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07020159 CITY OF CUPERTINO BUILDING DIVISION PERMIT It I�1EUl[ M�4'TI01�1. BUILD N(� RESS: PERMIT NO. � l RAINBOW DR HARTING STEPHEN W AND 07020159 TS NAME: PERMIT ISSUE DATE _ ARTING STEPHEN W AND GERALDI 05/17/2007 PHONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO REV I S I ON: FIREWALL, S2, BLDG ELECT PLUMB MECH CJ D O O p O LICENSED CONTRACTOR'S DECLARATION r fTE11 408 �0�],Description v F 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing ^^ ^�� ^^^���^ Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is a in full force and effect. j ? License Class Lic.# F Date Contractor ARCHITECTS DECLARATION i a< I understand my plans shall be used as public records )0.0 U.l- Licensed Professional j OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the z c ca 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 z y 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 3q.Ft. Floor Area Valuation F (commencing with Section 7000)of Division 3 of the Business and Professions Code)or ORE 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 APN Number Occupancy Type not more than five hundred dollars($500). ❑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 Required Inspections and Professions Code:The Contractor's License Law does not apply to an owner of q P 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 does 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 e�xx;T70 u e'F Sec. B&P C for this reason /< Date 7 WORKER'S OMP SATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑1 have and will maintain a Certificate of Consent to self-insurc 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 Compensation Insurance carrier and Policy number are: Cartier, Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is foranc hundred dollars($100) 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 manncr sosuhiecl to the Workersrts 'Compealion Laws of California.Date O Applicant � � l V NOTICE TO APPLICANT:If,after making Lhif 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 ~ CONSTRUCTION LENDING AGENCY E-r I hereby affirm that there is a construction lending agency for the performance of _ (Y i' the work for which this permit is issued(Sec.3097,Civ.C.) aQ Lender's Name z Lender's Address U Q 1 certify that I have read this application and state that the above information is r. correct.1 agree to comply with all city and county ordinances and state laws relating to Jbuilding construction.and hereby authorize representatives of this city to enter upon the W above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against (/1 liabilities,judgments,costs and expenses which may in any way accrue against said City r U Z in consequence of the granting of this permit. Date APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NOTPINT Issued by: SOURCE R vTo"-. Re-roofs Signature of Applicant/ ontractor Date Type of R sof HAZARDOUS M RIALS DISCLOSURE Will the applicant or future buil ng occupant store or handle hazardous material iefrned by the Cupertino Municipal Code.Chapter 9.12.and the Health and Safety Section 25532(a)? _ / All roofs ;hall be inspected prior to any roofing material being installed. El Yes Will the applicant or future building occupant use equipment or devices which If a roof i;;installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. District? ❑Yes �(No 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&Safety Codc,Sections 25505,25533 and 25534.1 understand that if the building does not currently have a tenant,that it is my responsibility to notify the occupant of the reywrc s whi must�met prior to issuance of a Certificate of Occu p c 0 Signature of Applicant Date �� S�� All roof coverings to be Class"B"or better Owner or authorized agent r Datc CITY OF CUPERTINO PERMIT �^iv.�+ R. BUILDING DIVISION PERMIT + �N7CRP.C4 }Y `URN� TIfIN PERMIT NO. ""'L Nf',¢DIJRESS � INBOW DR SAN JO S:� ROOF MAX 07050293 L J J U KFS PERMIT ISSUE DATE OWNER'S NAME: MA ANTHONY AND MARIA 1352 CH:CPLAY DR 05/31/2007 SANITARY NO. CONTROL NO. )NE: (408) 92 a-7663 BUILDING PERMrr INFO ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH p p LICENSED CONTRACTOR'S DECLARATION Job Description v[- 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing Z with Section 7000)of Division 3 of Ute Business and Professions Code,and my license is TEAR OF.' WOOD SHAKE AND INSTALL NEW ASPHALT ! w in cels and effect gZZ7 to SHINGLE 3 Licensea Class f -3q Lic. 'F La Date -3 j-D"j Contractor SflA oS[ I�IAK a ARCHITECTS DECLARATION i a< I understand my plans shall be used as public records >yU U.l- Licensed Professional O a OWNER-BUILDER DECLARATION aI hereby affirm that I am exempt from the Contractor's License Law for the p O 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 ?Z In prior ht its issuance,also requires the applicant for such permit to file a signed statement Valuation =G that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 >q.Ft.Floor Area 2 O O O 0 i-$ (commencing with Section 7000)of Division 3 of the Business and Professions Code)or r that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by arty applicant for a permit subjects the applicant to a civil penalty of 3665100 AM Number Occupancy Type not more than five hundred dollars(5500). 0 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 forsalc(Sec.7044,Business Required Inspections and Professions Cade:The Contractofs License Law does not apply a an owner of q p 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.). 0 1,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 does 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. 0 1 am exempt under Sec. B&P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I I have and will maintain a Certificate of Consent 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. 0 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 Compensation Insurance carrier and Policy number are: Carrier STATe F444 Policy No.: i 8)3953 Z 0C 6 CERTIFICATE OF EXEMPTION FROM WORKERS' 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 Workcrs'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 ,J O forthwith comply with such provisions or this permit shall be deemed revoked. Z, CONSTRUCTION LENDING AGENCY HFir I hereby affirm that there is a construction lending agency for the performance of Q.!> the work for which this permit is issued(Sec.3097,Civ.C.) W A Lendces Name az Lender's Address U C) 1 certify that I have read this application and state that the above information is w t" correct.I agree to comply with all city and county ordinances and state laws relating to Vbuilding construction,and hereby authorize representatives of this city to enter upon the a above-mentioned property for inspection purposes. (We)agree to save,indemnify and keep harmless the City of Cupertino against uj liabilities,judgments,costs and expenses wh'h may in any way accrue against said City V z in consequence of the granting oC is per Date l / ■'" APPLI NT UNDERSTAN AND ILL COMPLY WITH ALL NON-POINT Issued by SO ATI Air_ S- -O7 Re-roofs rgnat re-ofApplicant/Con4dw DateType of Roof HAZ OUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety Cote,Section 25532(a)? All roofs ihall be inspected prior to any roofing material being installed. ❑Yes Will the applicant or future building occupant use equipment or devices which If a roof i;installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? 0 Yes p(Ttu I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health&SafctyCodc, ctions 505,25533 and 25534.I understand thatif Ute building docs not ratty ave tcnan4 at it is my responsibility to notify the occupant of the rc a be me rior to issuance of a Certificate of Occupancy. Signature of Applicant Date All roof coverings to be Class"B"or better Owner&authorized ag Date CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: bethe COPY # 1 Sec: Twp: Rng: Sub: Blk : Lot: APN 36651009.00 DATE ISSUED. . . . . . . : 05/31/2007 RECEIPT # . . . . . . . . . BS000001512 REFERENCE ID # . . . : 07050293 SITE ADDRESS . . : 21330 RAINBOW DR SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER MA ANTHONY AND MARIA ADDRESS . . . . . . . . . . CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4978 RECEIVED FROM . . . . : SAT JOSE ROOF MAX CONTRACTOR VICTALIANO ARTACHE JR. LIC # 25318 COMPANY SAT JOSE ROOF MAX ADDRESS 13E2 CHIPLAY DR CITY/STATE/ZIP . . . : SAT JOSE, CA 95122 TELEPHONE (4C8) 929-7663 FEE ID UNIT QUANTITY TMOUNT' PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- BPERMFEE VALUATION 20, 000 .00 277.56 0 .00 277 .56 0 .00 BSEISMICRE VALUATION 20, 000 .00 2 . 00 0 . 00 2 . 00 0.00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 279.56 0 .00 279 .56 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 279.56 1597 --------------- TOTAL RECEIPT 279 . 56 CITY OF C'UPERTINO REROOF CUPERTINO PERMIT APPLICATION FORM APN# Date: Buildin Address: Owner's Name: Phone#: Contractor: License#: C�a� �� c', ROW Contact{ Cupertino Business License #: k4a t,� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles ZMII ' ood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy: Job Description' � ear o, o ,d -���q1/ -- � ��1 Residential XCommercial ❑ C•/mss. 3s"�' Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: U Cost o Project: Tre of Cons tr�3lbom Occupancy grou Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE 3ldg Permit Fees BUILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING 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 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 roofing installation. 4. To receive a final sign off from the City the following steps are required: 1) Pre-inspection and/or tear off apprcval. 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 mat trial down to the sheathing, so a proper City inspection can be performed. 7. NOTE: If you call for a plywood nail iu►spection 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.OjHomeowner's Name: r J,-a 14' Job Site Address: 0 ) ✓ <J C) i I'D n Uo L,� r� Roofing Company Name: .11!��-Cym paw I 04 Applicant's Signature: Date: �- d 1-,o 7 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 "UPEkTINO Building Department JOB ADDRESS: PERMIT# (1 I 7 y a1330 �,-;