08020081 CITY OF CUPERTINO ^�+:'�«�
BUILDING DIVISION PERNUT �fCON<TRA TQR IN�'QRNIA.TION'
S�-°£.F�i$°?- Rte' t � :zybY«£✓�.`d, xfS 4� f :a^�?.>��
BUILDING ADDRESS: PERMIT NO.
861 COTTONWOOD DR LOS GATOS ROOFING 08020081
NER'S NAME: FERMITISSUEDATB
JOINER STEVE P 0 BOX 1726 02/13/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BURRING PERMff INFO
REROOF,RMV 2LYRS CMP, INSTL BLDG ELECT PLUMB MECH
300
LICENSED CONTRACTOR'S DECLARATION 0 0 0 0
rd� I lemby amrm that I am Iksauod under provisions,or Clupter9(ammacing Job Description
rim Sector,700M of DMdon 3 order Business W Pmfessiam Code,led my Iicenm is
n N in full forts aed9r, .l6aJ J .J
A
z gars I.ic..
9 Dau Co,momer
e ARCHr1ECrS DECLARA ON
y I undersand my plans shall Ise good as public mcmd.
3 U
yQ�,s Licensed Professional
3 OWNER-BUILDER DECLARATION
ZOO I 1 nearby.(Ertn mat 11. eusin faro tiro Contractor's License taw co ne
O O following masa. emit t RD str Business and Profession,Code:MY city or county
S$ which mqu4rs a e.Aw to cnnwthe alta hnpmss.de permit
t or repair any gnnum
_Z y prim to its iavanec,alw requires the appliant forwch permit m fie a signed wtemmt
o
me,Wislicenwdpursuant tofProvisions oftieComencur'sl]asseLaw(Chaper9Sq.Ft. FloorArea Valuation
@% $ (commencing with Section 7000)of Division 3 of me Business and Professions Cade)or
S mat he is exempt motorman and he basis for ma Mated exemption.Any violation of .
Seeing 7031,5 by ary applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy e
not mom man fsw hundred dollars($ial). P Y EYP
1,as caner of the property.or my employees with wares a Meir Sum compensadon,
will do the work and the gructum 4 not intended or offered fora.(Sec.7044,Business
and Pmreas ma Code:Tae Ommiemes I i¢nns roto
se law dat apply an owner of — Required Inspections
propery who builds mimprems tiemona M who doesauh wmkhimmlfor Waugh his
awn employees,providedmaanehi Lizwld i areratinudcmaedon.foram.ir.
Iwime, mebuildingm no(proentisseldwithinoneyearwcampledfwtheowner-
bble.). will ham to burden of prvvan8 Nat he did wt WIM m impmw fm purpoa of
able.).
❑1,as owner of du property am exclusively contracting wim licensed contractors to
construct me Project(Sec]Dad.Business and Pmfadoa Cade:)The ConmactoM1 Li-
ana Law does not apply m an a mater of propeny who builds or Mpmvn memon,and.
who comment far projecm whin•eoouator(s)Ilanad purwanl m im Cam actor's
LIame law.
❑IamegmptunMSec. .BkPCfcudg. an
Dau
40-1 WORKER'S COMPENSATION DECLARATION
I hereby aflirm under penalty of perjury mete of the following declarations:
0 1 hew sod will maimse•Cer inam ofc.nant u self-loam fmwor4Ys Compere
aloof u provided fPe by Seeuon 3]00 of W labor Code,fm W pedarmena of the
week for shish cis permit is iaued. '
❑I have uM will mains.Woftres Cenpealloo Insurance.as required by Secdan
3700afhe Labor Cade.for the performance ofte work for which this permit is homd '
My Warks C rape ion I grams aria and Pollry nsum�er aGm:
6Mer. Policy No.M WOR Ii'
C 0.TIFl ATE OF COMPENSATION
EXEMPTION FROM WORKERS'
COMPENSATION INSURANCfi
(This smmlom need not W completed if Ne permit lafmme,hundred dollars(3100)
or gat)
1 certify,met in me performame of me,work for which this permit is isssed,I shall no
employ any person in any manner in as to become subject tome Warkms'Compensation
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:If,after making this Cen ricam of Exemption,you should
bmome Subject be ma Worker's Compensation previsions of me labor Code,you mug
.J O faMwith comply with inch provisions or mu permit shall be domed revoked.
'�
,.�r^yiCONSTRUCTION LENDING AGENCY
Inearby afro.
[-� mat them is.construction lending agency for the performance of -'
a> the week for which less Famm is Wood(Sec.3097.Cm.C.)
q Lcmices Name ,
] z Landers Md.
U GF I certify ma I have read War applicationnM sou maL me atom information is
Ly t— cornea I agme to comply with all city and county amilmgaod es ssum laws misting w
.0 Wilding construction,and hereby audience mpmsenuime of his city to enter upon Ne
aWw-mentioned Property for inspection m1mmo L
Cir (We)agme to aa,indemnity and keep harmlas tee City of Cupertino against
Tr, liabilities.Judgmmnu,cuts sod eapenses which may in any way acmm&Saimt said City !r ,
Uz in consequence of the ntin{of Nu permia
�r APPLICANT UN ANDS AND
WILL COMPLY WITH L ON-POIM' Issued by: Date
SOURCE RE U I 3 ,-,,�
Slgaauar of Apptam/Cenuear, Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Lim applicant or fumm Wilding oceupintwm or handle haaallous mamrial
de0md by the Cupenina Municipal Code.Chapter 9.17,and he Has and Safety
.Section 75337(a)7
Oyer All roofs shall be inspected prior.to any roofing material being installed.
Na
Will the applicant or fume building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,.I agree to remove
emit ha xd..a coif comemi nm as defined by the Bay Area Air Quality Management all new materials for inspection.
District?
Dyes No
1 haw mod he handws mamriam requirements underChap er 6.95 of tee Califar.
nu Heal"jamlyCode,Sections 75505.75533 and 75534.1 adommod mg Bde Wading
tau rose ynaw•nmank mal itYmY mryomibility to mufY Ne upatoloe
nomiarme h ugtem priorassuanaaaccruE...l. a, anor,�_ Signature of Applicant Date
Owner or aomomcd qcm oam�' All roof coverings to be Class��B°or better
I oroa 04
CITY OF CUPERTINO
at -
REROOF
*CUPERTINO PERMIT APPLICATION
APN# ,3 —0 c)'\V Date:
h:2-10<,
Building AdTQ e s•
4.(Oo 4
Owner's Name: Phone #:
c�vyw� 401ryy6- 1-2_03
Contractor: �J Phone#: ypd Zti� �j 3y`f
LS �� lL Fax #: g' M-e
Cupertino Business License #: Contractor License #:
Oo 70
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
s( Asphalt Shingles l� Asphalt Shingles
/❑ `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 ❑ Prov*de�Mfgr. Installation Specs.
S' S
Job�D�escription:
Residential Commercial
Fire Zone: Yes Ll Nq2Q Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
Have Read, Under tand and Will Comply with Cupertino's Tear-Off Policy:
Signature
CITY OF CUPERTINO
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
1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
s .
Community Development Department
Building Division
® City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
C U P E IST I N O 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. Al]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.
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: 4i 1/e ��LJO lh e r—n
Job.Site Address: I1h��T14(h,,.Al 0.CYnn�t
Roofing Company Name: I60.rY !h 9
Aplicant s Signature: / Date:
• 1�11+6lJCtD(�0
Greg eel
Building Official
Revised 1/30/03
Printed on Recycled Paper
® CITY OF CUPERTINO
2 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36917036 .00
DATE ISSUED. . . . . . . : 02/13/2008
RECEIPT # . . . . . . . . . : BS000003929 -
REFERENCE ID # . . . : 08020081
SITE ADDRESS . . . . . : 861 COTTONWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOINER STEVE
ADDRESS . . . . . . . . . . : 861 COTTONWOOD DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4621
RECEIVED FROM . . . . : LOS .GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P O BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
® TELEPHONE . . . . . . . . : (408) 298-9399
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 7, 554 . 00 0 . 80 0. 00 0. 80 0. 00
1REROOFRES SQ FEET 32 .00 . .416' 00 0. 00 416 . 00 0. 00
----------- ---------- ---------- ----------
TOTAL PERMIT ' " 41'6.80 0. 00 416 . 80 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
Community Development
_ 10300 Torre Avenue
;&Q-', Cupertino CA 95014
Telephone(408) 777-3228
CITY OF UPEk IN� Fax(408)777-3333
C IV Building Department
JOB AD S: PERMIT #
o0
OWNER'S NAME: PHONE # Q 0
GENERAL CONTRACTOR: LAE FAX#
I am not using any subcontractors:
Signature ba/e/
Please check applicable subcontractors and complete the following 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
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Dat