06090195 CITY OF CUPERTINO a ,a
BLILDING'DIVISION PERMIT CONTRACTCIR�INF,99 IATIgN,
BUILDINGADDRESS: DUBOIS ROOFING INC PERMIT NO.06090195
20800 HOMESTEAD RD # 2
ER'S NAME: PERMIT ISSUE DATE
OWN
PROMETHEUS/VILLA SERRA 99 DUARTE AVE 09/21/2006
71 NE:
SANITARY NO. CONTROL NO.
(510) 793-9760
ARCHTMCDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
;op LICENSED CONTRACTORS DECLARATION
C 1 Intercity affirm Nos 1 am licensed umkr provisions of Chapter 9(commencing Job Description
with Section]IXIU)af Divisi.n3af the Buvnusand Professiu.Codc.and my license is
.fll�ra�eaaeeff«e 3s g gC2_ '30✓� REROOF- TEAR OFF SHAKES, INSTALL 7/160SB, 30YR C
i.:� este Contractor — (N) RIDGEVENT, GUTTERS & SPOUTS . CLASS A.
££ ARCHRECTSDECLARATION CARPORTS 45 & 46 : TEAR OFF SHAKES, NEW COMP
i C< 1 understand my plans dull he used as public recorN
yV
cps Licensed Pm(asionel
OWNER exempt RDECLARATIDN
a C I inanity.lire I am exempt from Ute Convumh License law for IW
❑o fallowing meson.Permit
(Section 7 mn-n Business and ve.4crans Codc:Any city or county
<m which mquiru a Pemit m c.nstroc4 alcor,improve,demolish,or repair any structure
''!i Or prior N is issuance,also rcquims dan applicant for such Permit to Rle a signed ststemcm
€� that he is Barreled Pursuant to the provisions of the Convectors License Law(Chapter 9 Sq.Ft. Floor Area Valuation
`k $ (commencing with Section 7000)nfDivision 3orthe Business sed Profession Coca)or 18020
—
that W u exempt therefrom and the basis fm the alleged aemin om My violation of $Y
Section 7031.3 by any applicant for a permit subjects the applicant in a civil penalty of APN Number Occupancy Type
not mart Nan five hundred dollam(SSW).
I,asownm of the prop.y,mmy wploym with waguas thev sole compensati.,
will doth.wafk and thestmemreladmtintendedaranaaadraraale(Sac.7oa.Business Required Inspections
and Peafesslons Code:The Continuum,License Law dues,not apply N an owner of q P
pmpany who builds Or im proves thereon,and who dose such weals himself Or through his
Owncmplmyras,provided Nat such impeavemnu are trot indicated...IT mA feasible.If. '
however.the building or improvement is sold within am year of completion,the owner.
builder will brave the burden of proving that M did not Wild or improve for purpme of
ale.).
❑1,as more(of tW propcat,am udusively contracting with licensed.naacmn b
commie,the pmXci(Sec.7064.BUNK and Professions Godes)The DaoaaMYs U.
,case Taw dao at apply in an owner of progeny who Wilds or improves Nem.,and.
who contracts for such projects with a contrscros(s)licensed Forum to the Convenor's
License Law.
IamexemptunderSee .B&Pcfm Nismxxon
Owner Dau
WORKER'S COMPENSATION DECLARATION
1 hemby affirm under penally of perjuryarc of Ne following duloeuans:
IhaveaMwillmaintainace r.Qmof Coventmelf-insurefmwarkerscampen-
ation,as provided far by Section 37M of the Labor Code,fm the perform.of Ne
work for which this pcmit is issued.
Porhave and will maintain Worker's Compiesation Inwuta,as mquimd by Section
3700.(Ne Lather Code,far the performance of Ne work fm which this permit is issued
My WorkCommusati. es nicr and Policy nu rare
Carder. rC Pdi'loo, &G^&6' ZOb
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
Max seed.need wt W completed if the Permit is fare.hundred mll.($100)
or less.)
