06090102 CITY OF CUPERTINO
BUILDING DIVISION PERMIT .CONTRACTOR INFORMATION
BUILDING ADDRESS: RUNNING ROOF COMPANY PE""'06090102
22613 WOODRIDGE CT
OWNER'S NAME: PERMIT ISSUE DATE
LOU & SHERRI SABUDAR 866 HILLSD
NE: SANITARY NO. CONTROL NO
(408) 390-3185
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
lace LICENSED CONTRACTOR'S DECLARATION - IOb Description:m❑ 1 thereby alarm Nn I am licensed umler provision of Chapter 9(commencing
iia, with Section 7W0)of Division 3 of de Business and P�^feuihu Code. my license is
in fall . (pffl REROOF- TEAR OFF 1/2" PLYWOOD FRES . TL 30# FELT
m�? License Cl - LILd
;ro Dam - - contractor
ATION 30 SQUARES . CLASS A
ARCHITECTS DEC
1�� 1 undenunJ my plans shall M cud u puM1iic rtcnfds
?yU
'LL H Licensed Professional /
'Og tha Ia cxcmp ER DECLARATION j
a S 1 WrcM1y alTirm Nal I am exempt Wm the Contmaoh License Law for the
D o following muoa(Stench]1n 1.5,Business and Professions Code:Any city or county
m which mquirc5 a permit in canswct alter,improve,demolish.or mpair any Structure
prior in its isvuancc,also myuins the applicant for such permiuo file a Signedrutemcm
< that he is licensed pursuant to the provisions of do Coftusi uccuse law(Chapter 9 Sq.Ft.Floor Area r VaI 0 0 0
2FG (commencing with Section 7M)of Division 3 of dm Busineuand Prefeainu Cook)or
that he u exempt therefrom and the basis for the aIlcgcd esempdon.Any violation of
Stedan 7031.5 by any,applicant for.permit subjects the applicant to a civil Penalty of APN Number Occupancy Type
not mon than five hundred dollars(3500). 34215069 . 00
P y YP
❑I.0 owner of dao propmry,are my wployees with wagevdacir Sok compertsadon,
will do Ne work,end the stud..is not intended or Wired for Sala(Sec.7044,Business
and Professions Cade:The Contsxbfs License law does Shot apply in an owner of Required Inspections
pmpeny who builds or improve Thereon,and who does such work himself or through his
own employers.provided that such improvements are not intended or offend for Sala If,
however.Ne building or improvement is Sold within ane year of completion,me owmmv.
builder will have the burden of proving that he did not Wild or improve for purpose of
Sale.).
❑1,as owner of the property,am exclusively contracting with licensed cam...to
construct dere project(Sec.7044.Business and Profte s ons Cade:)The Comes Li-
nmuc law docs not apply as an owner of property who Wilds or improves daemon.and.
who contracts for such projects with a contractor(s)licensed pursuant th the contractor's
Lica.law.
❑1 am exempt under Sec. ,B&P C for this maven
Owner Date
WORKER'S COMPENSATION OECLARATION
I herby afRrm under pcvlty of perjury one of dte folldwing d l=[iou:
1 hall and will maintain a Ccnifiese of Cover w self-inrvrt far WorkehCompen-
Sab ah.u provided for by Section 3700 of me labor Code,for Ne performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,u mquird by Section
3700 a(the labor Code,for the performance of the work for which mu permit u issued. '
My Wori�m'ee/,��C,c�u/rrep—un/aiition in�ssyyyfarr'�aa�r/tgc.caniu and Policy numbbcr are;
Canier:L7�C�CC�^+'w"`J4"lJ Polity No.:>'`afCy
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W completed rate permit is We.hundred dollar(SIM)
or leu.)
I certify that in the performance of me work for which this Permit u issued.I shall Trot
employ any person in any manner So has to become subject to the Worker Compensation
Laws of Califamia.Data
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Excmpdon,you should
become subject th the Whimi's Compensation provisions of me labor Cade,you most
.,O forthwith comply with such provisions of this Permit she]bedeemedrevoked.
z ; CONSTRUCTION LENDING AGENCY
[-+ Ihcrcw aRthi that here in. len ding agency far the perfurtnaree of
E
me work fur which this permit u issued(sec.X197,Civ.G)
D]F Lcndcr's Name
CL
z Under's Addreas
C-)C) 1 certify that 1 have read this application and sum that me above information is
IL F-' correct.1 agree th comply with all city and county ordinances and state laws misting to
OU building eonsuuctinn,and hereby authorim npresenutives ofthis city to curer upon Ne
[t7 ahovc.mentmned property for inspection pugwses.
