08100028 CITY OF CUPERTINO -
BUN.DINCD-VISION PERMIT --CONTRACTORINIi'ORI4IATIONH'',.
BUILDING ADDRESS: Pe Mir NO.
10100 ADRIANA AVE ALLEGIANCE ROOFING 08100028
OWNER'S NAME: PERMrr ISSUE DATE
MINDLI LEE YEL 1566 HARVEST DR 10/06/2008
�Ne SANITARY NO. CONTROL NO
(408) 937-9757
ARCHI'IECDENGINEEI: BUILDING PERMrr INFO
BLDG EIECr PLUMB MECH
0 0 0 0
308 LICENSED CONTRACTOR'S DECLARATION
mi1 hereby afr m that l sin licensed under provisions of Chapter 9(commencing Job Description
< wiOSccdon70(10)oof fyDivinann 33of dmBUainessmdPra feLiomCnnde,,Wmylicenmis RE—RF RMV EXT RF— BUS' LIC RENWED 100608
<,y in full far¢and ere l-' / 9�7 r'/
>t3 z�License av� ' ��_ � Lm..
7W / m ARCHRECI'S DELL tic moo N
r < 1 uMcruanJ my plain slWl he send u public nmoN,
y�l; Licensed professional
3 OWNER.BUILDER DECLARATION
I hereby a1Rrm that I am exempt rmm dm Contractars License Law for the
p O following mason.(Seeder 1030,Busimas and Pofesaions Cork:My city or county
3$
winch Unioi,m a permit.construct.slur.minnow.dmul"W,Or repair my swerve
prior in its issuance.aim minims the applcam far such permit to file a signed summer
< W,Ise s licensed pursuant,.du provisions or the cmunnew'.Lan.Lw(Chaper 9 Sq.Ft. Floor Area Valuation
Y�9 (comet rcngwiNSemon7000)MDtwion3afft Businessmd Professions Cade)or 10(]00
Nat le is exempt Nmefrom and the basis for the alleged exemptiau My violation of
Seedm 7031.5 by any applicant for a permit subjects the epplmm,m a mvd penalty c Number Occupancy Type
not mom thin frsa hundred dollars(5500). 3 2 6 2 0 0 0 9 .I'(�
❑L u owner of th property.a my moployms wM"gnu Ness role compersadan,
andPo the wok,and the swmme Il sion's.MCtl maw it f am.(See.1014,Burin,of -
urd Prolusions Code Ina Conmcmrs Llama oes uau set apply if rt owner is Requited Inspections
popery who builds a1'(mpmwach impr,and who does&OCh worthimselfor through his
awn employees,pmHdd that such improwmmu are no,interWd moReed ror rata¢
howevrs,the Wilding or anprowmm,g,cold within arc year W cmocom for the owrcr-
bale.), will have the buNan of proving Nat K did rot build m impmw for propose of
tile.}
❑1,as saner or than prop r,am amlissivriy contracting with licensed conaumrs u
moment ent the project(Sec 7064.Business and Prefessiam Code:)Ile Commmrs U
cems Lw does Out apply m an owner of property who builds or improves theem,and,
who eonmets for such proKns wtN a commmr(s)licensed purmant m the Camr.mrs
License Law.
❑1 am exorn"uMer Sec B de P C(m Nis rrasrc
Owner Dam
WORKERS COMPENSATION DECLARATION
1 hereby xirum under pctuhy of perjury,one of the fallowing daiandm¢
1 ham and will maintain.Certificate of Comers,o self-huts.for Worker,Campm-
smon,is provided for by Section 3700 of the Labor Code,for the performance of the
wart for which than pmmo is issued.
❑1 haw W will maintain Worker.Compensation Insurance,as mgtdred by Section
3700.1'dm Labor Com.for dm dormmccof Nevmhfwwbich Nispmmnuivad.
My Worker, o usin. urince tamer and Policy numbe a.: afs e L
Cartier. /y e-��Policy No.: , -1"
CERDFICATE OF/5(ElUpnON FROM WO CEPS
COMPENSATION INSURANCE -
rids mcdcat need not W completed if the permit Is foram hundred dollars(SIM)
ar kit)
1 certify Net in the performance of the work fm which this perms,u issued.I shall Out
employ any person in my mmnerm u in bcoomo mbycot w the W(OkCr3 Compenumn
Laws of cahfomsa.Dn-
AppOcam
NODCE TO APPLICANT:If.after making this Cenifiam of Exemption,you should
become subject m the WOrteh Componcuim provimom of the Labor Code,you moot
,J,Z rOnbwM comply who such pmWhons or Nis permit Nall b1'deemed ewked.
z O CONsmuc 10N LENDING AGENCY
F"► Ilumbyart.that then I..comanctinn kmdmg agency for the pedmmance of
tool the work to,which this permit s issued(See.3097.Ci,C.)
