06080145 CITY OF CUPERTINO
4aJILDINC:DIVISION PERMIT C4')N'TI2A. TQR.�INFORMA.TION.-
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BUILDING ADDRESS: DRAEGER CONSTRUCTION INC PERMr '06080145
11082 CANYON VISTA
OWNER'S NAME: PERMIT ISSUE DATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL
NE: SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PER
'BLDG ELECT PLUMBMIT PLUMB MECH
0 0 0 0
Op LICENSED CONTRACTOR'S DECLARATION lob Description
V EI hereby affirm Nn 1 am liaised under pm Woes of Chapmr 9(commmcing
u� with Sccsion]OfNI)afDivision 3af Nc Rusinev and Prafessium Code,and mylicc�is
I.Out to. ad affect. REMOVE 3 TO 4" OF TILE, FELT & BATS . INSTALL NE
Licenu lass Lk.M tnl�fptn
?�- sFr- L� TI-POUNDING FELT & BATS'. ROOF REPAIR.
t v,
Data Co.,..,Comrmmr ,
ARCHIT DECLARATION
i g a 1 undcmand my plI•S ans shall be used espublic roamde
)yV
'0 Licensed Pmfcssional
OWNER-BUILDER DECLARATION
<i 1 hereby alTmm Not I am exempt from the Commenors License Law for the .
Q 0 following mum.(Section 707 L5,Businessend Professions Cade:Any city am county
j$9 which requites a Permit to commatct alter.tm arme.demolish,or repair any structure
_ito prior as its issuance,alsomequims theapplicum for such permit to file a signed summem sy
Q that beulicensed pursuanttothe Provisions ofNeContractor's LicenseLaw(Chapter 9 Sq.Ft. Floor Area ValuaC�tPEl(]8
1 (commencing with Section 7000)of Division 5 of the B haircut and Professional Code)ar
$ that he is exempt therefrom and the bun,for the alleged evanpdon.Any violation of
Section 7051.5 by arty applicant for a permit subject the appliomtt to a civil Penalty of ApN Number Occupancy Type
nut mart than five hundred dollar(SSW} 35628032 . 00
0 1,as owner artist prepeny,or my employees with wages as their solcrompeuadon,
will do the work.and the structure is nathanded araRcred forsale(Sec.7014,Business
amRequired Inspections
us Pmom fesslCode:The Cor mier's Licence am re
Law dt apply to in owner of q P
p r,euy who builds tarimprovertheroon,and who doessuchwork himselfarthrough his
awn employees,provided d nsuch impmvemenu amt notimomded oraRcred for sale.If.
however,the building ar imp.veor.I u mid within arc yeti of Completion.the owrcr-
builder .will hart the hums.Of proving that he did ret Wild or improve fur purpose of
sato.).
❑I.as owner of the properly,am esduively contracting with licensed Contractors to
construct the project(Sec.7044.Business and Profession,Code:)The COeOemra U.
clue law dons not apply to an owner of progeny who Wilds or improves thereon.and,
who contracts for such projects with a Contracmr(s)licensed pursuant to the Contractors
Lice.law.
❑1.m exempt sand"Se, ,B&P C far mu meson
Owrcr Data
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ane of the fallowing decimation,:
I ham and will maintain a CcniBeom of Consent to salf-In,ua for Warkcrs Compen-
sation,u provided for by Section 7700 of the Inbar Cade,for the performance of the
work for which this permit is usaed.
8'fhHvc and will maintain Wmkoes Competnnian Ina onvoc,u requ old by Sacem.
37W of the labor Code,for to,performance of the work for which this permit is island.
My Workers Complaisance
Wu ce an i"and Policy number art:
Choier..�Policy No.
�-
GERTIFICATEO Policy
COMPENSATION INSURANCE
(ITh seclon need notal complemd if the permit is formal hundred dollen(SIM)
tar leas.)
I comity that in the performance of the work for which this permit is touch.I shall not
employ any person in any manner m u to become subject or the Workers Compensation
Laws of California.Due
Appliant
NOTICE TO APPLICANT:If.after making this Ccnir,.w of Exemption,you should
become subject to the Worker`s Commusation provisions of the lahof Coce,you mow
.JO forthwith comply with men provisions or this Permit shall be deemed revoked.
z� CONSTRUCTION LENDING AGENCY
(—h Itotally affirm that them is a conhruction lending ageney(or the Performance of
CC r++ the work fur which this pet(nh i tumult(Sec.3097,Civ.C.)
