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060201080z Z 0 CITY OF CUPERTINO*-*.��� BUILDING DIVISION PERMIT CONTRA.CTOR`INFORMATIO BUILDING ADDRESS: WOODS ROOFING PERMITNO. O 6020108 10679 SANTA LUCIA RD W NER'S NAME: FERMff ISSUE DATE BOB HILL 2179 STONE AVENUE STE 22 02/17/2006 NE: SANITARY NO. CONTROL NO. (831)637-5576 ARCHITEC (ENGINEER: BUILDING PERMIT INFO BLDGELECT' PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Ib Description 1 hereby affirm Out I am liceread under provisions of Chapter 9 (commencing OOSCTIp with Section 1of Divinun 3 of IW and Business Prolossima Codm. and my lice.. u n 0(10) full force an defy Z �3 1 Damn. Cl Lica REROOF--T/O SHAKES, . ADD S EL TILE "A" Dam Co.'—FIN CLASS ARCHMIC" DECLAR ON I uermand my plans shall W Dun d public ecnrds M Lumbacd Professional OatNEm DECLARATION exempt 1 botchy aRrm that 11. exempt from Nr Cortins License Law for the following mason. 7W 1.5, Business and Calc: Any city Maso Cod county ys ?806 which improve. to structure requires a permit to ennsuucl, alar, improve, Permit t demolish. Ana its prior m its issuance, also mquirs IW applicant for such permit to Glc License signed staemcm h Permit t e a sianygned tme that pursuant LNe de Comrutur'snroflaons . Sq. Ft. Floor Area Valu Mornmecingwit ofpmvisions sionf Codrer9 exewit Screfro90W).f Division) of Business and Professions Calc) or Om he al li and de burs for the alleged exempn t Any violation of Natio u exempt tang Sermon to by airy applicant for a permit subjects to applicant m a civil penalty of applicant pppN }Nsi r CCU cyafype then not more Nan fire hundred dollars (5500). ,. '1 LL /U 3 4 217 �� 9 0 0 El 1, m owner of the property, a my employees with wages a their sole compenution, will do Ne work, and the structure is not intended or offered for fele (Sec. 7W, Business and Professions Code: The Conuactori License Law does not apply in an owner of Required Inspections property who builds or improves Lemon, and who does such work himalf or through his own employees, provided Nm such improvements are nos intended oroRerad for sale. If, however, the building or improvement is sold within one year of completion, the owner. builder will have the, burden of proving Net he did our Wild or improve for purpo. of sale.). ❑ 1, as owner of Nc properly, am exclusively convecting with licensed contractors to conila..l the pmject (Sec. 7164. Business and Professions Cade:) The Con racmr's U. come law docs not apply to an owner of property who Wilds or impmvu thereon, and. who contracts for such projects with a eontr.mKs) licensed pursuant to the Contractor's License law. ❑ 1 am exempt under Sec. , B & P C for this rtuon Owner Dme WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following decimations: 1 hs.a and will maintain a Cerdfiate of Conant to self -insure for Workers Compen. adan. so provided for by Section 37W of de labor Code. for the performance of the work for which this pernit is issued. nave and will maintain Workees Compensation Insurance, as required by Section 3100 of Ne Libor Cade, for the per its m um, of Use work for which this permit is issued. My Work!e Co�mpyswtion lny5unmc aria and Policy n�uma nCcr are: Cartier. �' fI V""I\ Policy No.:_295-C5')'ff7 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thisaction aced mol W carpleed i(Ihe perm, is i.e. hundred dollars (5100) or less.) 1 comfy Nat in to perf.rmanm of to work for which this permit is issued. I dell .at employ any Noun in any manner. as in become abject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you si oold become subject to the Worker's Cam Knsntion provisions of the Labor Code, you mum forthwith comply with such pmvisinm or Nis Permit It he deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm Nat tee is a construction lending agency for On Performance of the work fur which this permit is issued (Sec. 3091, Ci, C.) Lender's Name ' Under' Address I certify Nat 1 have read this application and sate that the slow information is correct. 1 agree to comply with all city and county ordinances and stale laws miming to building convection, and hemby amhorim mpmumoivu or this city to enter upon the shove -mentioned property for inspection purposes (We) agoee to indemnify ave, and keep harmless the City o(Cupertino against expcnuswhich may in any way accrue against said City incoitncluen uof thecostsand granting of this permit. ntconuyuNT of UNDERSTANDS APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date 7 �� BOURCF gE(iSICAi'IOr1S, is '��_-�•C--�l/</--- �7�d Re -roofs StgnMUM ofApplicanV om rano( tee HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future Wilding occupant store or W rill, hvardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and Nc Health and Safety we. Section 25532(.)7 ❑Yes �_ All roofs shall be inspected prior to any roofing material being installed. Will Nm applicant or future building =upon, use equipment or devices which If a roof is installed without first obtainin g an inspection, I agree to remove hazardous air contaminants as dermad by the Bay Area Air Quality Management all new materials for inspection. Dimrict9 ❑ you, uv_u T have nail the hvardous materials requirements under Chapter &95 of the Califor- niaRulN&Safety Co .S =25505.25533ud25536.1uMcr ftir Nc Wilding Z Joe nos currently ham that it u my ra"nalility m roily the p nr IW 71-06 re mqi rut[ mien mWm pri.rw menr.CcMifmma.r a ey. Signature of Applicant Date All roof coverings to be Class "B" or better Owner or ablihosized agpd, --hmc } h' CITY OF �UPEkTINO r Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS -.,"0677 u �d PERMIT #0 (�0Zr7/U� OWNER'S NAME: PHONE # -73-7-2-309 GENERAL CONTRACTOR: FAX # V I I am not using any subcontractors: "Dz& 62 ' $�„--t f --,x !1 06 Signa a Date Please check applicable subcontractors and complete the following information: 60 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/ ontractor Signature 2/(7/196 Date A .1 i al� 06 CITY OF UPEkTINO 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:�0 Job Site Address: ��G %' . /c �cT /C-U�wi2la�% Roofing Company Name, IAV �d-7 s Applicant's Signature:] •=, Date: � 6 Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper • ��71' OF CUPERTINO r APN # L CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM Z ° 1/Ds 17 Bldg Permit Fees l� Date: /1 0 Oo Energy BUILDING Building Address: /� / I BUILDING BSEISMICOM Owner's Name: BUILDING Phone #: J' n ?37-2--30 Contractor: Phone!#: q -0803 �1 �(J L6L_ j �i'� License #: Contact: Phone #: Cupertino Business License #: 47W ZoS-s//s -20c5/a Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof D Asphalt Shingles D Asphalt Shingles Wood Shakes D Wood Shakes ❑ Wood Shingles ❑ Wood Shingles El Other (Specify) .I.- X- Other (Specify) �[� , O Number of existing coverings / ❑ Provide I.C.B.O. Report # E�T/Z I SJ 7 �L To be Removed ❑ Provide Mfgr. Installation Specs. I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ob Description: Tia ��PcP ��ta / S 5 , �c2�� Residential ,, Commercial Fire Zone: Yes ❑ No 0— Confirmed with Planning Det. if there are any restrictions: LJ Cost of Project- 0-,1 Type of Construction: Occupancy group: 000 Qty. if Aunlicable FPP IT) FPP TiPC/�t`1.1+•/fit• 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'