06010128CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFOitMATIQN ">'
BUILDING ADDRESS:
PERMIT NO.0 6 0 1012 8
10012 SCENIC
OWNER'S NAME:
PERMIT L55UE DATE
STEPHEN BEARD
01/24/2006
NE:
SANITARY NO. CONTROL NO.
ARCHITECDENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
E 0 0
LICENSED CONTRACrOR'S DECLARATION
1 hfirm 1 licemed Chapter 9
Y
IDI Description
p
af under pmvitiaomm
ereby Nal an ns or (cencing
with Section 7") of Division 3 of the Business and Professions Code, and my license is
Inr"Lici,n�rle,andefre<,G_3 t,"D/�3 a
REROOF--T/O SHAKES, INSTALL SHAKES "B"
LiL.g
Damconlrxlo yea -vnPsu A-
ARCHITECTS DECLARATION
CONTRACTOR: MID PENINSULA ROOFING
I uiti,om dory pinsshallheused.'.Alis recruits
NALED
Licensed Professinnal
OWNER-BUILDER DECLARATION
I hereby affirm Nal l em crimp, firm the Convector. License Law far Ne
following reason. (Section 703 .5. Business and Pmfcssiuu Cade: Any city or county
^.g fjOOLa
i u
which m4Y1(Cs a'CRI11' "' CanalNCl, 81Mf. Improve. demolish. or IC'alI any slNCmm
prior to Its issuaM=,.1so ICQYInCt IAC appllLanl far SYLh TA'mlll la E [ a algned SIa1CnnCnl
th.theislicensedp..N ntlalhepmvisio¢of,hcconuacmriUcc=Uw(Chaplor9
(commencing with Section 7000)of Division 3 of Ne Business and Professions Cede)or
- V,
Sq. FC Floor Area ;j y�8Valu ib '�'�
(t y (r try � pj
that he is exempt therefrom and the baso for Ne alleged exemption. Any violation of
Section 9031.5 by any applicant for a permit subjects the applicant o a civil penalty of
man Rx dollar
APNNumber
�`Occu ant Type
p y
mol more hundred (ssoB).
35709051. 0 0
P
O 1, n owner of 0e pmpeny, m my employees with wag. u their sole compensation,
will do the work and the swctum ism intended m oRerrA hassle (Se,. 7061, Busnex
and Professions Code: The Contractor's License Law docs not apply to an owner of
Required Inspections
property who builds orimprnves thereon, and who doessuchworkhimself or through his
own employ., provided mal such impraxmem , art nes, intended reoffered forage. If.
however, the building or improvement is sold within one you of camplcuom. me owner-
buildef will have the burden of proving mal he did not build of improve for purpose or
sale.).
❑ 1, as owner of the property, am exclusively contracting with licenced commerma to
Couwct the project (Sec. 7044. Business and Pruncem. Cade:) The Cinsrsemes U.
cense Law docs not apply to an owner of propeny who builds or impmvm thcmon, and
who contracts for such insjects with a conuacmr(s) licensed pursuant to the Conuactofs
Lkcnx law.
❑ Iamaxemptunder Sec. ,Bk PCARWiuomon
mer Data
WORKER'S COMPENSATION DECLARATION
1 hereby allium under penalty of perjury one of We fallowing decimations:
1have vad will mainuim a Certificate mcimucnl to If-insumfor WorkeraCompen-
smion, u provided for by Section 3700 of We labor Code, for me performance of the
work for which this permit is issued.
❑ 1 have and will mninuin Workerpcua
's Camtion luuranct, u motored by Smimi
3700 of We Labor Code, for one pcifirms. or the wort, for which this permit is issued.
My Worices Compensation ivssumnce carrier and Policy number am:
Cartier://�%�%v�t/!� Policy No.Y�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu union need not he completed lithe Permit is for one hundred dollars ($100)
or less.)
1 certify mal in the performance of the work for which this Permit is issued, I shall not
employ any' person in any manncrso u to become subject in the Worker,Compeuason
Laws of California. Dam
Applicant
NOTICE TO APPLICANT: If, afmr making this Certificate of Exemption, you should
become subject to We Worker's Compensation pmvisiou of me labor Code, you most
roMwith comply with such provisoas m this permit shall W deemed mnluid.
CONSTRUCTION LENDING AGENCY
1 hemby gE m that there is a eouvuctinn lending agency for the pirfmmancc of
Me work fur which this permit is Wood (Sec. 3097. Civ. C.)
