06030007 CITY OF CUPERTINO + 'F'
BUILDING DIVISION PERMIT ,s CONTRACTOR INFORMATION:,,
BUILDING ADDRESS: CURT FLETSCHER ROOFING IN ""'N0.06030007
1114 S STELLING RD
HER NAME: PERMIT ISSUE DATE
EVELYN MARCOPULOS 354 MONTICELLO AVE 03/02/2006
PHONE: SANITARY NO. CONTROL NO.
(408) 267-2679
ARC HITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
X00 LICENSED CONTRACTOR'S DECLARATION Job Description
ZC I hereby affirm that I un licrossed under provisions,of Chapter 9(commencing
<t! with S.d..7")of Division3af NCBusin udProfessi�msC it and my lie is
inftr0to=and enect. d7 REROOF-REMOVE (E) ROOF/INSTALL 30 YR FELT COMP
p>aZ_ License Class t.ic.N
F p Dam P CO.", r
ARCHITECT'S DECLARATION
Sy els 1 understand my plans Mall W died as public records /®�L
,6D FIKI VSFD
g o� Licensed Professional -
OWNER-BUILDER DECLARATION
zoo I hereby.(Geon
that 11. exempt from do Contractors License Law for the
zoo fallowing moon.(Section 7omm Business and improve,
da of Cade:Any oily or county
- which requires a permit to cnnslmcL alter,impmvc,eemplLsh.or repair any swctum $7100
-teprior In itaissuance,also requires the applicant for such permiuo rile a signed statement
thath is licensed pursuant to tho provision of the Commumn's Ucensc Law(Chapter 9 Sq.Ft. Floor Ar AY cip 2006 Valuation
z�$ (commencing with Section 7")of Division 3 of the Budness and Professions Code)or
.- Net he As exempt therefrom and the basis for Ne alleged emmplion.Any violation of
Section 7071.5 by airy applicant for a permit subjects the applicant to a civil penalty of SUN N
Occupancy Type
not ream than Bre hundred doll..uSMk
I,m mnu of sea propeny,ar my employcu with wags u theb tale compemfion.
will do Ne workend th mime.umubdindedonoQerod rofsam(Sec.7064,Busin.<.
.it Professions Code:The ContrxwYs License Law eau not apply in an owner of Required Inspections
property who builds or improves thereon,and who dos such work hireaelf or iluough his
own employers.provided that such improvements are not intended moRemd for We.If.
however,Ne building or improvement is sold within ane year of eampicuon,the oam".
Wilder will have dee burdut of moving Nat he did nos build or improve for purpam of
tank.).
❑1.as owner of the property.am exclusively contracting with licensed Contractors m
construct the project IS".7044.Busineu and Pro4sdom Cade:)The Conuacuses U.
cense Law docs not apply An an owner of proper y.who builds or improves thereon,and
who contracts for such pmjecu with a contractor(s)licensed pursuant to the Contractor's
License law.
❑1 ore exempt under Sec. B k P C for this moon
n Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under pealty of perjury orc of the following dularaioncs: ,
Cj
1 M1aw and will meinuin a Cenificou of Consent mulf-insure far Workcri Campcn-
utton.a provided for by Section 3700 of the labor Code,for the performance of the
work for which this permit is issued.
1 have and will maintain worker's Compenution Insurance,as required by Section -
37W of the labor Code,for the performance of ite work for which this permit is issued.
My Waroca Compenulian Insumnee carrier and Policy number
ps-are
Cartier. PWicy Na.: '/msL/L/ (J b 0
CER77FICA7E ONMEMPf10N FROM WORKERS'
COMPENSATION INSURANCE
(Thissection recd not h Completed if rte Permit is for one hundred dollars(SIM)
or las.)
1 ceniry Nal in the Performance of the work for which this permit u issued,I shall not
employ any person in any mannerso as to become subject to the WorkctY Compensation
Laws of CaNfo.ia.Data
Applicant
NOTICE TO APPLICANT:If,afar making mia Certificate of Exemption,you should
become subjeCt An the Workers Compensation provisions of do labor Code,you mus,
.,O forthwith Comply with such provision or this permit shall h deemro
ed oked.
'Z..'" CONSTRUCTION LENDING AGENCY
F'.�. Iherby drum than them iso calumniation leadingfor the rfimmusce of
a> the work for which this agency pc
pcunit is issued(sec.3097.civ.C.)
az Iandcl,
.7 z Lender's Add Addreu .
U O 1 certify Nat I ave rad this applicAtion am sate Nu the above information IS
Ls,F cornett I agree to comply with dl city aid county ordinances and state laws relating to
0 U Wilding construction,and hereby authafixe MPMSCnativCM of this city to enter upon the
4 V aMvc-menudgm property for inspection purposes
(We)agree to ave,indemnify and keep harmless the City of Cupenmo agairta
Z incoitiauence, cnu,coarsing expenses which may in any way eccruc agdnstWdcity
U A APPLICANT
of the Reusing of A permit.
^ APPLICANT UNDER GSA WILL COMPLY WITH ALL NON-POINT Issued by: Date (I
SOURCE REGULATI / //
Signature of AppOaMCdt i Re-roofs - �G
HAZARDOUS MATERIALS DISCLOSURE pare Type of Roof
Will the applicant on future building occupant nae or handle harandous material
AS dcBned by the Cupertino Municipal Cale,Chapter 9.12.and de Health and Safetyode,
Section To zss32(a)7 All roofs shall be inspected prior to any roofing material being installed.
Will the applicant to f mm building occupant um equipment or dcvias which If a roof is installed without first obtaining an inspection,I agree to remove
Coal ha'rardnus air contaminants AS derined by Ne Bay Area Air Qudily Management all new materials for inspection.
District'
CYn loxa�J}-]No
Ihavcmaycom.S red msma505. requirements under ChapmdShut area Wilding
nia Hcalthd:SdctYCok.Savons secrials requirements
under Chapter
than if do building 1/ /
dors n01 c merely aw s tenant Wt it is my responsibility b notify th occupant of the
regdyyxAtswM1' mustsmelpiiormiaummoraCcrdneamafacupasty. Signature of Applicant Date
Owren or tat agent Dom g
� `ab All roof coverings to be Class "B"or better
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: sue
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36226009.00
DATE ISSUED. . . . . . . : 03/02/2006 p
RECEIPT #. . . . . . . . . : 33426
REFERENCE ID # . . . : 06030007
SITE ADDRESS . . . . . : 1114 S STELLING RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : EVELYN MARCOPULOS
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5021
RECEIVED FROM . . . . : CURT FLETSCHER ROOF
CONTRACTOR . . . . . . . : CURT FLETSCHER LIC # 22227
COMPANY . . . . . . . . . . : CURT FLETSCHER ROOFING INC }.
ADDRESS . . . . . . . . . . : 354 MONTICELLO AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
. TELEPHONE . . . . . . . . : (408)267-2679
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 8, 000.00 147.96 0,00 147.96 0.00
BSEISMICRE VALUATION 8, 000.00 0.80 0.00 0.80 0.00
• __________ __________ __________ ----------
TOTAL PERMIT 148.76 0.00 148.76 0.00
METHOD OF PAYMENT AMOUNT NUMBER '
_____ ---- ---------------__--
CHECK 148.76 4826
TOTAL RECEIPT 148.76
Community Development
t 10300 Torre Avenue
! i Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
�UPEkTINO
Building De artment
JOB
A t DRESS: / PERMIT #
7 63e!�)Po
OWNER'S NAME: IV, PHONE # 4 0
GENERAL CONTRACTOR S FAX #
I am not using any subcontractors: ( ]`0
Signature Date
Please check applicable subcontractors and complete the followin 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
Owner/Coifttractor Signature Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• CITY OF Telephone: (408)777-3228
Fax: (408) 777-3333
C U P E kT I N 0
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: / ' t e-,,rC opt y ;
Job Site Address:
Roofing Company Name: — 906
Applicant's Signaturezktl� Date:
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION FORM DSO 3 000 ;7
bog bate:
Building Address:
/ Sa. S D
Owner's Name: Pho e#:
c, o e c y6
C ntract • ff VS Phone#: License#:
(e1-sc �! I �lf� Fr .Z6`�a�7 ce
C tact: Phone#: Cupertino 13usiness License#:'
a3�(-aoYY
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
X Asphalt Shingles '%� Asphalt Shingles eiwy 19
❑ Wood Shakes ❑ Wood Shakes
O Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings Ttu O O Provide I.C.B.O.Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
o Description: fI (y
�_ a
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning D„pt. if
there are any restrictions: LI
Cost of Project: T e of Cons ction: Occupancy group:
�1 UD .UD 3
Qty. if
A licable Fee ID Fee Description Fee Group
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