06040028 CITY OF CUPERTINO
BUILDING DIVISION PEIRMT *zCUN'.CR; CTQR�T 41V', �?RMATION
a UILDINGADDRESS: CURT FLETSCHER ROOFING IN P�MrTNO'06040028
10380 OAKVILLE AV
OWNER'S NAME: PERMTT ISSUE DATE
TSOBANAKIS BOBBY AND HELEN TRU354 MONTICELL
NE: SANITARY NO. CONTROL NO.
(408) 267-2679
ARCHI ELVENGINEEK: BUILDING PERMIT INFO
BLDG BO PLUMB MEOCH
lop LICENSED CONTRACTOR'S DECLARATION Job 1 n
IUF 1 hemby affirm that I am limased under provisions of Chapter 9(commencing
a Sj t�a with Section 7")orDividon 7 of the Business and Profasam C my 1'..k
«Ilrnaeand erfatC g 5 REMOVE EXISTING SHINGL PE NEW' FLASHING
Dam� _Conuwwr NEW COMP 30YR CLASS AM
alp
ARCHI1CrS DECLARATIO vt I/
1 1 understand my plans slit he used u public rt �I/ )Al
SyU �♦ 9
°p Licensed Pmfcvional O� COp6
OatNEm use pER DECLARATION s
R a I hereby o(Sect that 11. .Bash= from Ulc Conons Co License: nyc Law for rite
O whichfollowre renson.Permit
t 703 L1 Business and improve.
cons ns Code:Any city as county
ure
11;awhich requires;•permh re cnnmu4 amr,improve,demolish,fire sig any structure
-za Prior=ies icteric.Wo=gut=s the applicant for such prmitmfiic signed summa=
G Inst he is Iiccnwd pummt w the pmvisions of tite Conuocwr's U-.law(Chap=9 Sq.Ft. FIOOr AIea ValuatilQl7 625
�� (commencing with Sutton 70131))of Division 7 of the Business and Professions Cade)or
that he k wrap(therefrom and she basis for the alleged exempdoo.Any violation of
Secdon 7071.5 by any application for a permit subjects the applicant to a civil pconhy ofpp7•�� 7q umber Occupancy Type
not mem than five hundred dollars(M). 3 6 913 014 . 00
1,as Owner of the Property.u my employee with wages as their wk compnodon,
will do thewerk and an.sWim.bactimmuedu offered forsale(Sm.70th,Business Required Inspections
and Profnsdans Code:The Contmewrs License law does ant apply m an an=Of q P
property who bullas m improves thenen.and tens does such work himmlr m duoagh his
awn employ=,provided that such Improvement,are not Indicated uroffend for sela B,
however,the buiwing or Impowmanl is sold within ori year of completion.0e owvur-
builder will law the trurden of moving this its did not Wild ar improve fu purpose of
sok.).
❑I.as owner of she PmPeny,am exclusively=nesting with licensed untnups to
contract the project(Sec 7044.Business and Pofeulam Code)Tic Conua ire's U.
conte Law does not apply m an owner of property,who builds or improves thereon,and
who convects for such projems with a unuwwr(s)licensed pursuant m the Contnawrs
Lice••-law.
❑I am exempt under Sea. B A P C for rots main
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby anima under pa=lsy of perjury One of the following declarWons:
I have rod will mainuin a Cardfiesm of owner a selRkwm fm Waders ComPeo-
motion.as provided for by Section 7700 of the tabor Code,for the Performance Of the
work for which this permit is bound.
I low and will maimaw Workers Compewtion Insurance,u required by Sco w
7 of the taWrc Code. thea performanceef�orrrmaan�u of We work for which this permit is Wesel.
My Works .r80...0 ad Policy
dP No.:nu am: .
Grt er.
CERTIFICATE OF EXEMPTION FROM W KERS
COMPENSATION INSURANCE
I
(This seelion need an,he completed if rite por=n is fmari hundred urban(11100)
ar ICan)
1 unify that In Ne perfomtwee of the work rte which this remit Is lased,1 shall not
employ any person in any mammy an as w biome subject to the Workers'Compensation
Laws of cahlbrols,Dam
Applicant
NOTICE TO APPLICANT:If,after making this Ouarkam of Exemption,you ahoum
become subjw to the Workers Compnsation provisions of due tatter Co&you man
.,O forthwith comply wins such Pmvieions u this Permit MVI w daunted rooked.
z CONSTRUCTION LENDING AGENCY
(-r Iherebyicht tiro dem uaCeoSce.3 len ding ageumy fm the prforman¢m
a the wok for whish ink permit u iasmd(Ses.X197.Civ.C)
QLenders Name
:D
7 Landers Addeo
U Q I certify that I haw read this applicadw and sow this the above information is
LU F correct.I agree to comply with all city rod county ordinaries and sue law relating to
DU building conswction,and hereby authodre mmosenossves of this city to enter upon the
W above-race coned property for inimedim pmpoms.
(We)agree to ow,indemnify and keep harmka Ne City of Capcnino against
razj) Ihbilidm.judgmcnsa.cospe
sandexnsewhich may in my my am=against said City /J
U a+ APPLIin CANTeof the UN ERSTANDS Araminj of IND WILL COMPLY WITH ALL NON-POINT Issued by: Date -7 -g--0 6
SOURCE REGULATONS. yy��
T— Re-roofs
Signawrt of AppliaDO Dow
HAZARDOUS MATERIALSDISCLOSURE
or URE Type of Roof
WIII the a Copenior TMuni Municipal
Cg occupant store u medic Hcardensd Salcey
a defined DY the Cupertino Municipal Cede.Gapes 9.12.rod the Halth and Sa(tty
Cede.Sued.25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes No
Will the applicamor future Wilding aeuPmL use equipment or deviva which If a roof is installed without first obtaining an inspection,I agree to remove
emit hucaawto air contaminants u de0rid by the Bay Arta Air Quality Management all new materials for inspection.
Diaultt7
❑Yea -4(N-
1 have mW the haardoa materials mquimmenu under Chapter 6.95 afthe Califon
nia Health k Safety Cocat Sections 35505,15533 and 25574.1 understand the if we building
Joon nOl amount y haa tenant,dual It Is my responsibility to nodfy the occupant of the
require I�rpten tyyst be met prior to Luauane of a ceniMam or occupancy. Signature of Applicant Date
Owner or adho3N t Dow"
All roof coverings to be Class "B"or better
CITY OF CUPERTINO
•em 1 of 11 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . I — : 36913014 . 00
DATE ISSUED. . . . . . . : 04/05/2006
RECEIPT # . . . . . . . . . : 33860
REFERENCE ID # . . . : 06040028
SITE ADDRESS . . . . . : 10380 OAKVILLE AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : TSOBANAKIS BOBBY AND HELEN TRU
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4519
RECEIVED FROM . . . . : CURT FLETSCHER
CONTRACTOR . . . . . . . : CURT FLETSCHER LIC # 22227
COMPANY . . . . . . . . . . : CURT FLETSCHER ROOFING INC
ADDRESS . . . . . . . . . . : 354 MONTICELLO AVE
CITY/STATE/ZIP . . . : SAN JOSE. CA 95125
TELEPHONE . . . . . . . . : (408) 267-2679
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BENERGY PERMIT FEE 1 . 00 34 . 86 0 . 00 34 . 86 0 . 00
BPERMFEE VALUATION 8, 000 . 00 147 . 96 0 . 00 147 . 96 0 . 00
---------- ---------- -'--------- ----------
TOTAL PERMIT 182 . 82 0 . 00 182 . 82 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 182 . 82 4865
TOTAL RECEIPT 182 . 82
•
Community Development
10300 Torre Avenue
acloF
Cupertino CA 95014
Telephone(408)777-3228
Fax(408)777-3333
OCUPERTINO
Building Department
JOB ADDRESS- PERMIT#
a0 60 C/ o02�
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR FAX # Y6 ,7at8d—SG
I am not using any subcontractors: 7pdE
Signature Z'19- 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
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
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.
7
Homeowner's Name: / S Q 614�1 AgLS
Job Site Address: io 3Y6 /3,aLkv,11e_
Roofing Company Name: PJ 6 1N C
Applicants Signature: ///WO— Date:19
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO O�O�
`1c REROOF
• CUPER,TINO PERMIT APPLICATION FORM
APN# Date: -0L
Building Address:
() 6a_ky A0Name: Phone#:
5 4v6- VLr/
Contractor License#:
Co ct: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
p( Asphalt Shingles It Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
`Q/ To be Removed ❑ Provide Mfgr.Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
J Description:
- -Nrw r 3Q
Residential Q Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
&aS GYS
Qty. if
Applicable Fee fD 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