06090165 CITY OF CUPERTINO
BUILDING DIVISION PERMIT �kCON'TRAGTORANFOBMAT"ION
BUILDING ADDRESS: D=S ROOFING INC PERMIT No.06090165
20800 HOMESTEAD RD # 20
OWNER'S NAME: PERMIT ISSUE DATE
PROMETHEUS/VILLA SERRA 99 DUARTE AVE 09 21 2006
NE:
SANITARY NO. CONTROL NO.
(510) 793-9760
ARCHI'fECfR:NGINEER:
BUILDING PERMIT INFO
BLDGEIECI PLUMB MECH
0 0 0 0
±op LICENSED CONTRACTOR'S DECLARATION
a 1MnbyafRrmthe lAnd licemed Maker provisions ofChaper9(commencing Job Description
'i- with S"cuonaulefOfDivision 3afthe Business And ProfeuiortsDede.iMmYlxcnml] REROOF- TEAR OFF FLASHING, (N) 30YR DIMEN. COMP
?�H in full forte and effca �t Z 4 W
Lice An Clu� Cooractor •T+_a OVER (E) 1 LAYER (N) RIDGEVENT, GUTTERS & DOWNSPO
r o Da
W �. ARCHITECTS DECLARATION CLASS A. CARPORTS 3940, 41 41 TEAR OFF SHK (N) CO
1 undersand my plans shall he used u public rtCar& r f
Tau
I, Licensed PmfesU0na1
} fr DECLARATION
1 Mnhy Affirm the I am exempt from
the ContractorsAc Law far the
00 following reason.(Section]fD1.5,Business and Pmfestlu oCade::Any ny dry Or county
i 3 which requires a Permit to construct,alar.improve,dem0luh,nr repair any structure
z< prior m its issuances also mquims IM applicant forsmh permit to nle a sigoo l uee.cnt
mat he is licensed purmamn,the provisions of the Conlraomr'a Umnse Law(Chaper9 Sq.Ft. Floor Area Valuation
u $ (commencing with Section 7M)ofDivision 3ofthe Business And PrefessionsCo1c)or $18115
s that he u Author therefrom and the buts for me alleged exemption.Any violation of
Section 7031.5 by any applicant(Or a permit subjects the applicant 10 a civil per.ty of ane APN Number Occupancy Type
not momthasJimhundreddollars(s50o). P Y YP
0 1,u owner of me pmpmy,or my uoployco with wages w IMk ma campewdon,
will do the work and thesvuctum ism,intended or offered Imu a(Sec.7014,Busious
And Professions Cade:The Cantrsevora License Law dues Out apply As an Owner of Required Inspections
preany wM buddsorimproes themon,and who dwauchworkhimselfor through his
ownemplayces,provided that such improvements art mthosseded.offend(Or sale.If. -
Mumma,the building or improvement is sold within one year a(mmpleuon,the owner-
builder will have IM I uNm of proving Wt M did sot build ar improve for purpose of
sak.).
❑1.as Owner of the pmpeny,am eaemsivcly contracting with licensed mnuxmn in
construct the pmjca(See.7004,Business and Professions Cade:)The Contractor's Li-
ceve law docs sot apply An an owner of property who builds or improv Merton,And
who contracts for such pmjects with a eonuacarp)licensed pursuant a me Convenor'.
Lkc.Law.
['1I amexemPtunder See ,B&PCfwthismamn
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby efrmunder pe (Y of perjury om o(the following daWa =
1h.mand will maimain a Cm rleswof Cementaself-insurefosWabdsCompcn-
mtion,, provided fpr by is
name 3]00 of IM labor Code,far the performantt of the
,w�oLrk..for which this Permit u issued.
Ip-nave and will maimain Workers Compensation Insurance,u required by Section
3700 of the Labor Code,for the Performance Otte work forwhieh this permit is Issued.
