08080194 CrrY OF CUPERTINO
BUILDING DIVISION PERMIT i@ONTRACTORINFOI.2MATION
4�ay,saR*2-
PERMIT NO.
BulLgl�cI�RFsI�EARDON DR CORNERSTONE ROOFING 08080194
NER'S NAME: PERMIT ISSUE DATE
Slj ER'CC 1605 MONTELLANO CT 08/25/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/FNGINEER: BUILDING PERMIT INFO
REMOVE EXISITING SHAKE BLDG EL£CI' PLurda MEcx
O O O O
u o O LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm Net 1 Sm licensed under provsiom of Chapter 9(romomming "'^"'"^ ^^^ ^"--- - - -Job DeseFlpnon
with section]O)(1)o(Division J of the,Busness and Pmfetslam Cade,and my license is
n in full forte and cff
fig= LieenmGlaas `3�/ Llo..
n F,q Dale�+-`]9(¢ 1<�' cmwacbr NGF +-`ts�
7W ARCHITECTS DECLARATION
U I undersand my plans shall M used as public records
IS G t; Licensed Professional
B3 OWNER-BUILDER DECLARATION
E I Mmby vRrm that I em cscmpt from the Camracmns ucenm law for She
ZOO following reason.(section 7031.5.Business and Pmfessiam Cade:Any dry or county
$
which requires a permit In Co..."alae impmw.dcmnlL h,ar mU'any umewm
pd.m is ismance.elea tegYima dC applicant for Such Permit In Ek a tigreAvat rnem
that M is licensed p octant to the Provisions of Ne Consommes license Law(Chapter 9 Sq.Ft.Floor Area Valuation
y (commencing with Scctian]000)of Division J of On Beat.and Professions Code)or
$ dot he in emmpr themfmm and the haste for the alleged cacmption Any violation of
Sation 7031.5 by arty applicant for•permit subjecs me applican to a er,ii penalty of APN Number Occupancy Type
we.than nes Modred doll.(S-R)n P Y YP
I,a owner Of the property,or my employes with wages as Our los compenudon.
will do She work.and She sWetam s Out intended or Offered for has(Sec.7014•Business;and Pmreadous Cade:T W canhacmna Li.naw thea net apply m an owner Or Required Inspections
propeny who Wilts orimpmsesdermon,andwW dessahwork himelfor thougb his
Own employees.provided mat such impmvemena me not intended oraRered fursale Ir,
bowever,the building Or Wpmwmant is mid within one year of completion,one owner.
builder will law She burden of pro ming mat he did net Mid or improve for p rouse of
Sale.). .. .
0 1,as owam of that property am mcluriwly contmtting with licensed mnuacters to
Commem the project(Sec 7044,Business and Professions Code:)The Convanmr's U.
scare law does hot apply m an owner a prapsty who Wilds or inS mares men em.and.
who contracts for such projects with a eantracar(s)licensed par mann to me Conuxtes
Lseme raw.
❑Iammemptunderscc .BAPcr.Oismamn
neo Date
WORKERS COMPENSATION DECLARATION
1 Manby affirm under Mutty of perjury one of the following decleratioMa:
Ihsw aMeide forbyvection 3Com of the La mCode.fum the
Waorma Camper
urian.r provided for by Section 3]00 of the IaWr Code.for drat paafarmenee of the
work for whkb this Permit is stuca
Mw and will mainam Wmkens Campemnlan Insurance•as required by Section
700 of me labor Code.for the perfarmusc of me work for which this permit s issued,
My Woolen, CamlpeMa—uiaLtlmandance cries and Policy numberraam:
Carrier: �i4;X -�n nQ( Policy No.:cQ oI&,2007
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(iTusection need CotM Completed ff IM permit is formse hunmed dopuan I00)
or lets)
1 codify that in the Mr...of me work fa which Shia permit is banned,I shall ons
employ anyperson in any mouser an as to become subject to the Worsen'Compensaflon
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption.you mould
Meomat mbjen m the Workers CompaMaltion provisions of She Tabes Code,you muu
.J z lenbwuh comply with Rxh pmvu s.W this permit shall W dec ned msoked.
y O CONSTRUCTION LENDING AGENCY
[-w I Manby SIBOO than mere tea eoress dnn lending agency fm the MCCrom eof
1� .>. ate wort for which wan permit is issued(San.3097.Civ.C.)
