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08080125 CITY OF CUPERTINO 'fro BUILDING DIVISION PERMIT C,O,NTRA CTURIN ` RMATION BUILDING ADDRESS: PERMIT NO. 8ii) DONNA LN LOS GATOS ROOFING 08080125 OWNER'S NAME: PERMIT 15511E DATE I'OC:K GAIL, F AND FREDERICK L P 0 BOX 1726 08/18/2008 NE: SANITARY NO, CONTROL NO. ARCHIIECT/ENGtNEER: BUILDING PERMIT INFO RE-RF RMV EXT TILERFNG INSTIL BQ ELECT� O MO u0o LICENSED CONTRACTOR'S DECLARATION - ' � C I Wrely aRmt Nal lam licemud under Pmvisimunr Chapter 9(Commemat ,.lob Description tt�l wird in full fora M force QBof Diviaian 3ofNe Buunm and Prafevsiam Code,and my sic is n c@c. D j�Z License Lit.# ' F p Dam Convsnar ¢7W MARCHITECT'S DECLARATION W U 1 uerstand my photo tall Ise used a public retards n #o In Licensed professional OWNER-BUILDER DECLARATION P 1 hereby affirm tat 1 am emoopt from Ih<Camractars License Law for the p O following reason.(Session 7031.1.Business and Pmfe'um Cade:My city or County $ which requires a Permit to contact,slcn improve,demolish.or repair any swctm poor ua its issuance.9.mquims tcapplicam for such permit t filo.mitrAsmcmmt ESG last heuHamad p...ant bthe promionsofdeCommunes LicevcLaw(Chapter9 Sq.Ft. Floor Area Valuation y1- (commencing wit Second 7000)of Division let to Business and Profeui.r.Code)or tat W u uempt tererrom and me bssts for to alleged exemption.Any violadon of section 7031.5 by any applicant for a Permit subjects Rc applicant m a civil penalty of APN Number Occupancy T ret mom tan Bva hundred doll.ISM P Y YPe 01,ao ofdepmpaty,amyemployeeswitcogAwdm mkmmpmsadon, will do Rework,and dmsuuctum is notmu:cumd or offered forsake(Sec.7014.Busiress and Pmressi..Code:The Comracmrs seam¢Law does Out apply In an manor of Required Inspections property who builds m improves duneon,and who does such work himsel r or tonight his Own employees,provided tat such improvements am not inkmd aroffered forsalo.B. however.the Wilding or improvement is mid witin are your or compleoan,the Owner- builder will love to burden of proving Rat W did not Wild Or improve for purpose of sake.). 0 1,as.wore or to property,are exclusively m nl oaing wish licensed enuxmn m Cdtsnwt to Mica(Sec.7044.Business and Proration,code:)The Cooaame rs Li- mme taw dose not apply in an owner of property who bolds or improves Remon.and. who Conmmsfar sect projects wit acwtrmmRs)licensed pursuant in to Cent item's Licene Ie W. ❑Iamexcenprundensce. ,B&Pcfortiawon Owner Dam WORKERS COMPENSATION DECLARATION I hucby air=under penalty of perjury one of the following deekmions - 1 have and will maintain a Cardinale of Consent in self-itou ,for WortmesCompen- sasion,as provided As by Section 3700 of the Labor Code,for me Performance of the: work:for which this permit is issued. ❑1 have and will maintain Workers Compensation Laurance,as required by Soman 3700.(de tabor Code.mar to pefmorance.f to..it far which this permit is issued. My Worker omrew' Wm a canner and Polity Gmrier. Policy NO.: � CERTIFICATE OF EXEMPTION MOM WORKERS' COMPENSATION INSURANCE (ITlsmaiw seed Out W completed if de Permit Isforonchundred dollen(SIM) or leu) 1 certify tat in to s rromawe of to work for which this Permit is issued,1 shall not employ any pemnn in any manrcrm as in become Cob*,m to Workus'Compendamen Laws of California.Dam Appliant NOTICE TO APPLICANT:If,after making this Cer ificac of Exemption.you should become subject m to Warkers Compmuaoan provisions of IW labor Cade,you mud .,z fortwit comply wit such provisions or this permit shall W deemed mwkcd. z OCONmucnON LENDING AGENCY [-a y. I herby airam dust sere as convection lending agency fm the Performance of P: me wuh for which this permit or issued(Sec.309.1,Civ.C.) !7] Q tenders Namc Dz Lenders Address V 0 I certify tat 1 have Mad this applicsian W cam Nat to shove information is U, F comma.I agree to comply with all city sed cowry ordinsmes and sate laws relating R 0(� Wilding construction,and hereby aumotac represemates or tis city to corer upon do a Wve-monoses property fm inspection purposes F W (We)agree to an,Indemnify and lump homeless;to City of CupcNnu against rn liabilities,Judgments.casts sudexpacas which may in my way meat agalmt said City CJ z m romequenee of to granting of this perms. APPLI ANT UNDERST OS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date I'/D Re-roofs Stgn arc of APpli®nUa comctor -Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will to applicant or future Wilding eaupant sort m Media hamdoas material as defined by tc Cupertino Municipal Code.Chapter 9.13,and to Halt and Safety Coda.sexYes us32p)T All roofs shall be inspected nor to an roofing material being installed. ❑vex � P P Y g g Will to applicant m future Wilding Occupant tato equipment at devices which If a roof is installed without first obtaining an inspection,I agree to remove it hanrdOa air commumonts as dcOrcd by dm Bay Area Air Quality Management all new materials for inspection. D str nT ❑res ,a 1 have mad to heardous materials requirements umtr Chapter 6.95 of IW Califor- nu Hcahhk Safety Coda.Somlaa25505.25333 am1Z5531.1 urilsswdd taillike Wilding ♦ d . F y man cunenoy aveamnm.tatiskmyrepmibilitymnotifytaupmsofto IAj () u' cntswhkhmustc mmpdaroodommeoraccrtificamor0 pores Sign Lure of Applicant Date IJJ.Am �� S�F6 O or autamcd All roof coverings to be Class';W'or better agent am' CITY OF CUPERTINO • 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35919031 . 00 DATE ISSUED. . . . . . . : 08/18/2008 RECEIPT # . . . . . . . . . : BS000005811 REFERENCE ID # . . . : 08080125 SITE ADDRESS . . . . . : 885 LONNA LN SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : EATOCK GAIL F AND FREDERICK L ADDRESS . . . . . . . . . . : 885 LONNA LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4324 RECEIVED FROM . . . . : LOS GATOS ROOFING CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481 COMPANY . . . . . . . . . . : LOS GATOS ROOFING ADDRESS . . . . . . . . . . : P 0 BOX 1726 CITY/STATE/ZIP . . . : LOS GATOS, CA 95031 TELEPHONE . . . . . . . . : (408) 298-9399 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1.13SEISMICR VALUATION 6, 413 . 00 0 . 70 0 . 00 0 . 70 0 . 00 11=00FRES SQ FEET 25 . 00 325 . 00 0 . 00 325 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 325 . 70 0 . 00 325 . 70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 1, 745 . 70 #2669 --------------- TOTAL RECEIPT 1, 745 . 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF • oio� PS S 4CITY OF CUPERTINO (, REROOF •CUPERTINO PERMIT APPLICATION APN# Date: Building Address: ,_Okh Ln Owner's Name: Phone #: Freda-�o//c k -/ --/ -O/ - Y- Contractor: L Q S Cr—c�.T �' S C>U -n if) Lj Phone #: LlU r j' C) ?— e)s e)1 `J Fax#: Out 2�g�- 13 -71 Cupertino Business License #: � ' I I Contractor License#: - / 0 70 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof Asphalt Shingles li5C Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles Other (Specify) �L� /�z Other (Specify) Number of existing coverings / ❑ Provide I.C.B.O. Re 'ort# XTo be Removed Provide Mfgr. Installation Specs. Baa /4 ss A Jot Description: 0.91 esidential Commercial ❑ Fire Zone: Yes L] N0 Confirmed with Planning Dept. if there are any restrictions: ❑ Valuation: / I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: • Sig6w r CITY OF CUPERTINO REROOF I OF •CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group IREROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 25 ., 25 1RER00FRES Re-roof Residential B 1SFDWLROOF r 1BSEISMICRE Seismic Residential B 1REROOFMRES 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. • 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 with the above stated policy on re-roofing. Homeowner's Name: Q�/ 'e/� Cl2 G Job Site Address: Roofing Company Name: S 1Ta Applicant's Signature: l. Z.ri � � Date: • Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue f' Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 qf,UPEI�TINO Building De artmenf JOB ADDRESS: PERMIT # 0 01 OWNER'S NAME: PHONE # GENERAL CONTRACTOR: S GL S FAX # ' I am not using any subcontractors: d Signature D 'e- 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 i Septic Tank Sheet Metal Sheet Rock Tile • /S o � Owner Contractor Si e Da e