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06070116 (2) CITY OF CUPERTINO +'�' »' BUILDING DIVISION PERMIT ,"C ONTiaM)WINFORMATIONN BUILDING ADDRESS: a BEST INVESTMENT CO PEaMIT No.06070116 11672 VINEYARD SPRING CT OWNER'S NAME: PERMIT]%UE DATE SAM & NADA GAHA 20370 TOWNCENTER LANE 07/18/2006 NE: SANITARY NO. CONTROL NO. (408) 966-6443 ARCHI'fECTWENGINEER: BUILDING PERMIT INFO BLDG EISR PLUMB MECH po LICENSED CONTRACTOR'S DECLARATION Job Description ou�j 1 bermy affirm that 1 am licensed under prowworu of Chapter 9(Commencing ,Zry with Smtim lIX"I)of Divisonlaf the Budneca PmfrssiomC ,Wmylicomean « inraIfare and TEAR OFF OLD ROOF, INSTALL 30LB UNDERLAYMENT License eh �3 Lk." FELT.Can INSTALL A 50 YEAR COMP ROOF. CLASS A i o Dam Iundersandmyplm.�Iloomed "hiRFT10sN BL FOR CASTILLO' S ROOFING WAS RENEWED 7/18/06 as pJiccois tiU H Licensed Prefcasional 5 OWNER-BUILDER DECLARATION 2I thereby alum Net I am exempt Truro ftCmu ere.License Law far Ila; a o following mann.(Satiun RD I.S.Business and Predications Code:Any city of county which requires a Permit an eanwucl.alter.improve,demolish,or¢pair any met.. .Z< prior mise issuance.than metairca the applicant for such permit in Ek a signed statement Nal he is licensed pusuam b thc imvisims of the Cannanore.Littvc Law(chapter 9 Sq.Ft.Floor Area Valuation $ (commcnnngwithSectionT000)o(Division3oftheBase.andPmfeadmeCade)ser $8000 - Nath u comp,thrtfrom and dte buts for the alleged eaemptioa My violation of Seetion 7031.5 by my applicant fora permit subjects the applicmt an a mil penalty of APN Number Occupancy Type not mote than five hundred dollars(33110). I,uo ofNepmputy,mmycmploymwiN r-suam4mkcampewdon, will do the work.and the structure Is notimanded or offered forsak(Sm.1064,Buinau and Penfomm.Code:Th Contractor's U.•Law don not apply m an owner of Required Inspections Own eery who s,pA provided tmass discretion.iremmebo doeam not i hwoek himudfertlmugb bit f. awn employers,provided this such improvements am not intended oroBcrtd rat sile.Ir. however,thebuilding armimprovementksold within am year of completion,theo Wilder will love Nr.When of proving that k did reimprove far Wild or impfor purposease o¢off nle.). ❑1.as owatcr of Ile Sec.7044. y,am excles am conussims with licensed mntrater's i- 7/ Construct it not apply in an wnerBusiold am p rty wh iou Cade:)M Cmuvaon, d l who Law cocanotchp1ro man ownerofproper(who Wildsoran,w OM thmmacand. y whence Lace for such pmjcas with aeonuanor(s)Bansed pursuant m the ConlractoYs (_lemur law. Q ❑1 tee esempt under gee ,B A P C for Nu reason / Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby arm under peulty,of perjury arc of the following aboalmommi, I hate and will m ureaio a Ccrlificam of Consent to uif-mo m for Warkce,Comport. wtian,as prmi4d far by Seeman 3700 of the labra Cade,far the peRam.of the Werk for which this pefruit is issued. I ham and will maintain Workcri Compensation lasurmce,as,required by Section 3100af Ne Labor Coes,far Ne perfommexof the work far which this pcmit is Woes. My Worker's ompecomm Insurance carrier and Policy number am: Gamer. Polity No.: owz /77 CERT.TCATE OF EXEMPTION MOM WORKERS' COMPENSATION INSURANCE (Th rsccdm need not W completed ifft Permit is far.hundred dollars(3100) or lcsx) 1 certify,cut in the perfommec of the work for which this permit is Coffee.I shill nal employ any person in my mount an as to become wbject to the Worked Compensation Laws of California.Date Applicmt NOTICE TO APPLICANT:If.after making this Certificate of Exemption.you should become subject in the Worker's Compensation provisions of the labor Coda you must .,O forthwith comply with such limitations an new peri,shall he deemed revoked. zCONSTRUCTION LENDING AGENCY [-+ Ihembyaffinn Out tum is a emomactim lending.,nc,far the,peffuma.of - C > Ne work for which Nis Permit is issued(Sec.3097,Civ.C.) Leader's Name z Undoes Address CJ Q 1 certify that I hate tend this application and sum this the shove infomatiun is IL f comcm.l agree to comply with all city and county ordinances and scale laws