The URL can be used to link to this page

07050289 CITE'OF CUPERTINO PERMIT BUILDING DIVISION PERMIT �N +t�T+Q IERNiAION PERMIT NO. BUILT�'i,EtTfESbENDERGAST AVE WINTER :MFING INC 07050289 2i / /1 PERMIT ISSUE DATE OWNER'S NAME: MARK SMITH 151 WAYANDOTTE DR 05/31/2007 SANITARY NO. CONTROL NO. NE: 4083638 )52 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description UI hereby affirm that I am licensed under provisions of Chapter 9(commencing z 8 with Section 7000)of Division 3 of the Business and Professions Code,and my license is REROOF—ZEMOVE (E) , INSTALL 3 0 LB FELT, 3 0 YR r<a j� in full License C1 force and eCf LieN SHINGLES, 13 SQS-CLASS A � Licen E„ca Dalc s Contractor A CHITECTS DEC A I i a< I understand my plans shall be used as public records )yU U.y Licensed Professional OWNER-BUILDER DECLARATION ja I hereby affirm that 1 am exempt from the Contractor's License Law for the 00 following mason.(Section 7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure Z y� 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 ;iq.Ft. Floor Area $4830 t= (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of 3752703 5 Number Occupancy Type not more than five hundred dollars(5500). ❑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.). ❑I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044.Business and Professions Code:)The Contractor's Li- cense taw 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 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. rI have and will maintain Worker's Compensation Insurance,as required by Section 00 of the Labor Code,for the performance of the work for which this permit is issued. My Worker's C9WppuauoLJ=rAnW carrier and Policy number are: Carrier. Policy No..- CERTIFt ATE 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,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 Q forthwith comply with such provisions or this permit shall be deemed revoked. 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.) aA Lenders Name .7 z Lender's Address U 0 I certify that I have read this application and state that the above information is LL,t-r corect.1 agree to comply with all city and county ordinances and state laws relating to O U building construction.and hereby authorize representatives of this city to enter upon the �U above-mentioned property for inspection purposes. (We)agree to save,indemnity and keep harmless the City of Cupertino against rpt liabilities dgmcnts,costs and ez cs which may in any way accrue against said City V z in corse cc oC the grantin o permit. Issued by: Date S APP A UNDER�T AND WILL COMPLY WITH ALL NON-POINT CE Re-roofs Signatu of ppl tractor Date T of Roof HAZARDOUS MATERIALS DISCLOSURE Type Will the applicant or future building occupant store or handle hazardous material fined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety ode.Section 25532(a)? All roofs ;hall be inspected prior to any roofing In being installed. ❑Yes . Will the applicant or future building occupant use equipment or devices which If a roof i:>installed without Irst obtaining an inspection,I agree to remove emit hazardous air contaminants as defined y the Bay Area Air Quality Management all new Aterials for ins p Ion. District? ❑Yes u I have read the hazardo�ihwit ials requirements under Chapter 6.95 of the Califor- ��% nia Health afcty Code,Secti05,25533 and 25534.1 understand that if the building ! does n mently have na is my responsibility to notify the occupant of the re nts which to issuance of a Certificate ofOce cy. gig t4b of Applicant Date -f/ All roof coverings to be Class"B"or better O er or author .cd agent Datc' f' CITY OF CUPERTINO 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 37527335. 00 DATE ISSUED. . . . . . . : 05/31/2007 RECEIPT #. . . . . . . . . BS000301510 REFERENCE ID # . . . : 07050289 SITE ADDRESS . . . . . : 18771 PENDERGAST AVE SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER MARK SMITH ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERrINO, CA 95014 RECEIVED FROM . . . . : WINTER ROOFING CONTRACTOR . . . . . . . : MARTINEZ, JAVIER LIC # 21207 COMPANY WINTER ROOFING INC ADDRESS 151 WAYANDOTTE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95123 TELEPHONE 4083638052 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 4, 830 .00 115 .56 0 .00 115 .56 0 . 00 BSEISMICRE VALUATION 4, 830 .00 0 .50 0 .00 0 . 50 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 116 . 06 0 .00 116 . 06 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 221 .32 mastercard --------------- TOTAL RECEIPT 221.32 CITY OF CUPERTINO L! CITY OF R:EROOF �^ CUPEkTINO PERMIT APPLICATION FORM APN#�� 5� Date: -31 u Building Addre 9771 Owner's Nam . Phone#: v 0�-S- ,.. 6 Contractor: Phone if: 3G3—&7 ,2_ License#: �y Contact: , Phone A: Cupertino Business License#: The of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof 0,"'-Asphalt Shingles LA "-Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# JB—To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With C iertino's Tear Off Policy: Job Description: C- - 17 q)l — Residential Commercial ❑ 3 Fire Zone. Yes ❑ No Confirmed with Tanning Dept. if there are anrestrictions. u Cost of Project: Type of ConstrL ction: Occupancy group: Qty. if Applicable— Fee ID Fee Description Fee Group BPERMFEE —Bldg 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 CITY OF Fax: (408) 777-3333 CUPEkTINO Building Department Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance,you must agrE-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 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.=irst obtaining an inspection, will require the removal of all new ma-:erial down to the sheathing, so a proper City inspection can be performed. 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: v.vA✓__,,-_ V`i[ " Job Site Address: Roofing Company Name: JALU fzL 114 S �� A plicant's Signature: Dater zr� Greg I teel Building Official Revi.,ed 1/30/03 Printed c n Recycled Paper u, Community Development Y a yM1 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 7UPERTINO Building Department JOB ADDRES PERMIT # 0 OWNER'S PHONE # - GENERAL CONTRACTOR: j,�i iii FAX # p I am not using any subcontractors: ignature Date Please check a licable subcontrac sand complete the followinginformation: 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 Tile Owner/Contractor Signature Date