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11030073CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10991 NORTHSKY SQ I CONTRACTOR: ROY BENJAMIN PERMIT NO: 11030073 OWNER'S NAME: ROY BENJAMIN 110991 NORTHSKY SQ I DATE ISSUED: 03/15/2011 1 OWNER'S PHONE: 4088599802 u LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 (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 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 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. Date 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). 463 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, Vis, and expenses which may accrue against said City in consequence of the sting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Y CUPERTINO, CA 95014 PHONE NO: r f— F BUILDING PERMIT INFO: BLDG ELECT PLUMB r r r— MECH RESIDENTIAL COMMERCIAL JOB DESCRIPTION: ADD 2 SKYLIGHTS TO ROOFTOP Sq. Ft Floor Area: I Valuation: $1616 APN Number: 31640005.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAY SAF PERMIT ISSUANCE OR 180 DA OM LAST CALLED INSPE TO . Issued by: Date:0 /� 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: Date: 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 1 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, Sectio s 25505, 25533, and 25534. OwAter or authorized agent: � Date: 41V11 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' (408) 777-3228 • FAX (408) 777-3333 • building(a—�cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: 1 10 3Cl'i�-Nq3 SITE ADDRESSAPN BP# 16 ? 9/ N c,- MS> <y �S' atPak-) MIC) O NER NAME I ^ OWNER ADDRESS. DESCRIPTION OF WORK: We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner- We will not issue a building permit until you have read, initialed your understanding of each provi §i d, and returned this form to us at our official address indicated. An agent of the owner cannot e e notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify thi his 'n ion.) Y 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. P6 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. P&3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. �5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. R6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �6_7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. �J 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc remised 04114/10 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(abcupertino.org MEP MISC L jPLUMBING LJ MECHANICAL LJELECTRICAL InMISCELLANEUUS PROJECT ADDRESS APN # OWNER NAME6-F/U , v7 jA, /�/ PION U / 9T` � E-MAIL STITREoET ADDRESSr]/ CITY, STATE, ZIP c� �"'3^ / TJAJ -i FAX APP�,ICANT� NAME / Y , >,V PH E-MAIL STREET ADDRESS CIT Y, STATE, ZII' c'I FAX OWNER OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPw4ANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS q j Y A ' COMPANY NAME E-MAIL AX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER • IC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF PROJECT IN WILDLAND STRUCTURE: Residential ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ NO p FLOOD ZONE ❑ Yes ❑ No I TOTAL VALUATION: I RECEIVED BY: I By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: �Cu� Date: SUPPLEMENTAL INFORMATION REQUIRED = ,OMCE use ONLY MEPMiscApp_2011.doc revised 03/02/11 CUPERTINO March 1, 2011 BUILDING PERMIT / APPLICATION EXPIRATION LETTER COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(&-cupertino.org ROY BENJAMIN 10991 NORTHSKY SQ CUPERTINO CA, 95014 SUBJECT: BUILDING PERMIT / APPLICATION EXPIRATION LETTER Site Address: 10991 NORTHSKY SQ"'° Permit Number: 10070110 Permit Expiration Date: 1/24/2011 FOR EXPIRED PERMIT APPLICATIONS: According to our records, a building pe>1a�ee�iKf�een issued for your permit application (noted above). Since an extension was either not requested or not granted, your construction permit application has expired. The permit application is null and void and you have 10 business days pick up your plans and documents or they will be recycled. The permit application will be voided in our Permit Tracking System and all documents pertaining to the permit application will be recycled. FOR EXPIRED BUILDING PERMITS: Your Building Permit (noted above) has expired. Please contact our office within 10 business days to let us know you plan to re -activate the permit. Discretionary Planning Approvals are also subject to expiration. Please refer to the Planning Department to determine if a new planning review process is required A code enforcement case will result if a construction site is left abandoned and unsafe. Please review your following options to re -activate your building permit: Construction has been suspended or abandoned less than one year. A request in writing to extend your building permit may be submitted provided no changes have been made or will be made in the original plans and specification for such work. Valid reasons shall be cited for the delays on your construction schedule with a justifiable cause demonstrated to the Building Official. The extension, if granted, will be for a period of not more than 180 days. A $39 processing fee plus one-half the current permit fees will be due upon submittal of the request. An extension will NOT be granted if any codes or any other pertinent laws or ordinances have changed subsequent to the date of application. Construction has been suspended or abandoned more than one year or codes have