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06080012 (2) CITY OF CUPERTINO +s' BrJILnING rAVISION PERMIT u CQN' l.I2"AC�TCI'R'CNI�Ui7M*a'T°T� 4 BUILDING ADDRESS: s - PERMITNO96 O 8 O 012 10698 LARRY WY OWNER'S NAME: PERMIT ISSUE DATE EANEFF CHARLES S JR AND LO RAI 09/02/2006 NE: SANITARY NO. CONTROL NO. a ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 %c O LICENSED CONTRACTOR'S DECLARATION FF I hcrtby affirm thu 1 an lice med under provisions of Chapter 9(mmmenein{ Job Description with Section 7000)Of Division 3 of the Business and Prgfeadaru Code.ad my license is <n, in full ftcoaMeff I REROOFING 3/4 OCB 30 FELT CLASS A � omaClw - -swamis �� HILL BROTHERS CONSTRUCTION PAID FOR A B/L TODAY 1 ARCHITECTSDECLARATION i aZ I undenlend my pals mall be used as public records i� C Licensed Professional rct OWNER-BUILDER DECLARATION S i hereby aRnu that I an attempt room the Conuaerars License Law for the o O following reason.(Secean 703 IJ.Business and Professions Code:My city of m.my �rJ,'.� i$ which requires a permit to carearuet allot aPmw,demolish,or repair my structure r— primmie usumre.Aoo regains sew applicant for sch permitw Rle assigned nuemam 'e '9wn JAr.ValuatlP - < that heh Iiccmmd pumsml m the pmvisiom of W Comrcmr't nm UccLmw(ChIPtr 9 Sq.Ft.Floor Area H 2 0 0 e� S tham a is stamps Saban and the basis for thea B ed axe and on.Any ns Cade)or dial a u exempt therefrom and W bah(m the alleged exemption.Any vlandon of h section 7031_1 by any appBanl fm a permit subjects the applicant to a civil pasahy,of APN Number • �' ccupancy Type .at same than that hundred da1Wa(M). 31602036 . ( 0 mwna es a ❑l,as caar of the property,or my ployewwagtheir sale compasoulon, I rein. iss will do the wank and the suuctore Is not intended or offered for We(Scc.7044.Business and Poofessions Cade:The Centimeters License Law Ones mal apply man ewmr of pmpeny who bullMw improm tin mm.mdwhodmasuch wmk hamelfar Waugh his wn emPb)m,provided thu w..a Improwmanu ere mtinleMN"offered rm esse if. bonev",the building or impoowment Is aid within on yea of compledoa the Owner. builder wed aw the burden of proving that he did ant build Or impeow(m purpose of ❑1,u war of thw property.sm ael"imely contracting with limmed caucmn to construct the project(Sec.7044.Business as Professions Code:)The Communes U. cam law does Out apply as m owner of property who W(Ids or imPoOM thereon.and. who convects for such projects with a mntractr(A licensed pumuanl mew Contractors License Law. ❑Iamexcuplunder See .B&PCformosemon Owner Dam WORKER'S COMPENSATION DECLARATION 40 1 hereby Arum under penalty of perjury am of the following dedluadoes: I ave and will maintain a Ce urlestetf Conaenito self-Imam for Workers Compen- su(on,an provided for by Section 3700 of W Lab"Code,for thw perfmmmm of W wark for which this Permit is Issued. ❑1 haw and will maintain Workers Compensation Insurance,u required by Section 3700 of the Labor Code,for the perforations:of the wart for which this permit is issued. My Warkch tmpenaWonl mea carti"md Policy number me: Cornier. Poliry Ne.:,.�"Z 9� ERTIFICA •OFEXEMPTIONFROMWORKERS' COMPENSATION INSURANCE (This acdon coed ant W canpkwd Ifft permit Is faro"hundred dopers(1100) or less.) 1 unify that in the pMarmance of the wort for which this Permit is issued,1 mil net employ anypeson in any mmnefm m m become subject lathe Worken'Compemadon Laws of California Data _ Applicant NOTICE TO APPLICANT:If.arm,making this Coolness of Emmpdon.You shout become whim in the Workers Compensation Pearlman,of W labor Coda,you mum .J z faMwith comply with such pro,bdom or this permit shall be rimmed rewked. CONSTRUCTION LENDING AGENCY [-r I hereby of ino dam Were is a construction lending agency for the performance of " the work fm which this permit h issued(Sec.3197,Ck C.) 14 Q Lenders Name Q z Lenders Address U Q I certify that I haw read this application and Nm that the show informatlon h U,F correct.I agree in comply with all city ad county aNlnances and sum laws miming to Q V Wilding construction,and hereby suthorim mpmsenutiws of this city to enter upon Nc W about-mentioned properly for inspecuon Purposes (We)agree to saw,indcmmry and trop harmless W City of Cupenino agsinsl rl"'r to liabilities,judgments.amu and expenses which may In any way ac000e against said City Uz in consequence or the psna{of this Pmnil. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE REOU NS. _= _ ;/-,:) 717, Re-roofs Si{vuure a/Applbutur meant Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant m future Wilding(muPantuare ff media hlzb*W"aerial at&ford by 0th Cupertino Municipal Codc.Chapter 9.13.and W Health and Safety Cade.SttNan 25532()7 All roofs shall be inspected prior to any roofing material being installed. ❑Yas ON. Will the applicml or mare Wading o"upsm um equipmcM an devices which If a roof is installed without first obtaining an inspection,I agree to remove it avamom alt contaminants a de0ned by W Bay Area Air Quality Management all new materials for inspection. Distiict7 ❑Yes 0 N IIs read the h"ardnua materials mquinrmnts under Chapter 6.93 ar the Califor. nit Health&SAely Cok,3ccew2550S35533 wW 25531.1undenund mmirea building rime not currently haw a mnm4 into[tie my nsponsihlllty w nmil'y W mcupanl of the requirements wh' be mel prior m ivuaceafa '(kat of Signa e0 Kant Date Own""orm E a agent Data All roof coverings to be Class"B"or better CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: kiersaw COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31602036.00 DATE ISSUED. . . . . . . : 08/02/2006 RECEIPT #. . . . . . . . . : 35485 REFERENCE ID # . . . : 06080012 SITE ADDRESS . . . . . : 10698 LARRY WY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : EANEFF CHARLES S JR AND LORRAI ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2057 RECEIVED FROM . . . . : HILL DEVELOPMENT CONTRACTOR . . . . . . . : LIC # COMPANY . . . . . . . . . . : ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , TELEPHONE . . . . . . . . : OE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ______ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 4, 000.00 104 .76 0.00 104.76 0.00 BSEISMICRE VALUATION 3,200.00 0.50 0.00 0.50 0.00 BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00 __________ __________ __________ ---------- TOTAL PERMIT 210.26 0.00 210.26 0.00 METHOD OF PAYMENT AMOUNT NUMBER ________ ___ ------------------ CHECK ___ _______CHECK 210.26 2350 TOTAL RECEIPT 210.26 • Community Development - 10300 Torre Avenue i1' ' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333PEI�TINO �U Building De artment JOB ADDRESS: PERMIT# OG' 060 �00f2-- OWNER'S AME: p o PHONE # GENERAL CO OR - n , 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 • 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 actor Signature Date CITY OF CUPERTINO REROOF • CUPERTINO PERMIT APPLICATION FORM APN# '31 —7D—a—te, Building Address: Owner's Namq:IPhone#: a Contractor: License#: Contact: Cupertino Business License #: 4-:5Q p os Type of Roof Covering: Existing: Proposed: ❑ Bui t-Up Roof ❑ Byilt-Up roof 61---Asphalt Shingles Asphalt Shingles C3 Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# a---ro be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: i a 31-11 OCA 30 Residential [rte C ercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project: Type pf Con ruction: Occupant grT 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 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 V4 " 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: A �a �tiE p J11 Job Site Address: Roofing Company Name: Applicants Signature: Date: . Greg Casteel Building Official Revised 11/2/04 Aug 30 06 03: 27p Lorraine Eaneff 408-564-4109 p. 1 08/30/2008 15:08 FAX 408 777 3333 CITY CUPERTINO IQ 001/001 CommututY Devdopmmt 10300 Tonc Ave= I hmcCupatina CA 95014 Telephone(408)777-3228 1 Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: I Ot oy 8 1 I- PEST# CUM/,,m'2— OWNER'S NAME: ll/'I 1--4: PHONE# -vVw GENERAL CONTRACTORFAX# �I am not using any subcontractors: S - usT 30, 2Cse S Date Please check applicable subcontractors and com le followinz information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring- 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 -4 Owner/Contractor Signature Date