A Taller'Name
CLz Lcrdeh Address
V 0 1 certify that 1 Mw read this application and sus mu the aurae information s
D, ^. coral.l alms to Comply w'im all city and County ardinano:a and sue laws msdng m
.� SV" Wilding construction.and hereby mmarim mpremnativm of this city to enter upon the
r I3aMve-mentioned property for imatirym
pon puet
F C (We)agree to Saw,indemnify and kap barmless Ou City of Copeninm against
IA I.emine umm oftheeosuandof Out prnit. may in anyway¢cols against City
V z APPL CANTeUNDERSfANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU;SOUy�REGULATIg�3
EO0�1Re-roofs
Signature ofAppliun omaacmr D,te
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will me applicant or froom Wilding occupant Oom or halls h—reom material
as defnnad by the Cupertmo Municipal de.Chapter 9.11,and She Heahh and Safety
Section zssyzp)7 All roofs shall be inspected prior to any roofing material being installed.
o
❑Yes
Will the.applicant Wilmer Occupant If a roof is installed without first obtainingan inspection,I agree to remove
PP t W ea Air u W devices which Pe
emir W„moan Mar emuminana as d erne y me Bay Area Air Quality Management all new materials for inspection.
Dbuim7 P
Iham real Shehecadom 2505, mquimme 511.Iudeapterfi95ofmc Golding
ns Beat"Safety Cab.Satimu ON
IS
ram olibil.i wdcmand mmifine Wilding
Joan sant curmnrly haw a tenant Shu it u my mspansiM1ility m notify me arupann of me /
m l�at� which muub tet prihrmi uancc hfacrnincam Z�� Sig nature of Applicant Date
Owner or manors ted Olean Date All roof coverings to be Class'%Q."or better
a CITY OF CUPERTINO
REROOF
ISCUPEIliTINO PERMIT APPLICATION
6 �q
APN # Date:
20 jb 11k
Building Address:
8CAP4tj OR.
Owner's Name: Phone #:
JQ_ S u 021
Contractor: Phone #: Z6 7 7663
Co20 Sto.tc Z�eg,;i Fax #: 76662
Cupertino Business License #: Contractor License #:
> 20��
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles z Asphalt Shingles
a Wood 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.
Job Description: /jevnecle !Ey-lS�r✓is S4ake_ Qori/t0sS a(I( Y2 63l3 h'ad.aHF71�
30 y2 4!Spk41-6-,.Sjj
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
Have Read, UnderQsta�nd and Will Comply with Cupertino's Tear-Off Policy:
%� /�
Signature
Revised 6/16/08
a CITY OF CUPERTINO V
REROOF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
3� 1RER00FRES Re-roof Residential B 1SFDWLROOF
1 1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
IBSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•
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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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/ "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: MR. 564
Job Site Address: /U 495 ado4 /J2_
Roofing CompanyName: 2'
: Cd> Of&s one
e \
• Applicant's Signature: /! Z444 g Date: O Z�'0d'
Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32630178 . 00
DATE ISSUED. . . . . . . : 08/25/2008
RECEIPT # . . . . . . . . . : BS000005888
REFERENCE ID # . . . : 08080194
SITE ADDRESS . . . . . : 10495 BEARDON DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SU ERIC
ADDRESS . . . . . . . . . . : 10495 BEARDON DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CORNERSTONE ROOFING
CONTRACTOR . . . . . . . : BITTLE, RUSSELL LIC # 21215
COMPANY . . . . . . . . . . : CORNERSTONE ROOFING
ADDRESS . . . . . . . . . . : 1605 MONTELLANO CT
CITY/STATE/ZIP SAN JOSE; CA 95120
• TELEPHONE . . . . . . . . : (408) 997-9788
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- - --- - ---- ---- ---------- --- -
IBSEISMICR VALUATION 18, 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
IREROOFRES SQ FEET 38 . 00 494 . 00 0 . 00 494 . 00 0 . 00
---------- ---- --- - ----
TOTAL PERMIT 495 . 80 0 . 00 495 . 80 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---- --------------- --------------------
C:HECK 495 . 80 6568
---------------
TOTAL RECEIPT 495 . 80
VOICE IO DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF