08080187 CITY OF CUPERTINO
BUILDING DIVISION PERMIT nCUIVTRACTC?R�IdNFRM, .A.TIN
BUILDING ADDRESS: PERMIT NO.
831 ROSE BLOSSOM DR JIM KRAUSE ROOFING 08080187
NER'S NAME: PERMIT ISSUE DATE
SMITH 13ARRY A AND DEE T 2310 DIANA AVE 08/25/2008
PHONE: SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER: BUILDING PERMIT nff0
TEAR OFF EXSITING SHAKE ROOF BLDG aLEcr PU)MB MECH
30$
LICENSED CONTRACTOR'SDECLARATION
!d1 hereby affirm that l an,licensed ander preview"ofChapter 9(eam
mcnamL Job Description
Ax with Section 70M)ofDWishm J of ft Business and Professions Code,and my license is
< in full force end efrect.
Cl G 39 Lk.g
Damcawm
ARcxnecrs os p Ano 1
I understand M
nJ my plane he useu d public records
U
6 Licensed Prornstiow
OWNER-BUILDER DECLARATION
ai I hereby.(Sero that i 1. exempt from the Camas;Co :Any c Lew for dm
i O O which tortuous
mason(Saito 7M I3,Businect..1mu and Professions;&..fi Code:Any city or county
5$
which rtquirns a pctmlt m eowroeL alcor,Improve,demnlW,or rtpWr soy awmum
i y prior m s licensed
eawa0.set requires Ne applic of for ouch p en's License
aa�Laed summent
�< matheineing eJpuntion70mMofDislout3ofW nusiness nkcuclsonCrusmr9 Sq.F[. Floor Area Valuation
(commeneing with Section 7000)nf DivrionJof tiro Business And Refeuiaos Cnde)w
mat Section r eu5 b therefrom and tiro aper for the dusted asm eat to Any vlordon of
AnnMmeet t by any applicant for x permit mbjtxu the appacsnno x civil penalty of APN Number Occupancy Type
' het mart Uuv five hundred dolrn(5300). P Y YP
❑I,u owner of the Pmperty,w my wpltycu with cops u their mle compc=dm,
windothewark,anditznmumrmiIntendedoronemdforsak(Sm.'f .Badness
and Pmk slime Cndc The CWtommaa I W.law does het apply to an owner or Required Inspections
Property who builds w improves thetcom and who dos soh work Almnel f w Uwuth his
awn employees,provided Nu such improvements arenot inmndrd oraRemd fwawc.If,
hawwr,Is building a improwment Is mid within one year of completion,the owner.
Wilda will bathe the burden of proving dot he did not build or improve for purpose of
per.).
❑1,a owner of Also property,am exclusively contracting with licensed convaetan to
conetmct the project(Sec.IDN,Bwinw and Profession$Code:)The Contractor's Lt.
comm Law A.not apply to an owner of property who builds or improwa Nerton,and
who contracts for such projects with a contraclef(s)licensed pursuant to Ne Con ose u's
Liens Law.
I am exempt under See, ,B B PC fee Nr mason
ne Dam
WORKERS COMPENSATON DECLARAnON
I hereby slnrm under penalty of perjury m of the following declarations:
Iluw prewlll for by eCWOesm of ft ether Cod in for faWorkmanCempen-
sWon,u provided for by Section J]OO of Ne labor Code.for dm peAannutce of tk
work for which her permit r ivuM
haw and will maintain Wwkeas Compensation Insurmu,As required by Section
1700 of Ne labor Code.far the wdormmca of Ne vert forwhicb this permit Is leaned. '
My Worker's Compensation Immmom artier and Policy number am:
Carder.iY/��TC/ -'-Wo Policy No.: 7,
CERTIFICATE OF EKEMPTON FRO WORKERS'
COMPENSATION INSURANCE
(Thr semlrm need mtaecesemm d lithe Permit r form hunNrddoBan(SIOM
of kat)
1 certify that In Ne perromanam At the..,it for which this permit is loved,I shall raw
cmployanypc in any moo mI mP Workers'ComperuW®
U.of Catt Own
Applicant
NOTICE subject
APP LIC ANT. ,ancr Commakingnp noncom of Leiner Co,youshould
baomesubjecty it Wohcas Compensationprovisionsofthe Labor Code.you must
.J 0 faMwith comply with such wvvidtns os her Permit Matl he damrA mwkc4
0 CONsrRUCnON LENDING AGENCY
(~ I hereby xM m that Nem is convection lending apency,for the perfurmence of
C da vert for which this Permit At issued(Sac.3097,Civ.C.)
