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08040086 (2) CITY OF CUPERTINO *�L7�aiatapxc �°}��"'+ '� BUILDING DIVISION "• PERMIT f of TUAOTORWIN e��^,I��D,y PERMIT NO. BInLDIr� gjgEsMINER PL XTERIA INC 08040086 OWNEIR'S NAMEE: PERMITLSSUEDATA BOWMAN CYNTHIA J 1709A LITTLE ORCHARD ST 04/11/2008 NE: SANITARY NO. CONTROL NO. (408) 289-5353 ARCHTIEC!(ENGINEER: BUILDING PERMITINFO BLDG EIECI PLUMB MECH �ssp6 LICENSED CONTRACTOR'S DECLARATION Job Descrlption 1 ncnby alone less 1 am Ikcucd under provisions of Chapter 9(commeming mW Sccdm7")of Divisim3ofthe Budnmmd Rofessiou Coale,mdmylkcniein RE—RF RMV DISPS EXSTNG TILE RF, INSTL CDX 1/2" real ran:anal g r Qa G10�2 z u«nann..•••n= 1—=t X& PLYWD 27SQ CLS A. BUS LIC NOT EXPIRED UNTIL Dale 4111!OG CanuaMr TSt�L- 4A l"(- ARCHnEC'S DECLARATION 11/30/8 1 understand my plans shall bo used an public ncerm 1 t w� Licensed Professional 50 OWNER-BUILDER DECLARATION N i 9 I hereby an0m that 1 am except from dr Coninctors Licence Law fon tW 0 0 following mason. arrut t 71m 1.5.a,Ate. and mm.do tans Cut:Any dry m county $ which equine,•permit in conswcL slur.improve,do Permit t a file a sig any statement ZS^ prim minsicused pruanquiru pthe applicant rorsuch do,Conpctor's iecrue sew ssaumem 3< Nu1nu11ceucJpurnunt7 N)OfDis on3NeConuecwrSllttnal io(Chapter Sq.F[. Floor Area Valuation kammenwate withmesion a nd)of 0iwtsiof 3 of the 9adneaara on.Any vi lade)of $13870 less r u eampt any appli and the bads for ubj alkged contraption.Any l imam of Salm 7031.5 five airy radiant fa a permit mhjeeU the applkant m•civil Penalty of Number Occupancy Type mtmanwnrtweudnddwlan(uom 31646034 Aff ❑1.an,owns or Ne property.or my wplay.with wages u their so to mmpeasednn, will do Ne work,and the structure Is rot intended or offend for sale(S=.7W,Business, and profession.Cudahe TContraenr;Lia,.e Law does Int apply m an awmr or Required Inspections property who Wlldaneimpravea thacon,and who dauaahwakhivurJlar Waugh his com employees,prvvlded that such improvements art not inueded aoRcne fousok.B. however,the building a improvement Issold within am year of oompledon,the owmr- builder will have W burden of proving that a did not build or improve for purpose of oak.). ❑1,u owns of the property..exclusively'"One ing with licensed conuacuns to construct an,pmjm(Sec 70x4,Business and Professions Code:)The Ccouaemrs U cense law dans not apply to an owta Of paopeny who Wilds ar improve,Norton.and . we contracts far such projects with acanuanarO)licensed putauant to the Contractors Liceve U.- 0 lamuempturea See .Bk PCfafddsnuon owner Data WORKER'S COMPENSATIONDECI RATION _ I hereby&Man under pointy,of perjury am of tie following declNdOns: I ban and will ma main.CeNBuuafConsent to self-Insure for Workers Compete udan,u pmvidcd for by Secdon 3700 of IM boor Code.for W performance of leo work for which this permit is issued. ❑1 have and will maintain WmteYa Compmenan im uance,as,rcgwnd by Section 370Dofthe Labor Cade,fa lW perfarromee often work far which this permit is Issued. ' My Workers Compessauan Insurance amu and r_APoliq nu W, Came7F �ND Poky NO.: 7 /w CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Ihlsseedm used rot x cmnPkard aft Permit is fame hundred organ(SIM) . nr ksa) I certify that in the performance of the work for which this permh Is Issued.l shall rot employ any person in try mannerm u to bccemc subject to the Worke'Corepenadan Laws of California.Due Applicvu NOTICE TO APPtICAN..IL after making thLL CeniRou of Exemption•you should WYane soo=to NC Workers Compensation provisions of ft Labor Code you am .J 0 forthwith comply with such provisions or this permit Mall W around treated. Zv w•" CONSTRUCTION LENDING AGENCY [–t.�. I hereby affirm that dun u a cmmunctirm leading agency for the parfmmance w C .