05080139 CITY OF CUPERTINO
BUILDING DIVISION PERMIT �SCONTRA&-i,6RkINFORMATION
x*ti»1i,'::.,h, .w.� --.. R1a'`�S ;.x�•T,s., d', i iv;>r
BUILDING ADDRESS: DISCOUNT PLUMBING & ROOTER PERMIT NO 05080139
AT PIMA DR
OW7NA PERMIT ISSUE DATE
JON 1330 VALOTL RD ng/17/2oosSANITARY NO. CONTROL NO.
650 333-5105
ARBUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
9Oo LICENSED CONTRACTORS DECLARATION Job Description
wF 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing
i`r$ with Stttion]IXXB of Division 3 ofthc Businssand Professions Coda,and my liccne is
inmdmea arta of REPLACE MAIN WATER LINE
n ? c lase Lic.p
Dam Cumm'or �S/"�]£�'
Liccnsp/,,y nnp
n 1-� _ CHITECTSDEC RA ION ,!• ��I';A H
D-< IundcrsunJ my plans shallthe uxdu Public records
D0.0
sS.0 t; Licensed Professional <7/�A ^
g IV
OWNER-BUILDERDECLARATION 1As 1,
'yes<I I hcrcby affirm am 1 am exempt from thin Contractor's License Law for the
00 following mason.(Section 7031.5,Business and Professions Code:Any City Or county japf �J
s g(Ka which myvirs a permit m Wde
co ual,eller,improve, molish,Or repair any sucelmn _ J{r�qy _ 000S83000
prior it)its issuance.also rostrums the applicant for such permit to rile a signed summenl k
<
thin is ma.islavnfth,Connector''sLicenselaw(Chapter9 Sq. Ft. Floor Area 3, Valuation
x1.=-0 (commencing with Section 7")of Division 3 of the Business and Pcofessimu Cade)or pd't� '^
y
that he is exedominantmdominantd
and the basis for de dinged exemption.Any violation of �/J
Section]031.5 by any applicant for a permit subjects the applicant to a civil penally of 3 MiN OCCU raC T e
or
nos me then five hundred dad...(S500). P a.,uY! YP
0 1,as owner of the property,or my employes with wages a their sole compensation,
will do the work,end Ne awctue is not intended or offered for aalc(Sec.7064,Business
and Professions Code:The Contra.es same law dors on,apply to an owner,or Required Inspections
property who builds or improve dlemon,and who does such work himself or through his
....play..provided that such improvements..at intended ar offered for sale.IL
however.the building or improvement is sold within one year of completion,the owner.
builder will have the burden of proving Nal he did not Wild or improve for purpose of
sale.).
❑L as Owner of the property.am exclusively contracting with licensed contractors to
contract the project(Sec.7044,Business and Professions Code:)The Contractors Li
come law dos not apply to in owner of property who Wilds or improves dmmrn,and
who contracts for such projects with a convaaor(s)limned pursuant to the Contractors
License law.
1 am exempt under Sec. .B h P C forthis..on.
Owner .-- Date
WORKER'S COMPENSATION DECLARATION .-=—r-
1 hereby affirm under penalty of perjury,one of de fallowing declarations:
I b.m and will mainuin aCenifcmto of Covent on self-imuur a for Worker's Campen-
sasion,is provided for by Section 3700 of floe labor Code,for She peRormanoc or be --
work for which this permit is issued.
O 1 have and will maintain Worker's Compensation Insurance,is required by Section
3700 of the labor Code,for the performance of the work for which this permit Is issued.
My Worke` CCofnpe9sauon In carrier and Policy numberarc:
Carrier. 7lllea..ti�'fllCC rt paliq No.: alb Z9
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not hecompleted if the permit is for one hundred dollars(SINN
or less.)
1 comfy that in the performance of the work for which this Permit is issued,l shall not
employ any person in any mannerso as to become subject o the Wortrri Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making this Cenificam of Exemption,you should
become subject to the Workers Compensation previsions of the labor Cade,you must
.J O forthwith comply with such provisions m this permit shall W deemed evoked.
IZ " CONSTRUCTION LENDING AGENCY
[—s em. I bclehy affirm that them is a construction lending agency for the performance of
C4 de work fur which Nu permit is issued ISce.3099,Ci,C.)
127 A Lenders Nam,
0. Lender's Adders
Z)2
V O I certify that 1 have read this application and main that Io above information is
I, F cures.1 agree to comply with all city and county on inumus and soon laws elating to
OV building conduction,and hereby authorim mpreenusives of this city to inner upon the
Gmove-mentioned progeny for inspection purposes
(We)agree to saw,indemnify and kap harmless the City of Cupenino againa
F'IA liabilidcajudgmen¢color and expenses which may in any way acme against said City
V Z in anequenca of the granting of this permit.
