08060103 (2) CITY OF'CUPERTINOg
BUILDING DIVISION PERMIT CONTRA TORINk`ORMATION, ;
BUILDING ADORE95: PERMiTNO.
7513 RAINBOW DR INTEGRITY ROOFING 08060103
OWNER'S NAME: PERMIT ISSUE DATE
HUANG PATRICIA S 6820 MOSELLE DR 06/13/2008
NE: SANITARY NO. CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMRINFO
REMOVE SHAKE INSTALL BLDGELECT PLurne MECH
0 0 0
uO0
p LICENSED CONTRACTOR'S DECLARATION - ., .JOb.DeSCII tlOn
U I h.cby affirm dm I am lianted under prvisian of Chapter 9(commeaing ^••---^- ^•-^^ ^ p
with Section]Q]U)ol'Division 3af tha Business sed Profession Code,and my license is
in fun(arta and effect 3 9
(�Z Lill.Class Lia.s
=p Dam Contractor
47W7W ARCHITECTS DECLARATION
W V I understand my plans sha11 he used u public records
g u. Licensed Profecti nal
S03 OWNER-BUILDER DECLARATION
.�4 E I hereby from that I am exempt tram the Cantockes License Law for the
i
20 mason.following
0following mason.(Section 7131.5,Business and Prokedur t Code:Any city or county
whch requires a permit to construct.alar.improve,demolish,or.,no any srnum
i� pair in Its issumoo,men.qui s the applicant for such Permit to file a signed summenl
<
that haislicensed pursuanitothe provisions ofthe ConuuturiseLa
Licenw(Chapter9 Sq.FL Floor Area Valuation
as (commencing with Scction]a00)of Division 3 of the Business and Profession Cade).
$ that he is exempt tha.frm and the buss for the alleged assumption.Any violation of
Section 7031.5 by any applicant for a pored,subjects the applicant to•civil penalty of APN Number Occupancy Type
. live.o.than .e hundred dollars tssoB). Pane Y YP
❑I,in owner of the property.in my employee with wages as thch sale compensation,
will do the work,and ammucm,is not intended in offered for sale(Sec.1041,Banca Required Inspections
and Profession de:CaThe Commune's Lune Law doe sol apply m N e owner of q p
property who buildsor improves thaeon.and who does such wort hinself.through his
awn emPloyeas,provided that such improvements an,not intended oraffered farsak If.
however.the building or imprvemcnt is sold within one year Mcompletion.the owner-
builder will have the harden of proving Nat he did Out build Or barroom for purpose of
sale.).
El I,in owner of the property,am exclusively contracting with licensed contractors.
conairms the project(Sex.7()44,Business ash Prressiou Code:)The Contranor's U-
cenu law docs not apply to an owner of property,who builds or improves thimon,and.
who contacts for such pmjeN with a conmacmr(s)lireued p.snant in the Contractors
Laterite Law.
❑la.exemptunder See ,B&I'Cfurthisreuon
Owner Data
WORKERS COMPENSATION DECLARATION
40 1 hamby affum under pensty al perjury one of the following declanuo se
1 ham and will maintain a ceuBeteof Conder to self-inure rte sorters Comped,
sstian, provided fpe SsNon 3]00 a(dte Iabur Code,far the perfannume of Uta
work forr which this permit is isued
❑I have and will maintain Winkles Compensation Insurance,as neryimi by Section
3100of dm labour Code,far the performancea!the work for which this permit is issued.
My Worker's Compensated low`qince cam.and Policy number ere:
Carrier S`F'CYF fui%,d Policy Ne.:�ew?I44 1AX71I
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(thuwco.m need Out M mmpieud if tie pe.I,is faronehundreddeltara($100)
or lest)
T artifv that in the perfarmauce of om work for which this Permit as Would I sedI had
employ any parson in any marnerw in to become subject in the Workers'Compensation
Laws of Califomis Date
Applicator ...
NOTICE TO APPLICANT:If,after making this Ce tificam of Exemption,you should ,.
became Subject in me Work.S Compensation provisions of the lab.Cod,you mus
.,z forthwith comply with such provisions or this Pearn shall be decreed remind.
Z O CONSTRUCTION LENDING AGENCY
[-rte 1hamhy affirm that them is a construction lending agency for the pafwmance of
a > the.,it for which this permit u ioued(Sol 3099,Civ.C)
n Pander's Name
z Lander's Addmss
U Q I anify 0-11 have rad Ws application and suis this the above hilmooNun is
If.H a.re i agma In comply with all lily and cauny,onli.and sum laws relating in I
0U building contraction,and hereby authori..p.aenwims of Nis city to enter upon the
aMmtmenudgm prpany for epeclonlains purpowhich ms
W (Wee)agree to atm,indemnify sed keep h l.leas the City of Cupi nine against
(n liabilities Judgmcnu.ceuaM explains which may in any way accrue against said City
f do
m,of this facreit.
U Z APPL CANT oN'ER uNDS AND WILL CO P W ALL NON-POINT Issued by: Date
SOU U A
Sver an Re-roofs
/ AZARDOUS MA ALS DISCLOSURE Dam Type of Roof
tell Pliant furor
as bua]Coamyntsom.haedle hauNounmaurial
ned the Cupenine nicmpal Code.Chapter 9.13.and the Health and Safety
.
On.ss533(.)]
❑Yu All roofs shall be inspected prior to any roofing material being installed.
Will thea applicant Wilding Occupant v If a roof is installed without first obtainingan ins ction,I agree to remove
PP d P 9 Pmm�t or dcviaa Mich pe
emit havardou air caneanti u defined by the Bay Area Air Quality Management all new materials for inspection.
Diwin]
❑Ye J(]No ant\
I ham mad the ha»rd.s materials mquimrentsundu Chapmr6.95 of thaCalif.-
nia Hcalth ASafmy Cade,S.%iou 25505.25533 and 25 30. wWtn.nd Nuifthc Wilding /
docs tet rid small tial it u my repo ' ,1 tify tk accapito of de i
requi. dim tprior i meta Occup gna[ureo ofCant Date
Rowr J
ora da agent Da. All roof coverings to be Classor better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylvidM
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36230015 . 00
DATE ISSUED. . . . . . . : 06/13/2008
RECEIPT # . . . . . . . . . : BS000005111
REFERENCE ID # . . . : 08060103
SITE ADDRESS . . . . . : 7513 RAINBOW DR
SUBDIVISION . . . . . . . 1
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HUANG PATRICIA S
ADDRESS . . . . . . . . . . : 7513 RAINBOW DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-5235
RECEIVED FROM . . . . : INTEGRITY ROOFING
CONTRACTOR . . . . . . . : GREGORY E. WILCOX LIC # 28418
COMPANY . . . . . . . . . . : INTEGRITY ROOFING
ADDRESS . . . . . . . . . . : 6820 MOSELLE DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95119
TELEPHONE . . . . . . . . : (408) 225-9263
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 12, 868. 00 1 . 30 0 . 00 1 . 30 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 25 . 00 325 . 00 0 . 00 325 . 00 0 . 00 .
------- ------ ---------- ----------
TOTAL PERMIT 436 . 30 0 . 00 436 .30 0 . 00
METHOD OF PAYMENT AMOUNT - REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 436 .30 9716
---------------
TOTAL RECEIPT 436 . 30
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602, ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
F CITY OF CUPERTINO
REROOF
CITY OF UPERTINO PERMIT APPLICATION
APN # Date:
A
Building Address:
7513 I�o:,nb�w `lam-�ve.
Owner's Name: Phone #:
913 -g3Orl
Contractor: II Phone #: 2Z5
Ir-L '! r,kt 1�ov�; �
�( � Fax #: 3(n?_- 99 3 O
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles 'A Asphalt Shingles
x Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
�w To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: Remove SiWx� ^54x11 Cer�d n�cQd T-.
Sh:n�1�s osier- `7/iL a.S .U_ 51x.akh�^� us:n9 3d6 3G " 12wF;n�
Residential Commercial El
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the there are any restrictions: ❑
application or if applicable, include in plan
set & the sheet index.
Valuation:
I Z 8 00
• I Have Read, Understand and Will Comply wi pertino's Tear-Off Policy:
Signatur
CITY OF CUPERTINO
REROOF
IUPEkTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B IMFDWLROOF
/ 1BSEISMICRE Seismic Residential B
I1BUSLIC 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:
k 1) Pre-inspection and/or tear off approval.
x 2) In-progress inspection approval.
A 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: �Q �',C i
Job Site Address: � S 13 JRi f i by W `pr;vl P
Roofing Company Name: Irl Ut rJ� � -Roo, �q
Applicant's Signature: Date: 6/1 3 hU
• Greg Casteel
Building Official
Revised 11/2/04