06090162 CITY OF CUPERTINO +•7 msa44 '
-BUILDING DIVISION PERMIT 'tC�T1TI2t�.G'r�nRIN�'�rRMA'�IN
BUILDING ADDRESS: DU OIS ROOFING INC PERMIT N0.06090162
20800 HOMESTEAD RD # 37
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
BLDGELECT PLUMB MECH
0 0 0 0
moo LICENSED CONTRACTOR'S DECLARATION
C 1 homey affirm Nes 1 am R¢vN under provisions of Chapter 9(commencing Job Description
'�- full farce and with SoOn 70X
aroismn3nrum[n fines and erara�iav ease.anamyu«n:c is REROOF- TEAR OFF FLASHING, (N) 30YR DIMEN. COMP
Da'1
' m� in""" Cas 9 Ue.g gl2 OVER (E) 1 LAYER (N) RIDGEVENT GUTTERS & DOWNSPO
-s•o Dam
Contractor ,
CISDs"Nic TION CLASS A. CARPORTS 75 , 76 77 TEAR OFF SHK (N) CO
i o e I uMcrsund my Plans shall he teed u public rccorm r m
iau
o I'n Licensed Pnmlcssional
g OWNER-BUILDER I..mue RATION
f I hcmby nlTrm Na 1 ;. exempt faro the Contremod License taw for Nc
p o following Mason.(Section
703;.5,Business and PIORa9lnns Code:Any oily Of C"YOIy
S_ which mqume;a Permit he eostrl alter,improve.demalish,or repair any structure
prior in its issuance,Arm mquim mho applicant for such peral in Ek a signed su ement
< thin he is licensed pursuant to me provisions of the CORMOO'SLiumeLaw(Chapter 9 Sq.Ft. Floor Area Valuation
9 (commencing with Section 7000)of Division 3 oflW Businesi and Professions Cade)of $18115
ey mut the is exempt decreforre And the basis for the alleged exemption.My violation of
Sccfion 7031.5 by any applicant for permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars(5500).
0 1.As owner of the property,m my employees with wages As mer sole camparoatun,
will do the work.and the swmure is not intended or offered for sale(So..7044,Business 32699056 . 00
Required Inspections
and Pmfesslom Cade:The Committees License law doss rot apply m e an owner of 9 P
progeny who WilcismimproMethueon.and whodoessuchworit hire lfo Uvough his
own employva,provided that such improvement am not intended oroRered forsile.If,
however,Ne Wilding or enprove TMOE is sold within ore year of complcuon.the ownu-
Wader will have the tender of proving that he did not Wild ar improve for parpo,e or
sal.).
0 1,as owner of the propcny.am exclusively contracting with licensed....in
construct the projeet(Sec.7044.Bmsineas AM Rofassiau Code:)The Contaemrs V
[case Law daco not apply to an owner of property,who Wilds or Improves meROn,and
who comment for such pmjecm with a conuacmgs)licensed personas in the Contractor's
Liccve Law.
0 I am exempt under Sec ,B&P C for the mason
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm strider penalty of perjury one of the fallowing decluMov:
I have and will maintain a Certificate of Convent in self insure for workers Compen-
ution,As provided far by Section 37M of the labor Code,for the performance of he '
Wart for which this Permit IS Issued.
have and will maintain Workers Compensation Inst ..As required by Schon
1]00 of me labor Code,for he perfasmanee of the wait:for which mia permit It issued.
My Workers Compemm�On 1 m nrticr and Policy number Arm
Carric. hTC r✓f✓Q Policy No.: 669 8�0 0(�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not W comple d if the pcsmit is Were hundred dollars($1011)
ter less.)
I certify mut in me performance or be,work for which this Perris is issued,I Nall not
employ any'person many manncrso az R,become subjccuo he Waftisr Compensation
Lam of California.Dae
Applicant
NOTICE TO APPLICANT:IL a0cr making his Cenificam of Exemption,you should
become subject to the Worker's Compensation previsions of the Lahor Cram.you must
.J O foMwith comply with such provisions or mu m
permit shall he dcomed revalued.
z '•' CONSTRUCTION LENDING AGENCY
[-+� IWmby affirm mus theresea consuucdon kndingaScmy far the PcrOm.of
6i the work far which his permit u issued(Sec.307.Ci,C.)
W�Q Lender's Name `
Lenders ders Address
U 0 1 MMify that I have mad this application and sue that me above infonnadun is
D.E.. cOnOct.I Agree to comply with all city and county ordinances and sum laws relating to
0 V Wilding eonwuction.and hemby aummim mprescoutives of this city to enter upon lM
ahove-mentioned property for insPecuon purposes.
H CL (We)agree to save,indemnify and Jump harmless the City of Cupertino against
A liabilities,judgemma,cost and esp.which may in any way...agaim(said City
V Z in consequence of the gre rting of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCEg�ATIONS.
y� �— Re-roofs
Signature of ApplicanUCanmctor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will dm applicnns ar future Wilding aaupansstme or hand.lumadoas material
As defined by the Cupertino Municipal Code.Chapter 9.12,and me Health and Safety
Cade,Schon 35513(x)?
❑Yn �a All roofs shall be inspected prior to any roofing material being installed.
Will he applicant or future building Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit havardnus air cmumi=m u defined by me Bay AMA Air Quality Management all new materials for inspection.
District? ..J
OYcs 200
I have mal the hmamous mamrials mquiremenu under Chaperb.95 ofthc Califor-
niaHcalm&Smcty CaM,Sccioms 505.15533md75534.lundcnundmviflhc Wilding
dura eat euremly Wm a mane Wt it 4 my mpnmibility to entry he occupant of he T 6
regairemcnsy - mussbcmelpriarnissuance m.certifinmar np Signature of Applicant Date
912
Owner�or authorvcd a ger YDam All roof coverings to be Class"B"or better
CITY OF CUPERTINO
2 of , 10 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 32609056 . 00
DATE ISSUED. . . . . . . : 09/21/2006
RECEIPT 4 . . . . . . . . . : 36144
REFERENCE ID # . . . : 06090162
SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 37
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTIN0
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
OE 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: $ PERMIT #
0(P1 OI LQ 1 - O(0I 0
OWNER'S NAME: ewya Lk PHONE # AM-25-7— 0(60
GENERAL CONTRACTOR: S FAX # 510--7
3"
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
zz
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.
Homeowners Name: Tre K c'I�e u s / V i <<4 SRI«
Job Site Address: Zo 8p0 S-r-e _,t 20 C�pmt w o 'gJckjS' I -39
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel /
Building Official
Revised 11/2/04
CITY OF CUPERTINO (XQ(�I 010-
? - REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# 3 OQ" Date: 0, 0
I o W
^
Building Address: —,., ,s1J^ ,y. wes 9-d + 3-7
Owner's Name:171Y-0� lf-_IAS, f V f 1 in :W @( Phon - 0-1 I MO
Contractor: VLA,)®IS ,)Cfily--�c. License#: all-304 ll-304
Contact: , , � 1 S 951(0-111'`'_Ta� Cupertino BusinessLicense #:
�V1Llyy-. Type of 7Roof Covering:
Existing: Proposed:
Cl Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ ood Shingles (y y� ❑ Wood Shingles /�'`,.,,�rn 1 mck—
B' Other(specify) NL TIAS�It {,II 9e"Other(Specify) VVR' IIAV SIt G'IfG ` l.V�
Number of existing coverings ❑ 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: ywm\A&i \ 1 P
Residential Commercial O Yl , C`a }�
Fire Zone: Yes ❑ NOR-- 1 11 IO -7Confirmed with Planning t. if P
there are any restrictions: U
Cost of Project ' Q ' 5 Type of Construction: Occupancy groin_
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