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06050052lo; to DO �q 3� eLL�' y egg CITY OF CUPERTINO BFIILDINCAIVISION PERMIT '� Q ti Q QI Fcorrect, V W raA 'z e-^ ,ra,;: a r x " rFr ° r "T- `N.C.RA--`�IRiId'�1''Y,d1',�'. DONE RIGHT INC BUILDING ADDRESS: PERMITNo'06050052 10539 LA RODA DR OWNER'S NAME: PERMry ISSUE DATE DALE BOEHM 1129 LONG FELLOW AVE 05/05/2006 ONE: SANITARY NO. CONTROL NO. (408)377-8777 ARCHITECTIENGINEER: BUILDING PERMIT INFO . BLDG ELECT' PLUMB MECH lam. tf 0 0 LICENSED CONTRACMWS DECLARATION Job Description I merely affirm that 1 un licensed under proritloas of Chapter 9 (commencing with Seed. 70110) ofDM io.3 of the Buumv and P1Mfim . /Code. and my liceve ts mfnurmeeandeIf %% REMOVE SHAKE INSTALL PLYWOOD 30LB FELT, 40 YEAR License Class Lk. R gp� CLASS A Dew Con nsecur DW ARCHITECT'S DECLARATION MAIN CONTRACTOR PAID FOR SUBCONTRACTORS BL 5/5/ 1 understand my plans shall he used u public reanrds Licensed Professional OWNER -BUILDER DECLARATION I hereby aRtm that I am exempt Owns the CMnmcwrs License Law far Ne following wsson. (Section 703 1.5, Business and Profmivas Code: Any city or county which .uiws a permit w emnwet, attar, rani mw, demolish• m repair any structure prior w its issuance, also acquires Ire applicant rorsuch permit w file a signed sea comm Contractor's License Law(Chaptm 9 Sq. Ft. Floor Area Valuation fleas be is licensed purewou w the provision, of the (commencing with Scum 70D0) of Division 3 of the Bvinmand Prefciaiow Code)m $14200 that M a exempt therefrom and Ilse basis for the alleged exemption. My violation of APN Number MAY Occupancy Type Sedan 7031.5 by my applicant for a permit objects the appliceal w a civil Penalty of nut more then Bw hundred do1Wa ($30n. 1006 01. u owner of the property, a my mplayees with wages a than sole mmpenvdon, L U ed (Sm. 7044. Business win dothe woe rode; he Conttsmis Lictedaraw dos an[ m owner ofL"tU� v Calc The Contractors Ligase Law does ml apply pm enywM f pmpeny sero milds or ire proses thereon, and whM dos ouch woh bvose3f. through bas WILD own mploy., pmvlded thmatwh Imprasemmu ase rot hamWd arartesd fiscal a. hwaver, the building v Improwmcn, u sold within am year of completiao. dee wrer- btieer, win haw the hurdm of proving denim did rot build or imprme per pmpm of saw.). 0 1. a carer, U dee property. am excluaiwly canuecting with Massed mntuuon w cmuuun the project (Sec. 7044, Business and Profeu)oes Code:) The Deprecates U. ave Law does not apply w an Mercer of property who banes or hnprows elsomn, and. who contracts for each Projeau with 1conuxmr(U licensed purewm w the Contractors ' Lice. Law. 0 lmvemptundersea. ,Bdpchodismawn Owner Data WORKERS COMPENSATION DECLARATION 1 hereby tifim under penalty of perjury, am of the fallowing declaradav: 0 I Mw and will maintain a Certificate of Consentw selfdvuw far WarkersCompa. soden, u provided for by Section 3700 of me Labor Cade, far W pesfommm of Iha work for which this pe.it is Iasurd. 0 1 have ad will maintain Workers CompaodMn Imurame, u required by Section 3700 of the Labor Cade. for Use perfomacc aflhe work for which this permit u Issued. ' MM Wmkce C rep sad Ivan : canicrPal ry they nu��j31/� FROM WORKERS' CERTI�PTION COMPENSA71ON INSURANCE r (Thbsedm aced at m completed if the Penh is foram hundred dollau ($100) or bell I cmufy next in Use pufarm acc of dee Bora for which this Pump Is issued. 1 shill not employ my person in my mmmrm u be become subject w thea Workers'Compeasd. Laws of Caiifomiu Duo Applicant NOTICE 7D APPLICANT: If. after making this Cerdncau of EampU., you should become subject a the Workers Compensation prowmael of me labor Cade- ym mesa forthwith comply with each provisions or this permit aiW I he decmd entailed. CONSTRUCTION ENDINCngagenY I mr which tenmutmise masa wiling agency for the performance: of - (Sec.3 tie work far which deb permit ts mad (Sec. 3097, Giv. C.) I= Name Lendee Address certify the, I Mw mad this appllcaam ad sum that the me. informed. n I agree w comply with all chy and county ordinances wld ace las wlaing w building construction, and hereby authorise representatives of this city to enter upon the ahow-mentioned property for inspcNon purposes (We) agree to mw, indemnify and keep stainless the City of Cupenino against Iia llltiv.judgments. costs and vpenau which may In my wayaawc against said Cray in consequence of the gssndng of this Permit. APPLICANT UNDERSTA� DS AND WILL COMPLY WITH ALL NO -POINT Issued by: Date 4 SOURC LAyr N,eJ Re -roofs '�`!— Type of Roof Q �/ ��UCMnuecwr'v Si ofAp I Daw HAZARDOUS MATERIALS DISCLOSURE Will the applicant Mrfnaur building occupmtsaam.Mv ndle basareloremaiai as defined by the Cupertino Municipal Code. Chapter 9.11, and the Health and Safely Came. Section 25532(&)' All roofs shall be inspected prior to any roofing material being installed. ❑Yes Or If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant Mr move Wilding Occupant use equipment or avim which ..It Mrerdnv air cmmmineets a de0red by use Bay Arca Ais Gustily Mavgmcnt all new materials for inspection. District? ,./ 0Yes ti1"< I haw mad the Msstdmu mawnatsrcquMrrcms under CMPer 6.95 oflhe Center. nu Hwllh&SafuyC .Seed.15305.15333 and 15534. I ereemmd due tithe building Jas rot c IIY wnm that It h my respoviMliry, w mIIfY 1 of the nuNi w m me, Prior In mama of a Canine r Signature of Applicant Date All roof coverings to be Class rB" or better r m thariad agent Daw •em 1 of 1 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 36933023.00 DATE ISSUED.......: 05/05/2006 RECEIPT #.........: 34279 REFERENCE ID # ...: 06050052 SITE ADDRESS .....: 10539 LA RODA DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ....... OPERATOR: amyw COPY # : 2 OWNER ............: DALE BOEHM ADDRESS ..........: CITY/STATE/ZIP ...: SARATOGA CA, CA 95070-5419 RECEIVED FROM ....: GLENN LENKER CONTRACTOR .......: LENKER, GLENN LIC # 17272 COMPANY ..........: DONE RIGHT INC ADDRESS ..........: 1129 LONG FELLOW AVE CITY/STATE/ZIP ...: CAMPBELL, CA 95008 TELEPHONE ........: (408)377-8777 •FEE ID UNIT QUANTITY AMOUNT BPERMFEE VALUATION 15,000.00 223.56 BSEISMICRE VALUATION 15,000.00 1.50 BUSLIC FLAT RATE 1.00 105.00 TOTAL PERMIT : 330.06 METHOD OF PAYMENT ---------------- OTHER TOTAL RECEIPT : • AMOUNT ------------ 330.06 330.06 PD -TO -DT THIS REC NEW BAL 0.00 223.56 0.00 0.00 1.50 0.00 0.00 105.00 0.00 ---------- ---------- 0.00 ---------- 330.06 0.00 NUMBER ------------------ VISA • 0 ;SCM. CUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM o(005W5�L APN #aq _ 32 _ �� Date: S O 6 Building Address:QJL/ q ve / lc' Owner's Name: Dale— ieDc Phone�(�, Contractor. / License Z Contact:�L j ori eti Cupertino Business License #: Plan Check Fee Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Asphalt Shingles ❑ Built -Up roof O'�A sphalt Shingles Cl -"Wood Shakes C3Wood Shakes L,a/Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing covering .Qr�To be Removed ❑ Provide I.C.B.O. Report # ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 30 0 I/C GL , Residential Coninfercial ❑ /Q J Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Proj t: X� Type of Co ction: Occupancy group: Qty. if Applicable Fee ID / Fee Descriution Fee Groun 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 Al aClOF CUPERTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS:PERMIT c�4el7e SUBCONTRACTOR # OWNER'S NAME: Oe Cabinets & Millwork PHONE # GENERAL CONTRACTOR: 6"- c► FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information • Owner/ Contractor Signature Date 15 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 U Septic Tank Sheet Metal Sheet Rock Til • Owner/ Contractor Signature Date 15 . 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 1997 UBC Standards 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: Job Site Address: Roofing Company Name: Applicant's . Greg Casteel Building Official Revised 11/2/04 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 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 first 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 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: Job Site Address: Roofing Company Name: Applicant's . Greg Casteel Building Official Revised 11/2/04