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07110034 CITY OF CUPERTINO ` ' BUCiDING DF-YISION PERMIT ��-�� , - r:; ..:: . ., ...._ ._ :.. ...::. :. .: BUILDING ADDRESS: . PERMIT NO. 10713 LARRY WAY ALL SE��SONS ROOFING SERVICE 07110034 . �JER'S NAME: � �� DA � BENETTI NATHALIE J TRUSTEE 1720 S1�ITH AVE � 11/07/2007 PHONE: SANITARY NO. CONTROL NO. ARCHITECf/ENGINEER: BU[LDING PERMITINFO RMV 2:�YRS EXSTNG ROOF SYS B� EQ P�� o p LICENSED COtJfRACfOR'S DECLARAT[ON � J ,.,, ,_,� „,� �,�ob Description � v C 1 hcrcby sf(icm that I am licensed unJcr provisions of Cluptcr 9(commcncing ^^ -�^,�^ —. .^ _ Z W� with Section 7000) of Division 3 of �hc Business and ProfessiO ��and my licensc is '� y in (ull Coree and effe _ �1 j�� Licensc Class Lic. 8� a y M p Datc Contractor ARCHITECI"S DECLARATIO ,� a� I undcrstanJ my plans shall be uscd as pubiic rccards s 4 O y Licensed Rufcssional y � OWNER-BUILDER DECLARATION +� I hcrcby alTirm lhat 1 am ucmpt Crom thc ConUactors Liccnsc Law for thc i p O foilowing reason. (Scction 7031.5. Busincss and Profcssions Caic: Any cily or county K,°, � which tcquires a permit to consuuc� attcr. impmve. dcmalich, or �epair any swcwrc y Z y prior w i�s issuancc, alsa rcquires Ux applicant for such permit �o filc a signcd s�atcmcnt < that Ac is liccnscJ pucwant to thc Movisions of thc Co�uactor's Liccnsc law (Chap�cr 9 Sq. Ft. Floor Area Valuation Y F� (commencing wiW Sccdon 7000) of Division 3 of �he Businegs and Profcssions Codc) or y�� hat he ia exempt thccefrom and tAe basis for t6e ailcgcd eumption. Any violatiun of Section 7031.5 by arry applicant for a pemiit subjecu �he appiicant �o a civil penalty af APN Number Oecupaney Type • nat moro �han five hundred dollars ( 5 3 0 0). ❑ I, u owner ot the property, or my employces with wages u �he'v solc compensadon, will do the work and ihe stcuauce is not intended or af[eced for asle (Sec. 7044. Busineu Re uired Ins ections and Professions Cadc: The Conuactor's Lic�nse Uw docs not spply m ao ox'ner of 9 P property who builds a improves thercon, and who does such work himael[ or Uuongh his own employces, provided that such improvemen�s ue not in�ended or otCered for sale. If, however, the building or improvement ia soid wilhin one year oC compledon, �he ownet- builder will have the burden of proving Wat he did not build or improve far purpase of sakJ. ❑ I, as owner of the propeny, am e�eclusively conuac�ing with lianaed rnntracwrs w wnsuuct the pioject (Sec. 7044. Businas and Professions Cade:)'ILe Contrxwr's Li- ccnse Law docs not apply W an owner of properry who builds or impmves Iheieon, and , who conuac�s tor such pmjects with a convactor(s) licensed purausnt to ihc Convaaors l.icense L.aw. ' am uempt under Sec. , B& P C fw this rcason _ «nu Date WORKER'S COMPENSA770N DECLARATION I hemby alGrm under penalty of peryury one o( the followine declarations: ❑ I hsve and will maintain a Cenifiate of Conaent W xlf-insure (or Workcr's Compen- satian, u provided far by Sectian 3700 of �he Labor Code. far Ihe performance oC thc work for which ihis pertnit is issucd. ❑ 1 have and will mainuin Workcr's Compensatian [nsurance, as �cquired by Scction 3700 of �he Labar Codc. for ihe pedorman of We woitc for w6ich ihis peimit is issued My Wor o penaaiion 1 nna u and Policy numbcr are: ,y�n ^�� Cartier: �� - �a - �e �'u ��.� No.: o� 6 't/" f O�i CER7'IFICA?E OF EXEMPTION FROM WORKERS' COMPENSATIONINSURANCE ' (f'his scctiai necd not be completed if the pcnnit is for onc hundred dollars (5100) or Icu) � 1 cenify �hn� in the perfortnancc of �hc work tor which ihis permit is issued. 1 shall not rmploy any person in any manncr so az w becomc subject to �he Workers' Compensation Laws of Cali(omia. Date Applicanl NOTICE 7'O APPLICAM: If, af�cr making �his CcrtiGca�c of Excmpuan, you should bccome subjcct �o �hc Workcr's Compcnsdtian provisions of iAc Isbor Codc, you muu , O forthwilh comply with such provisions w this pecmil shall6c deemed n.woked. Z "'' CONSTRUGTION LEND[NG ACENCY [- r�-� I hcrc6y aIl'irm Ihat there is a consuuctinn knding agcncy (ar thc perfortnancc uf . pC � ihc work for which �his permit is iuued (Scc. 3097, Civ. C.) W� A L.endet's Name ' Lcnder's Address V 0 I certify �ha� 1 have «ad this spplication and su�e Wat ihc ahove infortnation is w� corrcn. I agra w comply wiih all city md county oNinances and sute laws reladng w 0 U building consuuction, and hereby amhori�e ecpresentaGvcs of this city w cmcr upon ihc W aAove-mcntioncd property for inspecuon purposes. � a (We) agree to save, indcmn' and keep harmless �he Ciry of Cupertino against �,� � liabilities, judgmcnLS, cosls and nscs which may in any way accruc agsinst said City V,'� io consequence o[ �hc granting is permiG Date �-- ►"'� APPLICANT UNDERS'fA AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGULATION Re-roofs ,/ �� Signuurc of ApplianUContractor � T of R oof HAZARDOUS MATERIALS DiSCLOSURE YPe Will Wc applicant or future building occupant uarc or handlc ha•rardous matcrial ;fined by �he Cupertino Municipal Codc. Chaptcr 9.12, snd the Health and Safc�y ..