintended or offered (orsalc (Sec.7044, Busi�ss Required Inspections and Professions Cade: The Canuactor's License Law dacs nut apply to an owner o( property who builds or improves thercon, and who does such wark himselCor through his own employces, providcd that such improvements are not intended or otCered for sala If, however, �he building or improvement is sold within one yesr oC complction, U�e owner- builder will have �he burden oC proving �Aa� hc did no� build or improve for pmpose o[ salc.). ❑ I, as owner o( �he pcoperty, am eaeclusively contracting wi�h liansed conuutars w conswct the projm (Sec. 7044. Business aad ProCessions Code:) The Contnctor's Li- cense Law docs not apply to an ownu o( propeny who builds or improves ihaeon, and . who convacls [or such projects with a conlractor(s) Iicented pursuant to Itte Conuactar's License Law. ' am exempt under Sea . 8& P C for ihia reasan _ ..ner Date _ . WORKER'S COMPENSATION DECLARATION 1 hercby aflirm under penalty o[ pe�jury one of the follawing declaraGons: ❑ I hsye and will maimain a Cenificate of Canscnt to self-insure for Workers Compen- sation, u provided far by Sectian 3700 of the Labor Code, for �he performance of the work for which this permit is issued. ❑ I havc and will maintain Workcrs Compensauon Insunnce, as requircd by Scction 3700 of �he Labor Codc, Cor thc performance of �he work for which this permit is issued. My Warkefs Com In ncc carricr and Policy number are: f^ O Carrier. �^� �+ y� �� Poliey Na.: � I W�i � Z �� V� CERTIFICA7E OF EXEMPTION FROM WORKERS' COMPENSATlONINSURANCE � (fhis secUon need not be complctcd if the pertnit is for onc hundred doilars (S t00) or IcssJ I cenify �hct in thc performancc of thc work for which this permit is issucd, t shalt not employ any persan in any manncr so u w bccomc subjcct to the Workcrs' Compcnsation Laws of Calitomia Da�c Applicant NOTICE TO APPLICANT: If, a(�cr making ihis CcniCcatc of EzcmpGon, you should become subjcct to �hc Workcr's Compensadon provisions of ihc Lalwr Code. you muu � O foMwi�h comply with such provisions w this pecmit shall be decmed revoked. z ""' CONSfRUCT10N LENDWG AGENCY �� I hcrcby aftirtn ihat there is a conswction Icnding agency lbr the perfortnance of a, .� thc wurk for which this permit is issucd (Sce. 3097. Civ. C.) [L� Q L.endcrs Namc � � L.cnder's Address (� � 1 certiCy �hat I have rcad this applica�ion and sia� Ihat �hc above infortnauon is ��'" correct. 1 agrce to comply with all city and county oniinances and sute laws relating w rJ U building conswction, and hc�cby authori�e reprcscntativcs of �his ci�y to cntcr upon thc �� ahovc-mcnlioncd property for inspccuon pur�wses. (Wc) agree to save, indcm�ify and kecp hazmless ihc Ci�y of Cupertino against U z I�abititia, judg nts, cos�s and expenscs which may in any way accruc agains� said City in co nc o �hc rantin of Ihis rmit. �-+ APPLI U DERSfANOS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date � � "�� SOURC U AT[ON . 0 ��Q - a 7 Re-roofs �� Sign o(Appli o � of R�of OUS MATERIALS DISCLOSURE TYP �11 thc appli r futurc building occupant storc or handlc harardous ma�crial cfincd by tlu Cupenino Munuipa Codc. Chaptcr 9.12, and the Hca�� and Safety .,� ,Scction25532(a)? All roofs �hall be inspected prior to any roofing material being installed. ❑ Y� � . Will the applicant or futurc building occupant use eyuipment or devices which If a roof i;� installed without first obtaining an inspection, I agree to remove cmit harardous air con�aminan�s u dc d by the Bay Arca Air Quality Managcmcni all new m aterials for inspecr_ion. oistrict? . ❑ Ycs No I havc the haiardcws matcrials rcquircmcn�c undcr Chap�cr 6.95 o(ihc Califor- nia & S y Codc. Sc uoat 25505, 25533 and 25534. I undcrstand thaz i( �hc building d n u nan[, �hat it i� my responsibility w notify U�c occupant of thc rcy� ni st metpriortuissuancco[aCenificateofOccupancy. ` Signature ofApplicant Date � All roof coverings to be Class "B" or better cr authorize n Datc � CITY OF C'UPERTINO �� � `� � � � � :�. � - �►�oF pERMIT APPL=[CATION FORM CUPEf�TI(�O APN # Date: a���aaar� ��-��_o, Building Address: Mailing Address (if different from building address): 223�� � sr � tzr� v�t � 3 � t Owner's Name: Phone #: 1 r-q t�0 �'� IC- rL 11-sSo G �� Ti o J �-�' 0�- S 3 b-�o � z o Contractor: License #: �� .(r� _ C�ONST'('t.J L'�o J � �l C. �z. c�t _ 6`f � ���O � � � Contact: Phone: 4�'O� -u �-�o Cupertino Business License#: G / �OU 1� K�2'�'-'`�� t�Z Fax: �-!� o � -5'3 �> -o �3 �� 4 r .� Building Permit Info: Bldg Elect ❑ �'lumb ❑ Mech ❑ Job escription: �1����� A^�'� �GP���'� �� �i� �Q� L��-K= Residential f,� �A �"i $, � � � (.� (� �.'C� v � • Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: l�� S� r—� Cost of Project: Occupancy Group: S'$ a� — Type of Construction: Please check this box if thg project is a second-stor addition: � Project Size: Standard Large ❑ Major ❑ Quanti Fee ID Fee Descri tion Fee Grou BAPPLOTHER ()ther Appliances MECHANICAL BBOILERI Bo: ler <= 100,000 Btu MECHAI�TICAL 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 (:onstruction Tax BUILDING BCONSTAX Inc VOff/Comm/Quasi BUILDING BCONSTAXBQ Co:i. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Co�istax - Resi/Mobile BUILDING BELEC 1000 Elr,c 600V <= l 000A ELECTRICAL BELEC1001 E: ec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD F,nergy Add Multi BUILDING ' BINVESTIGA :nvestigation fee BUILDING 1 of 3 - � CITY OF (rUPERTINO * ��n�F pERMIT APPL=[CATION FORM CIJPfR,�TINO Quanti Fee ID Fee Descri tion Fee Grou BMISCELL TZiscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOMME N�,w Comm Electric ELECTRICAL BNtJCOMMM New Comm Mechanical MECHANICAL BNUCOMMP r ew Comm Plumb PLLTMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW At�nospheric Vacuum PLLIMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE ��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 Plai 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 PLtTMBING BPSTORM � torm/Rain Water PLUMBING BPTRAP Kitchen Tra PLUMBING BPVENT A: t of Drain & Vent PLUMBING BPWATER Inst��lVAlter Water Pi e PLUMBING BPWHEATER W ater Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT lZeinspection Fee BUILDING BREMACOVER A/C Unit > 10,000 cfin MECHAI�TICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI .�ppliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT I,ighting Fixtures ELECTRICAL BREMFURN Re: ocation of Furnace MECHANICAL BREMFURNOV Relc► Furnace > l OK btu MECHANICAL BREMHEAT �_eater Installation MECHANICAL BREMINHOOD In;�tallation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMNRAPP Rem Non-Res A liance 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 Re pair/Alter Heating MECHANICAL BREMRESAPP Rerr�odel Res Appliance ELECTRICAL 2 of 3 � � _� � CITY OF C'UPERTINO �: CUPE TINO PE�IT APPLJ[CATION FORM � Quantit Fee ID :F'ee Descri tion Fee Grou BREMSIGNAD Rmcll Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR The atrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Sin le Duct MECHANICAL BREMVENSYS VE ntilation S stems MECHANICAL BSCBLVD `�cb Specific Plan BUILDING BSEISMICOM Sei smic Commercial BUILDING BSEISMICRE ��eismic Fee Res BUILDING BSPECIAL �pecial Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Tem orary Power ELECTRICAL BTEMPPERM Tem ora Bld Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC liusiness License BUILDING ELECTRIC :�lectrical sq foot ELECTRICAL EPERMITFEE EIE�c Permit Issuance ELECTRICAL MPERMFEE 1V:echanical sq. foot MECHANICAL MPERMITFEE Me �h Permit Issuance MECHANICAL PPERMITFEE Plu:nbin Permit Issue PLUMBING PPLBG Pl»nbing 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: B11;: Lot: APN .. ....... 32i>59999.10 DATE ISSUED.......: 10,'19/2007 RECEIPT #.........: BS�)00003036 REFERENCE ID # ... 07:_00150 SITE ADDRESS .....: 22:330 HOMESTEAD RD #311 SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OWNER ............: HOI'IEOWNERS ASSOCIATION ADDRESS ..........: 44�1 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'i COMMERCIAL ST CITY/STATE/ZIP ...: SAl1 JOSE, CA 95112 TELEPHONE ........: (4�)8)536 FEE ID UNIT QUANTITY ;�'IOUNP 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 SCRATCH COAT 313 ROOF NAIL Community Development x` � ' 10300 Torre Avenue � '`;,�. , Cupertino CA 95014 Telephone (408) 77�-3228 C1TY OF Fax (408) 777-3333 CUPEt�TINO Buildi:n De artment JOB ADDRESS: PERMIT # � � ( � �' � 223 � Nro ►� �-�r �� �a . OWNER'S NAME: �p w( ���s �,Sp �c�•TiQ J PHONE #�-� �-� 3 6- o y- z0 GENERAL CONTRACTOR: X�rl,q ��2 Cr��f � FAX #'-�o �-- � 3 c - o� Z� I am not using any subcontractors: . �°- 0 V �-{ � O�. °� -�-( Si�;na e Date Please check a licable subcontractors and com �let followin information SUBCONTRACTOR BUSIrfESS NAME BUSINESS LICENSE # Cabinets & Millwork 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 � (�J N 1 o'I°l- o� Owner/Contracto i ature Date