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06090164 CITY OF CUPERTINO 77 -BUILDING DIVISION PERMIT C®NxTRAGTCIR INFORMAT,101V �'- BUILDINCADDRESS: DUBOIS ROOFING INC PERMIT NO.06090164 20800 HOMESTEAD RD 1 OWNER'S NAME: PERMIT ISSUE DATE PROMETHEUS/VILLA SERRA 99 DUARTE AVE 09/21/2006 NE: SANITARY NO. CONTROL NO. (510) 793-9760 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECTPLUMB MECH 0 0 0 0 loo LICENSED CONTRACTOR'S DECLARATION Ib Description i I hereby amm that 1 am biennsedm ukmm r provisions of Chapter 9(coeOlP ncing who Section 70f1U)of Division 3 of the Business and Professions Code.and my license is Inrmllfore=andercmV tog $tZ30Af REROOF- TEAR OFF FLASHING, (N) 30YR DIMEN. COMP `m"" na OVER (E) 1 LAYER (N) RIDGEVENT, GUTTERS & DOWNSPO p Da¢ Convenor SW ARCHITECTS DECLARATION iyI uncorks d my plans shall hbli e used as puc records CLASS A. CARPORTS 28, 29 , 30 TEAR OFF SHK, (N) CO >to 6 o Licensed Pmfessimnal OWNER-BUILDER DECLARATION E I hereby affirm that I am exempt from the Canwno/s Licence Law for Ne O O following mason.(Section 1131.5,Business and Pmfcstions Calc:Any city or county 5: which requires a permit to consumer,alcor,improv,demo sh,or repair any structure Z< prior It,its issuance.also requires the applicant for such X miuo Bk a signed stammcm ` Nat he m licensed positions 10 the provisions of the Contncmr's bars¢law(Chapues 9 Sq.Ft.Floor Area Valuation�$ (commencing with Section 70107 of Division 3mf the Business and Professions Code)., — that he u exempt therefrom and the basis for the alleged exemption.My violation of $18115 Section 7031.5 by Wry applicarn fora permit subjects the applicant la a civil penalty of APN Number Occupancy Type not more than five hundred dnllWs(SSW). ❑I,as owner of Uma Property,or my employees with wages as threw sok cmmpewdon, will do the work and Neswctom u not intended a mRerW for sale(Sec.7011.Bushooks 32699056 . 68 and Profession Code:The Contactors License Law don WE apply in an ower or Required Inspections propeny who builds or im proves theno n,and who does such wmk homelier Uvough his two employee.provided that such improvements art not intended moffend persuade.IL however,the building or improvement is sold within cote year mf mmpletitn,the owner. builder will haw the buNm of proving that he did cot build or improve for purpose of sale.). ❑1,as owner of the property.am exeloobody conuaetmg with licensed mmrvemrs to - construct the project(Sec.701x.Business W Rofesdors Code:)The Cmtafmr'3 Li. E..Law don not apply It,an owner of properly who builds or hnpmvn theremt,and. who contracts for such pmjecm with a conuacmr(t)licensed pursuant m the Convector's Lic=nm law. ❑1 am exempt under Sec. ,B&P C for this reason Owner Dau WORKER'S COMPENSATION DECLARATION 1 hereby affirm under pmaty of perjury one of the following dmlarWiens: I ham and will maintain aCerEdleu of Consent to self-insme for Wofker'sCompcn- miles,is provided for by Section 37M of to,labor Code.for the performance of the .w-ork'f�or which this permit is Issued.t•<V.rww and will maintain Workers Compensation hvunna,as required by Section 3700.f the labor Code,for the si fmmmce of the work for which this permit is issad. My Worker's Cornhus&donyrSumnc9 carticrrod Policy be am: Cartier._J�4'�{LPu•�1•/Il Policy Nm.: Ov CERTIFICATE OF EXEMP ION FROM WORXERS' COMPENSATION INSURANCE . Qhs section need not k completed if the permit Is furan,hundred dollars($100) or less.) 11-mfy that in the perfmmmee of the work for which this Permit Is issued.1 muds not employ any person in any.1 so is W become subject to the Workeri Compewtion laws of California.Dau Applicant NOTICE TO APPLICANT:If,after making this Ccnificas of Exemption,you should become subject In du Worker's Compceadmn provisions of the labor Code.you most ,,. O forthwith comply with such provisions of this permit shall be deterred o vnked. z h CONSTRUCTION LENDING AGENCY Pl hereby alEfm that Nen u a conswninn lending agency for the performance of ce 7 Rs work fur which this permit is issued(Sec.3097.Civ.C.) r,7 lenders Name a z lenders Address V C) I cenify that I have read this application W sum that the above information is CI.P correct.l agree to comply with all city and county ordinances and sum laws relating m OU building cmnsuucuoq and hereby authorize eprxmWives of this city to enter upon the rive ction tea a.bilid mentioned nrs.cl fond cxco=purposes. (We)agree m saw,inicmni fy and keep harmless We City of Cupertino against Hfn Mobilitiesuence f the flooding=xpenvsmit. may in my way aecroc against said City („)z in consequence of the Enmin6 of this Permit. ^ APPLICANT UN ERSTANDS AND WILL COMPLY WITH AL ON- INT Issued by: Date SOU Re-roofs Smgnazuroof ApplianUConuano 7 Das HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will ds applicsm ter furore building efcupanliame or handle hmardous material defined by the Cultures,Municipal Code.Chapter 9.12.and the Heahh W Safety cak,sxss3x(,)7 ❑Ye A. se roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant uta equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove as iemit horardous air connminanu as defined by the Bay Area Air Quality Management all new materials for inspection. Disvict7 Oyer ALN. Ihave read!thehantec ma505,25505,25533 and Chante East if the Glding '•-_1r"%_ L �//U!7 nias nolth&Safety Code,Sectio,00r it xmyoandx5531.1 as no-mnd thmifthe building 0 Jars not currently have a mnanL that it u my nspmeihilitY w nouly Uta mcupant fir e requirements which m ale r prinrmis:mancenra cmfifWmer Ocfnp Signature of Applicant Date Owner or amthorimdagent m All roof coverings to be Class "B"or better Y ' CITY OF CUPERTINO 4 of 10 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609056 . 00 DATE ISSUED . . . . . . . : 09/21/2006 RECEIPT # . . . . . . . . . : 36144 REFERENCE ID # . . . : 06090164 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 15 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 SEE 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 r 10300 Torre Avenue -✓" Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: $ PERMIT # ote1 OILQI — OtoC'J�1QZQC OWNER'S NAME: PHONE # 4M-2r1— X0(00 GENERAL CONTRACTOR: S FAX # 510— 3- 1 I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 61 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 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 "1.997 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$176.18. The re-inspection fee must be paid before another inspection can be scheduled IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: V, S¢!/'-, Job Site Address: 20 800 l-{-o wee S-rs-L t 20 � C, pyn t ,�o Sickj' , 1,—39 Roofing Company Name: 1��o S tLcso �.-+�� Its Applicant's Signature: Date: • Greg Casteel Building Official Revised 11/2/04 CITE' OF CUPERTINO Old MV04 CS- REROOF cny or • CUPERTINO PERMIT APPLICATION FORM APN# 3s p-OQ_O�u Date: c 1 12-01 VJ oI ^ Building Address: Owner's Name: nr ob rfE e 1rW, 'T'Vl / lff fit. C I(1Phone _6 0c) Contractor: V Ab0`1S, V- � En License#:01��4 Contact: s A�t/r,1' ��{')� 1510-_11�'`1_g1�.ya Cupertino Business License #: .'7 11'1 f�lJ✓� Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ;fWood Shingles :3 Wood Shingles t,�,,{ Other(specify) New�fledy?5 �Other(Specify) �'VG1' l�sl Number of existing coverings ❑ Provide I.C.B.O.Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: I s P 0V(y_e 4St1 � 0 VerSf. 1 Residential Commercial ❑ O Yl , neW Fire Zone: Yes ❑ No p—" 2 12cl 30 Confirmed with Planning P Dept. if there are any restrictions: LJ Cost of Project: I$ ' C Type of Constiuctjon: Occupancy gro 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 •