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07010182 7. CITE'OF CUPERTINO BUILDIXG DIVIS1OiV PERMIT �� I' g AGTC'IR I .0 TI�1 t; .: PERMIT NO. BUILDING ADDRESS: OWNER'S NAME: JOSEPH BUDLOCK 451 STROUD PL 01/30/2007 SANITARY NO. CONTROL NO. )NE: (408) 3()5-0553 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 40 p LICENSED CONTRACTOR'S DECLARATION Job Description �u P I hereby affirm that I am licensed under provisions of Chapter 9(commencing 4 z C with Section 7000)of Division 3 of the Business and Professions Code,and my license is REROOF-- T/O EXISTING BUILT UP ROOF AND INSTALL n y in(till farce and effgCt ClP� _ NEW v�z License Gass ` --�s� Contractor ARCHITECTS DECLARATION BUILT IJP ROOF a< I understand my plans shall be used as public records ALU 4 U.ti Licensed Professional OWNER-BUILDER DECLARATION 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 0- which requires a permit to construct,alter,improve,demolish,or repair any structure y prior to its issuance,also requires the applicant for such permit to file a signed statement _G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq,Ft.Floor Area Va uatlon t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or 8 0 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 375170,L 7 APN Number Occupancy Type not more than five hundred dollars($500). 0 1,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 for 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 Contractor's 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. 0 1 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: n i have and will maintain a Certificate of Consent to self-insure for Workces 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 Insurancecarrier and Policy number arcs: ��/ �i� Carrier. A d Polity No.: R 6 /( V ERTIFICATE OF EXEMPTION FROM VrOMCERT 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,1 shall not employ any person in any manner so as to become subject to the Workcrs'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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY F r I hereby affirm that there is a construction lending agency for the performance of (�> the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name az Lcndees Address U 0 1 certify that 1 have read this application and state that the above information is LL ►-� correct.I agree to comply with all city and county ordinances and state laws relating to rJ U building construction,and hereby authorize representatives of this city to enter upon the W ahove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against In liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. APPLICANT UNp STANDS AND WILL COMPLY WITH ALL NON-POINT Issued fly: Date 3G�1 SOURCE REG ONS. Re-roof s Signature of plicant/contractor Date Type of Roof HAZARDOUS MATERIALS DISCLOSURE yp Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? ,p/� All roo s shall be inspected prior to any roofing material being installed. ❑ (-1 Yes 7 If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ,C Cl Yes �1ryu 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building 77�� l C) does not currcpdy a tenant.that it is my ponsibility to notify the occupant of the rcyuircmcgts v ni frust be met prior w issu ee of a Certificate of Occupancy. Slgnatu re of Applicant Date f6` All roof coverings to be Class"B"or better Owne,r authori-rcd agent Date Community Development 10300 Torre Avenue ;* Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 -'7.UPEkTIN0 Buildi.n De artment JOB ADDRESS: PERMIT #-7 OWNER'S NAME: e �, PHONE # Q' 2p 0�r GENERAL CONTRACTOR: # L c _ 2-o ^ S I am not using any subcontractors: a S ignature Date Please check applicable subcontractors and corn plete the following information: SUBCONTRACTOR BUSI:vESS 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--oofing. 2. New roof coverings shall not be applies 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 apprc val. 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 vispection 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: f 1/4 1. Flat roofs must have a minimum oper 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: _- C S5� � V-kU.ZZ_O C/L Job Site Address: J0 2 n. kA A 12 0 T } � LU P e c Roofing Company Name: e C '� Applicant's Signature: Date: ! -3 c> O Greg Casteel Building Official Revi!;ed 11/2/04 CITY OF CUPERTINO REROOF CUPEkTiNO PERMIT APPLICATION FORM APN# Date: 3'�5- 11-b11 7,c Building Address: I Yl e 1 �1 v N cc) Owner's Name: Phone#: Contractor: License#: C Contact: Cupertino Business License #: Type of Roof Covering: Exist* g: Prop ed: C'j Built-Up Roof E uilt-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings Z�2 e ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With C u ertino's Tear Off Policy: Job Description: Residential Commercial ❑ p >_1 Fire Zone: Yes ❑ No Confirmed with Planning DYt. if there are any restrictions: Cost of Project: Type of Constiuction: Occupancygip: Ss o 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