08060029 CITY OF CUPERTLYO
BUILDINGD55'IYON PERMIT -�CONT"o"T'o INk'ORMA'�ION
N
BuILQIJ,JC.ApORFs AN JUAN RD JIM KRAUSE ROOFING P 08060029
OWNERS NAME: PERMIT ISSUE DATE
J & K FETTERMAN 2310 DIANA AVE 06/04/2008
WE: SANITARY NO. CONTROL NO.
AacwTEcrfEncINEER: INFO
RE—RF T/O EXSTNG CMPTRF 'BLDG BUILDING CG PER PLUMB MECH
0 0 0 0
w00 LICENSED CONTRACTOR'S DECLARATION
i�u I brachy afRrm that I am licensed under previsim n of Chapter 9 aommre
ming ^^ -_„ ,... _ ,._.. .._ -debDes"iption
with Section)010)of Division 3 oftho Business and Prokmme,CodC.and my liccnm is
in full forte and eff
j�� LicenscCus �� Lae. •s •�
k, Dato —f J C` Conu em ..
eQ� ARCHrrFCI'S DECL)CILATION
2< 1 undersand my plans shall he used as public reacnrrb
:t U
L O ra Licensed Professional
OWNER exurpt R DECLARATION
sZ i f I hereby.(Sect that I am eush from the C usimes at License Law far the
C o which re nawa(Salon 703LS,Buaimss and ere.de oli Calc:My city as county
which its requires a permit to construct,the
alter.Improve,de such Permit
t fie I Sig any stmewm
5=e
ZOU Ile
iaiensedpalso requima thovisio ant sofd a Contractor's
wicurse Law(Chapter
1Mf Mis licenscdpurnn(tothe provisions of Cite Conuutor's4uense law(CMpter9 Sq.Ft. Floor Area Valuation
yg$ (Co..
with Section]000)af DivusionJnf Ne Busin,ss and Professions CMe)ur
— that be or comp(therefrom and tk buss for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjcc s use applicant Id a Civil penalty of APN Number Occupancy Type
nm mom than fmva hundred dollars(S500).
P Y YP
I,u o-xncr of the pmpmy,m my cmployeu with wagu u theunle enmpemdm.
mid de umwons Co
a The come actors Li aedm Law
doesmnl apply an an owner
of Required Inspections
and erafeviola Code:The Contractors and who Law Circa mf apply lf,t owuer is q P
pmpmywyces.pdsmimptat suves ch
who acenotmundaud motioned
his
own cmployces,progded that such improvements am not intended moRered fm sok IL
however,the building ouImprovement Is sold within ore year of completion,duer-
e ownwill Mw de burden proving dos k did rot hoist far purpose of
Ca .).
❑1,as Moor of the property,am exclusively contracting with licensed Commit ant to
cmptmct NC pmjeu(Sec.TOa<,Buincss and Prolmi..Code:)TLB Contractors Li-
«oa law does twt apply on an amour of property who builds or improves thereon,and.
who cornets for such projects with a conuvcmr(s)Emoted pumuanf to the Contramers
License law.
❑lam uemp(uMur See ,B&PCfmthi,muan
Owner Dap
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under pemal(y of perjury oro of the following deslanfioac
❑I Mve ria will msinin a Certificate ofConsent fp self.imum fm Workers Compen.
ration.an provided for by Section 3700 of the labor Code,for the performance of the
wmk for which this permit is issued.
Mere and will mandate Workers Compensation Insurance,u required by Sanson
3700 of the labor Code,fm Can per(ormvmc of than work for which this permit is issued "
My Worker's Compensation Laurance es rim and Policy number art:
cmdo'...ST/}TL ✓ND Paltry No.:' -C i )0CV13
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Oma xNm need not he completed lithe permit Is fmmse hundred dollars(SI W)
or Ica.)
I unify Nat in the perfomtance of the work for which this Permit is issued,I shall not
employ any person in any mnmr u a to become subject to the Workers Compensation
Law,of California.Dap
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become Subject m Ne WorkuS Campcnsadan provisions of tM IaW,Co,,you muss
.J O (Orth With comply with such provisions m thus permit shall be amount revoked.
ZM CONSTRUCTION LENDING AGENCY
[—r 1 hemby affirm"them U a Construction lending agency for the perin rOmen of
CL > the work for which this pari(is issued(sec.3097.Civ.C.)