Landers Name
,
Lender's Addreu
1 comfy Out 1 have read this appimaion and state that We above information is
correct. 1 agree to comply with all city and county ordinances and state laws relating to
building eonswetion, and hereby audmroe mprexnulives of Nis city to enter upon the
above-mentioned properly for Inspection purposes,
(We) agree m save, indemnify and keep harmless Oc City of Cupertino against
liabilities, judgments, costs and expenses which may in any way accme against said City
in consequence of the granting of this permit-
APPLICANT UNDERSTANDS AN WILL COMPLY WITH ALL NON-POINT
SOURCE REGUL ONS.
Issued by: Date
�r�e lac_.
Re-roofs y
m
SlenatuafApplicaoV.ma=wr Data
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will me applicant or future Wilding occupant stare or handle hmardous material
defined by the Cupenino Municipal cod=, Chapter 9.12. and the Health and Safely
de, E] on 2sslz(n�i,q/All
❑ Ya IID vWill
roofs shall be inspected prior to any roofing material being installed.
the applicant or future building occupant use equipment or devices which
listo,39
If a roof is installed without first obtaining an inspection, I agree to remove
it h.vamoos air comminanls u JC reed by the Bay Arca Air Quality Management
all new materials for inspection.
❑ YLa
Ihavcmad C0dc,Srdrusm 5X)5. rc33and55underthroun6 War
ria HcalIhave mail Me humlouosouctia1mquimmn"un 1u Chap r6.95fthc building
tithe Wilding
does not, ... 11y have a cone Nat'
y rcspouihilily m rmily the oaupanl of We
requiremc tawhic vbemet lssumct ofa Ccnlficaeaf OLcupanq.
Signature of Applicant Date
All roof coverings to be Class "B" or better
Owner of authmia.=dagenl cone.
l
tit'" '
CITY 0,
�UPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS:
(2'r,)PUP=T v0
PERMIT #
066/6/'Lrr—
OWNER'S NAME: 5z Vc ZA=: -
PHONE #
CYRN19ML CONTRACTOR: M / i> _ Nr p ,
FAX #
I am not using any subcontractors: �• �7�d��y 1—:;z3— Ola
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/Contractor Signature
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
Til
Date
e
Owner/Contractor Signature
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
Til
Date
t
•
t
MEADOWS OF CUPERTIN0
101380 SCENIC BLVD.
CUPERTINO, CA 95014
(480) 446-1 81 8
January 23, 2006
To Whom it may Concern:
The purpose of this letter is to confirm that Mr. and Mrs. Stephen Beard, being the
homeowners of #10012 Scenic Blvd and that property being a part of The Meadows
of Cupertino Homeowners Association, have the approval of the Meadows of
Cupertino association to proceed with a re -roofing project which is in compliance
with the guidelines set forth by the association.
Details of the work to be done are set forth in a signed contract entered into by the
Beards and Mid Peninsula Roofing Inc. of Burlingame Ca.
Si erely, J
Jo Cleaver
F the Board of Directors
�� 2p06 /
CITY OF
CUPEkTIN®
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Building Department
Subject: Re -roofing policy for the City of Cupertino
Telephone: (408) 777-3228
Fax: (408) 777-3333
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:
Job Site Address: N/ C
Roofing Company Name: N11.) PE-1VI&I SULJ /20694�;NCr NCS
Applicant's Signature: �j�y�a4� J Date: _/—a 3--
Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
•
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t
CITY OF
CUPEkTINO
CITY OF CUPERTINO o z�
REROOF
PERMIT APPLICATION FORM
APN #�
SS%
Bldg Permit Fees
Date:
ZYd�
BENERGY
Energy
BUILDING
Building Address:
J&0/_�?- 3iJI�., �vp�2rit
Seismic Fee Res
_sC,6F
BSEISMICOM
Owner's Name:
BUILDING
Phone #:
ATL
BUILDING
408
Contractor:A Phone #:.
License #:
Contact: Phone #:Cupertino
Business License #:
nAPIM4 /BAR =7z ¢6'0-375_ _
Type of Roof Covering:
Existing: Proposed:
❑ Built -Up Roof ❑
Built -Up roof
❑ Asphalt Shingles ❑
Asphalt Shingles ZA Z 7)
}, Wood Shakes 0
Wood Shakes CtP�
❑ Wood Shingles ❑
Other (Specify) CL,45S d �RE7zG)ILA�/`�/� ❑
Wood Shingles
Other (Specify)
Number of existing coverings ❑
Provide I.C.B.O. Report #
COY To be Removed ❑
Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
Job Description:
T
Residential j�J Commercial ❑'
Fire Zone: Yes ❑ No ,pn—
Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: Type of Con truction:
(%0 l/
Occupanc group:
// 0
3
Qty. if
ADDlicable
Fee ID
Fee Descrintinn
Fee Clrnnn
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