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06070013 3 CITY OF CUPERTINO -�•�+� ,c . I7" -BUILDINC � DIVISION PERMIT CONTRAGTORfINFORMATION BUILDING ADDRESS: MBROWN CONSTRUCTION, INC PERMIT N0.06070013 1128 STAFFORD DR OWNER'S NAME: PERMIT ISSUE DATE FERRIE DON 702 S . DANIEL WAY 07/05/2006 NE: SANITARY NO. CONTROL NO. (408) 260-1260 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 0 o LICENSED CONTRACT'OR'S DECLARATION lob Description mF 1 hemby affirm that I am licensed under provisions of Chapter 9(commencing ;z. with Sued..7").fDlvlalon3ofdW Business and ProfessionsCode.and my license is +« in full fame and eff=L _ REMOVE EXISTING SHAKE INSTALL APPROX 32 SQUARE License el s-o 79 LK.Is D ar_ conte orJYgQF THE OSB RADIANT BARRIER AND CLASS A COMP ARCHITECTS DECLARATION sec f ce 1 undcrsund my Plans shall he need as public records 7yV s G Licensed Professional c v,� OWNER-BUILDER DECLARATION <2 I hereby alum Nat I am exempt from the Contractors License Law for the 0 0 following masons(Section 1.5.Business and Professions Cade:Any city at county u m ff which meal.a Permit m comm uel,alter,improve,demolish,or repair any structure _I< Inter to its issuance,six.ma.h.de,applicant to,saeh permil to file a Signed sunery Ot x the he is licensed pe...Lto due provisions of the Contractors lxcnm Law(chapter 9 Sq.Ft. Floor Area Valuat x000 'i-3 (hat hei exempt section7000)and of basis for of the Business and on.Any Cadc)of .. that he H exempt Ncmlmm and dm baso for Ne alleged exemption.Any violation of Section 7031.3 by any applicant for a permit subjects the applicant to a civil penalty ofppN Number Occupancy Type nor mom than five hundred dollars(SSW). 3 6 2 0 7 013 . 0 0 ❑1,as owner of Ne property,Or my amploym with wages as their cele campena radon, will do the wank,and the swcmm isnot intended or a@rad for aMe(Sec.7064.Business ns Required Inspections and Professions Cada The Contractor's License Low does not apply m an owner of 9 P property who Wilds or improves Neman.and who does such work himself or through his awn employees,provided than such improvements are not intended moRued far sale B, however.the building or improvement is sold within one year of completion.Ne owncr- builder will have the burden of proving Nat he did not build or improve for purpose of sale.). ❑1,as owner of the Property am exclusively contracting with licensed contractors to consumer the project(Sec.7044,Business and Professions Cade:)The Canvaewr's Li- cense law docs not apply to in owner of property who builds or improves thereon,and / who contracts for such projects with a eontraetor(a)licensed pursuant in the Comaxcmra License Low. ❑I on exempts under See .B&P C for this mason / Owner Data (� - WORKER'S COMPENSATION DECLARATION 40 1 hereby a1Nmunder Penalty of perjury one of the fallowing declarations: 1 Mw and will main tan a Certificate of Consent en self-imam for WodtersCampos. sation,u provided for by Seedon 3700 of the Labor Code,for the perfarmance of tem wort for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as requited by Section 3700 o(the Labor Cade,for due performance,of the work for which But permit is isswd. My Workers Compensation hwrance carrier and Policy number art: Cartier. S�e:-`�L �w-� Policy No.: -7/3 DO(O/7 if CERTIFlCATE OF&PPITON FROM WORKERS' COMPENSATION INSURANCE (fbu section need not Wcompeemd tribe permit is forone hundred dollar(SIO.) or leas.) 1 certify that in the performance of the work for which this permit u Tuned.I shell nut employ any person in any manner an as on become subject to the Workers'Compmande n Lowe of califarnu.Date Applicant NOTICE TO APPLICANT:IL after making this C.Mficmc of Exemption,you should become subject to the Wonkcra Compensation provisions or the Iobm Code,you most ,JQ forthwithcomply with such provisions or this permit shall W deemed.1ced. zCONSTRUCTION LENDING AGENCY P C4 l hereby alarm Nat Nem is a corsometh ,lending agency for the performance of 04 > the work for which this permit is issued(Sec.3097,Civ.C.) fjd Q Lender's Name jZ t<ndera Add. U Q 1 certify that 1 have mad this