relating to C)L) building construction.and hereby auNorne rcpresertaimu ofthis city to enter uponme W above-mentioned pmperiy for inspection purposes. f+py (Wo)agree to sacs indemnify and hicp hamlets the City of Cupertinomets against Z incoritin,judgmentsecastsand espeis pewhich may in any w'+Y acerae agaiutsaid City U rZ A APPLICANT of the financing SthisD WIl. y Date r-' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b SOURC R ULATIONS. �/Jr/cat - Re-roofs Signa rcof ApplinnUContfacmr /�mc HAZARDOUS MATERIALS DISCLOSU RE Type of Roof Will the applicant or future building Occupant store or handle huardous material as defined by ch Cupertino Mania ai Code.Chapter 9.12.and the Health and Safety Cade,Section 25533(a)? ❑Yes Nu All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,I Will the applicant of future building attvpant um cyvipmm,or dcviaa which g agree to remove P it havaNnn all crtenommu as dcOncd by the Bay Arca Air Quality Management all new materials for inspection. District' ❑Yrs Nu I have read Ne haeardnus materials onpimmema under Chapter Q95 of the calirm. nit HealthurSafety Code,SttainuMyreond25336.1 unotify dthss fifth Wilding dors not Currently M1aw a tenant Louat it. 55 rand 255 lity m notify the accupmt of the ✓'k-[�( 1/� re4mntswhkhmutWmeOn,toCan an..isCcmBcateeIOccupr. S' nature of Applicant Date a it, r/_ Owner Or autharirnd agcnl 1J.. I I All roof coverings to be Class"B"or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 �JPEkTINO Building I3e artment JOB ADDRESS: PERMIT # 1 ar b 1 OWNER'S NAME: --,Sam OJacic, & PHONE # - SS GENERAL CONTRACTOR: FAX # SJ- 6,- I am not using any subcontrac ors: Q Signature DA e Please check applicable subcontractors and complete the following ' ormation: 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 CITY OF CUPERTINO ,m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36654010 . 00 DATE ISSUED. . . . . . . : 07/18/2006 RECEIPT # . . . . . . . . . : 35303 REFERENCE ID # . . . : 06070116 SITE ADDRESS . . . . . : 11672 VINEYARD SPRING CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : SAM & NADA GAHA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . . . . : CASTILLO' S ROOFING CONTRACTOR . . . . . . . : JERRY CHEN LIC # 25050 COMPANY . . . . . . . . . . : BEST INVESTMENT CO ADDRESS . . . . . . . . . . : 20370 TOWNCENTER LANE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408) 966-6443 �EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -- -------- ------------- ------ ---- ---------- ----- ----- ---------- - - ------- - BPERMFEE VALUATION 8 , 000 . 00 . 147 . 96 0 . 00 147 . 96 0 . 00 BSEISMICRE VALUATION 8 , 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00 BUSLIC FLAT RATE 1 . 00 ., 105 . 00 0 . 00 105 . 00 0 . 00 ---------- ---------- ---------- ----- ----- TOTAL PERMIT 253 . 76 0 . 00 253 . 76 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER --------- -- - - ---- ------ - ----- --- --------------- CHECK 253 . 76 14019 TOTAL RECEIPT 253 . 76 • X0-7011 Ll0 CITY OF CUPERTINO REROOF CUPE TIM0 PERMIT APPLICATION FORM APN # avu Building Address: yj Owner's Name: ,\Q one #'a5i�. Contractor: C ash IIQ S )?oaw License#: 14 5-6 Contact: '©SP_ __01afiI I o Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof O Huilt-Upmof ❑ Asphalt Shingles V Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) __ O Other(Specify)____ Number of existing coverings___ LJL(:.H.O.Re "- - ......__._ Provide �n q _ V To be Removed O Provide Mfgr.installation Specs.-__ I Have Read, Understand and Will Com Iy With Cupertino's Tear Off Policy: • Job Description: -T _eAo n 11 #36d ta+ Residential Commercial Cgss(sj� Fire Zone: Yes ❑ No Confirmed with Planning De t. if there are any restrictions: Cost of Project:, Type of Construction: Occupancy group: O 6D. �i7 Qty. if Applicable Fee ID Fee Description Fee Group__ BPERMFF.E Bldg Permit Fees BUILDING _ B_ENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM _ Seismic Comnterc.ial _ BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC -- — -- Business License BUILDING -- •