06060142 CITY OFCUPERTINO & �wr'aa ^`%�alx•'� �py'�•"' y�,�'" "tet "'
' PERMIT FI.BUILDING!DIVISION 1\
BUILDING ADDRESS: , R EVELYN PERMITNO.O6O6O14Z
7455 DUMAS DR
OWNER'S NAME: PERMIT ISSUE DATE
WHITAKER EVELYN 06/16/2006
14 NE: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDO ELECT PLUMB MECH
O O 0 O
sop LICENSED CONTRACT'OR'S DECLARATION lob Description
�+ 1 barley alfrrm Nal 1 ern licensed under provitimu of Chapter 9(commencing
n� nlulll fo`rl am call.iNslon3oflhe Builnus and Profculunn Code,and my license Is TEAR OFF EXISTING ROOF, REROOF NEW COMP ROOF
�: ueenw�T pet LieB CLASS A
-- Dam Its—•4- =a-.r
ARCHITECTS DECLARATION
1 undenund my plans dull be used as public records
J U g—'
aua� Licensed Professional la((L— �{'�
OWNER-BUILDER R DECLARATION A
s��a 1 moun afnrm oat 1 1. uempt from the Colon,Co License Law for the`C o (allowing moon.(Section 70513,Bastes and ve,d coli Code:Any City or county
which rite ago a permit m cronsuirel the
alar,aprove,h Permit I file
mater ed mwnum
Z4` prior Me,heitscensedc,alwnt toga tM applicant for such Permit bleuLw summate
zC thalaencing cdparwanlmoaproviauwofoeDonuwesscolRnseLaon,codmr9 Sq.Ft.Floor Area 9 2006 Valera[ BOO
C� thammes marepttSmite7W0)of Divisionr oftheeged moeMon.Any
Cade)or o
3 peal he k 31.5 b tAcrtfrom and the aper for the alleged eumut 10 Any viaeNon of ch
Selman 7031.5 n airy red dont fora permit whjecu the applicat to a cavil Penalty of �,5+Ap7as�.T�f.Ty'I� 1xer ccupancy Type
ret mart dun eve hundred dollars(1500). 3=7 G 4 V T7 . O
❑I,uawrter of the pvpmy,amy emplayeu vela wageapethcuak eompenadon,
will do the wer"nd Mesrrocam Ismn Intended oranered Formic(Sec.7044,Business Re aired ns IeChon
ad Profects.Cade:The Contoomes L.k•"—Law dam tet apply m se owner of q P
propany who builds orimpnwa Mason,and who does such worthimwr or duuugh hr
owncmployees,provided tat well Improvements am not handed oroRered for male.IT,
however,the building or Improvement is sold wioinane you of Rmplemon.Me owner-
builder will have dm burden of proving dust but did at build or improve for purpose of
❑1,as awwr of the propeny,am eximilvely lamming wish licensed con incmn in
conmwcl the project(Sec.7044.Businpes and Profutiam Cade)The Cmulates Lt-
«ere Taw dope Mol apply In m owmu of properly who builds or improver memos,and,
who contracts for such prettiness wish s eonuaaor(s)licensed Pursuant he the Conuecmh
Lkeue Law.
❑I am exempt under See ,B&P C farur mawa
Owner Dau
WORKER'S COMPENSATION DECLARATION
I ready aRum under penally of perjury arc of to following dalantiong
I have and will..Irwin a
Card of Consents selGlmum for Worker'sCompen-
salon,a provided far by Section 5700 of dw Labor Code.for oa performume of the
wok for which Nis permit is eased.
have ad will malto Wollmrt Qa111pewalon INaraOR.a ti d by.9CCda0
7 the labor Code,Irl erfarmanR of the work for which o' peon
y War scompemdon elariam numberam.
Canter. No.:
C CA OF EXEMPTION FROM WORKERS'
MPENSATION INSURANCE
(Thrwcdm wed notbecompleud If tM permit Is forme hundrld all=($100)
or tea.)
I Reify Mal In the puformaaR or oa work fm which Our permit is Issued•I mall not
employ my pavan in my mmmr w as mhrmmo wbiecl m•••thea W,orkers'Compenadm
laws of Califomio-DaM (�
APPlicenl P
NOTICE TO APPLIC .If.after mill5lVaCcrifican of Excmpdon.you should
become subject m ths Womer's Compensation provisions of to labor Code.you muu
0 O raowidr comply with such provisos or or permit W deemed mmked.
„zt tiCONSTRUCTION LENDING AGENCY
t•w Ihereby affirm that them it a mwornalnn ladin{agenry for the performmal of
pY, s7 the work fur which des permit r issued(Sec.5097,Civ.C.)
fit Q lsndch Name
4 Ladles Address
U Q I Reify that I have read this application and use Nat the above information in
ii.F correct.I agree m comply with all city and county ordlance,and sur laws¢lams m
0 V Welding Maruaion.and hereby a darire teprtsenmima of this city m ants,upon oc
{i1 ab.vomenli.ccd property for inspection purposes.
Py (We)agwe to save•indemnify and keep hamlcas Me City of CupmfLmO agaiwl
rA liabilides,judgmants,costs mad .Pa.which may In my way same agtiwl aid City
L)7 in eowequm x of the granting of or Permit.
f i APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUn REGULAlT
G-( - k Re-roofs
Signasrl plianUCanuacmr Done
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Me appliant or forma building ocmpantaom m handle baalloos material
as de0md by oc Cupenst Municipal Cade.Chapter 9.15,ad the Heauh ad Safely
Code.Section Nu
632(.)7
oAll roofs shall be inspected prior to any roofing material being installed.
Yos
Will the applicans or future building Occupant use equipment or devim which If a roof is installed without first obtaining an inspection,I agree to remove
cmil hnaranus air cmuminansa defined by the Bay Area Air Quality Management all new materials for inspection.
Dlavict7
❑Yes ONO
I ban mW the huaNms mnwrlaisrlqueremenu underChapwr6.95 of dm Califor-
nia Wait&SafmtyCode,Sectiau25505.25555 and25534.1 undersuM lhulroe building
does an carom Iy sew a want.oil it u my responsibility m mtiry the oaupnl of the
'qui Ante which mug,be mel ''or meauanRaraccrenc/amorampaay. Signature of Applicant Date
ll .Y✓V \ Ln'�Fi
0a
Owner or mNndoea agate Dam' All roof coverings to be Class"B"or better
CITY OF CUPERTINO
•m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 359,24039 . 00
DATE ISSUED. . . . . . . : 06/16/2006
RECEIPT # . . . . . . . . . : 34888
REFERENCE ID # . . . : 06060142
SITE ADDRESS . . . . . : 7455 DUMAS DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : WHITAKER EVELYN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : CRAIG WHITAKER
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : WHITAKER EVELYN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
qEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000 . 00 147 . 96 0 . 00 147 . 96 0 . 00
BSEISMICRE VALUATION 8 , 000 . 00 0 . 80 0 . 00 0 . 80 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 148 . 76 0 . 00 148 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 148 . 76 3994
------------
TOTAL RECEIPT 148 . 76
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 co ly with the ab ve stated policy on re-roofing..
Homeowner's Name: f k I AT( , (I,(C2I-
Job Site Address: � c� C)M.04 �Lk U�
Roofing Company Name: 4
//�I
Applicant's Signature: Date:6T�_0�2
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
0 Torre Avenue
Cupertino C 9 014
I SO Telephone(408)777-3228
CITY OF Fax(408)777-3333
GVUPEkTINO
Building Department
JOB ADDRESS: PERMIT#
}qSS on' A-S TRW6
OWNER'S NAME: Cv�L�lU W K l itik �� PHONE # /
GENERAL CONTRACTOR: 1 c FAX # z -
-eel (
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
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Date
CITY OF CUPERTINO
- REROOF
CITY OF
• CUPERTINO PERMIT APPLICATION FORM
APN# -S,5q _ 24
I I ,OZC�
Building Address: 1�r�/ IoM D e` L16
Owner's NameVel—`J1 �1 Vj l r� Phone
Contractor: O VVM� Qv 1 L_PP e License#:
Contact: C f,A-i, vi i{,C f�,Ic-t l^ Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ,Built-Up roof
{O sphalt Shingles B' Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings Z ❑ Provide I.C.B.O. Report#
AK To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Descript
7S�tr ( 2— >rc� rr,5:w CU
Residential Fj V Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: IJ
Cost of Project:*00 C)u. Type of Construction: Occupancy group:
I (.J�
Qty. 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