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CITY OF CUPERTINO
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� R k It INFORMATION '•
' BUILDING DIVISION PERMIT
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BUILDING ADDRESS:
WESTSHORE' ROOFING COMPANY
PERMRNO-06090023
10415 CHERR
OWNER'S NAME:
PERMIT ISSUE DAIS
BEHNAM DENAI
2814 AIELLO .DR
09/05/2006
NE:
SANITARY NO. CONTROL NO.
(408)694-0060
ARCHITECT/ENGINEER:
-
BUIMING PERMIT INTO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Job D0SCilphOn
I hereby unrest that I sin licensed under provisions of Chapte 9 (commencing
with Section 7000) of Division 3.f the Emboss and Professions Code, and my license is
incfu llfamcandeffttt. _3
%8712
REMOVE 2 LAYERS OF COMP, INSTALL NEW COMP.
Lt..
Dam on Lt..I r •
LANDMARK TL 2200SQ FT. CLASS A
ARCHITECTS DECLARATION D—Q
i�
I undenund my piano shall M used as public record'
Licensed Pmfesai... I
OWNER -BUILDER DECLARATION
1 hereby affirm Nal I am exempt from the Contractors License Law per de
fallowing mason. (SeNon 7031.5, Business and Pmfcssinu Cade: Any city ...aunty
which requires a permit m consuuct, alar. improve, demolish. or repair any shuctum
prior m its issuance, also inquires the applicant (arsuch permit file a signed stammfni
Sq. Ft. Floor Area
Valuat"400
that he is licensed pursuant to the pmvisions of Ne Contractor's License Law (Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that M u exempt therefrom and the bssia fm the alleged exemption. Any violation of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of
not mare than five hundred dollars (65003
31633050.00
El 1, as owner ofthe property, m my employers, with wages u Cehale cempar adon,
Required Inspections
will do thewark. and thesumcm a la nemmnded or offered forsale (Sec. 7044, Business
and Professions Cade: The Contractors License Law doe oat apply to Me Owner of
Property who bui Ids or improves thereon, and who does such wink himself or Ihmugh his
awn employees, provided that such improvements eR notinanded orofferad for ale. It.
building or improvementissold within ora year of Improv for the owner -
hull&'w wild
builder M0 have da burde of pmvin6 Nal he did not bulW or Improve for purpose of
9�
rale.).
❑ I, u owner of property, adhttma e
convecting vW :) The Li-
B Code:) The Cantru
Suer
O
ct . sines, and
came La do a act (Sec. to an whose
ed.
cove law dmfs nal apply to to oath ar of property who builds or improves Cestan, and,
of aM property
(e,
for such projects with aconvaoartU licensed pursuant m the Contractor's
whonse
Lace
License taw.
❑ 1 oto exempt under Stt. . B d P C for this moon
Owner Dow
WORKER'S COMPENSATION DECLARATION
1 hereby alErm under penalty, of perjury one of the (allowing decimations:
❑ I hsw and will mountain aCce iOeeaf Conseem self -insure forWorker'sCompen.
$Adan. u provided for by Section 3700 of the Labor Cade, fm the performance of de
work for which Nu permit is issued.
❑ I have and will maintain Worker's Computation Insurance, a required by Section
3700 of the labor Code, for the performance of the work for which this permit is issued
Workere..4a�'e C`aympenudon mm�nce carrier andPolicyNo.: number
Q^
Ginier. u... Poll J1L
Ca
FROM WORKERS'
CERTIFICATE OF EXEMPTION FROM
INSURANCE
COMPENSATION INSURANCE
'
(This cacti.. decd not wcompleted If the permit Is faros, hundred dollars (6100)
or less.)
1 emery that in the performance of the work for which this permit Is, Issued, 1 shall not
employ anyperson in any marrcr se u to become subject to Ne Workme Compemadon
'
Laws of California. Doc
Applicant
NOTICE TO APPLICANT, IL mfmr making this Certificate of Exemption, you shouN
become subject to the Worker's Compensation previsions of the LAW, Code, you mum
faMwoll comply with such provisions or this permit shall w ditmed invoked.
CONSTRUCTION LENDING Y
1 herbyich thi that Nem is • lending agency for the performance of
dingap
Wood(Sec.3
work lar which this permit is lased (Sec. J097. Civ. Cd
Le Namc
,
Lender's Address
I certify that I have mad Nis application and sum that the above information ix
correct. l agree to comply with all city and county ordinances and sok laws miming to
building construction, and hereby authorim mpscsenutives ofthis city to enter upon rile
abov -memiu ed property for inspection purposes.
(We) agree to save, indemnify and keep hmmless Ne City of Cupertino against
Iiabilifica,judgmenlaeasta and expense which may in any way aecroc against aid City
in Of IND
APPLICANof the T UNDERSTANDS pending
NTWILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCEREG ONS.
Re -roofs
Type of Roof
Signature ofApplicaHAZA aelor Dam
HATARumna MATERIALS DISCLOSURE
Will Wilding o. handle us
yfaCupnnirso Muni
Heard
Charter 9.12, and
ss defined by Ce Cuperdno Municipal Code. Chapter 9.17, end the Health and Safety
Cade, Sued.. 25532(.)?
All roofs shall be inspected prior to any roofing material being installed.
[]Yu ONO
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant men equipment or devices which
emit Wesrdous air contaminants as dcfmMI by In. Be, Ara Air Quality Managemenl
all new materials for inspection.
District?
❑Yes ON.
I have mad the haurdous materials requirements under Chaper 6.95 of the Glifor.
nix Health; Solely Code, Sued= 25505,75533 and 25534.1 understood thin ifthe building
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docs not currently have a tenant, Nat it is my mapouihility M notify de aeeupat of he
mitemontewhich must Wmet pdariaiaaan.aof, Certificate oracapa.y.
Signature of Applicant Date
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All roof coverings to be Class "B" or better
Owner or authorized agcol Dam
Community Development
10300 Torn Avenue
aCO
Cupertino CA 95014
Telephone(408)777-3228
Fax (408) 777-3333
4§UPEkTINO
Building De artment
JOB ADDRESS: Gw,{ �t _
PERMIT #
OWNER'S NAME:
ScKc>tM
AOL A
PHONE # 4,A 72,5 - 2-b)6.
GENERAL CONTRACTOR: Wesbkw WA
FAX # 40'$ bqq' OOS'9
0y _L
I am not using any subcontractors: I�vv G Y� A -
Signature Date
Please check applicable subcontractors and complete the following information
Owner/ Contractor Signature
qt- r -o 6
Date
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
qt- r -o 6
Date
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 31633050.00
DATE ISSUED.......: 09/05/2006
RECEIPT #.........: 35907
REFERENCE ID # ...: 06090023
SITE ADDRESS .....: 10415 CHERRYTREE LA
SUBDIVISION ......
CITY .............: CUPERTINO
IMPACT AREA ......:
OWNER ............: BEHNAM DENAI
ADDRESS ..........:
CITY/STATE/ZIP ...: ,
RECEIVED FROM ....: PAUL FOWLER
CONTRACTOR .......: FOWLER, PAUL LIC # 21417
COMPANY ..........: WESTSHORE ROOFING COMPANY
ADDRESS • 2814 AIELLO DR
CITY/STATE/ZIP ...: SAN JOSE, CA 95111
TELEPHONE ........: (408)694-0060
•FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
-------------------------------------------------------------------------
BPERMFEE VALUATION 9,000.00 158.76 0.00 158.76 0.00
BSEISMICRE VALUATION 9,000.00 0.90 0.00 0.90 0.00
TOTAL PERMIT 159.66 0.00 159.66 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 159.66 MASTERCARD
TOTAL RECEIPT 159.66
•
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C TYO
CUPERTINO
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CITY OF CUPERTINO
REROOF
PERMIT APPLICATION FORM
APN #
Bldg Permit Fees
Date:
q
Building Address: l o j 1tJ� C kQ"y 6 ee
Energy
Owner's Name: •
Qehria.M -De+
BSEISMICRE
Phone #:
o,? 72s— "l G
Contractor: W5bsko& K00 V f - n
/W
BSEISMICOM
License #: 7892-2,1
Contact: �� � Vi1�'
BPLANCHK
Cupertino Bu�sLin s License #:
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
.fJ�'Asphalt Shingles
kY� Asphalt Shingles
❑ Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
❑ Other (Specify)
Number of existing coverings ?
To be Removed
❑ Provide I.C.B.O. Report #
❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: ReKode Z Lale✓ MA4,10 TnStr G Aea jZtuP Z2 -co -s�qrL
�
Residential Commercial F-1
Fire Zone: Yes ❑ No
Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Proje t: �T,�pe of Construction: Occupancy groups F� �
f<e�roo
Qty. if
Applicable
Fee ID
Fee Description
Fee Group
BPERMFEE
Bldg 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 Departmenk
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 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 1/4 " 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.
Homeowner's Name: be k K ODM D e n /.cam
Job Site Address:
Roofing Company Name Wes K k Oft° a 0 1p -e_
Applicants Signature: �1'lill/� Date: e�:kw
Greg Casteel •
Building Official
Revised 11/2/04