Loading...
07010043 CITY OF CUPERTINO ��,�7 BUILDING DIVISION pERNIIT � �� � �� PERMIT NO. BUILDING ADDRESS: 7615 DE FOE DR SAN JOSE PERMIT ISSUE DATE OWNER'S NAME: KOLB BRADLEY A AND ADRIAN G 1352 CHIPLAY DR. 01/08/2007 SANITARY NO. CONTROL NO. ,TONE: (4 08) 92 a-7663 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH a 0 a a o a LICENSED CONTRACTOR'S DECLARATION Job Description c V I hereby affirm that I am licensed under provisions of Chapter 9(commencing =z with Section 70(X))of Division 3 of the Business and Professions Code,and my license is REROOF- TEAR OFF SHAKE, OSB BOARD, 3 0 LB FELT, y in full force and effect. , COMP n? License Class L^35 Lic.# _E-° Date /-fr_o-> Contractor SHINGLES, CLASS A ARCHITECTS DECLARATION W U I understand my plans shall be used as public records a Z4.y Licensed Professional �v, OWNER-BUILDER DECLARATION `>3<2 1 hereby affirm that I am exempt from the Contractor's License Law for the i p O following reason.(Section 7031.5,Business and Professions Code:Any city or county e 9 which requires a permit to construct,alter,improve,demolish,or repair any structure 4 Z Y prior to its issuance,also requires the applicant for such permit to file a signed statement S Ft.Floor Area $14000 Valuation E_ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q yt- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of3592502 1 . Number Occupancy Type not more than five hundred dollars(5500). ❑I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or through his own employees,provided that such improvements are not intended or offered for sale.If, however,the building or improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did not build or improve far purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contactors Li. cense Law does not apply to an owner of property who builds or improves thereon,and• who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law. C:]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 the following declarations: ❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number arc: Carrier.ST/S—Ar r Polity No.:4U•3Z3 2ooG CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California.Date— Applicant NOTICE TO APPLICANT:if,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must ,J,`L forthwith comply with such provisions or this permit shall be deemed revoked. z O CONSTRUCTION LENDING AGENCY i-r I hereby affirm that there is a construction lending agency for the performance of a> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name = z Lender's Address U C) T certify that I have read this application and state that the above information is LL 1-4 correct.I agree to comply with all city and county ordinances and state laws relating to O U building construction,and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. >4 a (We)agree to save,indcmnif and keep harmless the City of Cupertino against hHt liabilities,judgments,casts and ex es which may in any way accrue against said City U z in consequence of the granting of is permit. APPLI �NDEAND AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �` —6� SOU F I `Sr-07 Re-roof: t of Applicant/C for Date HAZkRDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipa dc.Chapter 9.12,and the Health and Safety Cede,Section 25532(a)? All roof,shall be inspected prior to any roofing material being installed. ❑Yes o Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new naterials for inspection. District? ❑Yes u I have read the hazard ou atcrials requirements under Chapter 6.95 of the Califor- nia Hcal do S y Crub 25505.25533 and 25534.1 understand that if tic building daa u y that it is my responsibility to notify the occupant of the req ' c hict prior to issuance of a Certificate of Occupancy. Date ,a 7 Signature of Applicant ner or authorized a ~ Date 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 CUPEkTINO Buildi:n De artment JOB ADDRESS: PERMIT # ?P.3;- I-),r---z - 0-2 Drop.9r. �3 OWNER'S NAME: W- PHONE # GENERAL CONTRACTOR FAX # I am not using any subcontractors: Signature Date 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 Own r/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 r,?-roofing. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the buildirg 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 per:=ormed. 7. NOTE: If you call for a plywood nail nspection 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 abova stated policy on re-roofing. Homeowner's Name: Fr c4 1-10/A Job Site Address: (- Roofing Company Name: 3 rX Applicant's Signature: - Date: I V1 7 Greg Casteel Building Official Revis>d 11/2/04 CITY OF CIUPERTINO REROOF ,a CUPEkTiNO PERMIT APPLICATION FORM APN# 3GJ_ — I n 2G t Date: . 'J cry`7 Building Address: s Q e-4 e Owner's Name: Phone#: �f a rt--ad l l� o v- 012-9- 7663 Contractor: License#: a� s� 922760 Contact: Cupertino Business License #: Type of 11,00f Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles .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: 're X- s���� �s�, o�+;� FP 60.E Residential A,, Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: U Cost of Project: Type of Constn ction: Occupancy group: le 00 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