08080122 (2) CITY OF CUPERTINO
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Ell,JGDIVISION PERAGT C'
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BUILDING ADDRESS: Peal NU.
101- 10 PHAR LAP DR LOS GATOS ROOFING 08080122
"NEWS NAME: PERMIT ISSUE DATE
C.,MW31ET GEORGE J AND ALICE P 0 BOX 1726 08/18/2008
NE SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
RE-RF RMV EXT SHKRF INSTL BLDG EO
PLUMB MECH
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C z LICENSED CONTRACTOR'S DECLARATION
I local al�Ibal I am thosecal under previsions of Chapter 9(comes.19 Ob Description
with Scctbon7OXy)ofD
is full full an twmon3ofLhcB Moment and Profmcdons Code,and mylice 7`1
Li s- Dam Contacts
FXIM 4
-LUZ'
RIA21%.814L
memods
is
Licensed Prolload ..I OWNER-BUILDER DECLARATION
I thereby air,.that I am cal Inure the Central License Law for th.
0 following mul(Sadon 703 M,Busumess and Profession Code:Any city or county
ISE! which requires a Permit to consurem.alter.impel demolish,or repair my stracture,
N- pd.or its iss..alues requires ma,plicaunt for.h Konit to Jim a.il surcerem
Onto the is licensed pursuant to the provisions of thea, Lkeems,Law(Chapter 9 Sq.Ft. Floor Area Valuation
(commencing with Section 700M of DNrlsiom 3 of us,Business Me Professions Crude)or
that he Is cancomp,therefrom and the basis for the alleged conception.my violation of
Section 7031.5 by My applicant for a Permit subjects an applicant to advil Penalty of APN Number Occupancy Type
not noore than five hundred dollars(SM.
0 1,as Owner of the propel or my employees with wages all their sell comparul
will
thewmY.and the souCvmian
•
and Professions Code:Th.Cerebral Licsocce,Law dems Out apply ca am Oul Of Required Inspections
property who Wilds who demsauchworkhmaeffor through Itis
—employees.pmol
then such impossuchums am not inuendent creamed fornall If,
bussal the larildiol or is mid within mus year oftlempkel tho awl
tatilder will have ft burden of provin,that M did mot build or improve fee purpose of
sale.).
❑I.....,of ft property am excludoely.Mmuctir,with Homeless comracures to
construct the pro*1(Sec.7044,Busitheat and ponforl Cade:)The Ountracter'.Li.
cumen Law does not apply to an Owner of proper,who Wilds or importance Real and
who contracts for such project with a centracuer(a)licensed Poresearthethe
Comenal
License Law.
0 1 am...or under Son a&P C I.this won
Owner Dna
40 WORKER'S COMPENSATION DECLARATION
I hereby iffirm under Penalty of perjury crim of man following declarations,
I tol and will maintain a Cardficam,of Consul to self4asurd for Worker's Cool
nation,a pmvidcd for by Section TIM of We Labor Code,for the performance of the
work for which Was Permit is issued.
0 1 hw and will maintain Worker's Compensation bescurans,at it,mosel by section
3700 of the U1>m Code.for the peoffes.cities wok far which this permit is Wool
My Worley' postal carrier sell Policy`W thl W. Dfy
Cartier:!4 Policy No.: 11
-
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This seemed need our he completed lithe permit Is resume hundred!dollars($tOO)
Or
I curl that I.the perpommusce of the were lor which this permit is leaned,1001 on,
employ artypencom in any Wool as us assume subject to me Wormial Cmpcn on
taws Of Cahlboris.Gas
Applicaus,
NOTICE TO APPLICANT.If,911or making this Canalize of Escreption,you should
baccurn subject in the Worker's Concassatm.proO.O..of the Lainer Coim,you mut
z forthwith comply with such provisions or this permit shall he deemed re,mlood.
z 0
51 CONSTRUCTION LENDING AGENCY
I hereby affirm that ft.Is a orocurectim,leading agency for the performance of
the work for which this permit 4 issued(Sec.3097,Civ.C.)
