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03060192 CITY OF CUPERTINO :9•tt, BUILDING DIVISION PERMIT -ONTRACTORINFORMATION�, BUILDINGADDRESS: LEON MASONRY INC PERMIT NO 03060192 12 COTTONWimm GWNER's NAME: 240 MOSELLE CT PERMIT ISSUE DATE NE: (408) 365-1660 SANITARY NO. CONTROL NO. ARCHITECffENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION Job DBSCTI [[QI1.B I hcmby affirm Nat 1 am licensed under previsions of Chapter 9(commencing p Iflg7r��— with section 1")of Division 3 of the Business and PrefesffieCode.and my license is 'f�\`A�gI in(ull force and off t. ' V ''k�.aaE �gz unmwcam �2 Lic.g b733Ff9 CHIMNEY REPAIR q Dow Cumrwmr4 JUL I1 e 7W ARCHm:CrS DECLARATION O 9 ZOO'] L UI uMcretsnJ my plans mall he used u public meet& J s w Licensed Prommu mal BUILDING 5, y g�y uN was exempt OWNER-BUILDER Cont ION ID��LW�1�1/+ COO hereby.('firm Nat 1 1. exempt item we Cstions o License taw far the I��ttto LOO following masa.(Sadao]o L5,Business and vO.do oli Code:Any oily her county one 3$ whim equina issuance.pcait re coawm,sag imprese,demolish,nr repair ed nmctare imy that hpnortn,l ensedpelmntto She the ovisiosofcant for Co mnti'toicese Lew(ahaptert ggFa NatheitcingwitpunuantlathofDiviomofthe eBusinesiLlnnwlJw(GhodlerY Sq. Ft. Floor Area Valua[1on gy (cat he Is(commencing Scclion70nd the iaiiion?nf theeged exemption. Any Coda)or $ that he la exempt therefrom and the baso for the alleged eemp0on.Any violation of- Section 7031.5by any applicant for apetmltsubjects the applicant toacivil penaltyof APN Number Occupancy Type nal mom than live hundred dollars(S500). ❑1.u owner offt property.Or my employee with wages as she's wit compensation. nm willdo0c.,k..nd N,.".,..itemtinmr doroacndforulc(Sec,7W,Busineu — DACc; dInspections and Prolesaioa Code:The Conoacme.License Law docs not apply to an owner of property who builds or improvesthmon,and whodoewch work himselfor through his312 — CHIMNEY REBAR & STRAPS own employee.prodded that uch improvements aenot Intended orortued orale.If. 514 — FINAL PUBLIC WORKS however.the building or improvement is sold within one)ear of completion,Ne owner. builder will have the burden of proving That he did not Wild at improve for purpose of ole.). ❑1,a owner of the pmpeny,am exclusively contracting wish licensed contractors to coetwcl INC project(Sec.7044.Business and Prefesaunt Code:)The Coneracmrs Li. seem Taw does not apply wan owner of pmMny who W Ilds or improve there n,and, . who contracts for such pmjects wish a contractor(,)licensed pursuant to she Contractor's . License L." ❑I as.exempt under Sec. .B IS,P C ler this recon Owner Dale WORKER'S COMPENSATION DECLARATION I Aeby allhm under pemlly of perjuryone of the following dcclu.1ioe: I have and will maintain aCcnifinreof Convent loulfdnwre for Workers Compote - 10371,30 ion,u provided for by Section 37W of she Lwo,Cade.for Use peRurmaoec of the rk for which this permit is issued. I have and will maintsn Workefs Compensation Insurnce,a required by Section of the labor Code,for the petlormanee of the work fu which mh permit is issued. y Wokce,Comj�n�t��io^^n lnwnnIm C. crandpalirynmbcran: ner. -S4sal F C f^i..av G1 Policy No.:/5 y C O�_ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thhsection need not becomplewd If the permit is for..hundmddollan(SIM) ort Ieaa) I certify that in we performance of Ne work for which this Permit H Issued,1 Jail not employ any permn in my waver an as in become wbpXI to the Worker(COmPtnsadam Laws of caifomla.Dam _ - Applicant NOTICE TO APPLICANT.IL after making this Ccnincato of Exemption,you should become abject to the workers Compensation provisioe of the lain Code.YOU must .J z forthwith comply with such provisions or this Permit shall he deemed rerotrd. nCONSTRUCTION LENDING AGENCY (—t 1 hereby affirm that there Is a construction lending agency for da performance of �i the work for which this permit is issued(See.3097,Civ.C.) _ W Q Undoes Name z Lenders Address V 0 1 certify th.l 1 have tend this application and naw that the me"wform iliun la IL,H correct.I agree to comply with all city and county ordinances and slue Ire elating to O U Wilding construction,and hereby authonae representatives of this city to enter upon the Tal above-mentioned preperly for impaction purposes. W (We)agree m save,indemnify and kap armlets the Ci LY of Cup:nine against ail to IiabllWes,judgmenu,costs and expenan which may in any way ansa against aid City V z fing,or this permit. APPLt consequence ANDS cUNDERSor we TIAND WILL COMPLY WITH ALL NON-POINT Issued by: Dale V OURCER UL TIONS. 