Loading...
05100086 CITY OF CUPERTINO BUILDING DIVISION PERMIT -aCONTRACTORINF�ORMATION : BUILDING ADDRESS: DAN ELLIOTT' S ROOFING CO PERMITNO.05100086 10299 CT)TAY AV ER'S NAME: PERMR ISSUE DATE YEE ROBERT Y AND MARY TRIISTE2669 PHONE: SANITARY NO. CONTROL NO. 408) 559-7327 ARCHITECIENGINEER: BUILDING PERMIT INFO BLDGELECT PLUMB MECH l� E 0 don LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am limned under provisions of Chapmr,9(commencing Job Description whir Section 7")of Division 3 alto Business and Profession Code,and my license is �„ in full REMOVE SHAKES AND ALL FLASHINGS . INSTALL 1/211 pta,o Liccnu Clazs C_ -P/ Li<.x —p Dam i.d -y �-,9� Camracmr �— INSTALL 30-36 ELK 40 YEAR FIBERGLASS COMPLETE ARCHITECTS DEC ATIO e< l understand my plans shall W used u public mounds eau Licensed Professional 5 OWNER-BUILDER DECLARATION y I booby affirm Nn 1 am esempt from the Contractor's License Law for the p O following mason.(Scotian 7031.5,Business and Professions Club:Anyeity nr county 5 m which equies a permit to[nnmrua,aiMG improve,demolish.or repair any structure prior to its issuance,also requies the applicant for such permit to rile a sighod statement < that he is licompOd pursuant to the provisions of We Contractor's License Law(Chapter 9 Sq.Ft. Floor Area Valu$j]?06000 x~S (commencing with Section 7000)of Division 3 or We Business and Proportions Code)or '� .. thou he is exempt Mcmfrom and Ne basis for me 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 mart readfive hundred d.lir:(5500). - 31629027 . 00 I,m owner of me prefix,try,or my cmPloycu with wages to their sale Compensation. will do Me cmiork,and the structure is pots tended Licansa,Law ffered of apply to an,Business • t S and Profession Cade:The Contractor's Liana Law docs not apply lf an owner of is pmpery mploy builds. rovided Oats thceonownrep and t dmasuch work M1innalformrough his own employ..Me building Nat such improvements art not ear of tl m peerttl for ale.If, a however,thebuilding orimprovement iscoldwithin one year or completion,the posse of Owner- builder will pave the burden of proving Net he did not build or improve far purpose of ink.,. err 2005 c.h a owner of We property,,B sine exclusively contractingtrs wind:itched contractors i. comm a to project(See.to an,Business end Professions ds ori pr Canaa«on,Lid whocame, conwdaesnoupptymah owner ofpmpcny.who conarddsorimpmves thamoo,and, �� tsj rf a License races for such projects with acontracmr(s)limnsetl punuammthe Conlsactoh j License Law, i,t ,�{ ❑lam exempt under,See. .B&PCfor this mazon t� GX « Dem WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury One of Ne following decimations: ❑1 have and will maintain a Ccrtiricam of Conten to self-insure for W«kaesCpmpm- sation,az provided for by Section 3700 of We:abor Code,for Ne peffosmame of the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,az equimd by Section 3700 of the labor Code,for Ne perfarmarme of the work for which this permit is issued. My Worker's Compensation ins/Y�nrroc carrier and Policy number Carrier. �4'1'1GP(CG�, ^'2Yaer Policy No.1 CERTIFICATE 0FTAEM MON FROM WORKERS' COMPENSATION INSURANCE (This u«ion need not be completed if the permit is for one handed dollars(SI01) os Ica.) I oerufv that in Ne Performance of Ne work for which this permit b issued.I shall not employ any person in any mannerso as at become subjWL10 the Workers'Compensation Laws of CaliforniDam Applicam NOTICE TO APPLICANT:If,after making this Cenifmae of Escmption,you should become subject to Ne Worker's COMIcenation previsions of Ne lalmr Code,you most .J O forthwith comply with such provisions or this permit shall be deemed revoked. Z " CONSIRLIMON LENDING AGENCY I healthy affirm Nat More is a contraction lending agency lot Ne perfusmance of a� the work for which this permit is issued(Sec,3f39?,Civ.C.) W A Lender's Name Z) U 7 lenders Address U 0 1 eenee that 1 have mad thisapplication and county and sure Net and show information is OU bonding 1 agree m comply with all city and county oNineSOf and ante laws elating e C) buidinBconstruction.tioneantl hereby authorize rtpseumati xs of Nis city menmr upon the r W above-mmdoneee to sayforinpeNodd keep ea (We)ague m ave,indemnify and keep hay in m rbc City of Cupertino s against N inc.mmuluudgmcn¢cosusntl eap«ucswhich they in any way ecrncegatnm said City