06040056 CITY OF CUPERTINOT �{�k'7, h ''r" '*'" t "�'•�`
BUILDIIZC DIVISION PERNIIT <CONTRACTOR INFORMATIi
SUII�INGADDRESS: UNLIMITED ROOFING PE aalINV.06040056
034 CRANBERRY DR
OWNER'S NAME: PERMIT ISSUE DATE
DALLAS GREEN 2852
NE: SANITARY NO. CONTROL NO.
408) 281-0356
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMBMECH
3o A, LICENSED CONTRACTOR'S DECLARATION Job Description
hereby affirm that 1 am licensed under provisions of Chapter 9(eammenefng
with Scu,m70M)ofOivfucw3ofdvABuAd wul f nCgd ntl mYlxen¢u
AR.q? Limnse
>> mfullfwmand if [f / .REROOF—T/O SHAKES RESHEET OSB/ADD CERTAINTEED
3 q Lr.g
'
D, a. MARK LIFETIME COMP SHINGLES—CLASS A OR B
ARCH anal
e 6 I understand my Plw shall be seed u Public records
�U
eOy7ALE
Licensed Professional D
`y<I OWNER-BUILDER DECLARATION
<� I Maso .(Sero on 11. exempt from the Caskuds c :censeAny c Law for the
O O following rtasaa(Section 7(2 sone Easiness and Profnalous Cade:Any city or county
s$ which requires a permit W eons the alter.Imprapplicant
fora,h permit t or repair any mecturt
AP
SZS° priormss WuedpursAlto inquires the inion of the Contractor's
permflmfild a,Law sutemem
F a thournme IICCNedpSM1YN to the 70M)of ivdm 3.fuuc uSftWf4m1 tessimmOaPm9 Sq.Ft.Floor Area i4; Valuati$g 7 70
tl $ (commendy with Section 7000)of Divialon]mf the Bminns4nd Profeuione Cade)ar
- dtat be ts exempt therefrom and the basis fm the Alleged evmpdon.My violation of
Section 7031.5 by any applicant for a permit subjects the applicant ro a civil penalty of APN Number ancy Type
nut mart than five hundred dollar'(SSW). 3 6 2 0 4 0 5 2 . 0 0
❑1,u owner of the property.a my employees with wage u their role compewtion,
will ow the work,And due someone Is an,immaded,utuff.und forsAw(Sec.7044.Beareas Required Inspections
and Prafesalone de:CoThe Canuacmfs Limine Law don Out apply Wan e manner of q P
property who builds w Tm prows themon,and wha doetsuch wink himself ar through his
own employees.provided Net such improvemmu art notin¢Mad oroaertd fmsak.If.
however,Ne building or improvement is sold within one year of completion,the owner-
builder will haw Ne burden of proving that M did not build or improve for purpose of
.In.).
❑1,as owner of the property,am exclusively conuacdng with licemed cmnuaemra W
construct the pmlectt(See.7004.Business and Profeuldn Cade:)The Conuaerafs U.
mase Law dins not apply W an owner of property who builds m improves doemem,and
who contracts for such pm%N with aconu aw r(s)licensed pursuant W the Conuanofs
License Law.
❑I am exempt under See ,B l P C for this reason
Owner Dam
WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury aero of the following declaradona:
1 hue and will main Wn aCertiOmm of Consent W self-insum for Worl efsCompeer-
salon,u provided for by Section 3700 of the Labor Code,for the performume of the
work for which this Permit is Issued.
❑1 hove and will maintain Worwa s Compensation Insunnm,As requited by Section
3700m`the Labor Cade.far the performance of the work for which this permit is Wad.
My Workefs Compensation msurtnce carrier and Policy number art:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
I
This section sced native comphowd If the permit m foram hundred dollars(SIM)
or len)
I certify that in the performance of the work for which this permit is Wind.1 shall out
employ .soy pecan in any maws�smy mkrann W the ne Waken'Compensation
Laws of Caafami` ! !/(� '�
Applicant
NOTICE TO APPLICANT:If,After making this Certificate of Exemption,you should
become subject ro the Worws Compensetmn provisions of W LAW,Cade,you must
0 O forthwith comply with such provision w this Permit shall be deemed revoked. '
z CONSTRUCTION LENDING AGENCY
(-t 1 hereby a07rm that there its cmnmmshm lending agency for the pedormarcc of
the work fur which this permit is Wad(Sm.3097,Civ.C.)
