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05090006 .CITY OF CUPEwrINO BUILDING DIVISIONPERMIT nCONTRACfTOR INF®RMATION6 BUILDING ADDRESS: PRUDHON BUILDERS PERMIT N005090006 ,10'IRI LIN SAY AV OWNER'S NAME: PERMIT ISSUE DATE Ahk JIM PAGE 1096 NORFOLK 09/01/2005 NE: SANITARY NO, CONTROL NO. (408) 390-7251 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG EIECT PLUMB MECH (� PL TI LICENSED CONTRACTOR'S DECLARATION u C I hereby affirm that 1 am licensed under previsions of Chapor 9(commencing Job Description �zm with Section 7000) (Division Sof the Business and Professions Code.and my liceoso is �c. Mrnn.eanderr _ REROOF-T/O SHINGLES/INSTALL SHINGLES �? License Cl {k Lk.Y z�,� Date Contractor '�a CHIIECTS DEC A 1 N ,i Jm 1 understand my plans shall W used as public records •per—(]f� M1j� yU r a St- Licensed Pmfcssinnel Yipp i t res OWNER-BUILDER DECLARATION Yt 1j•J`�!1 � <I I hereby affirm that 1.m exempt r.m Ne Cmummotr's License Law far the L� 00 following reason.(Section 7131.5,Business and Professions Com:Any city m county vm which¢quires a permit to construct,alter,improve,demolish,or repair any structure ,s„-- 6 O O 0 rzeprior in its issuance,also.quims the applicant for such permit o rile a.signed statement l that W is licensed pursuant to the previsions of the Contracmr's License Law(Chapter 9 Sq. Ft. Floor Area JLUUa Valuation 5Fo (commencing with Section 70(1 of Division 3 of the Business and Professions Code)or to that W is exempt tW.from and the basis for tha alleged crampoon.Any violation of A..,2'= [ t "^`C•. iV Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofr '.e I' v ' f� i'.,�'•�OCCupancy Type not mom than five hundred dollars(ZOr. `QFi�: }.".t y \FFl/t 0 1,.owner of the pmpony,or my employee with wages u their to compensation, will do the work and the structure is not intended a offered for sale(Sec.71X6.But. ' and Profession Code:The Contractor's License Taw does not apply in an owner of Required Inspections prorainy who builds or impraves thereon,and who doe such work himself or thmuN his own employ os,provided that such improvements art not inmrWcd or offered for sale.If, however,the building or improvement is sold within on year of completion.the Mimes, Wilder will have the burden of proving Nat W did Get Wild or improve for purpose of stile L 0 I,as owner of the propcni,am exclusively contracting with licensed contractors to con.00ct the project ISec.7014,Business and Profourmas Code:)The Contracmr's Li cense law das not apply to an owner of property who Wilds or improver thamon.and who contracts for such projects with a contractor(s)licensed pursuant to Nr,Contractor's License law. Cl I am excmps under Sec .B&P C far this..on Own" Date WORKER'S COMPENSATION DECLARATION 1 hereby.(firm under penalty of perjury ono of the following decluatimuc 1 have and will maintain a Certificate of Consent to wit-ineure for Workers Carrier. Milan,as provided for by Section 3700 of the labor Codc,for the Performance of tW work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the labor Codc,for the peor.m men of me walk for which this permit is issued. My Worker's Comarms on Insurance carrier and Policy numberam: Cartier. 1 Polity No.: - E T COMPENSATION WORKERS' COMPENSATION INSURANCE (Thu section nand not tecompleted ifsbc permit is far one hund.d dollars(Sig) or less.) 1 certify mat in me Performance of me work for which this Permit is issued.I shall not employ any person in any manner so as to become subject to the WorkersCompeeraion Laws of California.Da. Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject o me Worker's Compensation previsions of me labor Cede,you most .J 2 foMwith Comply with such provisions or this Formic shall W deemed nwokod. z OCONSTRUCTION LENDING AGENCY [••� I hereby affirm mat men:is a emtsuuetinn kndingageray for the pcRmmmwof xftwork Cut which this permit Is issued(Sec.3097,Civ.C.) 1 A Izndcrs Name D z Lecom's Add. U C) I cenify mat 1 have read this application and sate mat tbo above infortn.tiun is ^r comet.l agree to comply with all city and county oruinanecs and sure laws misting to �U building construction.and hereby authorise teFascmadve of this city to enter upon the ,tea above-mentioned property for inspection purposes. (We)agree to save,indemnify and trap hafmlesv the City of Cupertino against F" h liabil des,judgments.costs and expenses which may in any way accrue against said City U z APLIC consequence NDERSf Re ni of this Permit.WILL APPLIC UNDERSoo OS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURnax EGULATIO � cure �o� tr.m Dam �� Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will ma applicant or future Wilding occupant some or handle hatandous material az dcnncd by me Cupertino Municipal Code,Chapter 9.13,and she Health and Saf ty Code.Orion 35531(x)? All roofs shall be inspected prior to any roofing material being installed. Yu `^�No Will me applicant o'Ituum building omupant uta equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove it bmrd aous at,cou ntaminants defined by the Bay Arca Air Quality Managcmcm all new materials for inspection. vrin? 0 Yes to I have.ml the hvardomanowdid,requi.mcnu under Ch inner 6.95ofthe Califon Health&SafelyCodc,Sceums 35505.25533 and 35534.1 urdersmnd Got irthe Wilding 7douion not corrcndy have a moan at it u o my responsibility notify dice occupant of me mme �'Inchmustho oissumon f.CertificamofOccuranay. Signature of Applicant Dale 0 (homed agent All roof coverings to be Class"B" or better Da. - Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPEkTINO Building De artment JOB ADDRESS: PERMIT # 036 1-;-qO G ds'o 00a 4�' OWNER'S NAME: 4 PHONE # 3`/O- 7; ) GENERAL CONTRACTOR 15y FAX # 3rg3 —o`I1 Lk I am not using any subcontractors: 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 S 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 ®r"a. Building Division k City of Cupertino � 10300 Torre Avenue Telephone: (408) 777-3228 CITY OF Fax: (408) 777-3333 $UPEklINO 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. Homeowners Name: 7 �tin lob Site Address: Id 33ai ILl t�`max A j -e Roofing Company Name: i Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO REROOF D � CUPERTINO PERMIT APPLICATION FORM APN# / Date: Building Address: 10381 I-i v ct5o j e Owner's Name: Phone#: .»1 C Z5-5'07�c1 Contractor: 1 Phone #: License #: v1 f �c�k0�-►�fNdti 3u, e✓ S (0 - 77s 77& -37 � Contact: Phone#: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles �Asphalt Shingles ❑ 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: ❑ Job Description: Rn � �y- — De) 1 eav- `O P& i✓i [e5 q me,( i,n N e w 5G , a Residentia Commercial ❑ Fire Zone: Yes ❑ No In Confirmed with Planning De t. if there are any restrictions: LI Cost of Project: Type of Construction: 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 3 � �Sv CITY OF CUPERTINO BUILDING DIVISION PERMIT �CONTRACTOR£INFORMATION a`5. +. .kr'iT»ua�' ?&3 n.e•.;. ,3s�¢a ^�.n.v'.%Sar BUI LDING ADDRESS: HOT WATER INC PERMIT NO.O S O 9 O 199 11497 LINDY PL OWNER'S NAME: PERMIT ISSUE DATE LINDA TONG 2531 GRACELAND AVE 09/29/200S NE: SANITARY NO. CONTROL NO. (650) 298-8494 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 u O o LICENSED CONTRACTOR'S DECLARATION mC 1 hemby affirm that 1 am limed under pmv om nrChaptcr 9(commencing Job Description �15 with Smdon7IX10)of Division3ofdic Busincna ofesst)MCodc,aMmylicenseis m mu rem=ant=rr kms/ 'J REPLACE WATER HEATER/SEISMIC RESTRAINTS, " ? Lice C s _Licht � / Date �c Comrs=mr T & P EXTERIOR {��. �� ® " ARCHITECTS DECLARATION ®�� P,\ 1 M< I ummonsod my plans shall W used as public¢cords "(, 1"'�11 J ly_^v t JyU a g C Licensed Professional 3 OWNER-BUILDER DECLARATION �g�j y2� .�<y 1 hereby affirm that exm tum ,,rapt from the Conmaor's License Law fur the 2005 cc following mason.(Section 7031.5,Business and Professions Cade:Any city or county E 3 which myuims a pcmrit m cnnmmct,alma marmot.OcmolLah,or repair any swmure C?{D aI,, r .,,,- prior m its issuance.also recuines Me applicant for such permit to rile a signed comment ,a.. Nat he is licensed pursuant the provisions of the Comerchos License law(Chapmt9 Sq. Ft. Floor Area �p �N �m ��jAVahlatio 5(] i $ (commencing with Section 7")of Division 3of the Business and Professions Cod,)or I � WWWyB ,�V� /s Q .. that he bi exempt Montfort and the bash for the alleged exemption.Any violation of .•.J.a Section 7031.5 by any applican for a permit subjects the applicant to a civil penalty of p,PN Number Occupancy Type out mum man film hundred dollars(SSM). 3 5 624006 . 