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06030032�w U� CITY OFCUPERTINO OTRACT.'° RINF.ORMATIOi: ': BUILDING DIVISION PERMIT BUILDING ADDRESS: MBROWN CONSTRUCTION, INC PERM'TND'06030032 10031 CARMONA COURT ` ER'S NAME: PERMIT ISSUE DATE CARTER, NANCY 702 S. DANIEL WAY 03/07/2006 P NE: SANITARY NO, CONTROL NO. ' (408)260-1260 ARCHITEC iENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTORS DECLARATION Job Description I hereby affirm that l am lice n wd under provision, of Chapter 9 (commencing p with Section7")ofDivislon3afdu Bualn,,dProf mC de, lieemo le InmRto= and effecl. �$ REMOVE EXISTING COMPOSITION AND EPLACE WITH CL License Cl ' A COMPOSITION Dau CentraMr ARCHITECT'S DECLARATION T'SD FfNALE[� FINALE 1 understood my plans Shell he used M public rccnrds 2OD6 Licensed Preform onal OW NEmBUILDER DECLARATION 1 hereby .(Sure that I , Lew for the exempt from the Conions MAR C 1 afer. Nd PNICAon-li (.'a11C:Any Cm arepanly maeaa.(BCC6a1 RDIS, : My c which re l construct. mse, or my moccudwar m w61ah iss a ri rm 01 Mob e a sir re quires;thealter, e. alll I h parinit u priorms issuer palsmmui the tMaision; nfar such perm'u01e eL1ov Raumcm its pureuant to Ota of the Camncmf'and Sq. Ft. Floor Area teat (thiatic commo,liccmsed of Division Preeiaw(Chapur9 Code)of (commencingwith SccOon7000) of O asisOI3ofthe Businessendon. Any that he c exempt therefrom and the basis for the alleged "emptier. Any violNon of �N7 1b, Occupancy Type Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penally of not mom than five hundred dolWs($500). 1pc�Ypp,7N�y 11b U1 3J/a.•`•EN 00 ❑I, as awn" of the property. a my employees with wages as their onto compensation, Required Inspections will de, the work and the structure Is not intended or offered fOvale(Sec.70W,Bualnesa and Profession$ Code: The Contractor's License taw dome not apply on an owner of q p property who build, or improve, Demon. and who doessuch work himself ar through his own employees. provided that such improwmenu me not Intended crartemd forme. 11. however. the building or improvement is sold within one year of compietion. the owner. builder will have the burden of proving that he did not Wild or improw for purpose of tele.). ❑ 1. u Owner of the propeny, am exclusively contracting with licensed contrawmas in construct the project (Sec. 704, Bminem and Philosophers Code:) The Coauacme, LF came Law does at apply in m Owner of factory who bullar or improve thereon. and who contracts for such projects with a cotnracter(s) licensed pursuant in the Cornerstones License taw, ❑ 1 em exempt under Sao. . B At P C fer this reason her Dau WORKER'S COMPENSATIONDECLARATION 1 hereby LMm1 under penally of perjury oro of the following d"lantion$: ❑ 1 ham end will malnuin •CeNficeu efCan$ent m ulFinaum for WorteY,Compen- sath n, ar provided for by Section 3700 of the Labor Code, fm the Performance of the work for which this permit is issued. have and will maintain Workels Compensation W urea, M required by Schon of the taker Code. for the performance of the work for which this permit is listed. yWarke m ado�ansuran�`e cesi" and Policy number am: Cartier. r `�`� Policy No.: I t �- 1? t CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This smion heed nothecampked if dm permit is f"anchundmddollsn (SIM) o coal 1 certify Nat in we performance of the work for which this permit Is Issued. I shall at employ any person in any manner an u m become subject to the Workers' Compematlon Laws of California. Date Applicant NOTICE TO APPLICANT-. If, after making this continents of Exemption, you should become subject to the Worker's Compensation provisions of the Lahor Code, you must Forthwith comply with such provisions "this permit shall he doomed m orkcd. CONSTRUCTION