Loading...
05070157 (2) CITY OF CUPERTINO 'o y °"•' BUILDING DIVISION PERMIT CONTRACTOR' E RMATION _ vibti «T'.,n«�e9R=` �K 1t'&. �✓.A^'Y9i.�3 BU[LONG ADDRESS: FOUR SEASONS ROOFING PERMIT NO.05070157 OWNER'S NAME: PERMIT ISSUE DATE HAMILTON PHILIP E: SANITARY NO. CONTROL NO. 408 278-0330 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH moo LICENSED CONTRACTOR'S DECLARATION G 1 hereby air,,.that 1 am licensed under provisions of Chapter 9(commencing Job Description U with Section 7M))of Division 3 of the Business and Profession COW,and my license is neR inrallram aenecL 39 REMOVE EXISTING ROOFING APPLY 1/2 PLYWOOD 30 LB LieenwGlasa Ll. u�alo8 SFO Dam �Y z�—cantraetar FELT 40 YEAR GAF �ASPHALTj'§H G E tJ` ARCHITECTS DECLARATIO (1 i'I 'i, tl ce U 1 undersunJ er plans shall W used az public records �J spin Licensed Professional ` 5 OWNER-BUILDER DECLARATION UUII�IG — -- 'yyi f 1 hereby affirm that 1 am exempt form life Contractor's License Law for the p O following mason.(Section 7031.5,Business and Professions CWc:Any city Of county / C ex8! which requires a permit to consumer,alma improve,demolish.or repair any structure d"al y �}' a]i ift ryr. a 0 n °iso priorb itsissuance.also requires the applicant for such permit to file a signed statement ( �� -Ri that Wislicensed purmanttothe pxvi,im.oftheCmurscbr3Licovmlaw(Chapter 9 Sq.Ft. Floor A'ieaAa B �s// INJy�li Valuati$is 0 0 0 x11-0 (commencing with Section 7")of Division Sof the Business and Professions Cuae)or V I `�I �I i that he u exempt therefrom me the baso for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy T e not mare than live hundred doilan($500). 34242028 . 00 '�� `�P FIN 0I,azowmroftAe property,or my cmploycuwith wegesazthcir sole compensation. IIII windo the work.and me structure is notimmnded oroffered formic(Sec.7044,Business Required Ins ection and Professions Code:The Contr actor's License Law does not apply to an owner of 9 P 179 9 prepeny who buildsmunprows thereon.and who doessuch work himselfor through his q��f. own employeesar ,provided that such improvements e not intended oro@red foram,If. FF N9N5 however,me building or imporve cut is mid within one year ofcompledon.the owner. builder will have the burden of proving that he did not build or improve for purpose of ���ptp�pJ]}), tI I1(1 {may yR 01. •� ��L1' �11 Jia. - Q L as owner of ct property,am exclusively masd contncting with licensed conlrmbrs m IILI,Y//t/t tl Y \[I1/�aY/=�dy ceme La d project(Sec.)044,Business and Rpwhomn Cade:?The Conuanon,Li cense law dors not apply b an owner of property who Wilds or improves menton,and who eonuacts for such projects with a eonmcbKs)IiumeO pursuant in the Contractor's 1..law. 0 lam exempt under Sec. ,Bh PC for mit ntazon .,... Owner Date WORKERS COMPENSATION DECLARATION 1 hcmby amrm under penalty of perjury sae of the following declaration: - I have and will maintain aCenificateof Common to self-insure for Worker's Compere sation,as provided for by Section 3700 of the labor Code,for the perfamnance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance,as required by Section _ W q of the labor Code,for Ne performance of the work for which this permit is issued. My Worker Com(pens1ai ln5wona artierand Policy number are: k,r l/ carie, r`r H v Z Polity No.: �L CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (73115 action reed nut W eamplemd ittW permit is for one hundred dollars(5100) or less.) I cenify that in the performance of me work for which this permit is issued 1 snail not employ any person in any manner m W to become subject m Ne Workers'Compematiun Taws of California.Date Appiicam NOTICE TO APPLICANT:Ir.after making this Cenileate or Exemption,you should Mxome subject to the Worker's Compensation provisions of the labor Cade,you most J Z forthwith comply with such provisions or this permit shall W deemed revoked. 