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07090026 CITY OF CUPERTINO BUILDING DIVISION PERMIT GdaT ` IRT-1� * PERMIT NO. BUILDING ADDRESS: 10680 LA RODA DR MICHAEL LUNNEBORG ROOFING 07090026 PERMIT ISSUE DATE OWNER'S NAME: MCFARLING RICHARD B AND DIANA 1328 WH--,TE OAKS RD 09/07/2007 SANITARY NO. CONTROL NO. NE: (831) 278-1837 BUILDING PERMIT INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH 0 0 L__J Cd p p LICENSED CONTRACTOR'S DECLARATION Job Description v P I hereby affirm that I am licensed under provisions of Chapter 9(commencing Z in full Coree and with Section 7000)of Division 3 of the Business and Professions Code,and my license is TEAR 0 F I' WOOD SHAKE, FILL SHEETING AS NEEDED, effect'1 T f t L r >E2? License Class Lica 40LBS FELT, INSTALL METAL TILE CLASS A ROFFING 34 t-w Date !g•Z^t0.:7 Contracts ARCHITECTS D SQ i d< I understand my plans shall be used as public records .96 WF- Licensed Professional y OWNER-BUILDER DECLARATION > I hereby affirm that 1 am exempt from the Contractor's License Law for the a Oa 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 r prior to its issuance,also requires the applicant for such permit to rile a signed statement Ft.Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 )q $19000 2 t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of Number Occupancy Type not more than five hundred dollars(SSW). 36933012 . V V ❑1,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure isnot intended oroffered for sale(Sec.7044,Business Required Inspections and Professions Code:The Contractor's License Law docs 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 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 Contractors Li- cense taw 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 Contratxor'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. ❑1 have and will maintain Workers 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 arc: Cartier: j�irl(L05 v4 PolicyNo.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars($100) or less.) I cenify 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 Z forthwith comply with such provisions or this permit shall be deemed revoked. z OCONSTRUCTION LENDING AGENCY (-a mom. I hereby affirm that there is a construction lending agency for the performance of (�.� the work for which this permit is issued(Sec.3097,Civ.C.) W A Lender's Name Lender's Address V 0 I certify that I have read this application and state that the above information is LL r e cortcct.I agree to comply with all city and county ordinances and state laws relating to rJ Ubuilding construction,and hereby authorize representatives of this city to enter upon the a ahove-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupcnino against liabilities,judgments,costs and expenses which may in any way accrue against said City J Z in consequence of the granting of this permit. Date �+ APPLICANT UNDERSTANDS AND Wl COMPLY WITH ALL NON-POINT Issued by SO CE REG CATIONS. Re-roofs igt°` oats Type Of R Oof L ARDOU ALS DISCLOSURE yP Will the applicant or future ding 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 shall be inspected prior to any roofing material being installed. ❑yesNo If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant r future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new IT aterials for inspection. District? C]Yes n)usmo I have read the hazyrials requirements under Chapter 6.95 of the Califor- nia Health&SafctyCodc,Sections 25505.25533 and 25534.1 understand that if the building docs not currently have a tenant,that it is my rasponsi .ity to notify the occupant of the requirements which must be et p' " uancc pfei ifmcateorOccupancy. Signature of Applicant Date a' c Date 4-7-07 All roof coverings to be Class"B"or better CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: B11i: Lot: APN 36533012 . 00 DATE ISSUED. . . . . . . : 09/ 07/2007 RECEIPT #. . . . . . . . . : BSC,00002575 REFERENCE ID # . . . : 07C,90026 SITE ADDRESS . . . . . : 10F,80 LA RODA DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : MCFARLING RICHARD B AND DIANA ADDRESS . . . . . . . . . . : 10E80 LA RODA DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4416 RECEIVED FROM . . . . : MIC'HAEL D LUNNRBORG CONTRACTOR . . . . . . . : MIC:HAEL LUNNEBORG LIC # 25896 COMPANY . . . . . . . . . . : MIC:HAEL LUNNEBORG ROOFING ADDRESS . . . . . . . . . . : 13,;8 WHITE OAKS RD CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE (8;1) 278-1837 FEE ID UNIT QUANTITY ! MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ----------- ---------- ---------- ---------- BPERMFEE VALUATION 19, 000. 00 266 .76 0. 00 266 .76 0. 00 BSEISMICRE VALUATION 19, 000. 00 1 .90 0. 00 1.90 0. 00 ----------- ---------- ---------- ---------- TOTAL PERMIT 268 .66 0. 00 268. 66 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 268. 66 VISA --------------- TOTAL RECEIPT 268 . 66 CITY OF CUPERTINO RE_ROOF CUPEkTINO PERMIT APPLICATION FORM 6o Date: qr 7-0 Building Address: hr Owner's Name: Phone#: Contractor: License M k -L-5— Contact: Cupertino Business License #: nkcLw�nebo36R kc?T- Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles `' - Wood Shakes ❑ Wood Shakes /❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) Other(Specify)MCk "+'(I-- Number of existing coverings 'j._- Provide I.C.B.O.Report# CT# Lr, To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: '` �,,o�1 S/� -rd( 5A-re}rn PrS caJ �o tb� 4(+ Ns-�,.�1 ►( � •l o Residential Commercial ❑ C,/mssA-A3''f- - Fire Zone: Yes ❑ No ❑. Confirm ith Planning Det. if there are any restrictions: LJ Cost of Project: Type of Construction: Occu cy up: (>_X.)(>_X.)t S � 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 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 afire 2 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 apprcval. 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 f rst 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 A$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: rK 1" CFAt-I tAi, Job Site Address: CL r Roofing Company Name: J4t�S�t rkt-q Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 7UPEkTINO Building Department JOB ADDRESS: PERMIT o �QO � c� �� � �� OWNER'S NAME: PkP�Awj PHONE #'f0 tf 3(*'1 -P,7) GENERAL CONTRACTOR: FAX # -icj r- S-#Q i 7>3 I am not using any subcontractors: i ?ethe e Date Please check applicable subcontractors and co followin 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 er ntractor Signature Date