06080129 -------------------
C;XY OF CUPERTINO sT
EuaoDIVISION PERMIT '�CtX�, XTQRI It1R1kIAT=Ifs-i�'"
t..�NT.'R�„
BUILDING ADDRESS: D R CONSTRUCTION INC PERMRNO,O6OS 0129
22356 RANCHO DEEP CLI DR
OWNER'S NAME: PERMIT ISSUE DATE
RANCHO DEEP CLIFF HOA 605 COMMERCIAL ST 08/18/2006
NE:
SANITARY NO. CONTROL NO.
(408) 536-0420
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
o p LICENSED CONTRACTOR'S DECLARATION lb DOSCrI t100
C 1 Mmby erfinn Net I am licensed under previsions of Chapter 9(commencino
g p
U with Sc"..TXU)of Division 3a1Nc BusincaaM Profession.Codc,andmyliccnuis
to immllmmoaM.rrext. REMOVE 3 TO 4 " OF TILE, FELT & BATS . INSTALL NE
,M— LicenseClma Lm.g (I 7!_ IU ANTI—POUNDING FELT & BATS . ROOF REPAIR.
ce Dam $Z--2 I— Contractor ,
ARCHITECTS DECLARATION
i I understand my plans aha11 be used M Public regia d.
aqV
°ay Licensed Pmfcasional
3 atIamexemptOWNER-BUILDER DECLARATION
I booby affirm Not I am exempt Wm the Contractors License Lew for the .
.c O following..an.(Seed..703 1.5,Business add Proposal..Cade:Any city or county
ISE! which.quires a Permit to cnnsuuct.alter,improve,demolish.or repair any structure,
Zj prior m its issuance.also requires the applicant four such Permit file a signed s.mment
ase Nat he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.F1. FloorArea Valuatfpl@208
0
L H$ (commencing aIsxem with Section 700 0)the
Division f r the
@c aged exaand ort.An Professions Coact at
Nat he b exempt Nemfrom and Ne barb for dee alleged esempuan.Any violation of
Section 7031.5 by any appliant f.a permit subjects Ne applicant i a civil penalty of ppppN N tuber Occupancy Type
not more Nan fin hundred dollars($500). 3 56 0 2!�4 7 . 0 0
❑h as owner of the property.or my employees with wages as their sale compenesdon,
win 4.the work,and Nea.uctum is not mounted or cRorrA for safe(Sec.7014,Business - Required Inspections
and Professions Codes The ConmucNr's License Law does not apply m an owner of q p
property who builds or i m prows themon,and who duex auch work himself or Ntough his
awn employees,provided that such improvements me not intended oroRered rorsele.If,
however,the building at improvement is sold within one year of completion,the owner.
builder will have Ne burden or proving that he did not build or improve for purpose of
sale.).
❑1.as owner of the property,am exclusively contracting with licensed contractors to
convect Ne project(Sec.7004,Business aM Professions Cdi The Contractor's Li-
came taw dors not apply in an owner of properly who builds or improv devices,and
who contracts for such projects with a comractarp)licensed pursuant he Ne Canusetar's
License Law.
❑I am exempt under Sew .B do P C for Nis reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury aria of dte following declensions:
Ihsve and will maintaina Cm rtmwof Content1.ulf-insum for Worker's Compcm
sation,an provided for by Section 37M of Ne tabor Code,for the performance of she
work for which this permit is Isamd.
I baste and will maintain Workers Compensation Insurance,as required by Section
3700 of NC Labor Crack.F Ne perfmmanen of the work far which Nis permit is issued '
My Workers Compensation Insumcancer end Policy number ape:
CartierSTA 1—ssnf Policy No,:�leij(702.f2Qd
CERTIFICATE OF EXEMPTION ROM WORKERS'
COMPENSATION INSURANCE
(This sermon nectl not he completed if the Permit is Enron,hundred dollars($100)
nr loss.)