'Z'O CONSTRUCTION LENDING AGENCY I hereby aRsm mat dam is a construction lending agency far me perimmam:c of the work for which this permit is issued(Sec.3097,Ci,C.) Q Undcls Name z Lender's Address V C) I cenify that I have read this application and suite Nat me above information is e, P cormcL 1 agree to comply with all city and county On inances and sum laws misting to 0 building construction.and hereby authorise representatives of this city to enter upon the ah.w.somfurod property for inspection purposes. f^ G (We)agme b save,indemnify and keep harmless the City of Cupertino against fA liabilities,judgments.casts and expenses which may in my myaccrue against said City U in consequence of the granting of this permit. !� ^ APPLICANT UNDERSTANDS&dp WILL COMPLY WITH ALL NON.POINT Issued by: Date '7 (1' SOURCEREGDGI$l �G 7 —'Z- Re-roofs f Signabrc of Ap,li,mVCom Dam HAZA MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant sum or handle havarduus macrud az calmed by tho Cupertino Municipal Code,Chapter 9.IS,and the Health and Safety cave.Dr s zss3z (a )? All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future brooding..,Of mm egaipmemt of devices whichIf a roof is installed without first obtaining an inspection,I agree to remove emit havarenus air contaminants as delncd by the Bay Area Air Quality Management all new materials for inspection. District? sr� D Yes 1 have read the haaaNnuxmamrialsmyuimments under Chmarb.95 of the Cables- niaHcalthASafctyCodc.Sccduns 35N)5.25533 and 25534.IundcrsmnJ thazifthc building Ci_ 2 _07— does notcumcnd have a¢mnL Out it is my mspamno Feasibility b noddy Me occupant of thc requircin in or issuNRofaCCNficabafQNpmey. Sign reoY_A 'can[ Date Owner ser authorizcJ agent —2 Dam of coverings to be Class"B"or better CITY OF CUPERTINO I� 5 of 5 PERMIT RECEIPT OPERATOR: suem COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34242028.00 DATE ISSUED. . . . . . . : 07/26/2005 RECEIPT #. . . . . . . . . : 30508 REFERENCE IO # . . . : 05070157 SITE ADDRESS . . . . . : 10207 CAMBERLEY LA SUBDIVISION . . . . . . . , CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HAMILTON PHILIP J AND KAY S ADDRESS . . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2632 RECEIVED FROM . . . . : CARLOS CAZARES CONTRACTOR . . . . . . . : DIAZ, ALFRED LIC # 21323 COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING ADDRESS . . . . . . . . . . : 502 HORNING ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408)278-0330 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL BPERMFEE VALUATION 6,000.00 126.36 0.00 126.36 0.00 BSEISMICRE VALUATION 6, 000.00 0.60 0.00 0.60 0.00 TOTAL PERMIT 126.96 0.00 126.96 0.00 METHOD OF PAYMENT AMOUNT NUMBER _________________ ------------ _________--_------ OTHER 634 .80 VISA TOTAL RECEIPT 634 .80 • r Community Development 0 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 ®UPERTINO Building Department JOB ADDRESS: PERMPr# 1,020 7 o SO ? ois-7 OWNER'S NAME: PHONE # GENERAL CONTRA OR: S AX # I am not using any subcontractors: 7_ 6 Signature Date Please check applicable subcontractor's 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 Owner/Contractor Signature Date Community Development Department Building Division City of Cupertino • 10300 Torre Avenue CITY Of Telephone: (408)777-3228 L U P E IST I N 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 comply with the above stated policy on re-roofing. Homeowners Name: ZAS/; lob Site Address: e° Roofing Company Name: Applicant's Signature: Date: al_ • Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper EE-. CITY OF CUPERTINO 4CUPEkTINO RFROOF ITY PERMIT APPLICATION FORM �IS 2 `I 6 . Date: 7-25--o5- Building 2 . —©SBuilding Addre 100_7 O er's Na e' y Phone#: i �r Co ctor: Phone � Licens #: �S// Co�c . Phone#:fes Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles 1Z, Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles / ❑ Wood Shingles ❑ Other(Specify) �'i°�a/ / ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and ill Cqmp,1 With Cu ertino's Tear Off Polic : Description: O� �2 're 0 Ale Residential o ercial ❑ t '�07 Fire Zone: Yes ❑ No Confirmed with Planning De t. if there are any restrictions: (Yost of Project: T of o ruc 'on: Occupancy group: ff, 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