QLenders Name
Z:) z Landers Addmos
U J 0 1 cenify that 1 have read this application and sate met the above information is
(~ correct.I agree to comply with all city and county ordinances and sate laws mlating to
0 Wilding eonatmrtion,and hereby authorim mpmmmslives afihu city to Cher uPnnthe
W ahuve-rucatitmed p.,,,y far instruction p reposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
rF•tN liabilities,judgmcnts,coru and C.,.rs which may to my way accmc against said City
U Z to consequence of me gelding of this MMiL
^h APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2-
'M!= AnN
S Grt of pp�twn✓Cunwcaor —� Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle Numerical material
as defined by the Cupertino Municipal Cade.Chapter 9.13,and the Realm and Safety
Cab.Sacoan 255324)? / All roofs shall be inspected prior to any roofing material being installed.
❑Yes p
Will the applicant or future building Occupant use aquipmcnt or&vim which If a roof is installed without first obtaining an inspection,I agree to remove
emit havallou it contaminants as dc0ned by the Bay Area Air Quality Management all new materials for inspection.
District?
DYht Nu
I have mad the coodau materials requirements under Chapter 695 of the Califon
ataHealth&Safety Code,Schmas 255()5,25533 and 35]34.l undcmaand that ifthe Wilding
does not currently have a tmm4 mar it is my rtspon,mllity to unify de occupant of the
N4Khmosmel prior to issuance:of.CemdficateorOccupancy, Signature of Applicant Date
Owner or authonsnd age., DameAll roof coverings to be Class°B° or better
4'
CITY OF CUPERTINO
8 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35628032 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT 4 . . . . . . . . . : 35684
REFERENCE ID # • : 06080145
SITE ADDRESS . . . . . : 11082 CANYON VISTA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RANCHO DEEP CLIFF HOA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . :
RECEIVED FROM . . . . : DRAEGER CONSTRUCTION
CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21895
COMPANY . . . . . . . . . . : DRAEGER CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 605 COMMERCIAL ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 536-0420
WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--BENERGY-------- --PERMIT-----FEE---- -- -----115---. -56- -- ----55--. 47-- -------0-. 00-- ------55--. 4-7-
------ -0-. 00--
BPERMFEE VALUATION 5, 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00
BSEISMICRE VALUATION 4 , 208 . 00 0 . 50 0 . 00 0 . 50 0 . 00
---------- ---------- - --------- ----------
TOTAL PERMIT 171 . 53 0 . 00 171 . 53 0 . 00
Q CITY OF CUPERTINO
cl rN FORM
CUPEI�TINO PERMIT APPLICATION
-D31 0�/a h•
N # 2 ' D Date:
OBI e OLD
70mwner's
ilding Address: B•Ja ` li Mailing Address (if different from building address):
Nam V Phone#:
Contractor: License#:
.D9 r n 1fc (01-1L01
Contact: 1 Phone:g25'313-O UU Cupertino Business License#:
�� �-Lt01Idyl Fax: 0
Building Permit Info:
Bldg 2�9'0[*N Elect ❑ Plumb ❑ M h ❑
Job Description: ,\/P, 8'bq 1
Residential yCommercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: L 41 �Q Occupancy Group:
Type of Construction: D Please check this box if the project is a
second-story addition: ❑
o'ect Size: Standard Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 1 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<= IOOOA ELECTRICAL
BELEC1001 Elec 600V> IOOOA ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
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CITY OF CUPERTINO _.
CUPiaE o PERMIT APPLICATION FORM
QuantityFee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
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 rinklerBackflo PLUMBING
BPSTORM Stom]/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
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 c$n MECHANICAL
BREMAIRHAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation ofFumace MECHANICAL
BREMFURNOV Relo Fumace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BRENU14 PP i 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 Heatmi MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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1. V1 CITY OF CUPERTINO
CUPEt�TINO PERMIT APPLICATION FORINT
Ouanti Fee ID Fee Description Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
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 Insection 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
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
Ah PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Change BUILDING
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