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09070068m U z _meg L g,F X037 rA p0 K$� CO3—rn F :EF< C 1. .7 Q Z 2 ..s &n 4 W ; a 0 rte% ,Z UO wH OU rE"-t CA Uz m -r BUILDING DIVISION BUILDING ADDRESS: 7448 STANF( NER'S NAME: ARCHTTECTIENGINEER: PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division of the Business and Professions C aj�d my license is in full force and effect i -/7 ��/JJ Licensc.pl Lie. I understand my plans shall be ti�cd as pudic iccofda Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the 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 prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 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 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 are not intended or offered for We. 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 consnuct the project (Sec. 7044. Business and Professions Code:) The Contractor's Li- cense Law docs 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. ❑ I am exempt under Sec B & P C for this reason ner 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 Workces Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the w9rk for which this permit is issued. k3I have and will maintain Worker's Compensation Insurance, as required by Section the Labor Code, for the performance of the work for which this permit is issued. My Worker' ,C o mpensation Inss}rlrance carrier and Policy number arc: Cartier. 1l 1 . YV 6 �� Policy No.: �1 tj COMPENSATION INSURANCE (This section need 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 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address I certify that 1 have read this application and state that the above information is correct I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorise representatives of this city to enter upon the above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of this permiL APP (CANT UNDERSTANDS AND WILL COMPLY WITH ALL NON POINT SOUREGUL, TWNS. -7 ( � r V Si" i Date -. H MoUS DISCLOSURE 1 the applicant or future building occupant store or handle hazardous material defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety dc, Section 25532(a)? ❑ Yes ¢fio Will the applicant 6r/fu1ure building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? ❑ Yes IEN'No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505.25533 and 25534.1 understand that if the building does not currently haus tenant that it is my responsibility to notify theupant of the redu'ememts which must So met otioiltrissuance of a Cenifrcate of Occup cv. - INC 408)626-9320 Job Description RE -ROOF REMOVE EXISTING 2 LAYERS OF COMP, INSTALL NEW 30 ASTM FELT & LIFETIME COMP CLASS A 3q. Ft. Floor Area 35932020.00 Issued by: Re -roofs Type of Roof Valuation Type Required Inspections All roofs stall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new maerials for inspection. Signat�, pplicant Date All roof coverings to be Classor better PERMIT NO. PERMIT ISSUE DATE S CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB a 0 0 Job Description RE -ROOF REMOVE EXISTING 2 LAYERS OF COMP, INSTALL NEW 30 ASTM FELT & LIFETIME COMP CLASS A 3q. Ft. Floor Area 35932020.00 Issued by: Re -roofs Type of Roof Valuation Type Required Inspections All roofs stall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new maerials for inspection. Signat�, pplicant Date All roof coverings to be Classor better CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS: - TL �� PERMIT # of O% OWNER'S NAME: Ll e- l� PHONE # 2q 3 — U GENERAL CONTRACTOR:(� G t L ,±IFAX # I am not using any subcontraors: �� --- 1 � U --- Si;;nature Date Please check applicable subcontractors and complete the following information: Owner/ Contractor Signature Date 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 3 ITEMS OF 6 CITY OF CUPERTINO PERMIT.' RECEIPT Sec: Twp: Rng: Sub: Bl}:: Lot: APN ........: 35+32020.00 DATE ISSUED.......: 07/07/2009 RECEIPT #.........: BS000008142 REFERENCE ID # ...: 09070068 SITE ADDRESS .....: 741:8 STANFORD PL SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OPERATOR: SylviaM COPY # : 1 OWNER ............: REDEKER NINA N AND ROSS G ADDRESS ..........: 744:8 STANFORD PL CITY/STATE/ZIP ...: CUPERTINO CA, 95014-5818 RECEIVED FROM ....: RE ROOFING CONTRACTOR .......: PROCTOR, PAUL LIC # 20615 COMPANY ..........: R E ROOFING & CONSTRUCTION INC ADDRESS ..........: 15,:30 CLYDELLE AVE CITY/STATE/ZIP ...: SAP1 JOSE, CA 95032 TELEPHONE ........: (408)626-9320 FEE ID UNIT QUANTITY l+MOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 8,000.00 ---------- 1.00 ---------- 0.00 ---------- 1.00 ---------- 0.00 1BSEISMICR VALUATION 8,000.00 0.80 0.00 0.80 0.00 1REROOFRES SQ FEET 20.00 260.00 0.00 260.00 0.00 TOTAL PERMIT ---------- 261.80 ---------- 0.00 ---------- 261.80 ---------- 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT : AMOUNT --------------- 549.70 --------------- 549.70 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- 1508 VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF -�, CITY OF CUPERTINO _ t� REROOF CUPEkTINO PERMIT APPLICATION e rcl 7e6 601 S_ APN # j 2 b2SJ , CO Date: `7 e �� Building Address. Owner's Name. Phone #: HOA: Yes ❑ No If yes, provide letter from HOA Contractor: Phone #: c^ 2 ' Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof A Asphalt Shingles A Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ? ❑ Provide I.C.C.E.S. Report # XTo be Removed ❑ Provide Mfgr. Installation Specs. Descri ton: Job i p �1; M u su �_X l �, � ,,v ;� �J L- �` � �� "Y= J P , l ►v � ��' L 14 Residential Commercial Green Building: Please complete relevant porion of the Confirmed with Planning Dept. if Green Building Checklist & attach it to the application or if there are any restrictions: ❑ applicable, include in plan set & the sheet index. Valuation: (;u) I Have React;- rstand and Will Comply with Cupertino's Tear -Off Policy: Signature ` Revised 02/05/09 am - CM OF CUPEkT1NO CITY OF C'UPERTINO REROOF FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1REROOFCOM Re -roof Commercial B 1COMMLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1 BSEISMICO Seismic Commercial B O IREROOFRES Re -roof Reiidential B 1SFDWLROOF 1BCBSC Cal Bldg Slandards Commission Fee B ALL PERMIT TYPES / 1BSEISMICRE Seismic Re3idential B 1 REROOFMRES Re -roof Mt.lti-Family B 1MFDWLROOF 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1 BSEISMICRE Seismic Re 3idential B 1BUSLIC Business License B 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 agree to comply with 2007 IBC Standards and manufacturers specifications on r,! -roofing. All roofs are Class "A" per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be applied without first obtaining all inspection and written approval from the buildir g 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 Citi, the following steps are required: 1) Pre -inspection and/or tear off apps oval. 2) In -progress inspection approval. 3) Final inspection approval. a) Spark arrester installation. 5. If plywood is installed, a plywood nai. 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 per.'ormed. 7. NOTE: If you call for a plywood nail :nspection 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 cwt be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/ " 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 compR ly with the above stated policy on re -roofing. Homeowner's Name. IWA j�C,0�'�.�� Job Site Address: Roofing Company Name: �•� u1� ��+�� Applicant's Signature: - � _� C-- Date: U Greg Casteel Building Official Revised 07/30/08