06080030 (2) CITY-OF CUPERTINO '
BUILDING DIVISION PERMIT z: ONT12 .CTQogI ORMATI,ON
BUILDING ADDRESS: LOS GATOS ROOFING PERMIT NO06080030
11594 OAK SPRING CT
OWNER'S NAME: PERMIT SUE DATE
OALLEN LEE 888 FAULSTICH CT08/04/2006
NE: SANITARY NO. CONTROL NO.
(408) 298-9399
ARCH ITZrfENGINEER: BUILDING PERMIT INFO
BLDG O ELECTO PLUMS MECIIO
W p LICENSED CONTRACTOR'S DECLARATION Job Description
i 1 Imemby affirm TNI I w 11¢nsed under provisions archaism,9(commencing P
with Section 700M of Division 3 or Ne Businessa d Pmfessm.Code,mll my license is
.mu,mu, inrullfarceNdef kW O REMOVE EXISTING SHAKE ROOF. INSTALL 30# FELT
License Clmou
Dam
cleara UNDERLAYMENT AND ELK 50 HD SHINGLES CLASS A
e ARCHITECTS DECLARATIOW
t m< I understand my Items aNll be used as public records
3 U
e u t; Licensed Professional
j01 OWNER-BUILDER DECLARATION
1 hereby alTrce that 1 am attempt from the Contractors License Law fan the
Z o C fallowing lesson.(Section 7031.5,Business and Prefoodoes Cade:My city of county
5$ftii which rauireS a permit W cmarua,alw,hnpno n.dcmnihh,nr repair any Wascone
-Z y prior to its issuance,also mquima the applicant for such p.mit to 0le leaned ammment
p < thatheislicensedpursuanttoOneprovisiomaftheCommuneslhmnselaw(CMapmr9 Sq.Ft.Floor Area Valuat 832
t�O (commencing with Section 7000)at Division 3 of the Business am Professions Code)Or
t� 3 that he is eanmpt Ihemfmm and the basis for the alleged ewnp0on.Any violation or
Section 7031.5 by any app0cant for a Permit subjects the applicant to a civil Penally of
1,aawner oflN pmpasy,ar mY.aplayw wlNngaa Neo am companWon, OccupancyiTYP
0
not mans Nan Ow hundred doll. 3 ur7� 0 0
0
will do awwork,and IN suucmre hoot Intended or offered fallen(Sm.7014.Business Required Inspections
and Professions Code:The Contractors Lit=Law does not apply to e an owner of q
property who builds or lm proves,daemon.mon.and who does such wart himaelr or through his
awn anploycns,provided that such imptotemenu v<activated W oroBeaed forak.IL mar-.�+
build. the Wilding hebrden Improvement 4anid tIm didnoneyw or imp.
Ne ower- Rx7n
builds will Mw the burden of proving that N did not build er impmw far purpose of
sale.).
0 T.a owner of the property.am mclmively contracting with licensed rontrutan to
construct dee pmjca(Sec.7OM.Business and Profesdom Code:)The Contractors U.
come law does out apply 0 an owner of prupeny who builds or impmw thereon.ad.
who contracts for such projects with arum emns)licensed pursuant to has Conucloh
License L.-
0 l am aempt and.See ,B k PC far this won
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hemby afRml under penalty of perjury ane of 0re following dalaratiom:
I haw and will maintain a CaNOam of Cameral lo self-iasure for WadmraComfort.
ation,u pmrided for by Secuan 3700 of the IJNr Cade,nor the perfomane,of the
work for which Nis Permit is issued.
Cl 1 have and will maintain Workers Compensation Insurance,as required by Section
3700 of d.Labor Code.for the perfofmana of Ne wart for which Nis permit isissted.
My Workers Com entad Nature ser and Policynumber ale:
tinier: N Policy No.:
CERTIFICATE 0•EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ThiswcdmneNnothacanpleedtf WeNmitisfmmmhundred&o (SIW)
or lass.)
I certify Net in the performance of the work for which this permit is indeed.I shall ma
employ any person in any manner an as N beams abject to the Workers'Compensation
Laws of California.Dam
Applicant
NOnCE TO APPLICANT.If,after making this Certificate of Exemption.you should
Income abject to de workers Compcaation previews,or tie labor Cade,you masa
.,O forthwith comply with such provisions or this Permit Nall on dammed remittal.„Z,n� CONSTRUCTION LENDINGAOENCY
[� Thereby uTRrm Nat thcrcis a construction lending upsurge,for dm Performance of
lYir� the work far which this Permit Is island(Sce.309'f,Civ.C.)
