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07030328 CITE'OF CUPERTINO BUILDING DIVISION PERMIT ��TGT{��INFt�R1VIATTQl�• _ PERMIT NO. BUILDING ADDRESS: �. OWN9k'§ ^`45 [ING ST 5" AR&O-2 Q 0 7 CONTROL NO. T C`t~r>('TTTT(ITT BUILDING PERMIT INFO ARCH1TECr/ENGINEER: BLDG ELECT PLUMB MECH Z LICENSED CONTRACTOR'S DECLARATION JOb Description u I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing U with Section 7000)of Division 3 of the Business and Professions Code,and my license is ;y in full force andyesk ►► Lic. 10880, :-0890, 10900, 10910, 10920, 10930 NORTHSKY 3? License ice a ll # a Date u'��'pa Contracmr SQUARE 80 SQUARES ARCHITECI-S DECLARATION a I understand my plans shall be used as public records REMOVE EXISTING ROOF SYSTEM TO DECK, INSTALL 30# i U Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the z O following reason.(Section 7031.5,Business and Professions Code:Any city or county o 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 t Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q,Ft.Floor Area -$ (commencing with Section 70D0)of Division 3 of the Business and Professions Code)or .. that he is exempt therefrom and the basis for the alleged exemption.Any violation ofccupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number not more than five hundred dollars(5500)• 0 I,as owner of the property,or my employees with wages as their sole compensation, 31640052 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.). 0 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code:)The Contractor's U. cense Law docs 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. 0 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: have and will maintain a Certificate of Consent to self-insure for Worker's Compen- .on,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 0 I 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 Wo(��res Compenution Insuraa�nce carrier and Policy number are: Cam ti`F t�K,1J Y tiV�[w.c�r^ Policy No.+•)L'�► " 11 D 101 pL J*-�.-,c*iRT7FICATE OF EX FnON 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 must Z forthwith comply with such provisions or this permit shall be deemed revoked. O CONSTRUCTION LENDING AGENCY ►�- 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.) 2~ Lender's Name Lender's Address I certify that 1 have read this application and state that the above information is correct.l agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize representatives of this city to enter upon the Uabove-mentioned property for inspection purposes. Q, (We)agree to save,indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs and expenses which may in anyway accrue against said City _^ Z in consequence of the granting of this permit. Date ►+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by sc U EGN "Q_4- Re-roofs Signature of Ap t/Contractor Dare Type of Roof HAZARDOUS MATERIALS DISCLOSURE yP Will pplieant or future building occupant store or handle hazardous material as defined by ft 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 �o Will the applicant or future building occupant use equipment or devices which If a roof i 3 installed without first obtaining an inspection,I agree to remove E hazardous air contaminants as defined by the Bay Area Air Quality Management all new rr aterials for inspection. ,rrict? G Yes �No I have read the hazardous materials requirements under Chapter 6.95 of dee Califor- nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building docs not currently havea tena ft' my responsibility to notify the occupant of the moist be et pilo issuance of a Cer ifica fOceu Signature of Applicant Date All roof coverings to be Class"B"or better Owner or authorized age i Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: kiersaw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 31640052 . 00 DATE ISSUED. . . . . . . : 03/29/2007 RECEIPT # . . . . . . . . . BS000000818 REFERENCE ID # 07030328 SITE ADDRESS 10880 NORTHSKY SQ SUBDIVISION . . . . . . CITY CUFERTINO IMPACT AREA . . . . . . OWNER NOFTHPOINT HOMEOWNERS ASSOCIAT ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : FOFT WORTH TX, 76116- RECEIVED FROM RECEIPT INTERFACE CONTRACTOR DIF.Z, ALFRED LIC # 21323 COMPANY FOLR SEASONS ROOFING ADDRESS 502 HORNING ST CITY/STATE/ZIP SAY JOSE, CA 95112 TELEPHONE (4C8) 278-0330 FEE ID UNIT QUANTITY J,MOUNT PD-TO-DT THIS REC NEW BAL ---------- -- -------- ---- BPERMFEE VALUATION 24, 000 .00 320 . 76 0 . 00 320 . 76 0 . 00 BSEISMICRE VALUATION 24, 000 . 00 2 .40 0 . 00 2_ ------ 40 0_00 ------ TOTAL PERMIT 323 . 16 0 . 00 323 . 16 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ---------- CREDIT CARD 323 . 16 AMEX --------------- TOTAL RECEIPT 323 . 16 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- ----- 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS CITY OF CUPERTINO REROOF CUPEf�TINO PERMIT APPLICATION FORM APN# Date: _31 (,4005d , vo - - -�- Building Address: o I $Q 1 O 1O�?O 10 tO lOR O �= 0 Owner's Name: hone#: s . s�i�g,—qqc.313+-1 Contractor: Phone & License#: Contact: Phone P- Cupertino Business License#: o33v .2 3 Type of Roof Covering: Existing: Proposed: ❑ O Built-up roof Built-Up Roof ErAsphalt Shingles G Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles & c3 Other(Specify) —other(Specify) Number of existing coverings ❑ Provide I.C.1 .C.Report# D To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Con-i1 With :�u erto's�Tear Of fP�i` D fJif Job Aescription:Residential (+�� Commercial [] o Fire Zane: Yes ❑ No 0' Confirmed with Planning there are an Cost of Project: T pe of Construction; Occupancy g�up: Qty. ifFee Grou A licable Fee ID Fee Descri: tion BPERMFEE Bld Permit Fees BUILDING DING B$NERGY Ener BUIL BSISMICRE Seismic Fee Res BUILDING Seismic Coznmereial BUILDINGBSBISMICOIYi BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License Z0 30dd ONI300d SNOSV3S ano-I EEE08LZ80b 90:80 L00Z/6Z/E0 F Community Development Department � Building Division 'c City of Cupertino ` 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408) 777-3333 CUPEkINO -- Building Department Subject: Re-roofing policy for the ,2-ity 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 bn ldir g 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 ar y roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off app oval. 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 material down to the sheathing, so a proper City inspection can be performed. IMPORTANT: 1. Flat roofs must have a rni -Lum 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 dne time on inspection. I understand and will comply with the abo'7e stated policy on re-roofing. Homeowner's Name: job Site Address: i0�`6D,10`�yt0°lUo,1��9117�10�'1.��Ili O r . �.��c.✓�- 'L`'P�r��+o Roofing Company Name: ��"�� _�e'``'��r �`� 7 Applicant's Signature: date: Greg eel Building Official Rei Wised l/30/03 Prinre i on rlacycled Paper Z0 39tid 9NI300N SNOSV3S �jnod EEE08LZ80b 90:80 L00Z/6Z/E0 Community Development 10300 Torre Avenue mFt,: Cupertino CA 95014 Telephone(408)777-3228 CITY Of Fax(408)777-3333 'UPEkTINO Buildiri 4epartment OB ADDRESS: RMIT #J > -7031� o O�o� �o�► �o�-LL7 k , r OWNER'S NAME: �") ONE # GENERAL CONTRACTOR: I am not using any subcontractors: Sig nature Date Please check a licable subcontractors and comp:.ete the followin information: LSUB�jZ: CONTRACTOR 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/- - 'O - er/Contractor Signature Date