02060066 I
CITY OF CUPERTINO
' ' ~rf
BUILDING DIVISION
PESIT CONT'RAC,TOR'rINFOR ION:',
BUILDING ADDRESS: PERMIT NO.
21700 RAINBOW CT A A G PROPERTY IMPROVEMENT 02060066
OWNER'S NAME: APPLICATION SUB DATE
MITCHEL & DORALEE WEINTRAUB 15135 MONTEREY ROAD 06/12/2002
PHONE: SANITARY NO, CONTROL NO.
(408) 778-7300
O O ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
�Z f LD CJ L_J
5 w i LICENSED CONTRACTOR'S DECLARATION
j Z v_�G ';lhnali)i ffvm shat l un licensed under pravisions of Chapter 9 komonaming lob DescI7pllOn
._C,u with SeripnJ0,00)ofDivision3 of the Business end PmlessiopsC Jye license RE—ROOF AND AWNING 9�+—e-��ALE®
Y g U i5at-c"tl Yom_eafk /./p
:ossa Liccns l2—_7s ll LicF..N
:O j..V Dem ';_ SDECLnr JUL 0
t Oto ARCHITECT'S tdb f� n 3
.LErBlcs,end my pl9ps s Ihy be used esnpub%ic`ecoi` �i /v 2oOsJ
I a O C Littn e hse�! S�v s anima ,E' BUILDER
Out I s.exempt from he DECLARATION BUILDING
-m 1 hereby a(firm,hat 1 1. exempt from she Comms Co License Law for the 167
t a following riots(Schon construct,
Business and Professions Cade:Any city or county
S ee which requires a permit,.constmn,ahcr,improve,demolish• fi...i end nrucwre $40000
3me prime.its issuance,e,Awatto the thoxisiocaoflm Contrarmis mfileuignedsatemem
that mis licensedpursuannoN!pot Divisiof the are Business
License Isw(Chapter 9 - _ V- - - --
(c thathe is ewith Section omand the baionor the aBgedex end Professions Code) '.36�3�'fi°Pr'6�a.' Valuation
or that he is exempt any a um and she basis for the subjects
thetl exemption.Any violation '
of Section 9031.Sby any epplicam for a pcmd,subjcro me applicant to a civil pmehy
ofa%t more then five hundreddollars(seoo). 305APN Occupancy Type
pl,es owner of she property,or my cmployeea with wages es their sale compen...to . n 7 _
will do the work,and the svucmm is no,intended or offered for sale(Sec.7004,
Business and Profusions Code:The Contractor's License Law does no,apply to an 601 — ROOF TEAlitgOP4PInspections
...of p.,a,Wbo builds or improves though his own employees.provided Nat such improvements ethacon,and who does such work himsalr 602 — ROOF PLYWOOD NAIL
u re not intended or
'offered for bale:If,however.the Wilding or W,m,ammt is sold within one year of 603 - ROOF BATTENS
compleion,she ownerAvilder will have the burden of praying thin he did no,build or
improve for purpose of sale.). 604 - ROOF IN-PROGRESS
O l;es owner of she properly,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Consmcmr's
License Law does not apply 1.oa owner of property who builds in improves thereon,
andwho contracts for such projects with a caatmclods)licensed pursuant to.she.
Contactors License Law.
❑1 em cumpt under Sec. B&P C for this sown
Ow112ra . ••.::. : 'Dale.
WORKER'S COMPENSATION DECLARATION
1 hereby aRrm under penalty,of perjury one of she following dealeamions:
❑ 1 have and will maintain a Certificate of Consent to selbinsure for Worker's
it
Compensation, our provided for by Scnion 3700 of the Labor Code, for the
- atomism,of the work for which his permit is issued.
• o 1 have and will Womt an Worker's Compensation Insurance,as required by Section
3700 of the Labor Code;for the performance of Ne work for which this permit is
issued.My Workers Compensation Insurance carrier and Policy number ere:
Car,1:CPolicy No .
claRlIFICNTION MPO_QM
�K
-
COMPENSATIONINSURANCE - ..... _.. .._......... _.__......- .... _ _.. _...._.. _....._ ._ __. .. . _. ._ .
(This aboado need not be completed if the permit is for one hundred dollar
D100)a,lass.)