ALenders Name
Q z Landers Addw .
U Q I eerily that T have read this application and sum Nat the aNw information is
LT.F cormCl.I game b comply with all city and county ordinances old atom laws relating to
Q” building construction.and hereby auNorm mpreienpliws of Nil City la cnmr Ypnn Ne
` W aNve-mcmiuned property for inspection purposes.
(We)agree to ars,indemnify ad keep harmless the City of Cupertino agaiml
rA liabilities.Judgments,costs and expenses which may in my ray amue against said City
V"Z in conanquence of the granting of this permit. [`^ !1
APPLICANT UNDERSTANDS AN[[[yyWILL COMPLY WITH ALL NON-POINT Issued by: Date 6 7� C
so! CU g1�
f�-dG
Signature aft - Re-roofs a(Appli on actor Dam
HAZARDOUS MATERIALSuCLOSURE Type Of Roof
WIII do applicant or forum building pantrore or handle anomalous
a de0ned by the Cupenina Municipal Cade.Chapter 9.12 Ne and HW and d Safcq
Cade.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
CYa l�No
will Ne applicant or future building Occupant use equipment or devices which If a roof IS installed without first obtaining an inspection,I agree tO remove
cm11 Mentions air contaminants u de0ued by he Bay Am,Air Quality Management all new materials for inspection.
Dimict7
Man JKNu
1 hoc mal the baandas materials requirements under Chapter G95 ofNc Califor.
ale Ha1N&Seely Cade.Sections 75505,25533 and 25534.1 undersand thou.if ton buikfing
does not cumndy haw a mnsm,that It is my responsibility to notify We acupanl of the
requimmcns which masa be met priarto an Tartirm.maroocvpucy Signature of Applicant Date
' ^` ��y�& All roof coverings to be Class"B"or better
Owner or aulhorixcd agcm Dam
CITY OF CUPERTINO
om 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36652069 . 00
DATE ISSUED. . . . . . . : 08/04/2006
RECEIPT # . . . . . . . . . : 35522
REFERENCE ID # . . . 06080030
SITE ADDRESS . . . . . : 11594 OAK SPRING CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ALLEN LEE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : 888 FAULSTICH CT
CITY/STATE/ZIP . . . : .SAN JOSE,'. CA 95112
TELEPHONE . . . . . . . . : (408) 298-9399
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 6 , 000 . 00 126 . 36 0 . 00 126 . 36 0 . 00
BSEISMICRE VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 126 . 96 0 . 00 126 . 96 0 . 00
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
*CIOF�
Telephone: (408)777-3228
• C I I D[kT f A I® 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 buildingAnspector. 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.
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 stat policy.on re-roofing.
Homeowners Name: / -94
/
A L—
_— Job.SiteAddress:___._
Roofing Company ame:
O
A plicant's Signature: Date:
Greg teel
• Building Official
Revised 1/30/03
Printed on Recycled Paper
aClOF
CommunityDevelopment10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
Fax(408)777-3333
CUPEkTINO
Building Department
JOB ADDRESS: S q7 , D� Pr�n PERMIT#
OWNER'S NAME: Lee-- PHONE #
GENERAL CONTRACTOR } 45a FAX# O� 2
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
Roofing_....-4-_----Septic Tank
Sheet Metal
Sheet Rock
Tile
• Owner/Contractor Signature Date
CITY OF CUPERTINO ow6w,30
REROOF
CUPEkTiNO PERMIT APPLICATION FORM
• APN# Date:
.J �-.. �Z-Q� 7 2G U �
Building Address:
IST(
Owner's ]Name: Phone#-
Allen L e m YOF 530--7q- ? 9
Contractor: Phone#: d License#:
a. kQq �q
Contact: Phone#: Cupertino Business I,tcen a#:
Salme� 3Y 8.
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
XWood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) X Other(Specify) 430
Number of existing coverings ❑ Provide I.C.B.O.Report#
To be Removed Provide Mfgr.Installation Specs. s 8—"
I Have Read, Understand and Will Com I With Cu erti o's Tear Off Polic :
Job Description: _
• %Ji Ef D .o (Gr J
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type o Constructi Occupancy group: /
832. oa p.
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERN4FEE Bldg Permit Fees =BUILDING
G
BENERGY Ener G
__._.--.•--------_- -••- S�ISMICRE_ _..___.._— . G - --
G.—�'.-
BPLANCHK Plan Check FeeGBUSLIC Business LicenseG