The URL can be used to link to this page

07110062 CITY OF CUPERTINO n � BUILDiPlG DIVISION PERMIT �*��"��« ,.: ,. . , _ : ' :>. , _ .. >:.. . . pERMIT NO. BUILDING ADDRESS: 10300 PALO VISTA RD CUPERTINO ROOF, INC 07110062 . PERMTT L55UE DATE NER'S NAME: VIEIRA RAYMOND A AND NANCY M 1052 KFILLY Dk � 11/13/2007 SANITARY NO. CONTROL NO. PHONE: (408)9�3-9427 BUILDING PERMIT INFO ARCHI'IECC/ENGINEER: HI.OG ELECI' PLUMB MECH � 0 � 0 u p p LICENSED CON'!'RACTOR'S DECLARA770N IOU DeSCT1pT10i1 ;� V� I hcrcby aftirtn that 1 am licenscd mule* Provisions of Chaptcr 9(commcncing _ w itASccdon70oo)o[Division3oftheBusincssandProtcssionaCodc , andmyliccnseis TR OFF SHAKES, INSTL 1/2 "�SB INSTL 3� LB FLT, INSTL °= y in full fo�ce and eftect S�y S �� .x � 50 YR C�AF 31 SQS � � Z Licenac Clus �� Contractur � j E ., O Da�c � ARCHITECI'S DECLARA770N � �—� I undcrstand my plans shell bc wed u public rccords m L p y Lii:ensed Prufcssianal y � OWNER-BUILDER DECLARATION � 1 hcrcby nflirm that I am oxcmpt from thc Conuactor's Liccnse Law far �hc � p O following reason. (Scction 7031.5, Business and Profcssions Ca1c: Any cily or county �� Pi which �cquires a pcimit to consuuc4 ahcr. improvc. dcmalish. or iepair any svucwm prior io i1s issusncc. alw rcquires ihc applicant for such permit io filc a signcd statcmcnt ?< t h a t hc i s i i c c n s c d p u rs u a n t t o � h c p m v i s i o n s o[ � h c C u n u a c t a r' s li c c n s c ! a w ( C h a p � c r 9 S C�. Fi. FlOOI' AIC3 Valuation y �$(commcncing wi�h Scction 7000) af Division 3 of thc Busincss and Profcssiona Cade) or � 1 2 � � � y �.. that Ae ia e:empt the�etrom �nd ihe bssu Cor tde allegcd exempdan. Any violauon o[ Section 7031.5 by arry sppiicant for a pertnit subjecu Uu applican� w a civil penalty of �. 5 �� Number Occupancy Type not moro �han fiw hundred dollars ( 5 5 0 0). 3 5 7 0 2 0_� ❑ I. u owner o[ the pmperty. or my cmQloyces with wages u their sotc compensation, wiU do ihe work. uid ihe structuce is not in�ended or oRered for sale (Sec. 7044. Business Re uired Ins ections and Prolessions Code: Tt�e Conuacars License Law does not sPP�Y w an owner of 9 P property who 6uilds or improves t6ercon, and wM daes such work himseltar thmugh hia own employces. providcd that such improvemen�s ue not in�ended or oRued Cor sala If, however, the building or improvement is sold wi�hin one year of completion, the owner- builder wiU have Uie burdan o[ proriog �dai he did noi build or improvc [or puryose of saleJ. Q 1. as awner of �he propeny. am exclusively convacting wiW ticensed rnnvactms w construcl the penject (Sec. 7044. Businas and Professions Code:) The Conlncwr's Li. ccnse Law docs not apply w an owner of propeny w6o builds or improves the�eon, �nd , who conuacta for such projects wi�h a contnctoKs) licensed pursuant to ihe Convacwr's License Law. n I am exempt under Sec. , B� P C fw �his rcasan ,� Date WORKER'S COMPENSATION DECLARATION I hereby afficm under penalty o[ perjury one o[ the following declarations: ❑ I hsve and will maintain a Cenificate of Consent to self-insme for Workcrs Compen- sation, u provided for by Secuan 3700 of �lu Labor Code, for �he pedormance ot the work Cor whied this pertnit is issued. ❑ I have and will m�imain Workers CompensaUon Insurance. az required by Sccdon 3700 of �hc Labor Codc, for thc pcdormancc of �he woric for which Nis permit is iuued. My Workers Compensadan lnsunncc carticr and Poliry number are: Catrier. � 4�L �V � � Poliey No.: �� Z--E�C � �1 CER7'IFICA'I'B OF EXEMP'ITON FROM WORKERS' COMPENSATION INSURANCE ' (This section necd not be completcd if We pecmit is for onc hundrcA doltars (5100) or Icss.) 1 certify Ihat in Ihc performancc of Ihc work for which ihis pem�it is iuued. I shall not cenpioy any person in my manncr so u w bceomo wbjcct to thc Worlccrs' Compenulian Laws of Califomia Datc Applicam NOTICE TO APPC.ICANT: If, a[ier making �his CcniGcate of Excmption, you should become subjcct to U+c Wariccr's Compensation provisions a[ �Ac Labor Codc, you muu , O foMwith camply with such provisions or this pecmit shall be deemed n.woked. Z N CONSIRUC170N LENDING AGENCY F►. I hcmby alTirm Wat thcre is a conswctian Icnding agcncy far ihc rcrfurtnancc o[ . p�., ✓ �hc work for which this pamit is issued (Scc. 3097, Civ. C.) W� Q L,endcr's Namc Lender's Addness (� � I certify iha� I have rcad this application and siaic that thc above informauwi is w � rnrtcct. I agree w comply with all city and counry oniinarces and sute Iaws �elating to 0 U buildins consvuction, and hetcby autharia ccprescntaGvcs of ihis ciry W cntcr �pon 1hc � w abovc-mcntio�d propcny for inspenion purposes a (Wc) agree to save, indcmnify and kecp humlest lhe Ciry of Cupcnino against � y liabiliva. Judgmcnts, cosu and expenscs which may in my way accruc against said City V z sequence oC the granung o! ihis permiL Date � J�� "'� APPL NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POIM Issued b �': SOU GULA170N y J � ( " �� ` Re-roofs _�— Signazuro of ApplicanUConuxtor �°� 'I'y�C Of � ZOOf HAZARDOUS MATERIALS DISCLOSURE �Il lhc applicant w futurc building accupant storc or Aandlc ha•rardous malcrial �cfincd by Ihe Cupertino Municipal Codc, Chaplcr 9.12, and thc Hcalih and Safcty :. Scction 25532(a)? All roof: shall be inspected prior to any roofing material being installed. Q ycs .----(� No If a roof is installed without first obtaining an inspection, I agree to remove wll thc a�licant or fumre buiiding occupant usc cyuipmcnt or Jcvices which ' cmi� ha•rardous air con�aminanu u defincd by �he Bay Area Air Qusli�y Managemcnt , 1aterials for inspection. a�� Q Ycs ❑ No I havc rcad �he hvacdous matcrials requircmcn�s undcrChap�cr6.95 of �he Califoo- � _'.. � l� I? a. nia ih & Satcry Codc, 5ecdo�t 25505.25533 and 75534. I uncicrsiand ihat iCthc 6uilding � I� not c nlly havc a �cnan�, �u it is my responaibili�y w notify the occupant of the rcyuire e��s � muu be i prior m issuancc ota Ccniricstc o� cup Signatun: of Applicant Date D � J`' All roof coverings to be Class "B" or better Owncr or auihoriacd agcm .. ��i o�� CITY OF CUPERTINO ,��'� R��Rt�� CuP��TrN� PERMIT APPLICATION FORM APN # � ,_ , Date: D� �S�.0 I�� -0�1 Building Address: ��UO ��O UIS-�1�} � Owner's Name: � \ � I � � � Phone #: � Z —6 � C� � � �/ Contractor: � � (�� ) � � License #: � 6 � � 3 � � Contact: ' � � Cupertino Business License #: Type of Roof Covering: E�sting: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles �8 Asphalt Shingles �0 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 Comply With Cupertino's Tear Off Policy: ❑ Job Descri tion: l� � P E' a 2 0� 5 l� Q� s �- ►� � L..