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07090105 CITE'OF CUPERTINO BUILDII\<;DIVISION PERMIT = � iOw i- PERMIT NO. BUILDJft"jP�A��ESN STELLING RD STONERI DGE ROOFING 07090105 l(J(� PERMIT ISSUE DATE OWNER'S NAME: JESICA REYES 1643 SHDRTRIDGE AV 09/18/2007 SANITARY NO. CONTROL NO. dNE: (408) 729-5101 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p Z LICENSED CONTRACTOR'S DECLARATION Job Description 'Z f^ 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing [ with Section 7000)of Division 3 of the Business and Professions Code.and my license is TEAR OFF WOODSHAKE, INSTALL 30 LBS FELTL, 50 t=y in full force and effect q M 9—S� 66 D' )i2 z License Class i'3 4 Llc•#—r YEARS .—CDare Contractor 11ARCHITECTS DECLARATION C OMP. (ELK) . i�J < f understand my plans shall he used as public records )yU U.f' Licensed Professional y OWNER-BUILDER DECLARATION > 1 hereby affirm that I am exempt from the Contractors License Law for the t 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 a Z r prior it)its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor rea AValuation < that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sq $9500 F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or i 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 32608049q. bN Number Occupancy Type not more than five hundred dollars($500) ❑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 sae(Sec.7044,Business Required Inspections and Professions Code:The Contractors License Law does not apply to an owner of 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 sat-_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(See.7044,Business and Professions Code:)The Contractors 13- 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 Contractors License Law. ❑I am exempt under Sec .B&P C for this ro�wa Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: L]1 have and will maintain a Certificate of Consent to self-insure for Workers 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 Workers Compensation Insurance carrier and Policy number am: Carrier: S4-Mt— P11, I Policy No.: 6 2 e CERTIFICATE OF EXEMPTION FROM WORKERS n COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I cer ity 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. z O CONSTRUCTION LENDING AGENCY f~r rte-. I hereby affirm that there is a construction lending agency for the performance of a.7 the work for which this permit is issued(See.3097,Civ.C.) Lfa A Lendcr s Name az Lender's Address U 0 1 certify that I have read this application and state that the above information is VL E correct.1 agree to comply with all city and county ordinances and state laws relating to 0 U building construction.and hereby authorize representatives of this city to enter upon the U above-mentioned property for inspection purposes. W (We)agree to save,indemnify and keep harmlcss the City of Cupertino against la,to liabilities,judgments,costs and expenses which may in any way accrue against said City V z in consequence of the granting of this permit. Date 7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: SOURCE REGULATIONS. 11Q±,C9/2�7i�� �2 f-1 X3-0 2 Re-roofs Signature of Applicant/Codffactor Data T Of):OOf HAZARDOUS MATERIALS DISCLOSURE Type Will do applicant or future building occupant store our handle hazardous material as defined by the Cupertino Municipal Code.Chapter 9.12,and the Health and Safety Code,Section 25532(a)? All roofs shall 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 s installed without first obtaining an inspection,.I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes ❑Nu I have read the ha7ardous materials requirements under Chapter 6.95 of the Califor- / ^7 nia Health&Safety Code.Sections 25505,25533 and 25534.1 understand that if tie building �\ _zli 1f7/k/JPL L docs not currently have a tenant,that it is my responsibility to notify the occupant of the /� T7 „/S mquircments which must be met prior to issuance of a Ccrtiftcate of Occupancy. Signature of Applicant Date S ez- A bgrqaict L �-�8 Q All roof coverings to be Class"B"or better Owner or authorized agent Date CITY OF (: Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408)777-3228 Fax: (408)777-3333 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 final inspection and approval shall be obtained from the bu_lding 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 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 i irst 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 ilspection 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: 7 S 1 Cu. eye C Job Site Address: ae I i"C Roofing Company Name: 1'i� 5- Applicant's Signature: y1GZ Date: 41 Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Bl{: Lot: APN 32508049 .00 DATE ISSUED. . . . . . . : 09/18/2007 RECEIPT #. . . . . . . . . . BSD00002668 REFERENCE ID # . . . : 07D90105 SITE ADDRESS . . . . . : 10555 N STELLING RD SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : JESICA REYES ADDRESS . . . . . . . . . . : 10655 N STELLING RD CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : SERGIO GONZALEZ CONTRACTOR . . . . . . . : SERGIO GONZALEZ LIC # 22435 COMPANY . . . . . . . . . . : STDNERIDGE ROOFING ADDRESS . . . . . . . . . . : 1643 SHORTRIDGE AV CITY/STATE/ZIP . . . : SAN JOSE, CA 95116 TELEPHONE . . . . . . . . : (408)729-5101 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 9, 500. 00 169 .56 0. 00 169 .56 0. 00 BSEISMICRE VALUATION 9, 500. 00 1 . 00 0. 00 1 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 170.56 0. 00 170.56 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 170. 56 #730 --------------- TOTAL RECEIPT 170 .56 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 #-,UPEkTIN0 Building Department JOB ADDRESS: PERMIT # • 6`"7a?-Otl e9-'- OWNER'S NAME: G PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: ature Date Please check applicable subcontractors and co m Mete 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/Contractor Signature Date