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07060069 CITY OF CUPERTINO BUILDING DIVISION PERMITET � ' PERMIT NO. BUILDI,NG,AT99hLKNAP DR BECKS RDOFING 07060069 OWNER'S�Z5N7A4ME:t5 PERIvM ISSUE DATE SOUZA KENNETH A AND MARY D 6191 OCIO RLOS DR 06/11/2007 AONE: (408) 36 -8979 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p 0 LICENSED CONTRACTOR'S DECLARATION Job Description i u t— 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing :UU with Section 7000)of Division3oftheBusinessandProfessionsC ndmylicenseis WOOD SHAKES, ASPHALT SHINGLES. TEAR OFF, OSB, 1<N in full force and cffec�` ��r ;:D z License es Lie•M #50 :; � °arc ARCHITECI'SnDECLARATION YEAR ELK, 30LB FELT i a< I understand my plans shall be used as public records :0. U.y Licensed Professional y OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the 3 00 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 prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation ?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq.Ft.Floor Area $11500 2 F-- (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 36210033 . Number Occupancy Type not more than five hundred dollars($500). [11,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 forsale(Sec.7044,Business Required Inspections and Professions Code: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 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 contractors to construct the project(Sec.7044,Business and Professions Code:)The Contracmis 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 Contractor's License Law. Q 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: I 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. I have and will maintain Workers 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 Co enation Insu ee cam and Polity number are: Cartier. Airy No.: 6 TIFI ATE OF E PTION 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 Oforthwith comply with such provision or this permit shall be deemed revoked. z , CONSTRUCTION LENDING AGENCY N C.4) I hereby affirm that there is a construction lending agency for the performance of r>~'> the work for which this permit is issued(Sec.3097,Civ.C.) WCi.Q Lender's Name z Lender's Address U 0 1 certify that I have read this application and state that the above information is (y �r correct.1 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 above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in any way accrue against said City V'Z in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by Date SOURCEGUL��ppN . /_ — ) I /�7.( � a Ica---r'— Re-roofs Signature of Appl canUContractor °arc 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 Cafe,Section 25532(x)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes f I No T 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 rr aterials for inspection. District? Yes P No 1 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 (, does not currently have a tenant that it is my risibility to notify the occupant of the requirements which met toissu of fit:ateortxcupancy Signature of Applicant Date All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 36210038 .00 DATE ISSUED. . . . . . . : 06/11/2007 RECEIPT #. . . . . . . . . : BSC00001599 REFERENCE ID # . . . : 07C60069 SITE ADDRESS . . . . . : 78S4 BELKNAP DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER SOUZA KENNETH A AND MARY D ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4906 RECEIVED FROM . . . . : CALL BECKS & SONS CONTRACTOR BECKS, CARL LIC # 21908 COMPANY BECKS ROOFING ADDRESS 61 S'1 OCHO RLOS DR CITY/STATE/ZIP . . . : SAT( JOSE, CA 95123 TELEPHONE (408) 365-8979 FEE ID UNIT QUANTITY liMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 11, 500. 00 191.16 0. 00 191 .16 0.00 BSEISMICRE VALUATION 11, 500. 00 1.20 0. 00 1.20 0. 00 BUSLIC FLAT RATE 1. 00 107 .00 0. 00 107 . 00 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 299 .36 0. 00 299 .36 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 299 .36 #24011 --------------- TOTAL RECEIPT 299 .36 CITY OF CUPERTINO RE OOF CUPERTINO PERMIT APPLICATION FORM APN# Date: l Building Address- v g V Owner's Name: Phone#: ` ) •� Contractor: License#: Contact: Cupertino Business License #: Type of P oof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles �r_Asphalt Shingles Wood Shakes ❑ Wood Shakes U 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: /I eo.,A— o, f-i- 11 o � � 0 :r� R— '3 Residential Comm rcial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning D t. if there are any restrictions: Cost of Project: Type of Constru,;tion: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE 3ldg Permit Fees BUILDING BENERGY Energy BUILDING BSEIS UCRE 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 agrc e 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 buildinf;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 mat trial down to the sheathing, so a proper City inspection can be performed. 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: .J LA--Z e' Job Site Address: J� C L t l' +\ Roofing Company Name: r 9 Applicant's Signature: ,.- Dater Greg Casteel Building Official Revised 11/2/04 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 Building )Department REROOF TEAR OFF POLICY 1. You must schedule an inspection for the tear off the day before you wish the inspection to be made. The procedure is to call the Building Division (408) 777-32'18 between the hours of 7:30 a.m. and 3:30 p.m. to request a next-day inspection. 2. When the roof is torn off, the rails have been removed or driven in, and all of the dry-rotted wood has been replaced, you must call the City Building Division. An inspector will be there within one hour. There are special hours for this: service: from 7:30 a.m. to 10:30 a.m. and 1:00p.m. to 3:30 p.m., Monday through Thursday and from 7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note: Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m. and will not be called during t hat time. City Hall is closed between 12:00 and 1:00 p.m. daily.) 3. If you call for a tear-off 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. Greg Casteel Building Official Revised 8/13/04