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04090027 (2) CITY OF CUPERTINOy BUILDING Divlslory PERMIT CUITRATb72 XNFUAMATIUN BUILDING ADDRESS: LOVELACE CONST" PERMIT NO'04090027 OWNER'S NAME: PERMITISSUEDATE STEARN ONE: SANITARY NO. CONTROL NO. 4 ARCHITECT/ENGINEER; BUILDING PERMIT INFO BLDG ELECT PLUMB MECH L O p LICENSED CONTRACTOR'S DECLARATION lob Descrl u 1 Wmby affirm that I am licensed under provisions of Chapter 9(commencing wilt Section 7000).(Division 3 of the Business and Fryfcssi...Code,i ntl my licamc iFINALED s se in fullfydr�c�e,§ndcrc ��? Lw'.n 7Ca / L .x ROOF-ASPHALT SHINGLES l n Data — ev/ C."I'ma / DEC y'�m�shall to Cfi Til used as bAl'tc recnOrJs COQ OCT I 200 W IunticrsunJ my Itr Licensed Pmfcaaiono ^1 1 I ®I 5 OWNER-BUILDER DECLARATION ■fY()U +�<f I herehy.'Kinn that I am exempt from the Comramar's License Law for the p O following reason.(Section 7031.5,Business and Professions Code:Any city ter really C$ which requires a permit to construct.ager,improve,demolish,or repair any structure ' v x y pd.,or its ismence ala.requires the applicant forsuch parat ra rile a signed solemn n that lue is licensed pursuant to the prevision of the Contmemr's License Law(Chapler9 Sq.Ft.Floor Area Valuation K€$ (commencing with Section 7")of Division 3 of the Business and Professions Code)or ' dust he is exempt therefrom and the bels for the alleged exemption.Any violation of -aa,Tf7o��ys..y�aa.. aa Semon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3 Ltto D TOMbef 0 0 . Occupancy e not more than five hundred dollars(5500). P Y TYP ❑1,a;owner afthe property,or my employees with wages as their sole compensation, will do the work,end me aWclart isnotinundcd or oRertd forage sm.7044,Business and Profession,Codc The Contractor's License Law does not apply 0 an owner of - Required Inspections property w he bu ilda or improves themon,and who does such work himself ter through his own employa s,provided thea such improvements are not intended oroffered forsam,If, however,the building or Improvement s sold within one year of compmdon,the owner- builder will haw the human of proving that he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to - construct the project(Sec.7014,Business and Professions Code:)The Contnethre Lt. came law does not apply to an owner of property who builds or improves daemon.and. who contracts for such projects with a contracror(s)licensed pursuant to the Contractor'.' License Taw. ❑I am exempt under Sec. ,B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury,one of flue following dectsra wror I have and will maintain aCutiOcau of Consent tomif-insum for Workers Compen. .clan,ea provided for by Section 3700 of the Labor Code.for the performance of the walk for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,as requited by Section 3700 of the labor Code,far the perfmmance of the work for which Nis permit is Issued. My Workefa mpemati n Inatome cafric en cy numbed, C e: NiDj5 F o,: (RK CERTIFIC E FROM WORKERS' COMPENSATION INSURANCE , (Thu sectics.m.dnot tecompletedBlhe permil is for ane hundreddoilars($10D) or less.) 1 terrify the,in the performance of the work for which this permit is issued,I shall not employ any parson in any mannerso M to became subject to the Workers'Compensation Law,of California.Dam Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject 1.the worker's Conix nsmien provisions of the labor Carlo,you most .,O foMwith comply with such provision mthis permit shat]W deemed rtveked. z ^' CONSTRUCTION LENDING AGENCY wN Ihemby affirm that marc isaconstruction lending agenry for the performance of ai 7 the work for which this permit is issued(Sce.3097,Civ.C.) aQ Lender's Nauru a z Lender's Address U 0 I certify Nal I have read this application and sate that the above information is fL F reflect,1 agree to comply with all city and county ordinances and sure laws relating to DU building construction,and Woubyeuthodm rcpmsenu,ivmof this city m macrame the r cm ahovc-mentioned judgment, c costs for inspection purpose,. (We)agree to save,indemnify and keep harmless the City of Cupertino against nF".r Z incenses,consequence of the aing of this expenses which they in any way eccmc against said City („)`� inconsequence of me groaning of this permit. APPLICANT ERSTA SAND ILL C MPLY WITH ALL NON-POINT Issued by: 67Date SOURCE ATIONS ` 0'D Re-roofs Sig ser ofApplicanVcW Dale H R AS MATERIALS DISCLOSURE Type of Roof will Ne applito m future building occupant store m handle hevsrdous na wool as defined by the Cu Hina Municipal Code,Chapter 9.13,and the Hegth and Safety Cole,Section 35532(.')