'—' APPLICANT UNDERSTAND AND WILL COMPLY WITH ALL NON-P INT Issued by: Date
SOURCA REGULATIONS.
¢ /��.'s ��L ��f$ OS' Re-roofs
sigTturc-fAppfiandcon tor
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will one applicant or ferule building occupant sloe or handle haardous material
as dcfined by de Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Co
de,Section zss3zm>I All roofs shall be inspected prior to an roofing material being❑Yen �Na P P Y g g installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
it hi.doue air conumin.; as fined by the Bay Area Air Quality Management all new materials for inspection.
Ym u
1 he maJ Nc hvaNnusmatorialsmyuimmenu unikr Chap¢r6.95 of Nin he building
cs nor currently have am...LthaitcumyrnpomihilityInnntily the accts a ofthuire enuw chmubem primtoinaanaoraeeNBeamuUc. r. Signature of Applicant Date
Owner orar� honzcdagent e Or. y All roof coverings to be Class "B" or better
Community Development
10300 Torre Avenue
JCupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
` UPERTINO
Building De artment
JOB ADDRESS: PERMIT#
1065 L-A jW0,AA4 pv, OrO000/ 3
OWNER'S NAME: AkeX c . —6 to PHONE # 650
GENERAL CONTRACTOR b 15 co n" um6i'l ..d FAX# G50 6 - S
I am not using any subcontractors: b
Signature Date
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
j� Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
� REPI EISEWERS/MAIN SERVICE
CUPEkTINO PERMIT APPLICATION FORM
APN# 3 5-6 — / (0 p2g Date. / 08 Q
Building Address:
I/065 La Wo/L),fa i>y.
Owner's Name: �1 Phone#:
1 + � DN (//00) ?—SZ - G-73,9
Contractor: /� Phone: Lic�S nse#:
coves+ lurn�✓i c��b koo � �.
L650> 3>3 g�5 / 36-27-
Contact: ^ ,^y Phone SO\ / z4 // Cupertino Business License#:
Building Permit Info: ) (9 1
Bldg ❑ Elect ❑ Plumb C-
Job Description: n441 W
t=Y
Residential Commercial ❑
Cost of Project: �{ 2
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg. Permit Fees BUILDING
BPGAS Gas Piping System Fee PLUMBING
% PPERMITFEE Plumbing Permit Issuance PLUMBING
BPREPIPE Re i e of Fixtures PLUMBING
BPFIXTURE Pbl . Fixture PLUMBING
BPWSVCS Main Water Service PLUMBING
BPSEWER Sewers PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BENERGY Energy BUILDING
BUSLIC Business License BUILDING
CITY OF CUPERTINO k
BUILDING DIVISION PERMIT CON, R G;TQR INFOMATI®N
dot ,-..,v. 5 F'4zi'a c'bsi$,..R _.a* LsP II �4
BUILDING ADDRESS: PERMIT NO.
ECONOMY ROOFING 05040176
• OWNER'S NAME: PERMIT ISSUBDA'IE
1ARCHITECTIENGINEXR:
E
SANITARY N . OL NO,
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
upLICENSED CONTRACTOR'S DECLARATIONlob Descri hOn
uI WMbY arflrm Thal l am littmed under provisions of Chapter 9(commencingpection 7IXM)of Division 3oflhe Busineasa P fc xinm Cnge and mY licenseis
fomeandef t. Uqse C�s���ue.a REROOF w/ COMP .
Z^ Doc. _71 Cumracror
r '11 ARCHITECTS DECLARATION G�
$� I understand my plans shall be used as public meet&
JyU
30t; Licensed Professional
OWNER-BUILDER DECLARATION
0 1 naso Affirm Inst 1 1. exempt from Ne Contractor's :Any C Law for the J`
K:0 0 following wires a (Semon 7113L5,Rosiness and ve,demolish,
Code:Any city or county
><$� which requires a permit uo rnnswa,cher,impmvc,demolish,nr rcpart any svucwre
to bill prior to iB issuance.also requires the applicant for such permit m file a signed statement
< that he is licensed pursuanuo the provisions of the Commerce,License Law tChapler9 Sq.F[. Floor Area Valua i
Cc (commencing with Section 7")of Division 3 of she Business and Professions Cotim or
y _ that M is esmpt themfmm and Be bath for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penally of3 �'9�bF[ 0 0 Occupancy Type
not more than fisc hundred dollars($500).
❑1,u owner of the progeny,m my employees who wegn u their sole compcnution,
will do the work,end mealmewrc isnot InmndcJ orottercd forsAIC(Sec.7144.Business
and Prolusions Cock:The Comnmor's License Law docs not apply to an owner of Required Inspections
property who builds or improve thereon.and whodoes such work himself or through his
own employee,provided that such improaemenW are not intended oroffered for ole If,
however,Ne Building or improvement is wild within one year of completion,the owner-
builder will have the burden of proving Nal he did not build or improve for purpose of
sale.).
