08030079 CITY OF CUPERTINO
BUILDING DIVISION PERMIT C,"QNT.I2ACTG1It IrTN'UItA4ta.TI(J
BUILQl13p�.(3DaF�9s;LONY HILLS LN KEVIN SULLIVAN ROOFING PERMIT08030079
OWNER'S NAtlME:C 11 PERMIT ISSUE DATE
PIEGLER NORBERT AND HELENA 1696 VALLEY OAKS DR 03/14/2008
SANITARY NO. CONTROL NO.
(408) 842-1057
ARCHITIEC(ENGINEER: BUILDING PERMIT MFO
'BLDG ELECT PLUMB MECH
coo LICENSED CONTRACTOR'S DECLARATION Job Description
i barely,cbbarely,effort that OesCrl I am licensed under Provide"of Chapter 9(mmmeecing p
MthStuIII 70(MO r III ePr Ifessl. ,amairy lhccums REROOF,T/O EXISTING SHKS, INSTL CLS A 36SQ LFTIME
^� in full farm and of `�I "�'
Llose , tae. SHNGLS
S Dam Co DEC
Z eawlha79 L
Cr3 OECLA TION
1 nal my plans shill W used u publLe rtcoms
J
k aid Licensed Professional
OWNRR-BUILDER DECLARATION
i9 I hereby affirm that I em exempt from the Committee,License Law for the
is p o following name.(Student 7031.5.Busiress and Profession Code:Any city of county
3$ which require a permit to connmm,her.Implore-detaches.or repair any someone
iy
favorite he isswnm.aim requires du applicant forrich Fermitoo rile asi9mdsumment
D thalheisliccuedpuraummtheprmislomorf eContrmmr'stj==Uw(Chapter9 Sq.Ft.Floor Area Valuation
9 (commendngwithSection7000)o(Division3oftheBudnwnndNofeuionsCade)or $11000
that he b eaempt therefrom and the but,for the alleged exemption.Any vmladoo of
Section 7031.3 by any applicant for a Fermis subjects the applicant to a doll penalty of Number Occupancy e
not men thin fore hundred dollars(SM 35928040!�� p yT'p
L u vww oldie property,a my wpleyens oro mgns u tlubmm compenuena,
Will dorbdre rloh.and the cCumbmat ersthreaded Liare,Lawdefor L (Sec.71X4, amerof
pad ery.h.ns case:Tec Gntrmmn Ld who Law dem net apply m in owner ea, Required Inspections
property who bulldaori d dese
eeach impr,and who doenauctendo Mmselred Wough his
scanner,the
or thatsuchimPlonmanuamnot intandedaroRuedInsWeIf.
-
hewerer,Ne brilhaw
th g u impmrmovin4 sold a Nin et year of mprove far
the owner-
builder NB Mw the When of proving;Wt K did ret Wim or ImPren(or purpose of
❑1,as owner of the Pmpeny.am exclusively contracting with licensee constitute or
muuuct the project(Sec.701 Biomass and Profeuriau Code:)The Communities U.
cense Law does ret apply to an owooer or poetical who Wilda o unmet.ft..and,
wbo cantrecls for such Projects with a cmntranlmr(a)0mnred pursoaat m the Commerce.
LLeena Law.
0 lunexamptu"der See ,B&PC(ormhbmam.
wins Data
WORKERS COMPENSATION DECLARATION
1 thereby W.under paint of peo)ory,arc aa,der following am uW"rtx
❑1 haw and will maintains Certifiam o(Co.m,m self-esum forWerkee,Compen- —
sedan.an provided for by Section 3700 of the labor Cade,far the performance of the
work for which this permit is Wood. "
0 I hire and will maintain Wa ime,Compensation Iv.Wrana.as required by Section
3700 of the labor Conks far the performance of the wusk for which dtis permit is blued.
My Wor}a`e,�pfom�peo1u^do .vrce curler and Policy number an:
Grier. �] 1 C�C�TLNn Policy No.:
CERTIFICATE OF EXEMPTION MOM WORKERS*
COMPENSATION INSURANCE
rrhb acnlm rued not b e con pkmd if the permit is for one hundred della,(S 100)
.r Inst)
1 mnify that in the performauco of the.,it far which this permit b issued I shall not
employ any person In my moneran Y m became subject as the Workers'Cemperesdon
laws of California.Dam
Applicant
NOTICE TO APPLICANT:IL after making this Certhflmm of Exemption,you should
became subject to the Worker's Compensation previsions of me Liber Code,you mow
.J O faMwith ovblons comply with such pror this permit shall W rimmed rooked.
z CONSTRUCTION LENDING AGENCY
[ti 1 handy drmn dun men u,cantrucdo.Lending agency Car du eaformmce or
IY ti
use work for which Nis permit is indeed(Sac 3097,Cho.C.)
W Iandaes Name
Z tender,Address
U Q I comfy that 1 hire rod We application and sum that the above informed..b
W� come.I agree he comply with all city and county and aaruns and ansa laws mixing to
C) Wilding mnmuctoom.and hereby autharm oprucrushms of this city m coma,upon du
W shove-mentioned property for Immacdan purposes
(•>. (We)agree m ave Indemnify and keep harmless the City of Cupmioo against
soy V1 liabilhdm,judgmum.cmtaan .sea which may in my way seem against said City
()7
an eonpegmnee of du f n of this I
APPLICANT UNOER SAN W L MP Y WITH ALL NON-POINf Issued by: Date [ C
SOU ^ �
sieve erA _ 14 - Re-roofs
pp HA aa, OUR MATERIALS DISCLOSURE Dam Type of Roof
Will Ureas canto tun Wiltling mcupmtatertmhanme heamow mamriai _
u damned by the Cu uatdpal Code.Chapter 9.17,and the Heath and Safety
Code,Section 2553](07 All roofs shall be inspected prior to any roofing material being installed.
40 0 Y.
Will the applicant or futon building=open,=equipment ar devices which If a roof is installed without first obtaining an inspection,1 agree to remove
"mit hevamnus air..ntaminanis a,defoad by the Bay Area At,Quality Mining emem all new materials for' ection.
Db rict7
❑Ym
/11
Than nal the haaamaw muaial Mmanuu pmrR.93ofthe Glifer- �—
nbHcalN&SaicoyCode.Senhau 3 ani .lis ntanddmhrlhe Wilding 1
daceMhorlixul
ntiy hew a mom. my rts ns h Ity m I'y Ne upset of the
Mauto as Signature of psi cant D to
egem Dam All roof coverings to be Class a�"or better
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT- OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35928040. 00
DATE ISSUED. . . . . . . : 03/14/2008
RECEIPT #. . . . . . . . . : BS000004163
REFERENCE ID # . . . : 08030079
SITE ADDRESS . . . . . : 1048 COLONY HILLS LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WIEGLER NORBERT AND HELENA
ADDRESS . . . . . . . . . . : 1048 COLONY HILLS LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5802
RECEIVED FROM . . . . : ROOFSERV ROOFING
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810
COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING
ADDRESS . . . . . . . . . . : 1696 VALLEY OAKS DR
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-1057
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 11, 000. 00 1. 10 0. 00 1 .10 0. 00
1REROOFRES SQ FEET 36. 00 468. 00 0. 00 468.00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 469 .10 0. 00 469 .10 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
---------------- --------------- --------------------
CHECK 469 .10 #6927
---------------
TOTAL RECEIPT 469.10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
CITY OF CUPERTINO
awl)_ REROOF
o
*CUPERTINO PERMIT.APPLICATION
APN # 35 9 a 8,Ug0 Date, (
Building Address: 1 ^ 1 L/ Y)
Phone #:
Owner's Name: �-b� j� -6
�
g�7Z5 - I29 l
Contractor: Phone #: O
�c g\p is p
Fax#:��J�-T7 �O' 1 Q I
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �U Asphalt Shingles
Nq 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: `Tgx- p ¢ S���ke5i W�S�I g �Ow Aslm
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
I Have Read, U d tand a d Vjjll Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
1REROOF
•CUPEkTINO FEE SCHEDULE.
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
•
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 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 withthe above stated policy on re-roofing.
Homeowner's Name: t-A oR S�2.T \ kArZE _"F_P
Job Site Address: 10% r-A cn y Lyn ,
Roofing Company Name: K2l/1 V1 \
Applicant's Signature: Date*1`t/Qg
• Greg Casteel f
Building Official
Revised 11/2/04
„y Community Development
10300 Torre Avenue
Cupertino CA 95014
N Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building Department
JOB A R S: PERMIT #
19 T� t� Lif) �3 vv't
OWNER'S NAME: (�-+ y,e� PHONE #
GENERAL CONTRACTOR Kevv., ,- -7
FAX #
I am not using any subcontractors:
Stle
ature Da
Please check applicable subcontractors arcomte the followinginformation
60 SUBCONTRACTOR BUS ESS 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
er/ ontractor Signature Da e