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07100172 CITY OF CUPERTINO = ` BU.ILDING DIVISION PERMIT C��1`T'� C�C'1]EL Ii��UR�ATION ;: ;. ,. ., _ .: .. _ . ,.: _ PERMIT NO. BUILDING ADDRESS: ��T�� -P��--�P�- 'ER'S NAME: , PHONE. 1 i V.7 �.t I�HAY DR S �CJ�M�� g�� 2 O O 7 CONTROL NO. � BU[LDING PERMIT INFO ARCHIT'ECT/ENGI NEER: BLDG ELECT PLUMB MECH � � 0 � > p LICENSED COMRACI'OR'S DECLARATION JOU DCSCiIpL10❑ � F. I hcrcby aIIirm �hat 1 am liccnscd undcr pmvisions of CAaptcr 9(commcncing . ; w with Scction 7000) of Division 3 of �hc Busincss and Pro(cssions Codc, and my liccnsc is � y in Cull forcc and cCfec 9 �� f 5"('p REMV EX I STING COMP � INSTALL # 3 � LB FELT � INSTL � ? Licensc Class ' o Datc a' Conuactor . GAF : � ARCHITECI'S DECLA Tt, % � I undcrstand my plans shail bc uscd as public rccords GR.ANDCANYON SHINGLES -� F' Liccnscd Profcssional � j OWNER-BUILDER DECLARATION 1 hcrcby aCfirm �hat I am cxcmpt (rom ihc Convactar's Liccnsc Law for thc j O [ollowing rcason. (Sccuon 7031.5, Busincss and Profcssions Caic: Any city nr county ;�i which rcquires a permit to conswc4 al�cr, improvc, dcmolish, or rcpair any swcture ,} pnor lo i�s iseuancc, alsu mquires the applicant for such permit to filc a signcd statcmem �' q . Ft. Floor Area Valuati on � a that hc is liccnscJ pursuant to thc provisions o( thc Conuactor's Licensc Law (Chaptcr 9 � -$ (commcncing with Section 7000) of Division 3 af ihc Busincss and Profcssions Codc) ur �.. �hat he is exempt therefrom and ihe bazis [or the allegcd eumpdon. Any violation o[ Secuon 7031.5 by arry applicant for a pemiit subjec�t thc applicant to a civil pcnalty of APN Number Occupancy Type nat more �han fivc hundred dollars (5500). 0 I, as owncr of the property, or my employces with waga as their solc compensadon, 3 6 6 5 2 013 . wilt do the work, and ihe structure is not intended or offered for sale (Sec. 7044. Business Re uired Ins eeti ons and Professions Code: The Conuactor's License Law docs not apply to an owner of q P propeny who builds or improvu �hercon, and who does such work himself or �hrough his own employces, providcd itiat such improvemen�s are not intended or o[fered (or sale. l[, howevu, the building or improvement is sold within one yeer of complction, the owncr- builder will have the burden oC proving �at he did not build or improvc (or puryose of salc.). ❑ I, as owner o( the property, am ezclusively conttatling wilh licensed rnntractors to construct the pcnject (Sec. 7044. Business and Pro(essions Code:) 7he Convactor s Li- ccnse Law docs not apply to an owncr of propeny who builds or improves Ihereon, and , who comcacts for such projecls with a contractor(s) licensed pursuant to the Convactor's License Law. ❑ I am eacempt under Sec. , B& P C(or this rcason .� Date WORKER'S COMPENSATION DECLARATION I 6ercby �rm under penalty of perjury onc of the (ollowing declarations: ❑ I have and will maimain a CeniGcate of Conscnt �o self-inswc for Workcr's Compen- sation, u provided for by Secdon 3700 oC the I.abor Code, for �he performana of ihc work which Nis permit is issucd. I havc and will maintain Worker's Compensation Insurana, as mquired by Scction 3700 of the Labor Code, for thc performance of �he work for which this peemi� is issued. My Worke Insucance carricr and Policy numbcr �;�� Cartier. � �/ f � r��l/f Polity No.: � �p �� • � ' � � � � CERTIFtCATE OF EMP'I70N FROM WORKERS' COMPENSATlON INSURANCE ' (This scction need not bc complacd if the pcemit is for onc hundred dollars (S 100) or Icss) I cenify that in �hc performancc of �hc work for which �his permit is issucd, I shall not employ any person in any manncr so as to bccomc subiCCt � �he Wor ' Compensation Laws of Califomia l)atc � � � Applinn _,.:'. - NOTICE TOAcPPLICA : If, aftcr making this CcniGca�c of Exemption, you should become subjcct to U�c orkcr's Compcnsation provisions of thc Lsbor Codc, you must � O foMwi�h comply with such provisions or this pccrnit shall bc dccmcd revokcd. i ""' CONSTRUCTION LENDING AGENCY �� 1 hercby amrm ihat there is a conswctinn Icnding agcncy Cor thc performancc of . i� �hc work for which �his permit is issucd (Scc. 3097, Civ. C.) � Q L.endcfs Namc � � z L.cnder's Addmss ) ) � I certi(y �ha� I havc rcad �his application and siatc �az �hc abovc informauun is ►� cortec� 1 agree �o comply with all city and county orefinances and state laws rclating �o j U building conswction, and hcroby authori�e reprcscntativcs oC ihis city to cntcr u{xm tlic � W ahovc-mcnuancd properry for inspccdon puqwses y a (Wc) agree to save, indcmnify and kecp harmless ihe Cily a( Cupcnino against �� liabilities, judgmcn�s, costs and expenscs which may in any way acerue against said City ) z in conscquence oi ttrc granting of ihis permit. �"� APPLICAM UNDERSTANDS AND WILL COMPLY WITH ALL NON-POIM Issued by: Date SOUR �ULATIONS. '" � �- � Re-roofs + natu otApplicandConuxtor Dalc HAZARDOUS MATERIALS DISCLOSURE Type of R�>of Will �he applicant or futurc building occupant storc or handlc ha•rardous matcrisl dcfincd by the Cupenino Municipal Codc. Chapl�r 9.12, and thc Hcal�h and Safety :, s��uo� zssszce>� All roofs shall be inspected prior to any roofing material being installed. �y� ❑No WiII thc applicant or fuwrc building occupant usc cyuipmcnt or dcviccs which If a roof is installed without first obtaining an inspection, I agree to remove cmit ha•r.azdous air con�aminan�s as dcfincd hy �he Bay Area Air Quality Managemcnt all new m� �terials for inspection. District? ❑Ycs ❑No Ihavcread(heha�ardousma�crialsrequircmentsundcrChaP�er6.95oftF�Califor ' /, /�} � ^ nia Hcalih & Sakty Codc, Scctions 25505, 25533 anJ 75534. I undcrstand ihaz iC U�c Irilllding - �� S �' docs nol curtcntly havc a Icnant, that it is my rcsponsiAi]ity to noufy Ihc occ�pant o! Ihc � �' �" reyuircmcnts whi&kmust bc mel prior w issuancc of a Ccnificaic of Occup �y. Signat re��f Appl icant Da e �-- � � v All roof coverings to be Class "B" or better -- Ownc or authocizcd agcnt Datc � � — o��o��. CITY OF �CUPERTINO �`' RE ROOF CUPE(�TINO PERMIT APPI,ICATION FORM APN # Date: � Building Address: 13 e �! �1 , r � Owner's Name: Phone #: r � � -I�c� o � - 5 Contractor: License #: 'f � � 1 1 l� L V �� I�OC� -4--� �T C �f � � � �O Contact: -- Cupertino Business License #: � bS-e A�,��11 l � Type of �;oof Covering: Ezisting: Proposed: ❑ �uilt-Up Roof ❑ $uilt-Up roof a� 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 Com 1 With Cu ertino's Tear Off Polic : Job Description: (R�rno�.e ��h .�— I�:� 1 e l k � l��aF r o� :� �n� (Ps. Residential Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are an restrictions: LJ Cost of Proje : Type of Constru�tion: Occupancy graup: � - �es� . Qty. if A licable Fee ID Fee Descri tion Fee Grou BPERMFEE Bld Permit Fees BUILDING BENERGY Ener 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 I�epartment Subject: Re-roofing policy for the C'ity of Cupertino 1. Prior to permit issuance, you must agre � to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 2. New roof coverings shall not be appliec_ 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 iristalled, a plywood nail �nspection is required. 