08030131 xo PERNUT CO1"t R CTURI1�tF(}ItMr =1(J!k� :
PERMIT NO.
am 'IV a 1�2EEKLINE DR LOS GATOS ROOFING 08030131
/R'2IS NAME. PERMIT ISSUE DATE
SIMON HO P 0 BOX 1726 03/24/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTtENGINEER: BUILDING PERMIT INFO
RE—ROOF RMV EXSTNG e1.0G ELECT PLUMB MECH
0 0 0 0
O o LICENSED CONTRACIDR'S DECLARATION lob Description
4 I hereby affirm that I am licensed under previsions of Chapter 9(commencing ^ ^^
with Section 7000)of Division 3 oohs Business and Profeaswns Cade,and my license is
n y in full released]effect. �O O� Q—]
Z Licenac Clay Lke.• / -
s. DamContacmr / s .. es
0 �r"T'ARCNTfECI-S DECLARATION vH�
U I undersand my plan shall W used as public records
6
ya Lic.nsed Pmfcuionel
y OWNER-BUILDER DECLARATION
o-p 1 hereby alrime that 1 am exempt from the Comrades Licata Law for IN
i a 6 following reran.(Section 703 1.5,Business and Profusions Cole:Any city or county
6 f which require a permit at comment,alter.improve,demolish,nr rtPat,any structure
r prior te is issuama.ansa requires the applicant far such permit m Me a signed sssmm.m
a
sb< Phu he is licensed pursuant to dee provisions of dee Connector'Wccosc iaw(Chapter 9 Sq.Ft.Floor Area Valuation
F (commencing wide Section 7000)of Division 3 of de.Business and Professions Code)or
$ Nat he b ex mph deeufrom and dee bub for dee alleged eumption.Any vidNon of
Section 7031.5 by ary applicant("a parnit subjects the applicant to a civil Penalty of ,UN Number - Occupancy Type
not mart than five hundred dollars($500).
0 Luow"safthepmperty.mmyemploymwtNwa uthurmleeompewdon,
will do deemk and themacture is notamnded"offered forale,(Sm.10th,Business Required Inspections
end Professions Code:The Causemes Lt.Law dean ml apply m an owner of q P
property who buildsorimprovesthe van,and who doessuch work himself or through his
awn employees,provided the such improvements are notinterWrd aro@red f"sale.If,
however,dee building or improvement Issold within ars year of completion,dee owner-
builder will have the burden of proving Nat W did net Wild"improve far purport of
um.).
0 1,as owner of the Property.as exclusively conducting with licensed conuatan an
construct the pmjeu(Sec.7014,Business sell Protestant Cade:)The Contra tee,U.
cam law does not apply 0 an owner of proPeny who Wilds or improves theme,and
who condoms for such pm%cm with aamuanoop)licensed pursuer in the Conuacmh
Lkeve Law.
Iamexceptunder See ,BkPCforthbmasun
46 at Dae
WORKER'S COMPENSATION DECLARATION -'
I hereby alarm under penalty of perjury am of to following dulandans:
0 l have and will maintain a Ceei uelmaf Canent in self-Imam fat Worker's Compen-
sation,u provided fm by Sudan 3700 of the labor Code,for the performance of dee _
wank for which this Permit is usual.
0 I have and will maintain Worker's Compensation Insurance,u required by Section _
3100 of Bre labor Cade,fm the performance of the wast forwhich this permit Is issued.
My Worker's o Pensaa Insurance ca�i�of and Policy number art:
Caroies.s n�C acrale.'lap'allcyNo.; J9A—Zm�
CERTIFlGTE F)( WEMP110N FROM WORKERS'
COMPENSATION INSURANCE
(This rim reed out W completed if the Permit is foram hundred dollar($100)
"Ira)
1 emir dent In the performanm of the work for which this permit b issued,I"I net
employ any Perron in any mumrsa as to become subject to dee Workcri Compensation
Laws of California,Dan
Applicant
NOTICE TO APPLICANT.If.after making this Certi(cam of Exemption,you should
became subject to the Worker's Compensation provisions of the Lmu,Cade,you mous
.,O forthwith comply with such Provisions"thb Permit shall W deemed emoted.
e.v CONSTRUCTION LENDING AGENCY
5 4 l lauby aRfm thus then is•connructinn lending agenctie Pem
y far rformee of
a.>-e the work for which thus permit Is issued(see.3097,Or.C.)
Q Lender's Name
Z)z Lender's Address
V 0 I certify that 1 have mW this application arM aam that the show information Is
{f.!�. correct.1 ugme in comply with all city and county eNimnces and sum laws relating to
-0 rV' Wilding convection,and hereby"Name representatives of this city to enter upon the
[i7 aWw-mendumd pmpcny for inspection purposes.
(We)agree to save,indemnify and imp harmless the City of Canaria against
„y y liabilities,Judgments,casts and expenses which may in my way amuse galmu said City
(„) in consequence of the loaning of this Permit.
APPLICANN�T..UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 't.lt-f,h
SOURCEIMULATTONS. v J2
�,.r. -f9 Og Re-roofs
Sign of ApplieAZARDOU Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will deeeCupent"futunibuilding
palCo e.Chaptawm2.ad
Health amaterial
MOmO by 0m CuPenino Municipal Code,Chapter 9.13,and the Health and Safety
Suction 25533(s)? All roofs shall be inspected prior to any roofing material being installed.
OYe g]No
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,,I agree to remove
.mit Wea dma.aircmuminuu u d sed by the Bay Am All Quality Mmalcmem all new materials for inspection.
District?
Ova u
I have mal the husrdne materials mquimmena under Chapter 6.95 of the caller.
nia Hnl"Softly Cade,Satiou25505.25533um125534.luWer=Wthmifdec building /vA/'7'�� •f�ZT�08,
does ret c ashy haw a"nam.that It b my responsibility ad entry tins occupant of the �^+ -
mqulre which melIpoioriniuuanceofaCeNBpmofocap ry.08 S'l tureofApplicant Date
_717_4All roof coverings to be Class'W'or better
O .r or mth"ned egoal Dam
CITY OF CUPERTINO
2 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36217045.00
DATE ISSUED. . . . . . . : 03/24/2008
RECEIPT # . . . . . . . . . : BS000004242
REFERENCE ID # . . . : 08030131
SITE ADDRESS . . . . . : 7855 CREEKLINE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SIMON HO
ADDRESS 7855 CREEKLINE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4155
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . RANDY BROWN LIC # 23481
COMPANY LOS GATOS' R.00FING
ADDRESS . . . . . . . . . . : P U 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 8, 470. 00 0.90 0 . 00 0 . 90 0. 00
1REROOFRES SQ FEET 35 . 00 455 . 00 0. 00 455 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 455.90 0. 00 455 .90 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
•
• (
CITY OF CUPERTINO 003UI :3,
REROOF
• CUPERTINO PERMIT APPLICATION
APN# � / /n Q �` v � Date:
Building )A.tddres
��
Owner's Name: Phone #:
t�
Contractor: L_0 S �r—Cc .7-v S /� 0 o I 1✓) C� Phone #: /�0 6' 2 9 8_ �j3 9 9
`J Fax#: U� � - ��
Cupertino Business License #: Contractor License #:
23yg �
00 70
Type of Roof Covering:
Existing: Proposed:
❑ . Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles N*1 Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ,-K Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. R port#
❑ To be Removed Provide Mfgr. Installation Specs.
S 5 3s Roof .
l_'i4 SS
Jo Description:
widen ' Commercial Lj
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation: �Q
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
•
i r
CITY OF CUPERTINO
REROOF
CUPERTINO 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 1SFDWLR00F
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 wi the above stated polic on re-roofing.
Homeowner's Name: (�
Job Site Address: d��
Roofing Company Name: S 1
Applicant's Signature: 43) Date: Y2� O�
•
Greg Casteel
Building Official
Revised 11/2/04
- - -`-
r Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
UHkTINO Fax(408)777-3333
Building Department
JOB ADDRESS: ( PERMIT #
-7855 GreeK ) lhe Dr f
OWNER'S NAME: 5; w C,, gc, PHONE # ¢cg— 29 $ — 5P3 9 9
GENERAL CONTRACTOR: Los a os FAX # f 09-2c) 8— 937
I am not using any subcontractors: 3 7- 0
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
1 • 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
Owner/Contractor Signature Date