06080177 CITY OF CUPERTINO
AT
'BUILDINGOIVISION PERMIT ION
a.
BUILDING ADDRESS: WOODS ROOFING PERMIT No.06080177
1610 S STELLING RD
OWNER'S NAME: PERMIT ISSUE DATE
Ank CURTIS LEE 2179 STONE AVENUE
E:
SANITARY NO. CONTROL NO.
(831) 637-5576
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 � � 0
lop LICENSED CONTRACIOWS DECLARATION lob Description
1 Whiny s1Brm Na 1 me liceneed..&I provisions of Clupmr 9(commencing
iW❑ with Section 7")ter Division 3 ofthe Business and Professions Cade,and my license is
�c, in full room ande&� v g Z / 3 1 TEAR OFF SHAKES . RESHEET OSB . ADD 50 YEAR COMP
u�z License s
a_a Dam g o Contracts, SHINGLES -
ARCHITECTATI
S DECLARON
1 underhand my plana shall be used a public words
,yU
o t� Licensed Pmfassional
ion
OWNER-BUILDER DECLARATION
iI I hereby affirm Nat I am exempt fmm tM Contractors License law for On,
:O O following mason.(Section 7(B 1.5,Business and Professions Calc:Any city ter[aunty
m which requires a permit m Construct.alter,improve,dcmnluh.or repair any swemm
prior to its imuave,also requires Jur applicant for such permit to file a signed summer,
Oat W fs liccnxd pursuant to Jur previsions of One Commuter's Liavc LAW(Chapter 9 Sq.Ft.Floor Area Valu$iibu3600
:H
?�$ that he a(commencing with Season7000)of Whatsof 3th al Business and on.Anysvi Code)
that he v exempt mcmfrom and the bazu far the alleged eumpdon.Any violation of
Section 7031.5 by any applicant for a permit subjecu On applicant 10 a civil penalty of FN Number Occupancy Type
mot mom than fire to edree dollar(SIM). 3 6 6 2 4047 . 00
❑1,u owner of Ne property.or my employes with wages u their sole campcnsauon,
ill do the work and the stru Lure u motintenac l or offered fmrsath(Sec.7014,Business
and my who
ons Code:The m Oman.Liarho law does ret apply ll an owrw of RequiredIons
owneny wyeec.provided
ireprova thereon,and who armnot imand k Interstellar Wough his
mW r..On Wilding
Drovldod m ro.s impromd wit are not i. fc aro@rcd for sale. r-
builder Nebuilding or Mpmvementu sold withinoa yea of comple,ifor me men of
builder will have Jur buNa of proving Jut he did not build or improve far POTase of
salc.).
❑1.as owner of abe property.am ea btai ,Iy eonussting with licensed cenuamors to
avtroa the es project(Sec.s an Business and property
who
Code:)The Contractors nd
cense Lawntr does f oat apply je an with
a of tractors Who builds or ImpmKe Coomm and
who contracts for such projects wire a contractor(s)licenses pursuant m ma Contrxtors y�
Lice ar law.
❑I am acme,unau Sec. .B k P C for JJs masom
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under pe.fly of perjury rex of On fnllwring declarations:
sat1ha m and will mainuinection 37M of CoventmCodamfor tforerhom Compen-
work,u provided for di Section 3700 of me tabor Code,for me perfmrmamx of me
wort for which this pertnit is issued.
16-fluave and will maintain Workers Compensation Insurance,as required by Section
3700 of the labor Code,for on,performance of the work for which this pemtit is issued
My Workeewcomnsstimn Ivunna amu and Policy 1b, .'� U 0 144 t 1a
Cartier. S s_ Policy No.: 9
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE(Tis section mctl not he completed if me pemrit is forma,hundred dollars(SIM)
m las)
1 certify mat in the performance of On work for which this permit is issued,l shall not
employ any person in any maunerm u to become subject in the Workers'Compensation
Laws of califnmia.Dam
Applicant
NOTICE TO APPLICANT:If.arm,making this Certificate of Exemption,you should
become subject to,he Workers Compensation provisions of the Labor Code,you most
.,z forthwith comply with such pmvisinv or mss permit Shut]be dcemcd onmk,d.
Z CONSTRUCTION LENDING AGENCY r
[--� IMothyaRrm that mere is a emnswctinn lending agemy rot On p,rformanaof
N. the work for which Jus permit is issued(Sec.3097,Civ.C.)
(t1 Q Landers Name
jz Lenders Address
U 0 1 cenify that I have rad mss application and sure ma me above information 0
D, F c..t.I agree to comply with all city and county imilnamca mol sum laws reladng to
pU building construction,and hereby au,horis represemmives of this city to cmer apnn the
J-'a shave-mentions property for inspection purposes.
(We)agme to save,indemnify and kap harnlesa the City of Cupertino agvvl
liabilities,judliano ensu and eapuus which may in any way amore gwnstsaid City
U in consequence of the granting of this Permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-Po1NT Issued by: Date
SOURCE RE_G�L(tTIO�JS. a L
f� --ye--- s Re-roofs
Sig
neturt of ApplicaDam
HAZARDOUS
US MATFJUALSOISCLOSURE Type of Roof
wl1mee Cupamtw future Wilding rmapapthomm horst[ Healthy material
as de,Scd m me Cupertino Municipal Code.Chapter 9.13,and Jur Health and Safety'
Code,Section 35532(a)? All roofs shall be inspected nor to an roofing material beim
pYa U.N.— P P � Y g g installed.
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or furore building by on,B,use equipment Qu or Mara which g
[mit haardnm air conumivnu u defined by the Bay Ara Air Quality Management all new materials for inspection.
Dishiell
❑Yu `LI1da�
1havema mehaatdousmaterialsmquimmcnuun&rChapmr6.95mfJur Califon )
M.HalthhSafcty Codc.Satiov 3550.S.3S537aW 355Ja.Iundcrsund thaifJa building �,-
docs no,currently hoe a rank mat it is my responsibility to notify the oa pen,n the
mgaim ,nmwhich ,IxnteIpriormivanceofaCcmrcateofa�y� Signature ofApplicant' Date
Owner m,�ri,.c t Daae All roof coverings to be Class"B"or better
CITY OF CUPERTINO
am 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36624047 . 00
DATE ISSUED. . . . . . . : 08/22/2006
RECEIPT 4 . . . . . . . . . : 35715
REFERENCE ID # . . . : 06080177
SITE ADDRESS . . . . . : 1610 S STELLING RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER CURTIS LEE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : BONITA JENKINS
CONTRACTOR . . . . . . . : WOOD, LAWRENCE E LIC # 20810
COMPANY . . . . . . . . . . : WOODS ROOFING
ADDRESS . . . . . . . . . . : 2179 STONE AVENUE STE 22
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (831) 637-5576
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - -------- ------ - - - ---- --------- - ---------- ---- - - -- - - ---------- - ------- --
BPERMFEE VALUATION 14 , 000 . 00 212 . 76 0 . 00 212 . 76 0 . 00
BSEISMICRE VALUATION 14 , 000 . 00 1 . 40 0 . 00 1 . 40 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 319 . 16 0 . 00 319 . 16 0 . 00
•
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: /.-Le
Job Site Address: /(9 /0 CV k ci
Roofing Company Name: 7 �s
Applicant's Signature: C-g�+ �� Date: o4
• Greg Casteel
Building Official
Revised 11/2/04
1
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
OF Fax(408)777-3333
#PEkTINO (51o) 38 - 328z - 13�aH;e
Building De artment
JOB ADDRESS: l0 5tA � /J PERMIT#
OWNER'S NAME: K d PHONE# 2-53 —/50 6
GENERAL CONTRACTOR W6LVePs FAX#
�( I am not using any subcontractors: Ot1y ze`s / - a 6
Snature 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
lip 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� Date
tX.eoBq'17
CITY OF CUPERTINO
lul_ REROOF
CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Building Address: 1610
kd
Owner's Name: ` . t Phone#:
oar zS3 —/So
Contractor: License#•
.�
Contact: / ' Cupertino Business License #:
/. Z o 8-! O
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof Cl Built-Up roof
❑ Asphalt Shingles >C Asphalt Shingles
). Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ ,Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
ATo be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Com 1ith Cu ertino's Tear Off Policy:
Job Description: 'rd o S 73 , 59 5 5
Residential Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: 0� Type of Construction: Occupancy group:
13 600
Qty. if
Applicable 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
•