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06090065 (2) CITY OF CUPERTINO BUILDING DIVISION PERMIT SRC®NTRACTOR INFORMATION BUILDING ADDRESS: PRINCIPLE ROOFING & PERMIT NO06090065 7545 RAINBOW DR OWNER'S NAME: PERMr'l'ISSUE DATE ANNIE LEE 1700 NORTH 1ST STREET 15 09/11/2006 NE: SANITARY NO. CONTROL NO. (408) 436-1681 ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT MECH PLUMB 0 0 0 0 dap LICENSED CONTRACTOR'S DECLARATION I Wool,affirm Nat 1 am licensed under provisions of Chapter 9(commencing Job Description �Zjy with Sued..7000). Division Sofdre Buri.and Phressm.Code,and my no,.is �y in fn llfomeandoffe REROOF- REMOVE EXISTING WOOD SHAKE, INSTALL OSB n uy z uanan claas Lac.11 /ti 3 Con & COMPOSITION SHINGLE. CLASS A ARCHr1EC oDECLARATION i I understand my plans shall he used as public records IyU LiccrucJ Pmfcasimnal OWNER-BUILDER DECLARATION i 0 I hereby.(Srtn Nal 11. exempt Imre the ConionsCo Licence law for 0e O O following mason.(Section 703 L5,Business and Pmrrssiom Calc:Any oily a courtly 5 m� which require..a permit m construct.IDmn im for h permish.m spar any mromum .ii primrm ice kssuanec..lso requires Om aPPlieant for such permitm�ilo asigneJ summcnt Nat he is licensed pursuant m the provisions of On Contractor's License law(Chapter 9 Sq.Ft.Floor Area Valua[ 5 0 0 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or $ Nat he u exempt rhcmfrom and IW basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjeeu the applicant in a civil penalty ofy��pTa�,`f�}�`}um�sp(�er Occupancy Type not more than five bundled dollar($500)_ 3 O L J V 01 J . 00 ❑1,as owner of the property,or my employe with wages as doh Win umpcnsation, will on,the work,and the structure is not intended or offered for sae(Sec.7014,Business and Professions Code The Conuacmrs License Law does not apply m an owner of Required Inspections mus bu Property wilds or improwsNumn,arW who doessuchwork himuelforthrough his own employers,provided that such improvnmenu am not intended aroffemC Inside.If. however,the Wilding or improvement is sold within one year of completion,the owner- builder will have the When of Proving Nat be did net Wild or improve for purpose of side.). ❑1,as owner of the(Sec.704,4. B uncor and contracting with:licensed C mmach 's U.construct On project(Sec.7014,umur Of and property who Wionislds Cade:)The Cr flame . n d ,^� Conte law cts f net apply 41 an Owner of property wce W itch or of an the Comma and �..1 who contracts for such projects with a convacwgs)liuved pursuam m the Conuacmr'a Licence law. �� ❑lam exempt under Sea ,B&PCfor this..on Owner Data WORKER'S COMPENSATION DECLARATION I hereby trims under penally of perjury one of Ne following declarations: 1 haw mul willmaintain a Ce Ease of Consent to self-insure for Worker's Compcn- mumn,as provided for by Section 3700 of the Labor Code.for the Performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Campos ion Insurance,as required by Section 3700 of the tabor Cath,for Ne performance of do work for which this permit u issned. ' My Workeer C,.00m11M�n�sasuoonn Insurance carrier and Policy number art: Cartier. sa•I�r-r C Policy No.: I D (J as J S CERTIFICA OFEXEMMON MOM WORKERS' COMPENSATIONINSURANCE (TUvectionneednothecamplced ifthepermit is formehundreddi lan(SIM) or Ices) I modify Nat in the perfam ince of the work for which this permit u ismed.I shall no empOy any person in any manner to u to become subject to tic Wonkus'Compcuatim Laws or California.Dam Applicant NOTICE TO APPLICANT:If.afar making this CcniRctm of Esmsird.n,you should Woman subject N the Worker$COmpcnsation previsions or the!aha Calc,you muss ,7 0 forthwith comply with such provisions Or this Permit shall be damcd mvoli Z N CONSTRUCTION LENDING AGENCY [-+ I hereby affirm that them is a convection lending agency rot the performaruc of �. On work for which this Permit is issued(so,.3097,Civ.C.) W Q Londe!)Name z