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08010161 (2) CITY OF CUPERTINO y* m: BUILdINGDIVISION PERMIT U1' 'Elk C ',CTR`TN1�f}TtMA,�I ON`s ',% BuaD1ft'YV%HELLY DR KEVIN SULLIVAN ROOFING PERMIT08010161 ER'SNAME: PERMIT ISSUE DATE ARVIND HALLIYAL 1696 VALLEY OAKS DR 01/29/2008 PHONE: SANITARY NO. CONTROL NO. A0.CN1'fERIENGINEFR: BUILDING PERMIT INFO RE—ROOF,T/0 & INS 7/16" BLDG ELECT PLUMB MECH O O O O O O LICENSED CONTRACTOR'S DECLARATION ,1plj-D u 1 hemhy affirm Nat 1 am licensed under provisions of Cha '^p¢r 9(commencing ^' ^^^^ ^^^ ^^_,^ =scrtP[IOn with Secdon7M)ofDiviion3ofthe Busineuantl Prafcssio OM,endmyliceneeu n H in full force an .(feet Q - Z . f Iq Lk.X Dem Comnc q ARCHITECTS DECLCL ARATION Du a 1 undersand my plane shall he used as public records id htad Licensed Profiled anal - - 7 OWNER-camp ER DECLARATION 9<E I hereby.(firmSect on I em exempt from the Conlnal Co e:LimmeAny c Law for the O O following ninon. Pani[17031.4 Business and ere.de ore Cole:Any city or musty $ which requires a e,aim....vect.a@r,improve,demolish,ani e aPat,sig any awmum _zy prior mits issuance,aim requires than applicant for such permit to fileasigenJ sakmcm that he wit pursuant 70th)of Dittoes of the CBusiness usines andPnrcLaw onC Code)or Sq.Ft.Floor Area Valuation $ thammendngsedpursunt to the ofvisision 3 onofof Nemmal sod Professionshapter9 ^ That he a exempt Un mfrom and the bates for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects Ne applicant m a civil penalty of APN Number Occupancy e oat man Nan five hundred dollars(SM. P Y •7 Ty P 0 L asawrer of the property,army employees with suspect dao sole compenuJon, will do the wells,red Nenuature isnatimemmd araffend forsae(Sec.7W.Business Required Inspections and Professions Cade:The Communes Littme Law drum nit apply m e ns an awns,of q p property who builds or Improves,Neroan.and who dace such work himssl(or through his ..employ..provided Narauch improvements art at intended arolfcmd fm see.If. bewever.Ne building or Improvement a sold within ane year of completion.the owner- builder will haw the Wrden of proving Nal he did wt Wild Or improve for Purpose of ole.). ❑I,as Owner of the property am exclusively contracting with licensed ronlnetan a ...net Ne projem(See.70X4,Business mid Pro(esslans Cade:)The Contrentir's Lt. comes Taw does not apply in an owner of property who builds or improves theman.and. who cone sees for such projects with a canwctoQs)licensed pursuant in Ne Conu cauer's License Law. - ❑I am exempt under See. B k P C for this mason er Dam WORKER'S COMPENSATION DECLARATION I hereby affirm uMer penalty of perjury arm of the following Osclaations: ❑I have and will maintain a Certificate of Consent in self-ileum for worker's Compen- sation,as provided for by Section 3700 of the Labor Cade,for the performance of the work for which this permit is issued. ❑1 have and will maintain Worker's Compensation Insurance,ss required by Section 3700 of the Labor Code,far Ne peRmmnce o(Ne work foreAuch this permit is Issued My WGrkces Con enutien Insurpece tamer and Policy nu Cartier. liNo.: ION FROM WORKERS'CERTCAE F EXEM COMPENSATION INSURANCE (Thu section need not he completed If the Permit is forms hundmA dollars($100) m I.) 1 certify thm in the performance of the work for which this Permit is issued I shall me employ any person in any m mmusa as a became subject in the WorkersCompensation Laws of Cilifomia.Dam Applicant NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you shauki become subject to the Worker's Compensation provisions of me labor Crude,you most .J 0forthwithhe forthwith comply with such provisions or this permit shall demand ma rked. - ,z.t CONSTRUCTION LENDING AGENCY ti (-+ I tummy ntfirm that Nert I.a ad(Sm.0 rending agency ler the Perlwmame of LYv the work for which Nu permit is usmtl(Sec.J097,Civ.C) W Q lender's Name z Lcndets Address U Q I certify Na 1 have read Iia epplkadon and sum Nat the above information is it,^' cor mL I agree to comply with all city and county ordinances and sum laws relating in Q 5V" building convection.and hereby auNodx repratenauves of this city to enter upon Ne W above-mmuuend property for impaction puryasss �"fy (We)agree in save,indemnify and keep hanless the City of Cupertino again r-i fA liabilities,judgmenla,casts and expenses which may in any wry acme against said City fJ'� in consequence of g ng Of this permit. '7 �r APPLICA ERST N WILL COMPLY WITH ALL NON-POINT Issued by: Date E ONS 2 Re-roofs Si mmA IicaMCOnuacmr Data HAZARDOUS MATERIALS DISCLOSURE Type Of Roof the pliant or future Wilding Occupant stem or handle bavrdous material depend by a Cupertino Municipal Code.Chapter 9AZ and the Health and Safety Sdcuon 25532(4)7 All roofs shall be inspected prior to any roofing material being installed. ❑yes NO Will the applicant or future building occupant use equipment or devices which If a roof is instal '[hoot first obtaining an inspection,I agree to remove emit hecankas air comma rets defined by the Bay Area Air Quality Management all new material for ins CtlOn. Disuics7 ❑yes O Ihave mad the sees rislsmquirensms underchamer6.95oftheCalifer- tHo calN&Safcly cum 505, 25f34.lundcmm�dthaifthc building t currendyh sant, t it' my n Mibilky m nodry um a map t ar Joeen which met Wt r issuance fa Cenificem of <upnry SlgnatU OfA licant Dateowor am omctl em c' All roof coverings to be Class"B"or bet r opo CITY OF CUPERTINO ® REROOF CITY CUPERTINO PERMIT APPLICATION APN # Date` .359 / < c) o2Co . 00 Building Address: 6U Owner's Name: Phone #: Z5z, (02gq I Contractor: Phone #: Fax #Aa Cupertino Business License #: Contractor License ense #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles .1q Asphalt Shingles N�< 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 Mfg. Installation Specs. Job Description: 7/mo ` rev OF �� dkB ` �S w • ! ! Cert nlead es 1 iaL T C ICAr Residential Commercial Fire Zone: Yes ❑ No'o Confirmed with Planning Dept. if there are an restrictions: ElValuation: $ f ®4Read, ta d Will Comply with Cupertino's Tear-Off Policy: CITY OF CUPERTINO ® (�a, REROOF OF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FCOM Re-roof Commercial B 1COMMLROOF 1BSEISMIC0 Seismic Commercial B 1REROOFRES Re-roof Residential B 1SFDWLR00F 1BSEISMICRE Seismic Residential B 1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B IBUSLIC 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 c/ 4. !_o�mpplly with the above stated policy on re-roofing. Homeowner's Nam1- -e:: V I tj i tv;hl Job Site Address: J Roofing Company Name A Applicant's Signature: Date: Greg Casteel Building Official Revised 11/2/04 ' CITY OF CUPERTINO 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 35911026 . 00 DATE ISSUED. . . . . . . : 01/29/2008 RECEIPT # . . . . . . . . . : BS000003796 REFERENCE ID # . . . : 08010161 SITE ADDRESS . . . . . : 20679 SHELLY DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : ARVIND HALLIYAL ADDRESS . . . . . . . . . . : 20679 SHELLY DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2923 RECEIVED FROM . . . . : ROOFSERV ROOFING SV CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810 .COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING ADDRESS . . . . . . . . . . : 1696 VALLEY OAKS DR CITY/STATE/ZIP . . . : GILROY, CA 95020 • TELEPHONE . . . . . . . . : (408) 842-1057 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 13, 750. 00 1 .40 0. 00 1.40 0. 00 1REROOFRES SQ FEET 28. 00 364 . 00 0. 00 364 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 365 .40 0 . 00 365 .40 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- - -------------------- CHECK 678 .20 #6895 --------------- TOTAL RECEIPT 678.20 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS 605 FINAL REROOF Community Development 10300 Torre Avenue aClOF Cupertino CA 95014 Telephone(408) 777-3228 Fax(408)777-3333 CUPEkTINO Building De artment JOB ADDRESS PERMIT# p OWNER'S NAME: ('Jtcn 1 qzq PHONE # Z- GENERAL CONTRACTOR YeV Kkd6FFAX # — I am not using any subcontractors: ' -, Signature DIte Please check applicable subcontractors lete 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 e /Contactor Signature Dat