06090213 CITY OF CUPERTINO �••rY� wiira«fl�UmJ "' "''�' ^
BOILDINC W VISION PERMIT co gAC'�ORgINF�ORMATION l
BUIInINC ADDRESS: MB CONSTRUCTION, INC P°IM�NO'06090213
10488 BONNY DR
OWNERS NAME: PERMIT 15511E DATE
JACHENS, KAREN 702 S . DANIEL WAY 0
NE, SANITARY NO. CONTROL N0.
(408) 260-1260
ARCNTTER/F1IGINEFA _ BUILI)ING PERMIT INFO
x BLDG ELECT PLUMB MECH
lop LICENSED CONTRACTOR'S DECLARATION ]Ob Description
n1 b«cNy arrkm thu 1 m licensed wdcr Pm'a»,a ChaN«9(Lom--t
MNS tuun7000)or!)I m 3afthc Buatmd Pmrevkm Codc.W mylk is
� y urwl tome arW_ ls {
c-) 2Z REROOF- TEAR OFF EXISTING SHAKES, INSTALL 28 SQ
a.aOF SHEATHING, CLASS A
Dam
ARCHITECTS DE TION
1 uMrma,W my plw shall be Ivm u ry,Nlk rrmrda
1nV
'aC 1.kwtd Rvf®aul
OWNER- DECLARATION
I WrtbY Arnim mu =mpt(I nn ea, pt mm Ibc CanuamoYa Licrnae LAw r«N,
p a follnuin{..(Scctlan 70 1.5,Buri.ami PrMrsimu Code:My cuY w count'
e$f' wiucL,egWrts• mmil b mndruLL aYa,mPmR,&-flhll«tePair any nr,tmurt
?iIy^ 'H«0 hs lauuee.alae mTwrta ftwpllont far a h Pit m Bk a.iPnsd a amnxw
< thatW is ikcn¢d p«au,nt b Be proisuodor de caan i$I�out La.(CNpiu9Sq.F FlFloor Area Valuati 000
(ounawntla{with Swwn 7000)of Divuicn J of N,Buairc uk Panf�itn Code)a
Na
c .. t bNeBa
,1,evmpl a «m We bWN
a f« ,aBgW oem6m.pMy woburi of pp N
SationllkflSby at,.ppBomtoraPumltaobjccu ib,appBrn m-civil penally a 35914 400 Occupancy 15Type
n«mart tbaR fiw hmdrtd dalhn(5500).
I,a.of 1Ne Pro'.y.or my e,ployeea widb S.u dies Sank crompmtvdm,
uiuP.I...Cn -Th«mrt Lkt,d«ara nut-W1YWa..Or Required Inspections
aM Paofe bn a Code The Cmm .d Mbo Law duo nut appy b N miner a(
ptapenyaehu IUJda MIulthal Otcam.and wto daeaauhw ahlmalf«daao{b his
awn enPbYm,pmvid,ddulach lm Is said um o«inkmdralaaortad fm Wolf, (I
ha.eRs,d,ebwld a,, arimpmvemeu Is said uidun om Yee of mmPY/for ft
pa Dura. /] 777
saki. wiR h,R de hudeo a paH„{W,K dW nm daiW«knPmR f«puryo¢or
ale.}
Cl L=oft pof Nepmpcn/.,B eiduaivcly conr..ar—with )Tbc umram«an
caau,aa die project(Sec,W. B "r „d P1Nesala rCode)The Cmmeota Ll-
La.
4
neve Vwdoermi,b pt mmower a!proPn,4 wiio dV«imp tome Nerton,at O
whP mnvacu f«Bach gojeaa vBh,cmuanarG)Bcs,ucd parawru b We CaeuaMfa� /
lam,.....p,undo Src ,BAPCr«dda,mm
m WORI(ERS COMPENSATION DECLARATION V
1 kn by ARrm under penahy of perjury trK of the(auwi,t{&CWWk= (�
I lure'and will main a ce (4,ae of Comew m Wif.huert f«Warkda cmn
adm,n poNticd I.by Salim JTIXI M de IAber Code.far N,perf«mu a ar We
wok r«which this permit I,Lma
❑1 NR.rd ti maim,nn W~a Cmnperumi.huvan¢,a copal by Salim
JT00M We IAbor Code,fm that Pafam,-r•a de v f«which Nu Permk u iam
My worket P.«...M I^WuT omi,Zy.ky number
Carrie: PoBCJ'IRO WO(�' I(�� 4�
IFI COMPS EXEMPTION I FROM WORKERS
COMPENSATION INSURANCE
(Than rcmim nod mt Ncc«npkmd lithe parch 1.rut.h duBua(3100)
or Itv)
1"rely that in the wmm.rc,a t1,rack f«which Wa Perch u owed.l ahal tit
empluy any pram io any mawmran eba9�e�bket io the wort,rY Cpopr�lbn
IJwa oruin
Dm JCO
NOTICE TO A :If.aft«make{Wia Cmrkam of Eaemphm you a W
Naomk aubjut dm da Campcnutian pmvwd of ftIAbnr Cndc Ym mutt
.J O ran itbcomply w'ub a«bprov mr this permit Out be dared mdc4
z^ CONSTRUCTION LENDING AGENCY
a' Ibvnby.frum mu Bert 6.cormnctlm kMin{Wacy(or dm Mr.d
> dm wart r«.hich WLs perch b usued(Sa.J .civ.C.)
QI<odeYa Name
z I<nd,taAddrta
U0 1 cW fy b.,1 h,R mad thio,pplkuim anal auu Nu de.NOR uf«m,dm u
U. F-' cams,.,a{rte to mmply wiN all aly and c..m,oNirun.aM alar M1 mlalin{m
OU buildingcannon.:uan,a MmhyauNofinm cnwi.csafNuci,ymrnwrup IW
>�W aM.c-mentioned p,ty far mapection purposes 67
(Wt) R.m aR,indemnify a Yup harmlea the City of Cmpmtim apaiou
rFi f/1 Iiabllltlea,JW{mewa,c and eapcow whuh mryln cry wyaa,m.{alulWd Cry
U,Z Incm!equnce aflW{ in{af this p,rmlLtAzw
^ 6
APPLICANT UND ANDS AND WILL COMPLY WfIH ALL NON-POINT Issued by: Date
SOURCE REG NS.
a Re-roofs
IS
Appl HAZARDOUS MATERIALS DISCLOSURE Type of Roof
WiB tW.ppllavt«fwne bulWin{—P"sue «h.rme hmmom material
u dcru by Ne Cuperum Mumnpal Cad,.Cbapmr 9.12,and the IIcaW and WNY
Coo,,.Sca1m 15572(.)' All roofs shall be inspected prior to any roofing material being installed.
❑Yu No
wn de.Pplkant mlw,building acalwnt wpdpmmt«acriaa wnkh If a roof is installed without first obtaining an inspection, I agree to remove
anh h,r�rhxo air cmuml u n dcBred Ny,he Bay Aro Nr Qualm ManaScmcm all new materials for inspection.
Dlauict'
Ya ➢ i o
Ihme rtaJ Nclunrd�«Cn,'yttulartq„keru,urumkr Cbaprr 695 of Ne Ulirw. mil 2, O�
nuNdN&Balmy Calc, u,it
my an,I255Jd.lu_. ._. .Nuiru ht nrft (I
dao wtc yha,c. dwuumy mapatdhllhybmdry Nc aaupan,til do
rta;.m naw mcPoxtok.,oaor.ceur..r Signature of ppli t Date
All roof coverings to be Class"B"or better
Owner ar au rircda
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp : Rng: Sub: Blk: Lot :
APN . . . . . . . . .. 35914034 . 00
DATE ISSUED. . . . . . . : 09/21/2006
RECEIPT # . . . . . . . . . 36158
REFERENCE ID # . . . : 06090213
SITE ADDRESS . . . . . : 10488 BONNY DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JACHENS, KAREN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : MBROWN
CONTRACTOR . . . . . . . : CHRIS BROWN LIC # 25108
COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC
ADDRESS . . . . . . . . . . .. 702 S . DANIEL WAY
CITY/STATE/ZIP . . . : SAN JOSE,'. CA 95128
TELEPHONE . . . . . . . . : (408) 260-1260
*FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - - - ---- -- --------- - - - - ---------- ------- - -- ------ - - -- ---------- ----------
BPERMFEE VALUATION 5, 000 . 00 115 . 56 0 . 00 115 . 56 0 . 00
BSEISMICRE VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00
TOTAL PERMIT 116 . 06 0 . 00 116 . 06 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- --- - - - - ----- - -------- ---------
OTHER 116 . 06 AMEX
TOTAL RECEIPT 116 . 06
•
Community Development
10300 Torre Avenue
;` Cupertino CA 95014
Telephone(408) 777-3228
V`L Fax(408)777-3333
� CI OF
uPEkTINO
Buildin Department
iOB ADDR PERMIT #
' OWNER'S NAA— C ( S' PHONE # S' CCS S
I_`;ENERAL CONTRACTOR: bl L7�� C��` '� L K. FAX # 5(. 210 ta 1 Z
am not using any subcontractors:
Signature Date
Please check a 2plicable subcontractors and complete the foli information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
rExcavation
C Fencing
Flooring. Carpeting
Linoleum / Wood
�E Glass / Glazing
Hear..�g
Insulation
i Landscaping
Lathvig
I_
Masonry
Ornamental Sheet Metal
i—
Painbng/ Wallpaper
Paving
Plastering
i Plumbing �4
Roofing 1'
Septic Tank
Sheet Metal
Sheet Rock
Tile
ems" Date
Ow-iier/Contractor Signature
12/18/2004 10'. 21 FAX 408 777 3333 CITY CUPERTINO Z 002/002
Community Developme t Department
Building Division
. City of Cupertino
Io30ct Torre Avenue
Telephone: (408)777-3228
OCOF Pax (408)777-3333
CUPEI�TINO
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standarlfs
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspectiO n
and written approved from the building inspector. A final inspection and ,
approval shall be obtained from the building inspector when the re-roofmg
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. U plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without First obtaining an inspection,
will regWxe 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 no
A ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of r/," per foot slope and demonstrate
that there is no ponding.
2 An I.C.B.O_report is required to be on the job site at the time on inspection
I understand and will comply with the above stated policy on re-roofing.
rP i� �O'Gk�
liomeownefs Name: hh f�,,�,,, , 1�y
job Site Address: V tIL � �r �'�1 CA - SCOPy
Roofing Company Name:
Date: G� ,
ApplicanYs Signature: �_
Greg inl
Buildingilding Official
Revised 11/2/04
Primed no Fsoyclad Papa'
CITY OF CUPERTINO
REROOF
OF
*CUPERTINO PERMIT APPLICATION FORM
APN # Date: aP
35q - F'� - 0$�P
Building 1ddr ss: Gn �� CA qS (tel
�y Phone#:
Owner's Name:
Phone#: U License#: �1 as
Contractor:MP7 �l� ,
Contact: ��y6 Phone#: Cupertino Business License#:
trCS rn `� z1� Cz¢o� o
Type of Roof Covering:
Existiin Proposed:
g:. ❑ Built-Up roof
❑ Built-Up Roof Asphalt Shingles
❑ Asphalt Shingles q Wood Shakes
Wood Shakes ❑ Wood Shingles
❑ Wood Shingles ❑ Other(Specify)
❑ Other(Specify) ❑ Provide I.C.B.O.Report
Number of existing coverings ❑ provide Mfgr. Installation Specs.
❑ To be Removed
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
lob Description:V-RMVt� , �ytsttnt�Sor 3, ]t^S�et11 2 7�
'S LIaSS A Crt''`ft `-w
Residential Commercial ❑
Confirmed with Planning Dept. if
Fire Zone: Yes E] No F-1thereare an restrictions: IJ
rostofProject- Type of Construct n: Occupancy group_'.
� �
L
Qty. if Fee Description Fee Group
Applicable Fee ID BldBUILDING
BE
PERMFEE Fn Permit Fees BUILDING
BENERGY ner BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License
i
� I