My Workers Comauation lesu/p'ntt caryRer end Policy nu/sober art:
Cartier. 5g /4��2 pZ Palic,No, bW9&
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu ac n.need.1 M cmnplead if the permit is rota.hundred dollars(5100)
.Ica)
I certify that in the perfomtance of use work for which this permit is issued.I shall nes
employ any person in any mans m as in Mame subject in the Wm keri Compauation
Laws of California.Dab
Applicant
NOTICE TO APPLICANT:If,ofar making this Ccniricam of Exemption,you should
become subject to the Warrens Compensation previsions of LM Labor Code,you muss
.JO forthwith comply with such roviriam or this Permit shall M duemed mmkcd.
z'y CONSTRUCTION LENDING AGENCY
(•+ IMreby affirm Wl there is a cpmuucunn lending agency for the Performance of
ai the work for which tis Permit u issued(Sec.3097,Civ.C.)
Lenders Name
z Lenders Address
U Q 1 certify that I harem read this application and sate that the above information u -
ly F" corms.1 agree to comply with all city and county ordinances and Sam laws relating m
�U building construction,and hereby authorize represemativa of this city to enter upon the
W ahovcmcmiuncdpmpertyst andex cnies which ms.
0. (We)agree m save,indemnify and keep harmless the City of Cupertino against
liebilitiu.judgmcnts,costs and expenses which may in any way accrue agaiui mid City
of do,
U z APPIL.ICANTeUNDERSTANDS Athis
ND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE RF17�.AnONs.
�&W
Re-roofs
Signature of AphearuXonchAw Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appucant.faun buildinge.Chaptr9.1or andMle Health ameatiest
as defined io 0e Cupertino Municipal Codc.Chapter 9.11.and tM Halm sad safety
Code.Schon 15533(.)?
t]Yu (]dao All roofs shall be inspected prior to any roofing material being installed.
41 Will the applicant or Tuan building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazudnus air conuminants As dcfired by Ne Bay Area Air Quality Management all new materials for inspection.
Dinrict7 P
❑Yes .deb,
I ham read the haraNau materials requiremmts under Chapter 6.95 ofthe Califor-
niaHeslth&Safcty Cadc,Sccd.s 305,25533and25534.1undcrswdmaiNM building �J
does sot cunendY hart:a tenant,the it u my respOmihility m notify the occupant of
ngairementswnienm MyfoormissuaruxafaCcnmcacorOce, Signature of Applicant D e
Owner or authorized agent Da . All roof coverings to be Class"B"or better
CITY OF CUPERTINO
5 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 # . . . : 06090165
SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 20'
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
IWE 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
t 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
UPEkTINO
Building Department
JOB ADDRESS: S " PERMIT #
ote1 01 LO I - OW(l R0
OWNER'S NAME:PmmeMew& PHONE #AM-Z5-7— 10(00
GENERAL CONTRACTOR: Txkba S FAX # S O—'T 3-
5t
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
s1 ' 2� 6G
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 pernut 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: �fb�e'I�e�s v, t(c,
Job Site Address: LU Soo 4o"�, S-re-o-ot 20 C„pytr,, o .71739
Roofing Company Name: S r cso I •v rte! 7 tj
Applicant's Signature: Date:_Wo�_
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# 3-Z�0q_Or�;)LO Date: 20 I o V/
^
Building Address: 2.0vow tin )eL1( f S P--d 4' z
Owner's Name: /V1. 1,0Phon40N" 2,61— 101VO
Contractor: E1 A IU0°IS Poofi m Inc. Liccnsc#:01,2-304
'v
Contact: s nCY_tL � �•` �po_,I _��� Cupertino Business License #:
1 f il)
12-0;514-
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles [y (+ y� ❑ Wood Shingles 't,,,�
9� Other(Specify) N T�QJ�•lt {,It E✓Other(Specify) wbel ION S1Me rW�
Number of existing coverings `J ❑ Provide I.C.B.O. Report# 1
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read,Understand and Will Comply With Cupertino', Tear Off Policy:
Job Description: P
Residential Commercial ❑ c y-) j,0\ 'LI A
Fire Zone: Yes ❑ No 8�— ILkD,q Confirmed with Planning Dept. if p
there are any restrictions: LJ
Cost of Project: y , 5 Type of Construction: Occupancy gou
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISNE RE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING