05110123 • CITY OF CUPERTINO '
BUILDING DlvlsiON PERMIT::::'C�NTRACTOIY=IIYFbIiMATION ^'
BUIEDING ADDRESS: YORKSHIRE ROOFING PERMIT NO. 05110123
- 11583 MORNING
OWNER'S NAME: PERM17 ISSUE DATE
DAVID DUPLANTIER 7275 NATION11 /22 /2005
NE:
SANITARY NO. CONTROL NO.
(925)484-1900
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDGELECT PLUMB MECH
too LICENSED CONTRACTOR'S DECLARATION Job DE;SCrlptlOn
ZC Iion7 affirm Jut1 em ftbc sedBu under
easprovisions ofs Codia.hapter 9lmmmming
ame,is
<L+ if Secuon]OOU)of Divitlon3a(Jc HuSinev and Pra(ecsium Cade,aM myliceueu
fnllfnnsarwnlI L REROOF--T O SHAKES, . INSTALL STILL TILE
s,v�Z Date lou — _ Contractor .Fql�f/� / V
Fp
Date Can 7th DEC ARCHITECTS DECLARATION
f�< 1 underwnJ mY Plw shill bo ueJ u public..&
yyU
e Licensed Pmfcssional Zoe Oat I am eU rept fr m CLARATION
0 C I hereby o.(Sem on 1 am exempt form Je CanuanCo License:Anyc law for ted
p O following mason.(Saito]011.5.Business aced Profession C.a,Any my at county �\ `
<S which requires a permit re laimtos,ilxr.improve,demolish, filo
mpuir and wacture97000
prior mits issuence.alw tequims the applicant forsuch Permit fileastgacJsummem
< that he is licensed pursuant mNcprovisiouofthe Conmctor'sLwcveLaw(Chapter 9 Sq.Ft. Floor Area o64 Valuation
YFC (commencing with Section 7000)of Division l of the,Business and Pmfeuions Code)Or
i
that he is eaunpt therefrom and the Words for the aliegcd exemption.Any violation of
Section 703 L5 by airy applicant for a Permit subjects the applicant to a civil penally of
not mom man In bond"dollars(35M).
r Vyr—
Occupancy Type
I,u ownm of the propvry,m my wplOyvet w'uh wages u tle'v sole mmpcnution.
will as tedwoh,and the he Cute ra not intended e,a w does
Out a(Sec. woo of `` �
and Profeordons Cade:The COntrenors Liana Law doss not apply lf an owns of Required InSpeCtIOnSJ
pmpeny who Wildsaimproves thereon,endwhadassab work himulfmthmogh his
awn cmploycus.Provided mm such ienproemrnu arc tanirueMeel oroRemd forsale IL
imamm.the Wilding or improvement is sold within arc year of complesim,the awnn-
Wilda will have use hordm of proving mat M did but Wild or improve for purpose of
sad.).
❑1.as owner of dm property.w a uclunwly created,with licensed smnuacton on
construct the project(Sec.]044.Business and Pmfessmu Code:)The Contractors V-
ccnse law doss not apply an in Owner of propenywho Wilda or improves rMxon.and
who contracts for such projects with a comracmr(s)licensed pursuant to the Contractor's
License Law.
❑IamaambinumuSee ,H&PCforthisreuoa
lwnu DauWORKERS COMPENSATION DECLARATION
I har my aff uMer pevlry ofperjury ace of the following declarations,
1hawandwillmainwn a Con,u provided fm by Section 3]00 of the tabor Code.far me perfommce of meit for which this permit is issued.
1 have and will maintain Wokers Compensation Insurance,u requited by section
Oof the Vbm Code,for Jx performance of the work far which this pe mit is issued.Worke�rts�Compensation luurance anion and Policy number are:
rier. 4AILk- Policy No.:
CERTIFICATE OF EXEMPTION FROM 0 ERS'
QtL
COMPENSATION INSURANCE
(Thu renins need Out W cmnpleed if the permit ts fm ane,nonmed down(sidd) .
