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07090182 7777777777777777777 CITY OF CUPERTINO BUILDINI;DIVISION PERMIT d) TR .C7�QX ItT�(�N' BUIL(�l1r� 44rq, ESS: PERMIT NO. UbCASTINE AVE WOODS RCOFING 07090182 OWNER'S NAME: PERMIT ISSUE DATE IRVINE WILLIAM G AND DONNA M 18675 ALAMS CT 09/26/2007 )NE. SANITARY NO. CONTROL NO. y©,Y` 7Z3- 7Y (831) 63-/-5576 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 p Q LICENSED CONTRACTOR'S DECLARATION Job Description m 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing t Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is T/0 EX S'I'NG SHAKE, RE SHEET OSB, 3 0 LB FELT, 5 0 YR A- in full force and WL� 3 i j Z— j3f z License Clan Lie.df COMP SHINGLES, 38 SQ. , CLASS A. s p Date 7 Contractor ARCHITECTS DECLARATION i a a I understand my plans shall be used as public records �yV w H Licensed Professional y OWNER-BUILDER DECLARATION > I hereby affirm that 1 am exempt from the Contractor's License Law for the j n C following reason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct alter,improve,demolish,or repair any structure a Zy prior to its issuance,also requires the applicant for such permit to file a signed statement S ao ;>q.Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter9 at- (commencing with Section 70(10)of Division 3 of the Business and Professions Code)or $17700 L 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($500). 3264404-, l7V' 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 Required Inspections and Professions Code:The Contractor's License Law docs 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 ask.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 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 contracior(s)licensed pursuant to the Contractors License Law. 0 1 am exempt under Sea B&P C for Otis reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 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. have and will maintain Workers Compensation Insurance,as required by Section 3r00 of the Labor Code,for die performance of the work for which this permit is issued. My Workers Compensation Insurance carrier and Policy number arc: yCarrier: FV� Policy 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,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 mus Oforthwith comply with such provisions or this permit shall be deemed revoked. zCONSTRUCTION LENDING AGENCY Er tom. I hereby affirm that there is a construction lending agency for the performance of . (� the work for which this permit is issued(See.3097,Civ.C.) aQ Lenders Name Z Lender's Address U O 1 certify that I have read this application and stale that the above information is IL o"t correct.I agree to comply with all city and county ordinances and state laws relating to r, U building construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. W (We)agree to save,indemnify and keep harmless the City of Cupertino against H to liabilities,judgments,costs and expenses which may in any way accrue against said City Lf U z in consequence of the granting of this permit. �. APPLI NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date j SO REGULA ONS c, Re-roofs Signature of Applicant/Conuaetor Date 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 Code,Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs:;hall be inspected prior to any roofing material being installed. 0 Yes ° 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? 0Yes ( fo I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Code,Sections 25505.25533 and 25534.I understand that if the building 2),er V doesof currently have a tenant,that it is my responsibility to notify the occupant of the re r cots which must be in rior to issuance of a Certificate of Occupancy. Signature of Applicant Date 9 fib• All roof coverings to be Class"B"or better Owner or authorize gen Date V-7 0i z, CITY OF (:UPERTINO :' "✓�` REROOF CUPEkTiNO PERMIT APPLICATION FORM APN# 3z& /� `� Date: ?_Z �o Buildi0�6 0 ` Owner' Name: �— Phone#: Wi� a 4 oP_ S/o(? 7Z 3 Contras or: ELicense#: 3-? UU// OF,vl Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles W Asphalt Shingles Wood Shakes ❑ 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 Cupertino's Tear Off Policy:- Job Description: S� e SS S Residential r4 Commercial ❑ Fire Zone: Yes ❑ No E Confirmed with Planning Dept. if there are any restrictions: U Cost of Project:/7, �f/U Type of Cction: Occupancy groin Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY anergy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK :Ilan 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 agre 2 to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 f rst obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfc rmed. 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: Ci���c<w. + �a ^ 5 / (/ e- Job Site Address: lO_�- 60 ss 5 4y e' Roofing Company Name: Ljo d cl"s :J-�G Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl}:: Lot: APN 32044042 . 00 DATE ISSUED. . . . . . . : 09/ 26/2007 RECEIPT #. . . . . . . . . : BS(100002776 REFERENCE ID # . . . : 07090182 SITE ADDRESS . . . . . : 10`_,60 CASTINE AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER IRVINE WILLIAM G AND DONNA M ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1311 RECEIVED FROM . . . . : EDWARD A GREGORY CONTRACTOR . . . . . . . : WOOD, LAWRENCE E LIC # 20810 COMPANY . . . . . . . . . . : WOODS ROOFING ADDRESS 18675 ADAMS CT CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037 TELEPHONE . . . . . . . . : (8; 1) 637-5576 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 17, 700. 00 255 .96 0. 00 255 .96 0. 00 BSEISMICRE VALUATION 17, 700. 00 1.80 0. 00 1 .80 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 257 .76 0. 00 257 .76 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 257 .76 MC --------------- TOTAL RECEIPT 257-.76 I Community Development 10300 Tone Avenue Cupertino CA 95014 Telepbone(408)777-3228 C� 'pEI�TINO - -- Fax(408)777-3333 Bui1din�3- Department JOB ADDRESSPERMIT# . C/0 s'60 Ss�� ri - Ov e ,-? D CFO l S�---- OWNER'S NAME:-Pa i t f W,-l/.u.- PHONE#'/p P�-'7" -7Yd- GENERAL CONTRACTOR FAX# I am not using any subcontractors: .e_o 2,�:S;a ;�' Y Z 6 0�> Signature Date Please check applicable subcontractors and complete the following information SUBCONTRACTOR BUSINE:iS 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 �C Roofing Septic Tank Sheet Metal Sheet Rock • Tile 9 Owner/Contractor Signature Date