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06060224upC �z J�C eC 10 �cc ane at i u CITY OF CUPERTINO 4 �' Ir r i' 7,7_17177-117,7777177 5 CON TR ACTIORINFRMATION u, BUILDMyG DIVISION PERMIT J1 N p, BUILDING ADDRESS: DIAZ ROOFING PERMrr No. 06060224 1182 STAFFORD DR OWNER'S NAME: PERMrf ISSUE DATE VICTOR LU 6 N ROYAL LINKS CI 06/27/2006 _ NE: SANITARY NO. CONTROL NO. (925)565-0960 ARCIIIIECDENGINEER: BUILDING PERMIT INFO BLDG EIEC, PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description P bereby affirm that 1 am Hemsed under provisions of Chapter 9 (commencing n1ullroronce ml fff.Division and Piro/fcsriun(sjCode. andmylicense u 9� TEAR OFF SHAKE, INSTALL 1/211 OSB, 50 YEAR COMP ._Business Lill, CI s Le. 9 %3 d D Dam l ComrECL CLASS A ARCHITECTS DECLARATION DIAZ ROOFING RENEWED BL 6/27/06 1 unticrsund my plan shall he uxal u public rtcnrm Licensed Professional OWNER -BUILDER DECLARATION I hereby aRrm Thal I am exempt from the Conumume. License Law for me i fallowing reason. (Section 703 LS, Business and Profamom Codc: Any city a county which requires a Permit to concert alcor, improve, demolish, or repair any structure t prior tit its issuance. also redim the applicant for such Permit o lite a signed statement a Comramr'sllcenwLaw (chapter 9 Sq. FL Floor Area - Valuation that he is licensed pursuan10the provisions ofthe a (commercing with Sold..7")of Division 3 of the Business and Professions Code)w $14900 that he u exempt NerUmm and the basis for the alleged exemption. My violation of APN Number Occupancy Type Section 7031.3 by any applicant for a permit subjects the applicant to a civil penalty of not mom than Eve hundred dollen (6500). D I, as owner of the property. or my employem with wages W their sole compenation. 4 6211922.00 - Required Inspections will da the work. and the structu, is nut intended Orartamd hotels lSa. 70 N, Busin.<v and Proration Codc The Commeme, License Law docs not apply he an owner of property who builds Or improves Umreon, and who daessuch work himselforthrough his own employees, provided that such improvements are not intended oroRered for We If. however, one building or improvement is; said within ane year of completion. the owner- Wilder will have Ne burden of proving that he did not Wild or improv for purpose of Wilth [t� (� /5t p w..,® ��\j[tVW[p�aF/AI/'(yf�ltlt7lpliryff�ttjg.(rta'_3�' �� D 1, as awns, of the property, am eschadvcly contracting with licensed comaerws to comtmct the projen (Sec. 7044, Business and Ptefa an, Cade:) The Convat Li. cense law does not apply at an owner of property who Wilds or improves thereon. and. who contracts for such with a conuachr(s) licensed m the Contractors rte' JUL Projects punuant License law. 'S_ -_ sa006 L D 1 am exempt under Sec , B & P C far this reason Owns, Dae BUILDING WORKER'S COMPENSATION DECLARATION 1 hereby aRim under Penalty of pe0ury, ane of Uta following discussions: 1 have and will maintain a Certifiaw of Conrado self -insert for WOrkmre Compcn- - .tatian, an provided for by Section 3700 or the labor Code. for the pcAmmance of the work for which this permit is maned. D 1 have and will maintain Workers Compensation Imuran, as required by Section 3700 of the Labor Code, for the performance of dor work for which this permit is issueQ ' My Workers Co , pens ren Ire cc ani and Policy numbs art: Carica. Polity No, ryl�``i( CERTIFlCATE FMEMP ION FROM RKERWO S' COMPENSATION INSURANCE (Thu scala. heed not bccoraplemd it Ne permit is forone hundred damn (SIM) . or leu.) 1 aniry mot in the performance of the work for which this lurmlt is issued, I shall not employ any person in any manner so at m become subject to the Workers' Compensation taws of Caltfomia m Da Applicant NOTICE TO APPLICANT: If, after making this Cortin am or Exemption, you should become subject to the Workers cmeperostim provisions of the Labor Cade. you meas e faMwith comply with such provisions or this permit shall bo deemeA muted. j CONSrRUCT1ONLENDING AGENCY 1hereby Ie.dl.g agency for du perfurmontt of then issld which ithat ' the work