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07080210 CITY OF CUPERTINO ��'tr (`� 7�T�T ��•t BUILDING DIVISION PERMIT V� �i* ��1�if� � l�'X� ' PERMIT NO. BUILDING ADDRESS: 10187 STONYDALE DR R E ROOFING & CONSTRUCTION 07080210 OWNER'S NAME: O-- PERMIT ISSUE DATE BILL KLEIN 15230 CLYDELLE AVE 08/23/2007 SANITARY NO. CONTROL NO. NE: (408) 626-9320 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH a 0 o a x Z LICENSED CONTRACTOR'S DECLARATION w P I herebyaffirm that 1 am licensed under provisions of Chapter 9(commencing Job DBSCTip[lOn {z with SectiofDivision3ofthcBusincssa-A7�ioysf�oae' glic—is REROOF–REMOVE (E) 2 LAYERS OF ROOF, INSTALL 1/2" y infulcu Ljs ( ` (J DX 30# FELT: 33 SQ, CLASS A ? Licenq 4 o Date Contractor ARCH CTS DECL R / i C a l understand my plans shall'jtc used as public ords — v )WU ' U.t- Licensed Professional a OWNER-BUILDER DECLARATION } 1 hereby affirm that 1 am exempt from the Contractors License Law for the 3 a 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county m which requires a permit to construct,alter.improve,demolish,or repair any structure t"w prior to its issuance,also requires the applicant for such permit to file a signed statementValuation ?'a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter9 Sq.Ft.Floor Area tT- (commencing with Section 7000)of Division 3 of the Business and Professions Cade)or $15000 ? 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 t��#D�7�Tr Number not more than five hundred dollars(5500). 3 2 6 3 7 0 5 6 . V V 0 1,as owner of the property,or my employees with wages as thew 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.). 0 1,as owner of the property,am exclusively contracting with licensed contrauars to construct the project(Sec.7044,Business and Professions Code:)The Contractors Ir- 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 Contractoes License Law. 0 I am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 1]1 have and will maintain a Certificate of Consent to self-insure for Workers Compen- sation,as provided for by Section 3700 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 Wo s Com ensatio osurance c ier and Polity number are: Q Cartier. Polity No.:CERTIFIC TE OF E) FTION FROM WO COMPEN ATION INSURANCE (This section need not be co pleted 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 0 forthwith comply with such provisions or this permit shall be deemed revoked. z t" CONSTRUCTION LENDING AGENCY [�C4 I hereby affirm that there is a construction lending agency for the performance of (Y. t7 the work for which this permit is issued(Sec.3097•Civ.C.) Lra Q Lender's Name C+ LcndeisAddress U 0 I certify that 1 have read this application and state that the above information is w correct.I agree to comply with all city and county ordinances and state laws relating to 0U building construction,and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against t4liabili i 'dgments,costs and expenses which may in anyway accrue against said City / U z in cc nsequcn of the granting of this permit. Date ►" APPLICANT DERSTA S N MPLY WIT ALL N-POI Issued b y: SOU �� 0 Re-roof: Signature of A. can V tractor are Type of Roof HAZA ATERIALSDISCLOSURE Will the applicant or future building occupant store or handle azardous material as defined by the CupertinoMuni'' I Code.Chapter 9.12,and the Health and Safety Codc,Section 25532(a)? All roof;shall be inspected prior to any roofing material being installed. 0 Yes No 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? f 0 Yeso /t Z 0 7 I have read the hazardous materials requiremcnu under Chapter 6.95 of the Calif, / ria Health&Safety Code,Sectors 25505.25533 and 25534.1 understand that if the budding„ �: docs ly have a tcnenC i y res ibility to nouCy the upan of the - Date rc iremcnm w.h t be met pri h suancc fa cats of pancy. U� Signatui e o ?Appt 1 a e All roof coverings to be Class"B' or better Owner or authonrc agent Date Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 Fax(408)777-3333 CITY OF "UPEkTINO Buildi�r� De artment JOB ADDRESS: PERMIT bAW OWNER'S NAME: PHONE # 0�- (o 2 - CA3 2:�) GENERAL CONTRACTOR. �, v I*1 cTNS. FAX #tic USS- b Zf�- c - I am not using any subcon actors: e `Date Please check applicable subcontractors and complete the followinginformation: _ZC-SUBCONTRACTOR BUSIrfESS 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 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: Blk.: Lot: APN 32E37056 .00 DATE ISSUED. . . . . . . : 08/23/2007 RECEIPT #. . . . . . . . . BS(�00002462 REFERENCE ID # . . . : 07(80210 SITE ADDRESS 10:.87 STONYDALE DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER BILL KLEIN ADDRESS 10:.87 STONYDALE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : R H ROOFING CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615 COMPANY . . . . . . . . . . : R H ROOFING & CONSTRUCTION INC ADDRESS 15230 CLYDELLE AVE CITY/STATE/ZIP . . . : SAIT JOSE, CA 95032 TELEPHONE (408) 626-9320 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- -- BPERMFEE VALUATION 15, 000 .00 223 .56 0 . 00 223 .56 0. 00 BSEISMICRE VALUATION 15, 000 . 00 1.50 0 .00 1.50 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 225. 06 0 .00 225 . 06 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 225 .06 11270 --------------- TOTAL RECEIPT 225 . 06 I CITY of CUPERTINO R7_EV `ilyo APPLICATION FORM CUPEkTINO PERMIT API' APN# Date: 3 � �� 23a Building Address: <��uner's Name. Phone#: / "License#: -,2 Contract `� � �a c�'F 1 h1 � � l�O1rJ �,�,vfil i 6w, Contact: Cupertino Business License #: Type of R sof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes X,\-Wood Shakes Wood Shingles ❑ Wood Shingles 11Other(Specify) ❑ Other(Specify) Number of existing coverings 2 ❑ Provide I.C.B.O. Report# ATo be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy: ❑ k� fJ�;tiJ Z Job Description: �N"% L l�T 1N� 2 �1% � ��t� � ick Residential Commercial F1 Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: ❑ Cost of Pro' Type of Construction: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMF'EE _31dg 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 f. Prior to perrilit issuarAcc you i�iust agrc: to comply with and manufacturers specifications on re-:oofing. 2. New roof coverings shall not be appliec 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 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 perfcrmed. 7. NOTE: If you call for a plywood nail irspection 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: l� �� l ►.! Job Site Address: Roofing Com an TN �' l V�►�� S CG)i Compan 7APplicant's Si at92- Greg Casteel Building Official Revises 11/2/04