07050218 CITY OF CUPERTINO
BUILDING DIVISION PERMITT IRVITIf� t
BUILDING ESS: PERMIT NO.
MESS: DR CONDITIONED AIR 07050218
PERMIT ISSUE DATE
OWNER'S NAME:
AMANDA REILLY 1701 LI"TLE ORCHARD ST 05/22/2007
)NE: SANITARY NO. CONTROL NO.
(408) 29:_-2220
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
p p LICENSED CONTRACTOR'S DECLARATION Job Description
V p I hereby affirmthat I am licensed under provisions of Chapter 9(commencing
;z w with Section 7000)of Division 3 of the Business and Professions Code,and my license is REPLACE FURN�C E & ADD A/C.
y in full force and feet 62
Z License Gass Lld•g
E Date Contractor ),J M%" A tt, 1 ft
ARCHITECTS DECLARATION
i a a I understand my plans shall he used as public records
)aU
U.F Licensed Professional
w OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the
p O following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to construct,alter,improve,demolish,or repair any structure
Z} prior to its issuance,also requires the applicant for such permit to file a signed statement <' Ft.Floor Area Valuation
- < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 `'(1 $6500
2 t= (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
Q that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of �]� Number Occupancy Type
not more than five hundred dollars($500). 3234505 3:'(7
❑I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044.Business Required Inspections
and Professions Code:The Contractor's Licence Law does not apply to an owner of Q p
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If.
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
❑1 am exempt under Sec B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑I have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code.for the performance of the work for which this permit is issued.
My Worker's Compensa�tion Insurance carrier and Policy number are:
Carrier.�( A,7onK Policy No.1Z 10 01! 6 4_S. 7i
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is far ane hundred dollars($100)
or less.)
1 certify that in the performance of the work for which this permit is issued,1 shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
Z, CONSTRUCTION LENDING AGENCY
Cn I hereby affirm that there is a construction lending agency for the performance of
CYC> the work for which this permit is issued(Sec.3097,Civ.C.)
(=1 Q Lender's Name
.7 z Lender's Address
U O 1 certify that I have read this application and state that the above information is
►' correct.1 agree to comply with all city and county ordinances and state laws relating to
O U building construction,and hereby authorize representatives of this city to enter upon the
U above-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities,judgments,toss and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
ER [ONS.
` Z1.-O Re-roofs
rc of Applicant/ ontractor Date Type Of Roof
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety
Code.Section 25532(a)? All roofs E hall be inspected prior to any roofing material being installed.
C]Yes �No
��\ If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes 03
,plu
I have read the hazardous materials requirements undcrChaptcr 6.95 of the Califor-
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
does not currently have a tenant that it is my responsibility to notify the occupant of the
requi cnts which must be nyt prior to i ancc of a certificate of Occupancy. Signature A Applicant Date
- All roof coverings to be Class"B"or better
r authorized agent Date
CITY OF CUPERTINO
8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: suew
COPY # 1
Sec: Twp: Rng: Sub: Blk : Lot:
APN 32345058 . 00
DATE ISSUED. . . . . . . : 05/22/2007
RECEIPT #. . . . . . . . . BSC00001421
REFERENCE ID # . . - : 07C50218
SITE ADDRESS lIC73 FIRETHORNE DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER AMPNDA REILLY
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-0456
RECEIVED FROM . . . . : BEFTHA A GARCIA
CONTRACTOR RICHARD READ LIC # 22334
COMPANY CODDITIONED AIR
ADDRESS 17C1 LITTLE ORCHARD ST
CITY/STATE/ZIP . . . : SAr JOSE, CA 95125
TELEPHONE (4C8) 291-2220
FEE ID UNIT QUANTITY TMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- ---------- ----------
BENERGY PERMIT FEE 1 .00 34 . 86 0 .00 34 .86 0. 00
BREMAIRHAN NO.UNITS 1 .00 10 .26 0 .00 10 .26 0. 00
BREMFURN NO UNIT 1. 00 14 . 31 0 . 00 14 .31 0 . 00
BREMRECEPT NO. OUTLETS 1 . 00 1.20 0 .00 1.20 0 .00
BSEISMICRE VALUATION 6, 500 .00 0.70 0 .00 0 .70 0 . 00
EPERMITFEE FLAT RATE 1 .00 38 .37 0 . 00 38 .37 0. 00
MPERMITFEE FLAT RATE 1 . 00 38 . 37 0 . 00 38 .37 0. 00
PPERMITFEE FLAT RATE 1 . 00 38 .37 0 . 00 38 .37 0 . 00
-- -------- ---------- ---------- ----------
TOTAL PERMIT 176 .44 0 .00 176 .44 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 176 .44 VISA
---------------
TOTAL RECEIPT 176 .44
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
505 FINAL ELECTRICAL 508 FINAL MECHANICAL
CITY OF C UPERTINO
N kCE/AC _
CUPEF�TINO PERMIT APPLICATION FORM -;)-IY
APN# 4 C . �Vy Date:
j (
Building Address:
Own 's Name — Ph ne#:
Ria
retractor: Phone: Li �e� se #:
L-DpiAv--m� s�,r- K 2-CY 0 (02,
tart: / Phone: Cupertino Business License#:
Building Pe it Info:
Bldg ❑ Elect P umb Er" Mech
Job Description:
Residential Commercial ❑
For Residential Installations:
Attic ❑ 1St floor ❑ 2nd floor❑
Adhere to min set back requirement El'
For Commercial Installations:
_eplacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation El
New installation Planning Approval Required ❑
Cos of Project. Type of Construction: Occupancy group:
Strapped ❑ On Platform Com- Bonded Sq.Ft. Floor Area:
New Location Replacement Er
Qty. if
Applicable Fee ID Fee Description Fee Group
BENERGY Energy BUILDING
BREMFURN Furnace MECHANICAL
BREMACOVER A/ Unit> 10,000 cfm MECHANICAL
BREMAIRHAN A/ Units <= 10, 000 cfm MECHANICAL
BREMRECEPT Re c tl, Switch & Outlets ELECTRICAL
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILIDNG
EPERMITFEE El-1c Permit Issuance ELECTRICAL
MPERMITFEE M,-.ch Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
BPERMFEE Bl ig Permit Fees BUILDING
BPLANCHK Plan Check Fee BUILDING
BPGAS Gas Piping System Fee PLUMBING
BUSLIC Business License BUILDING
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
CUPERTINO
Building Department
J l rb� D 't �` me �� PERMIT #(�20,5 L
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR FAX# Q( -
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSI:vESS 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
Owner/Contractor Signature Date
CITY OF CUPERTINO
BUILDING DIVISION PERMIT � Q IC}ILATI '
PERMIT NO.
BUILDJI�j�ffl'$ IRWOOD DR FOUR SEASONS ROOFING 07050088
�OWNElR'SSNAME: r PERM1T ISSUE DATE
CMS C/O DE ANZA OAKS HOA 502 HOR]4ING ST 05/10/2007
NE: SANITARY NO. CONTROL NO.
(4 08) 273-0330
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
i o O LICENSED CONTRACTOR'S DECLARATION Job Description
V I hereby affirm that I am licensed under provisions of Chapter 9(commencing
�z� withSection7000)of'Division3oftheBusinessandProfessionsCode,andmylicenseis REROOF-:ZEMOVE(E) SHAKE, INSTALL NEW 1/2" CDX
y in full force and e
3 ulz License C1as� Lic.x i•1-1��o$ PLYWOOD, 3 0 LB FELT 16 SQUARES.
f in Date�'�_ Contractor V. S.Q`
ARCHITECTS DECLARATION
7 a I understand my plans shall be used as public records
>yU
a y Licensed Professional
y OWNER-BUILDER DECLARATION
I hereby affirm that t am exempt from the Contractor's License Law for the
COO following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to construct,alter,improve,demolish,or repair any aructum
u►y prior to its issuance,also requires the applicant for such permit to rile a signed statement
_ that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 :;q.Ft. Floor Area8 O O O Valuation
Y[— (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
u R§ that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of ��Number Occupancy Type
not more than five hundred dollars(5500). 3 4 2 3 3 0 4 5
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of �l p
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If.
however,the building or improvement is sold within one year of completion,the owner.
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's li-
cense Law does not apply to an owner of property who builds or improves thereon,and.
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
[3I am exempt under Sec B&P C for this mason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
t_j I have and will maintain a Certificate of Consent to self-insum for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as rcyuimd by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My WorCo�mtpensatian Insurance carrier and Policy number arc:
Carrier. L+ A Policy No.W C`:SSS'Ll I 10 ll
CERTIb7CATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less.)
