08060097 CITY OF CUPERTINO x €a +t5-s': ,.:
BUILDIIJG DIVISIVN PERMIT CON-TRACTfiQR INFU,_RMATIOPI ,
PERMR NO.
Bull.TRII3fgTOZETTE LN R E ROOFING & CONSTRUCTION 08060097
OWNER'S NAME: iNe PERMIT ISSUE DATE
KARL KADIE 15230 CLYDELLE AVE 06/12/2008
WI)NE: SANITARY NO. CONTROL NO.
(408) 626-9320
ARCHITECTYFNGINEER: BUILDING PERMITINFO
BLDG EIFCf PLUMB MECH
o j LICENSED CONTRACTOR'S DECLARATION .IOU Description
tU
1 beach,are.Nal 1 am licensed took,Provieons of Chapter 9(commencing P
wiNSatlan 7IXMId )aMet.rDivision Jar cBnsilrssaM Prowse code. cad"'cnssc is RE—RF RMV EXSTNG LYR RF &INSTL NEW 1/2"CDX
r. in full free an ,
Limn l Lk.L �2 �� 30#FLT&
eD
Dam ARCHfIEcrS ECLARATIONo F7: ETIME CMP 30SQ CLS A
W
ds 1 ndmyp shall he uedupuhl' Ns
6
g G G Limned Profcasumal
OWNER-BUILDER DECLARATION
E 1 hcrohy amrm that I am exempt from the Conan em's License Law for the
20 followw
ing an.(Section 703I.5.Business and Professions Code:My city or money
E m which requires a permit to construct.alter.improve,demolksh,or repair any a.,..
Prior so its issue..asset requires the applicanr for such permit to ftle a signed statement
FFS< Nat M is licensed imenmuo Ne provisions of the Conusetber Limme Law(Chapter 9 Sq.Ft. Floor Area Valuation
YF (commencing with Section 70(0)ofDivision 3 of live Business and Professions Codc)or $15000
E F s— that he u exempt therefrom and the basis for the alleged eaemptim.Any violation of
Section 7031.5 by any applicant for a permit subjects Ne applicant to a civil penalty of Number Occupancy
Ire,mart Nan five hundred dolWs(SSW). 37507020 .E Pane Y Type
1,u owner of the popes,,car mY ernPloycex with wages u then tele compensation,
will do the wort and : roomer u mtinteMW,Law does
forsak(Sec.to an Bums of
and property
who
ons Cade:The Conuemis nicest Law does-t apply m an owner of Required Inspections.
pmeem wyebuildsriireprowtherms,andwho doessuchwork hivuelfedNrougb Ito
uvea sir.oyw,Provided Nowt impmtemmttasenot intended oronesed for Owner.
Wilder ill building orimProwmmtVmidwithinore id or cprowe for
ownery
Wilder will lose the hNra of proving that he did-t ddld m improve for Pomo¢of
sakJ.
❑1,u owner of he property,ane exclusively moussaing wide licensed mnuanms to
co stroet the pmject(Sec.70Cd.Business.rat Professions Cade:)The Conuanmr's Li- .
cense law,does me apply to an owmr of p ufam,who builds or improv thereon,and.
whoeonuaeu for such projects with a eonuacrol(s)licensed pursuant to the Con,remes
License law.
C]I me exempt under Sec ,B A P C for this won
Date
WORKER'S COMPENSATION DECLARATION
I lex mby sRlm under penalty of perjury aro Of the following declarations:
1 haw and will maintain a Cenifiate of Corinne to self imure for Women's Compem
attics.as proklm for by Section J700 of the labor Code,for the performance of the
work for which this Permit is issued.
❑1 have and will maintain WmkcYs Compemauon Insurance,as required by Steers
37W.fthe Lab-Code,for Ne performance of Ne work for which this perms,is Issued. 't' '
My Worker's Compensation htsurane carrier and Policy,number art:
Grtier. Policy No.:
CERTIFIG F EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This rection men!antbecorepleted Lithe permit u fame hundrA dollars($100)
less.)
1 certify that in the performance of the vrk for which this Permit is issued.I shall not
employ any perms in any mann,.as as become wbjmL m the Wodrers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT.If.after making this Certificate of Exemption.you should
become subjen to the Worker's Compensation provisions of the lahm Code.you must
.,O fosthwi,h comply with such Provisions or this permit shall be deemed revoked.
z CONSTRUCTION LENDING AGENCY
F IherehyEthi that them uamluSm.3nkndiperformanceroe the performance of
Uj dm work for which this permit is issued(Sec.J097,Civ,C.)
QLender's Name.
z Lenders Add.
