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06060076 CITY OF CUPERTINO ' DUILDINGDIVIBIGN PERMIT ±^a �b'rli'J. .a'R INFU .M.A:TIOI '� BUILDING ADDRESS: , MAURICE FESKANICH PERMIT N0.06060076 10180 BYRNE AVE OWNER'S NAME: PERMIT ISSUE OATS dk MAURICE FESKANICH Et SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG � t� PLUMB MECH tn LICENSED CONTRACTORS DECLARATION Job Description i m0F�,j 1 hcroby affirm that I am licensed under provismu of Clmpmr 9(commencing E with Seca..70(t1)ofDiHson 3.fthe Business and Profeulons Code.ardmy lite.is y I.full to=mel.ffa.7. REPLACE WITH 7/1611 OSB 30# FELT z License Clan Lk.g Dam Con CLASS A OR B SHINGLES qQ DELL l��ywi ARCHITECTSDECLARATION i 2 744 1 understood my plane shall be used as public rtcnNf e o ti Licensed Pm(essmal 'y5 OWNER-BUILDER DECLARATION I0 0 1 hereby slnrm that I em exempt from the Contractors c License: nyc law for We O o following mama.(Seca..78315 B,elMu and Pm(enl.ns Cede:Any city or county 9 which required a pctmn re cmnswc4 alcor,hnprmu,demolish,or repair any stramare, Szi paths aBssuarw'pubmaottorequinusWe the isionofWe tach pcmitm0um Law(ned taement Valuati13500 N Natheulku withSewemmlhpmvitlnion3of eBodlar'slucvclaw(Chapmr9 Sq. Ft. Floor Area War,he ncingup, Section and Division We Busneuardon.My Code) that o ls 31.5 b rMTlrom undo ort bus far Ibe subjects Ws esemant to Any l Penalty of SeNun 70311 by any appliant(a a permit mejeeu the applicant m a Civil penally.( ppN Number Occupancy Type ant m..rod.BK hundred&Ilam(M). 3 5 716 0 7 0 . 0 0 ❑L u awrer.f the pmpeny.a my eroployens died wage u then role emnpewaon; will&We Md.wdau mama Wsmintenaed«ortema targets(Sec.7a+,Buaaaa Required Inspections and Professionale:The Professionals Cademaroman: es l law dun mut apply e-drums, q P wr proptny who blot&m impmwa Wwsraa+na wbo de a such wort himself or throng.his .w.empl.yrfa,Provided Watsueh improvements am not Inmrded"offend for sale If. however,in he)Id on u enol prmmurolawithin oreyear ofim.pledm,theowwr- heildm aNl have,one burden of proving that he did not held or improve for Purpose of Zle.}/ y u Owns"of We Progeny-are,exclusively con.aNng with Banua consumers m ewtmct one project(See.7064,Busmen add Profesalons Co&:)The CooumaoYs U. eenw law mans ant apply w an ow.or of property who herds or impmws Weems,Md. who conwcu for such mojema vied a conuxwr(a)0ecnsed ieurawnt enWe Consanure LkumareLaw. ❑Tam a�emp�iJmems.. 6.PCfor u o oww naRru Dam O WORKERS COMPENSATION DECLARATION 1 hereby affirm under peulty of perjury,one of the fallowing Eecimmoss: I led and will maimed.a Carol ofCom mo W self-invert far W~$Compere noon.u provided for by Section 3700 mf Ile labor Code.for the performance of one doh fm which doe permit u isaned. I haw and will maintain Workeh Compensama Insurance,as acquired by Section 3700 of the labor Code,for the performanda o(We work fur which this Permit u issued. My Wohees Compensation Inemence artier and Policy number arc: Carse'. Polley No.: CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Guiseectim rcrd ant be eampked Uthe permit Is forom bendred&Ilse(SIM) or lux) I cmtify the in We W...of Wo wort for which Use Permit is blued.i shell nm employ any person in any& c dbTnome subjecl to the Walsers' mpemdun Laws of Calif. ire a.Dae AVPI am NOITCE T'0 A PI2CANT.If ager making this CeNfroe of Eampaan,you WouIJ become subject in We Worker`s Compensation pmvlsiw of the labor Code,you mus .^J Z forthwith Comply with such provisions or Wu permit shell he domed revoked. . . „Zy CONSTRUCTION LENDING LENDING AGENCY Fr 1 hereby affirm the,Wert is a constmNnn lending agency for We perfmmemu of D.> the wort for which this permit Is issued(Sec.3091.Civ.C.) 14 n~. lendees Name .7 z Lessees AM. U I certify that I have most this application and sum that We show inf.rmNun Is it. correct,l agree to comply with all city and county ordinamu am sum law.relating to 0U building Conswction,and hereby authorize representatives of this city to cnmr upon the above-mentioned property for impeeaon purposes. (We)agree to save.indemnity and kap harmless the City o(Cupcnino against aF.a VI liabilities,judgments,costs and expense which may In any way am=against said City U Z in commiumm,or the swung of this permit yO' ��G o--i APUD UNDERSTANDS AND WI L COMP WITH A N-PJ1lJ Issued by: Date SOURCE REGULATIONS. Re-roofs Signatumof Applican✓Con wam � Type of Roof HAZARDOUS MATERIALS DISCLOSURE Will de applicant or furore building occupant post or herdic havndous meesal as defied by Be Cupertino Municipal Code,Chapter 9.12,and the Health and Safely Code,saa.n 255324n40 ❑Ye —/ All roofs shall be inspected prior to any roofing material being installed. UN- Wlll the applicant or room building Occupant tax equlpment or dcvicra which If a roof is installed without first obtaining an inspection,I agree to remove emit hamrdame air comaminants as deflyAby the Bay Ama Air QUWiIy Management all new materials for inspection. Metric? ❑Yc. u I have mad the busted.materials mqulmmcnts under Chapter 6.95 of We Caum. pia Health&Safely Cade,Sections 25503,75533 and 25334.1 understand Wee lftho bolding Jau nwt cumnlly haw a meant that It u my ma hllily u ne'fy the occupant of the reyvirtmcn whichmuRhemelpn. moan of accrued r P Signature of Applicant Date o"^e cC 7 `r� 6XiA All roof coverings to be Class"B"or better Owner or authorized agent o.e CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # 3 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . 1 . : 35716070.00 DATE ISSUED. . . . . . . : 06/09/2006 RECEIPT #. . . . . . . . . : 34785 REFERENCE ID # . . . : 06060076 SITE ADDRESS . . . . . : 10180 BYRNE AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MAURICE FESKANICH ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : MAURICE FESKANICH CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : MAURICE FESKANICH ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE 4KE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 4,000.00 104.76 0.00 104 .76 0.00 •. BSEISMICRE VALUATION 3,500.00 0.50 0.00 0.50 0.00 __________ __________ __________ ---------- TOTAL PERMIT 105.26 0.00 105.26 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ -_____________---- OTHER 105.26 VISA TOTAL RECEIPT 105.26 • - Community Development 10300 Torre Avenue I Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 IOU PEkTINO Building De artment JOB ADDRESS: PERMIT# © �'J 13 %,. e, CS6 a6o�� 6 OWNER'S NAME: PHONE # 2w2--Z73-1233 GENERAL CONTRACTOR: AX # I am not using any subcontractors: 6 ©� Signature l5ate Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINESS 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 • Owner/Contractor Signature Date OWNER-BUILDER VERIFICATION 1. (Check one) I or. mm yiy immediate family (parent,spouse or child) will perfor • A. v All the work authorized by this permit B. _ A portion of the work C. None of the work If B or C is checked,complete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. A portion of the work (complete section below) Contractor Address/City Phone # State License # Type of work to be '2if vaTaced 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or • portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers compensation must be on file at the City of Cupertino Building Department office. Person/Firm Address/City . Phone Number Type of work to be erformed ..................................................................................................................................................................................... I declare under penalty of perjury that the above is true and c rrect. have read and understand the Owner-Builder Information (reverse side). Property Owner's Signature: Date: b1 O,0/ Job Address: e . Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build Department. • City of Cupertino Building Department a0f 10300 Torre Avenu.0 CU PEI�TINO Phone: (408)777-3228 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other,than yourself,you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract,you should be aware of the following information for your benefit and protection If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is$200 or more for the entire project,and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,workers' compensation insurance,disability insurance costs,and unemployment compensatiore contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S.Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale;property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit,erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors'State License Board in your community or at 1020 N Street,Sacramento,California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, Building Department, City of Cupertino • Printed on Recycled Paper Community Development Department Building Division City of Cupertino 10300 Torre Avenue • Telephone: (408)777-3228 Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any roofing installation. 4. To receive a final sign off from the City, the following steps are required: 1) Pre-inspection and/or tear off approval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nail inspection is required. • 6. Any roofing which is applied without first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on Jre-roofing. vJ Homeowner's Name: � 0,ez/'i,C 2 Fe- 5: 4- h t,C ry Job Site Address: ra/�� >>Y / h Ale- Roofing Ve-Roofing Company Named 42 4Z Applicant's Signature: Date:4201f • Greg Casteel Building Official Revised 11/2/04 p(�Cocv�lo CITY OF CUPERTINO REROOF CUPEkTINO. PERMIT APPLICATION FORM APN# 5eq , Building A rests: © / i ne14 11 2. Owner's Name: rr Phone #: ez,ar •'cl /'eS 2yie y0f" 973 — / 333 Contractor:Q License #: Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ uilt-Up roof ❑ ,phalt Shingles Asphalt Shingles p� Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# Cl To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: /2c �u 71E 4 C a s /t/J ee S i l S Residential P_ Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: IJ Cost of Project: Type of C t u tion: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group / BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING •