Loading...
07080130 CITY OF CUPERTINO I���rT 7� BUILDING DIVISION PER1v111 . PERMIT NO. BUILDfTIc�a�YTSCOUNTRY SPRING CT LOS GATS ROOFING 07080130 l L PERMIT ISSUE DATE OWNER'S NAME: NISHTALA SATYANARAYANA AND P 0 BOX 172 SANITARY NO. CONTROL NO. EP-I-L- (408) 293-9399 T_ BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH z LICENSED CONTRACTOR'S DECLARATION Job Description 0 E_ I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000)of Division3oftheBusinessandProfessionsCode,andmylicenseis REMOVE SHAKE ROOF. INSTALL #30 FELT AND GRAND a in full force and cf t z License LicGonactor D. 1 CANYON SHINGLES BY GAF :� Date ARCHITECTS DECLARATION a I understand my plans shall be used as public records U F- Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the ofollowing reason.(Section 7031.5•Business and Professions Code:Any city or county �i which requires a permit to construct,alter•improve,demolish,or repair any structure Valuation w prior to its issuance,also requires the applicant for such permit to file a signed statement >q Ft.Floor Area o that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 $5226 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3665104 3 . 0 Number P Y YP not more than five hundred dollars(3500). 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 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.). El I•as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractors 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. B dt P C for this reason [-]I am exempt under Sec Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: UI have and will maintain a Certificate of Consent w self-insure for Worker sCompert cation,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 Workces Compensation Insurance,as required by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued. My Workers Compensatio nsurance artier and Policy n other are: Cartier. Polity tic o CE TIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Kris section need not be completed if the permit is for one hundred dollars(S 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 Ccrtiricate 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. C) CONSTRUCTION LENDING AGENCY .— I hereby affirm that there is a construction lending agency for the perfortnanec of the work for which this permit is issued(Sec.3097,Civ.C.) a Q Lender's Name Z Lender's Address 0 1 certify that 1 have read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state laws relating to U building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against y ra/I liabilities,judgments,costs and expenses which may in any way accrue against said City C� l Z in consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b„ : SQ,UbTE REGULATIO S. � �S I I�DT t Re-roofs Sign tort of Applicant/Contractor Type of i Zoof 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(x)? All roof. shall be inspected prior to any roofing material being installed. fi ElYes 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 all new I naterials for inspection. emit hazardous air contaminants as dcGncd by the Bay Arca Air QualityManagement District? Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- niaHealth&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building `L/Q docs not urrently have a tenant•that it is my responsibility to notify the occupant of the Dat cyvi nu which must be et prior to issu of a Ccnificatc of Occ l cy, s Ig tui of Applicant 'ILLAll roof coverings to be Class"B” or better Owner r authorized agent Date CITY OF CUPERTINO 2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Bl{: Lot: APN . . . . . . . . . 36551043 .00 DATE ISSUED. . . . . . . : 08/14/2007 RECEIPT #. . . . . . . . . : BSDO0002375 REFERENCE ID # . . . : 07J80130 SITE ADDRESS . . . . . : 11522 COUNTRY SPRING CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : NISHTALA SATYANARAYANA AND SEE ADDRESS . . . . . . . . . . : 11522 COUNTRY SPRING CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5116 RECEIVED FROM . . . . : LAS GATOS ROOFING CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS P 0 BOX 1726 CITY/STATE/ZIP . . . : LOS GATOS, CA 95031 TELEPHONE . . . . . . . . : (408)298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 5,226. 00 126 .36 0. 00 126.36 0. 00 BSEISMICRE VALUATION 5, 226. 00 0. 60 0. 00 0.60 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 126 .96 0. 00 126.96 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 348.28 2508 --------------- TOTAL RECEIPT 348.28 F,(-4 L"t CITY OF CUPERTINO ]ZEROOFh � CITY of CUINO PERMIT APPLICATION FORM G APN# ^S / — o `L Date: -7 2-7 10 -7 Building Address: T r J'n C1 Owner's Name: � �/S i /Q/a Phone#: fic? h �F 996 -49 �z K2 Contractor: Phor e#: © License#: u. 1 c �60 -20 Contact: , _�- Phon,:#: Cupertino Business License#: / ,SaXV2(L, 3� Type of Roof 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)4S T3e Number of existing coverings ❑ Provide I.C.B.O.Report# To be Removed ❑ ProV-cr- I de Mfgr.Installation Specs. S Ste' Have Read, Understand and Will Co ly With Cu ertino's Tear Off Policy: Job escription- .3d ridential Co ercial [] Fire Zone: Yes ❑ No"Z Confirmed with Planning Dept. if. there are any restrictions: L� Cost of Project: ZZ� Type o Con.,tructi � Occupancy oup: , Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING _Seismic-Fee.ResB-UILD-ING-_ BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING I F Community Development Department Building Division f City of Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 C U! E 1 I 1 O Fax: (408) 777-3333 Buildings Department Subject: Re-roofing policy for the- City of Cupertino 1. Prior to permit issuance,you must z gree to comply with 1997 UBC Standards and manufacturers specifications or re-roofing. 2. New roof coverings shall not be apr lied without first obtaining all inspection and written approval from the built ing 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 witho-zt first obtaining an inspection, will require the removal of all new rzaterial down to the sheathing, so a proper City inspection can be performed. IMPORTANT: 1. Flat roofs must have a minimum of-/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 abc,ve stated policy on re-roofing. Homeowner's Name: !f� �f - .._._..._JobLSite_A -/.�.ddress:- ,.__ .1.. _ _..,5.�: �J __ Roofing Company Name: o O A plicant's Signature: Date: Greg teel Building Official Re-ised 1/30/03 Printec c on Recycled Paper Community Development N. ',- 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 CUPEI�TINO Buildin Department JOB ADDRESS: 115;Z2 � ERMIT# OWNER'S NAME: /� PHONE # GENERAL CONTRACT R: FAX # 2 c12--9 -7 / 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 Qom, i r/ ontractor Signature Anat