W I-menes Name
z lander:Add.
U O 1 certify our 1 haw mad this application and sum dues the abow Irdomudun is
E couch.l agree to comply with all city and county eminences and mos lawn relating to
.O [V^ Wilding mnmWction aM hemby autual rtpldernadns of this city to mler upon Ne
W ahem-mentioned propeny for inspection purposes.
LL (We)agree to pew,Indemnify and keep harmlw the City of Cupertino against
rn Irbilidu,judimenu.coau and expenses which may In my way mrnm agdutsaid City
(„)z in coosegtmnce of the granting dthr PmmIL
AP Nf UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO REGULATIg�+s.
_ � L tem r�7 2S d� Re-roofs
Signature or AppllesnuCanustw Dam
HAZARDOUS MATE ALS SCLOSUM Type of Roof
Will No applicant or future building occupant store orhandle hazardous material
defined by The Cupemno Municipal Code.Chapter 9.13,and the Health and Safety
.Section 23532(x)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yu
Will he applicant or fulum building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit haurdnus air conuminmin As deRned by the Bay Arta Air Quality ManxLemmnt all new materials for inspection.
District?
❑Yes
I hew mW therequirements under Chspmr6.95ofthe Califor. a'�
.is Health A,SafmyCod0.Socamm 255OL 25533 md25534.l uodcrsuntl NatifNe Wilding // 6
der a(cmmnuy haw.¢nanL Nat it U my responsibility 0 noun pew attupmr of pew X_ J
tM1 tswhmhmuuhemet iwtoiasuwmcancerdnesmar«eupsney. Signature of Applicant Date
Ownerwm 1-& n ' m� All roof coverings to be Class'V'or better
CITY OF CUPERTINO
• % REROOF
CUPERTINO PERMIT APPLICATION
APN # 3 " 610240 ,00
yG240 ,OU Date: �
Building Address: 8 3 y T ?/ S
0 se
r -
Owner's Name: �ee SM 1-4 Phone #:y�
Contractor: S;u� KrrivSe -r00 ^s/// Phone !/��— mss—yL yd%
`� 3iO 6��cnS Ove- A0/ 0w11_1104- 1T5O37 Fax #: �10d- 77P— PJD7
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
a Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles G Fwd�4rk
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles a Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
o To be Removed . ❑ Provide Mfgr. Installation Specs.
Job Description:
C145r 4/ 30 S .S
Residential 4 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:
/•Z 7c10
•I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF •
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
3� 1RER00FRES Re-roof Residential B 1SFDWLR00F
I 1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLR00F
1BSEISMICRE Seismic Residential B
IBUSLIC Business License B
Revised 6/16/08
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 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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/a "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: -Pee. S xi A
Job Site Address: 83 V 'gOS2 d��D S SO rr4
fi �r
Roong Company Name: : " {/ 4u 'R�D"tg
• Applicant's Signature: Date:,?-
Greg
ate:g-Greg Casteel
Building Official
Revised 07/30/08
3`� /�o se�/ossoµ• D�
Green Building Plan Check
Index of Green Building Points/Categories
A. Category Example of an Index or Table of Green Plan Sheet or Page Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) 5-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A-3 2 points
4. B. Fiber Cement Siding, (Note/Spec. A-4 2 points
F. Plumbing 1. Insulate all H.W. pipes, (Note/Spec.) P-1 2 points
5. Tankless W.H., (Note/Spec.) A-2 2 points
11. A 2500 Gal. Tank, (Note/Spec L-1 10 points
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A-3 1 point
3. Energy Star Refrigerator, (Note/Spec. A-3 1oint
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
Plan Review Process Work Book Page-12-Revised 3/25/08
• Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types,assigning a"total points'value to a project to be considered environmentally friendly is
not feasible. However,25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for"greening"your project.