1 certify that in me,performance of the work for which this permit is issued,I -
shall enol employ any person in any manner so as to become subject to the Workers
Compensation Laws of California.Data
Applicant .
NOTICE TO APPLICANT:If..1m,making this Cenificamof Exemption,you should
z became subject to the Worker's Compensation provisions of the Labor Code,you must
00
forthwith comply with such provisions or this permit shall be deemed revoked. tl
CONSTRUCTION LENDING AGENCY
1 hereby aArm that mem is a construction lending agency for me performance
Q of the work fm which this permit is issued(Sec.309?,Civ.C.)
Lender's Name
,7 z I Lender's Address -
V 6 1 certify that I hevc read mil application and sum that above informed..is
tTa U collect.1 agree ur comply with all city and county ordinances and nate tows staling
0W to,mavegcomwmiom,mr ,farinwthoonpin,senutivesofthis city to enterupon
y gTI the ebo(we)agree
propend(or indemnify
and
puryoses.
6:, (we) t..c save,stsand expenses
avd k hi hm may
in me Cie,acco eNno against
ta
V) liabilities,judgmcnu,costs and expenses which may is any way wcac ageinn said
V .Z., Airy in consequence of me granting of reds permit I
APPl T UNDERSTANDS AN a L COMPLY WTflj ALL NON-POINT sI CE GULAnONS. Issued by: Date
AO
srgn�tlttdEfllppG wJCantn<wr Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or fumm building occupant store or handle hi uedWs material Type of Roof
as defined by me Comic.Municipal Cade,Chapter 9.12,and the Health and Safety -
Cade•Section 5532bgT
❑Yea ON. All roofs.shall be inspected prior to any roofing material being.installed.
Will the app0,mm�abuilding ed by the nt Bay A .Air Qualityment or deviceswhichIf a roof is installed without first'obtaining an inspection,I agree to remove
emit heurdoue air contaminants future defined by me Bay Arte Air entity Management g P }ri
District? ' all new materials for inspection. Applicant understands and will comply with
❑Yea 0 N all non-point source regulations.
ie> •'I have mad the hazardous materials requirements under Chapter 6.95 of the
Cali(amia Health A Safety Code.Sections 25505,5533 and 25534.1 undersand that
tfthe Wilding does not cumntly have a tenant that it is my resp.uibiliry to badly me
man
of the requirements which must be met Prior to issuance of a Certificate of
_ ,Signature of Applicant Date
own .gem All roof coverings to be Class"B"or better
... r OFFICE. _.
CITY OF CUPERTINO�
CITY OF PERMIT APPLICATION FORM
• CUPEI�TINO
APN#
Building Address: Q
oQ k&d 6a u eT �YAAOI-mln SV/
Owner's Name: Phone#:
-7- a
onto tor: a3 License# g--,vT-e_ 6 3y)s5'
e12-53ZR
Contact: Phon #:
WO -7 — 73,00
Applicant/Contractor: Fax#:
A(� Alo . 778 - 6q)b
Building Permit Info:
.Bldg Elect Plumb Mech
Job Description:
Residential: 2 Commercial:
Sq.Ft, Floor Area: $/Sq.Ft.:
Architect/Engineer: Valuation: � 5 0 C7
Type of Construction: Occupancy Group.
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax—Resi/Mobile BUILDING
• BELEC1000 Elec 600V <= IOOOA 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
BMITIGATR Res. Housing Mit Fee BUILDING
BMNEWMULTI New Multi-Family Res MECHANICAL
BNEWMULTI New Multi-family Res ELECTRICAL
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP I New Comm Plumb PLUMBING
1 of
' • Building Division
10300 Torre Avenue •
Cupertino,CA 95014-3255
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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 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 of inspection.
We understand the above policy on reroofing and will comply with this policy.
Homeowners Name:�PQE EF � .
Address:
Reroofing Company Name:
Applicants Signature: Date:
Joe Antonucci
(Chief Building Official)
6/25/01
- � _ - - - - - '- ( i( is .rt+gy?S i 3F'yK�1}� �r�c'FF+'Y=Fs�4,��f�'�;a-�vY,s-�1�¢.#-�•?
i `- - - .. � r � �. .s� �� 7:".tsssS±,�"e.jt }.''�� � t � `i Yr-+�i�•+,{. .
