06070051 (2) CITY OF CUPERTINO r p ,-'--,
BUILDING Dlvlslory PERMIT 'COTVTRAGTOR INFORMATIO.,£NN
BUILDING ADDRESS: v MAXIMUM ROOF CARE CORP PERMIT No.06070051
21598 ROSARIO All
OWNER'S NAME: PERMIT I55UEDATE
CONNELLY THOMAS J AND DORO HY423 UEENS LN ryE; SANITARY NO. CONTROL 10.
(408) 441-0933
ARCHOECT/ NGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
±Op LICENSED CONTRACTOR'S DECLARATION
W FF 1 homey affirm that i am licensed umkr pomm imet of CWper 9(commencing lob Description
.zu, with Section 70(Q)of Division 3 ofdm Bossiness and^afessioru Code.mid my licensee
.Zito infull
on.C,candeRe9 LmE Z TEAR OFF CEMWOOD SHAKES, INSTALL CERTIFIED
q_ ueena el �—
>t-z Date Canmua LANDMARK TL SHINGLES
ARCHITECTS DECLARATION
e< I understand my plans shall M used in public records
,aU
e u
S v, Liccmed Professional
`7OOWNER-BUILDER DECLARATION
2 I I hereby affirm than l am exempt from Nc Contractors License Law for the
0 C following reason.(Section 7831.5.Business and Pmfesdons Cale:Any city or county
m which require a permit in enoarux,alcor,improve,demolish.or repair any swctarc
-iy prior m its issuance,also requires the applicant forsuch permit m rile a signed statement h.,
< Nat he u licensed pursuant to the provisions of the Contra or's License law(Chapter 9 Sq.Ft. Floor Area Valu$tbp 0 0 0
e�� (commencing with Section 70t of Division 3 of But Business and Procedure Code)or
y $
that he IS exempt IWmfsom and the btu for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit sonocta the applicant to a civil penalty of APN Number Occupancy Type
not more Nan five hundred dollars(5500} 35619017 . 00
0 I,n owner of the property,m eay employees with wages u Neb sole compensation,
will des the work and She smcturc is not intended or aRered for sale(Sec.7016,Business
and Profnuions o
Code:The Comnors License U.don m an not apply awns,of Required Inspections
propenywho builds or improves thereon,and who dwssuch.,it Inspector through his
own cmph you.provided Nat such improvemcnu arc not intended croRered formic.If,
however,the Wilding or improvement is sold within one year ecompletion,the owner.
builder will have the burden of proving Nat he did cot Wild or improve,for purpoSe of
sok.).
0 1,as owner of the propcny,am exclusively commuting with licensed connotations;to
come,La the project(Sec.s an i Business and n,who b i Cade:)Tho Comracmrs Li-
cense Law curs tat apply je an with
a of property who Wilds or improv thereon,and
who eomraeu for such projects with a eonmemr(s)licensed pursuant to IM Contractor's /
License Law.
El 1 am exempt undo See .B At P C for Nu reason
Owner Date
WORKER'S COMPENSATION DECLARATION D�
I hereby a1Rm under penalty of perjury one of Be following dttlerations:
1 hem and will maintain a Cctiricen of Conant to self-insure for WorkchCarmen-
suion.as provided fur by Section 3700 of Ne,Ubor Cade,for the performance of the
work for which this permit is issued.
1 have and will maintain Workers Compensation Inuuranm,ns required by Section
yWo Ne Labor Ccrosad Ne perfwmaneeofdIS I mommch this pemituusnM '
My WaWi(s Compensation I rnme nmier end Policy number
Cartier. Policy Ne.:
CE FICA OF EXEM ON FROM WORK Y
COMPENSATION INSURANCE
(Thu Section need nut M completed If the Perris IS farrow hundred callus($100)
or Ice.)
1 certify Bon.in the performance of the work for which this Permit is issued.l shall not
cmpl0y any Intim in any manMrso ta In,become subject to the Worker,Co npensuion
Laws of California.Date
Application
NOTICE TO APPLICANT:IL after making Nu Cenifca¢of Exemption,you Should
become subject in She Workers Compensation provisions of the Labor Cade,you most
0 2 forthwith comply with such provisions or Nu Permit shall be deemed reviled.
z OCONSTRUCTION LENDING AGENCY
(-� I hereby aRm that Nem it.eons semi knding agenq for the performana of
a Ne,work for which this permit is issued(Sec.3897.Co.C.)
QLender's Name
D Z Landers Address
V 0 1 cult,Nat I have read this application and state that Ne above information is
it, f-' correct.i agroe to comply with all city and county ordinances and state laws relning m
0 U Wilding construction.and hereby authariee rtmere mivcs of Nis city to emcrupnntbe
ahovcme judgm tonicitycosts
for inspection purposes.
H a (We,)agree to Save,indemnify and keep harmless the City of Cupertino against
ern inemoseeesocco the orrand ex pensu which may in anY way accmc againstsaid City
V z in consequence of the Eranting of Shia permit.
^ APPLICANNNN7777''''UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCER4GLI TIONS( 1 _ '���
Sign �Appl n o Dam Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne applicantor future Wilding oeeupant owe or handle hzaacdons nu mmil
as defined by the Cupertino Municipal Code,Chapter 9.13,and the Health and Safety
Cads,Secomi 15333(x)7
Yea ®N� /lo All roofs shall be inspected prior to any roofing material being installed.
41 ��..// If a roof is installed without first obtaining an inspection,I
Will the applicant err future Wilding Occupant use equipment or devices which g agree to remove P
emit hazardous air contaminants as de0ncd by the Bay Area Air Quality Management all new materials for inspection.
District?
0 yell
Ihommwl Ce ,Sv mamrialsrequimmcnu underChapmr 6.93 of Ne Wilding
dos Outs erlY an Secvonshall it my raxid25534.I in..of,th,otuix Wilding
docs Out c randy have t.Nat II u my msponsihility m notify the ocupant of the
rcquircm aw be issuan a Ccnifeal,of Occupancy.
� Signature of Applicant Date
Othar edase t D,te All roof coverings to be Class "B"or better
CITY OF CUPERTINO
1 of 1 PERMIT RECEIPT OPERATOR: kiersaw
COPY # 3
Sec: Twp: Rug: Sub: Elk: Lot:
APN . . . . . . . . : 35619017.00
DATE ISSUED. . . . . . . : 07/11/2006
RECEIPT #. . . . . . . . . : 35196
REFERENCE ID # . . . : 06070051
SITE ADDRESS . . . . . : 21598 ROSARIO AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CONNELLY THOMAS J AND DOROTHY
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4757
RECEIVED FROM . . . . : STEVE HUNTER
CONTRACTOR . . . . . . . : STEVE HUNTER LIC # 22369
COMPANY MAXIMUM ROOF CARE CORP
ADDRESS . . . . . . . . . . : 423 QUEENS LN
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408)441-0933
OE 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
•
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: *h aa�a.� N -9"( !!!f 7
job Site Address: a- SS $ S 4;A ;b
Roofing Company Name: )vvw, Ye� e, k--
Applicant's Signature: Date:
• Greg Casteel T�
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY Of Fax(408) 777-3333
*UPEkTINO
Building Department
JOB ADDRESS:a-1 PERMIT #
S9� -4Z,oS qri o �n-c--
OWNER'SNAME: ar..4 . `(rcm n PHONE # Y t f f -oq 3 j
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors: I-(j -0 C
gna Date
Please check applicable subcontractors and complete the followinginformation:
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
ALI -L02',
Owner/Contractor Signature Date
ZVI-
CITY OF CUPERTINO
, REROOF
City or
• CUPERTINO PERMIT APPLICATION FORM
APN#
Building Address:
Owner's Names hPhone#:�rc� CI ��Ne,TI � 1: — 13`70
Contractor: — License#: S2i®59 f
rne4v1RtM� �� t/W
Contact: Cupertino Business License #:
2.1-3 (9
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )( Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
`4 Other(Specify) eJt/rt+lrV,t/.5 ❑ Other(Specify) rr
Number of existing coverings 1 ❑ Provide I.C.B.O. Report#VL 3 l A Z
1T To be Removed ❑ Provide Mfgr. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description: (kl a
7•�_ o S l �n 7S 41 r iC TL J f" 1aS
Residential V Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with Planning 13�ept. if
there are any restrictions: L
Cost of Project: a�h Type of Construction: Occupancy group:
1
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
J BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
•