A. rte
i.Recycle Job Site Construction&Demolition Waste
'65%. =1 point;75%= 2 points;60%=4 points
IMaterials
! up to 4 Resource pts 0
4 Re2.Salvage Reusable Building Mate els ) source pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4.Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y--yes 0
6.Implement Construction Site Stormwater Practices 2 Resource pts y=yss 0
7.Protect Water Quality with Landscape Design 2 Resource pts y--yes 0
CC Design Resource-Efficient Landscapes and Gardens 1 4 Resource pts y=yes 0
9,Reuse Matedals/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes , 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y--yes 0
11.Provide for On-Site Water Catchment I Retention 2 Resource pts y=yes 0
1 1 I
B.Foundation
• 1.Incorporate Recycled Flyash in Concrete
25%Recycled Flyash=2 points;Add 1 point for every 10%
increase of flyash,up to 5 points up to 5 Resource pts 0
2.Use Recycled Content Aggregate "Resource =yes 0
3.Insulate ycledFoundation/SlabA before backf 11 =yes 0
1 1 I
C.Structure)Frame
1.Substitute Solld Sawn Lumber with Engineered Lumber 3 Resource pts y--yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood I-Joists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resource pts y=yes 0
5.Design Energy Heels on Trusses 6"or more 2 Energy pts Y_—Yes 0
6.Use Finger,Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered.Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c. Roof 3 Ener is
9Y P y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pis y=yes 0
12.Use 0513 � -
• a.Subfloors 1 Resource pt y=yes 0
b.Sheathing
. _ 1 Resource pt y=yes 0
xter or n s •
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y--yes 0
b.FSC Certified Wood 3 Resource pts y--yes 0
2,Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAQIHeaith pt y--yes 0
4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes D
1 1 1
E.Plumbing
1.Install Water Heater Jacket 1 Energy pt y--yes D
2.Insulate Hol and Cold Water Pipes 2 Energy pts Y--yes 0
3.Retrofit all Faucets and Showerheads with Flow Reducers
a,Faucets(1 point each,up to 2 points) Up to 2 Resource pts. D
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
4.Replace Toilest with Ultra-Low Flush Toilets
(1 point each,up to 3 points) Up to 3 Resource pts. 0
5,Install Chlorine Filter on Showerhead 1 IAQ/Health pt y--yes 0
6.Coned Gas to Tankiess Water Heater 4 Energy pts Y_—Yes 0
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 41AQ/Heallh pts. 0
8.Install On-Demand Hot Water Circulation Pump 4 Resource pts y--yes D
r.ciecmcar
1.Install Compact Fluorescent Ught Bulbs(CFLs) •
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to 4 Energy pts. D
2.Install IC-AT Recessed Fixtures with CFLs(1 point each,up to
5 points) Up to 5 Energy pts. 0
3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0
4.Install High Efficiency Ceiling Fans with CFLs
(1 point each,up to 4 points) Up to 4 Energy pts. 0
I 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt y=yes 0
2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes D
3.Instail Energy Star Rehigeretor 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pts y--yes 0
I
H.Insulation
1.Upgrade Insulation to Exceed Title 24 Requirements
a.Walls 2 Energy pts y=yes 0
b.Ceilings 2 Energy pts Y--yes 0
2.Install Floor Insulation over Crawl Space 4 Energy pts Y--yes 0
3.Install Recycled-Content,Fiberglass insulation with
No Added Formaldehyde 3 IAQ/Health pts y--yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation •
a.Walls 4 Resource pts y=yes 0
b.Ceilings 4 Resource pts y--yes 0
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts Y--yes 0
o.Ueilings 4 Resource pts y=yes 0
1 1
• 1.Winclows
–
11.'Install Energy-Efficient Windows
a.Double-Paned
1 Energy pt Y--yes p
b.Low-Emissivity(Low-E) 2 Energy pts y--yes p
c.'Low.Conductivity Frames 2 Energy pts y=yes p
2.Install Heai Transmission Glazing ' 1 Energy p y=yes p
Low
1 1 1
J.Heating Ventilation and Air Conditioning
,'-j"-Duct Mastic on All Duct Joinfs — 2 Energy pts Y--yes p
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes D