6. Any roofing which is applied withaut f rst obtaining an inspection, will require the removal of all new mat��rial down to the sheathing, so a proper City inspection can be perfc�rmed. 7. NOTE: If you call for a plywood nail ir�spection and the job is not ready, you will be charged a re-inspection fee �f $176.18. The re-inspection fee must be �aid 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: � � 1 � 1-tU�-�L �3Z.� � Job Site Address: I �� 3 �� n-� L�� Roofing Company Name: �� L �� S CJ� -j �� Applicant's Si�na#�e:..��-- Date: / � ��1� � Greg Casteel Building Official Revise� 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMI�� RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Bl];: Lot: APN ......... 36�i52013.00 DATE ISSUED.......: 10,'23/2007 RECEIPT #.......... BS�)00003066 REFERENCE ID # ...: 07:_00172 SITE ADDRESS .....: 11'i13 SEVEN SPRINGS LN SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OWNER ............. PR:�TI HUKKOO ADDRESS ..........: 11:i13 SEVEN SPRINGS LN CITY/STATE/ZIP ...: CU:?ERTINO CA, 95014-5131 RECEIVED FROM ....: CA:iTILLO'S ROOFING CONTRACTOR .......: J0:3E CASTILLO LIC # 25850 COMPANY ..........: CA;iTILLO'S ROOFING ADDRESS ........... 17�)3 CATHAY DR CITY/STATE/ZIP ....: SA]1 JOSE, CA 95122 TELEPHONE .... ....: (4�)8)251 FEE ID UNIT QUANTITY ;�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 9,800.00 169.56 0.00 169.56 0.00 BSEISMICRE VALUATION 9,800.00 1.00 0.00 1.00 0.00 --�-------- ---------- ---------- ---------- TOTAL PERMIT : 170.56 0.00 170.56 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 170.56 #14777 --------------- TOTAL RECEIPT : 170.56 j -'.., � Community Development ; 10300 Torre Avenue "' ; {�1' Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: PERMIT # � 5 � J J��/ r 1 J ', C t-J� , �� ' O O � I� OWNER'S NAME: }�r �-f-��, � c � - PHONE # 2� I- 3 5�� GENERAL CONTRACTOR: �' �-� � v �Lc� � �� FAX # I am not using any subcontrac �: "—" (� _ T= � 6 � 3 U� Si Date Please check a licable subcontractors and com �lete the followin information SUBCONTRACTOR BUSIrTESS 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 `--- / � � 3 � � Owner/Contractor Signature Date � Community Development ` 10300 Torre Avenue a-w,, �` _.s • Cupertino CA 95014 � - Telephone (408) 777-3228 • _1� ClTY OF Fax (408) 777-3333 CUPEI�TINO ` Buildin De artment JOB ADDRESS: PERMIT # -- - . _ _. t ' j - - �=� ' . �' , t � ; c z'- y_I�i • �; ` ' � � �/ ._ �� OWNER S NAME: � - �.--, ._ _ . ' , E--�� , :- � ' � I , ; �_ ; _. �, PHONE # � � � � � - �:� � � GENERAL CONTRACTOR ; �' �'; ";; �-� ' � ��; -_ 1� �:, �;.� = r � e FAX # : - / . � " -. . . /f � - � i -_ .. �.. , � 1 ` _ ;� = J � i . • f � G � �- #'. I am not using any subcontractors: _ "..=- c � ; Si ;nature Date Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIl`dESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation " Fencing � Flooring: Carpeting '� ' �- f Linoleum / Wood �` Glass / Glazing j� ._ ,- Heating �� { � �--� � " Insulation �--. .: ,' Landscaping `i �� `�� Lathing � ,�� , ; � Masonry �ti -__�' - . Ornamental Sheet Metal � 1� Painting / Wallpaper %`� Paving �' Plastering - ""�` ;- " Plumbing f` Roofing �' � Septic Tank % � Sheet Metal � Sheet Rock .. � ,�, Tile - --:�-'��\ � � � �'-�. 1 -;#' ,l C' �� -} �['`� � - - � , �' Owner/Contractor Signature ' D'ate