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05050115 (2) CITY OF CUPERTINO - m -d,f- •r.rs,_ BUILDING DIVISION PERMIT CONTRACTOR�INFORMATJON `'�': vs�,...•.e¢ . .«ice ase$,, &£._,iks,'4-a BU ILDING ADDRESS: HOT WATER INC PERMIT NO„5 0 5 0 115 OW NER'S NAME: PERMIT ISSUE DATE ONE: SANITARY 0. CONTROL NO. ARCHITECf/ENGINEEN: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH _oo LICENSED CONTRACTOR'S DECLARATION Job De o///JJJ o G I hereby aflnm Nu 1 am li¢nud under provision of Chode, 9(commencing q�� 1� U with Scclion 0M)of Division 3afthe Business and Profecaione Code,and my license is til®`� fTN�� ^ H in full force and effect � `'��.�• o 5qi Lic..aeClass Lic.N REPLACE WATER HEATER nHpBar¢ Costracwe A CMITECTS DECLARATION _" 2005 g¢ k I undersand my plans shall =it n public recorH �yU ;off Licensed Professional ��®� S OWNER-BUILDER DECLARATION y� .�i F 1 krchy affirm Na 1 em exempt from the Contractor's License Law for thetqr`�`— 00 following mason.(section RA fess I.5,Business and Proion Calc:Any city or county m which.quina a permit m construct,aloe improve.dcmollsh.or.,.it any shupum prior tit its issuance.also,Rquires the applicant for such Permit.rile a signed summcm that he is licensed pursuant o the provisions of the Contractor's License Liw(Charter 9 Sq.Ft. Floor Area Valuation toHn (commencing with Section]Till0)of Division 3 of the Business and Professions Code)or i $ that In is exempt therefrom and the basis for the alleged exemption.Any violation of Septan 7031.5 by airy applicant for a permit subjecu the applicant to a civil penalty of 3 y�$I It�rk�erp p Occupancy not more than five hund.d dollars(SKID). P Y Type ❑1,az owner of the property,or my employees with wages as Noir sole compensation, will do the work,and Be stmcnse is not intended or offered for sale(Sec.](144,Business and Professions Code:The Contractor's License taw does not apply.an owner of Required Inspections property who builds or improve tharcon.and who does such work himself or through his own cmployces,provided Our such improwoncou art not intended or offered for We.If. however.the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving Nat be did not build Or improve for purpore of sale I ❑1,as owner of the property,am exclusively contracting with licensed contractors to convect the project(See.704d,Business and Profession Code:)The Commerce's U cense taw does not apply to in owner of property who Wilds or improves tiamon,and. who contracts for such projects with a contractor(s)licensed pursuant o the Contrac.Ys License Law. C]1 am exempt under Sec. .B&P C for thin mazon Owner Date WORKERS COMPENSATION DECLARATION 1 hemby affirm under penalty of perjury one of the following doelmations: 1 Its and will manual a Certificate of Consent o self-imum fm Worker's Compen- sation,az provided for by Section 3]00 of Ne labor Code,for the performance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance,as mqui.d by section ]UO of Ne Labor Code,for Ne performance of the work for which this permit is issued. My Worker's Compensation lnnsum�bee caner and Policy number am: Cartier. s>f 7'T.t-lite /U fVC� Policy No.: ISy(J CERTIFICATE OF EXEMMON FROM WORKERS' COMPENSATION INSURANCE (Thea section need not k Completed if the Permit is(sone hundred dollars(SIM) or less.) 1 certify that in thc performance of the work for which this permit Is issued.I shall nut cmploy any'pefson now,mater,4as tabe�omgsbubjcct to the Wnkeri Compensation Laws of Californiapati / S � Applicant Nn PR - NOTICE TO APPLICANT:if,after making this Certificate of Exemption,you shoo Id become subject to the Worker's Compensation provisions of the tabor Code.you most .,z forthwith comply wit such provision or this permit shall k deemed revoked. z CONSTRUCTION LENDING AGENCY Fw� Ikmby affirm that them is a construction lending agency for the performance or - CL the work for which this permit is issued(Sec.3097,Civ.C.) ILl Q Lcodcr's Nam. 6. Lenders Address 7z U 0 1 certify that 1 have read this application and arm,Net the show information is D. P coned I agree.comply with all city and county ordinances and stare laws relating Or 0 U building convection,and hemby moheri.mpresemuivesof Nis city.enter upon the � Ibl above-mentioned formerly for inspection purposes. (We)ag.e to save,indemnify and keep harmless Ne City of Cupenino against y liabilities.judgments,casts and expenses which may in any way neme against=]it City U in consequence of the granting.(this pefmit. ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURSR }-AnONS. iY%p7f s��3�D.S Re-roofs Sighiat ru o orA llcanl/C.elra.lof Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will th,applicant or future Wilding occupant store or handle brrallous material az defined by Be Cupeninct Municipal Code.Chapter 9.12,and Ne Heahh and Safety ewe se.ac,zss3zarr All roofs shall be inspected prior to any roofing material being installed. o Ye Will the applicant or tet..building..,an,use equipment or Jcvl.es which If a roof is installed without first obtaining an inspection,I agree to remove it hazardous air contaminants az define the Bay Area Air Quality Management all new materials for inspection. isuict] Yes 1 have mail the harndtme materials requirements under Chapter 6.95 of the Califor nia Heath&Safety Code,Scedats 25505,25533 and 2553x.I undersund that if the Wilding _ Jars net cwc oly haus a.nam,Nal it u my responsibility m hairy the asupam of the, .quem cgs irnmtrstkmetpr;9rroiaeanan[aCcmfieteer spa�nyr,. Signature of Applicant Date T All roof coverings to be Class"B"or better Owner or authomcd agent pram Community Development' 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPEI�TINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: 00 e Z C-1,du PHONE # _ .- GENERAL CONTRACTOR f � r �, FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 65 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 lastering ,L Plumbing �/ !j t (�1fCke� �n G. L2/3/ / Roofing Septic Tank Sheet Metal Sheet Rock Tile�, / i'�l lti r �3 r�S Owner/Contractor Signature Date �- CITY OF CUPERTINO /�- WATER NEATER S CUPEkTINO PERMIT APPLICATION FORM APN# 3/ � �O O/ Date: Burg ress: r Owner's Name: Phone#: lk,mle-1h4 c- ela� - B SJ Cactor: Phone: License#: Contact::. Phone: Cupertino Business License#: Building Permit Info: Bldg ❑ Elect ❑ Plumb L5' Mech ❑ J Description: ICLcQ l,( cz*6r <�gisiln « S cies 7_r- ' �x�r or Residential Commercial ❑ Cost of Project: O Strapped On Platform ❑ Bonded ❑ ® New Location ❑ Replacement Qty. if Applicable Fee ID Fee Description Fee Group BPWHEATER Water Heater/Vent BUILDING PPERMITFEE Plumbing Permit Issuance PLUMBING BENERGY Energy BUILDING BUSLIC Business License BUILDING 2,�-7 � � CITY OF CUPERTINO oro BUILDING DIVISION PERMITCONTRACTOR,INFORMATION BUILDING ADDRESS: BECKS ROOFING PERMIT NO.05100015 19858 BAYWO OWNER'S NAME: PERMIT ISSUE DATE SHARON PARODY 6191 OCHO RLOS DR 10/05/2005 NE: SANITARY NO. CONTROL NO. (408) 365-8979 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 000 LICENSED CONTRACTOR'S DECLARATION lob Description m❑ I hereby aff rue that I am licensed under provisions of Chapter 9(commencing P �z with Section 7000)of Division fthe Business and Imfemion licenx6 m mu rome aaJ er `-(� REROOF--T/O TAR & GRAVEL �I�NSTALL COMP. j�: Lianx Class Uc.a_ nFa Dam Coodomte, A'1' 3'Y'j '� ARCHITECTS DECLARATION a Ven rf� ey¢ 1 understand my plans shall'E used as public records :' Y`(//Y✓`yy litu -o Lice read Pntfcssional n v,3 OWNER-BUILDER DECLARATION ray 1 hereby affirm that I an exempt ffum the Conuacsor's Lieenx Law for she '7S 00 following reason.(Se,cuan 7031.5.Business and Professions Code:Any City or county e m which requires a permit to construct,alcoimprove, m r. demolish. repair any structure A gr )�'to r $8500 prior or its issuance.also requires the applicant for such permit to file a signed statement .moi ag.77 that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq. Ft. Floor Area arxxvv/5 ,' ,,Valuation yFo (commencing with Section 7000)of Division 3 or Ne Business and Professions Cmk)or VB y,!'� �.4 y $ that he is exempt themfmm and the basis for the alleged exemption.Any violation or MWr sl Section 7031.5 by arty applicant fora permit subjects the applicasuo a civil penalty of ANr Od-c6pancy Type not mom than fm hundred dollars WWI. 1,as owner of the property.or my employees with wages a their sole compensation, will do thework.and the someone is nosimended of offered I...I.(See.7044,Business Required Inspections and Professions Code:The Comeacmfs License law does not apply m e ns an owner of 9 P property who Wilds or impmau doncon,and who does such work himselfor through his own employees,provided Nat such improvements tie not intended or offered for sale.If. however,the building or improvement is sold within ane year of completion,the comer- builder will have the burden of proving that W did not Wild or improve for purpose of salt.). ❑1,as owner of the property.am exclusively contracting with licensed contractors to conmuct the project(Sec.7064,Business and Professions Cade:)The Contncmr's Li- ve law dors not apply to an owner of property who Wilds or imprmes mamern,and who comment for such pmjees with a eommmor(s)licensed pursuant to Ne Contractors License taw. ❑I am eaam In under See. .B&P C for this meson Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following decloatiom: 1 ham and will maintain.Cenificam of Covent or self-insure for Workers Compere station,as provided for by Section 3700 of the Labor Code.for me performance of the , work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the tam,Code,for me peRarmare.of for,work fffoQo/rrq/��which aath��ispermit is issued. My Carrier.Worker' opens tion Ins nee carr' and I ry No.Y � LZ Camcr. CERTIFIC OMPE SATION'ION FROM W RKERS' COMPENSATION INSURANCE (This xesion need not W emoplered if the permit is foranc hundred dallam(310!0 r less.) 1 emily Nat in the performance or dm work nor which this permit is issued,1 shall not employ any person in any manner an,m to become subject o the,Workc Y Compensation Laws of California.Dam Applicam NOTICE TO APPLICANT:If,after making this Ccrti fens,of Eacmptian.you should Wcame subject o the WmkerS Compcnsatian provisions of dre Labor Code,you must .J O foMwith comply with such provisions of this Permit shall be deemed revoked. Z us CONSTRUCTION LENDING AGENCY [-+ Ihereby affrm that there is a constmninn lending agency for the perfurmanm of fYthe week for which this permit is issued(Sec.3097.Civ,C.) W Lender's Name D z Lender's Addnss U O 1 certify that I have read this application and state that me above information is 17. E' CmmCL I agree to comply with all city and county oNommecs and sok laws relating to 0 Wilding construction,and hereby authorin repremnatives of Ibis City to enter upon the r C[1 shove-mentioned property for impecuon purposes (We)agree,m save,indemnify and keep bafmles the City of Cupenino against mFi Taq liabilities,judgments.casts and expenses which may in any way eccmc against mid City U in consequence of the granting of this permit. APPLICANT UNDERSTANDS AWILL COMPLY WITH ALL NON-POINT Issued by: Date /v— SOURCE RE(.LILATt/�JS„ // �,1 /1)6 <u /V///✓/ Re-roofs f Signature orApplicare/Contruc, Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant Or Mrut=building uccuonrman,or handle hazardous material fine az ded by the,Cupertino Municipal Code,CTapomr 9.1 i.and the Health and Safetyde.Section 25532(3)7 17+r All roofs shall be inspected prior to any roofing material being installed. ❑Yrs Will the applicant or future building Occupant tax equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove it harardnus air contaminants as defined by thc Bay Arta Air Quality Management all new materials for inspection. DISUICO , ❑Yes Nu Ihave rem!them,Seems 25505lsncqui nd eas 25534JcrderMDt. tard.95oDM Caldi /N /� �� — �y ✓ for ria Hcalm&SnfctyCodc.Sccuom25X15.25533 end 25576.1 understad thatirthbildi1/ L� Jan not currently have a mnana t it is my responsibility o no my.iremen ria esteem 'armisomeraf.CerdfeaxSignature of Applicant Date Owner or amhodmd agent All roof coverings to be Class "B" or better .� Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 �UPERTINO B-uilding De artment JOB ADDRESS: 1 g �0Dn PERMIT # I J 0S'/ 00011r OWNER'S NAME: W WZ4 PHONE # GENERAL CONTRACTOR: 6-2 FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 60 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 (C7 Septic Tank Sheet Metal Sheet Rock Ahl Tile :�j Owner/Contractor Signature Date Community Development Department t Building Division S, City of Cupertino 10300 Torre Avenue pCI[TY Of Telephone: (408)777-3228 U P E��I I AA II V o 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 compI with the above Ztedpolicy on re-roofing. Homeowners Name: � Job Site Address: I D D /i'l 9d) I Roofing Company Name: S �T Applicant's Signature: / 0 e a A i Date: Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper CITY OF CUPERTINO C REROOF CUPERTINO PERMIT APPLICATION FORM APN # � I � /Z— Date: Building AddresW U O is Name,: Phon # SO T .Q ZZoo/o tractor: / _ j�S Phone L License #: Contact: ._ r(JJ' Phone#: r Cupertino Business License #: Type of Roof Covering: Existing: Proposed: Built-Up Roof ❑ Built-Up roof Asphalt Shingles Asphalt Shingles ❑ Wood Shakes t 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: ❑ J Description: b/ I Residential r Commercial Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: Type A Construction: Occupancy group: 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 5