08080019-
BUILDari; DIVSjION PERMIT
CONTRtIiCTOR INFORMATION
�r...-.,�.��•.
BUILDING Q ESS:,,
PERMIT NO.
T911 V.I.NEYARD SPRING CT
LOS GATOS ROOFING
08080019
OWNER'S NAME:
FERMrr ISSUE DAIS
JEFF & LORI NG
P 0 BOX 1726
08/04/2008
NE:
SANITARY NO. CONTROL NO.
ARCHI]ECr/ENGINEER:
BUILDING PERMIT INFO
RE—RF RMV SHKRF &INSTL ASTM BLDG ELECT PLUMB MECH
�GAF
LICENSED CONTRACTOR'S DECLARATION
Gila ig
Job Description
1 hereby Olean Wt I un thousand! under Provisions or Chapter 9 (ummemIq
—• �^ . .. .. . .. . ... .. .. p
with Section ]m1U) OiWaion 3 of ton Bnsineasmul Pmrexsians Codr.4M mY Iketsan k
ec
in full forte and eReu D
Lkenan Lle.N
'
Dem Convector
ARCHITECTS DECLARATION
1 understand my plans Nail In, used as public mmrds
Licensed Prufessiaw
OWNER -BUILDER DECLARATION
1 hereby e1Tim that 1 em exempt from the Canvxtous License Law for the
following memo. (Section 7031.5. Business and Proicaons Code: Any city or county
which nu sines a Permit in cmm=4 eller, imptnM, demolish, or repair my structure
prior to is, becomes. Can volume, the applicant forsuch permit to files signed Moment
Net he is licensed purmml to the provlGONUf the CWnlYble L ic. Law (Chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) or Division 3 of the Business and Professimm Code) or
that he Is exempt tberef rm and the basis for the alleged "*^mption. Any violation of
seed. 7031.5 by my appllcam fora permit mbjccu the applicants It, a civil Penalty of
APN Number
Occupancy e -
P y pr`]y P
rutmom men nwhundred dolWs(S50B.
❑ 1, u owner of dm poperty, or mY wployu4 NW Wena u Netr sok compenodon,
wed d,thesans andthetotemismletotbLMWe
Required Inspections
and Rafexeons Calc The Cenmrcm, License law dens but apply lf in owner
Lawapplyon in weer of
is
ern who Wilds mimprovesch mprandwho doesmalfm through his
semmuue not ietendedmoedon,fferval for owner,
own improvementsdoro
et,proWded ion
'
Is of completion, the
however. the m impmvemmt 4hat ane
however, the pmwm
uwar
the me,owner.
Its of
Wilder sift Nw the Judea of proving Not k did rot build or Impmw for VUNao of
have
ule.x
❑ 1. as owner of the property, am exclusively contracting with licensed unuacima to
conswct he project (Sec. 7044, Business and Professors, Cade:) Tho Contractor's LI-
ccma law does not apply to an owner of property who builds or improate Merton, and
who contracts for such gojeeu with a eonuactor(s) licensed pursum to Me Consomme.
LkGnce Law.
❑ larecacmplumerSen .B&PCrmdd..n
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby armualmte
uunder peaty of perjury oto ar the following decli
I haw and will mtlnan a CeNficaha niceness m ulf-loud for Wortees Compen-
-
andon, u provided for by Scm,km 3700 of de Labor Cada fm the performance of the
were: for which this permit is Issued.
❑ I have and will reenact Wmkees Compensation Insurance, as required by Section
37W of Me labor Code, for the performance of the wan fmwhkh this Permit is lusted.
'
My WorkeeaC penudoo carrier aM Policy num�b(m`ryye �s�,s�sp
!Y's
Cartier 5 ✓'r' PollcyNa:
CERTIFICATE OF EKEMP ION FROM WORKERS
COMPENSATION INSURANCE
Missxdm need act be complemd IrOte )emsit In former hwuleddoll. ($100
m leo)
I unify that in the performance or the work for which this permit is lssucd, l shall not
employ any person in my mannerw as w became subject to the Workrss' Cmmpenandon
Iaws of California. Date
Applicant
NOTICE TO APPLICANT. if, after making this Certificate of Exemption, yon Mould
become subject be the Workout Compensation provisions of the Iabm Coda you most
forthwith comply with such portions m thin permit Nall be domed moked.
CONSIRucnON LENDING AGENCY '
1 hereby alfrm that Nem is a construction lending agemy for the peffotmemte of
the work for whim Nin Perris It issud (Sec. 3097. Civ, C.)
Lmdcet None
--
Landee.Add.
I certify our I haw mad this applicator and wk the du above information i.
cor act. 1 agree to comply with el city and county aNiwura and sum laws plating to
.
building construction. and hereby enthodm otposmuuws of this city to enter upon the
ahove-mmdmpd Property for inspection pugroans.
(We) agree to ave, ha emsdfy and keep harmless the City of Capetian, against
liedlldes, jWgmenu. cmu and expenses which may is any way metue agents mid City
in consequence of the greens of this permit.
APPLICANr UNDERSf/[IDS AND WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SO REGULATION�S(�3/��/,�L�—M\
Re -roofs
Type of Roof
kkloi
Sigedluse of ApplicantCanuaelor -
HAZARDOUS MATERIALS DISCLOSURE Date
Will W applicant ar future building amrp rt sort or Leek NmNaus mamrie
as defined by the Cupertino Municipal Code, Chapmr 9.13. tab the Health and Safety
Code, Semon 255324)7
All roofs shall be inspected to any roofing material being installed.
❑Yes ��
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant of future building occupant use equipment or devices which
It hmardow aircmuminanu u defend by the Bay Area Air timidity Management
all new materials for inspection.
District]
❑Yon ptfu
Ihavemad thook-Sam mucriWrtquhcme 55 underUlding
nu HeslN&SNn'Cade, Srcdw 25505.25537 am125534.1walveval Nnif Nc building
udespmr6.95 oftenif
/ids
does tidy haw:. tau L Nat II u my reapoaNlity, m notify the cooment of the
f[�t W,�-J✓\ T
mqu'whkhmm,k epiarmisalanuaf.cmifcamar`M nry.
glv�j�h'
Signature of Applicant Date
I/�I���All
roof coverin s to be Class'sW' or better
g sT
Ownodmd
agent Dam'
• 2 ITEMS OF 8
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 36654011.00
DATE ISSUED.......: 08/04/2008
RECEIPT #.........: BS000005674
REFERENCE ID # ...: 08080019
SITE ADDRESS .....: 11662 VINEYARD SPRING CT
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER ............: JEFF & LORI NG
ADDRESS ..........: 11662 VINEYARD SPRING CT
CITY/STATE/ZIP CUPERTINO, CA 95014
OPERATOR: pdtg
COPY # : 1
RECEIVED FROM ....: LOS GATOS ROOFING
CONTRACTOR .......: RANDY BROWN LIC # 23481
COMPANY ..........: LOS GATOS ROOFING
ADDRESS ..........: P 0 BOX 1726
CITY/STATE/ZIP ...: LOS GATOS, CA 95031
TELEPHONE ........: (408)298-9399
• FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
---------- ------------- -------------------- --------- - -- ----------
IBSEISMICR VALUATION 6,390.00 .0.70 0.00 0.70 0.00
IREROOFRES SQ FEET 27.00 351.00 0.00 351.00 0.00
TOTAL PERMIT : 351.70 0.00 351.70 0.00
VOICE ID DESCRIPTION
------------------------------------
601 ROOF TEAR OFF
604 ROOF IN -PROGRESS
•
VOICE ID DESCRIPTION
-- ----------------------------
602 ROOF PLYWOOD NAIL
605 FINAL REROOF
0
• CUPEIIaTINO
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION
OTOS0619
APN # ll. Od Date: 3o U
Building Address:
2
Owner's Name: Phone #:
/ 6/
Contractor: L 0 S z /` 0 p 1? c{ Phone #: L o 8' „2 y g_ L3 9 9
Fax #: O2�- �?3 -7J
Cupertino Business License #:3 , / / Contractor License #:
`7 306707
Existing:
❑ Built -Up Roof
❑ Asphalt Shingles
Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings
To be Removed
Jot Description:
Residential
Type of Roof Covering:
Proposed:
a Built -Up roof
,;wC Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
X Other (Specify)-*--, 3,0 i4 S7 -M FEL)
❑ Provide I.C.B.O. Report #
❑ Provgr. Installation Specs.
S
Commercial
5'1_A
Fire Zone: Yes ❑ No 1� Confirmed with Planning Dept. if
there are anv restrictions: n
Valuation: 6396
I Have Read, Understand and Will Comply with Cupertino's Tear -Off Policy:
• �T/r �/m..� 7
•CUPEkTINO
CITY OF CUPERTINO
REROOF
FEE SCHEDULE
Number of
Squares
Fee ID
Fee Description
Fee
Group
Permit Type
1REROOFCOM
Re -roof Commercial
B
1COMMLROOF
1BSEISMICO
Seismic Commercial
B
TREROOF EES
Re -roof Residential
B
1SFDWLROOF
r
1BSEISMICRE
Seismic Residential
B
1RER00FMRES
Re -roof Multi -Family
B
iMFDWLROOF
1BSEISMICRE
Seismic Residential
B
1BUSLIC
Business License
B
0
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 Y4 " 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: za",
job Site Address: �16 b 2 12 a L14 /"'y Sj�,*,,7
Roofing Company Name: 0 S Lr i o c
y,p
Applicant's Signature: /1 // 1 iL }2/ Date: �3 d �V
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF
*UPEkTINO
JOB ADDRESS:
OWNER'S
I= RM128-9-C
11642 Viheuard..S
I am not using any subcontractors:
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
partment
PERMIT # C
PHONE#
FAX # Vii/ G
Signature
Please check applicable subcontrartnra and rmmn1PtP the
0806 i q
. /
% 3o d P -
Da em
z
O er/Contractor Signature
.fid oe'
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
z
O er/Contractor Signature
.fid oe'
Date