LENDING AGENCY L hereby affirm that them its construction lending agency for the performanm of Ne work for which this permit is Issued (Sec. 3097, Civ. C.) Lender's Name ' Leader's Addition; I certify that I haw read this application and sum, that the show information Is Covent. I agree on comply with all city and county ordinances and suite laws mining to building convection, and hereby autborme representatives of this city to enter upon tic shave -mentioned property far Inspection Pugmses (We) agree to sew, indemnify and keep harmless the City of Cupenine against liabilities, judgmu and expense, which may In any way acce agaimuald City cn. cam ry in consequence of the granting of this permit. APPLICANT NDERSTAND ND WILL COMPLY WITH ALL NON -POINT l 6 Issued by: Date SOURCER U ATIONS. Re -roofs Type of Roof //��((,,JJ��'//'((�� 'Daw� si,moura�pplicarntromor - ' 114VARDOUS MATERIALS DISCLOSURE Will The applicant or future building=uponumm orhendle harawou3 material as defined by the Cupertino Municipal Cade. Chapter 9.13, and the Health and Safely otle. Section 35532(e)? All roofs shall be inspected prior to any roofing material being installed. ❑ Yes If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or f tum Wilding occupant use equipment or devices which emit haulmoos air comumina B M defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yue l have mad the W.Oh rmaterialsmquimmcnu under Chapur6.95 oflhe Califor. h nia HUI" Safcty CSM, Sections 35505,35533 and 25534.1 undcmuM Nu ifthe Wilding docs not cu nil hewatear!Nmitsmyrespomihilityw.ofytk p.t.rfie raquimuents chmuatemet toruusmnaaracmuecateof r 0 6 Signature o Appli t Date All roof coverings to be Class "B" or better Owner or uIpfizod x,A pate V CITY OF OUPEkTINO Community Development 10300 Tone Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: CQyyy%pyjC,, C4-- PERMIT # (ja 0 3 00':3� OWNER'S NAME: PHONE # GENERAL CONTRACTOR: FAX # X24 6- C 1 O I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 21 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 " 7 * i WT • ., . aG ate Community Development Department Building Division City of Cupertino • la 10300 Torre Avenue Telephone' (408) 777-3228 CITY OF Fax: (408) 777-3333 CUPEkTINO 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 complywiththe above stated policy on re -roofing. Homeowner's Name: / " VY_ 1002))+1 �tz C,4 Job Site Address: �n . `' ^ Roofing Company Na \ u �-'v , C Y U 1 Date: Applicant's Signature: • Greg Casteel Building Official Revised 11/2/04 ' Printed on Recycled Paper cm or UPERTINO CITY OF CUPERTINO REROOF OW500 3a PERMIT APPLICATION FORM APN # - -- ------ ---- Bldg Permit Fees Energv Date' O Building Address: Owner's Name: BUILDING BUILDING Phope v S 3- C BUILDING BUSLIC Contractor: nit 1n BUILDING ori �� l Z� - License #: Contact:- Y_UW Vl Phone #: Cupertino Business License #: 2 S t 0 Type of Roof Covering: Existing: ❑ Built -Up Roof Proposed: ❑ Built -Up roof r. Asphalt Shingles Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles Li (Specify) Number of existing coverings ❑ Other (Specify). ❑ , Provide I.C.B.O. Report # (3 To be Removed _ ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will ComPlY With Cu ertino's Tear Off Polic : Job Description: � Oce, e) I .' l�.d„` cit �-1� Residential Commercial ❑ LOW e6S carte. Fire Zone: .Yes ❑ No ❑ Confirmed with Planning Det. if LJ there are any restrictions: Cost of Project: Type of nstructign: ; Occupant group: 14, v �Lc�� I b0 11zz Qty. if L`se Tlnen.i nfinn Fee Grout) Applicable rcu iL BPERMFEE BENERGY - -- ------ ---- Bldg Permit Fees Energv BUILDING BUILDING BSEISMICRE BSEISMICOM Seismic Fee Res Seismic Commercial BUILDING BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING