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06040180 (2) CITY OF CUPERTINO tIUILDING+DIVISION PERMIT CONTRACTOR IN FORMATION BUILDING ADDRESS: R J BEAN ROOFING PERMIT N006040180 11503 SEVEN SPRINGS LA OWNER'S NAME: PIZRMITIS UEDATE CHU JAMES K M ET AL 6355 COTTLE RD 04/27/2006 NE: SANITARY NO. CONTROL NO. (408) 358-4028 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH +op LICENSED CONTRACTOR'S DECLARATION Job Description -w FC 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing P pito with Section 7")of Division Sof the Business and Proposal..Code,and my license is <m- in full Teti TEAR OFF 301 SHAKE, .APPLY 30LB FELT, NEW VENTS = Liana Issa Lie.a `7' 3aZ AND VALLEY, 30 YEAR CL ' �t Contractor at DZ Z!, DECL.ARATIONv 1�ioU I understand my plans shall he used u public mcoNs io .O� Licensed Pndessional in OWNER-BUILDER DECLARATION MAY I hereby affirm that I am exempt from the Contractors License Law for do 2000 2.9 o following mason.(Section 7(131.5,Business and Proins Code:Any city ter county O u m 9 which requires a permit to construct.alter,impose,demolish.or repair any structure 1111111% sa - _miprior to its issuance.also requires the applicant for such permit to file a signed mommcm tiankatlicensed pursuant to the provisions of Ne Contracts.License Law(Chapter 9 Sq.Ft. Floor Area Vl 6800 ,r m C (comencing with Section 7000)of Division 3 of the Buunnss and Professions Code)orlt 1j Athat he Is exempt therefrom and the basis for the alleged esemp ton.Any violation of Section 7031.5 by any applicant for a permit wbjecu the applicant m a civil PendlY of Je}pp}N Number OccupdhEy Type not mom than finhundred dollars(5500). 3 tl 0 52012 . 00 I,in owner of the property,or my employes with asM v their sic compevation, will do the work.and the structure Is not intended or offered fonale(Sec.70W.Business Required Inspections and Professions Code:Thns The Contractors License Law don ret apply to an ow.or q P property who builds or improves themun,and who does such work hinum r or Nmugh his own employee,provided that such improvements are not Intended ororeerW forsala If. however.de Wilding or opponents.at sold withinorc year of wmpkuom.the ownv- builder will have the Wrden of proving that he did not Wild or improve for purpose of sale.I ❑1,as owner of the property,am exclusively contracting with licensed contractus to consume,the project(Sec.701q Bounm and Profession Code:)The Commands Li- ccosc law does mot apply to an owner of property who Wilds or improves thereon,and, who contracts for such projects with a contracmgs)licensed pursuant to the Contractor's Licensee Law. ❑Iameaemptunder See .B&PCforthismawn Owner Dale WORKER'S COMPENSATION DECLARATION 41 1 hereby affirm under penalty of perjury orc of the fallowing declantiorts: ❑1 hart and will munWn a rusificam of Consent to self-inure(a Wortrrs Compen- ' solos,as provided for by Secuon 37110 of doe Labor Cade,for the performance of the work for which this permit is issued. ❑I have and will maintain Workers Compenation Imurml as mquined by Sectors 3700 of the labor Code,for the performance of the work for which this permit is issued. My Workers Compensation Luttronce carie and Policy number - Cbmm,. Policy No.: CERTIFICATE OF EXEMP ION FROM WORKERS' COMPENSATION INSURANCE frills session need not be compicme fifth,permit is forone,hundred dollars($100) or Ince.) I certify does in the performance of the work for which this Permit is sowed.I shall nut employ any person in any man w bttom w¢�cctto one WormWCompewdon Less or Califom'a-( tn�' 67 V Applicant n Ka T NOTICE TO APP C .If.arm,making this Certificae of Eaemption.you should bootee subject to the Woheri Compensation proviuons of the labor Code,you muse .JO forthwith comply with such provisions or this Pamir W deemed invoked. z' CONSTRUCTION LENDING AGENCY [—ice Iknob,JErm Wt Nem is a construction lending agency,for the perform.of C! the work for which that permit is issued(See.3097,Civ.C) 1 Q Lenders Name . z Lenders Address U C) I century that 1 have read this application and soon that the move information Is C5.P comer.1 agree to comply with all city a dl county ordinances and oam laws miming to CU building convection,and hereby authorim mpmsenmives orthis city to enter upon the 1 abovomenuoned property for inspection purposes. (We)agree to save,indemnify and kap harmless the City of Cupcnino agunst r ;n liabilities,judgmcnas,cos;and cxpcnsn which may in my way accrm agairsl said City Of ft limmaing of this U Z eAPPLCANTUNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE n S. Y 27 Re-roofs Signnmm of AemuConusnor Dam �Z HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding Occupantnmrc or Wndlc havNous material U defined by the Cupertino Municipal Code.Chapter 9.11,aM the Health and Safety Coes. CIyoou,15532(a)? 01fo— All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding Occupant use equipment ordcvims which If a roof is installed without first obtaining an inspection,I agree to remove emit harardnn air contaminants u derrOcd by the Bay Ams Air Quality Management all new materials for inspection. District? ❑Yrs ONN tn✓�/3j,1s,/e]t 7 I have read toe R omalmatorials rey responsunecr notify 6.95ofthOMEOft e ( ?\'V i fy / O V nu H=IN&SafetyCodc.Sections 25505.25533 and 15531.1 undersand th;if lk Wilding don rut curcntly ow a tenant Nat it u my responsibility m notify Ile Occupant of Nc mquimmen h�uy.br met prior to issuance oO eeNrcam or Occupancy. Signatu of Applicant Date s�slpoUU(t of Z7-O gent out g All roof coverings to be Class "B"or better Owner or wtho co ' CITY OF CUPERTINO 66m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36652012 . 00 DATE ISSUED. . . . . . . : 04/27/2006 RECEIPT # • • • . . . . . . : 34171 REFERENCE ID # . . . : 06040180 SITE ADDRESS . . . . . : 11503 SEVEN SPRINGS LA SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : CHU JAMES K M ET AL ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1000 RECEIVED FROM . . . . : RJ BEAN CONTRACTOR . . . . . . . : BEAN, ROBERT JAMES LIC # 20511 COMPANY . . . . . . . . . . : R J BEAN ROOFING ADDRESS . . . . . . . . . . : 6355 COTTLE RD CITY/STATE/ZIP . . . : SAN JOSE, CA 95123 TELEPHONE . . . . . . . . : (408) 358-4028 *FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 9, 000 . 00 158 . 76 0 . 00 158 . 76 0 . 00 BSEISMICRE VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 159 . 66 0 . 00 159 . 66 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 159 . 66 6527 TOTAL RECEIPT 159 . 66 Community Development 10300 Torre Avenue rte' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 WUPERTINO Building De artment JOB ADDRESS: PERMIT # /1503 !-, , S O 60 f-( D �o OWNER'S NAME: CH PHONE # q0 -YO&t- /O'7 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 • 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 kfDwner/Contractor Signature Date 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. Homeowner's Name: T-6m�s Cl— u Job Site Address: 03 meu Sy - Roofing Company Name: 0/ Applicant's Signature: Date:-1-2,7-0-Z]-D 6 • Greg Casteel Building Official Revised 11/2/04 OWM) K) CITY OF CUPERTINO • `C1 REROOF CUPEkTINO PERMIT APPLICATION FORM APN# 2/ ^ U _5Ont _O I a Date: / J U[ \,,W Z 7 Building Address:15 c 5O 3 � e/✓ Ll/ i Owner's Nam Phone#- fl m� C 927-5503 Contractor: pp License#: �73030Z Contact: Cupertino Business License #: -Lf0 E,--3 1 D7 Inn Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ,O�Asphalt Shingles -a— 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: h ke�I APPI y -30110 ire If) N�� A(. opift 3oyr 1 1- ' L./- Residential Commercial ❑ Fire Zone: Yes ❑ No B Confirmed with Planning Dept. if there are any restrictions: Ll Cost of Project: Type of Construction: Occupancy group: O© V 1` 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 •