00 ❑Las a work.and pmPurty,or my otimende oras cages u ale(Sm.701 B inion, will Pr to work and the he Com is not s Licenser offered wdo for salt(Sec.to an Business end property Codas:The vo thermrs nd who taw docs nut apply if an owner or Required Inspections proem whoes.provided that sumerman,and who do notin work himself ormrough his awnemployees,lding r ima suchimprovementsartnm our fcled m llfaed for owner- however,me building or improvement is sold within one your of mpro a for me owner- Wilder of builder will have tn<W Nen of proving mat he did not build or impress for purpose of sale.). ❑I.as owner of the propmny,am exclusively contracting with licensed conuutom to cermet the project(Sec.7004,Business and Professions CMeq The Contractor's U. come law does not apply to an owner of property who Wilds or impro m mercer,and. who conuacts for such projects with a conuumr(U licensed pursuant to the Contracto', Licca¢law. ❑I am exempt under Sec. B&P C for this mason Owner Dem WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury arc of me following declarations: 1 have and will maintain a Cenificme of COmoat m self-insure for WorkersCmmpea- "'ion,as provided for by Section 37M of Me labor Code,for me perfmmance of Oc work for which this Permit is issued. 0 1 hats and will maintain Worker's Compensation Imuran¢,m mquied by Schon 37M e(mc Ld mr Cade.for the peforomace of the work for which mos permit is issued. My Workers Compemado-n�Insunnaeamer and Polity numbor aam: Cartier:�� / ,f_ t� ta",lp Policy N0.:1r118396`ZO CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Tobi section need not bccanpleted if tW Permit is for one hundred dollars(SIM) ser Mss.) I cenify that in the performauc of me work for which this permit is issued.I shall nut employ any person in any manner an as to become subjecuo Oe Workers'Compensation Laws of California.Dam Applicant NOTICE TO APPLICANT:If,after making this Cenifieam or Exemption,you mould become subject to me Wokcr's Corepemadon previsions of the labor Code,you mum .J O foMwi to comply with such provioum or this Permit Mall he deemed evoked. , Z `-' CONSTRUCTION LENDING AGENCY [-.� I hemby affirm Our dem iso consuu=tinn lending agency for Me pe,funromm of lt' me work for which this permit h issued(Sec.31N7,Civ.C.) W0 Lentos Namc Dz Lender's Address U 0 1 minify mat 1 have read this application and sate that the above information is W F' coma I agree to comply with all city and county Ordinantts and sum laws relating to 0 U Wilding=onmmnion,and hemby authono,mprrunmives of this city to enter upon the W Mcave-mcadoned pmpcny for lmpccdon purposes. (We)agree m save,indemnify and keep h.).Ne City Of Cupertino against nF-t f0./, IiMilides,judgraenm.calm and expenses which may in any way..rue ag.last said City in consequence of me granting of this Permit. '—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 4_ Zai-rep' SO,SIR/gC�R�EGULATIAAN,,S. n (fin cK J�r.r aCi�tet, 'l�24 a Re-roofs Signature of Applican✓Conuanor Dam i Type of Roof HAZARDOUS MATERIALS DISCLOSURE Will me applicant or future building occupant store or handle hatardous material as dented by the Cupertino Municipal Cook.Charm,9.12,sed the Hcalm and Safety AdKotic,see" un zss3z(a)7 All roofs shall be inspected prior to any roofing material being installed. 0 Yes wdl me apymant or room tmdamg«=meant lam egaipment ser d=meca which -If a roof is installed without first obtaining an inspection,I agree to remove it harardaus air conuminana as defined by the Bay Arca Air Quality Management all new materials for inspection. District? p Yes Ur mad me havaMms mawrialsmquimmenu under Clapmr 6.95 of Oc Califor- ria Hearth&Safety Catle,Secdom 255(15.25577 and 25534.1 undersand thazif the Molding doer not currently have a Lenanl that it h my meponsibility to amity me occupant of the re aimmrnbwhich mu be to pd no issmpnee of a Ccrdficate of Occupancy. Signature of Applicant Date Owner or amhori.d agent Da All roof coverings to be Class"B"or better Community Development is10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY 0, Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: PERMIT # //417 Lin 1a-ce_ Ds' 0 `jol tom/ OWNER'S NAME: /kdet PHONE # `W- a 5 Z -S ZS 7 GENERAL CONTRACTOR: C7 FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 66 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 /fof Gl/ r /nom Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO —la WATER HEATER --� CUPEkT`INO PERMIT APPLICATION FORM_ APN # 3 5 — ,:)- L/ _ O O(�D Date: 9 /0 r Building Address: Owner's Name: Phone#: L/,ktes61d8- d_�:j4 -!5-23-7 Contractor: Phone: License#: f l�✓cr7�cr /� Ci &50 - <o--3/-8S� 76 Contact: Phone:/� Phone: Cupertino Business License#: Building Permit Info: / Bldg ❑ _ Elect Er Plumb Mech Job Description: luce.. u/,rev ({P�-�ev� �rs n�� /LQsh a��fs TE P Ex herr 0/— Residential Commercial ❑ ' Cost of Project: ) -�-0 Strapped Er On Platform ❑ Bonded'❑ New Location ❑ Replacement - Qty.-if — - - — -- - ----- — - `A licable Fee ID" Fee Description . ` Fee Group, / BPWHEATER Water Heater/Vent BUILDING PPERMITFEE Plumbing Permit Issuance PLUMBING BENERGY Energy BUILDING BUSLIC Business License BUILDING