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07010071 CITE'OF CUPERTINO BUILDING DIVISION PERMIT BUILDING ADDRESS: 20600 STEVENS CREEK BLVD D.C. TkY PERMIT NO. OWNER'S NAME: BYER PROPERTIESPERMIT ISSUE DATE 140 MA30N CIRCLE STE D ONE: 01/11/2007 (9 2 5) 6 )3—110 0 SANITARY NO. CONTROL NO, ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 40 a LICENSED CONTRACTOR'S DECLARATION 0 e V U I hereby affirm that I am licensed under provisions of Chapter 9(comm encing Job Description DZie withSection 7000)ofDivision 3ofthe Business and Professions Code,and mylicense is COMMERCIAL REROOF— INSTALL CARLISLE TPO H in full force and effect. �? License Class Lie.fl S J MECHAN-'CALLY FASTENED. 67 SQUARES. t- to Date Contraclar 7A yLoR 1-t-5.7 -t ARCHITECTS DECLARATION Cd U 1 understand my plans shall be used as public records a 't C y License)Professional n'^ J OWNER-BUILDER DECLARATION +�<X 1 hereby affirm that I am exempt from the Contractor's License Law for the o 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 F= that he is licensed pursuant to the Provisions of the Contractor's License Law(Chapter 9 S Ft.Floor Area X F- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or q Valuation 3"r3•• that he is exempt therefrom and the basis for the alleged exemption.Any violation of $36880 Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars casco). 35908018 APN Number Occupancy Type ❑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 and Professions Code:The Contractor's License Law does not apply to an owner of Required Inspections Property who builds or imprnves 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.). ❑I,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 themon,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 mason 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 Conscnt 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 CoWnsation Insurance carrier and Pplliry number are: Carrier S�4 aC Fr/rrd Po1iryK,: 001)0o 7 CERTIFICATE OF F.XI]NPTION FROM WORKERS' COMPENSATION INSURANCE or less.)(This section need not be completed if the permit is foronc hundred dollars($100) I 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 Workers Compensation provisions of the Labor Code,you must Oforthwith comply with such provision or this permit shall be deemed revoked. z rA CONSTRUCTION LENDING AGENCY [�►-� I hereby affirm that there is a construction lending agency for the performance of LY,5 the work for which this permit is issued(Sec.3097,Civ.C.) W Q Lender's Name r7 z Lender's Address V 0 1 certify that 1 have read this application and state that the above information is LL o-r correct.I agree to comply with all city and county ordinances and state laws relating to 0 V building construction,and hereby authorise representatives of this city to enter upon the aabove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against fr liabilities,judgments,costs and expenses which may in any way accrue against said City U Z inconsequence of the granting this permit . APPLICANT / , UOSTANDS AND WILL COMPLY WITH ALL NON-POINT SOIssued by: Date / �-f� Re-roofs SrgnatureofApphcanUCantrador '�-- Datc HAZARDOUS MATERIALS DISCLOSURE Type of Ro)f 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)T ❑Yes All roofs sl•all 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 i nstalled without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air M District? r QuaManagement all new materials for inspection. ❑Yes p 1 have read the haza ttus materials requirements under Chapter 6.95 of the Califor- ria Health&Safety Code,Sections 25505,25533 and 25534.1 understand hat if the building ��//_�� Joel t currently have a tenant,that it is my responsibility to notify the occupant of the u .•� i n s which m t be or to issuance of a Certificate of occupancy, _��_U Signature o1 Applicant Date [0�wnftrorauthorizc�aa Date All roof rings to be Class"B"or better " CITY O:� CUPERTINO 2 ITEMS OF 2 PERM:CT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: B:-k: Lot: APN 35908018 DATE ISSUED. . . . . . . : 0_./11/2007 RECEIPT #. . . . . . . . . . BS000000195 REFERENCE ID # 0"010071 SITE ADDRESS . . . . . : 2C600 STEVENS CREEK BLVD SUBDIVISION . . . . . . CITY CILPERTINO IMPACT AREA OWNER BYER PROPERTIES ADDRESS . . . . . . . . . . CITY/STATE/ZIP , RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : BILL TAYOR LIC # 23898 COMPANY D. -. TAYLOR COMPANY ADDRESS . . . . . . . . . . : 140 MASON CIRCLE STE D CITY/STATE/ZIP . . . : CONCORD, CA 94520 TELEPHONE (95) 603-1100 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --------- - --------- ---------- ---------- ______ _ BPERMFEE VALUATION 36, 880. 00 427 . 68 0. 00 427 . 68 0. 00 BSEISMICOM VALUATION 36, 880. 00 7 .77 0. 00 7 .77 0. 00 ----------- ---------- ---------- TAL PERMIT 435.45 0. 00 435 .45 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----- --------------- -------------------- CREDIT CARD 435 .45 MASTERCARD --------------- TOTAL RECEIPT : 435 .45 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 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 "UPEkTINO Building Department JOB ADDRESS: PERMIT # � L ��a)�e vp"is C/ d (� '-?() / 607 OWNER'S NAME: /fi/-711 PHONE #S!/ -& 2 b -- 7d' GENERAL CONTRACTOR: L, v r FAX # II I am not using any subcontractors: X_ - /l-y Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS 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/Contr cto ature Date 0g01b0g1 CITY OF CUPERTINO RFROOF CUPERTINO PERMIT APPLICATION FORM APN# Date: v 35q- oA- oIS /— //— Building Address: -, v -� .2- c� 6OJ �,�e ��e��s fe� l" �/ud. Owner's Name: n Phone#: Contractor: License#: Contact: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: `i( Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes L1 Wood Shingles Ll Wood Shingles /� ❑ Other(Specify) b< 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 Description: � C /l _ s « L _�E-i e pl Residential ❑ Commercial Fire Zone: Yes ❑ No a Confirmed with Planning Dept. if there are any restrictions:Dy Cost of Project: Type of Con:truction: Occupancy roup: 3 � 0 k_zl Cal Qty. if Applicable Fee ID Fee Description 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