11050200 _ CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22344 MC CLELLAN RD CONTRACTOR:SOUTH VALLEY PERMIT NO: 11050200
ROOFING INC
OWNER'S NAME: CLAUDE SOLET 4960 ALMADEN EXPWY DATE ISSUED:05/24/2011
NER'S PHONE: SAN JOSE,CA 95118 PHONE NO:(408)269-1698
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r— PLUMB r—
License Class Lic.#
MECH f— RESIDENTIAL r- COMMERCIAL
Contractor Date JOB DESCRIPTION:TEAR OFF EXISTING COMPOSITION ROOF AND BUILT
UP,(25 SQUARES ON PITCH ROOF,5 SQUARES ON FLAT
I hereby affirm that I am licensed under the provisions of Chapter 9 ROOF)INSTALL NEW 30 LB CERT PRESIDENTIAL ON
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for whichthis permit is issued. Sq.Ft Floor Area: Valuation:$10710
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35705061.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep hannless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Issued by: Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION Date:
Signature of Applicant:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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&Professions Code)
HAZARDOUS MATERIALS DISCLOSURE
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by
the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date:
permit is issued.
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 Worker's CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)Lender's Name
APPLICANT CERTIFICATION 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
-)n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
:mnify and keep harmless the City of Cupertino against liabilities,judgments,
:)sts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: bethe
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN 35705061 . 00
DATE ISSUED. . . . . . . : 05/24/2011
RECEIPT #. . . • • • • . . : 99000000503
REFERENCE ID # . . . : 11050200
SITE ADDRESS . . . . . : 22344 MC CLELLAN RD
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CLAUDE SOLET
ADDRESS . . . . . . . . . . : 22344 MCCLELLAN RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2753
RECEIVED FROM SOUTH VALLEY ROOFIN
CONTRACTOR JAMES METHOT LIC # 20837
COMPANY SOUTH VALLEY ROOFING INC
ADDRESS 4960 ALMADEN EXPWY
CITY/STATE/ZIP SAN JOSE, CA 95118
TELEPHONE (408) 269-1698
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ---------- - -
OLBCBSC VALUATION 10, 710 . 00 1 . 00 0 .00 1 . 00 0 . 00
OLREROOF SQUARES 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00
OLSEISM VALUATION 10, 710 . 00 1 . 07 ------0_00 ------ -- --
------0_00
TOTAL PERMIT 392 . 07 0 . 00 392 . 07 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------
CREDIT CARD 392 . 07 me
---------------
TOTAL RECEIPT 392 . 07
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -----
309 EXTERIOR LATH 311 SCRATCH COAT
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD
BUILDING ADDRESS:22344 MC CLELLAN RD CONTRACTOR: SOUTH VALLEY PERMIT NO: 11050200
ROOFING INC
OWNER'S NAME:CLAUDE SOLEI 4960 ALMADEN EXPWY DATE ISSUED:05/24/2011
OWNER'S PHONE: SAN JOSE,CA 95118 PHONE NO: (408)269-1698
CTIOIN5 BATE SPECTO
F. _iDATION/PIERS/H.D.S. BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH
UFER GROUND RESIDENTIAL r COMMERCIAL
TEAR OFF EXISTING COMPOSITION ROOF AND BUILT
PAD/SET BACK-CERT JOB DESCRIPTION:
P, (25 SQUARES ON PITCH ROOF, 5 SQUARES ON FLAT
GARAGE SLABS/PREGUNITE ROOF) INSTALL NEW 30 LB CERT PRESIDENTIAL ON
POUR NO CONCRETE UNTI[ABOVE'HAS BEEN SIGNED
UNDERGROUND/SLAB
UNDERGROUND PLUMBING
UNDERGROUND ELECTRICAL
DO NOT POUR FLOOR UNTIL ABOVE RAS BEEN SIGNED
UNDERFLOOR PLUMBING
UNDERFLOOR MECHANICAL
WILDLAND URBAN INTERFACE FIRE AREA ER#
UNDERFLOOR ELECTRICAL
UNDERFLOOR FRAMING VENTS TO ARRANGE INSPECTION
UNDERFLOOR INSULATION Call 777-3228 between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours
PLACE NOSUBFLOORUNTILABOVEHASBEENSIGNED before required inspection.Job address and Permit Numbers are needed when
requesting an inspection.
ROOF SHEATHING
ROUGH PLUMBING CUPERTINO SANITARY DISTRICT
TUBS&SHOWER PAN Closed circuit video inspection of property line cleanout,point of connection
and street lateral required prior to passing FINAL CITY PLUMBING
ROUGH MECHANICAL INSPECTION. Call the District(408-253-7071)for an appointment.
ROUGH ELECTRICAL/POOL BOND
FP^MING/STAIRS/E.EGRESS NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
BUSINESS LICENSES ARE OBTAINED
i, —ATION/VENTILATION
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
EXTERIOR SHEAR/HOLD DOWN ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
INTERIOR SHEAR/HOLD DOWN
IMPORTANT
SHEETROCK/SHEETROCKSHEAR
When a permit has expired,a charge totaling one-half the fees to obtain a new permit
EXTERIOR LATH -SCREED must be paid in order to reactivate the permit.If a permit has been expired for more
/W
INTERIOR LATH than one year,a charge totaling the full fees to obtain a new permit must be paid
to reactivate the permit.
NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED
SCRATCH COAT
NOTES:
SEWER/WATER
T-BAR/MECH/ELECT ABOVE CEIL
FINALS
ELECTRIC METER RELEASE SPECIAL INSPECTIONS Inspector: Date:
GAS TEST/METER RELEASE ROOF INSPECTIONS
GRADE-PUBLIC WORKS PRE-INSPECTION:Inspector: Date:
FIRE—CALL(408)378-4010 TEAR-OFF: Inspector: Date:
PLANNING(408)777-3308 PLYWOOD: Inspector: Date:
SANITARY(408)253-7071 BATTENS: Inspector: Date:
ELECTTRICAL Date:
IN PROGRESS: Inspector:
MECHANICAL
FINAL: Inspector: Date:
PLUMBING
NOTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION.
HCAP
ENERGY *OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
INSPECTOR
BUILDING
CERTIFICATE OF OCCUPANCY'