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07080203 CITY OF CUPERTINO BUILDINO DIVISION PERMIT � R,� (j�j I TCI tet TION:: PERMIT BUILDIaD� EssWALLACE DR CASTO F OOFING S07080203 OWNER'S NAME: PERMIT ISSUE DATE CASTELLANO MICHEL J 1938 OI,D MIDDLEFIELD WAY 08/22/2007 NE: SANITARY NO. CONTROL NO. (650) 9(1-8922 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 00 LICENSED CONTRACTOR'S DECLARATION - JOb Description to p I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z with Section 7txx))of Division 3 of the Business and P fessions Cade,and my license is REMOVE (E) ROOF AND RE-ROOF WITH FIRE TX SHAKES H in full force and effe Z2 License Class 34 Lic.ri CLASS B 19 SQFT ;Fa Date Conti r a AR HITECTS D N a< I understand my plans shall be used as public records .0 U.y Licensed Professional 1 y OWNER-BUILDER DECLARATION } I hereby affirm that I am exempt from the Contractor's License Law for the :n O following reason.(Section 703 1.5,Business and Professions Code:Any city or county 3.9 which requires a.permit to construct,alter,improve,demolish,or repair any structure Zprior to its issuance,also requires the applicant for such permit to file a signed stalrment y =o that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area Valuation t- (commencing with Section 7000)of Division 3 of the Business and Professions Cade)or $9250 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 Number Occupancy Type not more than five hundred dollars(5500). 3260204 1V 0 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 ns Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q p 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.). 0 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractors Li- ccnse Law does not apply to an owner of property who builds or improves thereat,and. who contracts for such projects with a contactor(s)licensed pursuant to dte Contractors License Law. 0 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 LJ I have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3701 of the Labor Code,for the performance of the work for which this permit is issued. 0 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 WorkCompens n Insurance carrier and Policy number are: Z Cart �� Carrier,J�' �t"v'S Policy No.: 20tf CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ('Kris section need not he completed if the permit is for one hundred dollars($100) or less.) 1 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,alter 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 Fr tom. I hereby affirm that there is a construction lending agency for the performance of (x > the work for which this permit is issued(Sec.3097,Civ.C.) ALendersNamc z L.ender's Address U 0 I certify that 1 have read this application and state that the above information is Lt correct.I agree to comply with all city and county ordinances and state laws relating to Ubuilding construction,and hereby authorize representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against Hliabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting 9kffNPCTo1i1. "- APPLICANT UNDERSTAP6S A D WILL COMPLY WITH ALL NON-POINT Issued by: Date -'Z- SOURCE GULA N Z � Re-roofs Sig p Co ctor Date AZARDOUS MATERIALS DISCLOSURE Type of LOOP Will the a plicant 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)? All roofs shall be inspected prior to any roofing material being installed. Cl yes No Will the applicant or f turc If a roof s installed without first obtaining an inspection,I agree to remove building occupant use equipment or devices which emit hazardous air contamina is as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0 Yes No 1 have read the hazardo terials requirements underChapicr 6.95 of the Califor- niaHealth&Safety Code, 25505,25533 and 25534.I understand that if the )ding / y docs not curtently have a non that it is my responsibility to notify the occupant o �Wllel is wich be prior to i of a Certificate o ll of Applicant Date All roof coverings to be Class"B"or better ut r'. ag Datc — Community Development .� 10300 Torre Avenue '� : Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "WEkTINO Building Department JOB ADDRESS: PERMIT # ce- p�-? 6 "LOT, OWNER'S NAME: 4 rf-b o4,' PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractor:--� SJJ gnature Date Please check applicable subcontractors and corn plete the following information: SUBCONTRACTOR BUSI14ESS 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 /a 1-7 er Contractor Signature Date t CITY OF CUPERTINO RI-.',ROOF CUPER�TINO PERMIT APPLICATION FORM 67 APN# /I Date: Z 0 ^ 0__7 Building Address: 0,-;�0 3 UAW r '��ck � Owner's Name: �l Phone#: rn i ( Let�� i t�� c) /W� 73 = '7 Lf 7 Contractor: casto Roofing, Inc. License#: CN��-1)1938 Old Middlefield Way Contact: Mountain View, Cupertino Business License M (650) 961-8922 `232 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles 1L Wood Shakes M. Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed jt7 ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy: �- Job Description: l E a,4'_e, k y i s k� ,�oz '� /� -•1 ;,c ( -x e ti�-�L i �-- /y C Residential �9:1 Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: U Cost of Project: Type of Construction: Occupancy group: q a S� Q,CGC� n Nt v� (L -_3 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 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 applied 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 arty roofing installation. 4. To receive a final sign off from the Ciiy, 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 na.J 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 pei formed. 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 the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: "t C-ov-;fcc Job Site Address: Roofing Company Name: Applicant's Signa Date: �� 1107 Greg Casteel Building Official Revised 11/2/04 ' P CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 32602041 .00 DATE ISSUED. . . . . . . : 08/22/2007 RECEIPT #. . . . . . . . . . BS000002452 REFERENCE ID # . . . : 07080203 SITE ADDRESS . . . . . : 22093 WALLACE DR SUBDIVISION . . . . . . CITY CL PERTINO IMPACT AREA . . . . . . OWNER CPSTELLANO MICHEL J ADDRESS 22093 WALLACE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-0127 RECEIVED FROM . . . . : LINDSEY CASINO CONTRACTOR . . . . . . . : CF.STO, LINDSEY LIC # 21324 COMPANY CkSTO ROOFING ADDRESS 1538 OLD MIDDLEFIELD WAY CITY/STATE/ZIP . . . : MCUNTAIN VIEW, CA 94043 TELEPHONE (E50) 961-8922 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 9, 250. 00 169 .56 0. 00 169 .56 0. 00 BSEISMICRE VALUATION 9,250. 00 1. 00 0. 00 1 . 00 0. 00 - -- ------ ---------- ---------- ---------- TOTAL PERMIT 170.56 0. 00 170.56 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 170. 56 MC --------------- TOTAL RECEIPT 170.56