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06090170 CITY OF CUPERTINO `'' - BUILOING'DIVISION PERMIT n4CL1NTRACT()R INFORMATION BUILDING ADDRESS: DUBOIS ROOFING INC '.ivu.rID.06090170 20800 HOMESTEAD RD # 8 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 ELECT PLUMB MECH O O l� 0 oo LICENSED CONIRACOR'S DECLARATION Job Description i u E 1 Mmby affirm Nn I am licensed under provisions of Chapter 9(commencing '�a infuls fomeand f(ecof DivisianJof NC Business and professions Code.and mylicense k REROOF- TEAR OFF FLASHING, (N) 30YR DIMEN. COMP _ Li<eue sore C39 Vc,a $ IZ. 30a"/ ego Dam 4 n e nL eonvaemr /`r OVER (E) 1 LAYER (N) RIDGEVENT, GUTTERS & DOWNSPO 4 .T-'r� ARCHITECTS DECLARATION CLASS A. CARPORTS 11, 12 , 15 T/O OFF SHK, (N) COM i a 6 1 understand my plain shall he used u public records 1yV a Licensed Pmfcssionel OWNER-BUILDER DECLARATION iI I hereby alTirm diol I am exempt form the Contractors License Isw for the O o following retion.(Section 11131.5,Business and Professions Calc:Any city or county <§ff which requires a permit to cnnswct,alter i ni mve,dcmolLah..r repair any met.. priorm itshwanc4alsorequims 0m applicant fmsueh permit o file a signed smcmint < tat Misli<emcd prowintto doe provisions of use Conuacmri liecue law(Chapmr 9 Sq.Ft.Floor Area Valuation (comm endngwith Secdon70DO)of Diviion3ofl Business and Profmiom Code)or $14306 Nat Me exempt therefrom and the bus for the alleged exemption.Any violation of Section 1031.5 by any applicxn,for a permit subjccu the applicant to a civil penalty of APN Number Occupancy Type not mart Nan five hundred dollar(5500). I,u owner of die propmy,ar my employm with wages u the'v ink campcuauan; 32609056 . 90 will do the wort and the squctule is nesintended w OBerrE formic(STs.TOU,Business and Profession Code:TM Comncmes License Law does rot apply It an owner of Required Inspections property who huildsorimpmvu thereon,and who dnessuch work himselfor through his Ownemployees,provided that such improvements are not inmMed artificial foraale.If. boweva,Ne Wilding or improvement is mid within one year of completion.the owmer. builder will have the WrAcn of purring that M did ret Wild or improve for purpose Of mk.l. 1,as Owner of the property,not udmivdy contracting with licensed mmractim to construct Ne pmject(Sed.7044,Business and Pfofessions Code:)TM Commences U. cove Law does rat apply was owner of propmy who Wilds Or improves thereon,and whn<rnmN sur inch pro1eN wit aeOmlYlor(s)licensed puflllam W IM contractors License La ❑ I am exempt under See .B&P C far this recon Owner Data WORKER'S COMPENSATION DECLARATION I hereby afRtm under family of pidury one of the following declemdans: 1 have and will maintain aCcruGate of Consent in selfAmum for Workers Campen- Winn,an provided for by Scetion 3700 of the Labor Cod,for the performance of than work for whim this permit is issued. 1 bare and will maintain Workers Compensation Insurance.u required by Semon 3 of the Labor Code,for to performance Of the work for which thi permit is issued. ' MyWork,e.CompensaO_ti.O^Insurance canie,mal Policy numrpe�ry�g; �a�4y ©� Cartier.�?%CETT Polity N.s CERTIFFlSCCAATEOF NINN FROM W WORKERS' COMPENSATIOSArION INSURANCE (Thi secure need not W completed if the permit is for mm hundred dollars($1010 Icss.) 1 certify Nat in the performance of lM work for which this permit is issued.I shall am employ any person in any answer so as m become subject to the Workers Compensation Laws of California.Dale Applicant NOTICE TO APPLICANT:If,after making this Ci niBcmc of Eacmplion,you should become subject in thc Worker's Compenudon provisiom Of the Labor Code,yon muss .,O entwith comply wit such pmvisiom or this permit shall W deemed revoked. zy CON=UCIION LENDING AGENCY [•+ I hereby affirm that there is a construction lending agency for the performance of CL> the work for whim this permit is issued(sce.3091,civ.C.) fgl Q Lentis Name Dz Lenders Address U Q 1 certify that I have orad this application and stain Nat IM above information is W correct.I agree to comply with all city and county ordinances and stale laws relating to U U building construction.and hereby amhorim representatives of this city to enter upon the � L[1 ahovc-mcmioncd pmperty for ie pcNOs purposes. LL (We)agree t.UK.indemnify and kap humlesc the City of Cupertino agaimt vUZ liacmeac,iudgmen to espemu which may inany way oscine against said City U z m consequence of Ne gmming of this permit. APPLICANT UND S NOS AND WILL COMPLY WITH ALL NON 1 Issued by: Date SOURCE /ry�7' T//� Re-roofs Sigmtum of ApplianUCtmracmr P D21 — HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applies.,.,fuwm Wilding Occupintscre or handle havardom material U defined by the Cupertino Municipal Code,charm,9.12.and the Hulth and Safety Cale,Sccuon 23532(.)? All roofs shall be inspected nor to an roofing material bei, rya �r+a P P � Y g g installed. Will the applicuum or future building occupant use cquipmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hammors air contaminants ar defined by dm Bay Area Air Quality Management all new materials for inspection. District? El Y. Jr to I have mad On hnaWImsedmnals mess emenss under Chapter 6.95of the fabler nia Health&SafctyCOdc,Sccuom 25505,25533 and 25534.1 unticrsmnd thatiflM building - does not calmly have a tenml Nm it i my responsibility m notify the axupam of the require= wfh�'� '''IM mel pnormissunna ofa Ccnifmam of Occu Date ✓"l/G--L.� Signature of Applicant ownamamhafi>.<dag<nt 7� D All roof coverings to be Class"B"or better CITY OF CUPERTINO I� 10 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 # . . . : 06090170 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 8 SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PROMETHEUS/VILLA SERRA ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : CUPERTINO, 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 WE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL -------- - - - - -------- - -- - --- - ----- -- -------- ---------- ----- ---- - ---------- BPERMFEE VALUATION 15, 000 . 00 223 . 56 0 . 00 223 . 56 0 . 00 BSEISMICRE VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00 ----- - ---- ---------- ---------- ---------- TOTAL PERMIT 225 . 06 0 . 00 225 . 06 0 . 00 METHOD OF PAYMENT AMOUNT NUMBER ---------- ------- -------- - --- -- -- ------------- - OTHER 2446 . 80 VISA TOTAL RECEIPT 244G . 80. 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 E 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 �UPEI�TINO Buildin Ike artment JOB ADDRESS: S PERMIT # owcgol (.0l — 0(00g0 OWNER'S NAME:pmmewlaus PHONE # 4hB-257- O(a0 GENERAL CONTRACTOR: $ FAX # rj O-7 3- 61 I am not using any subcontractors: 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 s� z Owner/Contractor Signature 6�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 I Prior to permit issuance,you must agree to comply with 1997 U13C 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 LC.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: �I o+�'I��s V, IL Job Site Address: Zo SOo 40"A'e— S-r e ,t 2d G,P�n T spa gJe�s' � "39 Roofing Company Name: '1DA>a'S Fcs o 1-y r 4 7�j C v Applicant's Signature: Date: • Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO ,MI REROOF • CUPEkTINO PERMIT APPLICATION FORM APN# 32j_�C) _Or:—?Lo Date: 01 1 e�)0 I ul ^ Building Address: '20000D ,y���� � + Q lV Owner's Name:�/_onor IyUIJ llf'tA1�C A E���ICA � Phon Contractor: Vm 4./o`I(5��V— ch m g )C License#f:: y Contact: , LIY_k/�)C6t S 14�_��� Cupertino Business;icense #: ,v 1 IG Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ ood Shingles (q !,� y� ❑ Wood Shingles 'f,,,� ,,�,,t,, B Other(Specify) Neal-RasI l`t Ig,� 9�Other(Specify) qy I4 S1, je rog- 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: rcrm\A& t Q 027� Sfi1 0 \knt, Residential Commercial ❑ c Yl 0,1 cat A Ing Fire Zone: Yes ElNo 8,— 11 :12-, 15 Confirmed with Planning Dept. if P there are any restrictions: L Cost of Project: J�13010 Type of Construction: Occupancy grou Qty. if Applicable Fee lD 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