Lender's Nam.
z Lender's Addross
1 cmury that I Its"maul this application and sum that con all information Is
comm"L I'I"m to
come"Y With all city and county ordinal tele le laws mating to
building consurecuon,no hereby audsonen repecommuctincs ofthis city to enter nines ft
shove-mcmiumed Poll for inspeclion purposes.
P. (We)al 1...,indemnify and lacc,thereek.the City of Clipoldrut al
(Zi Iiabilitietjudgmenu.eusts and uparroms;which may In any way accrucilinfill city
Z in consequence of the granting of this permit.
APP NT UNDER AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
WA, mwjw -REGULA 401 Re-roofs
SlIfiesurecti'Applicault/Contracter , Dim
HAZARDOUS MATERIALS DISCI CS!IRE Type of Roof
Will the applicant or future building occupant am Or handle becoudow material
o defined by the Concern.Municipal Code.Chapter 9,12.and ft Health and Safety
Cecil Section 255324)7 All roofs shall be inspected prior to any roofing material being installed.
Yen 0<
kWill tha applicant or future Wilding men equipment a devices which If a roof is installed without first obtaining an inspection,I agree to remove
It h2us air cmuminants as defined by the Bay Am Air Qual Management all new materials for inspection.
Distfict?
D Y. Plan
I hal met the Wool model requirement under Chapter 6.95 ofthe Califor.
-is 1-malth&SptyCedo,Sections 25505.25533 and 27534.1 anduestand ft If the Wilding UUVV
does d hew
M th 1'4 my mameso ffily he roary ft occirstal the
LL Nat
, issuance OU Ontiftne of
irl Noruc!mone. or- Applicant Date
,4-L off
Owner atalmorinadcm Dow
All roof coverings to be Class'�W'or better
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CITY OF CUPERTINO
• 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32618042 . 00
DATE ISSUED. . . . . . . : 08/18/2008
RECEIPT # . . . . . . . . . : BS000005811
REFERENCE ID # . . . : 08080122
SITE ADDRESS . . . . . : 10110 PHAR LAP DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CARAPIET GEORGE J AND ALICE
'ADDRESS . . . . . . . . . . : 10110 PHAR LAP
.CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1112
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY . . . . . . . . . . : LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- ---------- ---------- ---------- ---------- ---------- -
113SEISMICR VALUATION 8, 995 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1.1REROOFRES SQ FEET 30 . 00 390..0.0 0 . 00 390 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 390 . 90 0 . 00 390 . 90 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
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CITY OF CUPERTINO
" i {
REROOF
Cu.
• PERjIN0 PERMIT APPLICATION
APN# Date:
3Z -/ -o�Z , 0 u o
Building Address:
Owner's Name: A L Phone #:
Geer e f Xl ce u� ) W' 259- y.5"0-7
ContractoY ii Phone #: z10 8` -2 C) g'_ Cj3 9 1
Fax#: Off' _2 -
Cupertino Business License #: 2 3 4 n / Contractor License#:
b , 0 70
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) p Other (Specify) 058 t iLr
Number of existing coverings ❑ Provide I.C.B.O. Report#
To be Removed g Provide Mfgr. Installation Specs.
Roo !.-I t Ss —
Jot Description: 7 6
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are nni,restrictions: ❑
Valuation:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
CITY OF CUPERTINO
REROOF
•CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
IREROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
3o 1RER00FRES Re-roof Residential B 1SFDWLR00F
r 1BSEISMICRE Seismic Residential B
1RER00FMRES 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:
job Site Address: �Q//d �JjLn
Roofing Company Name: -S T �— 0,
Applicant's Signature: �//��,p.G"�}per� � Date: 1�7?/
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
300 Torre Avenue
L , Cupertino CA 5014
''
Telephone(408) 777-3228
CITY OF 4 Fax(408)777-3333
*UPEkTINO
Building De Artment
JOB ADDRESS:/ �lo PERMIT #
OWNER'S NAME: _ PHONE #
GENERAL CONTRACTOR: S FAX #
I am not using any subcontractors: VD
ie-,Signature
Please check a22licable subcontractors and com Tete the followin 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 C ntractor Signa Date