08080156 CITY OF CUPERTINO _»:r^3
BUILDING DIVISION PERNUT ZX0NT U"GT,'GR11NFORMAT°,ICON':,, .
BUILDING ADDRESS' PERMIT NO.
18665 RALYA CT MBROWN CONSTRUCTION, INC 08080156
ODAMNER'S NAME: PERMTr ISSUE DA
j i00MAN MOOBED 702 S DPNIEL WAY 08/21/2008
NE: SANITARY NO, CONTROL NO.
(408) 260-1260
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDGD O PLMECH
O I�
u0a LICENSED CONTRACTOR'S DECLARATION Job Description
4 1 barely anion that 1 am licensed under previsions or Chapter 9(commencing P
withS tion7OW)ofDivi+ion3afdlo Budsstand RofeWom sad licever RE—RF RMV 1LYR EXT TAR&GRVL&INSTL APPX 22SQ CLS A
^ In full rose mutely � ?q
&r3 ere=n + Lio.{ o COMP W/4SQ FLT MULE
3W Date @ — TSDECLA
e As shall ARCHITECTS OECLa AT N
e I unclersund my ptau Mail bu used as public teCoNs
56
k cLicensed Pmfcaional
5 OWNER-BUILDER DECLARATION
E i 9 1 masoerebyn.
.(Rte that 1 1. exempt s an the Contomlessomctora :My C Law for thte
EMO following uires a (Suction 78313.Business and sad.de nu Code:Any city at courtly
S$ which require a permit re c.natsL pplk ifor such
de erten t m.:pair any suuctum
p^orb.l lensed Immant1.to dao.powistlicano for such pmunil Lim. rcd
<
load Ise otwit pmvtam70th)of Division
the Conlrecnr'a Licensefaw(ChaPur9 Sq.Ft. Floor Area Valuation
�9 (cam a iisiaS with Sreuan 7000)of basis f r the W Budnenand Prafeu vi Cade)of $4745
that o u axempl therefrom and ale Eur far the dlryed tumpthon.Any it penalty
of
.I me 7031.5.ary hundred
fora permit mbjtcu the applleant ro e civil penalty of Number Occupancy Type
net ream site„save hanama duilaa(ss0m. 37 5 2 5 0 0 9 .�
0 I,a owner of abs property,s my employees with wages as their saleCompeneadon,
will do Newark,and thesuuc sire r nninunded oraffered ferule(Sec.7044.Busi^-,•
and Profemou Cade:The Contestant Liana taw data Out apply n an owner of Required Inspections
property,who Wildsorimprova thereon,andwW daa+uch work himuJfor Waugh his
own employes,provided that such Improwmenu are not inu aced aaaeted foreale.If,
however,the Wilding orlmprowmem r sold within ore yea of completion.Ne ownef-
Wilder will haw thee,burden of proNng that he did net build or improond for purpose of
ale.).
E-)1.as away of the property.w exclusively cmormou.,with licensed c=nlrxbn to
Cousner,the porem(Seer 7044,Basins,sad Profeuleu Code:)The Conuuar+U.
time law does not apply he an owner of Property who builds or Impr=wa thereon,and ,
who Contncufauuch prekcu with aconuacur(+)Reamed purwant user Contract=Ys -
Lic..La
mw.
❑Teuempl undo See ,B&PC fs this moon
0. Date
WORKERS COMPENSATION DECLARATION
1 hereby afOm under Porosity of perjury one of the fallowing daluaionac
1 ham and will mdnuln•CaNOCom of Concent to self-iuuor for Woftes Coupon.
sola.,as provided for by Section 3700 of de labor Code,for that pens rmmec of the
work for which this permit is homed.
haw and will maintain Woreera Gmpa aauon Imonoem,u required by section
700.f the losbs Cade,for the performmce of the work fawbich this permit r lssad.
MY Wofkeh Csopeaation buy cea and Policy number am:
Gorier.
,puce
( TION O R .
L TIFl ATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thr auction eased mthecomplcatd if tie permit is Insane hundred dopers(SIM)
or lea)
I wary that in the performance of the wart for which this ptmmr is Tawd.l shad!nm
employ any person in my mannerm as u bcmme subject to the Worker!Compauadon
Laws of Cdiforola.Data -
Applheam
NOTICE TO APPLICANT:If.afar matin{this Ceninosu of aumption,you should
become subject an the Worker',Compensation pmvisiou of the tabor Code.You most
O forthwiW Comply with iou such provrs a
this pennil shill be clmed meted.
Z 51 CONSTRUCTION LENDING AGENCY
f" thereby affirm ft,ft.r a consrwtinn lending agency for the perfomanCouf
Ci e,7 the were for which this Permit Is lewd(Sec.3097.Cih,C.)
