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04040148 (2) EK'1'INO CITY OF CUP '� ?S'� ak2 m ' e•ta a; BUILDING DIVISION PERMITCONIRAGTORINFQRMATION ,� :-Lm?aio w'. l,y `S,a.r...-fZ. 1 BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMIT N904040148 OWNER'S NAME: PERMIT ISSUE DATE DAVID & SUSAN CHIU 605 COMMERCIAL04 /22/2004 lip ONE: SANITARY NO. CONTROL NO. (408) 536-0420 ARCI IIECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH WOO LICENSED CONTRACTOR'S DECLARATION _ p ^ a-Z� 1 hereby.(film Ill.,1 am licensed under provisions of Chapter 9(co9m sing Job Descripti A`6.,��! m< with Section7000)of Divixion 3 ofthc Businexs and Pufcsvinna Cndc,and ylicen i I.Limufineas erne'. REPLACE SIDING JUL 29 2004 it ? License Class Lic.p t O DatC Commerce nl£-£t9 ARCHITECTS DEC TI ?K U I understand my plans shall be used as pu tic me tris _�� Littnxd Promssional BUILDING cps OWNER-BUILDER DECLARATION 1 hereby affifm that I am exempt from the Contractor's License Law for the vs 00 following recon.(Section 7031.5,Business and Professions Code:Any city or county K m which requires a permit m ennatrua.alter.improve,demolish,or repair any arupune 2 -t2T 000 prior to its issuance.also rcr ids the applicant❑arsuch permit to file sm,reislammenl zs< mat he isliicensedpursuant tothe provisionsofthe ContractoriucenseLaw(Chapter 9 Sq. Ft. Floor Area Valuation yF� (con mencing with Section 7000)of Division 3 of the Business and Professions Code)or iFg Nal he u exempt therefrom and the basis for the alleged exemption Any vitiation of Section?031.5 by any applicant for a porrair subjects the applicant to a civil penalty of 3 6G3QrQ 5123e10 0 Occupancy Type not more man five hundred dollars(S500). p Y YP ❑I,as owner of the pori or my employees with wages as Ncir sole compensation, will do Ne work,and the strumum is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License law does not apply to an owner of Required Inspections property who builds or improves thereon,and who docs such work himself or through his own employees,provided that such improvements arc not intended or offered forsale.If, however,the buddingor improvement is sold within one year of cm aplction,We owner- builder will have the burden of proving that he did not build or improve for purpose of sale). ❑1.as r of the property,am exclusively contracting with licensed convectors to conswct the project(Sec.7044,Business and Professions Code:)The Contractor's Lh cense law docs not apply to an owner of property who builds or improves theme ,and, who contracts for such projects with a contractor(s)licensed pursuant the Contractor's License Law. ❑Iamexcord n Ee. .B&P C'forr this reason Owns Date e?yr2. it WORKER'S COMPENSATION DECLARATION I hereby.Kinn under Penalty of perjury one of the following declarations: 1 ban and will maintain a Ci nificam of Consent to self-insum for Worker's Comped cation,v provided for by Section 37110 of the labor Code,for me performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as required by section 37M of she Labor Code,for Be,performance of the work for which this permit is issued. My Worker's Compessation Insurance carrier and Policy number art: Carticc Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sectilm need nut hecompleted HIM permir is fur one hundred dollars(SIIX)) or less.) 1 ecnify that in the performance of the work for which this Permit is issued.I shall not employ any person in any manner set as to bemmc subject to the Wurkeri Compensation Laws of California.Dale Applicant NOTICE TO APPLICANT:If,after making this Certificate of Emmption,you should become subject to the Worker's Compensation provisions of the labor Code,you must UZ forthwith comply with such provisions or this permit shall be deemed revoked. zCONSTRUCTION LENDING AGENCY [--� I hereby alarm mal there is a construction lending agency for the Performance of 5 the work for which this permit is issued(sec.3197,Civ.C.) U.1 QLender's Name gt. Lender's Address Z)z U O 1 certify that 1 ban read this application and sum that the above information is Fcareer.I agree to comply with all city and county ordinances and sure laws relating to . �U building construction.and hereby authorim repmsentaGss. of this city to enter upon he F Wabove mentioned property for Inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against ret liabilities,judgments,costs and eaycnscs which may in any way acense against said City U Z in consequence of the grand ng of this JpermiL ^ AP ICA UN1l6RSTA DSA D WILL COMPLY WITH ALL NON-POINT Issued by: Date SOUR GULATI Re-roofs 7S fit ppfic.n Cnmmcmr Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building Occupant store or handle hacardous material as defined by the Cupcnion Municipal Code,Chapter 9.12,and the Health and Safety Codes Section 25532(.)? [D Yes El No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building keuponl use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove it hvaNws air contaminants as defined by the Bay Area Air Quality Management DiNrict? all new materials for inspection. ❑Yes ❑Nn I have mad me hazardous materials requirements under Chapmr6.95 of me Critter. nix Hcalth&Safcty Cod,Sections 25505.25533 and 25534.1 understand mar if dm Wilding chair not currently have a remans that it is my respumihility m nodry Bar nceupanr or the rtyuimmc t2 or rat issuance ofa Ccnificam' of Occupancy. Signature of Applicant Date 95�3^a*' All roof coverings to be Class "B" or better 6 r hmircd agcm Dale CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO 6 6 APN # Date: Building Address: Mailing Address (if different from building address): 6 " 2 Owner's Name: JPhone #: Contractor: License #: GI7Glo Contact: / Phone: r yof) Cupertino Business License#: Ic Fax: 0 7 Building Permit Info: Bldg Elect ❑ Plumb ❑ Mech ❑ Job Descriptio [� / Residential S/ *11�211ZI 'Commercial ❑ Sq.Ft. Ffoor Area: tt $/Sq.Ft.: 0 orb S 9 Cost of Project: Occupancy Group: �rJ Type of Construction: Please check this box if the project is a second-story addition: ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> l OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > I OOOA ELECTRICAL BELEC200 Elec Svcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING I of s�a8� CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO AIIIIi---Quantity Fee ID Fee Description Fee Group BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BOVERTIME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK- Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING BPSEWER Sewers PLUMBING BPSPRINK Lawn S rinkler/Backflo PLUMBING BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING BPVENT Alt of Drain &Vent PLUMBING AML BPWATER , Install/Alter Water Pie PLUMBING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 cfm MECHANICAL BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUSWAY Remodel Busways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Furnace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ' ELECTRICAL BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL BREMPOWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Mar uee ELECTRICAL 2 of 3 C�- CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMTHEATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECIAL Special Inspection BUILDING BSWIM Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERMITFEE Mech Permit Issuance MECHANICAL PPERMITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING • 3 of 3