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06120139 CITY OF CUPERTINO 7=777='* "N EILDINd DIVISION PERMIT CL11�t'I'12A(��,T�C11 t'TNk RM TTO PERMIT N0. BUILDING ADDRESS: PE ITLSSfIE DATE OWNER'S NAME: M & C ASSOCIATION MGMT 605 COMMERCIAL ST 12/21/2006 Dn7 rT n7.O SANITARY NO. CONTROL NO. (408) 536-0420 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG EO PLUMB MEOCH iioo LICENSED CONTRACT'OR'S DECLARATION .lob Description 'i1 U p T bercby.from Nos I am licensed under provisions of Coupler 9(commencing tX? hes.mion 7")orf Divide.3of J¢Bummussand Pmfessions Code,and mylica..is REROOF MFDWL GARAGES- TEAR OFF EXISTING, INSTALL in reneCI and in License CI Lic.d NEW 3/8" CDX OVER EXISTING 3/8" CDX NEW 5 PLY TAR � Dam ARCHITECTS DECLARATION �� & GRAVEL BUR. jj1 monstan my plans shall W used as public mond, y f cH Licensed Professional S OWNER-BUILDER DECLARATION 1< I hereby affirm Not 1 am exempt from the Convector's License CO.far Ne :O following mason.(Suction 703 LS,Business and Profeactim Code:Any city or county I j� which mq.i.a permit no conswct,almr,improve,demolish,ar¢pair any suumum prior he its issuance.also mqui es the applicant for such permit to III...igned smtomem Valuation s< that he is licensed pursuant the provisiaru of Ne Contractor's Licenx law(Chapter 9 Sq.Ft.Floor Area $2381 DLF$ (commencing with Section 7(X0)of Division 3 of Ne Bmenessand Profeain.Code)Or Nm he u exempt therefrom and M basis far M amcgcd exemption.My violation of Section 7031.5 by any applicant for a permit attitudes the applicant the a civil Penalty of 32652005 Aff Number Occupancy Type not...Nan Ove hundred dollars(3500) 0 1,as owner of the property,or my employees with wages as their sole compensation, will ad the work and the spromme 4 not intended or oReaed far.1.(Sec.7044.Business Required Inspections and Professions Codi:The Connector's License Law does net apply m as owner or q p property who builds or improves thereon,and who does such work himself or through his Own employees,provided thalsuch improvements as not intended aronercA ferrate.If, however.the building or improvement is mid within ane year of completion.the Owner- builder will have the burden of proving that M did wt Wild or Improve for purpose of _ said.). 0 1,as owner of the property.am exclusively contracting with licensed consumers te comouct the pmjeat(Sec.7044,Besmear and Professions Code:)The Caroni Li- Genu law docs not apply to an owner of property who Wilds at improves thereon,and, Who contracts for such projects wit a emilmemr(s)licensed pursuant to the Conuaclara License Law. 0 I am exempt under See. ,B&P C for this reason Owner - Dam WORKER'S COMPENSATION DECLARATION I y&!form under penalty of pirjury nes of the following decimations: re and will msia .Certificate of Camemmself-imusIreWorkersCompen- sa ,an. as provided for by Became 3700 of the labor Code,for the Performance of M ork for seLeh this Permit is Issued. We ave d will maintain Wnrkcrb Compematian lihm ame,as required by Schon 37W of Ne lobar Code,fes Ne pnOtermanee of the work far which Nis permit is issued. My Workers Compemado nuance cancer and Policy+nnuumm�bb�er�ra�are�'��aa///�� Cartier: Policy No.:�'_.Ld CERTIFCATEOFEXEM1rGQNFROM ORKE�RS' COMPENSATION INSURANCE (Thusection mail notbecomplmcd if the permit is fortune hundred dollar($1010 Or less.) ' 1 cenify that in the performance of the work for which this permit is issued.I abet not employ any person in any manner an as m become subjecuo the Wrrbers''Compenution Laws of California.Dam Applicant NOTICE TO APPLICANT:If,after making this Ceriricate of Exemption,you should become subject in the Workers Compensation previsions of Ne Labor Code,you most �Q forthwith comply with such provisions or Nu permit shall be deemed marked. .Zi a~�nCONSIRUCION LENDING AGENCY E-t Ihereby affirm that then is a coruwetinn lending agency for the performance of - !Yi> the work tof which this permit is issued(Sec.3097,Civ.Cd W Q Lender's Name z Lender'.Address U C) I certify dam 1 have wad Nis application and sum that the Move information is U. CCUCCL.1 agree to comply with all city and county ordinances and sate laws relating to U building conswction.and hereby authenre mpreminatives o(Nis city to enter upon the W .hove-normiuned p.,,,y for inspeiurn purposes. (We)agme to care,indemnify and keep harmless the City of Cupertino against iF"y rA"q liabilities,judgments.casts and expenses which may in any way accrue against said City U z in conuquemcar the Sopi of this permit. '" APPLIC ND STA S A ILL PLY WITH ALL N N-POI Issued by: Date 2 2Zw SOUR R 0 Re-roofs ignmum of APPliw HAZARDOUS °am Type of Roof HAZARDOUS MATERIALS DISCLOSURE Wilt the applicant or fM iWilding mcuputuorcor&ad M health .material as OeRmd by M Cupertino Municipal C apse,9.13,and the Health anJ Safety Codi.Section 35533(.)7 All roofs shall be inspected prior to any roofing material being installed. 0 Yes 40 Will the applicant or future building oceupam are equipment Of devices whim If a roof is installed without first obtaining an inspection,I agree to remove ..it mosmom air to imanum m d nmd he Be,Awa Air Quality Management all new materials for inspection. Disuict7 0 Yes ///a *Da Ih&Safetave Mhe&.a. 25505,25533rcments 4.1u Chrmandd5 ifM G �J/' Vria HcaI hav Safety Code,Salem 3550als req 3 amt nts un 1 rCha ter dm if th mt it is oche' 'fy M be met poor ssuan cni0c tar Occup cy. Signature of Applicant Owner Or amhorixed agcm Dn All roof coverings to be Class "B"or better • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec; Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32652005 . 00 DATE ISSUED. . . . . . . : 12/22/2006 RECEIPT #. . . . . . . . . : BS000000073 REFERENCE ID # . . ..: 06120139 SITE ADDRESS . . . . . : 10323 MARY AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO , IMPACTAREA . . . . . . : OWNER . . . . . . . . . . . . : M & C ASSOCIATION MGMT SERVICE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1338 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21895 COMPANY . . . . . . . . . . : DRAEGER CONSTRUCTION INC - ADDRESS . . . . . . . . . . : 605 COMMERCIAL ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 536-0420 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE ' VALUATION 2, 381. 00 83 .16 0. 00 83 .16 0. 00 BSEISMICRE VALUATION 2, 381. 00 0.50 0. 00 0.50 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 83 .66 0. 00 83 . 66 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 83 . 66 101358 --------------- TOTAL RECEIPT 83 . 66 ' VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS CITY OF CUPERTINO CUPERTINO PERMIT APPLICATION FORM 7W 00 2.—005 Date: �2.)LJ)07 3t- Phone 9: " ��u,j one Ictor: License Cupertino BLISi[ICSS ljCCJjSe C� Type of Roof Covering: E-NisIi11 PropooTsl: U Asphalt Shingles ,j Wood Shakes 11 Wood Shakes Cj Wood shimu'les LJ \Voo(I Silill,,jes ❑ ()tlicl (S'pCCdv) ol I . . — Q Otlicl (specily) :hien her QNlsllll,. cm,rim-'s CJ Provide I.C.B.O. Report j/ Relllov�cd 0 Provide Ml'gi, 111stillitic), Specs. • T-�- ' z I Ul(ICI-StTld MICI Will Comply With CU)eliOS Te,1OffPolicy: 12 Joh Commercial Fire 7()"c: Yes 0 No ❑ C011fil-Illed Wide Planning Dept. if there are any restrictions: ❑ Coe —0 e C 1: Fype OF Construction: OCCUINUICY ('l'0Llj): Phlicubl ['00 11) Pec Description Fee GI-OLIJ) 131do Permit Fees BUILDING 13 ENL E R G Y Encl-y BUILDING BSEISN/11CRE, scismic Fee Rcs BUILDING BSE'[SIN/1 lCom Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING