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06020068 CITY OF CUPERTINO C ?', _ �' ••�� * ^�' °� �` Eg31LDING 61VISION PERMIT CON,TRacTOR I1 FgORMATIQN �. BUILDING ADDRESS: FALCON ROOFING PERMIT N0.06020068 10221 PHAR LAP DR OWNER'S NAME: PERMIT ISSUE DATE J.B . JAYAPRAKASH 13088 POTTS DR 02/10/2006 E: SANITARY NO. CONTROL NO. (408) 225-1705 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUMB MECH tion LICENSED CONTRACTOR'S DECLARATION �. 1 nereby affirm shat I un licensed unde,r provisions of Chapk,r Y(commencing Job Description mE with Section 70f111)ol Divi' n3of eusirnss ar�ATI and inrpllrnrteand m. �-GREROOF-REMOVE OLD/INSTALL 1/2 OSB PLYWOOD ��? Licenu Claza LieN Dam cnmuamorX50 YR COMP-CLASS B-FELL��-�yyrT�yyy�//((yWW��}yTTT��Yiyyy IILI4S ARCall Cuss DELLJ w U 1 understand my plans dull E used u public records Se. a0 G Licensed Professional OWNER-BUILDER DECLARATION �� 2006 <y 1 h .Yarn Nat ereby.Ya1 em exempt from Ne Causer.,'.License Law for the FEB i 20 following mason.(Section 7031.5,Business and Prefutions Code:Any city or county .d: which requires a pmmis to conawes,e1mr,improve,demolish,or repair any structure -Zi prior or its issuance.also rnquirrs the applicant for such permit.Bk a signed statement Es0 shotheislicensedpursuan(tothepmvisionsnfdonConvacmrsLicenselaw(Chapter9 Sq.Ft. Floor Area x I- (commencing with Section 713M)of Division 3 nfthe Business and Professions Code)or ERE But he is exempt aroxfro rt and the basis for the alleged exemption.My violation of Section 7031.5 by any applicator for a permit subjects the applicant o a civil penalty of APN Number Occu ane Type nos..than five hundred dollars(S5130). 3 2 63 9 0 5 0 . 00 p y YP ❑I,uownm of the property,ar my employees wish wageso their.Ic wmpewtion, will do du work and the swnure u not intended.offered forsal.(See.7W.Business and Professions Code:The Contractor's License Law docs act apply m an owner of Required Inspections property who Wildsm improves therson,and whodocasuch workhimsellor through his - Own employee,provided that such improvements are not intended oroffered for sale.If. however.Ne Wilding or improvement is sold within one year of completion.Ne owner- builder will have the Widen of pwving that he did nm Wild or improv for puryose of sake.). Q 1,as Owner of de propeny,am exclusively contracting with licensed contracmrs m construct the pmject(Sec.7W.Business and Prokssions Code)The Conuacmr's Li- eeNe Law does not apply 0 an Owner of property who Wilds or Improves thereon,and who contracts for such projects with a contractor(s)licensed pursuant to she Comnemrs License Law. ❑l am exempt under Sec. ,B&PC for this moan Owner Dau WORKER'S COMPENSATION DECLARATION 1 hereby afrtrn under penalty of pointy 0.of dk,following declarations: 1 have and will maintain a Certificate of Consent n self-insua fm Wmk,exCompen- saion,az provided for by Section 3700 of the Labor Code.for she pedormance of the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as respond by Section 3200 of the labor Code,for the perfprman.of Ne work for which this permit is issued. My Workers Compensku .lawrame,ea r and Policy number'. umber art: Cartier. :i' _ Policy No.: CERTIFICATE FEXEMPf10N FROM WORKERS' COMPENSATION INSURANCE (Thu sectism recd not W eomplmed if the permit is for..hundred dollars(SIM) or less.) I cenify that in due performance of the work for which this permit is issued.I shall not employ any person in any manner.as w become subject to IW Workeri Compewtion Laws of Calilomia.Dau Applicant NOTICE TO APPLICANT:If,after making this CeniOcate of Exemption,you should become subject to the Worker'a Compensation provisions of the LsWr Code,you must .J z fOMwi0 comply with such provisions or this permit shall be deemed mated. Z O CONSTRUCTION LENDING AGENCY 'p+ ? 1Iomby affirm that there is a construction lending agency lot the Performance of Qi Jr,work for which this permit is Issued(Sec.3WO.Co,C.) W fender's Name a lenders Address 5z U O 1 anify that 1 haus head this application and sunk,thn the above information u w F correct 1 ague.comply with all city and county ordinances and auk laws relating to V building construction,and hereby authoria,repreumatiwa Of this city.enter Upon die ahopa.m,judg dproperty foran expecdonwhich may H y (we)agree.save,indemnify and keep harmless sbe City or Cupertino against N inconscapu co Of ns.the graBindng ofthis permit. mayin anyway acrnk,against said City V z APPLICANT O UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGU ATIONS.2f 44p,A Date Sib olAppliltio.—nncml Day Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof _ Will the applicant Or future building occupant store or handle havallous material az defined by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety Code,Section 25532(a)? ❑Yea ON. All roofs shall be inspected prior to any roofing material being installed. 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 rt houardpus air co oroormnts as defined by dm Bay Area Air Quality Management all new materials for Inspection. Di.ict? ❑Yes ON. I have mad the hanrdous materials nequinmcnu under Chapter 6.95 of the Califor- ni H deb&SafetyCode.Sections 25505,25533 am12553a.l umkrsund thatifdc Wilding does not eurenoy haw a u tr nt that is is my responsibility.notify the Occupant of theelgn requihemcnu which muslWmet prior.issuance OfainreofApplicant D e 6 All roof coverings to be Class"B"or better CITY OF CUPERTINO 1 of 1 PERMIT RECEIPT OPERATOR: suem COPY # 2 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 32639050.00 DATE ISSUED. . . . . . . : 02/10/2006 RECEIPT #. . . . . . . . . : 33178 REFERENCE ID # . . . : 06020068 SITE ADDRESS . . . . . : 10221 PHAR LAP DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : J.B. JAYAPRAKASH ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-1115 RECEIVED FROM . . . . : FALCON ROOFING CONTRACTOR . . . . . . . : MARIO RENTERIA LIC # 22568 COMPANY . . . . . . . . . . : FALCON ROOFING ADDRESS . . . . . . . . . . : 13088 POTTS DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (408) 225-1705 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 14, 000.00 212 .76 0.00 212.76 0.00 BSEISMICRE VALUATION 14, 000.00 1.40 0.00 1.40 0.00 BUSLIC FLAT RATE 1.00 105.00 0.00 105.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 319.16 0.00 319.16 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 319.16 3980 TOTAL RECEIPT 319.16 El Community Development Y '�' 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 mo CITY OF Fax(408)777-3333 SUPEkTINO Building De artment JOB ADDRESS: PERMIT z a /� (J(p C.c.c�i0 OWNER'S NAME: PHONE GENERAL CONTRACTOR: FAX # j Z -7_ I am not using any subcontractors: /�J G� Signature to Please check applicable subcontractors and complete the following information: hd SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting AOL 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 Community Development Department Building Division City of Cupertino 10300 Torre Avenue # CITY OF Telephone: (408)777-3228 UPEkTINO Fax: (408)777-3333 Building Department Subject: Re-roofing policy for the City 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 building 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 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. 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$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: .J P Ja v aPra/c a sA ri s h iyaM o a rTy Job Site Address: /l ZZ/ ✓�/l V Roofing Company Name: Applicant's Signature: ,— Date: . Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper ce'nu-', CITY OF CUPERTINO CUPEkTINO PERMIT APPLICATION LICCATION FORM N# Date: io oG Building Address: 2 6 g r a ✓C( e -oII Owner's Name: V lbone#: Contractor: Phone#: License # � c : o.v �� zZ5-ITo 3 z$'6 Contact: ne Cupertino Business License#: °r�gi 3-6�3a Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles W Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) Ecit4 ZA IO ,00 ❑ Other(Specify) 01 Number of existing coverings A nJr_ ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: 11obDescription: r�wea,-- e G �ti /,�5 g / f/ GI/tio tf- J�� t�S Go Residential Commercial ❑ Fire Zone: Yes ❑ No [3,' Confirmed with Planning D_pt. if there are any restrictions: E5 Cost of Project: �� Type of truction: Occup c grip: Qty. if Applicable Fee ID Fee Descri tion Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING