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06090189 CITY OF CUPERTINO 1 io," 'A - BUILDING DIVISION PERMIT nkGONTRAGT,QRINFORMATION'�s BUILDING ADDRESS: DUBOIS ROOFING INC . PERMIT NO.06090189 20800 HOMESTEAD R OWNER'S NAME: PERMIT 65UE DATE PROMETHEUS VILLA SERRA 99 DUARTE AVE 0 NE: SANITARY NO. CONTROL NO. (510) 793-9760 ARCHITECTrENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH ja LICENSED CONTRACTOR'S DECLARATION lob Description i EI Mmby affirm that 1 am licensed under provisions of Chapin 9(commencing Nu, withSecaan](t(0)of Division 3 of NC Business and Profcssimu CoM.md my licenseis in full fomeanderrccc6 917- 61' REROOF- TEAR OFF SHAKES, INSTALL 7/160SB, 30YR C s4= LICCOY Ix.g ;moo Dale contractor (N) RIDGEVENT, GUTTERS & SPOUTS . CLASS A. ARCHREGTS DECLAF. ION i s< 1 understand my plans shall bo used as public records u.>yV G Licensed Pmfcssional �0 5 OWNER-BUILDER m the CoATION C I hereby mTimt on I I.S.ucmpt from Nc I.m.C License taw for the p O following unres a (Section 703 LBusiness and P c.dimuss d.. Any city ser aunty 129 which requima a parent re cores(Im ally,improm.h PCMit I fi repair any tar inaCm -iy prion mits issuance. ensedprsuantto ft thovisiosofcant for mchpermitro file 3 cense w(Q.mem < that WUlkcnwit pursuant Nthe of Division of Nc Canu Business Proelaw(Chopter9 Sq.Ft. Floor Area Valua$arP373 [�D that exempt erafon70W)of 0ivur for the the Business and Professions Code)or that he is exempt therefrom and the Esso for Ne alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subject the applicant to a civil penalty of pPN Number Occupancy Type not more,than fin hundred dollars($5W). 3 2 609056 . 00 0 I,as owner of the property,or my employees with wages as their sale compeuradon, will do the workand de structure is not Warded ser offered for We(Sce.'f .Business Required Inspections and Pm � feons Code:The Conuxtan License Law does t apply le an owner of q P Property who Wilds or improvesthereon.and whodoessuchworkhimself or through his own emplo cm provided Nat such improvements are notimanded aroffered for sake If. howessr.the Wilding or improvement is mid whine ane year of completion,&a owncr- builder will have the When of proving out he did not Wild or improve for purpose of sal.). 1,as owner of the property are exclusively contracting with licensed contractors a construct the project(Sec.7044.Business and Professions Code:)71.ComOnco fs U. cense Law does not apply to an owner of property who Wilds or improve Dreman.and who contacts for such Projects with a contractors)licensed pursuant to the continuities License Law. ❑lamesemptunder Sec ,B&PCfar Nisreason Owner Data WORKER'S COMPENSATION DECLARATION I hereby f.under penaly of perjury one of the following declarations: 1 ham and will maintain a Certificate of Consen to selGinsum for Work esCompen- much,as Provided for by Section 37W of the Labor Cade.far the perfmename of the work for which this Permit is issued. 41 have and will maintain Worker's Campcmatiun[am..,as required by Section 7 W of the Labor Code,for Nc performance of the work for which the Permit tissued My worlon"Co�mvPeiwa(pp:I�wran/¢esmer and Polity nu Eer Cartier. J%T r r NN•R'a Paliry Na.: a at `r CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thu section need net bo completed if Ne Permit u Caron hundred dollars($10(1) or less.) 1 certify Net in the performance of the work for which this permit u issued,I.Nall nut employ any permn in any mmnerm As a become mbjcct to the Workers'Compensation Laws of California.Gina Applicant NOTICE TO APPLICANT:IL after making this;Certificate of Exemption,you should baame,subject be the Wank re's Compensation previsions of the Labor Code,you most .J O fOOhw1'h CamPly with tech Provisions or this pemitshall be deemedrevoked. z' " CONSTRUCTION LENDING AGENCY