0 Lenders None
D z Lenders Address
U 0 1 anify that 1 have mad this application and,ua Nu the above information is
LL E' carmcL 1 agree Or emoply with usus laws city and county oNinead and sulaws besting to
0 building construction.tend hereby auhomu
e mPreaative, m of this city enter upon to
r W above-mentiomd ur,te for inspection purposes
I•,r 0. (We)egos be save.indemnify and keep Msmkss the City of Caparison against
to inconscacoceofthecomandof this Permit. may in any way acme agsinst said City
U,z inconsequence of de drantinB of Nis permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT 'Issued by: Date (, 4 _c7w
SOURCE REGULATIONS.
/
Signuum afAMlmndCanuaamr Date Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the apCuper(m forum building occupantstereor and hnandoud Safety
C de.Sed io tie Cupenim Municipal Coale.Chapter 9.13,and the Health nJ Safety
Code.Sccdan 35332(a)?
40 ❑Yu 05ZAll roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtainingan inspection,I agree to remove
Will the applicant or future building by one B tie a,Air Qu or Manna which _ P g
emit havaNnu air confaminnts u ntcfiuent by one Bay Arta Air Qualify Management all new�mi[erials for inspection.
❑Yen
1 have read the hnarauw muedsamquiredems under Chapter495 of the Califon-
m-Health&SafetyCode,Sections 25505,25533 am125534.1 urdersund thudde building [�� ��
dna I unemly Mve a mnnL that itis my m,poulhility m nodfy the scup.,of de eAlrll f fi_�k/' A� 7
my awhich m be ptiar to Immune ofa Cmdricate oraeup.rey. Signature of Applicant Date
�C t 6-i -2.Ve
Owner or euthono sem Date All roof coverings to be Class';IV'or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . : 34218031 . 00
DATE ISSUED. . . . . . . : 06/04/2008
RECEIPT # . . . . . . . . . : BS000004994
REFERENCE ID # . . . : 08060029
SITE ADDRESS . . . . . : 22660 SAN JUAN RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : J & K FETTERMAN
ADDRESS . . . . . . . . . . : 22660 SAN JUAN RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3933
RECEIVED FROM EDWARD A 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
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 21, 700 . 00 2 . 20 0 . 00 2 . 20 0 . 00
1REROOFRES SQ FEET 54 . 00 702 . 00 0 . 00 702 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 704 . 20 0 . 00 704 . 20 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 1, 278 . 10 MC
---------------
TOTAL RECEIPT 1, 278 . 10
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
CITY OF CUPERTINO
Syeamol, REROOF
CUPE�TiNO PERMIT APPLICATION
APN # Date:
,-4 �U � % . 00 � - Y- zoo a'
Building Address:
z z �0 s ef.t. J v c?, �d
Owner's Name: Phone #:
SdK /o d'- ZS 7- 6
2 t'rWl an
Contractor:
Phone #:w b�- Z�r� yZ `l%
Fax #: 77P-
Cupertino Business License #: Contractor License #:
5—
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles �r Asphalt Shingles C/rss ,4
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify) zlS
Number of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
7b Descrtenption 4
� �
dL4;
//d yo 5;r/L-9 L'q/--q L/+/%r,-S G f N{_ -4 V e- 41 eo ve.zd ul
d
S—y
n I4'js 1- /Je. 3016 71e/� Sere„r
Residential Commercial
Fire Zone: Yes No ❑ Confirmed with Planning Dept. if
there are any restrictions:
Valuation: .:_2 l 7rry
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
241
Signature
CITY OF CUPERTINO
REROOF
U OF
cuPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
Sr �� IREROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roofMulti-FamilyB IMFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC . Business License B
•
' 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 LC.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-roufing.
Homeowner's Name:
Job Site Address: Z Z 660 a, 7c(
Roofing Company Name:
Applicant's Signature: U" Date: y ZJJ
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
SAW10 Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPERTINO
Building Department
JOB ADDRESS: PERMIT #
7 &6ep
,L tiuG ,(Z c� OG 6G'I�n1
OWNER'S NAME: e, , PHONE # S�a,p- z s7- S3I ?
GENERAL CONTRACTOR: 1 ;w K. v sz` vo ;A3 FAX # Bio - -77f= L'8J 7
I am not using any subcontractors. 6-
Signature U U 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
• 6 -2��
Owner/Contractor Si a e Date