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06100062 7777777777777 CITY OF CUPERTINO10 BUILDING DIVISION PERMIT liQZ ION; PERMIT NO. BUILDING ADDRESS: MONKS ROOFING 06100062 7877 BELKNAP DR OWNER'S NAME: PERMPC ISSUE DATE STEPHEN CULVER 794 BERRY NE: SANITARY NO. CONTROL NO. (408)262-4797 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH p C LICENSED CONTRACTOR'S DECLARATION Job Description m I hereby affirm that I am licenced under provisions of Chapter 9(commencing Z� with Section 7000)of Divisio of the Business an C d my license is A. in full force and fc�fec{`3 REROOF- TEAR OFF SHAKES, INSTALL OSB, 5 0YR COMP 0 Da �ey/ L'� * CLASS B, 29 SQUARES ;Ftp pate Contractor ARCHITECTS DELLA ATION i a< 1 understand my plans shall be used as public records )yU O H Licensed Professional t h OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the 3 p O following reason.(Section 7031.5,Business and Professions Codc:Any city or county which requires a permit to construct,alter,improve,demolLch,or repair any structure Zprior to its issuance,also requires the applicant for such permit to file a signed statement _`e that he is licensed pursuant to the provisions of the Contracwr's License Law(Chapter 9 Sq.Ft. Floor Area Valua$W 3 0 0 I.-$ (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not more than rive hundred dollars($500). 36208035 . 00 [11.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 forsale(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.). 0 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 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. 0 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: 0 1 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. ❑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 Worker' m�Watioq1rAsu-rance trier and Policy number are: Cartier. 1—7 � Policy Na.: 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 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 0 forthwith comply with such provisions or this permit shall be deemed revoked. z, CONSTRUCTION LENDING AGENCY Fr ter I hereby affirm that there is a construction lending agency for the performance of a+ the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name az Lender's Address V 0 I certify that I have read this application and state that the above information is Li,t 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 W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against rA liabilities,judgments,costs and expenses which may in any way accrue against said City U z in consequc of the granting of this permit. � APPLIC UNDERST NDS A WILL COMPLY WITH ALL N-P INT Issued by: Date G'4P'Z i-- SOUR GULA O /,X� �( V Re-roofs Signature of Applicant/Contractor Date HAZARDOUS MATERIALS DISCLOSURE Type of Roof 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 shall be inspected prior to any roofing material being installed. ❑Yes GV No If a roof 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 contaminrN.defined by the Bay Area Air Quality Management all new m erials for inspection. District? 0 Yes I have read the hazardous materials requirements under Chapter 6.95 of the Califor- I zA/10/ niaHcalth SafctyCodc,Scctions25505,25533and25534.IundcrstandthatiClhebuiWing l �E� ��w ponsibility to notify the occupant of the of Cer0catc of Occupancy. Signature of Applicant Date Owner or authorized age t Date roof coverings to be Class"B"or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408) 777-3333 '7UPEkTINO Building Department JOB,ADDRESS: PERMIT.# OWNER'S NAME: LLA e (2- PHONE # ` GENERAL CONTRACTOR ,)t J FAX # / I am not using any subcontractors: 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 Plastering Plumbing Roofing Septic Tank Sheet Metal eet Rock ;dile Owner/Contractor Signature Date CITY OF CUPERTINO ,m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36208035 . 00 DATE ISSUED. . . . . . . : 10/10/2006 RECEIPT # . . . . . . . . . : 36370 REFERENCE ID # . . . : 06100062 SITE ADDRESS . . . . . . 7877, BELKNAP DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER STEPHEN CULVER ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : MONKS ROOFING CONTRACTOR MONKS, DAVID LIC # 22117 COMPANY MONKS ROOFING ADDRESS 794 BERRYESSA ST CITY/STATE/ZIP . . . : MILPITAS, CA 95035 TELEPHONE . . . . . . . . : (408) 262-4797 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---- ------ ------------- ---------- ---------- ---------- ---------- --- ------- BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00 BSEISMICRE VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00 ---------- ----- ----- ---------- ---------- TOTAL PERMIT 181 . 46 0 . 00 181 .46 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER --- ------ -------- ------------ ------------------ CHECK 181 . 46 1630 TOTAL RECEIPT 181 . 46 DO I WOW- CITY OF CUPERTINO 4!j(1V REROOF CUPEkTINO PERMIT APPLICATION FORM APN# Date: Io Buildin r e p Owner's Name: PhO Contractor: ,� License#6 Contact: Cupertino Business License #: 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) ❑ 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: ❑ Job Description: c C- oS Residentiat�K] Commercial ❑ � S �S S P C� Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: LJ Cost of P�ojec�•� Type of Construction: Occup�y...�roup: 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 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 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 first 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 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: U LU10 ,Q_Ye_ Job Site Address: Roofing Company Name: AAOWA,S , /' L Applicant's Signature: �/ Date:lo//o � 6 Greg Casteel Building Official Revised 11/2/04