W Lemices Name
7 Z Iandefs Address
U O 1 certify that 1 have wad this application and mm dun the show:mfarmadom is
U,F^ cancer.I agree W comply with all city and county oNlnancn and emus Tawe relating w
Or, building eonuroction,and hereby authotimrepresenatimA of Nis city to eater upon the
W ahow-mentioned property for inspection purposes
G (We)agree to sew,indemnify and keep harmlns the City of Cupertino aCaimt
,.y rn liabilities,judgments,costs and expenses which may in my my acme against said City
UF in comegnence of the eranWg of this perish.APPLICANT UNDERSTANDS AVP WILL CPMPLY WITH ALL NON-POINT Issued by: Date �._( -(fp/
SOURCE RE LATIONS A
�ilo6Re-roofs C7
Signa n Douai Dale—
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applimat or future,building occupant more w handle award..material
As defined by the Cupertino Municipal Code.Chapter 9.13•and the Hplth and Safety
Code.Scotian 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
QYn No
Will the Applicant or fuwre Wilding Occupant use equipment w devimA which If a roof is installed without first obtaining an inspection,I agree to remove
emit hummus air contaminants as defined by the Bay Arta Air Quality Management all new materials for inspection.
Dis rictT
❑Yrs qNg/. .
I hew mad the hasantmumawrislsro ummcma underCMpmr6.95 ofLW CAlifer- t
nielicolth&SAlct�3!!O! 73 anJ 21l34.I�dcrsmM tlutifNc
building � ,per-.vJ
Jan nal tune ane,te th my.apo hllity lrotify the occup of err
royulremen shin et 'o lots sC m Ocmpsnhv
SignatureofA Ilea Date
ownmmrawhari.=d.gmt !!mm All roof coverings to be Class °B° or better
CITY OF CUPERTINO .
2 of 2 PERMIT RECEIPT OPERATOR: suem
COPY # 2
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36204052 .00
DATE ISSUED. . . . . . . : 04/11/2006
RECEIPT #. . . . . . . . . : 33929
REFERENCE ID # . . . : 06040056
SITE ADDRESS . . . . . : 1034 CRANBERRY DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . . .
OWNER . . . . . . . . . . . . : DALLAS GREEN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4926
RECEIVED FROM . . . . : BONITA JENKINS
CONTRACTOR . . . . . . . : DAVID IMHOF LIC # 26948
COMPANY . . . . . . . . . . : UNLIMITED ROOFING
ADDRESS . . . . . . . . . . : 2852 REGNART WAY
CITY/STATE/ZIP . . . : SANTA CLARA, CA 95051
TELEPHONE . . . . . . . . : (408) 281-0356
0EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL
'--------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8,770.00 158.76 0.00 158.76 0.00
BSEISMICRE VALUATION 8, 770.00 0.90 0.00 0.90 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 159.66 0.00 159.66 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 243.68 MASTERCARD
TOTAL RECEIPT 243.68
•
Community Development
ZCF
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
IJUPEkTINO St0 S3 6 -2_03S F" -?. o M"'Q—
Building Department
JOB ADDRESS: n PERMIT#
Vl n ,
62
OWNER'S NAME: o o G;j�..P� PHONE# Z
GENERAL CONTRACTOR FAX#
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
60 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 Z0 O
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor ' nature Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
U PE INTI NO 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.
Homeowners Name: 5 /_1-11
Job Site Address: �O 3 �/�4%y DA
Roofing Company Name:
Applicant's Signature: —Fxf'7 - G Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
�� CITY OF CUPERTINO
REROOF Q�ljS
CUPERTINO PERMIT APPLICATION FORM
APN # 3(, b 0 � Date:
Building Address:
/ d 3 4
Owner's N Phone#:
Contractr: Phone#: License#:
408 241-0356 2'3 96 `18
Contact: 'n one#: Cupertino Business Luse#:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ 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 ❑ Provide Mfgr.Installation Specs.
I Have Read, Underst d and Will Com With Cu ertino's Tear Off Policy:
Job D�p scription: T Gos B. 4-alce L-
C �crsi4 « Q .
Re id ntial Commercial
Fire Zone: Yes ❑ No 2, Confirmed with Planning D_pt. if
there are an restrictions: LJ
Cost of Project: o Type of Construction: Occupancy group:
8770 rv�
t2-
Qty.
2Qty. 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