U Q I certify Na,I have read this application and stare Nu Na,above information u
D.!` cornet 1 agree In comply with all city and-only adinauv and state laws relating to
.0 SV^ building construction.and hereby authorim repLxntatiw of this city to enter upon the
above-mentioned proPenY fm inspection pu,pnsea
.. gmc to core,indemnify and kith may
ut m Ne City of Cupertino ad City
h I 'udgmcnu,cosuandupcnsuwhich maylo any way asosue adainuseid City
GJ m common of the ,anung of Nis permit
ADPL ■ ND .aH LL COMPLY WITH ALL NON- 01 Issued by: Date
SO CS RE (TION . 1
Z Re-roofs
S of A,Ii uCm r Date
DOUS MATERIALS D119MOSURE Type of Roof
Will the appliantor Itmrebuilding oceupmtstom mile hoWc1mamaterial
as defined by the CupmimMe icoips ode.Chapter 9.12,sued the Health and Safety
Cade.Section M532(.)? All roofs shall be inspected prior to any roofing material being installed.
Yu
Will thea liar,o,future ordain atm ret taw e m If a roof is installed without first obtainingan inspection,I agree to remove
PPi p V pment o,devices which P
,mil haeb dous air contaminants a defined by Ne.Bay Area Air Quality Management all new materials for inspection.
Dive ct7
❑Yex `f}t111'
I have roal the emotions mamriaHrcquimmemu under0mpte,6.95 offt Califer-
nialmal Idt Gode,9ce' i5505TS5 end ZSSl4.l urslersund NuifNc building
dots m,^uIve y haw•Ire•I. at IL u my s mibililY
to
nedfY dte upon
griremcta m (;roua t�ectmre,mart>Ft Signature of Applicant Date
111
Owne,a,-Nan cdacmt--� `�D�teAll roof coverings to be Class';W'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37507020 . 00
DATE ISSUED. . . . . . . : 06/12/2008
RECEIPT # . . . . . . . . . : BS000005100
REFERENCE ID # . . . : 08060097
SITE ADDRESS . . . . . : 19147 COZETTE LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KARL KADIE
ADDRESS . . . . . . . . . . : 15230 CLYDELLE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95124
RECEIVED FROM . . : R E ROOFING & CONST
CONTRACTOR . . . . . . . : PROCTOR, PAUL LIC # 20615
COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC
ADDRESS . . . . . . . . . . i 15230 CLYDELLE AVE
CITY/STATE/ZIP . . . : SAN JOSE; CA 95032
TELEPHONE . . . . . . . . : (408) 626-9320
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
1REROOFRES SQ FEET 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 391 . 50 0 . 00 391 . 50 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 391 . 50 #12092
---------------
TOTAL RECEIPT 391 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
<-) �vG� oo � �
CITY OF CUPERTINO
REROOF
ICUPEkTINO PERMIT APPLICATION
APN # 7Date: d o
� 7bQ0e2. 0. OCA
Building Address: n / Ll
Owner's Name: I Phone #:
Contractor:�i �/n� IPhone #:
y Z�U l�t�� ( l�le' J� 24 Fax #: q4 16 —71(G
Cupertino Business License #: 2 Q l/ Contractor r Lense #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ ,Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings l ❑ Provide I.C.B.O. Report #
�5 To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
(tit` 2 �) X
i� t
JIM� 36 � L( ��M� `` oomp
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in plan
set & the sheet index.
Valuation'' `,g, U 4 '
7Ha(4vLeead, Understand and Will ly with Cupertmo's Tear-Off Policy:
CITY OF CUPERTINO
r = �` REROOF
_ICUPERTwo FEE SCHEDULE
Number of Fee ID Fee Description Fee . Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
D IREROOFRES Re-roof Residential B 1SFDWLROOF
IBSEISMICRE Seismic Residential B
1RER00FMRES Re-roofMulti-FamilyB 1MFDWLROOF
IBSEISMICRE 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 with the above/stated policy on re-roofing.
Homeowner's Name:
Job Site Address:
Roofing Compan e: 0Y 1�/(� 5 4)v I�C
Apphcant's ignature: - Date:
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
`^ 10300 Torre Avenue
y} Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
OCUPEkTINO
Building Department
JOB ADDRESS: (� I' (I R U��_ I(�
5� l PERMIT # 0 9 D /`P001
OWNER'S NAME: t l� r (L /Vn I in PHONE #
GENERAL CONTRACTOR: tsv1 J(� FAX # CkPn 9 _
I am not using any subcontractors
igna e!rr Date
Please check applicable subcontractors and comp
om Tete the followin 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
�- Owner-/-Contractor Signature Date