08030127 CITY OF CUPERTINOa � t'+ �
BUILDING DIVISION PERNUT '",COPITR"ACT& R?INk,ORM�TIQN.`-,,
PERMIT NO.
BDILDI'HlU91'E LORENCE DR R E ROOFING & CONSTRUCTION 08030127
Was NAME: TNIf PERMIT ISSUE DATE
JON HABETS 15230 CLYDELLE AVE 03/24/2008
PHONE: - SANITARY NO. CONTROL NO.
(408) 626-9320
ARCHTIECnPNGINEER: BURRING PERMTr INFO
BLDG EIECr PLUMB MECH
3 o p LICENSED CONTRACTOR'S DECLARATION IOb D0SCr1 UOn
I hereby"m deal 1 was licensed under pm rima of Chapter 9(aomman n{ P
z1 wap Swdm7")of0iviuon7afam Businmmd Profession,Com, amyrcense is RE-ROOF; RMV EXTNG LYR RF, CLS A 41SQ INSTL NEW
^Oor tnfullforttanaeR �2�5��'
use��'¢� SO -J 1/2"CDX
9 Dam-
{atI nitatq
ARCH S D 1
I nun;my plans shall N c race
{LL Lmeuta Pmfeasioml
50 Om I san exempt fr DECUBATION
N
a9 I nearby Wal I am thus from sec CmarksahmssCo :my law for the
O O which ng mama.(Socuan 703 13,Business am nt,deauns Cade:Any dry ser ceunry
$ which rtqus u a eemh requires
e NnmtmA plux,Mprow,m permit i nr measle any emmord
�S^
prior to iuissusnan,aianntto the tW Applicant ofthe suchpermitmftlam Laeasmmonl
(co51< WathaulkgwithSwamrolWPmvidomafWeConuuessme:Parmio(Chapmr9 Sq,F[. Floor Area 21 Valuation
dom be is mempat hecaon 7Und th basis
r of the Busialleged
css eM on.An vi Code)or 0 0 0
.. that io V esempl deorofrom and applicant or bash far dee aimged tsempnt M Any l penalty
of
OSectionut,..7ha S by helyreddollms(S emir subjects the algliunlm•rivll pmulty of pp7 Number Occupancy
oat roam than nor nuedroa aalWa(S100L 32635038!°'"7 U' Type
0 1,u mm of see Pmperty,m my emplaym with wg%u thahedle compemdon.
will do WewarkaM theawcumunorimmnded oroRered for We(Sec.70M,Ramada, Required Inspections
Nd Pmressmas Com:The Contractors Licensed law road not apply m e ns an owner of q P
property,am Wilds irepor.thereat,and who dmmeh workhimselrlWeats his
owe employees,pmNded that such ireprownwtu an not ime&ed oroRered forsake IL
however.eae Wilding w Imranoceum issokd within one,you of ee mpmtion,dee owner-
Wilder NB haw deo human of pmving east he did nal Wim or improv for purpose of
sale.).
0 1,as awtmr of the proporty,am uclumly contracting wide Rased contractors In
connotes dee pmjem(See.7Ma,Business and Professions Cam:)The Cartunmars Li-
ave law dm not apply to te owner of property who WAIN or import.thereon.and.
who conuaeu for such projects with a conumtor(s)licensee pulau lm dm Contractors
Licessa Law.
0 l sonexempt under See ,B h P C far this reason
w Data
WORKER'S COMPENSATION DECLARATION
1 Yreny Nom seeder penalty,at pemay arc of the followtna deelandmer
0 1 haw and will maintain a Certillcauof Cansent to self-insure forWorkersCompett-
niton,u provided fm by Sanson 7780 at rte labor Code,foram perfamtaace of the
the for which no permit is leaned.
I haw and will mumuin Worker's Compvtullon Insurance,as required by Section
00ofeae labor Com.foreaepeformutceof Weworkforwbin WisKmil6lssued. '
Warms'.Compaaudan Insurance curial aM Policy nusm�b�s1 m:
' Gnic. Polley No,:�{,y�""",�U_
CERTIFl COMP E%TIONI NFllAN WORKERS'
COMPENSATION INSURANCE
(This section need Out W completed Have panel,is farm hundred&Ilan(SIffl
or lea)
1 coldly that in IM performance of the wart far which this permit is Wood,l siWl rapt
employ anty perm.in any numerse u on brsrome subject m rte Workers'Compsnuaon
Lawsof California.Dau
Applicant
NOTICE TO APPLICANT..If.after making this Certificate of Exemption,you should -
become subjm to ave Workers Compenuuon provisions of red lab&Code you mus
.J O forthwith..Ply with such provWons or Wuew
pewit shall W all deemm
ed wked.