� Scction 25532(a)? All roofs ahall be inspected prior to any roofing material being installed. ❑ Ycs �No �11 thc applicant or futurc building acupant ux cyuipmcnt or dcvices which If a roof i; installed without first obtaining an inspection, I agree to remove emil hvardaus air conuminan�s u dcfincd by the Bay Area Air Quslity Managcmcn� all new m aterials for inspection. o��;�n 0 Yes �No 1 havc rcaJ �he hvardoiu rials requiremcn�s undcr Chap�cr 6.95 of �hc Cali(or- nia Hcalih & Safcry Cadc. Sccti 505, 25533 and 25534.1 un�icrsund �haz iCihe building docs nol curtcntly havc a tc Ihat it it my msponsi6ilily w naity ihe axupant of ihc rcyuircmcn�s which musl et 'or �u�� ore c�r�a� aro�NP��r. Signature of Applicant Date pa � . All roof coverings to be Class "B" or better Owncr or auth ri�.cd agcn� CITY OF �UPERTINO 2 ITEM5 OF 8 PERMIT RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ........ 31602007.00 DATE ISSUED.......: 11/07/2007 RECEIPT #.......... BSC00003183 REFERENCE ID # ...: 07110034 SITE ADDRESS .....: 10i13 LARRY WAY SUBDIVISION ....... CITY .............. CUF'ERTINO IMPACT AREA ....... OWNER ............: BErfETTI NATHALIE J TRUSTEE ADDRESS ..........: 10�13 LARRY WY CITY/STATE/ZIP ...: CUF'ERTINO CA, 95014-2056 RECEIVED FROM ....: ALI, SEASONS ROOFING CONTR.ACTOR .......: GOF:SHTEIN, VLADISLAV LIC # 21035 COMPANY ..........: ALI, SEASONS ROOFING SERVICES ADDRESS ..........: 17�:0 SMITH AVE CITY/STATE/ZIP ...: SAtJ JOSE, CA 95112 TELEPHONE ........: (4()8)971 FEE ID UNIT QUANTITY ��MOUNT PD-TO-DT THIS REC NEW BAL ---------- -�--------- --------- BPERMFEE VALUATION 17,500.00 255.96 0.00 255.96 0.00 BSEISMICRE VALUATION 17,500.00 1.80 0.00 _____1_80 ______0_00 TOTAL PERMIT : 257.76 0 00 257.76 0.00 Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408) 777-3333 Building I)epartment Subj ect: Re-roof ing policy f or the C iiy of Cupertino 1. Prior to permit issuance, you must agreE� to comply with 1997 UBC Standards and manufacturers specifications on re-roofing. 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 bui: ding 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 appro val. 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 fi rst obtaining an inspection, will require the removal of all new matE�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 ihe job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: � O�. 6 � � � ��.� - Job Site Address: �b� � � �c c� ��'� � (.�c.'�C'� �� C �— � �� l � Roofing Company Name: �, � F' Ci1<<�U �(L` V`�� 'n-� ��'"��3 i � 2 j Applicant's Signature: + ` Date: � 1 �� Greg Casteel Building Official Revisf�d 11/2/04 Qr7 i ( oo ��--�- CITY OF CUPERTINO �� :..� � RE��O� CuPE�T��vo PERMIT APPLICATION FORM APN #� j� O� L�� C., Date: �/� U- v� t l Building Address: , 1 l.,Cti�� ' �..v - �-. �r. �'��U �.. Owner's Name: Phone #: , C7 � � Cn; ' ��, � _ c� Co tractor: License #: \ - C C ntact: Cupertino Business License #: ��C�(� � Type of ��oof Covering: Ea�isting: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles �l' Asphalt Shingles � Wood Shakes ❑ Wood Shakes � Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify.) Number of existing coverings ❑ Provide LC.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Ct� ertino's Tear Off Polic : Job Description: eiw� vJQ. ;l \ 4.�.`� r� � x� 5 ,n� �C' �O � =�--� �-w. . �`/� 5-�-��.1 I a�s �s es , k; -> d�� Residential Commercial Fire Zone: Yes ❑ No Confumed with Planning Dept. if there are any restrictions: LJ ost of Project: Type of Constnction: Occupanc group: �� Qty. if A plicable Fee ID Fee Description Fee Group BPERIV�EE Bldg Perniit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BLTILDING BUSLIC Business License BLJILDING ; k� ' Community Development � 10300 Torre Avenue �; �'�= -' Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 CUPEI�TINO Buildin De artment JOB ADDRESS: PERMIT # � o�� 3 L Q e p w4 �~� �� a c� �'� OWNER�S NAME. �� q e�� e�V e t PHONE # �i � y� S GENERAL CONTRACTOR: ,9 S i2 S FAX # 9'3 - �/ /�' I am not using any subcontractors: Si gnature Date Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIrJESS 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 R k Tile . ; � �/ D �_ o � � /r Own r/ Contractor Signature Date