application and state than the above infom,atiun is ^F correct,I agree to comply with all city and county ordinances and state lawn reading to C U building construction,and hemhy autborim repmsenurives of this city to enter upon the r W about-mentioned property for inspection purposes. F gy (We)agme to save,indemnify and kap harmless the City of Cupertino against fq liabilitiesjudgments,casts and expense which may in any way acme against said City /^ U z s pormit. APPL CANTDS AND of WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REGULA /I —� 7- Re-roofs Re-roofs �-�— Signatme of Appeicam/Conuractor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant.,Imam Wilding occupant store Or handle hauadous material as&fl and by the Cupertino Munieuipa Cade.Chapter 9.q and the Health and Safety Calc,section 25333(a)? ❑Yu All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining n inspection,I Will the applicant or forum Wilding occupant use equipment at Jevicns which g aPe agree to remove emit lui,m aus air contaminants as dc0cd by dueBay Arca Air Quality Management all new materials for inspection. Dlalrlcl7 c Ya I have mad the hvaNrws mamrialsmquiremen s under Chaptcr6.95 of the Califon nia H.hb&Safely Code.Sections 35505,25533 am125534.1undersund thatifthe building dao not currently have a mount.that it u my ruponsibility m notify IM necupant of he "qui "a"which mtuu be w i co of a Ccnificom of Occvpanry. Signature of Applicant Date Owner or authorized agent Dam All roof coverings to be Class"B"or better CITY OF CUPERTINO �m 1 of 2 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36207013 . 00 DATE ISSUED. . . . . . . : 07/05/2006 RECEIPT # . . . . . . . . . : 35106 REFERENCE ID # . . . : 06070013 SITE ADDRESS . . . . . : 1128 STAFFORD DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER FERRIE DON ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : MBROWN CONSTRUCTION CONTRACTOR CHRIS BROWN LIC # 25108 COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC ADDRESS 702 S . DANIEL WAY CITY/STATE/ZIP . . . : SAN JOSE, CA 95128 TELEPHONE (408) 260-1260 •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------ ------- ---------- ---------- -- -------- --------- - ---------- BPERMFEE VALUATION 7, 000 . 00 137 . 16 0 . 00 137 . 16 0 . 00 BSEISMICRE VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 137 . 86 0 . 00 137 . 86 0 . 00 • Community Development Department Building Division 1t\; City of Cupertino gin' ,N 10300 Torre Avenue • nNa,+nPrg Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEkT1N0 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 " 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: Four l er p�, tt n y Job Site Address: I J a.e` 'SI�1T'ftlld Dr. � ��, � ��i C/� Roofing Company Name: \4600"T^ C�`l'"G�I0 , it, L Applicant's Signature: Date: I S DU • Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper ,4 Community Development F J 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 WUPEkTINO Building De artment JOB ADDRESS: PERMIT # 079 s 0 oY4 'Dr. C� v 1RD CA R�Dt 6 (60 _7116/3 OWNER'S NAME: ren i e Oov-) PHONE # 40 . a-(o p, GENERAL CONTRACTOR W" C'h-V-6)1.,+C FAX# �,,W }� I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followinginformation: 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 • 1 s fl� Owner/Contractor Signature Date CITY OF CUPERTINO O -ou-10012 J S-6REROOF WUPEf�TINO PERMIT APPLICATION FORM APN # ��" h I� Date: _s- Building - 119- ng Address: Dy- C�hrQ, GA ML 112E stn �Q Owner's Name: Phone#: erri n (ala1..,30J- ;-3W Contractor: Phone#: License#: 1 M1orrwn omwoo'a , ZnKc. �ii�.2(a� .�zioU oblo_ Contact: Phone#: Cupertino Business License#: UVIIgo() a5 ()?0 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑J Built-Up roof ❑ Asphalt Shingles p Asphalt Shingles d 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: j1et0`/ G�tsfi 91VK-i, Ivlrt4h qp s, 'a2� 0� TA& Ebb nfi f��1 OIY1(� f Pl C�1 i Residential 0 Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: T of Construction: Occupancy group: _ Q'--z S`i J 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 •