06060156 CITY OF CUPERTINO > �+
BUIL'AING DIVISION PERMIT -.C,0 I2�3•f°xTQR l ''p �T q.�
BUILDING ADDRESS: r MBROWN CONSTRUCTION, INC PERMIT NO.06060156
20187 LAS ONDA
OWNER'S NAME: PERMIT ISSUE DATE
RANDLE STEVEN 702 S. DANIEL WAY ng/16/9.0o6
NE: SANITARY NO. CONTROL NO.
(408) 260-1260
ARCHIIEC.ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30p LICENSED CONTRACTORS DECLARATION Job Description
4 I hereby of ace that l em licensed under provisions of Chapter 9(commencing
with Sudan 7000)of Division 3 of the Business and Profcssiom�yde and my license6
n, tnBnrrureeand<R D� L'Z, REMOVE 35 OF SHAKE INSTALL CDX AND COMP CLASS A
License 1 s Lk.«
�� Date Contractor
ARCHsS DE LLA ATI N
I on emend my plans shalltl behe used As public records ta1Cyygf��sA1®qS g//({+P�T.�ap®@t {.��+�s
' O FIPI FB{I' �I.`ilL U
kQ Licensed Professional
�,a 3 OWNER-BUILDER DECLARATION
a I hereby aRm Not 1 1. exempt Imre the ContrTessio Co e:Any c Law for the
9 O a following mason.(Suction 703 1.5,Business and Professions Cale:Any city or county
$ which requires a permit to canslr at.alar,impmw,demolinh,ar repoh any structure 8000 0 0 0
polar m is issuance.aim requires the applicant forsuch permit m file asignod sammem t aluatlOn
E NatheinllcentedpunumtmNeprovisionsoftheContractor'Licenselaw(Cheps,9 Sq.Ft.Floor Area
z H (commencing with Section700%of Divition3afthe Businessand Pmfassiom CodOur
Q that he in exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant far a permit mbjcc s the applicant to a civil pwlly of rSJU 11 llfilt-'WType
not mom Nan Ove hundred dollars(SSOB. L DY
Q L as aWucr of de pmpeny.IN my employees wW"gnu tie4 cele cempenxtiao,
will bu Newmk andc The Commences
LicdedIN ave de tmul apply owner
of Required Inspections
propand enywisians Cade The Conhxmrs Liana law dam or apply r an no u h of q P
Man emywhobuRdsINimpmwsthesrommdwW ran nsuchendedM xdfm Nmugh his
hmeemployes,provided Improvement
improwmmaartm imendndmaaered for sale -
huilder Nebuilding orimprovementinheldwithin aro year a Improve MB now the WAen of proving that he did not bold IN Wprow for purpose of
sale.).
❑1.as owner of Ne property am eaclusiwly conhaming with Beamed cenmoars m
mmtmo the project(Sec.7044.Business and Profusions Code:)The Conmcmra Li-
ana law dun oot apply to an owner of property who Wilds or improwa theeon,and
who ronmcts for such projema with a rontren.o(s)licensed paramount Ne Convenors
License Law.
❑iwnueenmder See .BAPCfarthinmason
Owner Data
WORKER'S COMPENSATION DECLARATION -
I hereby alRm under penally of perjury one of the following dttlamdars:
1 haw and WII m tinW e a CeNllam of Cameo to self-Insure TIN WmkerseomPm-
.ntion,as provided for by Section 3700 of Lou Labor Cade,for No performance of the
work for which this permit is hued.
❑I haw and will maintain Workers Compensation Inmrantt,as required by Section
3700 of On,Labor Crude,oar the performance of the work for which this permit is issued.
My We fau sed.Leona/q'jm'"m and Polky number art:
Cartier. �as� No.: wad t� ,
E0. COMPENSATION
IEXEMPTION Fl AN WORKERS
COMPENSATION INSURANCE '
(iris mcdun nod notbe completed if the permit in faonehundmddoBam($100)
or lcsa)
1 ttnify Not in the perfINmance of tie work fee which this Mordt in Weed.I shall tet
employ any person in any manneran a to become subject to the Workers'Compensation
Laws of Califomm.Onto
Applicm
NOTICE TO APPLICANT.If.nor making Nin Ceninam of Exemption,you should
become subject in the warkers Compensation provisions of lite labs Cade-you muss
.7z forthwith comply with such provkima or his lermilshall be darted ranked.
