05110135CITY OF CUPERTINO
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BUILDING DIVISION PERMIT.CONRAC
CORr^INFOR
BUILDING ADDRESS:
EM ROOFING
PERMIT NO. 05110135
21199 OROGRANDE, 2T,
OW NER'S NAME:
PERMIT ISSUE DATE
DANIEL CUNNINGHAM
843 7T
NE:
SANITARY NO, CONTROL NO.
(650)363-8388
ARCHITECTENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 � 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 ktcby affirm teat 1 am IiccnsN umkr provisions of Chapter 9 (mmmcncing
with Section 701101 of Division 3 of the Business and Professions Code, and my liccnx is
in full farce and effect
�F+
REROOF- T INSTALL PRES. TL
License Class �'
coat
Da¢ ComDECL
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U�V�+I
RCHITECrS DECLARATION
I understand my plana ilmill o amt u public records,
DEC
,`i 2005
Licensed Pmfesium.l
OWNER -BUILDER
Ce
m CormaON
1 hereby .(Tien that 11. exempt from the Gnnwelao License Law for the
Car,:
following mama. (Section RD I.s, Business and Po, dcri li My city or aunty
which mlvim a peri, re cnnwucL titer. improve, choir swctum
p� A
',I js su �Ss7l H813000
0 0 0
h Permit to ed
prior thovisio canf for mchpemi'urmica
its Tensed
Valuation
P.alwnt10ObCres
Law(uumcnt
(canoe is liccnmlion (Chapter
he
pSmdn7 th)of
on
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Disionsafo( Buactm's,
on mini oflkegedm
Professions Ction
ng with S,refrom
de bassion3
and rpt of
that k u exwpl lkrtlrom and the buil for the alleged eaemptim. Any violation of
that be
r
Occupancy Type
Section 701.5 by ury applican, for. permit subjects the .pplions, to . civil penalty of
not mom than BK Wrided lows (Ss0 y.
❑ 1, u owrcr of fee pmpmty, a my employees with wages u their sale compeasidon.
Required Inspections
will do the work and the swane, u rut intended orOBered far into (Sec.706a, Bonn.
and Pmfnubma Cadc: Th. Contractors License Law does, sal apply m an mermen of
_
property who buildsaroimpmm Nescon.andwo doesmch work himancl or through his
Own employees, provided that such improvements art not intended oroRened forsala IL
however, the building or improvement u sold within came year of completion. the Owner.
Wilderwill have Ute burden of proving that he did not build or improve for purpose of
sat.).
❑ 1, u owner of lk property- am nclusivcly contacting wife licensed contra mars to
construct fee pmjen (Sec. 7044. Business, and Profcssoro Cade:) The Conmacur's U.
_
cense law dao not apply u an owner of pra hunt"o Wilds or imprm thereon. and,
who cornets for such pmjccu with a contractor(s) licensed pursuant m the Contractors
License Law.
❑ l am cramp, under Sec .B k PC far this rtuon
Owen Dau
WORKERS COMPENSATION DECLARATION
1 krtby all under Penally of perjury one of the fallowing declarations,:
1 k.e aM will maintain a Certificate ofcamem u self-moure fm Warkers Compen-
"
,on, u provided for by Section 3700 of to labor Code, fm the perform of to
.
work for which this permit is issued.
❑ 1 have aed will maintain Worthies Compemuaton Insurance. u required by Section
]700 of to labor Code. for per(Ommce oftk wok for which this pemiluissued.
'
My wmr:��Rn . lrwrance orti�ud� 1'i number ane
y
Cartier. T/'C
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CERTIFlGTE OF EX NPMON FROM WORKERS'
COMPENSATION INSURANCE
,
(Thu senior recd Out ocompl.m d If tk perm is far. hundred dollars (5100)
or test.)
1 cutiry that in the perfomaecc of fee wart for which this pewit's issued. I shelf not
employ any permit in ray manarm ss in became subject to the wmr Compensation
Laws of California. Data
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption. you should
became subject in the Wo(kera GampcMatlan pmvido. o Ik Labor CedC, you mLLV
comply with each provisions or this permit spall he domed mveie d.
