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04100083 (2) CITY OF CUPER'1'INO + osv r BUILDING DIVISION P> RMIT CONTRACTOR INTORMATION a ter. �d p,,.. , . �, -per BUILDING ADDRESS; OMAEGER CONSTRUCTION INC PERMIT N0.4100083 1032 CANYON VISTA DR OWNER'S NAME: PERMIT ISSUE DATE Al RANCHO DEEP CLIFF HOA 605 COMMERCIAL ST 10/13/2004 so IIONI;: SANITARY NO. CONTROL NO. (408) 536-0420 ARCHITECUENGINEER: BUILDING PERMIT INFO n ee©m ELECT PLUMB MECtI LICENSED CONTRACTORS DECLARATION 1^m ad B^ Y, g O O 1 hereby from,hat I am licensed under provisions of Chapter 9(commencing Jig. I eJSCrI.W UUkt Zt„ with Section] p fDivision3ofthc Business an ,tyfcssions Co dc,and my license is ffffffP@mmmmm t ;„ mmurnm'a I 14 REROOF W/DURA LAST p�? nr0LiCl RCIIITF,CTS OECLA N APR 290 5 �y�u 1kt�`=�u—nd^er'�a�J�my�hall he used as publk-cenrJs .0 gLicensed Procssional OOWNER-BUILDER DECLARATION � L ®I ay 1 hcrchy mr,m that I am cscrop,fru. be Contractor's Laccase Law lar the 00 fullawing reason.ISc,ion 70315.Business and PrnEs.cort,Code:Any lily air county cu m fi which requires a Permit fit construct.a1mr.impro e,demolish,or repair any structure $10100 X"¢i is licensed pursuant to the thoiisiosof for mchpermit LrinseLacdxatemcm < tnatheisliccnscJpurswnnO,h.provisi�nsnf,bcCnnuactur'sLimnxlaw(Chapm,9 Sq. Ft. Floor Arca Valuation `s�° (commencing with Section 7")(if Division 3 of the Business and Professions Code)or i 3 that he is eaempl Ihcrefrom and dm basis for the alleged exemption.Any vinfil on Of Section 7031.5 by any applicant for a permit subjecks,he applicant to a civil Penally of Ile Occupancy Type not more Nan rive nummd dollars($10)). P Y YP ❑1,M Owner of the property,or my employees with wages ss their sole compensation. will do Re work,and the structure is not intended Lir offered far sale(Sec.7044,Business and Professions Code:The Convenor's License Law does nes apply to an owner of Required Inspections property who builds or improves thereon,and who does such work himself or through his own cm ployces,provided that such improvements are not intended or offered for sale.If, however.the building or improvement is sold within One year of completion,the owner. builder will have the burden of proving that he did not build or improve for purpose of sale.). [) L as owner of Be property,am eulusivcly cartooning with licensed comments 10 construct the project(Sec.7044 Businees and Professions Calc:)The Contrae.r's Li- cense Law does no,apply in an Owner of poll who builds o,improves themon,said who contracts for such project with a contractors)licensed pursuant o the Contractor's License Law. Ej 1 roe eaempl under Sec. .B&P C far this mason Owner Dalt WORKERS COMPENSATION DECI-ARATION I hereby affirm under Penalty of perjury one of the following declarations: ❑1 have and will maintain a Certihcnte of Coo urat In Ulf-insure for Worker's Cumpen- saBon,as provided far by Section 3700 of thc labor Code,fur the perfmmarce of the work for which Nis permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 77(1(1 of the IaMu Code,far the peounnare,of the work for which this permit is issued. MY�Wo��rkk�er'ss.,C�om�,paution Intention artier and Polley num her am: Cartest�� 1 lacy Nu.:IWORERS47-43 ✓✓// CERTIFICATE OFE%EM ION FROM WORKERS' COMPENSATION INSURANCE oressection need no,hecomple,ed iron permit is rot tine hundred dollars($0M) ar Ices.) I scnify Butt In the pofa m uce of the work for which this permit is issacd.I shall Bol employ any person in any nPanner an ss.became subjecumhe Workers Compensation - Laws of Calirroma.Dare Applicant NOTICE TO APPLICANT:If,after making,his Ceniticme of Eump,ion,you should motion subject o the Worker Compensation provisions of the IaMm Code,YOU must Q z forthwith comply with such provisions or this permit shall b.deemed invoked. Z O CONSTRUCTION LENDING AGENCY ;-i Ihemhy affirm Nat there is a cunstruc,inn lending agency lar the performance of x the work for which this permit is issued(Sce.3097,Civ.C.) 117 F) Lend.,',Name Le z nder's Address U Q 1 certify Na,I have rod this application and sate that,M1c above information is correct.1 agree to comply with all city and county ordinances and sure laws relating to Q U building cumparuction,and hereby amhcrin mpresestalins of,his city to Cofer upon the above-mentioned property for inspection purposes. y (We)agree to save,indemnify and keep harmless the City of CuPcnirm against Numb tics,judgments.costs and expenses which may in any way accrue against amid City � 'y �•l U z in consequence of the granting of this permit. .- APPLICANT UNDERSTAND ND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC REGU NS. Re-roofs Sul a ApplicanUCOMaUUOi b Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applicant or future building Occupant store or handle hazardous material ss defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety "doibLcode. �p )? All roofs shall be inspected prior to any roofing material being installed. Will the licam o,future building«ea ant use a If a roof is installed without first obtaining an inspection, I agree to remove PP s P a Air Qu or devices whim �s e.h Districts sae air ennmmmtn,s a,defined by the Bay Area Ai,Quarry Management all new materials for inspection. Diavin? ❑Ycs 1KNo I have read the haordnus materials aquircmcnu un,kr Chapmr6.95 of the Califon (1�\ niallcalrh&SalctyCale.Sccmms 255115.25533 and 25534.1 undcrsmnd thsiftM huiWmg ser O ,�I� .--�� LI) does no,to By taw a Icrant.Brum tics my respunsiml'uy in nndly the occupant n1 Na '1-' }'�� , )—o-_/ I 11 rt mrnmu:,,��!run,Pati,rosmnenoraCenficaeofOccupancy, Signature of Applicant Date 1'�~ " "F �1(1-13-oI All roof coverings to be Class "B" or better �.r or enthonzcd agent Dam ,,,,. Community Development 10300 Torre Avenue ice' Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 �UPEI�TINO Building De artment JOB ADDRESS: PERMIT # crn OWNER'S N �,- PHONE # GENERAL CONTRACTOR: FAX # 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 O 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 taw City of Cupertino Pr 10300 Torre Avenue Telephone: (408)777-3228 IUPEkTINO CITY OF 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:_ r ® 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. 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: AW>2- &I 4 kA l I 4r r Job Site Address: 0A Roofing Company Name: P A plicanY(s S�ig�nature:® Date: 0-)3_n L/ \�l/�LISDC.X1 Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper au- CITY OF CUPERTINO REROOF �{ CUPERTINO PERMIT APPLICATION FORM APN # 3S / Date: _a Building Address: �w Owner's Name: Phone#: Contractor: Phone#: License#: 10 7 1 l ontacf. Phone#: CupertinoBusiness License #: Type of Roof Covering: Existing: Proposed: Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify Number of existing coverings Ta= Provide I.C.B.O. Report# bo rc, — e s ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: _ r Residential ❑ Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if there are any restrictions: LJ Cost of Project: Type of Construction: Occupancy group: Qty. if A c e 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 � 7