Or kn)
1 certify mot in the Performance of the work for which this Permit is Wood.1 shall not
employ any person in any marmrso as to become subject to the Worker'Compnwdon
Laws of California.Dam
Applicutr
NOTICE TO APPLICANT:If,after making this Certificate of Eacmption,you should
become subject In the worker's Compensation provisions of tie Labor Code,you most
.J Z forthwith comply with each provisions or this Permit Nall In domed bowled.
z O CONSTRUCTION LENDING AGENCY
PI hereby alrtrm performance:that them u a construction lending agency far the performanof
a> me work for which JJs Permit Is issued(see 1091,Civ,C.)
4 p Lenders Name
z tenders Address
U C) 1 certify that 1 have mad this application asld sum than dee above inftmatlon is
LL F Comms I agree In comply with all city and county ominameas and sax laws misting to
O U Wilding conwactim,and hereby autharixe mprexnudveor of this city m enter upon the
move-me mormd pmpeny for inspection purposes-
F 4 (we)agree to saw,indemnify and kap hamlets the City of Cupertino against
fly Iiabilitim,Judgments.cow and expenses which may in my way aamc agilns,said City
U Z in co utecoc me of the granting of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 2 L
SOURVE REGULATIONS.
tikir Wm, s-1';G'U1; Re-roofs
Sigma of AppucuVComracsar Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding acupantsmx or handle havaraous material
as dented by the Cupertino Municipal Cade.Chapter 9.12.and Jon Halm and Safety
Almiguse,section 25532U)?
❑res r'fNo All roofs shall be inspected prior to any roofing material being installed.
Will ted applicxt or furore Wilding acupant sax cyuipmcnt or d<vias which If a roof is installed without first obtaining an inspection,I agree to remove
Lit harardnus air conuminu s u dcfiacd by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes [[3f1u
I haw reml the wood.maxrialsrequinmcw un@rChapter 6.95 oft ecUifor.
nu Health&Safely Coit.Sections 25305.25533 and!25534.1 understand!thaifthe Wilding 5\�k`/Af��(y' A / / i 2 t—o(c
does not currently have a unana that it is my responsibility to notify tha occupont of the Vl.L IIIA Mf 7f
regyymmetons which must bomctpdormir,tamcofacenFwamola.P.n .. SignatureofApplicant Date
�aYjO(Pf 1J�dLIh 1i'a®.O All roof coverings to be Class"B"or better
r or aumofiom agent Dow g
SR&
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�
IUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
,ice 6 r/,/ O/''-')
OWNER'S NAME: ,/ 16(1 ' PHONE #
GENERAL CONTRACTOR 11hV46Kiee, ?, eYIP1,11A FAX#
I am not using any subcontracto s: Ja
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 V0fV-6tk;(G
Septic Tank
Sheet Metal
Sheet Rock
Tile
r
Owner/Contractor Signature Date
Community Development Department
/ Building Division
City of Cupertino
v' 10300 Torre Avenue
CITY OF Telephone: (408)777-3228
Fax: (408)777-3333
U P E RT I N O
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: _ 606
job Site Address: J 111 Y nji' y Snn� f
Roofing Company Name: )bw%ilrQ, Ryeftr(!U p- d/019W)f CA
Apphcant's Signature. 1 Qry( &K Date: Uc7
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
Q. REROOF
CUPERTINO PERMIT APPLICATION FORM
qW'APN # �? (� S_ Z � Date: / O
Building Address:
mayn-8410 45ar4g
Owners Name: V Phone#:
Ir
Contractor: Phone#: 06� 400700 License#-
IL I' v{ i
C ntact: Phone#: Cupertino Business License #:
Type4f Roof Covering:
Existing: Proposed:
o Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
® Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) 4 Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr. Installation Spec .
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: Vj {l 10H Amnso
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupan y 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