❑1,as owner of she property,am exclusively contracting wit licensed contractors to
consuvm the project(Sec.7lW4,Business and Podmoions COdc:)The Contractor's Lt.
cense law does not apply to in owner of progeny who builds or improves Ibemon,and
who contracts for such projects with a Contnaor(q licensed pursuant to Be Contractor's
License law.
❑I Am exempt under Sec. .B&P C for this reason
Owrm Date
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under Penalty of perjury one of the following declarations:
I have and will maintain a Cenifinte of Consent to self-insum for Worker's Compen-
1C3373.LIW
on,u provided for by Section 3700 of the Labor Cade,for the performvrce of she
rk for which this Permit is issued.
1 have and will maintain Worker's Compensation Insurance,u required by Section
of the Labor Codc,for Be performance of the work for which this Permit is issued.
yWOr an
CenteIkc(S o pc satins auF anticPollyNoPolicy numbrram /�
SS CERTIFICATEOF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This seninn need net the completed If the permit is for one hundred dollars(SIM)
or Ii
1 certify tat in the performance or the work for which this permit Is lamed,I tell not
employ any Person in any manner sat u to Become subject to the Workers'Compensalum
Laws of California.Date
Applicant
NOTICE TO APPLICANT.IL after making this oci iacaue of Exemption,you should
become subject to the Worker's Compoproun o provisions of the Labor Code,you must
QZ forthwith comply with such pni isiom or this permit shall be deemed revoked.
zCONSTRUCTION LENDING AGENCY
[-1 1 ncrcby off ren Be,there is a con5treetion lending agency for performance of
Qi to work for which this permit Is issued(Sec.30YJ7,Civ.C.)
W Q Lender's Name
G Undoes Address
U 0 1 certify fix,1 have rota this application And sum that Be Above information is
ll i f-' correct.1 agree to comply with all city and county ordinances and argue laws relating to
O U building Construction,and hereby authorim mpresenmivea of tis city to enter upon the
W above-mentioned property of inspersion purposes.
D. (We)agree to cave,indemnify and keep harmless the City of Cupertino against
Vd Iiablliuies,judgments,costs and epenses which may in any way accroc against said City
U z
in APPhis Permit.L C9Acnce NDERSTANDSf in long of IAND WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURCE TI S.
Re-roofs
SlgnaV
pplicaMConuacmr ¢ -
HAZARDOUS MATERIA DISCLOSURE Type of Roof
o applicant or future buildingw pantsmrc or handle havmduus material
as doshe Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Cde25532007 All roofs shall be inspected prior to any roofing material being installed.
❑Yea YNo
Will the applicant nr future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,T agree to remove
mit ha'urdnus air contaminants As defined by the Bay Area Air Quality Management all new materials for inspection.
District]
❑Yeallo j
1 have mad the bwardous materialsmyuimmenu under Chapter 695 of Be Califim- / n
hie Health@S m Code,SeeWas 255115.25533 and 25534.1 understand dual time Wilding
does not curt Oy a a tenant.duet it is my mspomihility,to msuly the Occupant nr due r
Muni mmcn tum n Mat m tp tR s n.weor.Cerdfi of an . Signature of p icant Date
own It ora r,.ed agent Date All roof coverings to be Class "B" or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
/l �} BuildingDe artment
JOB AD RES. �� PERMIT #c�S 76
OWNER'S NAME: AJ PHONE # v S' 7
GENERAL CONTRACTOF-- — / ) j FAX# — / - 7Q
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors a4 complete the followin 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
Community Development Department
Building Division
t' City of Cupertino
> 10300 Torre Avenue
Telephone: (408)777-3228
UPEI�TINO
0CITY-OF 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 complywiththe above stated policy on re-roofing.
Homeowner's Name: 10 ,
lob Site Address:
Roofing Company Name: �4—
Applicant's Signature: A6Date: p ��
Greg Casteel
Building Official
Revised 11/2/04
Printed an Recycled Paper
�(�CS . CITY OF CUPERTINO
REROOF
CUPEKTINO PERMIT APPLICATION FORM
APN # 3�c% ` / a .� O{Date: ^ z
Building d en: S n j J
OM-
Owner's Nam . Sr, Phone#: 0 - ill
J
r
Contractor: np \ License#: 1 [ n
Contact: Cupertino Business License #:
Type of Roo overing:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles RL Asphalt Shingles
§,Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide LC.B.O.Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Comply With Cupertino's Tear Off Policy: Li A
Job Description: ,
v _, Ins [I V2" I o s0 lQ
Residential Commercial IFV
Fire Zone: Yes ❑ No Confirmed with Planning DOI, if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
low0
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