6-3vG Re-roofs SiSmdwcof pplinnnConuwmr Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applinnl or!arum Wilding Occupant sten her.odic harudon material a deflad by the Cupertino Municipal Code.Chapter 9.13.ad the Health and Safely Code, E3 Yet 33533(a)? No All roofs shall be inspected prior to any roofing material being installed. Will the.ppbnmheram Wading o .pant hew eyainm=est her u d n wmm� If a roof is installed without first obtaining an inspection,I agree to remove h huerdous air contaminants ss defined by the Bay Arca Air Quality Management all new materials for inspection. W,ict? ❑Yes No I have read the haardm smatenah eyuimmems undo Chapter 6.95 of the Califor. nia Hcal"Safety Code.Sections 35505,35573 and 25534.1 undcrslmW that if the Wilding docs not convoy have a tenant,that It is my esponvhillly le notify to Occupant of the remenu m metpnorwissuannofaCcnifteateofOccupaney. Signature of Applicant Date ono 630-03 Owner or mthmiad agent. Date All roof coverings to be Class "B" or better Building Division 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEPTINO Building Department Subject: Reroofing policy for the City of Cupertino. 1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards and manufactures specifications on reroofing. 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 reroofing 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) Preinspection 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 that the proper City inspection can be performed. IMPORTANT: 1. Flat roofs must have a minimum of YV 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 of inspection. We understand the above policy on reroofing and will comply with this policy. Homeowners Name: Address: AriSRR Cirum (ewL-tr .(�e j'i1kn C-A Reroofing Company Name: i D R oo jp; „ Applicants Signature: Date: 6 30 0 3 • Joe Antonucci (Chief Building Official) 6/25/01 �\ CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPERTINO APN # Dat C Q Building Address: ' 1 Co�O W o Owner's Ne: Phone#: I L�- 66v Contractor: I I License : Le-c, m Masooky3 g Contact: Cupertino Business License#: B i ing e it Info: B] Elect ❑ Plumb ❑ Mech ❑ Job scription: esidential ❑ &' Commercial ❑ Sq.Ft. Floor Area: S/Sq.Ft.: Cost of Project: Occupancy Gro : Type of Construction Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> I OOK to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to IM Btu MECHANICAL BBOILER4 Boiler> IM to 1.75 M Btu MECHANICAL BBOILERS Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comni/ uasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1O00A ELECTRICAL BELEC1001 Elec 600V> IOOOA 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 1 of 3 CITY OF CUPERTINO c oo PERMIT APPLICATION FORM CUPEkTINO uanti Fee ID Fee Description Fee Group BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi-Family Res MECHANICAL BMNEWSF&2F New Sf&2F Res Bldgs MECHANICAL BNEWMULTI Multifamily Res ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOMMM New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING BNUMULTI New Multifamily Res PLUMBING BNUSFD New Single Family Res BUILDING BOVERTRvIE Inspection 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 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 BPWATER Install/Alter Water Pie PLUMBING BPWHEATER WaterHeater/Vent PLUMBING BPWSVCS. Main Water Service PLUMBING BREINSPECT Reinspection Fee BUILDING BREMACOVER A/C Unit> 10,000 chn MECHANICAL BREMARMAN 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 Fumace> l OK btu MECHANICAL BREMHEAT Heater Installation MECHANICAL BREMINHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL AEk BREMNRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL .2 of 3 CITY OF CUPERTINO CUPEI�TINO PERMIT APPLICATION FORM QuantityFee ID Fee Description Fee Group 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 Sips,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 Issuance PLUMBING PPLBG Plumbing Fee sq foot PLUMBING ZADDCHG Address Chane BUILDING 3 of 3