06080214 (2) CITY OF CUPERTINO .� --'<, a'� *`*'� '� " °��` ' r'•"' ' `
BUILDING-MVISION PERMIT CAN'T
(IIt�INFUItM° TIN
`.YRY Gyp. $1nldxbFeegg 'ra.'%^+:S`sU" .a�''^S`:. `^'• -'e.
BUILDING ADDRESS: W ORE ROOFING COMPANY PERMIT"0.06080214
837 KIM ST
OWNER'S NAME: PERMIT ISSUE DATE
CONNIE BOND 2814 AIELLO DR 08/25/2006
NE: SANITARY N0, CONTROL NO.
(408) 694-0060
ARCHITECTPENGINEER: BUILDING PERMIT INFO
' BLDG lEff "Mr MECH
� 0
cep6 LICENSED CONRACr(i DECURA71ON Job O
Descrl On
1 hereby alarm Nal I am licensed under Pearson"Of Chapter 9(mmmcneing P
.]1 with Section 70M)ofDrAmon Sof the Business and Professime Code,AM my license Is
�arimm' mrceaneertxC REMOVE EXISTING WOOD SHAKE, INSTALL 1/211 OSB, 3
m Z Lkenu CI Lk.P
Dam - comruter txfP FELT LANDMARK 30, CLASS A
ARCHRECI'S DECORATION D_-`
j I udcrstenJ my plana shall W used u public mcods R+�1, �/tt��.as[�W�l yR�y� g tpt�j��,r l{r(I�/�y,
1 U GY '13 {.�'4m•SM�
C Licensed Professional
y OWNER-exempt frDECORATION
I a i 1 roam •(Sect that 11. exempt from the Cssions Co License law for the
.0e fallowinguirson.permit
703 1.5, and Professions sedum Code:Anycity Or county
tale which requires a permit no mawroe4 nkm hnpmse,&mans&,or mash any moisture �i InC
1z� priorteitsissnsed IM sure to the thovisios of far anehpermr's o rile a signed Lice=Law
- VEIU ibA950
•€e Nal mislkemd pSesuanuothe of Divisio of thehe Busincom Li¢nulaw(LTuluer9 Sq.Ft. Floor Area
$
(commencing he Is Imormin Section70,M)0d the
Division f r of the a cg etnexe and Professions la Coca)or
.. Net he is escarps thercfmm and the Eula for dm dkgd exemption.Any v101adon of pp[�j j�jpm k
Section 7031.3 by any applicants for a permit subjects the applicut M a civil penally Of 3 5 9 2 0 U U Ger 0 0 " ' VUB
ancy Type
nos mart Nan Ove hoMmd dollars($500). t
❑Lasomonafthe property,army employes with rages asdu'vukeompensmon,
will do Lim"kme she swnuu is noHnmMcd"offered Orsale(Sm.7W.Budnw Required Inspections
and Pmfesdow CMO:The Contractors Lican Law does rut apply to an Owner of q P
properly he WildaartmprovelMsrnn,ated who doexsuchwork himself.through his
crwnceployees.pmHdW thatnmh improvements am net inmMed"Offerd fe,sale IL
however,the building or Miume cat is told within arc year of wnpledon,the owner-
buil&'will haw she Writes of proing that Ire did vel Wild ar improve for poryou of
calcis
❑1,AS Owner of the property am exclusively contracting with licensed manometers to
construct the project(Sec.7014.Business and Professions Code:)The Contractors Ll.
came Law does not apply te an Owner of property who builds Or improve themon.and,
who contracts for such projects with a eon ramor(s)licensed pursuant te dre Contractors
Lice•..Law.
❑1 oro exempt under See. .B&P C for this mane
Owner Data
WORKER'S COMPENSATION DECORATION
1 hereby fibro ander pemlly of Perjury mm of the following&clardorva
I ham and will maintain a Certificate of Comemte Self-imom far m
Workers Copo-
e
- inion,m pravided for by Sutian 3700 of the labor,Code,far the perfarmance of the
work for which this permit is snood.
0 1 haw and will maintain Workers Compensation Inswance,As acquired by Section
3700 of the Labor Code.for the performance of lie rock for which this purl,4 issued. '
My Workers11,�C-o,m1—ppensatiioron..In��u�raanJntt carrier and Policy number aamm:��'��-�lr�
Cariev.s l)e Fy y`tn Policy No.:1161 0_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE -
(This sevum need rot he campeemd Irl&permb 4 forane hummed&Oars(SIM)
teas)
I canny thm in Ne perfaemerme of the work far which this permit 4 mud.I shall mol
employ any person in any mwmrm As m become subject to the Work<n'Comp onion
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If.after making this Cenirrcek of ammpsion,you should
war me Whjem In ate Worker's Compensation provisions of the Lahr CMc you must
OfaMwith comply with ueh provisions or this permit shall be deemed rewtrd.
Z► CONSTRUCTION LENDING AGENCY
(-m 1 heuby alrnm Thu dmrt 4 a conatrtmtion tending agency for sew perlormamc of
E> the wink for which this permit is inroad(see.3097,Civ.C.)
GQ Lenders Name
] Unders Address
U Q I canify that 1 have read this application and sum mat the above Mrornsuun is
comm.I agree to comply WIN all city Nd county aNinances and stale laws Reuling le
V building construction,and hereby aurhodm represenutives of this city rem enmr upon the
Ld3 above-romlioned PmNrty for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupmtino airliner
liabilities,judgments.costs and expenses which may in any way we=against said City
U 2 in consequence of the gruning of this permit.
.. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGUU NS r
�_ K'2-J`"0o- Re-roofs
Signature al'Applicanu'Conuacur Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applkanl fir for.Wading occupant pore or handle horn&w material
imit
defined by tiro Cupertino Monici 1 Code Chapin 9.12.And see Health and Safety
&,sedan 15!32(1)7 All roofs shall be inspected prior to any roofing material being installed.
CYca ;R
.-
If
the applicant or future building cacupano we equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
honednw air coemminants As road by the Bay Ama Air Quality MNagentent all new materials for inspection.
Dlssaiel7
❑Yet u
I hawmal Lhehmidwm=riaismquimmmmu ferChapmr6.95ofthe Carlo,. {/-�
n4Health&Sefelycode Stt6=25505.25533a 25734.1ura dibuiNhe Wilding Vv -OtJ
does net currently haw a armee that it is my responsibility te notify the occupant nr the
MAI m�e�u�whkItmusbemet poor missuance a(aCertificate ofOccup Signature of Applicant Date
7" " g—Z`--m- All roof coverings to be Class "Br'or better
Ow r or authotired agent Dom" '
CITY OF CUPERTINO
�m 3 of 3 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35920006 . 00
DATE ISSUED. . . . . . . : 08/25/2006
RECEIPT # . . . . . . . . . : 35769
REFERENCE ID # . . . : 06080214
SITE ADDRESS . . . . . : 837 KIM ST
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CONNIE BOND
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : WESTSHORE ROOFING
CONTRACTOR . . . : . . . : FOWLER, PAUL LIC # 21417
COMPANY . . . . . . . . . . : WESTSHORE ROOFING COMPANY
ADDRESS . . . . . . . . . . : 2814 AIELLO DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 694-0060
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -- ----------- ---------- ---------- - --------- ---------- ----------
BPERMFEE VALUATION 11, 000 . 00 180 . 36 0 . 00 180 . 36 0 . 00
BSEISMICRE VALUATION 11, 000 . 00 1 . 10 0 . 00 1 . 10 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 181 . 46 0 . 00 181 . 46 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 642 .48 1117
TOTAL RECEIPT 642 . 48
Community Development
10300 Torre Avenue
i
Cupertino CA 95014
Telephone(408)777-3228
Cl OF Fax(408)777-3333
4JUPEI�TINO
Building De artment
JOB ADDRESS: p �-, p� ` S� PERMIT #
D 1 , C� 66 a Z.
OWNER'S NAME: COVIM o PHONE # Q{7$ 2l0— 21
GENERAL CONTRACTOR QStV\rW& j4Y3 kAe FAX #
I am not using any subcontractors: WAS ,
Signature Date
Please check applicable subcontractors and complete the following information
60 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/Contractor Signature Date
owcftA
CITY OF CUPERTINO
4, REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN At 35°I
Building Address: '5 S'5-7 b
0 two S�
Owner's Name: _ y� Phone#: 2�t0 _2 1 �9
Contractor: vll1 � License#: -, 3-7 2-2we,5�5vk�ae
Contact: n( G(( 1viAlid / Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles X Asphalt Shingles
Wood Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings Z ❑ Provide I.C:B.O. Report#
XTo be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: ('C",D� ash 5 �C� 3k Y426l f (A,3tr t/2 �
`( Z( 3C4 poli{
" Lard Vy_ 30 . C ass rk
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: IJ
Cost of Project: Type of Construction: Occupancy group: Sr7
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. ,.
i 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: ,
Clany� lam`
Job Site Address:
Roofing Company Name:
` A ?�:n :k�`4
Applicant's Signature: tV�AI\ , Date:
Greg Casteel •
Building Official
Revised 11/2/04