�. �� Z O ��' � h S--� ��\'� ��'w 1\ U e � Resi entia ommercial ❑ � I Fire Zone: Yes ❑ No Conf'umed with Planning De�t. if there are any restrictions: U Cost of �roject:� � Type of Construction: Occ`�nc�roup: � � Qry. if A plicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Ener y BUILDING BSEISMICRE Seismic Fee Res BiJILDING 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 Subj ect: Re-roof ing policy f or the C'ity 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 appliec� without first obtaining all inspection and written approval from the buildin€; inspector. A final inspection and approval shall be obtained from the bu ilding inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to an�� roofing installation. 4. To receive a final sign off from the City, the following steps are required: 1) Pre-inspection and/or tear off apprc�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 .=irst obtaining an inspection, will require the removal of all new ma :erial down to the sheathing, so a proper City inspection can be perf ormed. 7. NOTE: If you call for a plywood nail inspection and the job is not ready, you will be charged a re-inspection fee of $176.18. The re-inspection fee must be paid before another inspection car� 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 abov� stated policy on re-roofing. Homeowner's Name: v �� J ob Site Address: ��-� U � ��, t> V� S T � Roofing Company Na . � V 1�� Q�r� `.,. u C�'�' Applicant's Signature: � __ na ��` Greg Casteel Building Official Revi�ed 11/2/04 CITY OF �:UPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 357�2055.00 DATE ISSUED.......: 11/13/2007 RECEIPT #.........: BS000003216 REFERENCE ID # ...: 07110062 SITE ADDRESS .....: 10300 PALO VISTA RD SUBDIVISION ....... CITY .............. CUFERTINO IMPACT AREA ....... OWNER ............: VIEIRA R.AYMOND A AND NANCY M ADDRESS ..........: 10300 PALO VISTA RD CITY/STATE/ZIP ...: CUFERTINO CA, 95014-2708 RECEIVED FROM ....: DA�E SMITH CONTR.ACTOR .......: DA�E SMITH LIC # 25701 COMPANY ..........: CUFERTINO ROOF, INC ADDRESS ..........: 10�2 KELLY DR CITY/STATE/ZIP ...: SAI� JOSE, CA 95129 . TELEPHONE ........: (4C8)973 FEE ID UNIT QUANTITY �.MOUNT PD-TO-DT THIS REC NEW BAL ---------- ---------- --------- BPERMFEE VALUATION 12,000.00 191.16 0.00 191.16 0.00 BSEISMICRE VALUATION 12,000.00 1.20 0.00 1.20 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 192.36 0.00 192.36 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ------------------ CREDIT CARD 192.36 MC --------------- TOTAL RECEIPT : 192.36 Community Development �W`:�, ' 10300 Torre Avenue �; � 3'�, ; Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 C1TY OF CUPEt�TINO Buildi:n De artment JOB AI�DRESS: PERMIT # O � � � � O i� � � � � v � S �-- � �P OWNER'S NAME: 1 � �"� PHONE # �%..�'� ' �l � GENERAL CONTRACTO : C � Pr ` � � � FAX # «, 5 ,`7 0 j v'� �- I am not using any subcontractors: Si;;nature Date Please check a licable subcontractors and com �lete the followin information SUBCONTRACTOR BUSIl`dESS N�ME 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 �� C �� a Sheet Rock Tile � ) �- J 3-- �� Owner/Contractor Signature Date