The URL can be used to link to this page

04030153 CITY OF CUPERTINO � ' ' ` BUILDING DIVISION PERMIT ,' N"P 'ZI; .'' BUILDING ADDRESS: _ RUFF ' S ENTERPRISES PERMIT NO.04030153 20669 S OWNER'S NAME: PERMITISSUBDATE LUCAS LOUIS B ONE: SANITARY N ONTROL N0. (408) 528-6227 ARCHITECTIENGINEER 08 52 - ARCHITECDENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH ep o 0 0 0 +I O p LICENSED CONTR S DECLARATION thereby NatIamfom dunderprovisionof Chap mr9(commencing - Job Descrep NALEO withSation] 0).fDviaien]ofilc Basi it Profmtium C.&,..d myliccnse is � „ mmRfo agdrifesu 34 Lie. S `t S S REROOF b m- Licenm C`�. MAR 2 8 2004 's, Dale Can r 3 e ARCHITELused a— A ATI i 3i 1 uneeramnJ my plans shell he used a public records Lecused Professional BUILDING OWNER-BUILDER exempt DECLARATION 1 hereby affirm on 11. exempt from uta Cosies res License Lew for the a0 following mason.(Section 71131.3.Business and Professions Cnde:Any city of county which mr,dics a permit to construes,amer,improve,demolish,or repair any structure FZ< prior an its issuance,also mquirm thcapplium,forsuch Permit to file a signed statement that he is licensed puruamlo the provisions of the Custmmr's Ucehou Law(Chapter 9 Sq.Ft.Floor Area Valuate z $ (commencing with Section 7000)of Division 3 of the Busiowerand Professions Code)air 3.. that M is exempt therefrom and Ne beau for the alleged exemption.Any violadon of Section 7031.5 by any applicantfor a permit subjects the appikent to a civil penalty of 3M1rla Mibber 00 Occupancy Type not mart than firm hundred della.($300). ❑I,as owner of the property,car my employees with wages as their mle compensation, will do the work end meswau ,isnot intended osufficing for sale(Sec.7014,Best=, and Profession.Code:The Conuactera Lkerue Law dors net apply to an owner of Required Inspections pmpeny who buildscrinn mom thereon,and whodoesmuch workhimselforthrough his own employers,provided four such improvements am nm intended moaercd fersak.if. , however.the building or Improvement Is gold within one year of completion,me mon". builder will have she burden of proving that he did not build or improve for purpose of .In.). 0 1,as owner of the property.em exclusively contorting with licensed contractors an construct the project(Sce.704,Business and Pro(e.ions Cods:)The Contmmre LL come law den not apply re an owner of property who builds or improves foemon,and. who contracts for such proje%with a contromr(s)licensed pu.vant ro the Commmuoes License Law. of amexempituder Sec. ,B&PCforthismamn Owner Date WORKER'S COMPENSATION DECLARATION 1 hemhy eBi, under penalty of'do,one of the following eeclaretiom: 'I have and will meinWna Caeifiate of Conserv to self-houreferWorkersCompen- satan.as provided for by Section 3700 of foe labor Code,for the performance of the work for which this permit is issued. ❑1 haw and will maintain Worker's Compensation Insurance,m required by Section 3700 of the Lebo,Code,for the performance of the work for which this permit is Wund. My Worlmr`ss Conmllp��madog�,Inaurmc�elari en Policy number am; mer: U ITttifC 1 ULA Iicy No.:_L(9 r . IV CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu sexton need net be completed lithe Permit Is for one hundred dollars($100) or less.) 1 certify that in the performance of the work for which this permit is issued.I shall not employ any peon in any manner an m in become subject to the Werkeri CompemNon Law.of California.Dam Applicant NOTICE TO APPLICANT.IL after making this Certificate of Exemption,you should become subject to the Workers Compensation previsions of the Labor Code,you must ,JO forthwith comply with such pmvisiom or,this permit shell be deemed revoked. . „zy CONSTRUCTION LENDING AGENCY 'r I hereby affirm that them is a construction lending agency for the performance of the work for which this permit Is issued(Sec.3097,Civ.C.) W� A Lender's Name z Lender's Address V Q 1 certify that 1 haw and this application and sum that to+bow information is n. coca 1 agree to comply with all city and county on inanms and stale laws mining in - building conawctian,and hereby aumodm representatives of this city to enter upon me res ¢hove-reentered pto saw,for indmnify an keep ho F esJu agree m mw,indemnify and kith harmless the City of Cupertino against fA incoiteajudgmcnhe&=tin&expenses Fe which may in anyway same against mid City V 7 A APPLICANT of megranting of this permit. s7• APPLICANT UNDERSTANDS AND WILL COMPLY WITN ALL NON-POINT Issued by: Date SOUR E ULATIONS. /6^0 ' Re-roofs Sig mm o Applicm ontormr Data - AZARDOUS MATERIALS DISCLOS RE Type of Roof Will the applicant or Ntwe building acupmt mercer herdic hamMous material m defsned by the Cupertino Municipal Coda Chapter 9.12,ane the Health and Safety role.section 25532(x)? All roofs shall be inspected prior to any roofing material being installed. E]Y. �Nu Will the epplicmr or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove r mil haranimmi air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0Yes lu /��///////// ��// //////// J [have mad the ode.S aom2mrials553immc5534.lrChepmrd.95ofine Wilding _i � � /� ninHeslfo&Safety Cade SatiomOgtit,25533m Mibility Wn.mndthuriffoc Wilding 6_ Y Jots notenta y hew a be I Net it u . ce or.co ty m mdl'y ,c p.q. of Jm myalm D, IIX.'in pllor u133Ya11Cc efBCerllflCdN of DeapNef. y S n re of Appli nt a v Date 27746..rs oylne n4mnazedasent Dam All roof coverings to be Class"B"or better �,._ 4_ .� ....� R._,.•.f� .en.... '+i' y..,...^ a )� exp'- n..�� •4yt n..+.t.<.^n-m... r.- tiiV' :t•+ Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 *001 Fax(408)777-3333 UPEkTINO Building Department JO 3co 4 3 ADDRESS 9 S'hide t . PERMIT # © OWNER'S NAMEJ `s PHONE # — S o- (o ,3 GENERAL CONTRACTOR: e l _ s`1 1 k Fo-P 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 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 yt /Con�gnature Date Community Development Department F I Building Division Ci of Cupertino .s City P y ' 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 4UPEkTINO Building Department Subject: Re-roofing policy fortheCity 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. 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: 1_.0L-Ju S a , UkC 43 - Job Site Address: "el ons (.o (o S cz7 f 7 1 2[ cQ 0 r , CL-1 e +r' o Roofing Company Nalfie: Ky P ` S 2 /J G-F_(L P 2( S E S A plicant's Signatur . Greg teel Building Official Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINOO REROOF ° CUPEkTINO PERMIT APPLICATION FORM APN# 3. 1 c) p oil Date: Building Address: co Owner's Name: Phone#: - �cA-S d- s - s *13 Contractor: Phone#: License#: LU C=r`5 yog- SD4 -(:, 33- c-34 - -7i7 -,_1V I Contact: Phone#: Cupertino Business License#: o — o — t`f 3o Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles -9C Asphalt Shingles 5i(- Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings 6— 13 Provide I.C.B.O.Report# 5d-_To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 4—C� r o. >,J tno9Cts s1jww W,.,) de-CV-03 Residential 91 Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with PlanningDept. if there are any restric ' Cost of Project: Type of Con stru ti Occupancy gro 100 Qty. A liif e 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