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes p
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y--yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes D
S.Install Attic Ventilation Systems 1 Energy pt y=yes D
7.Install Whole House Fan 4 Energy pts Y--yes 0
B.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9,Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes 0
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts Y--yes p
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes p
• 12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes p
13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stoves(nser s 1 IAQ/Health pt y--yes 0
J. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes p
14.Install Zoned,Hydropic Radiant Heating 3 Energy pts y=yes p
15.Install High Efficiency Filter 4 IAO/Health pts y=yes p
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes p
1 1
K.Renewable Energy and Roofing 4 1
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes p
2. Install Solar Water Heating System 10 Energy pts y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes p
4. Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts p
0Select Safe.and Durable Roofing Matenals 1 Resource pt y=yes p
6
Install Radiant Barrier 3 Ener
____ 9Y Pis Y=Yes � D
1 1
L.Natural Heating and Cooling 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes:L
p
• 1 1 1
. n oor r ue rty an m e es •
1.Use Low/No-VOC Paint 1 IADMealth pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAD/Health pts y--yes 0
3,Use Low/No VOC Adhesives 3 IAO/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AD/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0
7.Seel all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes D
B.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y--yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
i i 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2,Use Rapidly Renewable Flooring Materials 4 Resource pts y--yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0
5,Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
B.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes D
1 1 1
Total Points Availablel 1 1401 130 57 •
Total Points Project Received: r 01 57-751
G:data/progslgmenbulldmpguidelines4emadelersrgreenpoinlsflna121204pmlecled.ds
Is
Community Development
10300 Torre Avenue
t Cupertino CA 95014
Telephone(408) 777-3228
*CUPEI,TINO Fax(408)777-3333
Building De artment
JOB ADDRESS: // PERMIT#
S SID"7V,-
OWNER'S NAME: ,-e ,,,;744 PHONE # Yo?-Zs)-o PcF1
GENERAL CONTRACTOR J r rrSe_ .t FAX # 7 - 8,?J -7
I am not using any subcontractors: ✓X4�,,r� b'-�yj=0 ?
Signatur Date
Please check applicable subcontractors and complete the followinginformation:
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 ; , , a✓s e-�7,)r� Z Y«
Septic Tank
Sheet Metal
Sheet Rock
• Tile
Owner/Contra to S'gnature Date
• CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35904020 . 00
DATE ISSUED. . . . . . . : 08/25/2008
RECEIPT # . . . . . . . . . : BS000005883
REFERENCE ID # . . . : 08080187
SITE ADDRESS . . . . . : 834 ROSE BLOSSOM DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SMITH BARRY A AND DEE T
ADDRESS . . . . . . : . . . : 834 ROSE BLOSSOM DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-4214
RECEIVED FROM . . . . : EDWARD GREGORY
CONTRACTOR . . . . . . . : KRAUSE, JIM LIC # 21415
' COMPANY . . . . . . . . . . : JIM KRAUSE ROOFING
ADDRESS . . . . . . . . . . : 2310 DIANA AVE
• CITY/STATE/ZIP . . . MORGAN HILL, CA 95037
TELEPHONE . (408)779-0704
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ------------- ---------- ---------- ---------- ---------- ----------
I.BSEISMICR VALUATION 12 , 700 . 00 1 . 30 0 . 00 1 . 30 0 . 00
1REROOFRES SQ FEET 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00
---------- ---------- ---------- ----------
'I'OTAL PERMIT 391 . 30 0 . 00 391 . 30 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------- --------------- --------------------
CREDIT CARD 391 . 30 master card
------- --
TOTAL RECEIPT 391 . 30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF