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09070171
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7568 WATERFORD DR --ONTRACTOR:BAUTISTA BUILDERS PERMIT NO:09070171 OWNER'S NAME: GORDON JOHN A AND DOROTHY J 1506 W SELBY LN DATE ISSUED:07/27/2009 ER'S PHONE: 4089961169 REDWOOD CITY,CA 94061 PHONE NO:(650)465-4411 ❑ LICENSED CONTRACTOR'S DECLARATION �'q BUILDING PERMIT INFO: BLDG ELECT PLUMB License Classy 39"�( ��# �7L 7 � � n�(, Q MECH f— RESIDENTIAL COMMERCIAL Contractor� V(t 7� 4 f V�tw e �, s27� O / 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-RF RMV EXISTING SHAKE ROOF, INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions SSB Code and that my license is in full force and effect. SHEATHING,INSTALL 30#FELT,COMP SHNGLES& 3UTTERS CLS A 28SQ 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. 1 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 Sq,Ft Floor Area: Valuation:$13775 permit is issued. APPLICANT CERTIFICATION XPN Number:36616007.00 Occupancy Type: 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. j ,p Signature " `i Date�yT,y� Issued by: �v ����� � Date: 2-� •09 U OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, �!�(ate JZ Lt ,;` 7 O Business&Professions Code) Signature of Applicant: Date: 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1 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 HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should 1 use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,1 shall contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Ow er or authorized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date:�Zv d7r 0 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save it nify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address c 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 ARCHITECT'S DECLARATION 9.18• 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT' RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B11: Lot : APN . . . . . . . . : 36616007 . 00 DATE ISSUED. . . . . . . : 07/27/2009 RECEIPT # . . . . . . . . . : BS000008274 REFERENCE ID # . . . : 09070171 SITE ADDRESS . . . . . : 7568 WATERFORD DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GOI:DON JOHN A AND DOROTHY J ADDRESS . . . . . . . . . . : 7568 WATERFORD DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5234 RECEIVED FROM . . . . : BAUTISTA BUILDER' S CONTRACTOR . . . . . . . : MAURICIO BAUTISTA LIC # 31068 COMPANY BAUTISTA BUILDERS ADDRESS . . . . . . . . . . : 1506 W SELBY LN CITY/STATE/ZIP . . . : REDWOOD CITY, CA 94061 TELEPHONE . . . . . . . . : (650) 465-4411 FEE ID UNIT QUANTITY INOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- 1BCBSC VALUATION 13 , 775 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 13 , 775 . 00 1 .40 0 . 00 1 .40 0 . 00 1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 366 .40 0 . 00 366 .40 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 366 .40 #153 --------------- TOTAL RECEIPT 366 .40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 0c(0_70 ) 7 % CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION APN # Date: 3 Ce U L Building Address: Owner's Name: .�D(,�� y �p Phone #: HOA: Yes ❑ No ❑ If yes, provide leiter from HOA ()40'3j q 1 Contractor: Phone #: (6S0-) 46 S 1 Fax #: (�GSo� 3 644 - (N �6 Cupertino Business License #: � Contractor License #: 67 7 S� Type of Itoof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles tt Asphalt Shingles jK Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # 04 7 55 ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: rjLg��L,VL,5- ��p F�1=j t�v S i✓}-�Lj 15 K�1 4f l N U, /,V S L L_ � ,�/���JN� =c_T, C� �v S (Cl adv Std�.vU��s 1 1 12 5, p2� LJ Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: ( 3 7 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 02/05/09 CITY OF C'UPERTINO aK REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF P 1 BCBSC Cal Bldg S tandards B ALL PERMIT TYPES t Commissic n Fee 1 BSEISMICO Seismic Cc mmercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BCBSC Cal Bldg S`.andards B ALL PERMIT TYPES Commissic n Fee 1BSEISMICRE Seismic Residential B 1 REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1 BCBSC Cal Bldg S:andards B ALL PERMIT TYPES Commissicn Fee 1BSEISMICRE Seismic Residential B 1 BUSLIC Business License B 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 ag-ee to comply with 2007 IBC Standards and manufacturers specifications on ra-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 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 arty roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off app:-oval. 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 fe,? of$176.18. The re-inspection fee must be paid before another inspection cavi 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 or.the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: Vo C—©( 6-C)� [ !V Job Site Address: 75 6 W/E 4 FO P P d UP r ( (N Roofing Company Name: t 1 (50 1 L 75 Applicant's Signature: <'.� .c^ � Date: OUB 7 cmc/ Greg Casteel Building Official RevisA 07/30/08