1 certify that in the performance of the work for which this permit is issued.I shall not
employ any person in any manner so as to become subject to the Workcrs'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Qforthwith comply with such provisions or this permit shall be deemed revoked.
Z, CONSTRUCTION LENDING AGENCY
Fr mom•) I hereby affirm that there is a construction lending agency for the performance of -
Ix > the work for which this permit is issued(Sec.3097,Civ.C.)
W A Lender's Name
Z Lender's Address
U C) I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances and state laws relating to
Ubuilding constriction,and hereby authorize representatives of this city to enter upon the
Uabove-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
o.4 c/) liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Issued by: Date
" APPLICANT UNDERST WILL COMPLY WITH ALL NON-POINT
CATION J
'l Re-roofs Vt
Signature of Applicant/ n ctor Dale
q9ARDOUS MATERIALS DISCLOSURE Type of R sof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cu o Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)7 All roofs:;hall be inspected prior to any roofing material being installed.
❑Yes No
Will the applicant or future building occupant use equipment or devices which If a roof is;installed without first obtaining an inspection,I agree to remove
emit hazardous air co mans as defined by the Bay Area Air Quality Management all new m 3terials for inspection.
District?
C]Yes No
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Sect; 5,25533 and 25534.1 understand that if the building
does not currently have a to that is my responsihilily to notify the occupant of the
ch must be t pri issuance of a Ccrtifcatc of Occup Signature of Applicant Date
S-1 a- r All roof coverings to be Class"B"or better
Owner or authorized a Int V Date
CITY OF CUPERTINO
2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: suew
COPY # 1
Sec: Twp: Rng: Sub: Blk.: Lot:
APN . . . . . . . . : 34233046. 00
DATE ISSUED. . . . . . . : 05/10/2007
RECEIPT #. . . . . . . . . : BSC00001276
REFERENCE ID # • • • : 07C50088
SITE ADDRESS . . . . . : 10050 FIRWOOD DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : CME C/O DE ANZA OAKS HOA
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2640
RECEIVED FROM . . . . : RECEIPT INTERFACE
CONTRACTOR . . . . . . . : DIF.Z, ALFRED LIC # 21323
COMPANY . . . . . . . . . . : FOUR SEASONS ROOFING
ADDRESS . . . . . . . . . . : 502 HORNING ST
CITY/STATE/ZIP . . . : SAI�' JOSE, CA 95112
TELEPHONE . . . . . . . . : (4C8) 278-0330
FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000 . 00 147. 96 0 .00 147. 96 0 . 00
BSEISMICRE VALUATION 8, 000 . 00 0.80 0 .00 0 . 80 0.00
-- -------- ---------- ---------- ----------
TOTAL PERMIT 148.76 0 .00 148 .76 0 .00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
305 FRAME 307 INSULATION
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
'iGJ;s'IX' t
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEf�TINO
Building ]department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agrE,e 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 firtal inspection and
approval shallbe obtained from the budding inspector -o,h(-n thP,r?-rr,r,fi„
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 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.
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:
Job Site Address:
Roofing Company Name:
A plicant's Signature:
Greg teel
Building Official
Revised 1/30/03
Printed cn.3ecyded Paper
CITY OF C UPERTINO
REROOF
CUPEl T NO PERMIT APPL[CATION FORM
APN# L/.� G� D�r� O -0-73-
Building Address::
Owner's Name�a,
Phone #:
Cry.S 9 "1",, Q.�k S yDq ('4/a,?) 5�5_-'�7— /2 7
Contractor: License#:
FU s�so�s o� �- 911�712 /o
Contact: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
L9�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.
L I Have Read, Understand and Will Comply With Cupertino's Tear Off Policy: Er
Job Description: Ae..r'✓e eYi rllV00
/0X14-// ze 30 4,6� t/f moi`// svt ��m/`uw �'/fir /� 6i0,z_ e5�41rll.Sc c.s,
Residential Commercial ❑
Fire Zone: Yes ❑ No [J— Confinned with Planning Det. if
_ there are any restrictions: lJ
Cost of Project: T e of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE E ldg Pen-nit Fees BUILDING
BENERGY Hnergy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC 3usiness License BUILDING
•