H y
(We)ag a so save,indemnify and keep harmless IW City n Cupertino against
fry I.'mostruch of thetostsand expense which may in any wayaccme againasaid City
U z A APPLICANT
of UNDERSTANDS
in6of this per mit /
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR REGULAT ON ,f O� -
gnawrt of Applman 7 ak Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or futum building occupantsthr or handle haaardaus material
as claimed by the Cupertino Municipal Cade.Chapter 9.12.and the Health and Safciy '
Cade.section 25532(.)7 All roofs shall be inspected prior to any roofing material being installed.
40 ❑Ye �Wu
Will the applica l or future building Occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
emit husughst air contaminants u defined by the Bay Ama Air Quality Management all new materials for inspection.
Distriert P
[3 Yes
Ihave&Safet Coda zrdntiss 25505.2553itla 3rtmc as 55u1,1 rdeareathan of ifhthe Wilding
his Health&Sntly Cade,knaaruhat it i 2my not d25534.1 to four red amt if the Willing
docs not currently have a meant that it i5 my rcapovihility m nhdly the occupant nr IM
rtyuirt uwhkhm tbe tpdortoissuance ofaCertifinteofOc 8ignatureofApplicant Date
Owanr mData All DaAll roof coverings to be Class "B"or better
• Community Development
F 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
46UPEkTINO
Building Department
JOB,5 21?S: PERMIT #
OWNER'S NAME: fzpjfa4C7PHONE
GENERAL CONTRACTOR FAX # ry
I am not using any subcontractors: /�{ v,h
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
Owner/,C5;7�actor Signature Date
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 34215069 . 00
DATE ISSUED. . . . . . . : 09/14/2006
RECEIPT # • . . . . . . . . : 36044
REFERENCE ID # . . . : 06090102
SITE ADDRESS . . . . . : 22613 WOODRIDGE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOU & SHERRI SABUDAR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : THOMAS RUNNING
CONTRACTOR . . . . . . . : TOM RUNNING LIC # 28008
COMPANY . . . . . . . . . . : RUNNING ROOF COMPANY
ADDRESS . . . . . . . . . . : 866 HILLSDALE AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95136-1107
TELEPHONE . . . . . . . . : (408) 390-3185
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- - - - ------ ---------- -- - - - - ------- ----- ----- ---------- ---------- -------- - -
BPERMFEE VALUATION 15, 000 . 00 223 . 56 0 . 00 223 . 56 0 . 00
BSEISMICRE VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00
---------- - - - - - - - - - - - - - ------- --- -------
TOTAL PERMIT 225 . 06 0 . 00 225 . 06 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - -- - - - - - - - -- ---- ------------ ------------ -- ----
OTHER 225 . 06 VISA
TOTAL RECEIPT 225 . 06
•
0 QM 01 U2
CITY OF CUPERTINO
,_em REROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN# Date:
Building Address��
Owner's LO ate. _S11_(e_j O«c �J r40',<0
Contractor: i VI n�j
j 1 G k License
Contact: ' / Cupertino (Business License #:
Type Af Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
xT❑Y1 Asphalt Shingles $ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles �n
El Other(Specify) ❑ Other(Specify) No`.! �L
J
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 erti((n��o's Tear Off Policy: ❑
Job Description-.
Residential Comm rcial ❑ mil �N/�rY� C�cC/..
Fire Zone: Yes ❑ No WConfirmed with Planning D,ot. if
there are any restrictions: u
Cost of Pr J
aest: Type o Construction: Occupancy group:
1 Qc �,� 2z--3
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
•
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:
nn ,/L (G 77� /J � AJ
Job Site Address: &�9 J (i�(� D��CX ��f
Roofing Company Name: V�OVI ter 0 <fVP51
Applicant's Signature: L,_�_, Date: Q(�
Greg Casteel •
Building Official
Revised 11/2/04