CONSTRUCTION LENDING AGENCY
(.r I hereby alrtrm Nat then in a comhactlan lending agency rot that performance of
ra the work for which this permit Is Wad(Sec.3097•CN,C.)
W�Q Lenders Name
D z Lenders Addmss
U O I certify that I have mad Ods application W sum Nat the anew Infecou n in
Iy H -- -- I agree m comply with all city and county aNinances and auk laws relating to
0 building construction.and hereby authorim representatives of Nis city m enter upon Ne
G show-nterfuxd property for inspects..pmporea
(We)agree to save,indemnify and keep harmless the City of Cupertino against
vF.+ A Iiabilitin,judgments.emu and expenses which may m my way amuc against said City
U z in cansegucnce of the grmong of Nis lermn
^' 'APP"cc A UNDERSTANDS AND L COMPLY WITH AL NON-POINT Issued by: Date
SOURCER U TIONS. r
e^�l�(�-i�O,. G Re-roofs
Signa of A&UcAmJCan I Ism
at
HAZAR66US MATERIALS DISCLOSURE Type of Roof
Will da applicantor fumm building aaupmt mom IN handle hazardous at
as defined by the C.Ince o Municipal Code.Chapter 9.12,and the Health and Safety
Code,Section 05532(.)7 All roofs shall be inspected prior to any roofing material being installed.
(]sin No
-� Will tie applicant or ore building occupant tax equipment or Jevlees which If a roof is installed without first obtaining an inspection,I agree to remove
mil hvardous air camamirt as delved by the Bay Area Air Quality Management all new materials for inspection.
Dlsbict7
❑Ya
I have mW the Nuard. mountain roptimmens under Chapter 6.95ofdeCatifor-
ninHealth ASafety Coca.Secd 25503.25533 and 25534.I understood the iNe building
drum on cmiandis bow•mranL that It k my responsibility m ratify W=upmt of da
requirement w hmlmhe 'arm issuance of aOmifka ar Pre . Signature of Applicant Date
Omm,ormilMdoed. a mm All roof coverings to be Class "B"or better
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 re-roofing.
Homeowner's Name: V e Wa �
Job Site Address: � ` Z019-7 Las
Gl
Roofing Company Name:
Applicants Signature: Date:
6441
• Greg Casteel q g,
Building Official
Revised 11/2/04
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36931005 . 00
DATE ISSUED. . . . . . . : 06/19/2006
RECEIPT #. . . . . . . . . : 34912
REFERENCE ID # . . . : 06060156
SITE ADDRESS . . . . . : 20187 LAS ONDAS WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : RANDLE STEVEN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . :
RECEIVED FROM . . . . : MBROWN CONSTRUCTION
CONTRACTOR . . . . . . . : CHRIS BROWN LIC # 25108
COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 702 S. DANIEL WAY
CITY/STATE/ZIP . . . : SAN JOSE, CA 95128
TELEPHONE . . . . . . . . : (408) 260-1260
�EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000 . 00 147 . 96 0 . 00 ' 147 . 96 0 . 00
BSEISMICRE VALUATION 8, 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 148 . 76 0 . 00 148 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 148 . 76 AMEX
TOTAL RECEIPT 148 . 76
•
CITY OF CUPERTINO ,Un/
• REROOF
CUPERTINOQ PERMIT APPLICATION FORM /
APN# 2�J I Ut7� Date: 6 O 1�
Building Address:
�2—W7C� (w
Owner's (ve AH e. Phone n j� /-260
Contractor• �j / License(#: . G/a
J>/0y2-2--
Contact:
/DyZZContact: /'� J� Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �' Asphalt Shingles
�C Wood Shakes ❑ Wood Shakes
{] Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Jobst rnpti1o'n-: ! /1
vl,
Resi enti qchmercial ❑/
Fire Zone. Yes ❑ No ❑ Confirmed with Planning Dept. if
there are any restrictions: fJ
Cost of Project: 1� C06 Type of Constructs n: 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
•