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08040106 CITY OF CUPERTINO %/� ��a=.,��x.��p[qq�54"x//�p'^ /� �y�r` '. BUILDING DIVr?ION PERNIIT gQsA411[if�T'V0ROQMTIQ •°' BUI 1 PERMIT NO. �M'EINDA VISTA PL TBD — TO BE DETERMINED 08040106 OWNER'S NAME: FERMI[ISSUE DATE SRINIVASAN 04/15/2008 NE SANITARY NO. CONTROL NO, ARCHfIECrfENGINEER: BUILDING PERMrf INFO BLDG EIYLT PLUMB MECH I� t� Sop LICENSED CONTRACTORS DECLARATION Jb Description FFy 1 bmeby nfRm that 1 am lessened under provLdons or Chapter (comO 9 mencing a S Mth3eNan7O10)afDlNdon3afdeeBudreasm 13 admyliccnmu RE—RF RMV WDSHK, INSTL ASPHLT SHNGLS CLS A 32SQ SS in full force and erten _0Z Lironq Cl��Lic.I_ CCJ D Contractor e� ARCHf1ECYS DECLARATION y I undermnd my plans NN W used as public meet& g rra Licensed Professes...I 5 OWNER-BUILORe DECLARATION I bomby at ural I.m uempt from Out Cunoactofl Lkcnm law for the y Q O following Mama(Section 703I.S.Business and Ra(easioN Code:Any city or money IRE! which required a permit to cnnmtcL alter.Improve,dro niW,Or repair my sroemme Za prior to its MunNp..late ruquiMa the applicant fo&such permit M rile&signed statement tend he It licensed pursuant to ft pmvislons of the Contractor's Lissom Law(chapter 9 Sq.Ft.Floor Area 9500 RValuation (commencing wins as tab Fro(eulnN Code)W That he is exempt Ikmfrem and the basis for the alleged reception.Any violndon of Section 703M by airy applicant for a permit mbjem the appliant le arnil penalty of ,p�Number Occupancy not mace than five hundred dWlan(5300), 35608008Atl _ T�ype 0 I,u arena of the property,a my wployeu wide wages as dark=in cmnpensation, will do dee work.and Our swctme is Out i domed or offered(a sato(Sec.7014,Business and Prof eaioN Cade:Tim CoWsemr's Liaam Law does met apply m an mums,of Required Inspections property who builds aiespmves Nemon.andwho doessuchwmkhimselfor through his awn employers,psovdded thatsch improvementa me not inumed moRorm foram.If. - however.the building or Improvement u mid within am year of mmpietim.the owers, Wilder real haw the badem of proving dust Its did not build or Improve for purpose of vk.k 0 1.as swat of the property.am exclusively conuMing wins Bathed ceniracmrs m construct the project(Sec 7044.BNirt.and ProfGdos,Code:)11.Consumes U. mom law dace not apply to an owner of property want Wilds or improves shaman.ted, who contacts for such projects with a coma sor(a)licensed pursuant to the Comnmar's Lomas Law. ❑Iunasemptundes See. ,BhPCfa thiamaun Owner Dam PIWORKERS COMPENSATION OECLARATION 1 busby aBinv nder perWty o!perjury oto of Ne following declvWonc have and u will main am a fiw cenim of conmmmmlf-Wure forwoher'sCamper- antion,a provided Wr by Seaton 7700 of the labor Code,for the performance of the wait for which this permit is issued. ❑I have and will maintain Water's Compensation Insamtt,a required by Session 3700 of dm labor Code.for Ne perfun s.of dee were forwbich dais permit u banned. My W Here, Compeaoufi ns rm�Cama and Policy number s c,rtien �ThTe 1'�x.�1 CEBIT CATS OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Crossection red tot W compiemd If she permit larararta hundaAdollies($100) or leu) 1 certify that M the performance or tW work for which this permit is stood.I shall are employ any person in my m reser an as 0 become subject to the Wodoss'Compensation Laws of CatifoMa,Due Applicant NOTICE TO APPIJCANf:If.deer,malting this Certificate of Exemption,you shouse become subject or the Worker's Compensation provisions of the labor Code you mus O O forthwith comply with such provisions or Nemmk is pdt shall be deemed ,ocd- �.~N.. CONSrRUcnON LENDING AGENCY F I hereby affirm Nat Nero iia coNuucNm ImHngagemry,for the perrronnanceof C' dee wort for which oda pt u)mod IS=.3097.Civ.C.) fA A lender's Nave i`-7. Z lender's Addrm U0 I ceiffy that I have Mail Nu application atm mon that the above Information is )y carton 1 agree to Comply with all city and county onRnaaes and sum taws relating Or .