06050020 (2) CITY OF CUPERTINO ^ "T
v BUILDING DIVISION PERMIT
BUILDING ADDRESS: CAL—WEST ROOFING CO. PERMglvo.06050020
10313 TONITA WY
NEWS NAME: PERMR 65UEDATE
AORUNKUNAR, BALLARAN 3939 QUIMBY RD 05/02/2006
PHONE: SANITARY NO. CONTROL NO.
(408) 531-1961
ARCNITECf2NGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
;op LICENSED CONTRACTOR'S DECLARATION - Job Description
i C"i F 1 hereby afErm Nell w limiued under provisions of Come.9(commencing
with Section 70000 of Division of the Business and Profmsium Coda,md my licenses
�z Llee1famuand cif cL Lk.N X35 b REPLACE CEDAR TILES , WITH CERTAINTEED PRESIDENTI
Dam lramr
f Q ARCHITECTS VLA
CenRATIO 5
cy7 1 undcnund my plans shall he used as public ranNs
Licensed Pmfmstanal
3 OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the
.00 following mason.(Sweden 7031.5,Business and Pmfessiom Cade:Any city or County
3$ which requires a permit in contend,alar,improve,demolish,or repair my structure $3800
prior m its issuance,also requires We applicant forsuch permitm 0a a signed summcnl Ft.Floor Area Valuation
< that he is licensed pursuant to the provisions of the Co mecmr's Licence law(Chapter,9 Sq•
F G (commencing with Section 7000)of Division 7 of the Business and Professions Cade)or
y $ that he is exempt themfmm and the bum fa we alleged exemption.My violation of
Section 7071.5 by any applicant for a permit subjects We aPPlkml.lo a civil penalty of r Occupancy Type
net mom than rive hundred Callus(5500).
0 L ss owner ofthe property,a my employees with warmer Weirmle Compensation,
will do the work,and the stsumue Is ret WendW or offered formic(See.7011,Business Required Inspections
and Praressione de mr
CaThe Canau 's Lt.=Lia, m m owner
danot apply m of 9 P
pmpenywho builds or(mprawf Women.andwhodoessuchworkhimself or through his
own employees,pmA&d that such improvemmu see not Intended maffered forsake.H.
however.the building or improvement Is mid within one year ofmmpletion.the Water,
builder will have W,burden of proving that M did ml hula or improm for puryme of
ram.).
❑1,u owner of We property,am exclusively contracting with licensed continence m
Construct the project(See 7011,Business and Profession Cade)The Cantracmr'a Li-
man ,Law dem nal.apply to is owner of property,what builds wimproves Merton,and
who contracts far such projects with a centracmr(a)licensed pursoml to We Commences
License Law.
❑Imenemplunder See .B&PCformtstamom
nor Date
WORKER'S COMPENSATION DECLARATION
I hereby aflim under penalty of perjury am of the following dmlmolons:
❑1 haw and will.&main aTeNricem of Convent as self-Imum far WorkeesCompen.
nation.u provided for by Scotian 7700 of We LWa Cade,for the performance of the
work for which this permit Ia issued.
zI1 have and will maintain Worker's Compensation Insurmm,u required by Sedan
w of the Labor Cade,fm We performance of Me wank for which this Permit is Issued.
My Worker's CompensationInwcarme Wrier and Policy number are:
Carries: A2k_9*'0� Policy No.:
CER71 CATEI�PTION FROM WORKERS'
COMPENSATION INSURANCE ,
(rb0 sedan tied not be eampload if the permit u far ant hundred dollen(SIM)
or less.)
I certify Lou,in the performance of We wad for which this Permh is issued,l shall not
employ anypenon in my mmmrWu omaaubjecllotheworlmoccomumum
lawsorcalifomp�(E�.Dao G/ fl
Applicant, Mr r _
NOTICE TO APPLICAND If. net making this Ccrtincaa of Eaemption,you Meow
become subject to the Worker's Compensation provisions of the LAW Code,you muse
.J O foMwith comply with such provisions m Wu permit be deemed revoked.
,Zy tiCONSTRUCTION LENDING AGENCY
[ti Thereby M.that then is a eonslratinn[ending agency for the Performance of
�i> tire work for which this permit is Lucid(sec.7097,CIv.C.)
W�Q Lender's Name
z lenders Address
U Q 1 certify that I have mad Wit application and sus mu the show information is
n.E correct.1 agree to comply with all city and county ordinances and sea laws relating to
0 building construction,and hereby autharim wprermatiws or his city to enter upon the
L77 shove'rmatiomcd pmperly for inspection purposes.
(We)agree to sew,indemnify and keep hamless We City of Cupertino against
rr '(4 liabilities,judgmcnu,costs and expenses which may In anyway neem against said City
in U^+ of the jidunding of this call.
APP L CANT `UNDERSfANDS AND
IWILL COMPLY WITH ALL NON-POINT Issued by: Date
SGU
OU --.f M- A 2 .
Re-roofs
Signatuf"I'ApplicluctlContractor De
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Use applicant or future building occupant store or handl,havardous mamrisi
u Conrad by We Camrtiaa Mumklpal Cad,,Chapter 1,12,and the Hcatth and Safely
Section 755774)+ Z_ All roofs shall be inspected prior to any roofing material being installed.
r]Yd /Ll No
Will We applicant of fuwm banding aaePam ace equlPmem or devims which If a roof is installed without first obtaining an inspection,I agree to remove
wall.hava dma air cmuminanu u dented by the Bay Area Air Quality Management all new materials for inspection.
District?
❑Yes No
I have mad the huardnmmemrialsrequirements underchapar6.95 of the Celifor.
n4 Health isSafelyCcde,Sectiom75505.25577 and 15534.1 undmtand the tribe building
does t currently haw.ayany-t�eF4a4am s oand"ty m mdry the occupant of the -
myul men hmhmus t ertoitseame crunmmoroccapar / Signature of Applicant Date
I.���/ All roof coverings to be Class"BI'or better
Owner a uthonza a,nt Dam
CITY OF CUPERTINO
*m 1 of 1 PERMIT RECEIPT OPERATOR: bethe
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35914001.00
DATE ISSUED. . . . . . . : 05/02/2606
RECEIPT #. . . . . . . . . : 34211
REFERENCE ID # . . . : 06050020
SITE ADDRESS . . . . . : 10313 TONITA WY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : AORUNKUNAR, BALLARAN
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-2931
RECEIVED FROM . . . . : ALEX QUINTERO
CONTRACTOR . . . . . . . : ALEX QUINTERO LIC # 24054
COMPANY . . . . . . . . . . : CAL-WEST ROOFING CO.
ADDRESS . . . . . . . . . . : 3939 QUIMBY RD
CITY/STATE/ZIP . . . : SAN JOSE, CA 95148 ,
TELEPHONE . . . . . . . . : (408) 531-1961
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 4,000.00 104.76 0.00 104 .76 0.00 '
BSEISMICRE VALUATION- 3,800.00 0.50 0.00 0.50 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 105.26 0.00 105.26 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 105.26 MASTERCARD
TOTAL RECEIPT 105.26
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPERTINO
Building De artment
JOB ADDRESS: PERMIT#
03/ 3 'Fbn "S-002G
OWNER'S NAME: n � PHONE #
GENERAL CONTRACTOR C_c, FAX #
I am not using any subcontractors: ���
Signature Date
Please check applicable subcontractors and complete the following information:
60 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/Contractor Signature 15ate
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 i/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: ./D,3/�Z5 71,,1
Roofing Company Name: �q/4 4rf
Applicant's Signature: - Dater w
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
• �� '' REROOF
CUPERTINO PERMIT APPLICATION FORM D60So(�,0
APN# 359 ' / / Dat 2 0
Building Address: 7 T
Owner's Name: Phone#:
JY� Jh S I - I
Contractor: License#:
Contact: Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ;PO'Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
,' Other(Specify) Co1111�'I /'t,15 ❑ 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:
Residential,12 ommercial ❑
Fire Zone: Yes ❑ No a Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Eneriy BUILDING
/ BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING