06070097 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 V4" 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 w�iityh� the
above stated policy on
re-roofing.
Homeowner's Name:
Job Site Address: L.01AX;tr_ A✓E
Roofing Company Name:
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO '�'
BUILDING DIVISION PERMIT � ."Oi7CRAG2'U.,I2�INT•„ORMr�TON
BUILDING AlsGRISS: ALLEGIANCE ROOFING PERMIT N006070097
18594 LOREE AVE
OWNER'S NAME: PEBMITISSUEDATE
JAMES MEADOWS 1566 HARVEST DR. 07/17/2006
NE: SANITARY NO. CONTROL NO.
(408) 937-9757
ARCHIIECT/ENGINEER: BUILDING PERMIT INFO
BLDG EO O 0
boo LICENSED CONTRACTOR'S DECLARATION Job DeSCrIpI100
Z1 wroby affirm dist 1 am lio:ved under pma visioof Chapter 9(commencing
< MSection 7")of Division 3 of He Business and Protectionist Code,and my license,is
In OsR torte a ad effncL�c9 �.8p�(, REMOVE TAR & GRAVEL TWO LAYERS MODIFIED BITUMEN
License Class Lk.N
Data Contractor SYSTEM. CLASS A
'• � ARCHITECTS DECLARATION ALLEGIANCE ROOFING RENEWED BL 7/17/06
I o< I understand my plans shall M used as public records
V
e GC' Licensed Prvfessianal
'y� OWNER-BUILDERexemptonDECLARATION
a0 I hereby a(SN on 11. exempt from the Contractors License taw for Ho
p O following reason.Permit
t 71D str Budneu and Pmfessiom Cade:Any city or county
which requires Waseca.pumit m cmawc4 aper.Imprevq h Perm N.fie 2 Sig any ned MWMOL
d-i Pte' priormiu ensedprsu rt to the
prevision applicant Cohpmmi'mfcimse,aw(uumcm
€� thuMie licensed pursuant la the prevision of He Contractor's License law(Chaptor9 Sq.Ft:Floor Area Valuation
pq $ (commencing with Section 7000)NDivision3ofaeBudnesaandProfessions Code)ar $7000
C
that he el exempt therefrom and the bods far the alleged examption.My vblatian of
Section 7031.5 by any applicant for a permit subjects the aWlkaut M a civil peexlty of APN Number Occupancy Type
not mart Nan five hundred doltsrs ISS00).
❑L as owner ofthe property.or my employees with wags as their sale cumputsadon,
will do dm work and the structure is nonnundad.,onered fanale,(See 7014.Business Required Inspections
and Pra(essiaa Cade:The
e CO, Nlar't Ul d taw sin not apply us an Owner Of q p
property who buitdsorimproves th rmon,and whodossuch warp treesu(erNmugh his
own amptoycos,provided that such improvements m nminunded oroRered for sale.U.
ha ocum.the building or improvement is mid within ON year of comFle ion.He Owes-
builder wild have the burden Of proving that M did Out bund a improve for purpose Of ALM ale.). tau t�9tvtta�Lrsw
❑1,u aw.of M e propmY•i m exclusively,comuting with licensed conocrarm to
coawct the project(See.7044.Business and ProfesdoN Cade)The Cootrsc m's U
ceexe Law does not a 713'to m owns of property who Milds or impww Hereon.satl.
wboconpa,tsf h prdjeesa with a contractor(s)licensed pursuant to dm Contractor's n
Fou
C(I(10
❑lamex pt under Sao. .B k PC for ppyyQ`gg4ptQ��IZ1is 7 s' p
. / l Dau WON tt fJ C7 °�,
WO 'S PENSATION DECLARATION p_—may� If1 t871i //1/) Itll
I hereby affirm con ally of perjury ane of IM folbwiig dalantiaa: fn�
I loveand will maintain a Certifrcam of Consent to NlNiasure for Wmker'
WsCompen-
son,u provident fm by Section 3700 of tie tabor Code,fur the performance of da
work for which this permit is/aced.
❑1 haw and will maintain Worker's Compensation Iaarance.as required by Section
3700 of the lobar Code•for the performance Of the weak fur which this permit is 1"'v d. .
My Worker's Compensation Insummo carrier and Policy number am:
Canter. Polity No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
Intel=IN need act h lcomplemd lithe permit Is forme,hundred dollas,($100)
or less.)
I acidly tharii
ance of the wad for which is permit el based.I shVl not
employ any =10.ttoMYamC rob' Ito the Wodaa• 11 crusdon
Laws al Cal -
Applkant •'
NOTICE TO APPLICANT. I'TT{gIler making CeniOcae of Exemption.you should
become subject to the WohrYtCamperea provision of the labur Coda you moth
.,O forthwith comply with vest provisidn u pe" shill M dcomed revoked.
z CON Cf10N LENDING AGENCY
[.r IMrebya1r, thC thenuaconrNtlonlendiogageney forthationeararmitf
tri IM wad for which TMs permit Is dossed(Sec.3091,Civ.G)
WQ Lender's Name
it.
0 z Lender's Addrea
U 0 1 arify that I have mad Mix application and sum Ha the aMve informatiun u
W F
comm.I agree in comply with all city and county ordinances and sine laws relining to
O V building construction,and hereby audo me representatives Of this city m enter upon the
W ahovcmcmiuned property for impaction pugtoses
G (WO)agree to sena indemnify and trop harmless H,City of Cupertino againt
hr fn liabilities, nss,casasandexp,nses which may in any way accrue against aid City
V",� in co ulna a IN granum,of His p.
4 APP CANT UNDERSTANDS D WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO CEREOULATI S,/
�4 tib Re-roofs
Sign um of Appli nt ch" m
r A�ARDOUS MATERIALS DISCLOSURE Type of Roof
Win tie applit(nI ar future building occupant stare orhandk haardom material
as defied by tie Cupertino Municipal Cole.Chapter 9.17,and rhe Hcadth and Safety
Code.Section 2353z(a)7. JJ All roofs shall be inspected prior to any roofing material being installed.
Dyes /No
Will He applicant or future building occupies use equipment or devices,which If a roof 1$installed without first obtaining an inspection,I agree t0 remove
emit hovardous air conuminam,as defined by the Bay Area Air Quality Managmaenl all new a 'a s for inspection.
District? JJ
❑Ya XNo
I 11.2"M theh random mammals requimmew Ndo,Chapin 6.95 of He Califor.
in a Health .afetyCade,Sation 2550, )3am125S34.lumkOrwdrhmifthe building '� �'�' 06
docs N urtehfy have a Icoam;Nu It u m rapoaihilitY to notify the=up.,of the
rtyul cntsw jchmunMmmpdartoi unccofaCcnifiutoofOcco ay. Sign are of Applicant _ Date
- AI of coverings to be Class"B"or better
Ow er m ambo �xgcnt oto"
a;-01
Community Development
1300 Torre Avenue
Cupertino CA 9 014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building Department
JOB ADDRESS: I a 5qq Lo rye A-Ve. PERMIT #
c! O(0o7C09-7
OWNER'S NAME: JVtrWS WT PHONE #40-252.-4-70
GENERAL CONTRACTOR: F #
am not using any subcontractors:
Signa Da e
Please check applicable subcontractors and com 1 e 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
CITY OF CUPERTINO
•m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37525075 . 00
DATE ISSUED. . . . . . . : 07/17/2006
RECEIPT # • • . • • • . . . : 35278
REFERENCE ID # . . . : 06070097
SITE ADDRESS . . . . . : 18594 LOREE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JAMES MEADOWS
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : ALLEGIANCE ROOFING
CONTRACTOR . . . . . . . : SUSAN TANUPO LIC # 23080
COMPANY . . . . . . . . . . : ALLEGIANCE ROOFING
ADDRESS . . . . . . . . . . : 1566 HARVEST DR.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95127
TELEPHONE . . . . . . . . : (408) 937-9757
*EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ----- -------- ----- ----- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 7, 000 . 00 137 . 16 0 . 00 137 . 16 0 . 00
BSEISMICRE VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 242 . 86 0 . 00 242 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 242 . 86 MASTERCARD
TOTAL RECEIPT 242 . 86
•
CITY OF CUPERTINO
• 1 REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# O15 Date:
Building Address:
/?�5-9 L!J G'� �'•
Owner's Name: Phone#:
V4A,/E(r ti/r ALC [s'
Contractor: License#:
/An/cE )F&IFP/A/� L D �80�PLo
Contact: Cupertino Business License #:
Type of Roof Covering:
Existing: Prop sed:
Built-Up Roof }d Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number 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 Policy:
Job Description: /245MVrEF 77ve-d A7AV?_-L _ Tk/O LAyArR- "VP1 /6j3-
/b/e/rl,F_" (/ EA./
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Deft. if
there are any restrictions: IJ
Cost of Project: Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
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
•