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07030221 CITY OF CUPERTINO PERMIT fit' BUILDING DIVISION PERMIT V �" g� y ��` i�O�• PERMIT NO. BUtLb1NGADDRcSS: EASTMAN CONT(-kCTING, INC 07030221 10208 TONI CT ' PERMIT ISSUE DATE OWNER'S NAME: DONALD & KATHERINE DISNEY 1418 DOUGLAS ST 03/23/2007 SANITARY NO. CONTROL NO. NE: (408) 97'--9000 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB IAECH )C C LICENSED CONTRACTOR'S DECLARATION Job Description ,oI hereby affirm that I am licensed under provisions of Chapter 9(commencing Z w with Section 7000)of Division 3 of the Business and Professions Code,and my license is REROOF—`�' O 41 S QUAARE S INSTALL 40 YR COMP, ;>z in full force and f tq l Lics 5Z 56 -FIBERGLASS REINFORCED. ? License Class p Datc Contractor t- ARCHITECTS DECLA ATION 7 a< I understand my plans shall be used as public records )yU u.y Licensed Professional C a OWNER-BUILDER DECLARATION >.� 1 hereby affirm that 1 am exempt from the Contractors License war c jp O following reason.(Section 7031.5,Business and as Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure —y prior to its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation ?< that he iis licensed pursuant to the provisions of the Contractor's's LiLaw(Chapter 9 $13495 Z i- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i 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 A��1 Number not more than five hundred dollars($500). 3162310 V U ❑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 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 he did not build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractoes U- 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. ❑1 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 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. ❑1 have and will maintain Worker's Compensation Insurance,as required by Section 3700 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 am: Carrier.VC D Policy No\W,± t!1 t 1 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is Cor 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 must ,J Z forthwith comply with such provisions or this permit shall be deemed revoked. rZZ CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a constructinn lending agency for the performance of ai> the work for which this permit is issued(See.3097,Civ.C.) , Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to rJ- building construction,and hereby authorize representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the Ci tino against liabilities,judgments,costs and expenses which m in an ay accrue a st said City �^ 2_v V Z in consequence of the grantin f this perm' Date / APPLICA ERST SAN L COMP H ALL NON-POI Issued by: SOURCE ATIO 7� �3 Re-roofs s' u or Applicant/Contractor are T of Roof MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material as defincd by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑Yes *o building occupant use equipment or devices which If a roof:s installed without first obtaining an inspection,I agree to remove Will the applicant or flutes emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new r laterials for inspection. District? ❑Yes �N. I have read the hazardous materials requiremeVsunder Chapter 6.95 or- nia Health&Safety Code,Sections 25505,25 534.I un building does not torte vc a tenant,that it' t o no the axupant o c requiremc rch must be met r t uance of a cupancy. Applicant Date All roof coverings to be Class'B"or better O r or authorized agent Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT' RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: B1{: Lot: APN . . . . . . . . : 31523104 . 00 DATE ISSUED. . . . . . . : 03/23/2007 RECEIPT #. . . . . . . . . : BS)00000764 REFERENCE ID # . . . : 07)30221 SITE ADDRESS . . . . . : 10208 TONI CT SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : DO:JALD & KATHERINE DISNEY ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2073 RECEIVED FROM . . . . : RE-'EIPT INTERFACE CONTRACTOR . . . . . . . : JAMES EASTMAN LIC # 22140 COMPANY . . . . . . . . . . : EA3TMAN CONTRACTING, INC ADDRESS . . . . . . . . . . : 1418 DOUGLAS ST CITY/STATE/ZIP . . . : SAJ JOSE, CA 95126 TELEPHONE . . . . . . . . : (4 )8) 971-9000 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- BPERMFEE VALUATION 13,495.00 212.76 0.00 212 .76 0. 00 BSEISMICRE VALUATION 13,495. 00 1.40 0.00 1.40 0. 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 214.16 0 . 00 214 .16 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 214 .16 32466 --------------- TOTAL RECEIPT 214 . 16 CITY OF CUPERTINO laz- REROOF CUPER�TINO PERMIT APPLICATION FORM APN# 1/ � /yl Date:113 Building Address: 20 bye t'-,t . �✓l.� Owner' Name: .1�0�/¢� P4- Phone����/ L40`3 . " l , "J C UC=U Contractor: License#: Contact: Cupertino Bus�iLicense #: SCC Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles c2t--Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings 1 ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I HaveRedd,Understand and Will Comply With Cupertino's Tear Off Policy: Job Description: �2a3 - o�F xA -,j-e0_V- Y-e-in'K-,u' Residenti . al'kS - Commercial ❑ Fire Zone: Yes ❑ No 0' Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project: 01�- Type of Co�stru(:tion: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE 13ldg 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 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 apprcval. 2) In-progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nail nspection 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 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 :)f$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: 1'J• \'���� Job Site Address: Roofing Company Name: Applicant's Signature: ��:t��—Uate. Greg Casteel Building Official RevisEd 11/2/04 Community Development 10300 Torre Avenue as Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 "UPEkTINO Building Department JOB ADDRESS: ,Q-�� -cx-\, � - PERMIT # 4�5�n OWNER'S NAME: `�`• Nlti� . �'1 PHONE 0 1 GENERAL CONTRACTOR: FAX # h4Z I—ri C-1 I am not using any subcontractors. _ 93 ID7 11 Signature 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 P>stering Plumbing ` Roofing Septic Tank Sheet Metal Sheet Rock 3/��k7 Owner/Contractor Signature Date