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07090022
CITY OF CUPERTINO J T�,��TT +�� iTR� TCT � �0�4TION BUILDING DIVISION PERMIT / BUILDING ADDRESS: PERMIT NO. 1085 MILKY WAY R E ROOFING & CONSTRUCTION 07090022 OWNER'S NAME: PERMIT ISSUE DATE SOW CHU 15230 CLYDELLE AVE 7 .qE: SANITARY NO. CONTROL NO. (408) 62E-9320 ARCHITECT/ENGINEER: BUILDING PERMr'INFO BLDG ELECT PLUMB MECH ix 0 0 Cc a LICENSED CONTRACTOR'S DECLARATION Job Description F I hereby affirm that I am licensed under provisions of Chapter 9(commencing z� with Section 7000)of vigiop 9fthean ylicenstis REMOVE LAYERED WOOD SHAKE & INSTALL NEW 1/2" ? y in full force and eff L r "II( f I t F= Licen c Lic..it- .. CDX, 3U ASTM FELT & "PRESIDENTIAL" COMP — CLASS p Datc ��-Iplans Contractor ` CTS DECLAR. (SN, "A" ; 29 .75 S Q' S i a used as public rccoriTs >yU U.y Licensed Professional y OWNER-BUILDER DECLARATION } 1 hereby affirm that I am exempt from the Contractor's License Law for the :m O following reason.(Section 703 1.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure zy prior to its issuance,also requires the applicant for such permit to file a sighed statement e that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 ,r,tq.Ft.Floor Area Valuation I= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $15000 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 �1 Number Occupancy Type not more than five hundred dollars(5500). 3 6 2 19 0 0 3 . V U Q 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 Ctde: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 awn 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 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 Contractors License Law. ❑1 am exempt under Sec. B&P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION I 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 WorkersCompen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the for which this permit is issued. I have and will maintain Workers Compensation Insurance,as required by Section 3 of the Labor Code,for the performance of the work for which this permit is i tied. My Worker's Compensai on Insurance carrier and Policy number are: Carrier. li(1 Policy No.: %-1 t u CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is forone hundred dollars($100) carless.) 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z"" CONSTRUCTION LENDING AGENCY F+►�-� 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.) QLenders Name z Lenders Address U 0 1 certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to J U building construction,and hereby authorise representatives of this city to enter upon the above-mentioned properly for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against rA liabilities,judgments,costs and expenses which may in any way accrue against said City U z in consequence of the granting of this permiL Date U 7 ► APPL NT UNDERSTANDS AND WHA,,COMPLY WITH ALI4 NO POINT Issued by: SOURCE G ONS- J -[-2 o Re-roofs ( Signatu Applicant/Comractor Dare Type of R)of HAZARDOUS'MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Codc.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? r All roofs,hall be inspected prior to any roofing material being installed. ❑Yes /p 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 a new m lterials for inspeetiorl. District? ` Q Yes I have real the hazardous materials requirements under Chapter 6 95 of�Ix Califor- nia Health&Safcly Codc,Sections 25505,25533 and 25534.1 understand that iCthe building `. W does- t currently ave. tenant tha6it"is my gRibility to notify the ant of � _ rcyuire hi I e issy a Ccrtificatc of U Signature �f Rpplicant Date {• All roof coverings to be Class"B"or better O r iuthorizcd agent Datc CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 36219003 . 00 DATE ISSUED. . . . . . . : 09/06/2007 RECEIPT #. . . . . . . . . : BS000002568 REFERENCE ID # . . . : 07090022 SITE ADDRESS . . . . . : 1085 MILKY WAY SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER SOW CHU ADDRESS . . . . . . . . . . : 1085 MILKY WAY CITY/STATE/ZIP . . . : CUFERTINO CA, 95014-5008 RECEIVED FROM . . . . : R E ROOFING & CONST CONTRACTOR . . . . . . . : PRCCTOR, PAUL LIC # 20615 COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVE CITY/STATE/ZIP . . . : SAN 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 #11322 --------------- TOTAL RECEIPT 225 . 