? ❑Yrs ON. All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment at devices which If a roof is installed without first obtaining an inspection,I agree to remove it he mines air conmmimorts.dcOncd by the Bay Arca Air Quality Management all new materials for inspection. evict? ❑Yes ON. I have mad the hsrardaus materials requirements under Chapter 6.95 of die Califon .is Health@ Softly Cade,Sections 35505,M533 and 35534.1 understand mer if the Wilding Jots nut curmndy ham a))enan4 mal it 1 my maponsiCe ti ic madly the pear) t of the require I hickm n',m t,0 1.1. Certificate th,oc.cy. �D V y `nignature of Applicant Tate rera.'Wrirad rat Date All roof coverings to be Class "B"or better CITY OF CUPERTINO m 1 of 1 PERMIT RECEIPT OPERATOR: suem COPY # 1 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 31631010.00 DATE ISSUED. . . . . . . : 09/08/2004 , RECEIPT #. . . . . . . . . : 26953 REFERENCE ID # . . . : 04090027 SITE ADDRESS . . . . . : 19866 PEAR TREE LA SUBDIVISION . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : STEARNS DAVID M AND BONNIE J ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2319 RECEIVED FROM . . . . : E R LOVELACE CONTRACTOR . . . . . . . : RANDY LOVELACE LIC # 23465 COMPANY . . . . . . . . . . : LOVELACE CONST. ADDRESS . . . . . . . . . . : 10144 CAMINO VISTA DR. CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408)255-4923 *E ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ______ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 5, 000.00' 115.56 0.00 115.56 0.00 BSEISMICRE VALUATION 5, 000.00 0.50 0.00 0.50 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 116.06 0.00 116.06 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------_____----___ OTHER 116.06 VISA TOTAL RECEIPT 116.06 • CITY OF CUPERTINO OREROOF CUPEkTiNO PERMIT APPLICATION FORM APN# i Date: ^/O Building Addre s: 98 6 Gti 4 vIII CrM-)O Owner's Name: Phone#: Contractor: Phone#: License#: 60 V �i0 z Z— Z �Sr� Contact I Phone#: Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof 0;!Asphalt Shingles Asphalt Shingles ZK 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 Description: ©F- Residential r5Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with PI g De t, i there are any res cti s: Cost Ect: Type of ConstOccupancy gro p: Qty- ' A is W 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 U CITY E IST I N 0 Fax: (408)T77-3333 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. 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: ��a�� S /✓�NN� jT/ ,, / s Job Site Address: / /� (� Roofing Company Name: �y� �fi� e/� Oc F— /ASC. A plicant's Signature: LDate: \�lI�1Dt� Greg eel Building Official Revised 1/30/03 Printed on Recycled Paper Sul Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 -UPEIQTIN0 Building Department JOB AD RE�� � /�' PERMIT # " hoC/'/ OWNER'S NAME: PHO GENERAL RACTO FAX # I am not using any subcon!!5 rs: -/O D tl Si to Date Please check applicable subcontractors and complete the following informa 61 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 Contractor Signature Date Community Development „ k 10300 Torre Avenue Tel pC p rtino CA 95014 .- h oAe'(408) J77:7'3228" CITY OF� 9;;(408)'777-3333 -AEUPEkJINO Building Department ' JOB A RE�� � / ' '/ PERMIT # \, ZAg /-vet/ ' 'OWNER'S.NAME: S PHONW GENERAL RACTO FAX# I am not using any subcon!!F prs: ✓/ Si �-� Date Please check applicable subcontractors and com0ete the following inforrn1i n: SUBCONTRACTOR BUSINESS NAME x 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 r Septic Tank Sheet Metal Sheet Rock Tile �J Contractor Signature Date