� buiming construction.and hereby authorise mprommatives of this city to enter upon the Ik7 above-mensiaend property for inspection purposes. y (War)agree to sure,indemnify and keep harmless Irk Cly of Cupenino against try n.bniues,judgmenu.com mderpeNes which may In my way amus against aid City V Z in consequence of tie grmfing of this permit. ^� APPLICANT PNDERST 000666---AAMiyJJD WILL COMPLY WITH ALL o -Po1Nr Issued by: Date SOURCE I ULA / U� sign mar / K o� Re-roofs ppl ARDOUS MATERIALS DISCLOSURE Oam Type of Roof Will the ap,IlCant or future Wilding occupant more Or handle haamow material as defined by de Cupertino Municipal Code.Chapter 9.11.and she Health and Safely Code.Suction 2S531(07 All roofs shall be inspected prior to any roofing material being installed. ❑Yas .f7ltve - Will enc applinnl or future Wilding occupant use equipment or deviea which If a roof is installed without first obtaining an inspection,I agree to remove It hmardaas alr cnntaminsn as defined by the Bay Area Air Quality Management all new materials for inspection. DisWc1T OYc3 No' Ihave mad Ne Nadeaum5505. mquimmmuunderCNpmr G93ofthe Calefng rtes HCalN d syctYCedc,Satiau 25703.iSall uW753M.I walavatal Nemin eminent of the does tot c ndY Mw•Imant,this it's mY mspaltubrin"y m'Tnufy de o¢upml of the rogmon are maw melpriatiilastacaracadfm SignatureofA licant Date Dam pp All roof coverings to be Class'%¢"or better 0 anthorveda 1 ' CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35608008. 00 DATE ISSUED. . . . . . . : 04/15/2008 RECEIPT #. . . . . . . . . : BS000004484 REFERENCE ID # . . . : 08040106 SITE ADDRESS . . . . . : 22096 LINDA VISTA PL SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SRINIVASAN ADDRESS . . . . . . . . . . : 22096 LINDA VISTA DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4022 RECEIVED FROM . . . . : DEN-MARK STRUCTURL CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC # 00096 COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ------- ----------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 91500. 00 1.00 0..00 1. 00 0. 00 1REROOFRES SQ FEET 32. 00 416 . 00 0. 00 416 . 00 0. 00 -- ------ ---------- ---------- ---------- TOTAL PERMIT 417 . 00 0. 00 417 . 00 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --- --------- CHECK 416 . 50 #1822 CREDIT CARD 0. 50 VISA --------------- TOTAL RECEIPT 417 . 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ------ ---------------------------- -------- ----------- ------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF oko q o I b(, CITY OF CUPERTINO ` � Gp REROOF OCUPEkTiNO PERMIT APPLICATION APN# n�n ` J✓t'� Date:��'U- Building Address: Owner's Name: Phone #: � �1C �LA,� � 5 �\ x/08 F�3g��a�Z Contractor: ,L e S Phone #: x o T g 4` -3 2;5'T. Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ;3( Asphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles o Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: w�tl�e u90*VeG SkaKE ! L&eF4— vo is ✓�`� o Residential Commercial Fire Zone: Yes No Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: �v I Have Read, Un stand Will omply with Cupertino's Tear-Off Policy: Signature CITY OF CUPERTINO REROOF •CUPEI�TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B • 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. t6. 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$176.18. The re-inspection fee must be paid before another inspection can be scheduled. IMPORTANT: 1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate that there is no ponding. 2. An I.C.B.O. report is required to be on the job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: / ! S C^t /� u \f(�{ Q Job Site Address: A.2�} 6 //h- !`1LG L p S—�4 C' Roofing Company Name: Applicant's Signature:� %l Date: Greg Casteel Building Official Revised 11/2/04 Community Development -, ✓ 10300 Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 *UPEkTINO Building Department JOB ADDRESS: PERMIT # // OWNER'S NAME-r. PHONE # 4D$ g-S 4- 00-SY, GENERAL CONTRACTOR: FAX # Ao g 7Z 7- 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 -7l-Ss Septic Tank Sheet Metal Sheet Rock Tile �f-rte os' Owner/Contractor Signature Date