CONSTRUCTION LENDING AGENCY'
hereby.ffim that then u. cansoumnn hmdmg.gemuy far the iteif.. of
fee work far which Nu Permit u wound (Sec. 3097. Civ. C.)
Lemdies Name
Lenders Address
'
1 certify Nat 1 have read this application and sale two the move information is;
'
1 agree u comply with all city and county ordinances and scale laws, relating m
building construction, and thereby auhouire¢premnudm of this city m enter upon the
shove -mentioned property for inspection purposes
(Wee) agrom u save, indemnify and kelp hawkss the City of Cupertino against
judgments. eons and nope. which may in any way.crne against it City
n consegnemec of the granting of this pemit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date �� fL 3 ^ 6
'OURCERES.I1�Jff
Re-roofs ' `T
Type of Roof
C/ L
I( E' jle
S of pin Date
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or fuwe building auopantsmrt Or handle hanNous maeriil
u dcfimed by are Cupertino Municipal Code. Ospur 9.13, and to Hdth and Safely
otic. recti. zss3zU)?
❑Yes 0 N
All roofs shall be inspected prior to any roofing material being installed.
Will Nee applicant or future building Occupant use equipment or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
mit hnvardOns it mnumimns u defined by lk Bay Ares Air Quality Managcmcm
all new materials for inspection.
p
District?
❑ Yrs ON.
Ihave mad yCode.endwns Z5 aum33and! msundcr ChaPmrd.9safthe Cdi(w-
undcousbul building
nus nl,urrealyCode. SectionsZ5I,i ft
ji�
myrapenssX.l
ic notify lk aecupml of to
ecoup
Jaen ort cumnhli have s tenant, Wt It u my m_c of.
cei,ai
¢yuirtmcnts which must k ,I ran iestran¢ora eertirinte ar�<
Si re fAppricant- Date
All roof coverings to be Class "B" or better
Ow ut n d g,m Date
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
�L o'4'0Cc,rde L
PERMIT #
DS/
OWNER'S N C i —
_
PHONE #/65-n pp
GENERAL CONTRACTOR: Ent d�c .
FAX # So
I am not using any subcontractors: - / t LZ 710, "
ignature Date
Please check applicable subcontractor and comnlete the following information
Owner/ Contractor Signature
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
Owner/ Contractor Signature
Date
�CITY OF
UPERTINO
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:
Job Site Address: Zf l c( cf - O e o 9 v c.,A c1 , P L
Roofing Company Name: n— tL-? 12.o O Cl Yi q
Applicant's Signature: Date:
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
I
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION FORM
aS-(� a13�i
APN # J/Z ` 1 6
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Bldg Permit Fees
Date:
dd
Energy
O �
Building Address:
Seismic Fee Res
2-112cf oro ,rcl-V,d-e
BSEISMICOM
Oner's Name:
BUILDING
Phone #:
a n' e 1C m
BUILDING
6.5,0 61,V F 9y1sa
Contractor:
Phone #:
License #:
C -M dZao ,"
-5-0 ?!03 8386
77 26
Contact:
Phone #:
Cupertino Business License #:
Ed uovyi&o DSL 0,01 a VVA
C ,V 0) (0)LO 08
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
❑ Built -Up roof
❑ Asphalt Shingles
C�C Asphalt Shingles
X Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
❑ Other (Specify)
Number of existing coverings 0 ✓GCC
❑ 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:
rnc,�-o
Residential Commercial ❑ y2 oS Q3 may, a ; n s i / i9-ew 1'-ce g 7-L
Fire Zone: Yes ❑ No
Confirmed with Planning Det. if
there are any restrictions: LJ
Costof Project: Type of Construction: Occupancygroup:
I ., 0o0
k -3
Qty. if
Aunlicable
Fee iD
Far T)aerrintinn
RPP (:rroin
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