_ a` - - i ' I I ( l i . . I- •.. i ( .__. � ! s I I � - .,+ s .y ��.a.s#�4#�f'x#�t`t�ci� �S µ
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vd ;ea,�1�•U TolIae Roo,<pC/ '
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i ��` iRei=2eESIFFrNglisi
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1oralee & Mitchel Weintraub, Owner
- - n Ghon - �ontrac�or 21700 Rainbow Ct., Cupertino, CA 95015
A.A.G. Co stru
15135 Monterey Rd., Morgan 1 fill, CA Roof Extension 3'0" x 12'0" .
{ • DATE:
ADDRESS OF PROJECT:
PRE-SUBMITTAL COMMENTS
NOTE: THIS IS NOT A PLAN CHECK
APPROVED
IN AAMIR®ANCE WITH THE CITY 0A
CUPERYINO DUES ANO UNUINANGES
DATE 1 C)
SIGNED
This set u! p ana; mid spec!i:' ions UST
be kep, on me p;u a. ill Lifnes ano it is in
lawful to m„ke aay c:iargc•.; or alteratiom
on same withini w.:, ..n e!mission from
the buiid:ng i)epi., City of Cupertino.
The stamping:;f ib,s p.an and specifications
SHAL inn
fpproval of the vmieucn of any provision
'^ r,:� 0 d.rl or State I aw
perms
ll5 �
SEE THE PLAN REVIEW PROCESS WORKBOOK
FOR SUBMITTAL REQUIREMENTS
• SIGNATURE:
h
F CM
��` J���121��j/
CITY OF-CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: .. PERMIT NO.
21700 RAINBOW CT A A G PROPERTY IMPROVEMENT 02060066
OWNER'S NAME: APPLICATION SUB DATE
eZMITCHEL & DORALEE WEINTRAUB 15135 MONTEREY ROAD 06/12/2002
PHONE: (408) 778-7300 SANITARY NO. CONTROL NO.
w O O ARCHITECDENGINZ]BU BUILDING PERMIT INFO
r -- BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
iz-❑ airi«auyam.that.)am licensed under pool of Chapter 9(commencing. Job Description
.:tomm3edio!t�BUBIgrDiaiaign3ormeBu.mea.pnarmfe.[.i.n�99.cnav�Byuanae RE-ROOF AND ,AWNING
is to full force a c / ` t _
z�� Liccnsp�L ss�L.1 Lic.
. jeonm
�u O 'r' � ANCHITECf' DECLAR 1 N,r to �c '
tend my pl s shall b�uxd`s public recaNy
!EQ'g OWNER BUILDER DECLARATION
u u. 1 hereby infirm that 1 am eern,pt from the Contractor's Licence Law for the
t z a following ma5nn.Serum,7031.5.Boomers and rmfestmn.code:Any city or county $4 0 0 0 0
E F❑ which requires a perm t to conspiracy,t alter,improve,demolish.or repair any structure
a3� poor t issuance.also the applicant for such perm m file a signed statement
that he I d pufm t to the provisions, of the Commctor s License Law(Chapter 9 ,
(come ng_thSect7000)of Division 3ofthe Business and Professions Carl) �r"'ca' 36 3 ,Q�ad.',:ti-*� St1,• , Valuation
or you be is ceempt therefrom and the basis rnr the allcgW caemptimn.Any violation
of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not mom than five nunimJ dollars(SSW). 305 'LN'� t] . Occupancy Type
❑I,as owner of the propend,or on,employees with wages.their sole compenmtion,
will do the wod,-arM the structure i5 not intended or offered for sale tSec.7044,
Busincsa and Prmfessium Code:The Comracmh License Law does not apply m an 601 - ROOF TEF11tg6FIpInspeetions '
over,"f progeny Who builds or improves thereon,and who does such work himwlf
m through his own employees.providW that such improvements Ire not intended or 602 - ROOF PLYWOOD NAIL _
offered for sulc:IL however,the building '-' i is sold within one ear of _.. ._.._.
ob tmenof pro r 603 - ROOF BATTENS
' completion,the owner-builder rill have the burden of proving tom he did not build or •
mprove far purposeofmle), 604 - ROOF IN-PROGRESS
-01str he myth pmpcn70".Bi lusivdy contracting n,CWcnu he C.mmms ro
construct the project(See. to a owner es rurapro erty who b CW e:)The improves
tmrein.
