06080239 CITY OF CUPERTINO sec;e•� n r ' ''�
mesa
BUILDING DIVISION PERMIT CC11R -C (t1�''ItI ',? M' TZE '1�a .
a .r-a.. r•a .' r�,"'?smr is 4,..w.. �u,^ ffitrd?'
BUILDING ADDRESS: SOUTH VALLEY ROOFING CO PERMITNO.06080239
1062 NOVEMBER DR
OWNER'S NAME: PERMIT ISSUE DATA
BOB WOLFF 929 BERRYESSA RD 06
NE: SANITARY NO. CONTROL NO.
(408) 345-0550
ARCHRECT/ENGINEER: BUILDING PERMIT INFO
H_LLD�O EO PLUMB MEOCH
fop LICENSED CONTRACTOR'S DECLARATION JOb Description
hereby air,.Nn de
I am licensed unr pradmies of Chapter 9(commencing
with in
gersond
9pInsMMI
Buuneasand Professi Cod and neylicenseis
1 immTEAR OFF EXISTING SHAKE, INSTALL 7/16" RADIANT
'M4 LlcanLic BARRIER OSB, 30 LB FELT, NEW. CERTAINTEED LANDM
:Fa DamCost,
M CCSDECLAR 3O YEAR CLASS A
ICt76 used u public record, /]yh��/yy
tau KIL I l.n
'c�; Licensed Professional
(H 3 OWNER-exemptBUILDER se Me CoATION
C C I hereby.(Rete Not I I.S.exempt from Nc f anlmelao License Law for the
:CC fallowing reason.(Section](131. Busher, and ove,demolish.
Cade:Any city ar county
129 which its common,
a permit n .s.Mesa alms,imPmro,de ermitt Oi a psis any rouctum
ument
-, pearoits iuuaunrlsontto Me the inion applicant for moatpermits,incem Law(Chapter
< met Mulicenud pursuant to Jte provisions of Jte ConlOcorY Liccuc law(Chapmr9 Sq.F[.Floor Area Valuation
E;I (comm eruing with Section 7000)ofDivision 3oflheBminessandPrarmamus Code)tar $5800
�.- Nat W u eaempl therefrom and the basis for the alleged ascription.My vialauan of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penally Of APN Number Occupancy Type
on,inose Nan Ova hundred dollen(SSW).
❑1.u owner or the Property,or ney m playcn with wages as Mensem compensation,
will do the weak.and man sinumue,is not intended m Offered for sale(Be..70th,Buil. Re uired Inspections
and property
who
Cade:Thr COnuacmra ndwho Law don tet apply f rt awnv Of q P
pmpeny who Wiprovid mprovesch imP.md,No daenot h workmandle bimaelf edthrough his
mrsemploymn,ees,provoedthat rproom lmPmsamrnuanmyearMWmoRered for Owner.
however.the Wining Orden of pmmtt ts wed within ore year of mmPbOao•Ne ower-
Wilder will haw the burden of proving Nat he did not Wild m improv for purpose of
soled.
❑1,as antes of the propeny am exclusively conlnming with Ik d mnoacon to `
mutmet the project(sec.7014.Busweer of and Prafeassionsproperty
who Wild,
Cade:)The was thereon, nd /
who c law cora not apply o ts Dither Of paaPmiY who Wilds ra im,nKs thrrean,and
whonse Lacts for such projearo with a epnlsanar(a)licensed parwam o the Gntnetora
License law.
❑lam exempt undo See ,B&PCfor Nu reason
Owner Dam
WORKER'S COMPENSATION DECLARATION
40 I hereby sante under penally of pe jury aro of the following declarmons:
❑e have and will maintain aCmtifcateof Consent to self-insure forWorkers Compen.
sation,u provided for by Section 3700 Of the Lahor Code.far Ne Ford..of the
work for which this Permit is issued.
1 have and will maintain Wastes',Comp reatian Insurance,u required by Section
l of Jte labor Cade,few the Performance of the wok for which this Permit is ism d.
My WorkeesC u on ce sand PWiry num are:
Cardv. ," it'y` ' Policy No.: '
CERTIFICATE OF ISXEMPnON FROM WORKERS' �ty
COMPENSATION INSURANCE �vrAv'
(ITuxcdon used tothecomPlemd if Jin Form,u(,sone be dy�ay-SIad( a)
ar lass.)
1 testify Met in the performance of Ne work for which this permit is leaned,I,hall not
employ my person in any manrxrso O so become subject to Om Workers'Compensation
Laws of Califomis.Dam
Applicant
NOTICE TO APPLICANT:If.after making this Certficam of Exemption.you Mould
become subject N the Worker,Compensation providam of the labor Code,you muss
J O forthwith comply wish such provision,Or this permit shall W deemed revoked.
