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06060072 CITY OF CUPERTINOZ. � BUILDINGOIVISION PERMIT JFONTRA.CT(►I2INk�URMATIp1V: BUIWING ADDRESS: OPAL LEMMER PERMIT NO06060072 1120 S OWNER'S NAME: PERMIT ISSUE DATE OPAL LEMMER 06/0,9 /2006 VIE: SANITARY NO, CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 p p[ LICENSED CONTRACTOR'S DECLARATION Job Description i u tj 1 thereby ar8rm Jut 1 am liuconsd under promotion of Chapter 9(commencing ;IW wiNSees.70filyrdDivision Softhe ButiM..and Profciam.Code.arm myl e'.is !�F in full force andcnccL S5d TEAR OFF, NEW SHEATHING, 40 YEAR ELK COMP CLASS Lic;�q Dole Lk.x RE-ROOFING THE STORAGE SHED ALSO 'F'i Dam �GOn DECL ARCHITECTS DECLARATION �� IundcrstanJmyplansshallbcused uPublic records SPECIALTY ROOFING PAID FOR BL 6/8/06 ryU G Licensed Pmfcssional 3 OWNER-BUILDER DECLARATION in p 1 hatehy aRrm that I am exempt room Ne Conmaeme.License Law for IW 1 :Cc following mason.(Seetion 7031.5,Business and ProfasSiOm Code:My city or county a 'moiwhich requires a permit to...L alcor.improve,formil h,or repair any andemse ry prior m its issuance.also requires the applicant for such permit us rile a signed summcm ,,,r €� Npursuant at he is licensed pursuano the provisions of ftCOmmcue's Leena Law(Chapter 9 Sq.Ft.Floor Area ' p Valuation 2 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y a $11520 $ that he u exempt dmmfrom and der,basis for the alleged exemption.My violation of d - Section 7031.5 by any applicant far a permit subjecu the applicant to a civil pmtalty,of APN Numbev:IC� Odeupancy Type not mom than Rvc hundred dollars(85W). ❑1,as ownm of Ne propeny,ar my wployces with wages at their sole campauadnn, will damework..ndmeswcmreis Out mmndedoraBamdfar eao(see.7 .Busit�, �y1i d specb ns and erty who ns code:The Contractors s Licence law does ar apply lf,n owner or propertywho Wildsorimprow theistplo arrearsdolad ae..I mworthir.Mrer through has own emplmeuprogNatswabim is semenuare not intendedmoffcre,deamforsidaIL builder the building.,Improvementisaaldwithinoroyearof completion,NeOwner- builder wig have Ju burden of proving Wt W did wt ddW m improve for puryosc of sale J. ❑1,as Owner of dm property am exclusively conuacsing with licensed cnnuacrors m construct the project(Sec.70ad,Business and Professions Code:)The Conmemrs Li- ccnse Law doss not apply in an Owner of property who Wilds or improv thmeon,and. who conuacts far such projects with a,anuxmK.)licnved pursuant to dies Commerce. Lice.law. ❑I ore cacmpt undo Scc. .B&P C for Nu mason Owner Data WORKERS COMPENSATION DECLARATION 1 Wreby am.under penalty of perjmy ane of the following dalandonr. U I ham and will maintain a Certificate croissant in self-insure far Wobde Compere sedan,as provided for by Section 3700 of dte Labor Code,for the performance of for were for which this permit is isued. ❑1 have and will maintain Worldes Compensation Insurance,as required by Sectio 3700.(IW Lobar Code,for the per(urmancc of Ne wore for which this permit is issued. My Worker.Compensation Wum us carrier and Policy number art: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu sectio need not W completed if IW Noun is fmrone hundred!&ran($IBM or less) I cani).that in the performance of the wort(or which Nis permit is Isstmd.I shall am employ anyperson in mymann b subject m his Waste.,Compensation Laws of CalDate Applicant NOTICE TO APPLICANT:If.after making this Ccr woo of Exemption,you should become subject in the Workers Comperuation provisions of the Labor Code you moa .J .z forthwith comply with such provisions or this permit shall be deemed revoked. z O CONSTRUCTION LENDING AGENCY 'e+41 thereby affirm Nat them is a comtoomien lending agency for dm perfmmana car . a > the work for which this permit is issued(Sec.309.1,Civ.C) 0. Q Lenders Name 7 z !enders Addm•. U0 1 coni(,dist I lave read this application and aunt that the mew infamatiun H (y comm I agree to comply with all city and county ordinances and state laws mlating in OU building construction,and hereby suthmirz mpmeemaivnsof this city m enmruNo use Ahow- W limflim,judgadproperry for ar, ensca purposes. ,� gy (We)agree to save,indemnify and keep hared.the City of Cupertino against fq in rthotrading ex penses wit. may in any nyacctue against aid City U z in comequenco of the gruthne°(Nis permit / '--' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date !J/ ' /4� SOU EGU Ano s. �' K Re-roofs Signature of ApplianmConuactor I Dam HA7ARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant Or future building oavpantnom rehandle haaadous material az de0ned by l;Cupertino Municipal Code.Chapter 9.12,and the Heal,and Safety Code,Section 25532(87 0Yen 11— jNa All roofs shall be inspected prior to any roofing material being installed. ins a Will the applicant or forum building occupant sex equipment Or Jcvia*a which If a roof is installed without first obtaining an inspection,I gree to remove cmil Dismiczzardnns air contaminants as defined by Ne Bay Area Air Quality Managcarom all new materials for inspection. Q Yes "u I hats mad dm harardeds mamdalsrequimmess under Chipter6.95 Often,Califor- 'ArjA/ /J//�//1ry� /A/ /J nice Or curSafetyhaw.Sationsuriti2myr33 am125534.ofly in entry dthmifthc Willing ��D Jtunoth&Sifeyhasta ocuor Jut0u55mspunsihilityeanotifydmaddhe mfthe out.n, Is who cons�tymer ter} wwme con eemrm,te oraoupamy. Signature of Applicant T— Date ?_�Q// / /J✓gi 6 -L� Owner m mNmi ed.gem All roof coverings to be Class B or better am Community Development a 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 OUPERTINO Building De artment JOB ADDRESS: � S , STEl�I/I/G RP PERMIT # G a6b4�� OWNER'S NAME: ® 4ZL _ Q PHONE # _ a t GENERAL CONTRACTOR: 4 FAX # _ 3 cl 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 71�Yj 611,4 - 6L-lvt, l S �/- ef�vtdU�4L Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Si ature Date 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. Homeowners Name: Job Site Address: Roofing Company Name: L r Applicant's Signature: 6!' Date: 6 • Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO !m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36226008 . 00 DATE ISSUED. . . . . . . : 06/08/2006 RECEIPT # . . . . . . . . . 34762 REFERENCE ID # . . . : 06060072 SITE ADDRESS . . . . . : 1120 S STELLING RD SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : OPAL LEMMER ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : SPECIALTY ROOFING CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : OPAL LEMMER ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : •FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 12 , 000 . 00 191 . 16 0 . 00 191 . 16 0 . 00 BSEISMICRE VALUATION 12, 000 . 00 1 . 20 0 . 00 1 . 20 0 . 00 BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 297 . 36 0 . 00 297 . 36 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- -- ---------- ----- - ------------ CHECK 297 . 36 1519 TOTAL RECEIPT 297 . 36 CITY OF CUPERTINO ' REROOF • CUPEkTINO PERMIT APPLICATION FORM APN# n � O� Date: Building Address:j),2 0 E 5-M�& 1AJ6 ,eo. Owner's Name: Phone#' a mE sh- 3.2qg> Contractor: L O / License#: 9Z/2650 Contact: h Cupertino Business License#: �iQ/U,C>i4LG Gt/A6✓I/� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof A Asphalt Shingles *A Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings_ ❑ Provide I.C.B.O. Report# lTo be Removed ❑ Provide Mfgr. Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic Job Description: A�-d�� S �/�l 1/�j (� / 4/O ( So Residential Commercial ❑ �� n Fire Zone: Yes ❑ No�� Confirmed with Planning Dqt. if there are any restrictions: LJ Cost of Project: 0 Type of Construction: Occupancy group: , DING 51 u-e <, 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 •