Lender's Address V C) 1 certify Nat I hate read this application and sum dist the above 111101cre ion is gy P Correct.I agree m comply with all city and county ordinances and sue laws Misting to rJU Wilding convection.and hemby authorize mpresenutives of this city to enter upon the 7^ w above-menuonm property ror inslecdon purpose.. F y (We)agree m save,indemnify and kap harmless be City or Cupertino!gains rq liabilities,judgmenu,costa and expenses which may in my way accrue against said City of to growing of this pannit. V? APPLICANTOUNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date ( / SOURCE EGULATIONS. 09lot Re-roofs G7 Sig.... TApplicannCinnractor Dae ' HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applioant or future building uccupantstnre Or ban haraNmm material u defined by the Cupertino Municipal Code.Chapter 9.13.and the Health and Safety Code.pvG 25532(.)' No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtainingan inspection,I agree to remove Will Ne applicant or fume WiIJ'ng acupam use cyuipmcnt or devices which P g kit 121.1.air conuminanu u recd by the Bay Amo Air Quality Management all new materials for inspection. District? ❑Yes ❑ u 1 have mad the hounhous materials mquiremcnr under Chapteru.95 of the Califon nia Health&SaretyCede,Sauom 25505,25533 and 25531.1 understand desirthe Wilding dors not curmlly hose a enan.Nat it is my retpomibilily to nonny the occupant of the myuiemcuwNy It muuxmet prior wiatuaam of.ceriBcam nraapamcy. Signature of Applicant Date Owner or awhommd agent All roof coverings to be Class "B"or better CITY OF CUPERTINO em 1 of 1 PERMIT RECEIPT OPERATOR: amyw COPY # 2 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36230019 . 00 DATE ISSUED. . . . . . . : 09/11/2006 RECEIPT # . . . . . . . . . : 35980 REFERENCE ID # . . . : 06090065 SITE ADDRESS . . . . . : 7545 RAINBOW DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : ANNIE LEE ADDRESS . . . . . . . . . . : CITY/STATE/ZIP . . . : , RECEIVED FROM . . . . : PRINCIPLE ROOFING CONTRACTOR . . . . . . . : DERECK LOI LIC # 27564 COMPANY . . . . . . . . . . : PRINCIPLE ROOFING & ADDRESS . . . . . . . . . . : 1700 NORTH 1ST STREET, #154 CITY/STATE/ZIP . . . : SAN JOSE, CA 95112 TELEPHONE . . . . . . . . : (408) 436-1681 •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 MASTERCARD TOTAL RECEIPT 170 . 56 • J £ Community Development 10300 Torre Avenue JCupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 6UPEkTINO Building De artment JOB ADDRESS: PERMIT # �5 i2 0C�C90 (�S OWNER'S NAME: PHONE # 220 -_S K(( GENERAL CONTRACTOR: aliXJFAX # 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 Tank Sheet Metal Sheet Rock Tile • _ m9��/ate y Owner/Contractor Signature Date CITY OF CUPERTINO dll�`' lbb �!Ul REROOF • yor CUPERTINO PERMIT APPLICATION FORM APN# Date: 2'3d- Diq Building Address: 4 Rf41 *W P/Z Owner's Name: Phone#: IX rv/vic LL 6442u- Si// Contractor: . License#: rL�NG (C �tvv c bi�dln�w tsi� c l 6j p Cono o Business License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ iIt-Up roof ❑ sphalt Shingles S' Asphalt Shingles Q Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other(Specify) Number of existing coverings ❑ Provide I.C.B.O. Report# ❑ To be Removed ❑ Provide Mfgr.Installation Specs. • I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: Job Description: 12r.Iupv& �Xl3l�-,J,� t�o!> >HsK i ri✓.Crtr.�li are , ea ori lr7�Z_ rlvi- /•� Residential Commercial ❑ Fire Zone: Yes ❑ No ❑ Confirmed with Planning De I. if there are any restrictions: U Cost of Project: Type of Construction: Occupancy group: (/ Qty. if Applicablq 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 Building Division y 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: A Job Site Address: .714 S' 1��+✓�hri n/Roofing Company Company Name: OSG✓+'Gii Applicant's Signature: - Date: m9 ii�o 6 Greg Casteel • Building Official Revised 11/2/04