CONSTRUCTION LENDING AGENCY
[r (hereby alrt.Nes a..1.,ceuuuctirm lending agency far Ne pofurmasmc of
ai> Ne work for which Jus permit is chain(Sec.3041.Civ.C.)
U]QLanders Name
=z Lenders Add.
V Q i cmdfY that I have read this application and sum that the W.infmmation is
Uy Comm I agree to comply with all city and county andiunces and sum laws relating to
Q V building camunction,and hereby auth tiv mpresentatives of this City to enter upno the
{r7 move-mentioned pmpcny for inspection paapems.
(We)agree to Ore•indemnify and keep harmless Ne City of Cupertino agaiut
F'r(Z) Iiahilitice,judgments,cuts and expenses which may in my way accsuc against said City
()Z in conmqumme Of Ne granting of Nu permit. .''L.rye'
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date e
SOURCE REGULATIONS.
/l A- ry if �n Re-roofs
Signature ofA UCon o Dem
OUSMTERIALS DISCLOSURE Type of Roof
Will the a Cupentar fMure Wilding rcmpanlmorc mhatMm havudau material
u Oe0ste0 DY Jin Cupertino Municipal Cade.Chapter 9.1].and the HeMN ache Safety
Code,Smdo 25112(ar. All roofs shall be inspected prior to any roofing material being installed.
❑Yu tANa
Will the applicant or u tom building occupant on,equipment or devices,which If a roof is installed without first obtaining an inspection,I agree to remove
emit huardnu air cunumistanes u dcNed by the Bay Area Air Guilty Management all new materials for inspection.
oxides
❑Yes IV
Ihevcal N
me moenals manu
requireunJer C7uPmrg.95 of Ne Glifor-
nu Heslth&Safety Code,Scetiwu25M.25533au1255N.lunderund NuifJm Wilding o ✓f v
doesrot curmnly hero s mrtana thin it ism t 'n'torourydriclactmarm.ruic
requite boo m t ,to -ream° Signature of Applicant Date
.Ownery1fitonsedapm Dam All roof coverings to be Class "B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4VUPEI�TINO
Building De artment
JOB ADDRESS: PERMIITTg D 9—d Z3
OWNER'S NAME: PHONE # — (p
GENERAL CONTRA R # qQ P3 -2613 / IM
I am not using any subcontractors: _
61 Signature Dat
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
Septic Tank
Sheet Metal
Sheet Rock
Tile
OwiKer/Contractor Signature Date
CITY OF CUPERTINO
am 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36216035 . 00
DATE ISSUED. . . . . . . : 08/29/2006
RECEIPT # . . . . . . . . . : 35817
REFERENCE ID # . . . : 06080239
SITE ADDRESS . . . . . : 1062 NOVEMBER DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BOB WOLFF
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : SOUTH VALLEY ROOFING
CONTRACTOR . . . . . . . : METHOT, JAMES M LIC # 20837
COMPANY . . . . . . . . . . : SOUTH VALLEY ROOFING CO
ADDRESS . . . . . . . . . . : 929 BERRYESSA RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95133
TELEPHONE (408) 345-0550
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 6, 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
BSEISMICRE VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 231 . 96 0 . 00 231 . 96 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
---- - --- --------- ------------ ------------------
CHECK . 231 . 96 5386
------------
TOTAL RECEIPT 231 . 96
•
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 the above stated policy on re-roofing.
�.�
Homeowner's Name: 6b '" " O/ '?_y �p�
Job Site Address: 10CC kjoo -'� / / `'lup 1 / Dr�J• ��;
Roofing Company Name:: 6ou �" , Valk Coo► f 63
Applicant's Signature: ( Date: /�te�
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
Owner's Name: Phone#:
Contractor: License#:
Contact: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ 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: Li •
Job Description:
Residential ❑ Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
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
•
CITY OF CUPERTINO
REROOF C
CUPEkTINO PERMIT APPLICATION FORM
APN# Da
3(02—
'nnG—I to_OWO te: �e D
Building Address: / �O& Mw.emb&I br.
Owner's Name: Phone#: , ,0Q
Contractee o /y^ I/a//e . License#:`T�VVDSo�D•`50
Contact: In In,�I ' / (/ 1 Cupertino Business License #:
(/► I Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles k( 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 Cr Provide Mfgr.Installlyion Specs. {71Qecl
LGt�Iq,�U'K 3D �'
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
• Job Description.
i /l %'v i c2S3 alb �t-l�
Residential Commercial ❑ &/ —a
Fire Zone: Yes El No [TC 7Confirme/d with Planning De t. if
there are any restrictions:
Co of Qject: OT Type of Construction: Occupancy groin l tULL.
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
•