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07010047 CITY OF CUPERTINO ��{ BUILDING DIVISION BUILDING ADDRESS: PERMIT "' " PERMIT NO. 410 OAKVILLE AV T DD ROQI PERMIT ISSUE DATE OWNER'S NAME: CAL WESTERN PROPERTY 675 TUL:,Y RD 01/08/2007 SANITARY NO. CONTROL NO. (408) 89:?-8872 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH O p LICENSED CONTRACTOR'S DECLARATION Job Description W P I hereby affirm that I am licensed under provisions of Chapter 9(commencing e.Z� with Section 7000)of Division 3ofthe Business and Professions Code,andytyIicenscis REROOF— REMOVE OLD WOOD SHAKE, INSTALL NEW 30 y in full force and effect, b � ? License ClaA Lic.M SHINGLES, 24 SQUARES, CLASS A t-C Date_j Z Zf coatnctsr X t,,..j' ARCHITECTS DECLARATION ?toi U I understand my plans shall be used as public records o, Z. H Licensed Professional y OWNER-BUILDER DECLARATION +�<I 1 hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county K which requires a permit to construct,alter,improve,demolish,or repair any structure y Z} prior tri its issuance,also requires the applicant for such permit to file a signed statement gFt.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 9 t=-$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $7 0 0 0 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 of 3691301 L . Number Occupancy Type not more than five hundred dollars($500). ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work and the structure isnot intended oroffered for sale(Sec.7044,Business Required Inspections and Professions Code:The Conractoes License Law docs 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 for purpose of sale.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense Law docs 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. ❑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: t]I have and will maintain a Certificate of Consent to self-insure for Workefs 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 WorkeesCorlipenajpon Insurance carrier and Policy number are: Carrier.—_ Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('Ibis 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,1 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 O forthwith comply with such provisions or this permit shall he deemed revoked. z R CONSTRUCTION LENDING AGENCY [~.t 4 1 hereby affirm that there is a construction lending agency for the performance of p�> the work for which this permit is issued(See.3097,Civ.C.) W Q Lender's Name � Z Lender's Address V C I certify that I have read this application and state that the above infotmatiun is CL►-� correct-I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against ►F-t liabilities,judgments, osis and uses which may in any way accrue against said City z / V Z in consequence ' g ' of this permit. Date � APPLICA E ANDS AND WILL COMPLY WITH ALL N- INT Issued by: / SOURC L ONS. O Re-roofs Signature rcant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of F.00f Will the applicant or futum building occupant store or handle hazardous material as defined by the Cupertino Monier al Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? .� All roofs shall be inspected prior to any roofing material being installed. ❑Yes CJ No Will lnc applicant or future building occupant use equipment or devices which If a roof:s installed without first obtaining an inspection,I agree to remove :mit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes FrN. 1 have mad the hazardous materials requirements under Chapter 6.95 of the Califor- nia Heal th&SafctyCodc, a 505,25533 and 25534.Iunderstand that iCthe building does not currently I Utas it is my responsibility to notify Ute occu ant of the reyuiremcn�s h met prior to issuance of a Certificate ofup cy. Date Signature of Applicant Owner orauthorized agent Da1e All roof coverings to be Class"B"or better Community Development w. 10300 Torre Avenue :. : • ;�,- Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 *TPEkTINO Building Department JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE AbPy�/ s'4, 5-- GENERAL CONTRACTOR: — FAX # I am not using any subcontractors: Si;;nature 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 Owner/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 applieI 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 arr,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 t irst 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 he job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: G/ �l Job Site Address: z&/ 1✓//I(- Roofing Company Name: `�� o -•.�� C Applicant's Signature: Date: �/ �� ", Greg Casteel Building Official Revise 111/2/04 . � n SDI 00 4-7 CITY OF C'UPERTINO ' = REROOF CUPEkTINO PERMIT APPLICATION FORM APN# Date: 3Uq- i 3- O I I �- s- Building Address: /D %v Owner's Na Phone#: fi mor s- / - j Contractor: License#: Co Pa. Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles e Asphalt Shingles I]911"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 Cu3ertino's Tear Off Policy: ❑ Job Description: .K ` l� / ,?01 y.� �..�� oIl// 4.�L►'U- �-,�isf mac? rte' . '�/i Residential 0-- Commercial ❑ Fire Zone: Yes ❑ Confirmed with Planning Dept. if there are any restrictions: LJ Cwt of ProjectTye of Constru1ion: Occupancy group: 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