1 canlfy that in the performance of the work for which this permit is issued.1 shall not
employ anypers.n in any manner so as N become Subject to Ne Workers'Compensation
Laws or California:Data
Applicant
NOTICE TO APPLICANT:If,after making Nis CerliOcam of Exemption,you should
become subje.N the Worker's Campensafan pmvisions of Ne Lahnr Code,you most
.J O forthwith comply with such provisions or Nis permit shall be deemed revoked.
Z~�. CONSTRUCTION LENDING AGENCY
r
[-+ Ihemhy affirm Out there lea comuuctinn lending agency for the performauc of
♦Yi .>-t the work(ser which this Permit I.issued(Sec.3097,Co.C.)
Q Lenders Name
v7. z Lenders Address
U Q 1 certify Nat 1 have fund of.application and sum dem to,Move information is
F 70111 agree to comply with all city and county ordinances and slate laws misting t.
JU building conswetion,and hereby auNoria representatives of this city to enter upon the
W above-mentioned property(.r inspcetion purposas.
gy (We)agree to save,indemnify and keep harmless the City of Cupertino against
tF".t fA Iiabililies,judgrommescasu and expenses which may to any way acrotic against said City
V Z in consequence of the granting of this permit.
APPLICANT UNDER ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
50(1 A71 S..__..___._ .
,do S-`L1-NI Re-roofs
Signmurca pplican amranor Dem
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant some or handle hamal us material
as defttmd by the CupeNno Municipal Code.Chapter 9.12,and the Heald and Safety
Code,Scoliom,25532(a1' / All roofs shall be inspected prior to any roofing material being installed.
❑Yes d7 No
Will the applicant or ff/u'tture building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hoxmdnns air contaminants u dcfned by the Bay Area Air Quality Management all new materials for inspection.
D.lfiet7
❑Yes n
1 have mad the board ms materials requirements under Chapter 6.95 of the Califoo
ma Healdt A Safety Code.Section M05,25533 and 25534.1 undersand Nat if oro building
does ;currently haw a is my cc M aiCcr.d fc tc.f 0m aapant of Nc
rem tdarmis..anaaneeni0eamarOccupaney. Signature of Applicant Date
-a(-n In All roof coverings to be Class"B" or better
O ncr or authorised agent Dam
CITY OF CUPERTINO
2 of 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
i
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35602047 . 00
DATE ISSUED. . . . . . . : 08/18/2006
RECEIPT # . . . . . . . . . 35683
REFERENCE ID # . . . : 06080129
SITE ADDRESS . . . . . : 22356 RANCHO DEEP CLI 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
i
WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----- -- --- j
BENERGY PERMIT FEE 115 . 56 55 .47 0 . 00 55 .47 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
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CITY OF CUPERTINO oWoft L�
cuPErZTINo PERMIT APPLICATION FORINT
,� O Date:
C&I1'25IOQ0
Building ddress: / ` I Mai dress (if different from building address):
2?��J10 2.2S(,PU Poncho Mi
Owner's ame: Phone #:
Contractor:Wa (�,cnontq Sov) 100' License #:—y
ulo 0-S9
Contact: Phone:941-313-TWO Cupertino Business License#:
RiOrIP W%t d&I Fax: ZISq
Building Permit Info:
Bldg R'IeCX�PKElect ❑ Plumb Mech ❑
Job Description: 3to " 1
Residential Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
^/ second-storyEladdition:
oject Size: Standard M Large ❑ Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
------ BBOILER2 Boiler> 100K 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/OfFComm/ uasi 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> 1000A 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
CU%vc
PERMIT APPLICATION FORM
EkTINO
Quantity Fee 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 Ins ectiori Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pb1g 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 F,ee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinklerBackflo PLUMBING
BPSTORM Storm/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 cfm MECHANICAL
BREMARUTAN A/C Units <= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREIVSFIXT 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
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
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CITY OF CUPERTINO
aITYOF PERMIT APPLICATION FORM
CUPEkTINO
Quantity 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
_ BSETSMICOM 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 Ternp 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
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG I Address Change BUILDING
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