�. lea work rte which this permit 4 issued(Ser.3097,Ci,G) W� lenders Name Z) Z LeadersAddna V 0 I certify that I have nod thin appiiatian area suns that the sew information Is COMM.I agree to comply with all city and county ardinanens and some laws minding to Wilding construction,and hereby mthmin mprennutives of this City m enur upon len til above-mnnti.d property for inspecdan purposes G (We)agree m ave•indemnily and tap hannkn the City of Cornelia.against IA liabilities,judgments.case and expenses which may In any way acaue against said City V Z in consequence of the Starting of this permit ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURC IPAULATIO 16t Re-roofs n� Signuu of App' UCanuaaar HAZARDOUS MATERIALS DISCLOSURE Data Type of.Roof .. _ isoa Cupertre(run Willing o Chapterreaand Health amaurial u de.Sed io the Cupertino Municipal Cone,Chapter 9.13,and du Health and Safety Code.ScWu 25532(.)7 All roofs shall be inspected nor to an roofing material beim Installed. ❑re, tell Na P P � Y 8 g Will to applicant of future bwlding=Paul use equipment or device,which If a roof is installed without first obtaining an inspection,.l agree to remove It haardou air contaminants ss defend by IW Bay Ana Air Quality Management all new materials for inspection. sirict7 ❑Ya red No I haw mud the ha ardmu materials nguiementa unmrchapter 6.95 ofthe Califor. nk Nahh J,Safety Cade Sees.35505,35533 sew 25534.1 undcratara less if do Wilding doe rot currently sew•—L it o Y me,µnniwlity m no de owu of au mquinm hicham 'ser ssunr.fkComfianafO, Signature of Applicant Date Owner ora 1r_.gem Dae All roof coverings to be Class' W'or better CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31646034 . 00 DATE ISSUED. . . . . . . : 04/11/2008 RECEIPT # . . . . . . . . . : BS000004456 REFERENCE ID # . . . : 08040086 SITE ADDRESS . . . . . : 10273 MINER PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : BOWMAN CYNTHIA J ADDRESS . . . . . . . . . . : 10273 MINER PL CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2012 RECEIVED FROM XTERIA INC CONTRACTOR . . . . . . . : PHILLIP ULLIO LIC # 22345 COMPANY . . . . . . . . . . : XTERIA INC ADDRESS . . . . . . . . . . : 1709A LITTLE ORCHARD ST CITY/STATE/ZIP . . . : SAN JOSE CA 95125 TELEPHONE . . . . . . . . : (408) 289-5353 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 13, 870. 00 1.40 0. 00 1 .40 0. 00 1REROOFRES SQ FEET 27 . 00 351 . 00 0. 00 351. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 352 .40 0. 00 352 .40 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 352 .40 #2149 --------------- TOTAL RECEIPT 352 .40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS -604 ROOF IN-PROGRESS 605 FINAL REROOF • 0oS'4 CITY OF CUPERTINO REROOF • CUPEk,TINO PERMIT APPLICATION APN # Date: 21 �� o3y�yJvv Building Address: iDa � Owner's Name: C'��oy /moo rim 9� Phone #N10 1 996n� Contractor: XTE2(A- 1tiG Phone #: 7(10k) 7.73_'-7&,Z FQ.A��Ox ; _M56 C4 �l'S/� Pax #: (VOM 70 3- 76,& Cupertino Business License #: as 37 5 Contractor License #: $(olooa Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles A Asphalt Shingles • ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# yr To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: /�f//JdUE F ZW/ ,�S& of 6>4157/N6 776E can F1_,v )0n0 .*VL> .may a 7 SsuAIPfS o r C'ER7A/1/TE4V La uD/Y/f1RK TR( LAm/nA�� gyafflG� camfbs;7sav 6V11766ES. Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the there are any restrictions: ❑ application or if applicable, include in plan set & the sheet index. Valuation: tp /3 ,70 00 I Have Read .0 d stand and Will Comply with Cupertino's Tear-Off Policy: Signature s CITY OF CUPERTINO REROOF :CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 2� 1RER00FRES Re-roof Residential B 1SFDWLROOF 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B Ak 1BUSLIC Business License B • s 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 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./j Homeowner's Name: ` / ,/ AW/y"5k) Job Site Address: /Oa73 01125}2 RZ4C6' Roofing Company Name: Al �J e, Applicant's Signature: /z Date: Yfit de • Greg Casteel Building Official Revised 11/2/04 _ Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY Of Fax(408)777-3333 �UPEkTINO Building De artment JOB ADDRESS: /0a73 17714E-1,(Z 15;1L.¢CE, PERMIT # 0J6 L a i d-4 OWNER'S NAME: Cll/Dl /xxv/n9iv PHONE # V08 7a3 7&ee3 GENERAL CONTRACTOR: ;ef//VC FAX # W& 7c?3 7&& I am not using any subcontractors: y//'12 we Signature Date Please check applicable subcontractors and complete the followinginformation: 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 te Contractor Signature Date