Loading...
11030044CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10394 GLENVIEW AVE CONTRACTOR: ; PERMIT NO: 11030044 OWNER'S NAME: RICHARD J DENESHA 1�l2( �-{ p j�' DATE ISSUED: 03/10/2011 O`NER'S PHONE: 4082570542 PHONE NO: G LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F_ ELECT F PLUMB r License Class__ Lic. # c \' . D off- 's �'iy MECH r RESIDENTIAL F COMMERCIAL r Contractor Date 3 --\0 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: RE -ROOF OVERLAY ASPHALT SHINGLE PER (commencing with Section 7000) of Division 3 of the Business & Professions MAUFACTURE SPECS 2ND LAYER PER CBC CLASS A, 30SQ 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 which this permit is issued. 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 permit is issued. APPLICANT CERTIFICATION VtA I Sq. Ft Floor Area: 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 accrue against said City in consequence of the 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. Signature A�(��G� �(1�1 !\ Date l OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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 which this permit is issued. 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 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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, r and expenses which may accrue against said City in consequence of the ig of this permit. Additionally, the applicant understands and will comply wun all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date. APN Number: 36911021.00 Valuation: $6000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: -;L t(i) I / RE -ROOFS: 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. Signature of Applicant: \'10W2 �1Z— Date: 3/loll/ ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ovar o auth rr agent: 12 �\ ate: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 3 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN 36911021.00 DATE ISSUED.......: 03/10/2011 RECEIPT #......... BS000012868 REFERENCE ID # ...: 11030044 OPERATOR: patg COPY # : 1 SITE ADDRESS .....: 10394 GLENVIEW AVE SUBDIVISION ...... CITY CUPERTINO IMPACT AREA ...... OWNER RICHARD J DENESHA ADDRESS 10394 GLENVIEW AVE CITY/STATE/ZIP ...: CUPERTINO, CA 95014 RECEIVED FROM ....: FARSHID NAMDAR CONTRACTOR TBD - TO BE DETERMINED LIC # 00096 COMPANY TBD - TO BE DETERMINED ADDRESS .......... CITY/STATE/ZIP ...: , TELEPHONE ........ FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW -------------------- BAL ----------------------- 1BCBSC VALUATION -------------------- 6,000.00 1.00 ---------- 0.00 1.00 0.00 1BSEISMICR VALUATION 6,000.00 0.60 0.00 0.60 0.00 1REROOFRES SQ FEET 30.00 390.00 0.00 390.00 ---------- ---------- 0.00 TOTAL PERMIT ---------- 391.60 ---------- 0.00 391.60 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER -------------------- ----------------- --------------- CREDIT CARD 391.60 VISA --------------- TOTAL RECEIPT 391.60 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 CUPERTINO i ( b�) REROOF PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building aDcupertino.orp PROTECT ADDRESS APN # _ 17/ " I OWNER NAME PHONE �/� 3 I ` © E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX APPLICANT NAME ` PHONE. c� I (� /a(� ,6 E-MAIL STREET ADDRESS(r CITY, STATE. FAX q -�❑ *INER ❑ OWNER -BUILDER ❑ OWNER AGENT ACONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME F _ LICENSE NUMBE (L LICENSE TYPE BUS. LIC. # COMPANY NAME Seo \� /S E-MAIL p," -LV FAX 6�'� `�/ •���/ / STREET ADDRESS / wx� t>l CITY, STATE, ZIP rf� G ` ✓V \ ✓ PHONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC. # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE [USE OF BLDG: 19 RESIDENTIAL ❑ COMMERCIAL ROOF AREA: J"� VALUATION: 6)(9b EXISTING ROOF TYPE: ❑ BUILT-UP ROOF XASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY) REMOVE /REPLACE ❑ YES NO IF NO, PLYWOOD %i' ❑ THICKNESS: ❑ 5/8" PLYWD ❑ OSB TYPE: ❑ CDX PITCH:-12ROOF CLASS: A PROPOSED ROOF TYPE: 11BUILT-UPROOF 9 -ASPHALT SHINGLES 13WOOD SHAKES 11WOOD SHINGLES ❑ OTHER ICC -ES REPORT # DESCRIPTION OF WORK: ,� It)010 .A A Cl�h�l�'4,: �.lbc /P�����r.v.fl� ��.� �. ►�.��.�+ ReroofApp_2011.doc revised 03/02/11 CITY OF CUPERTINO la ►i l TIFF F.QTlMATnR — RITII,DINO DIVISION FEE ID ROOF AREA s.f. 1REROOFFRES 3,000 NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept /or aaan'l info. FEE ITEMS (Tee Resolution 09-051I;ff ?x_1,10) FEE QTY/FEE MISC ITEMS F71 A Permit Fee: $390.00 Work Without Permit? 0 Yes No $0.00 Strom Motion Fee: IBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $391.60 $0.00 TOTAL FEE: $391.60 Revised: 01/15/2011 ADDRESS: 10394 glenview ave. DATE: 03/10/2011 REVIEWED BY: bobs. APN: BP#: '"VALUATION: 1$6,000 *PERMIT TYPE: Minor Building Permit PLAN CHECK TYPE: Re -roof PRIMARY SFD or Du lex USE: P PENTAMATION 1 SFDWLROOF PERMIT TYPE: WORK overlay asphalt shingle per manufacturespecs. 2nd layer. Class 1 SCOPE FEE ID ROOF AREA s.f. 1REROOFFRES 3,000 NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept /or aaan'l info. FEE ITEMS (Tee Resolution 09-051I;ff ?x_1,10) FEE QTY/FEE MISC ITEMS F71 A Permit Fee: $390.00 Work Without Permit? 0 Yes No $0.00 Strom Motion Fee: IBSEISMICR $0.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $391.60 $0.00 TOTAL FEE: $391.60 Revised: 01/15/2011