W n~. Lsnder'.Nam-
Mz IrndraAaae-
U 0 I certify Nat I huts dad this application and suit Nu the show information s
w CorrCCL 1&gee in comply with all city and county ardhnaMO and soon lam miming in
0 buildmgconan lion,and hereby mNarias.pmaenuuvu of Ns city m enter upon the
W al mm-mmtrorcd property for inspemm Pmryaet
6. (Wc)'kgrte m sew,ledemaify and keep harmless the City of Cupertino against
r�i h
li.bili asrrjud,rruumls,Costs and salter winchm to any way mcric against aid City
t.)7 9ucrme of the{rinsing Of Nia pewit
Ac LICANT UNDERSTANDS AND WILL C MPLY WITH ALL ON- INf Issued by: Date /�" /aT
RCIS REGLIWIONS. _
/6 {/°° Re-roofs Q
Signue u of ApplieNVC mcmr� 'E
/ x OUS MATRIALS DISCLOSURE Type of Roof
Will the spin lOr room Wilding amrpm.stem w hasMle has kumi mucrial
in deEned by the Cupenyo Municipal Code.Chapter 9.12,and the HCalth and Safety
Conn. mm2s (a)+ All roofs shall be inspected I to any roofing material being installed.
crytnir— m No
� Will the applicant Or/more holding Occupant..equipment o,drleu whim If a roof is installed without fir obtaining an inspection,I agree to remove
t humans air emusionan coned by the Bay Arm Air Quality Management allnew alerials formspecti
Uxmict7
❑Yca Nu
Iffll"'-Y�_husNwsmeterialsreq remmu under Clupter6.95 of Ne Glirory
nice Hc.IN od.ScNau2550!2553am17553 d.I not ddudNe budding set rt it reipormiihilit� n9tify dm oaupmt Of Nc to" ofa Cctrf wofa l /�f, �� Signature of Apkllicant \ Date
Ownerurmthorindagen&/ t' Da(e All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT- OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN 32620009 . 00
DATE ISSUED. . . . . . . : 10/06/2008
RECEIPT # . . . . . . . . . : BS000006282
REFERENCE ID # . . . : 08100028
SITE ADDRESS . . . . . : 10100 ADRIANA AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MINDLI LEE YEL
ADDRESS . . . . . . . . . . : 10100 ADRIANA AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1126
RECEIVED FROM . . . . : ISAAKO P TANUPO
CONTRACTOR . . . . . . . : SUSAN TANUPO LIC # 23080
COMPANY . . . . . . . . . . : ALLEGIANCE ROOFING
ADDRESS . . . . . . . . . . : 1566 HARVEST DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95127
TELEPHONE . . . . . . . . : (408) 937-9757
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- -------- ------
1BSEISMICR VALUATION 10, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1REROOFRES SQ FEET 20 . 00 260 . 00 0 . 00 260 . 00 0 . 00
---------- ---------- --- - ----------
TOTAL PERMIT 371 . 00 0 . 00 371 . 00 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 371. 00 MC
---------------
TOTAL RECEIPT 371 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ------ -----------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
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 2007 IBC Standards
and manufacturers specifications on re-roofing. All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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 vaid before another insvection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/ "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 a bove stated policy on re-roofing.
a
Homeowner's Name: /t'/«/.��/ . G L.- Y/V
Job Site Address: /V OO AP111A+-/e!:%-- AV
Roofing Company Name: A �/A�GC'L% .�G� �Air
• Applicant's Signature: Date: W/ CV
Greg Casteel
Building Official
Revised 07/30/08
0 �/ voo�) k
UMalian CITY OF CUPERTINO
ON REROOF
CUPEkTINO PERMIT APPLICATION
APN # O O O r`f U O Date:¢� 491,
Building Address: 2' AV'
Owner's Name:: tV//ve>t/ L�� yC� Phon #:
0/00 Ary
Contractor: ALL47/<},it/C,E ,E'477�/^'�¢" Zi�/� Phone #: (/jV ?3-7 7-7S,?-
/ ZOlro .N4?W41 i
7P—ACS/ / rA t7-9�73-V Fax#:
Cupertino Business License #: Contractor License #:
9/vo,�3
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
Asphalt Shingles X Asphalt Shingles
❑/Wood Shakes ❑ Wood Shakes
0 fG 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.
Job Description: /ar7wOVG
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation: 10/C
I H d, Un rsand d Will Comply with Cupertino's Tear-Off Policy:
s � t
v%Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
0 0
CUPERTINO FEE SCHEDULE •
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial I B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
IREROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
'� (7 IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
l
1BUSLIC Business License B
Revised 6/16/08
•