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07090027 7777.. CITY OF CUPERTINO PERMIT J BUILDING DIVISION PERMIT �� � �� � BUILDING �tDRESS: PERMIT NO. 103.15 STONYDALE DR WOODS ROOFING 07090027 OWNER'S NAME: PERMIT ISSUE DATE HOSE RICHARD K TR AND JANET K 1020 HICKORY CT 09/07/2007 NE: SANITARY NO. CONTROL NO. (831) 637-5576 ARCHTTECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 00 LICENSED CONTRACTOR'S DECLARATION .lob Description vs I hereby affirm that I am licensed under provisions of Chapter 9(commencing z with Section 70()0)of Division 3 of the Business and Professions Cade.and my license is TEAR OFF EXISTING SHAKE RO F F RE-SHEET OSB, 3 0 LB ! y in full force and ecu.G,,�3 t Ltc# ?-e /'�l �? License Class J FELT, 50 YR COMP, CLASS A, 42 1/2 SQ. -t,,,a Date -I­ -G 7 Contractor ARCHITECTS DECLARATIO i a< I understand my plans shall be used as public records )yU ' U.y Licensed Professional OWNER-BUILDER DECLARATION > I hereby affirm that I am exempt from the Contractors License Law for the c Op� following reason.(Section 7031.5,Business and Professions Code:Any city or County Ii 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 rile a signed statement =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 Code)or $22000 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 ofNumber Occupancy Type not more than five hundred dollars(5500). 3263701 1U ❑I,as owner of the property,or my employees with wages as their soic compensation, will do the work,and the structure is not intended or offered for We(Sec.7044,Business ns Required Inspections and Professions Code:The Contractor's License Law dors 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 sate.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 contact 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 conu=tor(s)licensed pursuant to the Contractor's 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: 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. have and will maintain Worker's Compensation Insurance,as required by Section 700 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's Compensation Insurance carrier and Policy number are: Cartier.-"!io/ J Policy No711_� CERTIFICATE OF EXEMPTION FROM WORKERS' 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 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 ,J 0 forthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of (1: the work for which this permit is issued(See.3097,Civ.C.) QLender's Name Lender's Address Uz IJ C) 1 certify that I have read this application and state that the about information is IL ' 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 U above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against r�r liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date APPLI NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOU C EGULA NS. i- 7-v " Re-roofs Signature of ppl) Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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 roofs shall be inspected prior to any roofing material being installed. ❑Yes C o 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? Q Yes rusmaterials l have read the hazardc requiremens under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.I understand that if the building does not curte ve a tenant-that it is my responsibility to notify the occupant of the requirements is ust be met p' r to i cc of a Ccrtificate of Occupancy. Signature of Applicant Date f `� All Too coverings to be Class "B"or better Owner or authorize age Dare CITY OF CUPERTINO 3 ITEMS OF 3 PERMIP RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 32537011. 00 DATE ISSUED. . . . . . . : 09/07/2007 RECEIPT #. . . . . . . . . . BSS00002578 REFERENCE ID # . . . : 07D90027 SITE ADDRESS . . . . . : 10335 STONYDALE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : HOSE RICHARD K TR AND JANET K ADDRESS . . . . . . . . . . : 10335 STONYDALE DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1029 RECEIVED FROM . . . . : EDNARD A GREGORY CONTRACTOR . . . . . . . : WOOD, LAWRENCE E LIC # 20810 COMPANY . . . . . . . . . . : WOODS ROOFING ADDRESS . . . . . . . . . . : 1020 HICKORY CT CITY/STATE/ZIP . . . : HOLLISTER, CA 95023 TELEPHONE . . . . . . . . : (831) 637-5576 FEE ID UNIT QUANTITY MOUNT PD-TO-DT THIS REC NEW BAL ----------- ------------- ---------- ---------- ---------- ---------- ---------- 13PERMFEE VALUATION 22, 000. 00 299 .16 0. 00 299 .16 0. 00 13SEISMICRE VALUATION 22, 000. 00 2 .20 0. 00 2 .20 0. 00 BUSLIC FLAT RATE 1. 00 107 .00 0. 00 107 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 408 .36 0. 00 408.36 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ------------------ --------------- -------------------- CREDIT CARD 408.36 MC --------------- TOTAL RECEIPT 408.36 D709ooz77 CITY OF CUPERTINO RE-ROOF CUPER`TINO PERMIT APPLICATION FORM APN# ��z b 3 20 // • ( U Date: — C� Building Address:e3 ���0 le— Owner's � pr 6 Owner's Name: - Phone#: I clGt d S� Yo ?- 73 6- 4'2 v 3 Contractor: License#: 3 WOODS DS �uu` 0,, __ c_ 3 7— Contact: Contact: Cupertino Business License #: C7 f c� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles X Asphalt Shingles S—O y r Jj Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) NAnber of existing coverings ElProvide I.C.B.O.Report# To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cuuertino's Tear Off Policy:- ` ` ' ❑ Job Description: Ssr ✓v x, f ti S t /-6L. ,raw 0,5 Q .So Residential Commercial ❑ S S Fire Zone: Yes ❑ No P-'- Confirmed with Planning Dept. if there are any restrictions: U Cost of Project: 000Type of Construction: Occupancy group: IF Qty. if Applicabip 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 YJ� 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 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 perf��rmed. 7. NOTE: If you call for a plywood nail ilspection 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 a/bovc stated policy on re-roofing. Homeowner's Name: / j 1-G G✓-C� `/ ) S-� Job Site Address: C9 3 `1q (e- 12t Roofing Company Name: W c�l� cl S J c7 rJ" �► L Applicant's Signature: Date: 5;0- 7---) U 0 Greg Casteel Building Official Revised 11/2/04 Community Development �+ J orte Avenue C1 p Orono CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: PERMIT# �-rV OWNER'S NAME: PHONE # -112 U 3 x GENERAL CONTRACTOR: FAX # /I I am not using any subcontractors: 7 7 Signature Date Please check applicable subcontractors and co m )lete the following information: SUBCONTRACTOR BUSII*,fESS 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 (i(JD j-S s�c t, Septic Tank Sheet Metal Sheet Rock Tile Owner/Contract Signa Date