07050090 CITY OF CUPERTINO
BUILDING DIVISION PERMIT
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BUILDING ADDRESS: PERMIT NO.
10572 RANDY LA CUPERTINO ROOF, INC 07050090
PERMIT ISSUE DATE
OWNER'S NAME:
MARCHESE SALVATORE A AND ADELI 1052 KELLY DR. 05/10/2007
SAMTARY NO. CONTROL NO.
)NE:
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
TEAR OFF SHAKE AND INSTALL BLDG ELECT PLUMB MECH
!0 p LICENSED CONTRACTOR'S DECLARATION Job Description
U p I hereby affirm that I am licensed under provisions of Chapter 9(commencing
z w with Section 7000)of Division 3 of the Business and Professions Colic,and my license is
r y in full force and eff
License ass J Lk•8
t Date_SrContractor
ARCHITECTS DECLARATIOIN
7 a a 1 understand my plans shall be used as public records
>yU
u•t— Licensed Professional
ycn
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for
Cthe
OO following reason.(Section 7031.5,Business and Professions Code:Any city or county
8c. which requires a permit to construct alter,improve,demolish,or repair any structure
u 14 prior to its issuance,also requires the applicant for such permit to file a signed statement Valuation
that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 iq.Ft. Floor Area
14 t— (commencing with Scction 7000)of Division 3 of the Business and Professions Colic)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 APN Number Occupancy Type
not more than five hundred dollars(5500).
Q 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 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 arc not intended or offered for sale.If,
however,the building or improvement is sold within one year of compaction,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sak.).
Q 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.
Q 1 am exempt under Sec B&P C for this reason
OwnerDate
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Q I have and will maintain a Certificate of Consent to self-insure far 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.
Q 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 Compensation IIn�surance trier and Policy �be2 VIA am-
Carrier f"X74 Policy No.: S
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section(teed not be completed if the permit is for one hundred dollars($100)
or less.)
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 Worker's Compensation provisions of the Labor Code,you must
,J- O forthwith comply with such provisions or this permit shall be deemed revoked.
Z''" CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
Lei 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 1 have read this application and state that the above information is
LL r—+ correct.I agree to comply with all city and county ordinances and state laws relating to
Ubuilding construction,and hereby authorise representatives of this city to enter upon the
W
ahovc-mentioned property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City or Cupertino against
liabilities,judgments,costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
AAWANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by
SOU CATION .
Re-roofs
Si u pplianVContractor DamT e of Roof
HAZARDOUS MATERIALS DISCLOSURE Type
Will the applicant or future building occupant store or handle hazardous material
as dened 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.
fi
❑Yes ___----moo`
Will the applicant or future building occupant use equipment or devices which
If a roof i 3 installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Area Air Quality Management ew rr aterials for inspection.
District?
QYcs
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
t,l
ty Cade,Sections 25505,25533 and 25534.1 understand that iC the buildingy have a tenant.that it%my resporsibility to notify the occup' lxmetp' issuartccoCaCcnifica roecu er. Signature of Applicant Date
.-� All roof coverings to be Class"B"or better
rised agent Dam
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: bethe
COPY # 1
Sec: Twp: Rng: Sub: Blk : Lot:
APN 31602061. 00
DATE ISSUED. . . . . . . : 05/10/2007
RECEIPT #. . . . . . . . . BSC00001279
REFERENCE ID # . . . : 07C50090
SITE ADDRESS . . . . . : 10572 RANDY LA
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MAFCHESE SALVATORE A AND ADELI
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2038
RECEIVED FROM . . . . : RECEIPT INTERFACE
CONTRACTOR . . . . . . . : DACE SMITH LIC # 25701
COMPANY CUPERTINO ROOF, INC
ADDRESS 10E2 KELLY DR.
CITY/STATE/ZIP . . . : SA-Y JOSE, CA 95129
TELEPHONE (4(8) 973-9427
FEE ID UNIT QUANTITY I,MOUNT 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
-- -------- ---------- ---------- ----------
TOTAL PERMIT 214 . 16 0 .00 214 .16 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- ---------------- --------------------
CREDIT CARD 214 . 16 mastercard
---------------
TOTAL RECEIPT 214 .16
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CI OF Fax(408)777-3333
"UPER,TINO
Building Department
All Cupertino building permits must meet certain conditions related to maintaining
environmental quality and public peace and safety. The two most common
conditions are described below.
STORMWATER POLLUTION CONTROL
State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and
the Santa Clara Valley Water District coni rol stormwater pollution. Educating local
residents and businesses and enforcing stormwater pollution control laws are key parts
of the City's compliance efforts.
Stormwater pollution prevention: It's up to us
In northern Santa Clara Valley, storm drains flow directly to local creeks and San
Francisco Bay, with no treatment. Storm Nater pollution is a serious problem for wildlife
dependent on our waterways, for people iving near streams and baylands, and for the
local water supply. Common sources of stormwater pollution include:
• Dripped oil, fuel, and antifreeze from vehicles and heavy equipment;
• Construction debris, including dirt. concrete and paint;
• Landscaping runoff containing pesticides or weed killers; and
Any material dumped or spilled into streets or storm drains
The property owner and the contractor sl-are ultimate responsibility for activities
occurring at a construction site and will be held responsible for any environmental
damage caused by subcontractors or employees.
For more information on construction-related stormwater requirements, see the
Stormwater Quality Regulations section cf the City of Cupertino web site at:
http://www.cupertino.org/city government/departments and offices/
environmental services
COMMUNITY NOISE CONTROL
The basic noise control requirements for construction sites are as follows:
• Typical construction work hours are:
- Weekdays - 7 a.m. to 8 p.m.
- Weekends - 9 a.m. to 6 p.m.
• Construction other than street corstruction is prohibited on holidays.
• Residential daytime noise levels from complaint site - 60 dBA
• Nonresidential daytime noise leve s from complaint site - 65 dBA
For more information on noise cortrol, please see Chapter 10.48 of the Cupertino
Municipal Code, which can be accessed at http://www.amlegal.com/cupertino ca/
Greg Casteel
Building Official