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05070020OQ WQ az UO a UL41 CITY OFCUPERTINOr m� '"Y� •`' IN II'OItMATION BUILDING DIVISION PERMIT ,t�CO1VyTRA.C�TOR - BUIIDINGADDRESS: 90-l';1-4 CITIAIRRAPQ AIT WESTSHORE ROOFING CO """'05070020 OWNER'S NAME: PERMIT ISSUE DATE E: SANITARY 0. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 (� LICENSED CON7RACTOWS DECLARATION 706 eLICH I Wreby affirm that 1 Am licensed under provisions of Chapter 9 (commencing p with Section 7011u) of Division Sof the Business and Formation Cade. and my license is full as Claund erten. L1c N REROOF W/PLYWOOD—�Jy'�f. ``1j ZUUS / Dao Contractor ARCHITECTS DECLARATION IundcnunJ my pons shall Wutsdn public rernrds jnV' ®u��®�O Licensed Rufeadond DECLARATION Oat ®J � I am exempt fi 1 hereby alarm I am exempt from to Comtracmrs License Law for the following moon. (Section 7071.5, Business and Pmfearoli Code: My city at county Maso on which mguiru a permh re crostmcL pMr. narrow, of repair any mamcm, h permit t the applicant ge, Conpant'w OlesSigned malcmcm that wits censed pursuant to Mw(CMpur9 thnhearneenwit puewantwthe of the Sq. Ft. Floor Area Valuation ofprovisions (commenting with Section7000) of Division Business And Code)re 3 of to Business and Profmy vi tat M 4 exempt thertfmm and Ute bub for shad alleged exemption. My viobRon of F 3 yVBl511*$l;r0 0 Occupancy Type Section 7031.5 by any Applicant for a permit subjects she eppliMI to A civil penalty of not more thm Bw hundred dollars ($500). ❑ I, As ownm of the property, or my empMycu wish wages as their sole compensation, Required Inspections will do the work end the structure Is not amended or offered fonak (See. 7044, Business and Profestlana Code: The Comracures U. Law does =t apply to an nomer of property who builds or im pm a ns terrors. and who dura such work himsel f or through his own employees. provided thauuch improvements arc not Intended mortared forsale. If, hewewr, the building or Improvement is sold within ate year of cempletion, the owner. Wilder will Mw the WNor of proving Wt M did nm build or improve far puryose of sal Yl.'ax owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. Trial, Business and Profesdons Code:) The Contractors V. cents law doss not apply to an owner of property who Wilde or Improves Lemon, sad, who contracts for such projects with a conuscwr(s) licensed pursuant to to contractors License Law. O 1 am exempt under See .B&P C far tisrenin tier ni Dau % C WO (ERS COMPENSATION DECLARATION I hereby aRrce under penally of perjury one or the following declarations: Q 1 have and will muinuk •CeAncete of Consent wselbinsure far Workers Compen. utter, As provided for by Section 3700 of the Labor Code. for the Performance of the work for which this permit Is issume. [:) I Mw and will maintain Workeh Cr mpenaation Inaurmce. As requited by Section 370O orshe labor Code. far to performance of tie work for which this permit is issued. My Worked Compensation Insurance carrier and Policy number art: Csnien Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section home not M eompleame if she permit is free= hundred dollars (SIM) or jest) 1 ceNfy tat in the performance of the work for which this Permit is Issued, I shall nam employ any person in any mm=rm uwhreom ��yo de Worken'Compewtion Laws of California. Dew ��� Applicant r7— NOTICE TO APPLICA1IY:L a r making this Certificate or Exemption. you should become subject to the Worker, Cumpevsation provisions of the Labor Cada you mus foMwiJe comply with such previsions or this Permit hall W deemed rooked. CONSTRUCTION LENDING AGENCY I hereby alRtm Jut tem is a construction lending agency for the Performance of the work for which this permit Is issued (Sea 3097, Civ. C.) ' Leaders Name , Landers Address I certify dram 1 Mw read this application and law that to aW ve information It corrcn. I agree to comply with all city and county ordinances and sue laws totaling to Wilding construction, and hereby autherim representatives of this city w enter upon the , move -mentioned property for inspection purposes (We) agree w saw, indemnify and keep harmless the City of Luper ins, against liabilities, judgments, costs and expenses which may In any way same against said Cry in of the APPLICANTeUNDERSTAntiNDSof �ANhisD WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCE REGULATONS� Re -roofs �r Signature ofAppli a r DAM HAZARDOUS MATERIALS DISCLOSURE Type of Roof Willy applicant no fuwre building re handle mammal As deMme the a, Chanutom Municipal Code, Chapter 9.13. and Ju Heslth and Safety t Health 32(a)?Cupertino Code, Section 2ss3:(.)7 io ❑ Yu �yJo All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building =open, use equipment or devices which mil hrrardnps air conumimnu u deft=d by Je Bay Area Air Quality Management all new materials for inspection. District dNu ❑Yes I have read the Msardommadmis k requimmenuunder Chapmrd,95 orlhe Califor. nia Health A, Safny Cade, Sectors 25515, 25573 and 35534.1 undcrsmnd thBlNe Wilding dna not currently Mw a names. that it is my responsibility to notify tui =want or de requirements which rttvW el wiuemm ora ceninesw erOe c/y. Signature of Applicant Date 7 / All roof coverings to be Class "B" or better Owner or Authorized agent Case __ _ _ _. To : o u�/Ot � 6-� er E) / 12-0 Iln �Tt i1 2k4pl� 203 z S, ;/ ve--a.ato ewe. aY2�7�L P ' Ceo� 9 L�'o l 7 r,4L /6,ef, zz-o e,,o y, e, VL/ tSlc�e ,�s h vL,b rel Z797Y F%2z4 /00 - z©off Q4- a213S-7 ra4�r 7e722- 13* of gowa7k Ca np4ell , . C4 gk-4g60 ItOok-2/3-- 37.-o S . 24e, 0 070�Z�J aClOF «JPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Department JOB AJ)�RESS: PERMITO�„D�OC�D OWNER'SNAME: jj �7Gc �G PHONE # GENERAL CONTRACTOR /i/ate off. �✓� FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information Owner/Contractor Signature 7 Q Date 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/Contractor Signature 7 Q Date • CITY OF CUPEI�TINO • • 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: Job Site Address: 3 Z3 P A,4 640 QAM— C( PJB I L 10 Roofing Company Name: iJy i i S Ln—e, Zrc,Q_ Applicant's Signature: '.�i,� Date: 0 Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper 0ci o "PERTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION FORM APN # 30,39- dol Date: sup s_ coos Building Address: BENERGY 7-0323 S'ill/&-ado AVe. Dirt%rta CA 9$0/4 Owner's Name: Seismic Fee Res Phone #: Jt,n ZAgU Seismic Commercial 4p08-2-.52--3LF36 Contractor: Phone #: License #: BUSLIC Business License %_�; 2 0q2 Contact: L�cir�� Lee Phone #: Cupertino Business License #: 21-000-51s-54�$ Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Asphalt Shingles -/❑^Built-Up roof Asphalt Shingles `br V' Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # x/ To be Removed ❑ Provide Mfgr. Installation Specs. Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 7o Residential Commercial. ❑. Fire Zone: Yes ❑ No Confirmed with Planning Dept. if there are anrestrictions: LI Cost of Project: 7nov, vvVAI Type of Construction: Occupancy group: 2 Qty. if Annlicable Fee ID Fee Descrintion Fee Groun 13PERNMEE 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 3o z3