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06030052 (2) CITY OF CUPERTINO 'a BUILDING DIVISION PERMIT -ONT.Rf,0T'0RjNFO MATION BUILDING ADDRESS: CUPERTINO ROOF, INC PERMITNO.06 03 0052 10818 E' 2STATES DR OWNER'S NAME: PERMIT[SUE DATE PHILLIP PA UETTE 1052 KELLY DR. - 03/10/2006 NE: SANITARY NO. CONTROL NO. (408) 973-9427 ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 'loo LICENSED CONTRACLOWSDECLARATION IobDescri tion F 1 Wmby Offr n that 1 m se licensed unr pmvianns of Chapter 9(commencing P with Se g.7").f Dlviaon Sof No Beat.aid Profcekna Cade.and my license felt ena ai License enande �{ bs 3 REROOF-REMOVE SHAKE$/I> �� OLB FELT SH Li e mClrsue UectC Z Date 381_ con am CONCRETE TILE-CLASS A ARCNf1EC1'S DEC, ION I understand my plans Wall W And As public records f a tg Licensed Profcstinunl '�M/99IF (006 OWNER-BUILDER DECLARATION i�i 1 toothy affirm that 1 am exempt from the Controem's License Law for the .0 a 0 following moan.(Section 7031.5.Business and Profession Calk:My city At county $ which inquires a permit to connrum alter.hnprove.demolish,or repair any structure b�^, prier 6t i61YWMe.also Acquire the applicant for such permit to Die a signed statement a that he is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 $q.FI. Floor Area 1000 (commencing with Section 700(p)of Division 3 of the Business and Pmfaviom Cade)or Nat An is exempt therefrom and the bub for the alleged exemption My violation of Section 7031.5 by any applicant for a permit subjects dte applicant An a civil penalty of APN Number Occupancy Type am mare sen Rw hundred doll.(5500). 36922009 . 00 ❑1,As owner of the pmpcoy.or my employes with wage As their sole eompenwBon. will do the work and unnumure is nothanded wonercd fmnd.(Sm.70/4•Business Required Inspections and Protest..Code:The COnammr'!License Law doss sol apply m An owma of 9 P pmpeny who bui Ids her impruwes thereon.and who does such work himself her tluuu{h his own employees,provided that such Improwmenu art notintetdrd wagered(wade.H, however,the Wilding or improvement Is mid within one wv o(completion,the owner. Wilder will have W Wrdm of proving that he did trot Wild her improve for purpose of Asia.). ❑1,as owner of the property,am exclusively contracting with licensed consmmrs m construct the pmjec5(She.7044.Business and Prafedona Code:)The Consumer's Lb cave law docs not apply An an owner of propeny.who Wilda or improwa them=.and, who contracts for such pmlecta with a consaumr(a licensed par ouna to Bane Consanoe. License law, ❑loin exempt undo Sec. ,B&PCfwthbmsmn Owner Date - WORKERM COMPENSATION DECLARATION I hereby afBm under ptinalty of perjury,one of the following declvWom 1 hew and will msintain ACeNOate of Covent mselhinmm fw Warl aesComp=- When•as provided for by Section 3700 of tite labor Code,fes do p ufarmana of the work for which this permit is issued. ❑1 have and will maintain Workers Compensation Insurance,As required by Section 3700 of the Labor Code•fes the performance of ft work for which this permit 1,Issued. My Warkela Campenutian Inatuanee auric and Policy number K• Carriv.�+rn!-e FTM Polity No.:.)12--�G WHO CER'11FIC OMPE SATION70NFRAN WORKERS COMPENSATION INSURANCE (This auction And not W completed If the permit Is fucose hundred dollarsnioll) or lcsa) I certify that In the performance of We work for which this permit is issued.I dull not =ploy any person in my maserm W At become subject m the Warteri Compensation Laws of California.Data Applicant NOTICE TO APPLICANT:If.after making this ComiOeM of Exemption,you should Weame subject m Na Worker's Compensation provisions of the Labor Code,you most vJ z forthwith=reply with such pmvismos or this permit shall he domed invoked. r y CONSTRUCTION LENDING AGENCY [—r I hereby affirm that mem iso conmm�inn performance agency for the lerfoance of E4 9 the work for which this permit b Issued(Sec.3097.Co.C.) w Q Landers Name z Landers Mdrom U0 I certify that 1 ave mad No application and sum that the own infarmatlun is U' comm 1 mgrs m empty with all city and county uNinsaes and Aum caws miming m pU Wilding connection,and amby Authorize,wpreenmim of this city to enter upon the above-mentioned pmpeny for inspection Purpwea W (We)agree in caw,indemnify and kap hamlets the City of Cupertino against in liabilities,judgments.ensu and expenses which may in my way accrm against sold City U In owe of the OanIt. fthis permit Nog NT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOU CE ULATI ry S—(oro( Re-roofs �-- Sr umof AppllcantrCanumtor Data HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will dm applicant w forum building o=upantstore or handle haerdouA materia as defined by the Cupertino Municipal Code.Chapter 9.12.and IN Hcalth and Safety Code,Section 15532m)?0Ye '5]No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future Wilding occupant uau equipment At devices which If a roof is installed without first obtaining an inspection,I agree to remove McAdoo,air eonuminants As defined by the Bay Area Air Quality Managa..i BIT- terials for inspection. ssiw7 ❑Yes No Ihow rod the handout materials requimmenuumkr Caper 6.95 of to Califon 1 0 nb Health&SafctyCode.S Liim 25505.25533 ao125534.1 undemmd thstlftim Wilding umntly haw a tenant.that It b my maponsibility In And tiro mqui- cu =nfa Ccniicaw ooccupaWcuryp.ant of the --Signature of Applicant Date an 3— ?o-6(0 Ower wamhodmd agent Dam All roof coverings to be Class"B"or better Community Development ✓ peCupertino CA 95014 Telephone(408)777-3228 Cl of Fax(408)777-3333 «JPEI�TINO Building Department JOB ADDRESS:C— ES� e- PERMIT # 1 ��3G1Js CZ OWNER'S NAME: 'P H, l ( u e- -L PHONE # 5 9l -9 2 Q GENERAL CONTRACTOR: Cv Rte. FAX # I am not using any subcontractors: 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 ile Owner/Contractor Signature Date CITY OF CUPERTINO •1 1 Of 1 PERMIT RECEIPT OPERATOR: Buem COPY # 3 Sec: Twp: Rng: Sub: Elk: Lot: APN . . . . . . . . : 36922009.00 DATE ISSUED. . . . . . . : 03/10/2006 RECEIPT #. . . . . . . . . : 33515 REFERENCE ID # . . . : 06030052 SITE ADDRESS . . . . . : 10818 E ESTATES DR SUBDIVISION . . . . . . : ' CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PHILLIP PAQUETTE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . . , RECEIVED FROM . . . . : CUPERTINO ROOFING CONTRACTOR . . . . . . . : DAVE SMITH LIC # 25701 COMPANY . . . . . . . . . . : CUPERTINO ROOF, INC ADDRESS . . . . . . . . . . : 1052 KELLY DR. CITY/STATE/ZIP . . . : SAN JOSE, CA 95129 TELEPHONE . . . . . . . . : (408) 973-9427 OE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW SAL ______ _____________ __________ __________ __________ __________ __________ BPERMFEE VALUATION 10,000.00 169.56 0.00 169.56 0.00 BSEISMICRE VALUATION 10,000.00 1.00 0.00 1.00 0.00 __________ __________ __________ ---------- TOTAL PERMIT 170.56 0.00 170.56 0.00 METHOD OF PAYMENT AMOUNT NUMBER ----------------- ------------ ------------------ CHECK 170.56 1687 TOTAL RECEIPT 170.56 • Community Development Department Building Division City of Cupertino 10300 Torre Avenue • Telephone: (408)777-3228 CITY OF Fax: (408) 777-3333 CUPERTINO 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 Raid 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: l 1 1 n^Qy�— job Site Address: I ' I C . E S C Dra Roofing Company C l J Qe+ ^G CT Applicant sSignature: --- Date:�6 f • Greg Casteel Building Official Revised 11/2/04 Printed on Recycled Paper G CITY OF CUPERTINO REROOF O�f3saz lUPETR6' PERMIT APPLICATION FORM APN # Date: 3 0? ad I- to - off Building Address: I Q De Own �a�,,j o Phone#: Contractor: Phone#: License#: Cu k2-f- 1 ,� � CFr_P1Nt:IPhone#: ZIR Cuperti Bu ine License#: �z - �S�D Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles --B Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles I I� ❑ Other(Specify) ❑ Other(Specify) 1 e 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 Polic Job Description: 1 -'5' 1 ` z c lh lql '3 r-i It ss `A Reside Commercial ❑ Fire Zone: Yes-0'N-0-17 Confirmed with Planning Dept. if there are any restrictions: LI Cost ofProject: Type of Construction: Occupancy group: 11 VJJ Qty. if Fee Description Fee Group F7iBPLANCHK Fee ID RMFEE Bld Permit Fees BUILDING NERGY Energ BUILDING EISMICRE Seismic Fee Res BUILDING EISMICOM Seismic Commercial BUILDING Plan Check Fee BUILDING BUSLIC Business License BUILDING