06090150CITY OF CUPERTINO
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BUILDING DIVISION PERMIT
CONT RACTORJNFORMACION
BUILDING ADDRESS:
RIGHT ROOFING
PERMITNO.06090150
22674 WOODRIDGE CT
OWNER'S NAME:
PERMrr ISSUE DATE
ILISA KIM
467 SARATOGA AVE
09/19/2006
ME:
SANITARY NO. CONTROL NO.
(408)254-4439
ARCHITECT/ENGINEER:
BUILDING PERMITINM
BLDG ELECT PLUMB MECH
O O O O
LICENSED CONTRACTOR'S DECLARATION
- JOS DGSCrIpSOn
I hereby affirm Wt late licensed under pmvisimu of Clu nor 9 (commencing
with Section 7000) of Dindon 3af the Busincssand Professions Cade.and my licca, u
ifall forte aM.rrm.
�'
REROOF- REMOVE SHAKES INSTALL 1/2" PLYWOOD, 30
LcaDamnuC COtnlrador
FELT , PRESIDENTIAL COMP, 28 SQUARES, CLASS A
ARCHTfECfS DECLA loth
I undcrsund my plans shall W cud ss puAlic rtcorN
Liccnud Professional
OWNER -BUILDER DECLARATION
affirm that 1 law for dm
I Wmso
from the Cessions
/
1..Bumps oLicense:C
following moron. (Section 703 1.5. Business and
. Professions Calc: Any city or county
alcor, i w. de
demolish, erre pair any swnme
which mgvirn a permit m enres
dre t for such
prior mslissuance. alwre tot he theapplicants for suchPermit mfile Law statement
Out of the Canuacmr'a U.. Law
NommencceauJ purwant to to
Sq. Ft. Floor Area
Valua¢fiir3000
t Seclion of Dwiom
Cade) of
Code) or
n3 of the.g.d
Outhe is excer exemton. Anynns
Nat he Is exempt Nmdrom and the Ansa for Ne alleged exemption. Any violation of
rout itm baxis
q+pN
Number
Occupancy Type
Section 7031.5 by any applinntfor a permit subjects the applicant m a civil penally of
not mom Nan Rw hundred dollars (5500}
3 4 2
15 0 6 1. 0 0
❑ LuOwner Of the propuact
cmntendedwithwageuales..compeaaness
Re uired Ins ections
will r is Baircu
Newoes de: swmu¢unol.
and Pmfassioa Code: The
Pr C Liter setoff it Out apply to an auger
Ldwhus law don eras apply lf
q P
wstheemr:
rt is
propunywe Auipraorirepravnchimpr endwM doe souchworkhimselfer through hu
mOBcred for
ui provided Nal such improwmenu are nes ear
aleded
howmune er. the Owner.
however. Ne building ar Improvement ie sold widldn one yesr of completion, the
builder wiB have the Wrden of proving Na he did nm Wild ar improv for puryou of
pose of
ale.).
❑ 1, a Owner of the propcny, am exclusively contracting with licensed consncmrs to
consumer the pmjcct (See. 7044, Business and Professions Code:) The Comommurs Li.
cc= Law dues not apply to an Owner ar property who Wilds or improves thereon, and .
who contracts for such propos win a conuaeror(s) licensed Pursuant to Ne Convectors
License law.
❑ Iamnempuunder Sec ,Bh PCfor Nisraasan
Owns Das
WORKER'S COMPENSATION DECLARATION
10 I hereby afnml under penalty of perjury one of the following declarations:
I ham and will maintain a Certi late of Consentto self-iomm fm Waiters Compere
anion, a provided for by Section 3]00 of Ne tabor Code, far the performance of the
work far which Nis permit is issued. ,
❑ 1 have and will maintain Worker's Compensation Insurance, a required by S ccian
37W of the tabor Code, far Ne performance of ere work far which nit permit u issued.
'
My Wortrrs/Cs000r,mandom Insurance tinnier and Policy nu�m/berraam/
L/
Cartier. J /'/ JC r—UNO Policy No.:J(..,LC1L
CERTIFICATE OF EXEMPTION FROM W ORKERS'
COMPENSATION INSURANCE
mus section need not W completed ifthe permit is fa one hundred dollars(SIOO)
or less.)
I cenify Nat in Ne perfam moron of the work for which Nis Permit u issued. I shall trot
employ any person in any manner so a w became subject m the Workers' Compensation
laws of California. Dau
Applianl
NOTICE TO APPLICANT: IL after making this Certificate of Exemption, you should
become subject m the Workef s Compensation previsions of NC Labor Code, you must
comply with sum provisions or this pi mu shall be deemed rowketl.
CONSTRUCTION LENDING AGENCY
I hereby affirm that Nem u a com ection lending agency for the perrunnanec of
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lenders Name
Lendeh Address
'
I certify that 1 have mad this application aced sale that Nc neve Inrminatiun is
correct. l agree to comply with all city and county eminences and sum laws relming m
building conswction, and hereby authmim mpmumatiws or this city no enter upon le
aewmentioned, propc hn pcmon purposes.
(We) agree to saw, indemnify and keep h mnless the City of Cupertino against
a
fiabdiifq jdgest may in any way scenic against mid City
incormOiriccorhecostsesofthinseswhich
in coargnence of Ne granting Of Nu permit.
APPLICANT UNDERSTAN WI OMPLY WITH ALL JJJ000t7N-ppp000INT
Issued by:
SOURCE REGULATIONS. A��� /
Date
Re -roofs
Type of Roof
V / dti
Signaurt of ApplianUCa Dam
H MATERIALS Osameor U
Will the un=b=DOUS
(mum building occupant same or handle
o C.pentrm
az de0ncd by Ne Cupertino Municipal Code. Chapter 9.12 roti the Health and Safety
Health add
Code. Session 25532(')7 !
y'suit No
Yathe
All roofs shall be inspected prior to any roofing material being installed.
6/ \
applicant ( building occupant vu equipment or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
g
emit hmardna air conuminans a dcrincd by 0m Bay Area Air Quality Management
all new materials for inspection.
District?
C] Y_
1 have mad thu hoardtu
rials requirements under Chapter 6.95 of nc Califon
ries n
ria HalNkSafcty Cak.Ssuon 25505.255J7 and 25514.1 undcrsuntl the i(lM Wilding
it. no,
dw not currently bane .4 it u my ms nsihility m natily occupant or nc
cuts;Irmhsaasme ora certiramor cep Y.
Signature of Applicant Dale
All roof coverings to be Class "B" or better
owner or au d ageDam .
,m 1 of 2
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 34215061.00
DATE ISSUED.......: 09/19/2006
RECEIPT #.........: 36114
REFERENCE ID # ...: 06090150
SITE ADDRESS .....
SUBDIVISION ......
CITY .............:
IMPACT AREA ......
OWNER ............:
ADDRESS ..........:
CITY/STATE/ZIP ...
22674 WOODRIDGE CT
CUPERTINO
ILISA KIM
OPERATOR: amyw
COPY # : 2
RECEIVED FROM ....: RIGHT ROOFING
CONTRACTOR .......: LOSTRIE, JEFFREY LIC # 20696
COMPANY ..........: RIGHT ROOFING
ADDRESS ..........: 467 SARATOGA AVE
CITY/STATE/ZIP ...: SAN JOSE, CA 95129
TELEPHONE ........: (408)254-4439
•FEE ID UNIT QUANTITY AMOUNT
---------- ---------------------------------
BPERMFEE VALUATION 13,000.00 201.96
BSEISMICRE VALUATION 13,000.00 1.30
TOTAL PERMIT 203.26
•
PD -TO -DT THIS REC NEW BAL
------------------------------
0.00 201.96 0.00
0.00 1.30 0.00
---------- ---------- ----------
0.00 203.26 0.00
1�
CITY OF
•CUPEkTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:
226 a,
PERMIT #
�o �t o� r6
OWNER'S NAME: ,, ,>rPHONE
# fop YY6 3 Y(,GENERAL
CONTRACTOR: ;
FAX #
M
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
4i. ter,
• y ;r
< l&
Da e
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 — N-
i,'ayrleq &4
Septic Tank
Sheet Metal
Sheet Rock
Tile
4i. ter,
• y ;r
< l&
Da e
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: 615• /,.)-I
Job Site Address: I ZO Y Wfd �u 16�
Roofing Company Nan
Applicant's Signature:
• Greg Casteel
Building Official
Revised 11/2/04
;San.
• cnror
CUPERTINO
•
•
CITY OF CUPERTINO
REROOF
PERMIT APPLICATION FORM
APN #
Date:
BUILDING
BENERGY
Building Address: 2 �,7,v
BUILDING
C(/
(�y0 ri4
Seismic Fee Res
Owner's Name:
n1 er. r"
BSEISMICOM
Phone #:
M- YY6-3t`Y6
Contractor: n 41 A(0 4 pA
�
BPLANCHK
License #:? 783 ,
Contact: OF �rI�e
BUSLIC
Cupertino Business License #:
Type of Roof Covering:
Existing:
Proposed:
❑ Built -Up Roof
�(❑Built-Up roof
❑ Asphalt Shingles
Asphalt Shingles
i
'I,—Wood Shakes
❑ Wood Shakes
❑ Wood Shingles
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings
❑ Other (Specify)
❑ 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: ,,
Aawye I
2
41b;���7'f
s s/
41y41j ;J
Residential RL Commercial
IfNAW
Fire Zone: Yes C] No 0
Confirmed with Planning Dpt. if
there are any restrictions: LJ
Cost of Project'/3 �O Type of Construction: Occupancy group:
Qty. if
Applicable
Fee ID
Fee Description
Fee Groun
1 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