Liceme i.aw does not apply man owner with
progeny who bullas s impruves th10 the
.. . .,and woo cmntmets for such projects wiN a commcmr(s7 licensed pursuant m.the_
C 1 am
pt under
Law,
p"l am ex<m�t under See,- ,B&PCfor this mason
Owner ' s _
WORKER'S COMPENSATION DECLARATION '
;:•vc,'a.I hereby affirm under penalty of perjury one of the following declarations:
- ❑ 1 have'and will'mointain a Ccnificam of Consent to self-insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
_ - rformance of the wed("r which this Cermit is issued.
O I bmve and will maintain W.uker'.,Compensation Inmrance.a5 requited by,Smt!on
37W of the Labor Code,for the performance of the work for which this permit is
issued.My Workers Compensation hy4rnce menet and Policy number are: —
CainrtPolicY No �1j�0'I
4ERTI1(CATION OF EXEMPTIONC OMWORKERt .l 1.�..• a E.,S r-, sG iKF f: ._ :�.. �s , F ICj'li..
.r... COMPENSATION INSURANCE '
(This nwttin tired not be cot plated fthc pemtt is for one hundred dollars
1S10T.rlcseJ . .
s•I cenify Thai in the perfnmtanec of the work for which this permit
ihall'not employ any person in any manner so as to become subject m the Workers'
A licam .„ California. te
.
CPP uon laws of,. _
pcnsa
NOTICE TO APPLICANT the Work:1L after Compensation
this Centficate of Labor Codn. ,y uM1mJd -
0 Z I'onhvvuh comply with such ,mit shall he deemed revoked. 1 -
become subject m the Workers Compensaiion provisions of the labor Code,you most
or this
� 0 'p, proviso, pe
1
M '` CONSTRUCTION LENDING AGENCY
(~ 1 hereby off this there is
issued(Sec.
lending agency fonhe performance
96 of the work for which this permit is issued(Sec.3097.Civ.C.) '
L.Q Isndcr's Name . . ,-.. .. : . . .. .. ...:. :
Lender's Address -
C.7 •,12cit!fy that l bavc;cad thi,ii,oication and Sime U m mo amwe infu,mmion is
tobuild I agree to comply with all rapt and county repre matinees and stale laws relating
0 V the above nons..red ,and lryfobyauNonmapreuntntives of thiscity to enterupon
the nboveancmree to propend for inspection p harmless
y' fWe7 agree to saver, ad aerie s whikeepch
hm ay a con way of crus ag inst sast
id
W liabilities,sequence Gose and carriers of
which may in any way,accrue against said L !—
C.3 City in consequenceofgranting of this pc CO " f+
MPI TUNDERSTnNOS ANCCC���WI COMPLY WITH ALL NON-POINT ISslledb ! Date
50 fCE N:GULA'nON�Sp, t,{—� ' !_ Y
ss HA' RDOUS MA E >, Date Re-roofs
.; HAZARDOUS MATERIALS DISCLOSURE
Willfuture
' •
w m �pbaa t r t mtJdmg p t,int.oonr ha Jle hazardous ma¢rialType of Roof .. - _ - . . .. ...
aid fed by the Cupertino Mmyci,l Code.Chapter 9.12.a d the Health ands fey
Cane Sect on 255320)° s i 1
, . ,]
mYra All roofs .hall be'ins '.•.r r 1 \ ' i s%'o . .
-installed.pr i
Rill th applicant future building' p t use equipment devices which If a roof is installed without first obtaining an inspection;?agree.to`remove
em i hazardous it contaminants m defined by the Bay Area Air Quality Management
District ' .. all new materials for inspection. Applicant understands and will comply with
�f•1 ❑Y«, . ., , 0 N all non-point source regulations. „
'1,have(read the barna us rumenals requ mmems under Chapter 6.95 of the
California Health A,Safety Code:Sections 25505,25533 and 25534,1 understand that
if@e building does not currently have areuant.Nat it is my oalsyrodyl sty ro notify the -
udfupant of the requirements which must be met poor to issuance of a CeniOcne of
°c p`y Signature of Applicant Date
All roof coverings to be Class"B" or better
. .OFFICE. . . .. . . .. . . .