Z CONSTRUCTION LENDING AGENCY
(ti r I hereby affirm that ft.I..coutmodan lending agency far the performance of
!Yi i the work for which this permit Is Woes ism.3097.Civ.C.)
Q Lender!Nunn
= z fenders Address
U O 1 artiry that I law rasa this application and sum and the aWw hromtatron Is
Iy corms"1¢{rte m comply wild all city and county aNinarmv anm se
d sum relating m
.0 Wilding construction,and hereby authorize mpmsenutim ofthis city m enlerupon see
W .have-mcn&ned PMPerty for inspection Puryasee
y (We)agree to nor,indemnify and kap bamileaa the City of Cupenino against
h liabilities,judgments,cam aed expenses which may In any my amus against said City
C.1 in consegtrrn of the panus{of thispermit. � �
APP NT UNDERSTANDS AND WILL COMPLY WMT[ c.1
LL NQN.POINT Issued by: Date �2 - '
SOURCE EOU 9. I 88
'l
signata ser ucan o.m Re-roofs "�-�---
HAZARDOU MATERIALS DTSCL RE Type of Roof
WlB see app ort ort forme Wlldin0 aaupanlsmro khanNow material
de0ned by the Cup:�®r
Mu ''pic]Code.Chapter 9,11 W the Health and Safely
In.Section 23533/ All roofs shall be inspected nor to an roofing material beim installed.
❑Yea No P P Y g g
Will the a- fumm Wilding anvpant use equipment ser device which .-If-¢-roof' installed without first obtaining an inspection,I agree to remove
..it huallous air conuminaou u dented by rte Bay Arse Air Quality Mangemara all new m for inspection,
District?
❑Yea Nu
I hawmslthehexardm mamrislsmquimmcnuunmr CluPmr6.93 afthc iter- \
niaHulnkSafely Code,3mians 233n3,35373 ana2353d.iunmtsued nulfdec Win{
dn I haw a roma"Wu Itis responsibility m noafy roup 1 h, \
ulreme h' "o`m' ora Cmsifwam of SlgnatUre of-Appltcafif� - ale
owners anmor agent Dau All roof coverings to be Class'¢ or better
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot: -
APN . . . . . . . . : 32635038 :00
DATE ISSUED. . . . . . . : 03/24/2008
RECEIPT # . . . . . . . . . : BS000004240
REFERENCE ID # . . . : 08030127
SITE ADDRESS . . . . . : 10501 FLORENCE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JON HABETS
ADDRESS . . . . . . . . . . : 10501 FLORENCE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1105
RECEIVED FROM . . . . : R E ROOFING & CONST
CONTRACTOR . . . ... . . : PROCTOR, PAUL LIC # 20615
COMPANY . . . . . . . . . . : R E ROOFING & CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 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 21, 000. 00 2 .10 0. 00 2 .10 0. 00
1REROOFRES SQ FEET 41 . 00 533 .00 0. 00 533 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 535 .10 0. 00 535 .10 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 535 .10 #11867
---------------
TOTAL RECEIPT 535 . 10
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
REROOF
�CUPEI�TINO PERMIT APPLICATION
APN # 2� t03 50mo U Date: Z 0
Building Address: 1066 I V L 0�,CI
Owner's Nam 0>J ��i���5 Phone #:
`tA --I J— 140
Contractor: Phone #: L44- 932J
Ll �11U/CiT1�ll/� I�(C . Fax #:
Cupertino Business License #: 2C) I Contract r2Lic nesse #:
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 ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:IeK&18
��I�IN(� l �y (�U 1 ��9 iYr l ���1 2 1
Residential Commercial ❑
rZk
Fire Zone: Yes ❑ NoAl Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuatio
* Zl ,uuo . '`'
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signa re—�
CITY OF CUPERTINO
La,spou REROOF
CITYCUPEI�TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
i 1RER00FRES Re-roof Residential B 1SFDWLROOF
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 with the above stated policy on re-roofing.
Homeowner's Name: �K1 _�"xn
Job Site Address: I U5 U [ �L CAa,1/
k
Roofing Cgmpany me: h L 1�� ( 4J G h ,�1T�(I
Applic (aft/s Si `e: Date.��/O
Greg Casteel
Building Official
Revised 11/2/04
r - Community Development
10300 Torre Avenue
-%` Cupertino CA 95014
Telephone(408)777-3228
*CUPEQjINO Fax(408)777-3333
Building De artment
JOB ADDRESS: 1 U�U 1 FL6�,&4 ° PERMIT# 0>GFO'3 p /-L 7
OWNER'S NAME: PHONE IF - 2f,-q
GENERAL CONTRACTOR: FAX # _
I am not using any subcon actors: 3 Z U
Signa Date
Please check applicable subcontractors an ete 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
Owner/Contractor Signature Date