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06090183 CITY OF CUPERTINO c= vswa r - x "" :'� BUILDING DIVISION PERMIT KONTRACTOR�INFORMATIONIN BUILDING ADDRESS: DUBOIS ROOFING INC PERMIT"°.06090183 20800 HOMESTEAD RD 3 OWNER'S NAME: PERMIT ISSUE DATE PROMETHEUS/VILLA SERRA 99 DUARTE AVE 09/21/2006 NE: SANITARY NO. CONTROL NO. (510) 793-9760 ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH I� t� a a LICENSED CONTRACTOR'S DECLARATION m I hereby affirm Wal I am licensed under provisions of Chapter 9(commencing Job Description :Z with Section70fty)of Division 3 ofie Bud.and Prnfusions Code.and my[it..is F`oro-e imm�fn aandefrea f2 �y REROOF- TEAR OFF SHAKES, INSTALL 7/160SB, 30YR C License iam Class �� La •moo Dam Cinumeter (N) RIDGEVENT, GUTTERS & SPOUTS . CLASS A. cxlTEcrsDEcuannods CARPORTS 69a 71a 72 TEAR OFF SHAKES, NEW COMP. 1 undersand my plans shall W used u public records )yU o Licensed d Pnsfcuiana Oat I am commit DECLARATION 1 bemhy.(Tom on I a1.eumpt(core is Cadres Co License Law for We E p o fallowing mala(Saito 7 o L5,Business and Pmfectiu i Cade:Any city or manly 3: which require¢a.,a],t re construct.Oben impmsu h per demolish.fi repair any vmnum -ate pd., its icomed p,alsumto ave tWvisions of far Conlremiva Gkm,Lawdvammcm < that me can..w.msnm code omd¢iau artW Comrncessandvwlaw(QodWr9 Sq.Ft. Floor Area Valuation E se a that ba I, ng ,, Sectionfrom,and of the bods f r of all,.dnwand Prereon.Any i Code)or $22013 ��$ that W i camp.thue(rom and Ibe Eui far the alleged ezempuoe My violation of Section 7031.5 by airy applicant for a permit aubjecu the applicant W a civil penalty of APN Number Occupancy Type no,marc than five hundred dollars ❑1,u ower of the property,m my employees with wain u the'v sole catmawdan, will Fr Wework.and c:The Cmc i mot,License Law mi,apply Ina4,Husinw Required Inspections 08 propenand Pt,who u Cade:The Canmcmh Liana law than era apply lf an owner e. q P own em who Wild provided at mens pr slid when danoti work aroffr athrough hie owneer.OveWilding ip ingo� that men improvements ma not icm ded ofcoro@rrd far sale If. huilder.Ovetaave theorimprovemmnimid wiiinone year ofcprove fomi.r purpose Dwarf builder will love the When of.coving that M did not build or improve far purysse of sale.). ❑1,as Owner of We property,am escluively contracting with licensed contractors to mantlet the project(Sec.7044.Business and PmfC&uou Cade:)The Committees V. ccue law does nos apply W an owner of proper}what Wilds or improver thmrmn.site. what concocts for such projects with a comrutuds)Iiansed pursuant W the Conmactar's License Taw. ❑ 1 am nempt under Sec ,B&P C for dei reamen Owner Dam WORKERS COMPENSATION DECLARATION 1 hereby affirm under partially of perjury rn of the following declamo s: 1 have am will maintain a eerditcam of Consent W u1f-insure for Worker's Caman- sation.as provided far by Section 3700 of ie labor Code,for Ya performamc of We work for which this permit is issued. have and will maintain Worker's Compensation Insurance,u required by Section 37W of the laWrCade.for the performmm of the work for which this permits issuW. ' My Warkees Compensation IInnasurance�carrier and Policy number are: Carrier. STpolicy,No.: 669 t3 oaL 6 CERTIFICATE OF EXEMMON FROM WORKERS' COMPENSATION INSURANCE (Thi section acd notbecanpleu:d iftbe permit is panic huntlreddellars(SIM) or leu) 1 unify Wet in thc performance of the work for which this permit is issued,l shall not employ any person in any manner m as to became subject to WC Warkera Compcnsation laws Of California.Dom Applicant NOTICE TO APPLICANT.If,after making this Ccnificl a of Eum.tian,you should become subject W 0r'Waher']Compensation provisions of the Labor Cade,you must .,z forthwith comply with Ruch proviinu or this permit shall he deemed levelled. LZ.I O CONSTRUCTION LENDING AGENCY (•+ I hereby affirm Nal them is a consuuctinn lending agency for de perroromase or 6i thc work for which this permit is issued(Sec.3097.Civ.C.) !r3 Q Iandees Name 7 z Lender's Add. ' V 0 1 certify than 1 have lead this application am sum that the above information is ^f comet.I agree to comply with all city and county ONinances and sate laws relating W Q V Wilding construction,and hereby auWarim repmaematives Of this City 10 enter upon the W ahtvrmcmiuncd.ro.cny for impcction.ur.utts. (,y (We)agree W.ave,indems ify and kap harmless the City of Cupertino agaiom Z incoitln,judgmcnh,tossing eaperrsca which may in any way eccrnc against said City V z A PLICA 'T of the granting of this D WILL ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCERE / �1 ti Signuule of AppliaRanor DeW b Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dee applicant or(Muni Wilding e.Chapter tom or Ingle Hcardou material u de.Sce by the Cupertino Municipal Cage.Chapter 9.13.and the Nealth and Safety Code.Scotian zss3xa)? q�. All roofs shall be inspected prior to any roofing material being installed. 41 ❑Tu Will thc applicant or future Wilding Occupant use,equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove conit hvaNnm air ter am mus as defied by the Bay Arta Air Quality Management all new materials for inspection. District? ❑Yu INt 1 have mad the hvargma materials mquitommts under Chapter 6.95 of the Califon Fla Hnl"Safety Code,Sections 35505,35533 and 35534.1 undround thou ifthe Wilding does not Currently haw a mmak that it h my responsibility to noul'y dm neeup¢nt or We requiremenswhich priarWissaaac n(a Certificate of� YY. / Signature of Applicant Date Owner or auth 00; All roof coverings to be Class 'B"or better orized agent �� Dam' g CITY OF CUPERTINO �m 3 of 10 PERMIT RECEIPT OPERATOR: amyw COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 32609056 . 00 DATE ISSUED. . . . . . . : 09/21/2006 RECEIPT # • . . . . . . . . : 36146 REFERENCE ID # . . . : 06090183 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 35 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 •EE ID UNIT QUANTITY AMOUNT PD-TO-DT ' THIS REC NEW BAL - -.- --- ---- ------ - ------ ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 23 , 000 . 00 309 . 96 0 . 00 309 . 96 0 . 00 BSEISMICRE VALUATION 23 , 000 . 00 2 . 30 0 . 00 2 . 30 0 . 00 --- ----- - ---------- ---------- --- ------- TOTAL PERMIT 312 . 26 0 . 00 312 . 26 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 • MCommunity Development 10300 Torre Avenue r" Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 4YPEkTINO Building Department JOB ADDRESS: $ PERMIT # Otvt of Lei - o(DCR 0 OWNER'S NAME: PHONE # 4M-25-7- 10(0 0 GENERAL CONTRACTOR: QLktU$ FAX # S O' 3- t I anot using any subcontractors: rs: 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$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: �(o 'I�e s / V 1(4 SrZJ/� Job Site Address: Zo 800 S-rea..o't 20 C pmt w o 846W 1 ,—39 Roofing Company Name: 0�(2.0;S P,_� 1 • f C Applicant's Signature: � r—� Date: . Greg Casteel `7— Building Official Revised 11/2/04 CITY OF CUPERTINO « - REROOF • CUPERTINO PERMIT APPLICATION FORM APN# 321D— Oq"0501 Date: cl ZO ou Building Address: 20500 O 500 Homes�a�-d rj d 4- 35 Owner's Name: VLJLJ (��1 1`E�� "one 35 Owner's _ ce Contractor: License #: Contact:"Cry- C ry S vubc � S'0�1�`7'-I�� Cupertino Business License #: F- Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof � sphalt Shingles Qe Asphalt Shingles - Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Num er of existing coverings ❑ Provide I.C.B.O. Report# To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off P lic • Job Description:'I19nr S 1 , In i r � ,��Tr s 0. A Residential Commercial r�, ' Ir offr ln$tiI1 CD Fire Zone: Yes ❑ No Confirmed with Planning D_pt. if there are any restrictions: U Cost of Project: Type of Construction: Occupancy group: 02-210. - . Qty. if Applicable Fee ID Fee Description Fee Group I 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 •