06090161 CITY OF CUPERTINO &
BUILDINCbIV15(ON PERMIT hCONTRr�CT,,C1RINFORMt1.TION„
BUILDING ADDRESS: DUBOIS ROOFING INC m PERMITNO.06090161
20800 HOMESTEAD RD # 36
OWNER'S NAME: PERMIT ISSUE DATE
PROMETHEUS/VILLA SERRA 99 DUARTE AVE 09/21/2006
NE: SANITARY NO, CONTROL NO.
(510) 793-9760
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
loo LICENSED CONTRACTORS DECLARATION lob Description
i U F 1 home,affirm that 1 am licensed under provisions of Chip.,9(commencing
>qwith Sccdon 70W)of Division 3 of del Business and Profcssionr Code,and an,license is
i lae1 CT and errLk.a 812 3CV REROOF- TEAR OFF FLASHINGr (N) 30YR DIMEN. COMP
•Fo Dam Contra — OVER (E) 1 LAYER (N) RIDGEVENT, GUTTERS & DOWNSPO
'•�� ARCHTECTSDECARATION CLASS A. CARPORTS 70 , 73 , 74 TEAR OFF SHK, (N) CO
i m< I undersun my plans shall W used as public records
ayU
cat, Licensed Professional
Oat I am CULLDER m use CommON
ences
0 E I hems a(ffrm that 1 1. exempt from the Cmions o LiCcnaa Law co the
o O following reason.permit
t 7(n 1.5,Business and improve.
4moes Code:Any city or roomy
i which roquires a permit m coruvuc,,alcor,impmn,dcmndsh,or repair any sticture
:z< prior to its issuance.alw require ft applicant rot such permit to file.signed summcnt
than W is licensed pursuant to tic Provisions ofthe Contractor's Lictie Law(Chapter 9 Sq.Ft. Floor Area Valuation
Ii- (commencing wish Section 7000)of Division 3 of the Businessland Professions Cock)or $18115
Wt he u exempt thcmfmm and the basis for the alleged eamnption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not mom Nan Rn hundred dollen(5500).
❑1.as owrcj of she property,or my employee with wage as their sok compensation,
will do the work.and me struatum is nat ntended at airmail for sak(Sec.Tilde.that ... Required Inspections
and Professions Code:The Contractor's License Law doe trot apply to an owner of q P
Property
who builds a improves thereon,and who does such work himselfor mmugh his
awn emplaycea,provided that such improvements are not intended or offered for sales IL
however,the Wilding or improvement is sold within one year of completion,me owner-
Wilder will have the hod.of pining that he did nor WiW or improve for purpose of
sale.).
E)1,as owner of the property,am exclusively contracting with licensed contractors to
consumer the pm)en(Sec.7814.Business and Pmfese Cade:)The Committees U.
cense law doss not apply he an owner of property who builds or improves marcors,and.
who contracts for such projects with a conuamar(s)licensed pursuant to the Contranoes
License law.
❑Lamaemptunder Sec ,B&PCforusiamaaan
Owner Date
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following dccsstiae:
I ban and will maintain a CamOces of Consent ke self-imum for WorkcesCooper.
Much,a provided for by Section 37W of the Labor Code.for die performance of tW
work for which this permit is humid.
ALI have and will maintain Worker's Compensation Insurance,as mquimd by Sccum
37W of she label Cade,for me pm(orrum.of die work,for which this permit is issued.
My Worker's Compensation Wormer canner and Policy number
Came,,"�AftT/. policy No.: (aa
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Ms seeuon xcd nmhecomplecd if do Permit Is for.nundmddollas(S100)
or less.)
I cenifv roes in die Performance of the work for which this Permit is issued.)shall not
employ any person in any manner sou m Miomc subject to the Workers Compensation
Laws of California.Das
Applicant
NOTICE TO APPLICANT:If,after making d s Certificate of Exemption,you should
become,subject in the Worker's Compensation provisions of the Labor Cade,you mum
.J O forthwith comply with such provisions or ms permit shall W deemed revoked.
z N CONSTRUCTION LENDING AGENCY
Pl hereby affirm mat rocs is s cmuwctinn kndingagcnry for the Md...of
CL > the work ret whim this permit is issued(Sea 3097,Civ.C.)
W Lender's Name
Dz Lender's Address
V Q 1 ccmfy mat 1 have read dill application and sum mat the above information is
I, (^^ corect.I gree to comply with all city and county ordinances and sum laws misting to
U Wilding construction,and hereby amthmivr represenutives of this city to emir Mors the
res
move.mentioned pmpcne farimpcNon which s.
(We)agree to save,indemnify and keep bare less me City of Cupenino agamst
vF-s Z inciosectuame ens,cmum,and expenses which may in any way accmc against said City
(„),'Z A ePLICANTt of me granting S A permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGUj/ITIONs.
Re-roofs
Signature of ApplianUComracmr DaT
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant.,future Wilding occupant more mrhandlc harallous maurial
as dcfmcd by t e Cupertino Municipal Code.Comer 9.13,and the Health and Safety
Cale,Section 355324)?
❑Yes ANO All roofs shall be inspected prior to any roofing material being installed.
Will the a kare,or future building are,ant use to If a roof is installed without first obtainingan inspection,I agree to remove
Ire d P 9 pmrnt or loss...which P g
..it havardoes air canuminanu u defined by the Bay Area Air Quality Managcount all new materials for inspection.
