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06060259Im, 2< +1" u f- f=- yyC tot �G< <me u—a ?2 YI—e CITY OF CUPERTINO OR -PI DUILDING DIVISION PERMIT %CONTRACTORINF BUILDING ADDRESS: OLD COUNTRY ROOFING PERMIT N006060259 10281 PARLETT PL OWNER'S NAME: PERMTT ISSUE DATE BHASKAR CHAUDHUM 125-B GROBRIC CT 06/30/2006 NE: SANITARY NO. CONTROL NO. (707)864-5557 ARCHITECT[ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 LICENSED CONTRACT'OR'S DECLARATION JOb DCSCrIpI100 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing Division 3afthcBusincaadd Professions Code, and myliccnmis in ullll fortes dcrff `l+-_31 �i` 7'� TEAR OFF SHAKES RESHEET OSB ADD 50 YEAR COMP License Glj. ZZ Date cor .a SHINGLES LIFETIME, CLASS A ARCHIVECT N 1 undersmnd my plans shall Licensed Professional OWNER -BUILDER DECLARATION 1 hereby alTfm that I am exempt from me Canlnctor's Lieena Law far the following reason. (second 701.5, Busincu and Professiom Cade: Any city or county which requires a permit to cnnsuua, alter, improve, demolish. in.pair my structure ! prior in its issuance, also require the applicant for such Permit to file a signed comment he is licensed of lM Conimter's License Law (Chapter 9 Sq. Ft. Floor Area Valu 000 that pursuant m the pmvisimu (commencing with Section 700(1) of Division 3 o the Business and Professions Code) or that W is exempt therefrom and the basis for the alleged exemption. Any violation of Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of{,9�PN)}v{,P not more man five hundred dollars (5500). .{y�er 3 1 O 4l) V �1 . 0 0 I,uowner of me property, or my employees with wageas Heir sole compcnauan, Required Inspections will da dee work. and dteaWcmre Y not intended or Offered for sale (see 704,1. BILd2l\ and Proreuiom Code: The Contractors License law does not apply man owner of q P property who buildsorimproves thereon, and who doessuchwork himalfor through his ' own employees. provided that such imptmemenu art an, intended oroffered formula. If. however, the building or improvement is sold within ane year of complcuon, the owner. builder will have the buNW en of proving that did not Wild or improve for purpose of ala.). {tt�' �� 1, as owner of the property, am exclusively contracting with Burned contractors to � k construct me project (Sec. 7014. Business and Professiona Code:) The Communes V. ��ppp yrw}Ix crena raw does not apply in an owner of properly who Wilds or improves meson, and . who contracts for such pmjece, with a contactor(s) licensed pursuant ur the Contractors Vh'•'( I,�� Lemmas Taw. O/ /{/� g C ❑ I am exempt under Sac .B&PC for this .anon Owner Damf,{ l� yy�7 fggy 13 D1 I47W71 WORKER'S COMPENSATION DECLARATION 1 hereby a1RmM ucr Pitiably of perjury arc of cine following decmti laans: elf 1 have and will maintain a Ccnifieate of Consent to self -insure for Worker's Campion. anion, as provided forby Section 3700 of the labor Cade. far the perform. of the work for which this permit is iso.d. 1 have ve and will maintain Wcokor's Compensation Insurance, as required by Section W of me liber Codd, far the pedormmce of dre work for which mu permits isv.d. My Worker's Compensation Insurance carrier and Policy number are: Carrier.g JS U'y'4,EVA Polity No.: 12-1381, CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATON INSURANCE Misme ran need act W completed ifthe Permit Is issued hundred dollar(5100) or less.) I cmtify Nat in the peofarmsncc of tW ..,it for which this permit u issued. l "I not employ any forms in any reactor sec tib become subject to the Workers Camp hemi e Laws of California. Date Applicant NMCE TO APPLICANT: If. after making Nu C., ifiate of E`emp i.r. you should become Subject m the Waher's Co n,troadim provisions of me labor Cod, you most ' formwim amply with such provisions or this Permit shall W deemed rtwked. j CONSTRUCTION LENDING AGENCY I hemhy drum mat mart I., e nn lending agency fns me perrurmana of wo ' the rk fur which this permit is issuedd (Sec. 7097, Civ, C.) c. Urater'Loomis Nam. Lender's Add. ' j I cmify that I have read this application and sun: man the above information is ' ' correct. 1 agree to comply with all city and county ordinances and sure laws .lating to building mnswnion, and hereby authorize representatives or this city to cner upon the I shove -mentioned Property far inspectionpurposes. (We) acme to save, indemnify and keep harmless the City of Cupenino against j liabilities,judgments, costs and expense which may in any way second against aid City in consequence of the granting of this permit. ' APPLICANT UNDERS DS AND WIL MPLY TH ALL NONP INT SOURCE REG ULA Issued by: Date 6 - O-G� '`Z4 Re -roofs Signature of ApplicxnUContracmr Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof �f— Will me applicant or future building oceupantamre or handle herardous material az dermcd by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Calc, Section 25532(a)? Oyer Q y, All roofs shall be inspected prior to any roofing material being installed. Will rod, applicant future building =upon, tea or devices which PP e Wuipl If a roof is installed without first obtainingan inspection, I agree to remove P $ emit s air conuminans as Jcfincd by the Bay Arca Air Quality Managcmcnn e Qu all new materials for inspection. Disui.,T ict? Ores 6N� I have naa l the haardrus.aerials requirements under ChapW 6.95 of tmecalifon niasHcaldh thaifde Wilding Cad a Sections; las and!25534.ndcify .'//�J Yr/ sg' (( am,&Sdcsy does rot I. y have a lenanC ma it iv my ma ouihiliry m notify me aeupant of me t naraapan5r. nL, which myuiremcnu which mus met per as r, ceNO Signature of Applicant Date f"e All roof coverings to be Class "B" or better �� owner or amhori dose. Date Community Development 10300 Torre Avenue ki. Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 �PEkTINO ,,//JJ Building Department JOB ADDRESS: PERIVIIT # OWNER'S NAME: PHONE # 4 Lf G - 9Z S GENERAL CONTRACTOR. -OC 41 GLP, FAX # I am not using any subcontractors: 0 (d C--&, V, — 6);006 Signature Date Please check applicable subcontractors and rmmnlatp +ha WinvAno infnrmnF:. - 21 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 KRoofing kl 6 ab Owner/Contractor ignature Date CITY OF CUPERTINO �m 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31646051.00 DATE ISSUED.......: 06/30/2006 RECEIPT #.........: 35084 REFERENCE ID # ...: 06060259 SITE ADDRESS .....: 10281 PARLETT PL SUBDIVISION ...... CITY .............: CUPERTINO IMPACT AREA ...... OWNER ............: BHASKAR CHAUDHUM ADDRESS ..........: CITY/STATE/ZIP .... , RECEIVED FROM ....: BONITA JENKINS CONTRACTOR .......: FOLK, DIETER LIC # 20389 COMPANY ..........: OLD COUNTRY ROOFING ADDRESS ..........: 125-B GROBRIC CT CITY/STATE/ZIP ...: SUISUN, CA 94585 TELEPHONE ........: (707)864-5557 •FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ------------------------------------------------------------------------- BPERMFEE VALUATION 14,000.00 212.76 0.00 212.76 0.00 BSEISMICRE VALUATION 14,000.00 1.40 0.00 1.40 0.00 TOTAL PERMIT : 214.16 0.00 214.16 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ OTHER 214.16 VISA TOTAL RECEIPT 214,16 • 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, the down will require removal of all new material 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. Homeowners Name: Job Site Address: /0 .2 - Roofing Company Name: O clnxy 4 �, y Applicant's Signature: Date: • Greg Casteel Building Official Revised 11/2/04 • city OF CUPERTINO F_I L 40 CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM APN # 3 G G U r/ BUILDING Date: o aG Building Address: p f BSEISMICRE Owner's Natye:� BUILDING BSEISMICOM Phone #: L/ L _ C� Z 5 S Contractor: Glop BPLANCHK Plan Check Fee License #: 62-273 / Contact: VCupertino BUILDING Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles >0. Wood Shakes 1>* O Asphalt Shingles Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # 1�11 To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description , k_44^ o S /q _ O d -0 yn cv� Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning Det. if LJ there are any restrictions: Cost of Project: Type of Construction: Occupanc roup: / a ,:::7V 3 Qty. if Applicable Fee ID Fee Descri tion Fee Grou BPERMFEE Bldg Permit Fees BUILDING BENERGY Energy BUILDING f BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING