The URL can be used to link to this page

07090087 777777777 CITY OF CUPERTINO BUILDING DIVISION PERMIT OB".-- JN* BUILD N DMV ESS PERMIT NO. � CHARSAN LN ALL SE1,SONS ROOFING SERVICEE 07090087 PERMIT ISSUE DATE OWNER'S NAME: LEE HIRSCH 1720 SMITH AVE 09/14/2007 SANITARY NO. CONTROL NO. NE: BUILDING PERMIT INFO ARCHITECT/ENGINEER: REMOVE 1 LAYER OF EXISTING BLDG ELECT PLUMB MECH p p LICENSED CONTRACTOR'S DECLARATION ` V F I hereby affirm that I am licensed under provisions of Chapter 9(commencing ^^ '^ ^^^ - ^^ --Job Description :z m with Section 7000)of Division 3 of the Business and Professions Code,and my license is t<o. in full force and cfEsc ,vnn Z License as l• Lic.ri t p Date Contractor ARCHITECTS DECLAATI ,,-J I understand my plans shall be used as public records ryV W I Licensed Professional y OWNER-BUILDER DECLARATION > 1 hereby affirm that 1 am exempt from the Contractor's License Law for the 3 p O following reason.(Section 7031.5,Business and Professions Code:Any city or county e w go which requires a permit to construct,alter,improve,demolish,or repair any structure 1Z- prior to its issuance,also requires the applicant for such permit to file a signed statement t .Ft.Floor Area Valuation =a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >�] oF $ (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than five hundred dollars(5500). ❑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 Contractors License Law does 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 be 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 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 Contractors License Law. ❑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: Q 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compen- sation,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 Workers 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 Compensation Innsuran a Cartier and Policy number ate: !- Carrier:GA"A} Policy No.: 4(0-MVI Is CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section teed not be completed if the permit is for tint 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 Workcrs'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 �`L forthwith comply with such provisions or this permit shall be deemed revoked. Z OCONSTRUCTION LENDING AGENCY (~�. I hereby affirm that there is a construction lending agency for the performance of a. the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name aLender's Address U 0 1 certify that I have read this application and state that the above information is Lt+t correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction,and hereby authorize representatives of this city to enter upon the W about-mentioned property for inspection purposes. _ LL (We)agree to save,indemnify and keep harmless the City of Cupertino against L.4) liabilities,judgments,costs and expenses which may in any way accrue against said City U Z in consequence of the granting of this permit. ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date (� SOJJRCF.REGULATIONS a1 I.ml co Re-roofs igniture of ApplicanitContrattor Dae Type of Roof HAZARDOUS MATERIALS DISCLOSURE 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)? p All roofs ;hall be inspected prior to any roofing material being installed. ❑Yes �NoA,� Will the applicant or future building occupant use equipment or devices which If a roof i;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 materials for inspection. District? ❑Yes Nt>� I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my responsibility to notify the occupant of the _Du icy'rcmcnL4whirt must be met prior to issuance of a Certificate of Occupancy. Signature Of Applicant Date ° All roof coverings to be Class"B"or better Owner or authorized agent Date- CITY OF CUPERTINO 2 ITEMS OF 4 PERMI`[''RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl:c: Lot: APN . . . . . . . . . 36:310049 . 00 DATE ISSUED. . . . . . . : 09 /14/2007 RECEIPT #. . . . . . . . . : BS000002642 REFERENCE ID # . . . : 07090087 SITE ADDRESS . . . . . : 11,145 CHARSAN LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . . LE], HIRSCH ADDRESS . . . . . . . . . . : 11,145 CHARSAN LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4981 RECEIVED FROM . . . . : ALIS SEASON ROOFING CONTRACTOR . . . . . . . : GORSHTEIN, VLADISLAV LIC # 21035 COMPANY . . . . . . . . . . : ALI, -S.EASONS ROOFING SERVICES ADDRESS . . . . . . . . . . . 1720 SMITH AVE CITY/STATE/ZIP . . . : SAIT JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 971-4455 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 12, 000. 00 191.16 0. 00 191 .16 0. 00 BSEISMICRE VALUATION 12, 000. 00 1.20 0. 00 1.20 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 192 .36 0. 00 192 .36 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 308.42 #22279 --------------- TOTAL RECEIPT 308.42 0' 09 o c) B-T CITY OF ("'UPERTINO "`� REROOF CUPEkTINO PERMIT APPLICATION FORM APN#a(4 I Date: (�A 1 ��C Building Address: -S L_CNf\Q- -DRQ CGS r � Owner's Name: Phone#: Contractor: License#: 2.p�,SOos ).O Contact: n \;>cx `',VAS Cupertino Business License� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles �K Asphalt Shingles ';a( Wood Shakes Ag� Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify.) Number of existing coverings ❑ Provide I.C.B.O.Report# To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu pertino's Tear Off Policy: Job Description: CMX0Q0_ \ \G V�-- (o 30 i �t Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Det. if there are any restrictions: LJ Cost of Pro•ect: Type of Construct' Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE I 3ldg 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-1 oofing. 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 appro,Tal. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nail i-ispection is required. 6. Any roofing which is applied without fi 7st obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfo-med. 7. NOTE: If you call for a plywood nail in3pection 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: Job Site Address: ,��Lk� cJ 5a Y\ L_k��. 5 1 r Roofing Company Name: Ie S Applicant's Signatu e_ Date: A Cs ec1Sc��S ��5 S�viI res Greg Casteel Building Official Revises l 11/2/04 Community Development A 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 %PEKTINO Building Department JOB ADDRESS: PERMIT# ��O L-,(\ Sc OWNER'S NAME:12aAWj PHONE # C _ y — GENERAL CONTRACTOR: FAX # '`k v f\ S JC�`> I am not using any subcontractors: Signature Date Please check applicable subcontractors and corn ►lete 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