QLender's None
z, Isende'sAddress
U O 1 ruin Na I ha m rosd this application VW state that the also.infommdon r
Cootpn I a{fa th comply with all city and country mNnances and mre m Irelating be
C)SV' Wilding construction,arta hereby authodu upre¢nutiva of this city u enter upon oh
W al mm-mendmrcd Property for iupecdon purposes
(We)Agree to ave,indemnify sed keep homeless the City of Cupertino a{aiost
r�A liabillaea,Judgments,costs and expenses which may in my way see=against aid Clly -
V Z in conagmnee of the granting of this PurmiL
^� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date Q
SOURCE RECD TIONS.
_ I Re-roofs
Simadure afA eMl/G or Dau
HAAAADOUS MATERIALS DISCLOSURE Type of Roof
Will this applicant or rumor building occupant some or handle haradous material
as denned by the Cupertino Municipal Cade.Chapter 9.12.and tin Health ad Safety
aa
Cade.San M5324)? All roofs shall be inspected prior to any roofing material being installed.
❑Yos e
Will the applicant or alum building Occupant era equipment or dmdm which If a roof is installed without first obtaining an inspection,I agree to remove
It Nm
havanalrconumiunu a de0ncd by the Bay Area Air Quality Management all new materials for inspection.
OWH'17
i]Yos u
I ha.reW the heard mmdsi mquimmmuunder Clupurh.95ofWCalifar- e�
ma Hosllh&S+fctyCadc, 'ou25505,25533am125534.lundnundthaifan Wilding
duo ret cumnay haL�
a unarm,that It u my mmandhilitY n nadfY do oceupant of the
tequGemcnuwhichm k.tpd o. aousofa CaWkauor .7 1a Signature of Appl' t Date
Owner of anthodud agent DILoow All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37525009 . 00
DATE ISSUED. . . . . . . : 08/21/2008
RECEIPT #. . . . . . . . . : BS000005856
REFERENCE ID # . . . : 08080156
SITE ADDRESS . . . . . : 18665 RALYA CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HOOMAN MOOBED
ADDRESS . . . . . . . . . . : 18665 RALYA CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : KRISTINAM HAGAN
CONTRACTOR . . . . . ... E CHRI& BROWN LIC # 25108 .
COMPANY . . . . . . . . . . : MBROWN CONSTRUCTION, INC
ADDRESS . . . . . . . . . . : 702 S DANIEL WAY
CITY/STATE/ZIP . . . : ' SAN JOSE, CA 95128
TELEPHONE . . . . . . . . : (408) 260-1260
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 4, 745 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1REROOFRES SQ FEET 22 . 00 286 . 00 0 . 00 286 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 286 . 50 0 . 00 286 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--- ------ -----
CREDIT CARD 286. 50 AMEX
---------------
TOTAL RECEIPT 286 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS "-605 FINAL REROOF
CITY OF CUPERTINO of o
REROOF
01f
•CUPEIQTINO PERMIT APPLICATION
APN # Date:
Building Address:
rO
Owner'sName: 1 Phone #:
YY1 An /4)L-C cs 49,
Contractor: Phone #:
Mpj1 (9. 2� 013LG0
a'CS1 JY1 Fax
Cupertino Business License #• Contractor License #:
2S 10� �/c7�2Z
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles .4—Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
Other (Specify) Other(Specify) 6F-' M t,(•e
Number of existing coverings 1 ❑ Provide I.C.B.O. Report # kCA=
❑XTo be Removed ❑ Provide Mfg. Installation Specs.
Job Description:
Residential Commercial
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: 41
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPEIITINO FEE SCHEDULE
Number ofFee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
iBSEISMICO Seismic Commercial B
24 1REROOFRES Re-roof Residential B 1SFDWLR00F
/ 1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roof Multi-Family B IMFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
12/16/2004 10'.21 FAX 408 777 3333 CITY CUPERTINO /0002/002
Community Development Department
Building Division
City of Cupertino
• 10300 Torre Avenue
OCIO Telephone: (408)777-3228
CUPEkTINO Fa)c (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 1947 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspectie n
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) hi-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 murt
be paid before another inspection can be scheduled.
IMPORTANT:
I. 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 reroofing.
Homeowner's Name: 'VViyi G n moo 64
Job Site Address: I V/105 kA J/ dt �"t-b�/CA— qs-M 4--
Roofing Company Name: �N' rO 1M l ,�llo`_V0— IM i 7
Applicant's Signature: A Date: ... "
Greg Casteel
• Building Official
Revised 11/2/04
Printed an Redyded Paper
Community Development
10300 Torre Avenue
aCITYF
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408) 777-3333
OUPEkTINO
Building Department
JOB ADDRESS: `��(� 7� iQ PERMIT# �0�6
15040
OWNER'S NAME: M 00►.jd IPHONE # f s-&Q , 1-73to
GENERAL CONTRACTOR:HbRjo QVL*UCfj0 SH(,I FAX # Y, 2l0t I Z 0
I am not using any subcontractors: ;n Zr
gnature Date
Please check a pplicable 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 W 0114U'6NL )6
Septic Tank
Sheet Metal
Sheet Rock
Tile
Z(
Owner/Contractor Signature Date