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06120161 CITY OF CUPERT[NO x �r i'te. fp'r AW: BUILDING DIVISION PERMIT Y'CONTRAGT 'VIN'F, RMA:TION BUILDING ADDRESS: PERMIT NO. OWNER'S NAME: A M & C ASSOCIATION MGMT 605 COMMERCIAL ST 12/21/2006 SANITARY N0, CONTROL NO. (408) 536-0420 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG EO PLUMB MEOCH Op LICENSED CONTRACTOR'S DECLARATION lob Description 1 hereby M.that I am licensed main,provisions of CMplcr 9(commeecing with Section 7(Xm)afDiviAon3afdod Business add Pmfeandom Code,sed my license is REROOF MFDWL GARAGES— TEAR OFF EXISTING, INSTALL ! H In full forte and aCA o.mam _ cations, t v.6 NEW 3/8" CDX OVER EXISTING 3/8" CDX NEW 5 PLY TAR IpQ' ARCHITECTS DECLARATION ..� & GRAVEL BUR. Q< I undcrsmnd my plans shall w used as public menrde V u Licensed Professional - OW NER.BUILDER DECLARATION 1 he¢by aRrm that I am uemps from the Cma me m,;License Law for the , :00 following mason.(Section 7031.3,Business and Prefedium Code:Any city or county 1$ which mquiru a permit to construct alcor,arprew.demaluh,or repair my stmctum -I< prior to its issuance.also requires,Ate applicant forsuch permit m fmlc a signed statement �Fth Valuation Nat he is licensed puramm to the provisions of Ne Contrsewr's license Lau,(Chaptm9 Sq. Ft.Floor Area (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $2 3 61 9 that he is eaempt therefrom and the basis for the alleged eaemption.Any violation of Section 7031.5 by arty applicant fora permit subjects Are applicanua to.civil Penalty of Number Occupancy Type notmore Nen fmw hundred dollars(M3 32652035A p y yp ❑I.as owner of the property,or my employee,with wages as their sale compensation, will do the work and the mom.is not Intended or offered for sale(Sec.70th,Business and Profess ms Cad Th.Comveclnh Licuum Law dam nal apply to ad owner of Required Inspections property who buildsorimprove,thereon,and whodoessuch work himselfarthrough his own employees,provided that such improvements art not intended oroRered formic.If, however,Ne wilding or improvement Is add within am your of completion,dm comer, Wilder will lu m the warden of proving that M did and build or improve for purpose of sale.). ❑1,as owner of the property,am exclusively convecting with licensed contractors to construct the project(Sec.70".Business and Profession Code:)The Condsctor's U. corm,law doe,not apply to in owner of property who builds or impmses thereon.and who contracts for such pmjects witha eombactor(a)licensed pursuant to the Contractor's Lieenm law. ❑l am summit mach See. .B&P C for this reason Owner Dam WORKER'S COMPENSATION DECLARATION 1 h by affirm under penalty of perjury one of the following decimations: assn and will maintain a Catifinte of Comer mself-imam for Wartrls Compen- m,an,as pmvlded for by Section VW of de,labor Lode.for the pe farmance of the, work(or ich this permit is issued. vc and will maintain Worker's Compensation T....u ttquired by Section 3700 of du labor Code,for the po formann of the work for which this permit is issmd. My Wo,keh Compensation Insufglmce norma and Policy number are: C.trier., 1'q71�F oIicy No.: � _ �� CERTIFICATE OF EXEMPTION FROM ORKERS' COMPENSATION INSURANCE (Thu section need dot w completed if the Permit Is for an hunde ddodars(SIW) ter less) 1 certify dot in the puformsme of the work for which Nis Permit is issued.I shall not employ any person in any manner an as to become subject m the Workers'Compensmon Laws of Califomia.Dam APPlinns NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should became subject to the Worker's Compensation provisions of We labor Cade,you must .J O forthwith comply with such provisions or this permit shall be dorevoked .z r . Z" CONSTRUCTION LENDING AGENCY F-m� I hereby affirm that Nero is a construction lending agency for dm Performance of C We work for which this Permit is bro d(Sec.3097,Civ.C.) W�Q Lender's Name D z lender's Andreas U O 1 codify chat 1 have read this application and state that dea above information is I. H coven.1 agree to comply with all city and county ohtinanca and sum laws o Wing m O U building construction,and hereby authorize repmsentsancs of this city to comer upon the 0. awve-ommiuned property for inspection pntpases. (We)agree to save,indemnify and kap hvmleas the City of Cupertino against mF'—m Vl liabilitiesjudgmcnu,cosuandexpemes which may in anyway seem ca,mestsaid City U z in consequence of the grartmil of this permit ^ APPLICA UN RST S AND WILL WITH ALL NON-POINT Issued by: to SOUR Re-roofs ' mgnmum otApficadEnCondommor Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the a Cupertino or(Muni building e.Chapter or handle hazardous material u defined by Ua:Cupenina Municipal Calc.Chapter 9.13.cosi Jmc Health and Safety. Cade,Section 25532(a)? �� Al]roofs shall be inspected prior to any roofing material being installed. Ye, 40we,Ws,applicant or futum wilding a pane mse equipmnt or dcvla4 which If a roof is installed without first obtaining an inspection,l agree to remove emit ha arboas air canuminams as @ftmtl by the Bay Area Air Quality Management all new materials for inspection. District? ❑Ym Ihaw,mad the,hvaNfi.m25 5,2553 i.d 25534.1lChawdUpSof We Califon /0 ell .^ doHealth&Safety Code,Sectia4riLil 5y33 Hbility nourydthxcuputofthe (J/ dna not cummntly n a¢rent that h u my responsibility m nmtil'y Arc acvpent of sire require metpiar Ccrdm:amofoc P _ Signature ofApplicant - Date Owncr or author] dagcnl ,Date All roof coverings to be Class "B"or better • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32652035 . 00 DATE ISSUED. . . . . . . : 12/22/2006 RECEIPT #. . . . . . . . . : BS000000095 REFERENCE ID # . . . : 06120161 SITE ADDRESS . . . . . : 10385 MARY AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . : OWNER . . . . . . . . . . . . : M & C ASSOCIATION MGMT SERVICE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1342 RECEIVED FROM . . . . : RECEIPT INTERFACE CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21895 COMPANY . . . . . . . . . . : DRAEGER CONSTRUCTION INC ADDRESS : . . . . . . . . . : 605 COMMERCIAL ST CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 536-0420 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL --------- ------ ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 2, 381. 00 83 .16 0. 00 83 .16 0. 00 BSEISMICRE VALUATION 2, 381. 00 0.50 0. 00 0. 50 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 83 . 66 0. 00 83 .•66 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 83 . 66 101358 ---------------- TOTAL RECEIPT 83 . 66 VOICE ID DESCRIPTION VOICE 'ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 305 FRAME 307 INSULATION 601 ROOF- TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS • CITY OF CUPERTINO 901�o CLJPF.RTINO PERMIT APPLICATION FORM Date: L 1311ildim, �\ddlcss '161 10\ Yll�el M11" 1111011c 9: C0Ml'iXL0l': License #: collLict. CUI)CI-til'10 BLISiUSS License 1l: Type of—Roof( (Wei—1110: C1,5 Ex k I i I I Propo�STI: .J HillIt-Up Rmoj 11 Built-Uproot U Asphalt sllinajcs 0 Asphalt Shingles D Wood Shakes 0 Wood SIiAcs� U W,)"d shi[I"Ies 70 Wood Shingles Othul (SpccilY) 0 0111cl (specily) —uplilci 01 exisum, co%ellllus 1-j Provide I.C.13.0. Report it � ' I o I�Q Removed --- ,\3 c Q Plovidc I'vilgi. Installation Spm, ,"ivc Read. Understand and \Vill C01111)1y With Cupertino Teffl' Off J)0jiCy: Cy Job L:SQ['1j)t10jj: Residential © Commercial ❑ T-Ti-e 7-1*)—nc: Yes 0 No ❑ Confirmed with Planning Dept. if there are any restrictic)ns: ❑ Cott .,I Prgject: Tyj)C 0CC0l1St1'UCti011: OCCUIX111CY 0"I'OUIX o )a Ow. if Fee 11) Fcc Description Fee G1'01.11) [11)1-�11,m ffidg, Permit Fees BUILDING B E Ni IF R G Y Energy --m BUILDING Scismic Fee Res BUILDING Bs131s,\l1 1com Scismic Commercial BUILDING BPLANCHK/ Plan check Fee BUILDING BUSLIC BLIShICSS LiMISC BUILDING