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04040162 (2) CITY OF CUPERTINO � �¢ - - BmLDINGDIVIS1oNPERMIT ico '''T; RINFORMATION-` BUILDING ADDRESS: _ SKYLINE ROOFING PERMIT N`b4040162 10650 MERRIMAN RD OWNER'S NAME: PERMIT ISSUE DATE DANIEL DUARTE 1630 FOXWORTHY 04/26/2004 10 ONE: SANITARY NO. CONTROL NO. (408) 353-3935 ARCHITECT/ENGINEER: BUILDING PERMITINFO BLDC ELECT PLUMB MECH Oo LICENSEDCONnRACTOt, alwW as ICON' ' 1herebyaffirmthat 1t3 ftheBuunderProvisionsof,Cod v(commencing -Job Description FINS with Section]IXllB of Divixion3of Nc Business and Profcssiens Codc�yli�Ell ea li� nfull force and L. 7 t f REROOF ��� Date sc Class x`39' Cntinuer MAY i"- ' 2004 ¢F¢ ^ AR HITECTS DECLARA ION jv a:� I understand my plans shall he used as public records DWu R� It Licensed Professionsl Be,V10`�IN g OWNER-BUILDER DECLARATION V CC a I I hereby affirm that 1 mm exempt from the Contractor's License Law for the p O following reason.permit t IIonstr Business and improve, demolish, Code:Any city or county K$ which its requires a permit ra quires the alter,improve,demolish,or repair any structure 110 0 yZi prier to ireceevance,also edpursuant to The the applicant forsuch the Cranston's o file a License Law(Chaptem ppxp that mtreaingwiJ pursuant 70he pmvivision 3 oM1eCn usinesandPnussons Coal)or Sq.Ft. Floor Area Valuation (cayt- Oaths is exempt Section7000)the Divisionr of mtheeged Business and Any violation or i Netio is exempt therefrom.and Ne beer for bj alleged exemption.Any vitiation of �v�.���_ Sections, him L w any applicant rm a permit subjects the applicant to a civil pcnehy of a.WLLYIBE10 0 Occupancy e not more than Ere hundred dollars(1500). 3 p yTyp 1,or owner of the property,or my employees with wages as draft sole compensation, will do Ne work,and Ne suucture is not intended or offered forsale(Sec,7W Business and Professions Code:The Contactors License Law does not apply to an owner of Required Inspections Property who builds or improves thereon,and who does such work himselfor through his own employees,provided that such improvements are net intended or offered for sale.If, however,Ne building or improvement is sold within one year of completion,the owner- builder will have the burden of proving Nat he did not Wild or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contacting with licensed convenors to construct the project(Sec.7044,Business and Professions Code:)The Contractors U. ccme law docs not apply to an owner of property who builds or improves thereon,and who cuntroals for such projects with a contracmr(s)licensed pursuant m the Contractor's License Law. ❑ 1 am exempt under Sec. B&P C for this reason Owner Dau WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a Certifrcam of Consent to self-insure fur Wmker's Compem solar,as provided for by Section 3700 of the tabor Codc,for the performance of the t work for which this permit is heard. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 37M of the labor Code,for Lie pnformance of Ne work for which this Permit is issued. My WrAl Compensation Insurance carrier and Policy number are: //JAt Carrier: Policy No.: rCj CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need nor he completed if the permit is forone hundred dollars(SINN r less.) I coolly that in the perroar ance of the work for which this Permit is issued,I shall not employ any person in any manner so as ba become subject I.the Winkrox Cnmpen anion Laws of Confer Data Applicant )n ^ NOTICE TO AP Lhe Work If,Compensation chis Cisions of of Exemption,you should become subject to the Worker's Compensation provisions of the deemed Code,you must ,JO forthwith comply with such provisions or this permit shall Wdecmcd revoked. 'zN CONSTRUCTION LENDING AGENCY [+ I hereby affirm Nat Uere is a comvuction lending agency for the performance of !Yi 7 the work for which this permit is issued(Sec.3097,Civ.C.) aQ Under's Name z Lender's Address V Q 1 certify Nat 1 have read this application and stare that the above information is (y coffee(.1 agree to comply with all city and county ordinances and sure laws relating to V building construction.and hereby anthorim opmacluativcs of Nis Cl ry to enter upon the ra shove-ms,judgdproperty(and expenses Partwhich ms. (We)agree to save,indemnify and keep harmless the City of Calls o against V1 liabilities,judgmcnu.costs and expenses which may in anyway accrue against laid City U, 5 in consequence of the granting of this permit. EGU tr7� APPLICANT UNDERSTANDS AND ILL COMPLY WITH ALL NON-POINT Issued by: Date 'DO \ SRL 5 z n Re-roofs Signal— u e id Ap�ynVCommcmr Dam �- HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tic applicant or future building occupant store or handle BaNumus material - as defined by the Cupeninn Municipal Code,Chapter 9.12.and the Health and Safety aillikede,Section 25532(aj? All roofs shall be inspected prior to an roofing material being❑Yes q� p p y g g installed. Will the appi com or future buiwmg occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove ti(hacardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. Wrict? JJJ ❑ aIhIll. SNnu❑smayvi ChapterNe Calra Health &Sfety Cade,Sections md25534.Iunderstood tholif building does.to currently how a uolmWm it is"Arts' cAnotify the o1.10nof themquip;mtonccofacmreal;,lacapncy.� _ Signature of Applicant Date Own,,m aohorilad agent Date All roof coverings to be Class"B" or better Community Development 10300 Torre Avenue 9 Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 i1UPERTINO Building Department JOB ADDRESS: PERMIT # / OG >-U 1 © V6y0t-" 6 2_ OWNER'S NAME: A.2 PHONE # 3 3 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: 6 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 Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Community Development Department Building Division ' ;' City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 14 U P E kT I NOCITY 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. l 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. 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 stained policy on re-roofing. Homeowner's Name: N (� l G-L- 00,p�,CZ I G Job Site Address: Wl �1. ) Roofing Company Name: A plicant s Signature: Date: \N�1ti1D�Xl Greg teal Building Official, Revised 1/30/03 Printed on Recycled Paper CITY OF CUPERTINO REROOF v/�Z CUPEkTFINO PERMIT APPLICATION FORM APN# 7 2_ j / / 7 Date: Z C',_ay Building Address: 10050 /4,E29 t ,4)0J Owner's Name: Phone#: 4211 6 Jd N /t:L 00 A 62E Contractor: Phone#: 35-3„3 License: 7 9 / /Z6OF/ Contact: Phone#i,/ -74ye9j Cupertino Business License#: 91Cl Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles g Asphalt Shingles .2�Wood Shakes ❑ 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: Job Descrip 'on: ift Xakocla �Xf .cIG % PL /iJ.c�� v �6 Yr-+�R /1s�liAtj—SNN Residential k] Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are anrestrictions: 15 Cost of Project: Type of 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