06 0-70q 00c2o� CITE' OF CUPERTINO lEA-L '. CUPEkTINO PERMIT APPLICATION FORM APN#&(PCq/ q©O 3` O O Date: Building Address: Owner's Natne: I` V Phone #: Contractor: / Lcense#: t C Cc1 � Z 151 1 Contact: Cupertino Business License #: '2-U (o < Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles 0 Wood Shingles ❑ Other(Specify) 0 Other(Specify) Number of existing coverings 2 ❑ Provide I.C.B.O. Report# XTo be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cupertino's Tear Off Policy: Job Description: '�e N15V1 'L �n -1�YVJ Uy- W cel') 5 N A'y tti�ST/ LA_ N kc) I, c%1�TiAL `�� 0,0 Pk — t_A,5 . � Residential Commercial r Fire Zone: Yes ❑ No01 Confirmed with Planning Dept. if there are any restrictions: ❑ Cost of Projec : �U Type of Construe ion: Occupancy oup: 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 flan 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 ISI"iol- to perl-nit issuancc,)'olL to cm-apfy Wv71ih 1.110", �-'Llndarc l and manufacturers specifications on re-roofing. 2. New roof coverings shall not be applied without first obtain ing all inspection and written approval from the building nspector. A final inspection and approval shall be obtained from the buil ling inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to any:•oofing installation. 4. To receive a final sign off from the City, he 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 fii st obtaining an inspection, will require the removal of all new mate:•ial down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail in,,pection 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 I e 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: M� Job Site Address: Roofing Company-N e. Applicant's Signature: >� Date: Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 COOf Fax(408)777-3333 ';UPEkTINO Building Department JOB ADDRESS: (� PERMIT # � MIL VA -?oro6L'1— OWNER'S NAME: PHONE # A - (e2(0-'13 Zv GENERAL CONTRACTOR: i, FAX # - 71 (o I am not using any subcontractors: - Signature--` ate Please check applicable subcontractors and co m Bete 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 CITY OF CUPERTINO 7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 37541014 . 00 DATE ISSUED. . . . . . . : 09/04/2007 RECEIPT #. . . . . . . . . : BS000002539 REFERENCE ID # . . . : 07090004 SITE ADDRESS . . . . . : 886 MILLER AV SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ROSA TORRES ADDRESS . . . . . . . . . . : 886 MILLER AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4641 RECEIVED FROM . . . . : ROSA TORRES CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : ROSA TORRES ADDRESS . . . . . . . . . . : 886 MILLER AVE F CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4641 TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BENERGY PERMIT FEE 137 .16 65 .84 0. 00 65. 84 0. 00 BINVESTIGA # OF HOURS 1. 00 60. 00 0. 00 60. 00 0. 00 BPERMFEE VALUATION 7, 000. 00 137 .16 0. 00 137 .16 0. 00 BPFIXTURE UNITS 1. 00 9 . 00 0. 00 9 .00 0. 00 BPLANCHK PERMIT FEE 137 .16 183 .04 0. 00 183 . 04 0. 00 BSEISMICRE VALUATION 7, 000. 00 0 .70 0. 00 0.70 0. 00 PPERMITFEE FLAT RATE 1. 00 40.79 0. 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 496 .53 0. 00 496 .53 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------------------- CREDIT CARD 496. 53 MC --------------- TOTAL RECEIPT 496. 53 x CITY OF C-UPERTINO 0-7 0 Q 0 00 Ll h :� CITY OF PERMIT APPLICATION FOM CUPEkTINO PN #27 5 , / / l7 I L/d Date: 5/;O�/o Building Address:(11?�& HIRre A _ Mailing Address (if different from building address): Owner'sme: Phone#: Contractor: License #: Contact-,-r--, Phone:qp�S 13 y 3 Cupertino Business License#: VC Fax: Building Permit Info: Bldg N Elect ❑ Plumb CR Mech ❑ Job Description: -: Residential Lam" Commercial ❑ Sq.Ft. Floor Area: Sq.Ft.: Cost of Project: Occupancy Group: J Type of Construction: Please check this box if the project is a second-story addition: El -oject Size: Standard Large ❑ Majcr ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boil.r<= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH F:otel and Motel BUILDING BCONSTAXR Con lax—Resi/Mobile BUILDING BELEC 1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec !��vcs 600V<= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of3 CITY OF CUPERTINO CITY OF PERMIT APPLICATION FORM CUPEkTINO Quantity Fee ID Fee Description Fee Group BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREMTHEATR Theaffical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD S;b Specific Plan BUILDING BSEISMICOIl RUILDING BSEISMICRE Seismic Fee Res BUILDING -- BSPECIAL Special Inspection BUILDING BSWIM S wimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary Bldg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC B asiness License BUILDING ELECTRIC Electrical sq foot ELECTRICAL EPERMITFEE Elea Permit Issuance ELECTRICAL MPERMFEE Mechanical sq. foot MECHANICAL MPERMITFEE Mecli Permit Issuance MECHANICAL PPERMITFEE Pluirbing Permit I sue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING PLLONGRNGCPlannin LR Comme/Multi-Fam PLANNING PLLONGRNGR —d—Plannin Long Range Residential PLANNING 3 0-3