06070219 CITY OF CUPERTINO � 'z,aw.�sq g;y,�xy�rrv5z �w'm<�� �'�'"`
BUILDING'OIVISIOPI • PERMIT eCON'TR ET RIII ,QRrMATIQ,N
BUIB LDING ADDRESS: s OOFING PERMITNo.06070219
10400 STERLING BLVD
OW HER'S NAME: PERMIT MUT DATE
2067 LA CON CT. 07/31/2006
NE: SANITARY NO. CONTROL NO.
(408) 559-5105
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
O p LICENSED CONTRACTOR'S DECLARATION O O O O
wC I hereby affirm that 1 and,licensed under provisions o[Chnner 9(canmmcming lob Description
with Section 7")of Division 3 ollhc Business and Pwilossioa Code.and my license is
;'p zin tall tame arta err ,�� G9y TEAR OFF OLD ROOF INSTALL NEW BASE PLYWOOD AND
License Class Lr g CLASS ,A
CHITECTS DECLARATION
i o 1 ulMcruanJ my plans shall be used as public retards
yU
°Qy Licensed Professional
1 5 OEM I am cMmpt fr DECLARATION
<5 hereby Maso .(Tire the 11. .Bumps from an Ne Commis Co Any C Law for da
cc which
mason. etch in
PB 1.3.Business and ow.deme Cole:Any city or county
m which requires a permit ac cat.We aper,improve.h remain
Ear mash ed umnotat
xy pdamits iensedpamu re to the Weapplicantfor suchpermit m Glcaugnedsutem.m
< Natheu te,wd Scenic 7 theprovisionofNcCanunness licenseLaw(Chapter9 Sq.Ft. Floor Area Values[
IFC (eomeIt ca pt Section 7000)of ndit asisfrshon 3 Mlcgeinexe sedon,Anyvilati, r
Nat he u comps dwm(rom and Ua baro far the alleged exemption,Any violation of
Section 7031.5 by any applicant for a Permit subjects the applicant to a Civil penalty of 3Ap71 TJ�TyytyeiOO Occupancy Type
ret more Ilan Gw hundred dollars(5500). ""JJ��jj2z ZI o 6
Q 1,Us owner of Ilio property,or my employee with wages as their sol.compenesdon,
will do the work,and Ibeavuouu u ma inmrdied ar.115maA fora sic(Sac.7014,Business
and Pmfessmes Calc The Conuaclars License law does out apply Iq an away or Required Inspections
property who Wilds orimprove Eastman.and whoriassuch work himselforthrough his
ownemployes,providedrpro mimprosemenuoramt can fano@red dreale r,
however.the building or improvement m hale within ane year of mmplotif r purowmr-
builder will have the burden of proving that M did ret parole o improve far puryase of
aloe).
❑Las owner of Ile property..Bexclusivelyt. d contracting with Barbed tmntraemn m n / • \
cem La the es not (Sec.]Dad. oral of mcl property
who W Cade:)The Cminemrf U. 7!/
cane law rias not apply je an owner of groans who builds or anno W e thetmn.and O/
who.Lacts for such projects with a contractions)licensed punwnt to Ute Conossmrn 5/O
License Law.
❑1 am aempt undo Sec ,B&P C for this reazon
Owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby,(rota under penalty a(perjury am of Our following dedi mom:
I haw and will malouin a C.rsifieatt of Continuo self-insure for Warkces Camper.
nation,a provided for by Section 3700 of the labor Cod.,for Ne perfanname of Ne
work for which this permit is issued.
❑I have and will maintain Workers Compensation Imureacc,Us MaIuimd by Seton '-
37WofNeLabor Cash.for the pedo...of the wade fawhoch this pe mit u batted _
My Workers Compensation Inarana artier said Policy number ales
Cartier. /�/LY.1 Policy No:
MC
TEMPPTION FROM WORKERS'
COMPENSATION INSURANCE
(rtu aemlmt wood Out bcconplemJ If Ne Permit is foram hundred dollN(SIM)
Or las.)
1 anify that in the pofomame of the work for which this mmlit is iaaad.1 shall Out
employ anyperam in any mmworha is to become subject he da Wmkasa Compensation
Laws of California.Dau
Applicam
NOTICE TO APPLICANT:If.,nor making this Certifies¢of Eacesptim.you sh old
become subject w the Worker's Compensation provisions of site Labor Cook.you most
.,O forthwith comply with such provi.4ons or this pcmit shall b.clamed mwktd.
EM CONSTRUCTION LENDING AGENCY
[•+ 1 hereby Nim that dam u a coir ma lending apenry for the Iedo..of
E
> da work fa whim this pomp is itsccl(Sec.3047,Civ.C.)
GA Lenders Nam.
Z Landers Address
V C) I terrify that I have read this application and sole the the about infomaduo is
fL F' coma I agree at comply with all city and county ordinahas and sum laws relating be
0U Wilding construction,and hereby auntoma repteaenutiwa of his city m enter upon the
U ab..-awnlamd property for inspmuon purposes.
Fpy (We).9.to saw.indemnify and keep hamless the City of Cupertino against
C`1 liabilities,judgments,costs and expenses;which may in any way seem,against aid City
V z A APPLICANT
of thegranting SthisD WIl.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SONS.URCT �4j.,1 (et� Re-roofs
Signa of ApplianVComosmar Dale
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building acupant Marc or handle havrdotu material
Ea d.Bmd by the Cupertino Municipal Coda.Chapter 9.12.and site Health and Safety
Calc,3.etion 25532(,)+ All roofs shall be inspected prior to any roofing material being installed.
40 ❑Yea ON.
Will thc applicant or future building occupant use equipment m devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hnrafdnas it cmumuams is defied by the Bay Area Ail Quality Management all new materials for inspection.
District?
O Yes r-1 No
Ihavesalsite W2a smawrialsmquimmenuunder Chapwr6.95ofthe Ulifo,
ria Hcaldt&SafctyCode,Sa'110m 25505,25533 and 25534.1 undcm.d thuifNc building
Jas ret c ntly haw a tenant.that it u my ma,aeihility m mufy the occupant of the
lequimmn h sea mepdortuissuance araccrufiawofaupency. Signature of Applicant Date
w ens ����/`� All roof coverings to be Class "B"or better
Owner oiuthoriud agent tunc
Community Development
10300 Torre Avenue
;tk� Cupertino CA 95014
"~ Telephone(408)777-3228
CITY OF Fax(408) 777-3333
OUPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
l04ab 5 -rt-X4-1,,6 d p 7 aZ/
OWNER' NAME: &6-4- 066 PHONE # �rDS-
GENERAL CONTRACTOR: 84-Aa FAX #
I am not using any subcontractors: CLI 71--3-'/0�
Signature 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
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
V� -..-1
er/Contractor Signature Date
CITY OF CUPERTINO
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 37524006 . 00
DATE ISSUED. . . . . . . : 07/31/2006
RECEIPT # . . . . . . . . . : 35454
REFERENCE ID # . . . : 06070219
SITE ADDRESS . . . . . : 10400 STERLING BLVD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . :
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : JAMES BAKER
CONTRACTOR . . . . . . . : JAMES BAKER LIC # 25384
COMPANY . . . . . . . . . . : BAKER ROOFING
ADDRESS . . . . . . . . . . : 2067 LA CON CT.
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 559-5105
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 7 , 000 . 00 137 . 16 0 . 00 137 . 16 0 . 00
BSEISMICRE VALUATION 7 , 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00
--------- - ---------- ---------- ----------
TOTAL PERMIT 137 . 86 0 . 00 137 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
--- - - --- - - - - ----- ----------- - --------- - - -- --- - -
CHECK 137 . 86 682
TOTAL RECEIPT 137 . 86
•
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: - l �OU r�R 4•r G
Roofing Company Name: � /�J�%� /�`ft J /
Applicant's Signature: Date: �! �� /z�h
• Greg Casteel
Building Official
Revised 11/2/04
•i � o�cT102IR
CITY OF CUPERTINO
? REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# Date: ' �7 D
sis 2 - opu (:f�� 7
Building Address:/6 er srXe41 yC
Owner's Name- Phone o� l�
Contractor: SLA . License Z
QO 4e � y�
Contact: !�- Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
* Built-Up Roof & Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ 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:
Job Description:
I-/Rte 41"�
Residential W Commercial ❑
Fire Zone: Yes ❑ No e' Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project Type of Construction: Occupancy group:
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