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07050237 CITE'OF CUPERTINO BUILDING DIVISION PERMIT C� TR��CTt� IMATIE�N" PERMIT NO. BUILI3Jt ppp ESS 07050237 STELLING RD TBD TO BE DETERMINED OWNER'S NAME: N PERMIT ISSUE DATE MARIAN CROWEL 05/23/2007 ZONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH O z LICENSED CONTRACTOR'S DECLARATION Job Description u F I hereby affirm that I am licensed under provisions of Chapter 9(commencing :z� with Section 7000)of Division3oftheBusinessandProfessionsCode,andmylicenseis REROOF-REMOVE SHAKE,RESHEET 1/2 ' CDX ARCH COMP 30 ?7y iiceneClasand effec4 / LB FELT-20 SQUARES-CONTRACTOR J SAENZ ROOFING PD .= License Clara l s�/ Lic.S 6y 965 - - ^'a Date-23.-en-7 contractor T Sas__,z '-Z5 �— ARCHITECTS DECLARATION FOR BUS LIC. 7 C< I understand my plans shall be used as public records )W U U.H Licensed Professional y OWNER-BUILDER DECLARATION a 1 hereby affirm that I am exempt from the Contractors License Law for the 00 following reason.(Section 703 t.5,Business and Professions Code:Any city or county i which requires a permit to construct,alter.improve,demolish,or repair any structure o Z In prior to its issuance,also requires the applicant for such permit to rile a signed statement Valuation =G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q.Ft.Floor Area $8400 i t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or y 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 3263010 D Number Occupancy Type not more than five hundred dollars($500). ❑1,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 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.). ❑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 1 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. ❑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 are: 3lSt�� Carrier S r � �l to PolicyNo.: �S CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workcrs'Compensation Laws of California.Date Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should become subject to the Worker's Compensation provisions of the Labor Code,you must Oforthwith comply with such provisions or this permit shall be deemed revoked. Z"'-' CONSTRUCTION LENDING AGENCY Fr CA I hereby affirm that there is a construction lending agency for the performance of rt,> the work for which this permit is issued(Sec.3097,Civ.C.) ALender's Name a z Lender's Address U O 1 certify that I have read this application and state that the above information is ►" correct.I agree to comply with all city and county ordinances and state laws relating to 0 U building construction.and hereby authorize representatives of this city to enter upon the U above-mcntioncd property for inspection purposes. 0. (We)agree to save,indemnify and keep harmless the City of Cupertino against ,.�'.d r/I liabilities,judgments,costs and expenses which may in any way accrue against said City V Z in consequence of the granting of this permit. Date �� G ►' APPLICANT UND ANDS AN WILL COMPLY WITH ALL NON-POINT Issued by: ` SOURCE REGU ONS. S^Z 7-o -7 Re-roofs S igna5lpeof Appl ican'tlContractoDate T of R sof HAZARDOUS MA IALS DISCLOSURE }ape Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs,,hall be inspected prior to any roofing material being installed. C:1 Yes An No Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants a$defined by the Bay Arca Air Quality Management all new m.Iterials for inspection. District? C]Yes �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. t it is my responsibility to notify the occupant of dw requirements whi mhtst be prior to issuance of a Certificate of Occupancy. Signature A Applicant Date S-z3-o All roof coverings to be Class"B"or better Owner authorized agent Date CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT' RECEIPT OPERATOR: suew COPY # 1 Sec: Twp: Rng: Sub: B1}:: Lot : APN . . . . . . . . : 32(130100 . 00 DATE ISSUED. . . . . . . : 05 '23/2007 RECEIPT # . . . . . . . . . BS000001440 REFERENCE ID # . . . : 07050237 SITE ADDRESS . . . . . : 104:94 N STELLING RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : MAI'IAN CROWEL ADDRESS 104:94 N STELLING RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : J SAENZ ROOFING CONTRACTOR . . . . . . . : TBI) - TO BE DETERMINED LIC # 00096 COMPANY TBI) - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY 1,MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BPERMFEE VALUATION 8, 400 . 00 158 . 76 0 .00 158 . 76 0 . 00 BSEISMICRE VALUATION 8, 400 . 00 0 . 90 0 . 00 0 . 90 0. 00 BUSLIC FLAT RATE 1 . 00 107. 00 0 . 00 107. 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 266 . 66 0 . 00 266 . 66 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 266 .66 8771 --------------- TOTAL RECEIPT 266 .66 CITY OF C-UPERTINO RE ROOF ciry or CUPERTINO PERMIT APPLICATION FORM APN# Date: /C S 3 -0 . Building Address: Owner's Name: � M Pho�SL�3 1/ z 1{ • CAL/ Contactor?_ 4 f A)2 License#: J i (,Set 6 Contact;_ Cupertino Business License #: Type of P.00f Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ,'W Asphalt Shingles d Wood Shakes ❑ Wood Shakes ❑ 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 Cu ertino's Tear Off Policy: El Job Description: I �0� s�� - ( sG.�.�t C b x . - 1 h AT���. Residential ©- Commercial ❑ 0 r:�4_k - class -- A - 2 Fire Zone: Yes ❑ No JR1 Confirmed with Planning De t. if there are any restrictions: Cost of Project: Type of Construe;tion• Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE =31dg 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 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 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 first obtaining an inspection, will require the removal of all new material down to the sheathing, so a proper City inspection can be perfc rmed. 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: 1M/2 S - 6,o� -," Job Site Address: /0 V�q N 1 Roofing Company Name: J O-eA.) 2- 900 N`e Applicant's Signature: Date: 5'-2.7-o ? Greg Casteel Building Official Revised 11/2/04