V z A APPLICANT ofthe Floating of this per mit. APPLICANT UNDERST DS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date /Z),—/ '(,o 0 C TION . /0-/ 7-06- /7-0CS s V Re-roofs Sigmaurrool'ApplicrOACMumotor Dam HAZARDOUS DISCLOSURE Type of Roof Will the applicant or fumes Municipal C6 occupant erre or handle Health and az defined by the Cupertino Municipal COJc.Chapter 9.12.and the Health and Safcry dc.Se❑coou 25532(:)? /-Na All roofs shall be inspected prior to any roofing material being installed. will the applicant or mmrt Wild ng occupant ase egaipmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit havamous it contaminants az defined by me Bay Area Air Quality Management all new materials for inspection. D'Weiet? ❑Yes ICS Na Ihave&Safetmol Me Cook,seWmr ssions mriabrt533 and 5534.1al rChaper695 dove C.Wilding fiOl his Health currently Colo sessions s.h its my and 25534. to mury that dove Me /o Jots nal curtcndy haw a mnanr,Nar it is my r«ponuhility m nndfy We occupant of the ' -q `me swMb mast E btpdurmismakeeor,CcnlricatcafOccupancy, Signature of Applicant Date / /0 ./ 7-0`� All roof coverings to be Class"B" or better Owner or authorized agent Dam CITY OF CUPERTINO I� 1 of 1 PERMIT RECEIPT OPERATOR: kieTsaw COPY # 3 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31629027.00 DATE ISSUED. . . . . . . : 10/17/2005 RECEIPT #. . . . . . . . . : 31635 REFERENCE ID # . . . : 05100086 SITE ADDRESS . . . . . : 10299 COLBY AV SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : YEE ROBERT Y AND MARY J TRUSTE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2421 RECEIVED FROM . . . . : DAN ELLIOTT ROOFING CONTRACTOR . . . . . . . : DAN ELLIOTT LIC # 21466 COMPANY . . . . . . . . . . : DAN ELLIOTT'S ROOFING CO ADDRESS . . . . . . . . . . : 2669 COIT DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95124 ® TELEPHONE . . . . . . . . : (408) 559-7327 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL __________ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 11, 000.00 180.36 0.00 180.36 0.00 BSEISMICRE VALUATION 11, 000.00 1.10 0.00 1.10 0.00 TOTAL PERMIT 181.46 0.00 181.46 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ---------------___ CHECK 181.46 12323 TOTAL RECEIPT 181.46 ` Community Development 10300 Torre Avenue . , Cupertino CA 95014 Telephone(408) 777-3228 Fax(408)777-3333 CITY OF CUP.EkTINO` Buildin De. artment JOB ADDRESSPERMIT r�� / , / : oZo l jAza°l �\ Hev�v`2 OWNER'S NAME: Y�r�vo4 �? '� PHONE # Z73- 3 GENERAL CONTRACTOR: '�o v���I o ^hood CG FAX# ( (O$ IO- (n••DS I am not using any subcontractors: Date Signature . Please check applicable subcontractors and complete the o 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 (VP— Septic Tank Sheet Metal • Sheet Rock Tile to -b-o, Owner/Contract Si ature Date 051 o00&,o CITY OF CUPERTINO Oz,_( � . RE ROOF CUPEI�TINO PERMIT APPLICATION FORM �q Date: APN # ?31I0— D I — Co Building Address: o�0� 1 b Owner's Narne: Phone Contractor: Phone #: License#: paA&aa-vys `lZ Co ` W9 -55q=I3Z'I Contact: Phone#: Cupertino Business License #: DON 0 ICN Type of Roof Covering: [Existing: Proposed: ❑ Built Up Roof ❑ Built-Up roof ❑ Asphalt Shingles F! Asphalt Shingles OWood Shakes ElWood Shakes CIA Li0 r O Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings i0 h.2_ ❑ Provide I.C.B.O.Report R y © To be Removed ❑ Provide Mfgr.Installation Specs. pe Read, Understand and Will Comply With Cu ertino's Tear Off Polic escription: 'r-e0ov-C' S 4 S all a I Y^qf oxSI'tO 2tt mk St4 L 3o-3io �I k `�fl enf �bzrasstomteIc ential [a-,' Commercial . ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project: Type of Qpnstruction: Occupancy group: �� 000 r Qty. if Applicable Fee lD Fee Description Fee Group / BPERMFEE Bld 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 f 10300 Torre Avenue Telephone: (408)777-3228 CITY OF Fax: (408)777-3333 CUPEkTINO 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. Anyroofingwhich is applied without first obtaining aninspection, 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 naifinspectiori 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 LC.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: 1 1\ C 1)4 9 e-e -1 Job Site Address: � Roofing Company Name: Ll/v^ ( Ili n (S ICU 0-t W ® Applicant's Signature: Date: t b _ 005 Greg Casteel Building Official Revised 11/2/04