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08040104 (2) CITY OF CUPERTINO acv a*7�g�ya:� = t 'y�rg� ��ao-g"♦' w^� '? BUILDING DIVISION PERMIT r uW�u,aryl\taR-�li�.� 7R3XA.tZdv BUIL I G ESS: PERMITNO. �. BUBB RD PRINCIPLE ROOFING & 08040104 OWNER'S NAME: PERMIT ISSUR DATE RAGHUARJA 10160 STERN AVE 04/15/2008 ONE: SANITARY NO, CONTROL NO. (408) 898-7298 ARCHnECUENGINEER, BUILDING PERMIT INFO 'BLDG ELECT PLUMB MECH Y00ai� LICENSED CONTRACIOr'S DECLARATION ' Job Description ,=1 huaffi cby affirm that I am licensed under previsions escrlp visians of Chapter 9(commencing with Section 7000)afDividon 3 of the Buaimes end Profeuimm,Coban,and my license is RE—RF RMV EXSTNG I0SHK INSTL CLS A 26SQ EAGLELITE In fall fame and Affect L3 9 A5 ucenreClWWLID, TILE 7� Date nth Cmus"mr gg ARCHITECTS DECLA ATION I undcrata y plans sbpll W used u public weards 5y1t,F LON Lw_.dNa1_b m I p 5 OWNER-BUILDER DECLARATION 9<� 1 heathy affirm that 1 am sanmpt from tie Con"clues License Lew for the C❑O following mune.(Section 7031.5,Business ad Professions Cade:My city or county ISE! which¢quires a permit to conswc4 Alter,impmw,demalbh,or repair any motion S Ser prior us its issuance.also requires tM applicant forauch permit to Ole a signed summer that he is licensed purstrani M the provisions of the Contractor's Uccnsc Law(Chapter 9 Sq.Ft.Floor AreaValuation $ (comet ming with Secdon7000)ofDivision 3oftheBusinemandProf $essinnsCode)or 14000 �.. that he u eaempt therefrom and time bub for the Alleged exemption.Any violation of Section 7031.5 by airy appllc nt fora panit mbjesu the Applicant in A civil penalty ofNumber - - Outmamthan Eva hundmtldollars($Mn 35620009 'Number ❑1,As awnv of the PmPAVY.r my employees with wages u chair new cempensadon, will Oct the worlr_and the sanctum is nut intended or offered for seal(Sec.7W.Business and Profesdav Cache The Contractor',License Law docs net Apply te an awwr of Required Inspections property,who Wildsorimprovea thermen,awl who doessuch workhimselfor through his ownemPloyeas,provided thatsuah improvements are not Intended aroRered forsd.IL - hawever,thebuildingmimpmo entbmldwithimmuofcompmuon.theawwr- - ' Wilder will baw as burden of proving that W did rot Wim ar improve for purpose of ole.). ❑1,As owner of the property,am axeludwly contracting with licensed comamrs m construct the pmject(See.7044,Bawas and Profraskr s Cade)The Cmtracmr's Li. _ cave law dors not apply to an owner of propeny who Wilds or improves Ihemon,and, who conbacte for such projects with a contactors)licensed pursvnt in One,Con ewes Liceme law. ❑I oro esempt under See .R&PC far this reason Owner Dam WORKERS COMPENSATION DECLARATION I hemby affirm under penalty of perjury ow of Ute following dewlaradons: have and will mdnum A Certificate of Covent to sellhowan far WorkmesCompen- n,As provided far by Section 37M of the Labor Cade.for the perfurmanca of the for which this permit is issued. ❑I haw and will maintain Worker's Compensation Insurance,As retained by Sermon 3700 of the Labor Code,far Ne performance of the work forwhich this permit is issued. ' My Worker's Compevadon Ms.artier and Polity number am: Gw< S'�T.r'�tiwr.-/ Polity No.:�uG CEAFI TEOF WPPTIONFROMWORKERS' COMPENSATION INSURANCE (Ihbsectlan wed not W complemd Iftim permit is forane hundred dollars($ld) Or inn.) 1 certify that in the performance of the work for which this Permit b issued.I dull not employ any person in any mmwran an in become subject to the Warken'Crnpevatlon Laws of Caltfomia.Data Applicant NOTICE TO APPLICANT.If,a0er making this CcniOvm of Exemption,you almuld become subject in the Worm's Compom adon previsions of the LAhor Code.you muss vJ O roMwith comply with such provisions or this permit shall W droned tewke0. z" CONSTRUCTION LENDING AGENCY I-t Ihereby cErm that them ismad(Secontraction.3W7.lending s.egctwy fns the performance of CL ren time lurk for which this permit b iaswd(Sr.3W7.Cis.C.) W�Q Lender's Name Z lender's Address , U 0 1 certify that I haw teed this Appllesuan And sum that the aWw infasmaliun is V.!" Corona 141=m comply with all city and county oNlnamans and sum laws elating to -0 rV^ Wilding construction,and hereby mtborim repmsenstiws of this city m enter upon the a Ww-menduwd pmpeny for ivpcmon purpnw. �"y (We) S.to ave,indemnify mrd keep harmku has City of Cupertino again VI liabilities,judgments,costs and expenaes which may in my soy stern against said City ()Z in cangwwm of the grsnting of this permit. 1 Cv ^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCE E� ONS. iS/al Sigu natre of ApplicantlCMaracmr / Dam Re-roofs HAZARDOUS MATERIALS DISCLOSUREType of Roof Will wasapplicant or(atom building occupantamre or Aandm haardam mAmrid As deOwd by the Cupertino Muni 1 Code,Chapter 9.12.and we Ham and Safety Code.Section 25532(a)?s3z(.)7 ❑Y. All roofs shall be inspected prior to any roofing material being installed. es No Will the applicant or forum Wilding weapon,use equipment err devices which If a roof is installed without first obtaining an inspection,.I agree to remove 11 WaNnm air contaminana u 0 Ad by the Bay Acta Air Quality Mamgclaws all new materials for inspection. let? ❑Yes Nu 1 have mall the hrnNws maim alsmquimmcnuurkr Chapterd.95 of the Califur. nia Hwith&Salary Cod.SecdownM5.25533 md25534.I andcutan lthatifthc Wilding dors not currently haw a mnanl that it b my mspondolity m andry the wcupant of the' requirements which Most W met prior to israw,of a Certificate of Ocapanq. Owner or aulhorivcd agent DamSignature of Applicant Date r All roof coverings to be Cl ' 'or better ' g assTW CITY OF CUPERTINO • 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35620009 . 00 DATE ISSUED. . . . . . . : 04/15/2008 RECEIPT # . . . . . . . . . : BS000004482 REFERENCE ID # . . . : 08040104 SITE ADDRESS . . . . . : 11161 BUBB RD SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : RAGHU ARJA ADDRESS . . . . . . . . . . : 11161 BUBB RD CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4956 RECEIVED FROM . . . . : DERECK LOI CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564 COMPANY . . . . . . . . . . : PRINCIPLE ROOFING & ADDRESS . . . . . . . . . . : 10160 STERN AVE CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . : (408) 898-7298 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL - --------- ------------- ---------- ---------- ---------- ---------- -- -- 1BSEISMICR VALUATION 14, 000. 00 1.40 . 0. 00 1 .40 0. 00 1RER00FRES SQ FEET 26. 00 338 . 00 0. 00 338. 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 339 .40 0. 00 339 .40 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 339 .40 MC --------------- TOTAL RECEIPT 339 .40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------------------ ---- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS :604 ROOF IN-PROGRESS 605 FINAL REROOF o�?oy 0 Oq CITY OF CUPERTINO a REROOF CUPEkTINO PERMIT APPLICATION APN # 2 09 D U Date: a 41/ 5-1a 60 Building Address: Owner's Name: Phone #: C ' "`c ArC�j'cz C4a�J Zo3 — oz4io Contractor: Phone d'��'- pl�.i,<��C�,�.rr�y� � fpr-a✓�i -st.��,� T Fax#: Cupertino Business License #: Contractor 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) L<rrt trielarzf �? Number of existing coverings t ❑ Provide I.C.B.O. Report # ❑ To be Removed, ❑ Provide Mfgr. Installation Specs. Job Description: Ize ✓� � y✓va/> S/lu/cr� � ��„fr,�� M FAGrLPL.ti- GLarS 4 Residential Commercial Fire Zone: Yes ❑ No ❑ Confirmed with Planning Dept. if there are nnv restrictions: ❑ Valuation: 41 I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: *Signature CITY OF CUPERTINO REROOF °` CUPEI�TINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group IREROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES Re-roof Residential B 1SFDWLR00F / 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B 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: R AAg1& /_ _L1 Job Site Address: WeG Roofing Company Name: Applicant's Signature: Date: ® Greg Casteel Building Official Revised 11/2/04 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY OF Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: PERMIT# C7 / 6 tcoCoL ,��_ ,:FO yo I OK OWNER'S NAME: q -d. PHONE # GENERAL CONTRACTOR: rk,;— ,, FAX # I am not using any subcontractors: !2± eJ%.? 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 Tiley, Owner/Contractor Signature Date