for which Ulu permit u issued (Sec. 309'!, Civ. C.) (Sec. 3 jLanders Name t<mera Aaerece 1 certify that I hast rand this application and sum that the, above information is current- I agree to comply with all city and county onliturces and sure laws mlaing to Wilding construction. and hereby authorim represemaniva of this city to enter upon me anovcmcntidnednts.CO fond inspection purpowhich ms. (We) agree to sari, indemnify and keep harmless tion City of Cupcnim against j liabilitim,judgmcnta.costs and cxpcmcs which may Many way aarhe against sud City t consegucrce NDER!i7rANDS AND r I ' APP NT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date Re -roofs Type of Roof gnaturt of ppltat HAZARDOUS MATERIALS DISCLOSURE Dole H Will dm applicant or future building actipanuwre or handle h.,Odom material as defined by Uu Cupertino Municipal Code. Charter 9.13, and the Holm and Safety Code, Smio. 25532(x)? Dyes All roofs shall be inspected prior to any roofing material being installed. Will If a roof is installed without first obtaining an agree to remove inspection, I P dm applicant or (wore Wilding Occupant um cquiPmcnt of devices which it halsodunds, air com nsinsnta as defined by me Bay Arta Air Quality Mwtagcment all new materials for inspection. District? ❑Yes �1a 1 have read the haasrdom materials requirements uwerOtapur 6.95 ofthe Cabral. nix Health& Safny Cade. Sections 25303.35533 and 25534.1 undersand datif the WildingJwAf docs tort cu y Mss a unana that it u my resp9Aaihiliry m testify Uta occupant of the 'R�� requi rte astbcmetpdorwl coofaccmBcamafaaupaay. gnatu (Applicant Date '" �' Z� �� gs to be Class "B" All roof cover or better Owner or num and agent ° Dow sm 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36211022.00 DATE ISSUED.......: 06/27/2006 RECEIPT #.........: 35030 REFERENCE ID # ...: 06060224 SITE ADDRESS ..... SUBDIVISION ...... CITY .............: IMPACT AREA ...... OWNER ............: ADDRESS ..........: CITY/STATE/ZIP ... 1182 STAFFORD DR CUPERTIN0 VICTOR LU OPERATOR: amyw COPY # : 2 RECEIVED FROM ....: DIAZ ROOFING CONTRACTOR .......: RODOLFO DIAZ LIC # 26457 COMPANY ..........: DIAZ ROOFING ADDRESS ..........: 6 N ROYAL LINKS CIR. CITY/STATE/ZIP ...: ANTIOCH, CA 94509 TELEPHONE ........: (925)565-0960 *EE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL BPERMFEE VALUATION 15,000.00 223.56 0.00 223.56 0.00 BSEISMICRE VALUATION 15,000.00 1.50 0.00 1.50 0.00 BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00 TOTAL PERMIT : 330.06 0.00 330.06 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT • AMOUNT NUMBER ------------ ------------------ 330.06 2008 330.06 CITY Of OCUPEkTINO • • Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: i SL-Loeoa6 PERMIT # zz OWNER'S NAME: 16PHONE #'i� 5- O 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 - 1 Septic Tank Sheet Metal Sheet Rock Tile Owner/ Contractor Signature Date E 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 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 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: _ job Site Address: Q� Roofing Company Name: Applicant's Signature • Greg Casteel Building Official tc�ck- 1-k . «Z od wt� Revised 11/2/04 Date: 0—Z7 --T5"6 Suva • cuVor CUPERTINO • 0 CITY OF CUPERTINO U�QoD22q- PERMIT APPLICATION FORM APN# 802-11_M Bldg Permit Fees Date: (0-2-TOco Building Address: 1182 CA-0,� C)C6 �c - Ener Owner's Name: t BSEISMICRE Phone #: v l c Fo 1-U BSEISMICOM llkta - 8Si - 8 010 Contractor: License #: e1 Contact: 1 �O D\�Z \ BUSLIC Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles W_ Asphalt Shingles 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: •t2GC Os;li gMICe QRS§o.\\ `h" OSlfj I g0 �C- COMA clgsS A Residential Commercial ❑ Fire Zone: Yes ❑ No ©" Confirmed with Planning De t. if there are any restrictions: Ll Cost of Project: Jy t,:�dd Type of C/ ction: Occupancy group: V M-3 Qty. if Applicable Fee ID Fee Descrintion Fee C'rrnnn BPERMFEE Bldg Permit Fees BUILDING BENERGY Ener BUILDING t BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING