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07060180 CITE'OF CUPERTINO �� ����IQRM�TI�N� BUILDING DIVISION PERMIT PERMIT NO. ""'I'61n "IRA VISTA AV LOS GATOS ROOFING 07060180 l U 3 t 1 PERMIT ISSUE DATE OWNER'S NAME: 06/21/2007 BOCCHIERI CARMELO J AND ADELE P O BOX 17 2 6 SANITARY NO. CONTROL NO. )NE: (408) 298-9399 BUILDING PERMIT INFO rARCHITEc-r/E:NGINEER: BLDG ELECT PLUMB MECH lpooLICENSED CONTRACTOR'S DECLARATION Job Description vereby affirm that I am licensed under provisions of Chapter 9(commencing ZuViwilhcction70(l0)inin of sion3ofthcBusincssandProfcssionsCodc,andmylicenscis REMOVE :? LAYERS EXISTING ROOFING. INSTALL 7/16" i a a in full force and OSB AND -ROOFERS SELECT FELT. INSTALL LANDMARK 30 j Z License Cl s effec , Lic.# o Dare Contraclar SHINGLE BY CERTAINTEED. ? u� ARCHITECTS DECLARATION a a U 1 understand my plans shall be used as public records U.y Licensed Professional -O a OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for the no following reason.(Section 7031.5,Business and Professions Code:Any city or county < which requires a permit w construct, improve,demolish,or repair any structure u-ti prior m its issuance,also requires the applicant for such permit to file a signed statement 3 ,Ft.Floor Area $5216 Valuation -z a that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 fl S!I=- (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 Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 357 0 2 0 41 4tl Number not more than five hundred dollars(5500). 0 1,as owner of the property.or my employees with wages as their sole compensation, Required Inspections will do the work,and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law docs 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 It, 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 Cook:)The Contractor's Li- cense Law does not apply to an owner of property who builds or improves them n,and. who contracts for such projects vitt a contractor(s)licensed pursuant ro the Contractors License Law. 0 I am exempt under SeB&P C for this reason Sec. OwnerDate 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 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. 0 1 have and will maintain Workces 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 ore easy n lnwrnce carrier and Policy number am: — - Carrier: Policy No.:�aQr CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars(5100) 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'Compensali°a 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 2 forthwith comply with such provisions or this permit shall be deemed revoked. Z CONSTRUCTION LENDING AGENCY E.t►�-. 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.) W Q Lender's Name a Lender's Address I certify that I have read this application and state that the above information is U correct.1 agree to comply with all city and county ordinances and state laws relating to O V building construction.and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. a (We)agree to save,indemnify and keep harmless the City of Cupertino against F" ) liabilities,judgments,costs and expenses which may in any way seems against said City V Z in consequence of the granting of this permit. Date -'2 T✓f �-+ APPL C UNDERSTAND AND WILL COMPLY WITH ALL NON- INT Issued by: SOU GULATIONS D Re-roof; Signatu of Applicant/Contractor Date T of Roof HAZARDOUS MATERIALS DISCLOSURE Type 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 roof s shall be inspected prior to any roofing material being installed. 0Yes O'° If a roo- 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? [3 Yes ° I have read the hazardous materials requirements under Chapter 6.95 of thc Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building doyrcts rrently have a tenant,that it is my responsibility to notify the occupantDate icwhich must be et prior to issuan a Certificate of Occc � Signature of Appl ieantt/v o All roof coverings to be Class"B"or better Outhorized agent Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 35702041.00 DATE ISSUED. . . . . . . : 06/21/2007 RECEIPT #. . . . . . . . . . BSC00001736 REFERENCE ID # 07C60180 SITE ADDRESS 10-- 53 MIRA VISTA AV SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER BOCCHIERI CARMELO J AND ADELE ADDRESS . ,, 95014-2718 CITY/STATE/ZIP . . . : CUPERTINO CA, RECEIVED FROM . . . . : LOS GATOS ROOFING CONTRACTOR . . . . . . . : RA14DY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS : P () BOX 1726 CITY/STATE/ZIP . . . : LO3 GATOS, CA 95031 TELEPHONE . . . . . . . . : (4)8)298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL _ __ ___ __ ___ ____ ---------- ---------- - --------- ---- BPERMFEE VALUATION 5, 216. 00 126 .36 0. 00 126 .36 0.00 BSEISMICRE VALUATION 5,216. 00 0 .60 0. 00 -----0_60 ------0_00 ---------- ---------- - TOTAL PERMIT 126.96 0. 00 126 .96 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -- CHECK 126 .96 #1916 --------------- TOTAL RECEIPT 126 .96 CITY OF CUPERTINO 0-7c) (P t EROOF CU CITYOFiNO PERMIT APPLICATION FORM APN# Date: 617 Building Address: Owner's Name: Phone#: r v�-ass -�2-K Contractor: Phone #: 0 License#: �0020 Contact: '�-- Phone #: Cupertino Business Li e# Sa,11z)e_" : Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles `� Asphalt Shingles Wood Shakes ❑ Wood Shakes Wood Shingles ❑ Wood Shingles ❑ Other(Specify) �a Other(Specify) Number of existing coverings Z ❑ Provide I.C.B.O. eport# 01"To be Removed Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu ertino's TeV Off Poli y: eb Vescnp e_-S�106 A—r- CL'Yv O Residential Commercial [] Fire Zone: Yes ❑ No Confirmed with Planning Deft. there are any restrictions: L� Cost of Proje t: Type o Coni tructi :— Occupancy Tup: �1 90 - S . a3 Qty.. if Applicable Fee ID Fee Description Fee Group BPERNIFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING -- RE-_- Res__Seismic Eee Res_._ B-UILDING- - BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUU-DING Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPE�TINO 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 witho rt first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be p 2rformed. IMPORTANT: 1. Flat roofs must have a minimum of A" 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: e 96CL 1 - _:__._:Job Site-Address:- _..-- - ---- -- ---- Roofing Company Name: �~ O A plicant's Signature: ,� Date: Greg teel Building Official Revised 1/30/03 Printod on Recycled Paper Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Buildin De artment JOB ADDRESS: 3s� n I rc� V15�_A PERMIT # ©�v 040 40 OWNER'S NAME: heccA i er I PHONE # GENERAL CONTRACTOR ' o S FAX# I am not using any subcontractors:. 0j GCJS Si;;nature Date Please check applicable subcontractors and complete 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 T' 12-i D caner/Contractor Signature ate