f—' I hereby airum that there is a construction lending agency for the Performance of Cli the work for which Nu Permit is issued(Sce.3W7,Civ.C.) CQ L<ndcfs Namc .7 z Lendefs Add. U 0 I certify that I ham reed this application and suite WI the store information is it, F coven.I agree to comply with all city and county oNinam:es and state laws relating to pU building eonswction,and hereby authorise XProsentmivu Of this city in enter upon the pur,c W ahove-mentioned dgmener,property st fand exp n es which a Fgy (we)agree a save,indemnify and kap hannicss the City of Cupertino against 'fA in cnine growing ing of this permit. may in anyway accrue againstmid City V z in cansequenee of Ne greeting of Nis permit. ^ APPLICANT UNDER NDS AND WILL COMPLY WTH ALL NON-PD1 Issued by: di Date SOURCEREG 9 iF' / Re-roofs Signaure of A,fcMuC.mmCa, ser HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant ser future building occupant ease or haMle harvdous material as defined by the Cupertino Municipal Code.Chap ct 9.11,and thC Health and Safety Code.Section 155314)+ All roofs shall be inspected prior to any roofing material being installed. ❑Yes Paflf 41 If a roof is installed without first obtainin an ins action,I a Tee to remove Will Nro e applicant or future building occupant use equipment or devise which g P g emit heuarduus air contaminants u dcfirmd by the Bay Area Air Quahly Management all new materials for inspection. District? ❑Yu 1-0", I have mal the imenhass materialsrequirements under Chapter G95 of lW ealirm, O� nia Health&SafciyCadc,savms25505.25533 am115534.1 undcrsued thatiftbo Wilding +/ does not,anomaly ban a Leat.Net it is my responsibility an notify the..P.,nT the _ 4 requirements whi�W met prior a issuance ofd CCNBcaa Of0au y Signature of Applicant Date —` All roof coverings to be Class "B"or better Owner or authoris0 agent p g CITY OF CUPERTINO �m 9 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 # . . . : 06090189 SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 2 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 OEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - - ------- - ------ -- ----- ---- -- -- - - ---------- ---------- -- -------- --------- - BPERMFEE VALUATION 13 , 000 . 00 201 . 96 0 . 00 201 . 96 0 . 00 BSEISMICRE VALUATION 13, 000 . 00 1 . 30 0 . 00 1 . 30 0 . 00 ---------- ----- - --- - -- -------- ------ --- - TOTAL PERMIT 203 . 26 0 . 00 203 . 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 • av',� Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 �UPEkTINO Building De artment JOB ADDRESS: 1,31GqY PERMIT # otpt of Le I — O(D(:)q OWC OWNER'S NAME: PHONE # 4M-Z5-7- 10(00 GENERAL CONTRACTOR: S FAX # 5 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$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: V, 1(r< SalYc1 Job Site Address: 20 Soo 4o"A.e_ 2d C„?sit c, 814j5' 1 39 Roofing Company Name: f��o S F cso :*jt 7 rJ C_ Applicant's Signature: Date: • Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO « � PEROOF • CUPEkTINO PERMIT APPLICATION FORM APN# 320- 0q-05U Date: nI ZO I 6LO Building Address: 2 O Q 00 OnIe 9-d4- 2" Owner's Name{ VrW � ` t Sen(( Phone#; r _r Contractor: i" , , 6 License #�( ��i 2 '� 11,�c1� . �1 ' Contact: upertino Mark PUbo�s 51�-1�'- -01�JG CBusiness License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) Cl Other(Specify) Num er of existing coverings ❑ Provide LC.B.O. Report# To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off P lic : • Job Description:lisn1' t 1 S$. 1(1 CUMCMICIN001 CMDXI&N Residential Commercial Fire Zone: Yes ❑ No Confirmed with Planning Dqt. if there are any restrictions: LJ Cost of Project: 12 l 3 2 Type of Construction: Occupancy group: Qty. if Applicable Fee ID Fee Description Fee Group 1 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 •