1 c.nffy that in use perromaxe of dm work for which Nis Permit is issued.I shall nos
employ any person in any noansso as to beeme.subject m the WorkersCompensation
Laws of Califemia.Doc
Applicant
NOTICE TO APPLICANT:If.after making this Comficale of Eacmption.you should
become subject m the Workers Compensation provisions of the labor Code,y.most
.,O (aMwith comply with such pr wnti s or Nu permuW
ihall deemed revaked.
Z� CONSTRUCTION LENDING AGENCY
D4.7 I hereby arum Net them is a cautioned..lending agcy Or ho perfumame,of
C4 the wok for which thin pmmis is issued(Sec.3097.Civ.C.)
QLenders Name
.7 z Lenders Address
U 0 1 nearby No 1 have read Nis applicamm and state No the above information is
p.^F correct.I agree to comply with all city and county aNinances and suite laws relating to t
CU building construction.and hemhy amhorin,rtpresenutivcs of Nis city to enter upon be
V) above-mentioned Pmperty for impaction purposes,
mu N
H a (We)agree to save,indemnify and keep halce City of Cupertino against
U Z in coiuu.judgmcn6,cosuand se
and may in any way accmc against mid City
onseguence of the flamingo(this
^ APPLICANT UNDERSTANDS ANDD WILL COMPLY WITH ALL NON-POlppp[[[TTT Issued by: Date
SOURCE
Re-roofs
Stgnourt of Applicaa� p
HAZARDO
HAZARDOUS.Amann Lagoa LOSURE Type of Roof
Will the a Column or(mum Wal Co mcupapt wort ser handle Haultau material
u Befitted Section
the 32(.)'.Municipal Code.Chapter 9.11,and the HnIN and Safety
Cards. 0y.25s33(a>? � All roofs shall be inspected prior to any roofing material being installed.
40 ❑rte
Will the applicant or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hateardous air contaminants as de0ncd by Ne Bay Am,Air Quality Management all new materials for inspection.
District?
❑Yn �L U
Lhave real the vafda5alsrequream CWPs or Califon
iiaansZ505534.1 n ands Wilding
dos net commit,have-gnaol.am(it ismy aniounsihility in muly tth.ouecupmwrre
O
rognha::nsw ' Wrmpnouanmaccm(.CcNrkona]Ocapayey Signature of Applicant Date
Owner or eumarixcd agent o All roof coverings to be Class "But or better
CITY OF CUPERTINO
m 5 of 9 PERMIT RECEIPT OPERATOR: amyw
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 32609056 . 00
DATE ISSUED. . . . . . . : 09/21/2006
RECEIPT # . . . . . . . . . : 36157
REFERENCE ID # . . . : 06090195
SITE ADDRESS . . . . . : 20800 HOMESTEAD RD # 23
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 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
.' 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
•CUPERTINO
Building Department
JOB ADDRESS: $ PERMIT #
oiP1 01 W — Olo(7RQl
OWNER'S NAME:Vmmemeus PHONE # Atjle — 10(00
GENERAL CONTRACTOR: TUW S Qmfirp FAX # 5j0--7Cj3—Ct
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 1.997 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 r/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
Job Site Address: Zo Soo 20 C„pav-T, , o $SC S' 3R
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO 0(�pan� ��
REROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN# 32' n— OGI—01D ^ Date: n1 I L n ry
O I O
Building Address: 2 o Q f "omestend
9-d -* 2:3
Owner's Nam Q '� ...AS /V 0t �evrn Phone# _ r, _2_V5-1— lmoo
Contractor: mc
Licensee #: �3 � g
Contact:A ^Qry- pU4JC ,S 51D_7�`1"_-1�Cj Cupertino BusinessLicense`#:
1"1 Type of Roof Covering: 1
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ sphalt Shingles tyAsphalt Shingles
� Wood Shakes O Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Num�Jer of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off P lic
• Job Description:-MT- t
i nrnnew Q A
Residential Commercial lNYpy Y v�T I In$�1`�
Fire Zone: Yes ❑ NoSK j Confirmed with Planning D_pt. if
there are any restrictions: cornpU
Cost of Project:0Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
I BPERMFEE Bldg Permit Fees BUILDING
BENERGY Ener BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•