changed subsequent to the date of application. A request in writing to renew your building permit may be submitted. A $39 processing fee, $126/hour exploratory inspection fee and full plan review and permit fees will be due upon submittal of the plans for the project. For projects that require plan review, six (6) new sets of plans designed to meet current code are required to be resubmitted for review. An exploratory inspection will be required to determine if any part of the existing construction can maintain vested rights with Building Codes standards in effect at the time the original building permit was issued. Sincerely, Sylvia Mendez Senior Office Assistant City of Cupertino sylviamncupertino.org Expiration Letter. doc revised 12/06/10 CUPERTINO March 1, 2011 BUILDING PERMIT/ APPLICATION EXPIRATION LETTER COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building@cupertino.org ROY BENJAMIN 10991 NORTHSKY SQ CUPERTINO CA, 95014 �0 91 - s P QJ i' - SUBJECT: BUILDING PERMIT / APPLICATION EXPIRATION LETTER Site Address: 10991 NORTHSKY SQ Permit Number: 10070110 Permit Expiration Date: 1/24/2011 FOR EXPIRED PERMIT APPLICATIONS: According to our records, a building permit has not been issued for your permit application (noted above). Since an extension was either not requested or not granted, your construction permit application has expired. The permit application is null and void and you have 10 business days pick up your plans and documents or they will be recycled. The permit application will be voided in our Permit Tracking System and all documents pertaining to the permit application will be recycled. FOR EXPIRED BUILDING PERMITS: Your Building Permit (noted above) has expired. Please contact our office within 10 business days to let us know you plan to re -activate the permit. Discretionary Planning Approvals are also subject to expiration. Please refer to the Planning Department to determine if a new planning review process is required A code enforcement case will result if a construction site is left abandoned and unsafe. Please review your following options to re -activate your building permit: Construction has been suspended or abandoned less than one year. A request in writing to extend your building permit may be submitted provided no changes have been made or will be made in the original plans and specification for such work. Valid reasons shall be cited for the delays on your construction schedule with a justifiable cause demonstrated to the Building Official. The extension, if granted, will be for a period of not more than 180 days. A $39 processing fee plus one-half the current permit fees will be due upon submittal of the request. An extension will NOT be granted if any codes or any other pertinent laws or ordinances have changed subsequent to the date of application. Construction has been suspended or abandoned more than one year or codes have changed subsequent to the date of application. A request in writing to renew your building permit may be submitted. A $39 processing fee, $126/hour exploratory inspection fee and full plan review and permit fees will be due upon submittal of the plans for the project. For projects that require plan review, six (6) new sets of plans designed to meet current code are required to be resubmitted for review. An exploratory inspection will be required to determine if any part of the existing construction can maintain vested rights with Building Codes standards in effect at the time the original building permit was issued. Sincerely, Sylvia Mendez Senior Office Assistant City of Cupertino sylviam@cupertino.org Expiration Letter. doc revised 12/06/10 lw-Go --Ak, cc :y a PLAN VIEW 10991 Northiky Square Cupertino, Ca. 95014 2X8 24"O.C. �O m Z "'' W _ ° a� Cf1 =or N �ONORTHPOINT HOMEOWNERS ASSOCIATION 10880 NORTHPOINT WAY CUPERTINO, CA 95014 (408) 996-3734 Roy and Simona Benjamin 10991 Northsky Square Cupertino, CA 95014 Re: Skylight approval Dear Mr. and Mrs. Benjamin, NPHOA.ORG November 30, 2007 This is to inform you that your request for skylight installation dated October 16, 2007 has been approved by the Board of Directors. Please note all installation requirements and responsibilities on the Architectural Review application, a copy is attached for your information. Also, I would like to remind you that on Monday, December 3, 2007 the fence repair people will be doing the needed repairs on your fence. Thank you, Linda Starnes On Site Manager MAR 15 2011 PML MANAGAGEMENT, 655 Mariners Island Blvd. Suite 301, San Mateo, CA 94404 (650) 349-9113 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 05014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinana cuoertino.org r Dear Property Owner(s): t An application for a building permit has been submitted in your name listing yourself as the buirproperty improvements specified at: 1o� SITE ADDRESS APN B # OWNER NAME OWNER ADDR ss /�d ' cf C'.G(' l illO DESCRIPTION OF WORK: n L_cQ S We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) A1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. * 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. &L3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. t5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. �6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �6_7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 6 J 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderFortn2010.doc revised 04/14110