04070162 CITY OF CUPERTINO �+xzmu�.�s�di" `" "�
BUILDING DIVISION PERMIT C01�(TRACT'.O$I�ITORMtJTI( '
� . �L.�- _ ' ���.-tea
BUILDING ADDRESS: JNSJ ROOFING INC "B"n N'64070162
10880 FRANC
OWNER'S NAME: PERMIT ISSUE DATE
CUPERTINO SAFE STORAGE 1 W SAN
ONE: SANFFARY NO. CONTROL NO.
4082796171
wRCHITEC,ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
.umoa LICENSED CONTRACTOR'S DECLARATION Job Description �0/f�n
C 1 h�ercby affirm Net 1 am liwrucd under pmviiloru of Gaplu 9(commencing 'ASA
W
with Seeuba-7dM))ofDiviaion 3af NCBuainev and Pmfcs mire Co M.and my licca is W
^tgm Limummuccl daneeB 3 3 8C7 REROOF W� 4PLY SHEET. BUR AU^
�SSwData ARCH C DEC Tn f
ra< 1uulmada dmyplans shall seitupuhlic Ids ILAn �� 20p(�
p/®3 u0 t7 Licensed Professional
Ost I..cURDER DECLARATION `O(�®YM1Yw
1 kmhy affirm on 1 am eaempl rmm d r Contractors An U.Law for Ne [tll'ata=U
o o fallowing m.. Permian]economics.
Busiram, and .dcaom Cod,:Any ciy ar couny
K$o which¢quires a c. iPermit re uir s alcor,impmsu h pori mit i or¢pair any swnum
a42N poor
mlLlcromdprsuant to the BeNovisiosofapplicant for eaehpminil mimmm Law
ihapterl
ass that he is li¢nwJ pursuammthe provisions o[NeContractors License law(Chapmr9 Sq.F[. Floor Area Valuation
asi-0 (commencing with Section 7000)of Division 3 of Ne Business and Pmfessmas Cades).1
u. $ Nat he is exempt Iheaefmm and Ne basis for tk alleged cxempt on.My violation of
Semon 7031.5 by any applicant fora permit suhjrmu the applicant to a civil penalty of Occupancy Type
not ream Nan Gro hundred delbrs(5500).
r
❑Lureworof tkpesamm m,is airoaycmwiN erect 7
will M thesimit Code: h.Conractors Lt. orowdes burials orapply(Secto 7044,Business
of Required Inspections
and ent, h bas CDM:The Contractors License Law does or apply to an owner is q P
pmpeny who buildsor impmvu ch impo and who aresamh work h at
offered
his
ownewer.m aruipmviMd Nm such impmsammu are a,yes,n of
aro@mA for sale If.
however.Ne building m en a(pmmt u sold within one yea of completion.the owner
build¢will kw the burden of proving Nat he did rwt build in imPmw for purpose of
sale.).
❑1,as owner of Be property,am=elusively contracting with licensed contractors to
mutmct the project(Sec.7044,Basin.and Professions Code:)The Commerce.Li-
cease Law ams not apply In an owner of pmpeny who builds or improwes thereon.and.
who contracts for such pmjecu with acomwetor(s)licensed paasmm rc Ne Committees
Liamc Law.
❑1 son eaempl unMr Sec. .B h P C for Be.mason
Owner Dale
WORKER'S COMPENSATION DECLARATION
1 hereby alarm under penalty of pens y am of the following drmHntiom:
❑Duw and will for by action 3wm of Co Latuo,Code.
use
WarYCSComp¢-
worn, r pmvidhi for mi Section 3](10 of Ne Inbar Code.far Ne peRormarmm of the
work for which this permit is issued.
❑1 have and will maimam Worker's Compensation Insurance,a required by Section
3700 of ate labor Code,for Be perf am um,of Ne work for which this Permit is issued.
My Workers Compensation Msumnce caner and Policy number are:
mer. PoRey No.:
CERTIFlGTE OF EXEMPIIOIY FROM W ORKERS'
COMPENSATION INSURANCE
Clint section need not kcemplemd ifthe Permit is reform hundmddnllare(SIM)
or less)
1 charily Ws in the performarme of Ne work for which this Permit is issued.I shall not
cmploy any perw R blrmt to Nw
eworims-compcuon
law.of all
ApPIII a.
N 1 TO APPLI ANT:If.aftialmaking Ni.Ccnif a¢of Exemption,You should
httom subjcm to the orkci a Ca pcmation pmvJJ'si ns of the labor Code,YOU comm
w,Q roMwi imply with s ah pmviaiana or fRnit.hall k dcomed rewk,d.
