The URL can be used to link to this page

07030089?OQ Z : :Z Z Z ?�a )qU rL y -O 000 <m �za >�so L+� CITY OF CUPER"111NIJ BUILDING DreISION PERMIT C1NTIt�! ISON AV ILINDY ROOFING CO INC OWNER'S NAME: MILLER RONALD J AND SHIRLEY A 5554 HA'ZVARD DR .ONE: (408)286-9990 ARCHITECT/ENGINEER: LICENSED CONTRACTOR'S DECLARATION Job DCSCiIptlOn I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is NEW C PX 3 HEET ING , T / O EXISTING SHINGLES, in full force and cffecy s�,�2 1 Lic. I `z l & 30 LBS FELT, GAF 30 YEAR COMP, 27 SQ. Datc J U! Contractor ARCHITECTS DEC ATl N 1 understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Calc: 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 ($500). ❑ 1, 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 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.). ❑ I, 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 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. ❑ 1 am exempt under Sec. B & P C for this reason Owner Date _ WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: L3 I have and will maintain a Certificate of Conscnt to self -insure for 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. ❑ 1 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 Cmp nsation insurance carrier and Policy number are: 07 Cf-�. Carrier. f Policy No.: / PIS 7 c- �% CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for anc 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 Oforthwith comply with such provisions or this permit shall be deemed revoked. Z CA ' ' CONSTRUCTION LENDING AGENCY Fr 4 I hereby affirm that there is a construction lending agency for the performance of a i the work for which this permit is issued (Sec. 3097, Civ. C.) (Sa A Lendcr's Name Lender's Address U 0 I certify that I 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 U building construction, and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. LL (We) agree to save, indemnify and keep harmless the City of Cupertino against In liabilities, judgments, costs and expenses which may in any way accrue against said City U 2 in consequence of the granting of this permit. ►" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOU EGULATIONS. , Signature of Applicant/Contractor �— Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Munici Code. Chapter 9.12, and the Health and Safety Code, Section 25532(a)? ❑ Yes o Will the applicant or future building occupant use equipment or devices which :mit hazardous air contaminants as defined by the Bay Area Air Quality Management District? ❑ Yes 1 have read the hazardous materials requirements under Chapter 6.95 of the Califon nia Health & Safety Code, Sections 25505.25533 and 25534.1 understand that if the buildinl does not currently have a tenant that it is my responsibility to notify the occupant of th( reouivlm)w which must be met ftq)r to issuance of a Certificate of Occupancy. PERMIT NO. 07030089 PERMIT ISSUE DATE 03/13/2007 SANITARY NO. CONTROL NO. BUILDING PERMIT INFO BLDG ELECT PLUMB Owner or ST. Ft. Floor Area 31629053: Issued by: Re -roofs Type of R,)of INSTALL Valuation $14791 occupancy Required Inspections All roofs, hall 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 m iterials for inspection. Signature of Applicant Date All roof coverings to be Class "B" or better CITY OF CUPERTINO 2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: suew COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31629053.00 DATE ISSUED.......: 03/L3/2007 RECEIPT #......... BSO)0000677 REFERENCE ID # ...: 07030089 SITE ADDRESS 10319 DENISON AV SUBDIVISION ...... CITY CUPIRTINO IMPACT AREA ...... OWNER ............: MILLER RONALD J AND SHIRLEY A ADDRESS ........... CITY/STATE/ZIP ...: CUPERTINO CA, 95014-2428 RECEIVED FROM ....: RECEIPT INTERFACE CONTRACTOR .......: RUMFORD, LINDY LIC # 3921 COMPANY ..........: LINDY ROOFING CO INC ADDRESS ..........: 5554 HARVARD DR CITY/STATE/ZIP ...: SAN JOSE, CA 95118 TELEPHONE ........: (408)286-9990 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT ---------- THIS REC ---------- NEW BAL ---------- ----------------------- BPERMFEE VALUATION ---------- 14,791.00 ---------- 223.56 0.00 223.56 0.00 BSEISMICRE VALUATION 14,791.00 1.50 0.00 ---------- 1.50 ---------- 0.00 ---------- TOTAL PERMIT ---------- 225.06 0.00 225.06 0.00 CITY OF CUPERTINO ' REROOF CUPER�TINO PERMIT APPLICATION FORM APN# 3 os�3 Bldg Permit Fees Date: Building� �r�� V c liner y BUILDING BSEISMICRE Owner's Name: BUILDING Phone #: 7 �7 Contractor:License BUILDING #: Contact: BUILDING Cupertino Business License #: Type of Rcof Covering: Existing: Proposed: A ❑ Built -Up Roof ,� Asphalt Shingles ❑ Built -Up roof Asphalt Shingles y r r O Wood Shakes Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # 1W To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read; Understand and Will Comply With Cu ertino's Te r Off Policy: Job Description: Residential, Commercial ❑ Fire Zone: Yes ❑ No Confirmed with Planning De t. if LJ there are any restrictions: Cost of Project: Type of Construction: zl .% Occupancy group: Qty. if Voo Tn FaP DPco.rintinn Fee Group BPERMFEE Bldg Permit Fees BUILDING BENERGY liner y BUILDING BSEISMICRE 'Seismic Fee Res BUILDING BSEISMICOM :Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC 3usiness License BUILDING 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 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 -oofing 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 fust obtaining an inspection, will require the removal of all new mate -ial down to the sheathing, - --so-a proper City inspection can be perfoi med. 7. NOTE: If you call for a plywood nail in:.pection 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 I e 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 & e job site at the time on inspection. I understand and will comply with the above stated policy on re -roofing. Homeowner's Name: �4% % c/ l/�'�� //ems Job Site Address: /0 3 Y �i �e 'l ' s ` ' I Ay � Roofing Company Name: Applicant's Signature: �Lf Date: 3-13 ' 0? Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue . Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 7UPEVINO Building Department JOB ADDRESS: /v 3 L/ C,k^ ► PERMIT # y OWNER'S NAME: .,� L d �l , 4 - PHONE # y 7 GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information Date Owner/ Contract tune Date 60 SUBCONTRACTOR BUSI: 4ESS 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/ Contract tune Date