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05110100BUILDING DIVISION PERMIT 8960 NEWSOME A NER'S NAME: JULIA ABRAMS 408)874-078 ranml m 05110100 M PERMIT ISSUE DATE 11/17/20C SANITARY NO. CON BUILDING PERMIT 'BLDG ELECT PL 17-1 r__I C Job Description REROOF--T/O TAR & GRAVEL, ADD SHINGLE, FLY ROOF MEMBRANE CLASS "ADI I understand my plans shall be Cowl as public mmmt Licensed Pmfemimlal OWNER.BUILDER DECLARATION I hemby affirm that 1 am exempt from the Canmaclor's License Law for me following moron. (Section 70713, Business and Professions Cade: My city or county which mqulru a permit m commuct a[W.. Improve demolM. Or mpair any museum prim in its iuuance. film requires the applicant for such permit to 01c a signed sum emu that be is licensed moment m the provisions of the Concurs Lkenm law (Chapter 9 (commencins with Section 7000) of Division 7 of the Business W Professions Cade)or that to is attempt theeftom and Ih basis for Be alleged ummptim My doidan of Sermon 70713 by my applicant ter a permit Subjects the applicant m a Civil penally of nal mom than Bve hundred dollars (SM. ❑ L u owner of the property. m my employm with wages es thenalecompewtian, will do the mark, and thesmutum b tmtimmnded monemd f esam (Sec. 7061, Business and Prole shtem Cade The Conuarora License Law do" ant apply b in owner of property who build, m improvex thereon, and w ho loco such week himself fir through his ownemployeea, provided thatauch improvements are entlnmMW eroQered fmsate. IL however. the building or improvemant is Said within oro year ofmmpictwn. the awmr• builder will haw the burden of proving But be did nal build or improve for purpose of ❑ 1. as owner of the prapeny w exclusively cmuusing with firmuld Commuters, m commuct Bm project (Sec. 7044. Busseem tad Professions Code:) The Cmuacmr, U. Coat law data al apply le a owrw a propertyvEo Wilda m improves ft.. and who mom scat for tach wakma with a Contractm(O Recred panuam m the Contractor, License Law. ❑ Imaremptundm Sep .Bl PCfmthbnmwm Own" Dau WORKERS COMPENSATION DECLARATION I hereby ainrm under penalty of perjury aro of the following declamtiom: I ham and will maintain aCadlicasof Cananita selfdnsure fm WorkcesCompen- saBon, as provided for by Section 7700 of Bm labor Cade, far the Perfaml"M of the Mare and will maintain Wurkels Cumpensedon insurance, as mgdmd by Section of the Leber Code, for the per(ermance of the wart for which this permit is issmd Area ge Required Inspections IThts sections need not h complemd If the permit is for ane hundred dollars IS IM) or ICaa) 1 certify, that In the performance of the work for which this permit is Issued. I Shall me employ any person in my meaner an u to become subject to tic Warbers' Compensation law of Caiifamia. Data Applicant NOTICE To APPLICANT: If, after making this Centum of Exempdon, you Shouse Weaves objon an the Worker's Compamemon provisions of the Labor Code, you most JO forthwith comply with curb Provisions or this permit Shall rwv l be shouted . z tiCONSTRUCTION LENDING AGENCY [~n Ihereb,.M. this dem u,.=..due lending ager ser the perfurmanCouf C4 > the work for which this pemot is named (sec. 7697. CW. C.) �W A Lenders None 7 z Lenders Address U Q I certify that 1 have toad Wnppliea ton and sum that the above information U ECOMCL I agree to Comply with all city and county oNIna1M" and sum laws reladng m Ubuilding construction, and hereby authorin repmsenutiw alibis City m cow upon the U shove-mendoned property for inspection purpums. (\\ gL (We) agree ro save, indemnify and kap harmless the City a(Cupenino 89siut ren y liabilities, judgmemu.cam, and exporters which may In my way amtm against said Cry ()7 in consequence of the granting permit t "-' APPLICf�r UNDEI�lf AND Wj. COMPLY WITH ALL NON -POINT Issued by: HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building aceuPIALUM"handle hmdous material Oned by IIIc Cupertino Municipal Cade. Chapter 9.17. and the Health and Safely Section 25572(07 [_1 yes 0 N VIII the applicant or fmum building occupant use cWlionera or devices which h"adons air ronmminsnu as deBmd by the Bay Area Air Quality MU490MCOL let? ❑Yee ONO I here read the hondarveurc,isbmquiwrcmsunderCNpw69 nu Had" d: Safety Cade. Smriw 25.505.25577 am125574.1 mtderYad th roes rot cummruiv M. a sen rot 0afa 1, my msoduibility, ld soh the Re -roofs Type of Roof Date //r- / 7 -e7 dl - All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Is, (; , orf Signature of Applicant 17`0—S Date All roof coverings to be Class "B" or better :7 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department .:DD-- OWNE BUSINESS NAME BUSINESS LICENSE # I am not using any subcontractors -646W. s- tgnature Date Please check applicable subcontractors and complete the following information W11 //// Qs Date 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 W11 //// Qs Date CITY OF UPEkTINO Community Development Department Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (406)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 Stapdards 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: Job Site Address: 1�1r�� 0LOIYLA�— Roofing Company Name: ( ,V_ /� 41:4=1 � Applicant's Signature: QL�. Date: 7y 7 QJ� Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper 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 fopowing 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: Job Site Address: 1�1r�� 0LOIYLA�— Roofing Company Name: ( ,V_ /� 41:4=1 � Applicant's Signature: QL�. Date: 7y 7 QJ� Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper G a-10 CUPERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM OrIl 0/0 0, APN # Date: / Jill -710S- 6 Building Addr`` ess Owner's N Phone #: ZS3 Phone #: License #: ' L R Fi z 4� Cot t: �. Phone #: Cupertino Business License #: Type of Roof Covering: Existing: Proposed: Y_ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles b Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) >' Other (Specify)�c �Number of existing coverings ❑ Provide I.C.B.O. Rep rt It $0 ` S Iv To be Removed Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 9 Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are anrestrictions: E Cost of Projut: 9?::� Type of Construction: Occupancy group: S 553 Qty. if ADDlicable Fee ID Fee Description Fee GrouD 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 Qty. if ADDlicable Fee ID Fee Description Fee GrouD 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 it-- 3 l