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06090262 CITY OF CUPERTINO ag 1'- '" '"t`°" '�' •BUILDING DIVISION PERMIT -0, BUILDING ADDRESS: JOHN MARSHALL PERMIT NO.06090262 21851 SAN FERN OWNER'S NAME: PERMLSSUE DATE JOHN IT MARSHALL 09/27/2006 NE: SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 LICENSED CONTRACTOR'S DECLARATION mF T Mmby affirm that I am Acetated under pmvisiono ofClmptm 9(commencing lob Description ;iwwith Section 7IX1U)of Division 3.1'the Bun.and Profosiom Cmdc.mdmy license is r« in full force and effect. REROOF— TEAR OFF EXISTING INSTALL NEW 1/2" Li...ClassLuca PLYWOOD �� Dam COnuxOr , 30LB FELT PAPER. CLASS A OR B. 12 SQUA ARCHITECTS DECLARATION i s< I undersunJ my plans shall he used as public rtrnrdo >yV s C G Liccnse0 Pm(essioval OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Co oramufs Liccom law for the p o following mason.(Section 7th 1.5,Business and Profoodov Calc:Any city or county <m which tequiw a permit to construct alcor,improve,demolish,or repair any structure Z< prior m its issuance,also mquims the appliemt for such Permit la file a signed statement -Z�s i that he a lianud Punuam to the provisions of the Contractor's Lkanu law(Chapter 9 Sq.Ft.Floor Area fl 0 0 0 i F•� (c.mcncingwith don700G)or Divuion3ofN Busirc and Pmfmiom Cadc)or $ that he is exempt therefrom and the buss for the alleged emmpuoo.Any violation of Section 7031.5 by any appik ant for a perm t subjects lie applicant to a civil penalty of ppN Number Occupancy not mom Nan five hundred dollars(M5 3 5 715041 . 00 ❑1,u caner of the pmperty,or my moplo em with wages u the"e mlecompenndon, will do the work,and the structure is not intended or offend formic(Sec.7W.Business Required Inspectionsy and Prefenuov Code,The Coaumm's Liccme Law does and apply mass e Owner of 9 property who Wilcs or improwthcmon,and ximci ssochworlahimselfor Waugh his .we employees,provided donsuch improvements art not intended ooRcmel for ole.If. however,the building or improvement is mid within one year of completion,the owner- builder will have the Auden of proving that he did Out httild or improve for purpose of sale.). M.1,as owner of the property.me exelusivdy contraming with licensed caeummn in constmm the ptojem(Sec.71144.Business and Proukas us Cade:)the Conuamo's Li- cave law does not apply ban Owner of property,who builds or improv thereon,and who contracts for such pmjecu with a canna or(s)licensed pursuant to dna Contractor's Lice.law. of...I loser .11 meads n Owner p2n Game WORKERS COMPENSATION DECIARATTO40 N / O� i hereby alfiml under pevlty,of perjury ane of the following declarations: ❑I have and will maintain a Certificateof Cavem to self-imure far WmkefaCompcn- sation,u providW for by Section 3700 of die labor Code,for the perfomuae of the work for which this permit is cooled. O 1 have and will maintain Worker's Compensation Ivmma,as required by Section 3700of the labor Code,for the performmce of the work for which this permit is issued. My Worker's Compensation Tnsumnce Cartier and Policy number art: Cartier Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE rntu section Cased not M completed if the permit is far one hundred Collins(SIM) or less) 1 certify Nat in the performance of the work for which this permit is stood.1 shall not employ any person IrrRrtoTdm became wbjecl m the WOrtms'COmw petion Laws of Calierson 11M1M1 66 Applicant NOTICE TO APPLI Nr:If,after making thA Certificate of Exemption,you should become subject m the Worker's Compensation provisions of the labor Cede.you mvt 0 foMwith comply with such pmvisiom or this permit shall A:deemed revoked. 'Z..' CONSTRUCTION LENDING AGENCY (—I I hereby affirm that then Is a construction lending agency for the performance of a> the work for which his pemtn is issued(See.3097,CA.C.) 6�. A Landoes Name ` Z Lenders Addrm U C) I Certify that I have rod this application and sure thn the above information is correct.I agree Ire comply with all city and county ordinances and state laws relating to �U building construction.and herby authodm mpreaentadw of this city to enter upon the move-mentioned ProPc sit for inspection purpowhich may L4 (We)agree to save,indemnify and keep harmless the City Of Cupcnino againn h incromeas.judgm ftheevumdOf this expenses;which may in my way attmc against aid City U z A APPLICANT UNDERSTAii.fingNDS of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE RFTIONS. 1 w0 Re-roofs Signature o pplicm OU Dem HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the a Cupertino o future Wilding e.Chapter nand the IHeallov material u defined by the CupeninO Municipal Code.�lapmr 9.12,and the Health and Safety Calc,Sermon 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes KN. If a roof is installed without first obtainingan inspection,I agree to remove Will the applicant or future building occupant tau equipment or devices which p g ' emit ha ardeus air emiuminanu as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ow. I have mad the hina dous materials nq.imentens under Chmm,6.95 of the Califar- meHcaith&SaletyCode.Savoy 25505.15533 and 25534.1 understand t hatifdte Wilding does not currently ha W a tendo.that it Is my rmponsibilily to notify the oCcup ort of the mgeimrPgnis hmq hlnyslbemmpnorminuarrccofaCeniGnmo!Occup y. Signature of Applicant Date ��7b6 All roof coverings to be Class"B"or better Owner Srauthorind agent pate 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-]997 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: IvM 1 Job Site Address: Roofing Company Name: ��N Q ✓� Applicant's Signature: Date: I L® o6 • Greg Casteel ! J Building Official Revised 11/2/04 CITY OF CUPERTINO •em 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 35715041 . 00 DATE ISSUED. . . . . . . : 09/27/2006 RECEIPT # . . . . . . . . . : 36234 REFERENCE ID # . . . : 06090262 SITE ADDRESS . . . . . : 21851 SAN FERNANDO AVE SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : JOHN MARSHALL ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : JOHN MARSHALL CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY JOHN MARSHALL ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ----- - -- - - -- ----------- ---------- ---------- ---------- -- -- - ----- ---------- BPERMFEE VALUATION 5, 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00 BSEISMICRE VALUATION 5, 000 . 00 0. 50 0 . 00 0 . 50 0 . 00 ----- -- --- ---------- ---------- ---------- TOTAL PERMIT 116 . 06 0 . 00 116 . 06 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER - - - - - - -- - - - ------ -------- ---- ------------------ OTHER 116 . 06 MASTERCARD TOTAL RECEIPT 116 . 06 • Community Development 10300 Torre Avenue sis Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 OCUPEI,TINO Building Department JOB ADDRESS: PERMIT # 04-l V '541, U6'0?0 2 6--?- OWNER'S -2OWNER'S NAME: -J-6" + PHONE # 4osr 6x 6�( GENERAL CONTRACTOR 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature lbate �X.�J 1 VV`�Y✓` CITY OF CUPERTINO • REROOF CUPERTINO PERMIT APPLICATION FORM APN# Building Address: J 6/ Sat, fu k��d!o /die Owner's Nam q: � Phone#: Contractor: II AA License#: Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles —A Asphalt Shingles Wood Shakes ❑ Wood Shakes �'- Wood Shingles ❑ Wood Shingles 1- / ❑ Other(Specify) ❑ Other(Specify) CC b��6 Number of existing coverings 1 ❑ Provide I.C.B.O. Report 1' To be Removed ❑ Provide Mfgr. Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: I Nil 34,�k k hztj VDA o Ib �F� cls. ll Residential Commercial ❑ S Fire Zone: Yes ❑ No Confirmed with Planning Dot. if there are anrestrictions: L Cost of Project: Type of Construction: Occupanw- rou 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 •