ITstria7 P
❑Yes ;jLNu
1 have mal the kvaNuus materialsmquirernenu underChmser6.95 orthc Califor.
ms Health&SurayCade,Savour 25505,25533 and 25534.1 understand matifuc Wilding
doe not contend have a corn.that it is my respensihiiny to history the occupant or the
require wIn.chmu be nit pdormissuance ofa Ccrtifstau of Occup tr.. Signature of Applicant s.(0
OEMg��/a
Owner Or ammarued agent i pare All roof coverings to be Class "B"or better
CITY OF CUPERTINO
1 of 10 PERMIT RECEIPT OPERATOR: imyw
Om COPY #
Sec : Twp: Rng: Sub: Blk: Lot :
APN 32609056 . 00
DATE ISSUED. . . . . . . : 09/21/2006
RECEIPT # ... . . . . . . . 36144
REFERENCE ID # . . . : 06090161
SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 36
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . :PROMETHEUS/VILLA SERRA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : MARK DUBOIS
CONTRACTOR . . . . . . . : DUBOIS, MARK LIC # 20514
COMPANY DUBOIS ROOFING INC
ADDRESS . . . . . . . . . . : 99 DUARTE AVE
CITY/STATE/ZIP . . . : FREMONT, CA 94536
TELEPHONE . . . . . . . . : (510) 793-9760
SE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -------- -- ----- ----- -- -------- ----------
BPERMFEE VALUATION 19, 000 . 00 266 . 76 0 . 00 266 . 76 0 . 00
BSEISMICRE VALUATION 19, 000 . 00 1 . 90 0 . 00 1 . 90 0 . 00
---------- ------ ---- -- -------- ----------
TOTAL PERMIT 268 . 66 0 . 00 268 . 66 0 . 00
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
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
Building Department
JOB ADDRESS: S PERMIT #
01,v�OI LG I — 0(ol7q 0
OWNER'S NAME:VrtmetheU& PHONE # AM-257- 1 0(60
GENERAL CONTRACTOR UUtQS FAX # 510-7 5—
6
I am not using any subcontractors: 2/
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
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
i Oz
Owner/Contractor Signature Date
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: Tro,-11,�' V, 1(c,
Job Site Address: Zo SOD i ow��STea a� R 0 f C. P_n.r ";0 $)dgs —39
Roofing Company Name: ���� S Cis o � jt lt3 C_
Applicant's Signature: Date: /6
Greg Casteel /
Building Official
Revised 11/2/04
sLYNG
I ( Iiti;r � ,,
I T °,
• I ` MI 1.'1xt �ti 11^<lj'41 I� Y >},J ® ��:
y( Iii w F f l
I tp
< L
I '
I
relk
CA T
IM
�---- 's r w
J W LJ Cly
J
lbi
jf my tl nn lair � r l I _
m a I
ur� l �i
'� Iienlll'Ir'Y tUjSw�fy��lgl ' :. I �.f it `'i
a71
` `til
/jlr y , ;, t
//
J l
F a4
N ' -
�f }�.i J .1a Id�' I� �'] L�� L_I L_I _,, rl � J!! Y '^_ ..��'•,��" _^ /-`_Y
rl__L �•(�" 1 �'e S> IJ, ul re�:�( P' JI l'Y`7 A J (r _
p]
1 —T�.-....I I l�^{,, l�5�i it ¢"�I hi I II'�t6 �Ii11'�r is 41Yt Li'`'J 'r, i— JI r�y{l�j • I L.! .� ..
.[ alltl it Pi elrpi 111 sllllll lYl��itlt tl(I rtl SI' a D 1-
�Il
11[I 0#,t yu.
jaiIJ1#I
SS L1
Al
1�! �—`�w rt4.. ,a.✓-'" 11�it'1 I ,/ 13� o� (_ V'S'1 l I "J
J I 1 I� lrty�4 w nll"hr.,,+lief
�F I!`rli'Iliat
r#'iIT;•tr; 11l'!li , 11��11 I't�JJ,tf!MLl7' l�ollINJev''rim rJr}�n 1f r1iT41y+s9Y71"�ryTTi i tJ!hIfdl l+itI9r.Jt')ytkix"k6;1}q!TSI+J�tLi+.ErL+1S1J 4Nw,17I1,'R cb IlIe',A�
u
{1
I; G3,!'h11}IIV4
•/��t IIIc
l hullU 'jl�r nPV';1 I ly Il Ir ✓ '1 y [ LII mi ')� t f�
�r {'�
::•� � W L 'I v� r ,`1 'Illri s7� 1{ Y �i^A'Q " ' !�. ,
�—
rt.-1�� �Fri.
jM
VIP
i
ISN
I x:11 •� � .4' I 1 Y ��
-
,bs
N d 1111 H 'd 04
CITY OF CUPERTINO
fUVA- REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# 5221 x-09--051 Date: � � I o lV
^
n ma.,
Building Address: OW t_b ffe'S
Owner's Name: OYY1 ����J�/ U,I in 9E!yrV, Phone_n r-1—
Contractor: V A�•IS, Po� knc License#:0 112
X04
Contact: , A�vr,1i .y� Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof D Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
O �ood Shingles El Wood Shingles
Sr' Other(Specify) NeW (y lyl-IM3 5a,"'Other(Specify) �VG7 IVIV �. �t C!►�
Number of existing coverings D Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
Residential Commercial ❑ rJ Yl , 0,1Q
Fire Zone: Yes ❑ No B-' 7017Sl-7L+ Confu-med with Planning Det. if P
there are any restrictions: LJ
Cost of Project tg I'1 Type of Construction: Occupancy grou
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