06090134 (2) CITY OF CUPERTIN ''W"''
BUILDING DI VISION PERMIT CONtj,JUQQR INFORMATI ,
,4 rv_cs+?"k^dv a ha't ,sInir,:
BUILDINGADDRFss: WINTER ROOFING INC PERMIT NO.06090134
10554 ORANGE TREE LA
OWNER'S NAME: PERMIT ISSUE DATE
PRAGNA PARMAR 151 WYANDOTTE DR 09/18/2006
,NE: SANITARY NO. CONTROL NO.
4083638052
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
;oo LICENSED CONTRACTOR'S DECLARATION - Job Description 1 hereby affirm Net t am 1'Imvcd make,Provisions of Chapter Y(commencing
;<w whit Second 7MU)of Division 3 of We Business and Professions Code,and my license is
=y in full face and of e REROOF- TEAR OFF WOOD SHAKES 1/2" OSB. INSTALL
'n: License '�a `k'"-Contractor PRESIDENTIAL TL, 30LB FELT & 1/2" OSB. 30 SQUAR
-k,o Dam
s! ARCHITECTS DECLARATION CLASS A
L U I undersund my plans shall he used to;public retards
to
CLicensed Professional
5 OWNER-BUILDER DECLARATION
i f 1 hereby affirm Nal I em exempt from the Conlrsmoes License Law for the
O0 following rosson.(Smtion 703[.5,Busincssand Professions Colic:Any it,or county
<$ which recants,a permit to car.,,aIle,improve,demolish,a repair any suaemre
°iy prior m its issuamre.also requires Womplicant for such permit to fslcasigned statement
FSG that he o Booted pursuant to We pmvisi,mar We Contraomrs Licevc law(chapm,9 Sq.Ft.Floor Area Val
dfiLjW
is
(commencing wild Section 7000)of Division J of We Business and Professions Code)or 0
Wait he k exempt therefrom and be bssia for We alleged exemption.Any violation of
Section 7031.5 by arty applicant for a Permit su ij.the applicant m a civil penalty i f APN Numberc Type
not tome dun f hundred dollars(ZOO). Y YP
❑1,as,wirer of the pmpenY•a mY emplrym with wages u their sole compemaJon,
whit dothowmk.and the ha Contractors
hounded or rffe d..1 apply to an owne,of Required Inspections
00
Nd propProerty
who
Cade The ed;the WY5 LdCnm Law aOea MI apply m rt roller is q P {/O
propertywhobuiWo i improwch improvements
and who amensuchworkhimself ded edthmugc his
owever. ebuiprovided prat suchimps midwiitarenot ear ofompletied formic.r.
however,thebuilding orimprovementissold tdid ore Weld ofimproefor We owner.
builder will have the burden of proving that he did wt build or improve far purpose of
sakJ.
0 1,as Taus r of the property,am exclusively consraming with licensed ronsractors to
construct IM project(See.1044.Business and Professions Cade:)no Contrumr's Li-
cense Law does not apply m an owner of pmpeny who builds or improves themoe,and
who contracts for such projects with a contractor(s)limned pursuant m the Contractors
Licrns Law.
E]land exempt under Scc, ,B A P C for Nis reason
Owner Data
WORKERS COMPENSATION DECLARATION
40 I hereby affirm under penalty of perjury ane of the following daluatioiu:
1 ham and will maintain a CmtlOcas of Comm to self-ma tic for workerscompen-
smirn,as provided for by Section 3700 of the Labor Code.for the perfrrmartm of the
work for which Nis permit is Wind.
❑i bane and will maintain Worker's Compensation Insurance.as rcquimd by Section
37W of the labor Code,for We performance of We work for which this permit is named. '
My Warta i Compensation huurarltt carrier and Polity number arc:
Gorier: I ATEOrFEXEMPTION O Od WORKERS*CERTIFICATE OF EXEMPTION FROM W ORKEAS'
COMPENSATION INSURANCE
(This sector need nolbecomplcmd if IK Permit is forme hunEteddollars(SIM)
or less.)
1 cenify that in the Performance of We work for which this Permit is issued.1 shall not
employ any person in any manners^as to became subject m the Worke,sCom abodann
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If,after making Nis Certificate of Exemption,you should
become subject It the Worker's Compcnsstion provisions of We labor CMc.you must
Z forthwith comply wish such Provisions or this permit shall be deemed revoked.
ZO CONSTRUCTION LENDING AGENCY
[-. 1 hemhy affirm shat mart is a consmmclinn lending agency(."he performance of
Cr> the work for which this Permit Is issued(Sec.3097.Civ.C.)
dLender:Name
Z Lenders Address
U O 1 cenify Nu I have read this application and Soto Nat We above infotmatiun is
FCarred.1 agree to comply with ail city and county oNinareas and site,laws relating to
CU building consuucoon.and hemhy authorize npresenutives of this city to enter upon the
r L2J ahon mentioned property for inspection purposes.
(We,)agree to save,indemnify and keep harmless We City of Cupertino against
,Hyh
liabilities,judgmenu.costs and expanses which may in any way accrue against mid Ciy
of the granting of
s Permit.
U^Z APPLICANT`UNDERSTANDS AiND WILL COMPLY WITH ALL NON-POINT Issued by: Date -71L
SO CE REqULATIONS.
� L7) 1 2 06 Re-roofs
Signature ol'AplosiddConomiDataHAZARDOUS MATERIALS DISCLOSURE ,I,
ype of Roof
Willy t applicant rm future W al Cu acupapt r 9.1 a handle becarcous.I W and
as de,Sed by the Cupertino Municipal Cade,.Chapter 9.12,roti the Hcaith and Safely
Calc, 25532(a)?
Dyes
❑res FYN. All roofs shall be inspected prior to any roofing material being installed.
41 Will dm applimnt or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove ,
emit Wardens air contaminants ra derided by the Bay Area Air Quality Management all new materials for inspection.
District?
Q Ycx �No
1 have mai the Whardousmamrials requirements;under Chopmr6.95 ofthe Glifor.
via Health dr Safcsy Code.$ceders 25505,M533 and 25534.1 undersand that little building
does net currently base a torsos,that it is no,mrpansibllily to noddy Ne,acap.,or lde
Mmen��wwhichmh ma metpriorwjwuanmofacrrdreamora
mp^^ Signature of Applicant Date
ap, G_1�{4b
Owner oraumant, gem D,m. All roof coverings to be Class "B"or better
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.
Homeowners Name: �W( tic (A
Job Site Address: ^ —
Roofing Company Name: W 1��� r1C�J�/ �n ADCC
Applicant's Signature: Date:
• Greg Casteel
Building Official
Revised 11/2/04
e Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: _ PERMIT # OrO O I/11 I
OWNER'S NAME: fv /JL PHONE #c f0
GENERAL CONTRACTOR: FAX # rr
I am not using any subcontractors:
Signatur 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
Tile
Owner/Contractor Signature Date
CITY OF CUPERTINO
am 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31634017 . 00
DATE ISSUED. . . . . . . : 09/18/2006
RECEIPT # . . . . . . . . . : 36091
REFERENCE ID # • • . : 06090134
SITE ADDRESS . . . . . : 10554 ORANGE TREE LA
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : PRAGNA PARMAR
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . . ,
RECEIVED FROM . . . . : IRLANDA MARTINEZ
CONTRACTOR . . . . . . . : MARTINEZ, JAVIER LIC # 21207
COMPANY . . . . . . . . . . : WINTER ROOFING INC
ADDRESS . . . . . . . . . . : 151 WYANDOTTE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95123
TELEPHONE . . . . . . . . : 4083638052
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
----- - ---- - - - - --------- --------- - ---------- ---------- ---------- --------- -
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
-- - -------- - - - --- ------------ -------------------
OTHER 170 . 56 MC
TOTAL RECEIPT 170 . 56
•
CITY OF CUPERTINO
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# 'Nu + _ Date:
Building Address: to
5
owner's ame: Phone#:
Contractor: License#: '
1
Contact: 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 ❑ Provide I.C.B.O. Report#
O Tobe Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑
Job Description:
n �
p 0 7
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: T e of Construction Occupancygroup:
C4 q T1
02
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
•