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07080131 ---------------- CITY OF CUPERTINO PET ,gqYyT. r� ��IN�`.R1A�I�1� BUILDING'DIVISION �L'A1V11T — PERMIT NO. BU1LDT�$D,gF�ss:SIERRA SPRING CT LOS GATJS ROOFING 07080131 l (lJ! PERMIT ISSUE DATE IOWNER'S NAME: MARCUS BERBER P 0 BOX 17 SAN ARY N6- CONTROL NO. 'E: (408) 298-9399 BUILDING PERMIT INFO ARCHITECT/ENG:11N�EER:: = HLDG ELECT PLUMBL=LICENSED CONTRACTOR'S DECLARATION Job Description J I hereby affirm that I am licensed under provisions of Chapter 9(commencing U with Section 7000)of Division3ofthcBusincscandProfessionsCode,andmylicenseis REMOVE (E) SHAKE ROOF. INSTALL TYPE 30 ASTM FELT in full force and effect. 31q Lic.ft too U tl AND ELK PRESTIQUE COMP SHINGLES ? Lieense,Cl s S Date C Contractor ARCHITECT-S DECLARATION 1 understand my plans shall be used as public records C, F' Licensed Professional OWNER-BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors License Law for the a i471 o following reason.(Section 7031.5.Business and Professions Code:Any city or county �i which requires a permit to construct,alter,improve,demolish,or repair any structure Valuation N prior o its issuance,also requires the applicant for such permit o file a signed statement t' Ft.Floor Area that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Q' $3810 o (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 N Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty of 366530 4 3 AEU not more than five hundred dollars(S500). C]1,as owner of the property,or my employees with wages as their sole compensation, Required Inspections 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 o 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 CW 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 J. p 1,as owner of the property,am exclusively contracting with licensed contractors a construct the project(sec.7044.Business and Professions Code:)The Contractors Li- ownercerise Law does not apply to an of property who builds o who contracts or such projects with ao comra rfs)licensed pursuant the Conultaloes License Law. 0 1 am exempt under SeB&P C for this reason Sec. Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a CerilBcae of Consent toself-insure for Workers Compen- sation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑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'§4pinfiensati9p4lisuranfe carrier and Policy ngt�mber aree' Cartier: Polity Na.. OS� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is far one hundred dollars(5100) or less.) I certify 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 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 0 forthwith comply with such provisions or this permit shall be deemed revoked. ►+ CONSTRUCTION LENDING AGENCY ate. 1 hereby affirm that there is a construction lending agency for the performance of i>, the work for which this permit is issued(Sec.3097,Civ.C.) a Q Lender's Name + Lender's Address �z I certify that I have read this application and state at the above information is O drcorteci.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 of Cupertino against y liabilities,judgments,costs and expenses which may in any way accrue against said City Date Z in consequence of the granting of this permit. ►� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b;i: S E REGULATI0 S. f , &Hcalth Re-roofE Sign m of ApPlicanUContracor Type of (Zoof HAZARDOUS MATERIALS DISCLOSURYP Will the applicant or future building occupantstorc or hanrial as defined by the Cupertino Municipal Code.Chapter 9.12•and ety Code.Section 25532(a)? All roof;shall be inspected prior to any roofing material being installed. ❑Yes If a roof is installed without first obtaining an inspection,I agree to remove Will the applicant or future building occupant use equipment or devices which all new materials for inspection. emit hazardous air contaminants as d fined by the Bay Area Air Quality Management District? Yes Nu 4 1 have read the hazardous materials requirements undcrChapicr 6.95 of the Cahlor- O nia Health&SafctyCode,Sccdons 25505,25533 and 255 understand that if the building docs not urrently have a tenant.that it is my responsibility to notify the occupant of the Date reyu cots which must be el poor to issu of a Certificate of° `p� - Sign ui e of Applicant �� 61� e All roof coverings to be Class"Br or better Owner or aulhorircd agent Date CITY OF �UPERTINO 2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: CathyS COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 36653048.00 DATE ISSUED. . . . . . . : 08/14/2007 RECEIPT #. . . . . . . . . : BSC00002375 REFERENCE ID # . . . : 07C80131 SITE ADDRESS . . . . . : 11E01 SIERRA SPRING CT SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . • OWNER . . . . . . . . . . . . : MARCUS BERBER ADDRESS : 11£301 SIERRA SPRING CT CITY/STATE/ZIP CUPERTINO, CA 95014-5143 RECEIVED FROM LAS GATOS ROOFING CONTRACTOR RANDY BROWN LIC # 23481 COMPANY L0.3 GATOS ROOFING ADDRESS . P 0 BOX 1726 CITY/STATE/ZIP . . . : LO3 GATOS, CA 95031 TELEPHONE . . . . . . . . : (438)298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC- --NEW-BAL- ____ -------- -- - BPERMFEE VALUATION 3, 810. 00 104 .76 0. 00 104 .76 0. 00 BSEISMICRE VALUATION 3, 810. 00 0.50 0. 00 0.50 ------0_00 TOTAL PERMIT 105 .26 0. 00 105 .26 0. 00 CITY OF CUPERTINO IXROOF CUPEk iNO PERMIT APPLICATION FORM v7v� o l 31 APN# Date: 71-3 i/p 7 Building Address: Owner's Name: �a ,Pe&S � /��`., Phone Contractor: Phone#: Ll C>Cy License k60 20 Contact: Phone #: Cupertino Business License#: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles ',k Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles / ❑ Other(Specify) Other(Specify) 7" Number of existing coverings ❑ Provide I.C.B.O.Report# �/� �� To be Removed )if Provide MfD Installation Specs.57T �• 5 S /?00f elass I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: Y�-� I 4' Residential Commercial [] Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: ----Type o Constrcti Occupancy group: j g 1 �'. c � Qty. if Applicable Fee ID Fee Description Fee Group BPERM FEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE---__ Seismic_Fee_Res= - __B-UILD-ING, 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 CIN OF Fax: (408)777-3333 CUPEIEIT VIINO 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 and manufacturers specifications on re-roofing. 2. New roof coverings shall not be app:ied without first obtaining all inspection and written approval from the build ng:>inspector. A final inspection and approval shall be obtained from the-wilding inspector when the re-roofing is completed. 3. All roofs shall be inspected prior to E ny roofing installation. 4. To receive a final sign off from the City,the following steps are required: 1) Pre-inspection and/or tear off ap::)roval. 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. IMPORTANT: 1. Flat roofs must have a minimum of " 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-�SiteAddr-ess:- Roofing Company Name: Q A plicant's Signature: i Date: J Greg teel Building Official Revised 1/30/03 Printe d on Recycled Paper Community Development 10300 Torre Avenue Cupertino CA 95014 -a_a Telephone(408)777-3228 CITY OF Fax(408)777-3333 CUPEkTINO Building Department JOB ADDRESS: PERMIT # �n OWNER'S NAME: PHONE # 9' 2 GENERAL CONTRACTOR �;�- �5 FAX # �lv� cj cj 3 I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following 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 Owner/Contractor Signature Date