Z,N CONSTRUCTION LENDING AGENCY
I kmby union Nat Vert is a communion leading agency for the performance of
(L' Ne work for which Ni.pernit is issued(SIL.309x,Civ.C.)
LTJ ALenders Nauru
a z Lenders Address
U 0 1 conif,Nn 1 haw read this applinuan and su¢But,Nc above infmmauun is
IL E' cones.l ague he comply with all city and county on inarnes and sum laws rehiring to
0 U building coastruction.and Mosby auNctim mpmsenutiv=af Nis city in matter upon use
} akvcmenrianed
Property for impccrion purposes
ndemnity and
tiN Imbiliumajjudgcnu,costs ree to saae,Land expanses which may in any wayCity
imm,against said City
U z APP NT UN eR MAIin'DS AmND W'noILL COMPLY WITH ALL NONPOINT Issued by: D
R EREGU
2 Re-roofs
° ca° tar ° e Type of Roof
HAZAR OUS AA ALS DISCLOSUf�� yp
W5 OmapPlieant in
In ing rccupons one or handle haadous mamrial
as MOnesFG ma"I al Coda,Chapter 9.12...it Ne Health and Safety
Code,Seeu.n 25532(=)? / All roofs shall be inspected prior to any roofing material being installed.
m Q/❑
Will the applicant or future Wilding occupant ase equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit havudous air comaminanu u fined by Ne Bay Arta Air Quality Management all new materials for inspection.
Dooim?
❑Yes
I haw read We W=arders mamri ds oupio menu under Chapter 6.95 or Ne cathm,mu N ryCOM.Semimu 25505.25533 and 25534.I undersrand met i(Be Wilding
it. unead rc reform,or a CenOeate of Oc�ancy. Signatu4iEE
Date
ib to be Class"B"or better
Darc
.,, Community Development
. Gni 10300 Torre Avenue
=' Cupertino CA 95014
Telephone(408)777-3228
CITY Of Fax(408)777-3333
� �UPEI�TINO
Building De artment
JOB ADDRESS: PERMI6
(08%o FYeoco C� 0gG'?0(6L
OWNER'S NAME: C w Sic PHONE # p8 2Z q-6(
GENERAL CONTRACTOR: 1 FAX #
I am not using any subcontractors:
Signature ate
Please check applicable subcontractors e 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
,112616
r C actor Signature ate
Community Development Department
Building Division
r City of Cupertino
VVV 10300 Torre Avenue
' Telephone: (408)777-3228
CITY OF
OUPEkTINO 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.
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.pl
Homeowner's Name: t- A"2Q preYw' -s
r, rr
Job Site Address: b 9 a0 F c o C+, F
Roofing Company Name:
A phcanfs Signature: Date: 71—WO
® Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF C5 Z '- 7 /( 2
CUPER IN PERMIT APPLICATION FORM
APN# 32G — (0 0 S S Date: i� D
Building Address: I O t a D C rr gid T- r t
T.
Owner's Name: Phone#:
Contractor: Phone#: License#: 73 9 9 8 d
d N SJ (t-bd�M1 t �� o� �7y-6171
Contact: Phone#: Cupertino Business License#:
mit^ l�S
Type of Roof Covering:
Existing: Propose •,
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#
PY To be Removed ❑ Provide Mfgr.Installation Specs.
.I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
C r< (d) cv sk-t r--Lni>,J w.� In cljl t O U R
Residential ❑ Commercial ET'
Fire Zone: Yes ❑ No [- Confirmed with Planning Det. if
there are anrestrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
Z06 eo
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
7 7. 62,
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 2
Sec : Twp: Rng : Sub: Blk: Lot :
APN . . . . . . . . : 32610055 . 00
DATE ISSUED. . . . . . . : 07/26/2004
RECEIPT # . . . . . . . . . : 26447
REFERENCE ID # . . . : 04070162
SITE ADDRESS . . . . . : 10880 FRANCO CT BLD I
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CUPERTINO SAFE STORAGE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : , CA
RECEIVED FROM . . . . : JNSJ ROOFING, INC
CONTRACTOR . . . . . . . : STEPHENS, ALBERT J LIC # 20948
COMPANY . . . . . . . . . . : JNSJ ROOFING INC
ADDRESS . . . . . . . . . . : 691 W SAN CARLOS ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95126
TELEPHONE . . . . . . . . : 4082796171
' FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- -- - --- --- ------ - ---- - - - - -
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
BSEISMICOM VALUATION 5, 200 . 00 1 . 26 0 . 00 1 . 26 0 . 00
TOTAL PERMIT 127 . 62 0 . 00 127 . 62 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- --- --------- ---- --------
CHECK 127 . 62 23277
TOTAL RECEIPT 127 . 62
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
--305--- FRAME ==307=== INSULATION====-------_______
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
i