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06100008CITY OF CUPERTINO .(CTQ I1FC}R�TTON* BUILDING DIVISION PERMIT PERMIT NO. 06100008 BUILDING ADDRESS: JACK MYERS CONSTRUCTION 10628 LONNA LA PERMIT ISSUE DATE OWNER'S NAME: STOKES CLAYTON 1965 COLLEEN DR. 02 2006 SANITARY NO. CONTROL NO. )NE: (408)761-1185 BUILDING PERMIT INFO ARCHITECTIENGINEER: BLDG ELECT PLUMB MECI4 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is REROOF- WITH 50 YEAR PRESIDENTIAL, 30LB FELT, in mu force and effect c/(�(v License , " . CLASS SHEETING OSB 1/2 2 2 SQUARES , A Contractor Date otor ARCHITECTS DECLA ION I understand my plans shall be used as publ' records Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior m its issuance, also requires the applicant for such permit to file a signed statement 9 `S(1 Ft. Floor Area Valuati$f� 5 0 0 that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter (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 fire hundred dollars (x500). 35919012.00 ❑ 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 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 saRJ. ❑ 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 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. ❑ 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: Q 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. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance o the work for which this permit is issued. My Worker's C on Insurance carrie Policy number arc: Carrier. y 14 olicy No.: IMPFICATE OF WEMPUON 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 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.) Lender's Name y 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 building construction, and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permit. APPLIC UNDERSTAN AND L MPLY WITH ALL NON-POINT Issued by: Date SOUR RE CATIONS. t e Re-roofs lieanvcontrao.a1CType Of Roof HAZARDOUS MA LS DISCLOSUREhoapplicantor fubuildin upant stoic or handlehazardous material 7JI0--pp e Cupertinouncpaldc. Chapte9.12, and the Health and Safety Cod25532(.)? All roofs shall be inspected prior to any roofing material being installed. ❑ Yes If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future buildin occupant use equipment or devices which emit hazardous air contaminants u do cd by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes 1 have read the hazardous materials requirements under Chapter 6.95 of dtc Califor- nia Hcalth & Safety Code, Sections 25505.25533 and 25534.1 understand that if the building O does not currently have a ten t, that it is responsihility to notify the occupant of the require ich must uan of a Certificate of Occupancy. Sig ure of Applicant Da All r coverings to be Class "B" or ett r Owner thorizcd agentDa CITY OF ''M TINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department .:... c) xn ro Lane,, . . ••�a SUBCONTRACTOR BUSINESS NAME MIL �� L �� I am not using any subcontractors: Signa Plaaco rhPrV ann1irih1P )4 D a G»hrnntr rS and comnle the following information: Owner/ Contractor Signature Date 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 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 Nar. Job Site Address: Roofing Company Applicant's Signat Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO :m 1 of 1 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35919012.00 DATE ISSUED.......: 10/02/2006 RECEIPT #.........: 36274 REFERENCE ID # ...: 06100008 SITE ADDRESS .....: 10628 LONNA LA SUBDIVISION ....... CITY CUPERTINO IMPACT AREA ....... OWNER ............: STOKES CLAYTON ADDRESS .. ....... CITY/STATE/ZIP ...: OPERATOR: amyw COPY # : 2 RECEIVED FROM ....: JACK MYERS CONST. CONTRACTOR .......: JACK MYERS LIC # 24312 COMPANY ..........: JACK MYERS CONSTRUCTION ADDRESS ..........: 1965 COLLEEN DR. CITY/STATE/ZIP ...: LOS ALTOS, CA 94024 TELEPHONE ........: (408)761-1185 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT --------- THIS REC NEW BAL BPERMFEE VALUATION ---------- 8,000.00 ---------- 147.96 0.00 147.96 0.00 0.00 BSEISMICRE VALUATION 8,000.00 0.80 0.00 0.00 0.80 105.00 BUSLIC FLAT RATE 1.00 105.00 ---------- ---------- ------0_00 TOTAL PERMIT ---------- 253.76 0.00 253.76 0.00 METHOD OF PAYMENT AMOUNT NUMBER ------------ ----------------- ------------ CHECK 253.76 10744 TOTAL RECEIPT 253.76 r4p,-eie i CITY OF CUPERTINO REROOI'�j CUPCITY ER�TINO PERMIT APPLICATION FORM APN # 3' -Iq--012 Bldg Permit Fees Date: - iv BENERGY Energy z Building Address: /06,2ff Seismic Fee Res Owner's N BSEISMICOM Phone #: ��- 6 Contracto BPLANCHK License #jam, n BUILDING BUSLIC Business License 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: f� 4 Residential0 Co real ❑Z S �� Z A Fire Zone: Yes ❑ o Confirmed with PI gt. if there are any restrictions: Cost of P, eject: Type of Construction- Occupancy group: -7 5-0 > Qty. if 11 W PPP TT) tl Fee Descrintion 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