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06090176 CITY OF CUPERTINO BUILDING DIVISION PERMIT CO 1,10ORMAT10....N _ BUILDING ADDRESS; DU ROOFING INC PERMIT No.06090176 20800 HOMESTEAD RD # 3 OWNER'S NAME: PERMIT ISSUE DATE PROMETHEUS/VILLA SERR.A 99 DUARTE AVE 09/21/2006 E: SANITARY NO. CONTROL NO. (510) 793-9760 ARCHITECTAENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH lamp LICENSED CONTRACTOR'S DECLARATION p E I facreby affirm Oat I am licaused under provismas OfCWpm 9(Commencing Job Description REROOF- TEAR OFF FLASHING, (N) 30YR DIMEN. COMP L' xaCI I with Scction]Of,U)O(Division 3af the Business and Professions Code,and mylice"•"isb a Dam Convector --Jpu`z�z OVER (E) l LAYER WRIDGEVENT, GUTTERS & DOWNSPO 94- — CLASS A. CARPORTS 02 , 03 , 04 T/O OFF SHK, (N) COM I—ARCHITECTS DECLARATION I y plans shall W used as public meards Luxxoned Pronaficaut OWNER-BUILDER DECLARATION I hereby affirm We[I am examin from We Convector's License Law for the :aC following wascon.(Section 7031.5,Business and Professions Cos Any city Of county <29 which mqui=a formil to construct.allar,improve,demolish.fie my structure prior to its issuance.also requires the 1PPImx1n for such Perron to file a signed sallement Sq.Ft. Floor Area Valuation that he is lic.round pursuant to We provisions of We Contractor's License Law(Chapter 9 al-M (commencing with Section 7000)of Division 3 of We Business and I'milessimes Code)or Nat he is exempt therefrom and We basis for the alleged exemption.My violation of $13371 Section 7031.5 by any applicant for a permit subject,We applicant to a civil Penalty of APN Number Occupancy Type an,...0an five hundred dollars(5500). 0 1,as owner of Ne property,or my employers with weglas as Wait sole compensation, will do da..00ksoul themactow is tontiourabod.r.ffered fmxam(Sx.7W.Bashw.x and Prefesomm Code:The Commuctor's License Law down Out apply W in Owner of Required Inspections property who Wilds or improves theresn,and who docs such work himself or through his Own employees,provided Oat such improvements are not mutual at offered for We.It. however,We Wilding or improvement is sold within one year of completion,the owner, builder will have We hatchem of proving Oat he did not Wild or improve for purpose of sad.). E]1,as Owner of We Properly,am exclusively contranning with licensed contractors to construct On project(Sec.7044,Business and Professions Code:)The Curnmences Li- come Law dons not apply to an Owner of property who Wilds or improves theater,and, who contract,for such irmptats with a comereacter(s)licensed pursuant to We Connector's License Law. r'l 1 am exempt under Sex. B&P C far thirs random Own er Dam pWORKERS COMPENSATION DECLARATION I Mouthy affirm under penally of perjury am of me,following declarations: I have and will maintain a Courfifunce of Consent W self-insum for Workees Compen. canon,an provided for by Section 37M of don,Labor Code.for We Performance of We work for which this pe mit is issued. .2n have and will maintain Worker's Compensation Insurance.0 required by Section 11 3700 Of We Labor Coda,for We Performance of We work,for which this permit is issued. My Worion's Comparom Insurance farrier and Policy no Cartier. Poll,Na.: ly CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Croix acels.needmol W completed lithe parrok is We.hundred d.11.(SIM) less.) I camily Oat in We performance of We work for which this Permit is ismaxi.I shall not employ anypersons in any manner so u to become subject to the,Workers Compensation Laws of C.1iforma.Dow Applicant NOTICE TO APPLICANT.If.Offer making this Cemlican,of Exemption.you should tXstmon Subject to the Worlocu's Compensation pmvisions of We Lfb.Code,you most PrOwalt comply with well provisions of this Permit shall to deemed revoked. LZ.'0 E�5 CONSTRUCTION LENDING AGENCY I hereby affirm that Were is a construction heading agency for We performance or On walk I.,which Win permit is issued(So..3091.Co.Q Lumm"s Narm z lender's Address, U 0 1 certify that,I have load dos application and tome then Of above ittfaren.forn is I, correct.)agree to comply with all city and county ordinances and state laws oclating to 0 building construction,and hereby authorim mPTcSentahwS of this city to enter upon the above mentioned property for inspection purposms. 6. (We)agree to save,indemnity and keep harmless We Cay Of Cupertino adzzf Liabilid",judgments.costs and expenscat which may in any way areeme against am City U Z in consequence of the gaming of this permit. APPLICANT UNDERSTAND�AND WILL COMPLY WITH ALL �ONJOII Issued by: SOURCEREG Date Re-roofs Sagarmure ol'Applicand/Commewr /Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Of applicant or fretum official;Occupant store or handle hateardous romenal as defined by the Cupenino Municipal Code.Chapter 9.12.and We Health and Safety Code,Section 25532(a), All roofs shall be inspected prior to any roofing material being installed. El You 40 Will We applicant or future building Weapons use equipment of devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hazardous air contaminants M defined by the Bay Am Air Quality Management all new materials for inspection. District? 0y. ON. I heve fund the Wxardmax materials mcf.immema archer Chapter 6.95 of We Culirca. nia Heal"SuRty Cade,Sccuoax 25505.25533 and 25534,I understand Out ifOc Wilding Ones not currently haw a tenam,Ou it is my res"nobility to notify We occupant of We mquimmen h tWmmpmnrtaisxumccof2CcmficamofOcancy. Signature of Applicant Date Owner or autharit,cd agen. /be. All roof coverings to be Class "B"or better CITY OF CUPERTINO �m 6 of 10 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 32609056 . 00 DATE ISSUED. . . . . . . : 09/21/2006 RECEIPT # . . . . . . . . . 36145 REFERENCE ID # . . . : 06090176 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 3 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 SEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -- ------ ---------- ---------- --- ------- BPERMFEE VALUATION 14 , 000 . 00 212 . 76 0 . 00 212 . 76 0 . 00 BSEISMICRE VALUATION 14 , 000 . 00 1 . 40 0 . 00 1 . 40 0 . 00 ---------- ------- --- ---------- --- - - --- -- TOTAL PERMIT 214 . 16 0 . 00 214 . 16 0 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION 305 FRAME FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS • Community Development isJ 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPERTINO Building Department JOB ADDRESS: $ PERMIT # Otgl Ol LG I - OIO QZOC OWNER'S NAME: PHONE # 4M-25-7- 0(oO GENERAL CONTRACTOR: S FAX # rj O— 3- 1 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 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: 7r,-It", / V, IL Sa fY� Job Site Address: 2_050P 20 C„p� T w o 81 5' 39 Roofing Company Name: (2.0 S cso its C Applicant's Signature: `' �— Date: 7� . Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINOREROOF Z11yo • CUPERTINO PERMIT APPLICATION FORM APN# 132Cp-09_QDLO Date: 1201 oIV! F Building Address: t1 - S Owner's Name: f 0' F f p 1 0 5. -��C� �Phon�I#R�� Contractor: 6' A F` tis �� k f�� License#:011-304 11-3 `4 Contact: s A�t/rlk- � 'S 5IO'-1i4-q�pq Cupertino Business License #: 1.2514- Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ ood Shingles [y `,� ❑ Wood Shingles /�,`,,,� ,,�,,!^ ,,.,�^� B Other(Specify) NeW flO 03 E✓Other(Specify) Dy IN SI` o/ e 1 (c}_ 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: CA1 P 17VE'�Q��C�Sh Cl \el t'. YEN Residential Commercial ❑ (� 1(lj, Ci a A Fire Zone: Yes ❑ No 0--' 21314 Confirmed with Planning,Dot. if P there are any restrictions: LJ Cost of Project: I Type of Construction: Occupancy grow : 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