08100139 CITY OF CUPERTINO .:-mom
BUILDING DIVISION PERMIT C0NfiRATOI2INT�ORMATI( N
BUILDING ADDRESS: PERMIT NO.
19735 AUBURN DR WESTERN ROOFING SYSTEMS 08100139
OWNER'S NAME: PERMIT ISSUE DATE
IFNE A CONTROL 10.
(831) 278-1837
ARCHf1ECTYENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
l� 0
a0c LICENSED CONIACTOWS DECLARATION IOb D0SCIhon
U`v I hereby affirm that I ser Eounsed took,provisionsmf Chapter 9(comm7encing P
F with somas 70M)ol'Divisios 3 ofOes
c Business Rofevrimu nse
Code.and my licee
n to in full force andaliq t. rt" RE—RF T/0 WDSHK FILL SHTNG AS NDED OLB FLT INSTL
14 Liccnre ChadL'�t Lk.
°y-o Dam /t,1—ser.—/yr comraaor 28SQ CLS A MTL TILE RF SYS
Mun W ARCHf1ECfS DEC 0
! 7 1 understand my plum slWl he wetl
public records
JyU
g we In Licensed Pufessianal
I OWNER-BURDER DECLARATION
gm1 hereby aQirom that I am exempt from the Contractor's License Law for the
OO following terms.an.(Secumn NO 1.5,Buainss cand Pmfessinm ns Cade:Any city county
S$ which mquhats a Permit to commucl,sime impmw,demolish,tor minor any structure
prior to its issuance.alsu mquims the applicant for such pencil to file asigncd Laement
pp that he is licensed pursuant to dm provisions of the Cnnlmcmrs Liecnsc U.(Chapmr9 Sq.Ft. Floor Area Valuation
Y�S (commencing with Section 70()0)of Division 3 ofthe Business and Professions Cook)or
that he is exempt therefrom and the btu for the alleged anc mpuom Any Wladms of 16 2 0 0
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
Inst mart thus five hundred dollars(5500). 31632006 . 00
❑I,u owner of the properly,or my aanployces with wages as their sole compensation,
will do IhC work.and Ibis mums.a not intended o(aBCmd for ask(Sec.7044.Bial.
and Plefetamns Code:The ComacmYs License Law don not a"IY m an wmmr N Required Inspections
proPeny who builds m improves thereon.and who den such work himsel l err through he
own employees,provided that such impermanmm att not im ende t moRemd for.ule.IL
however.the Wilding or improvement is sold within one year of completion.the owner-
builder will have the burden of proving that he did net Wild of improv for purpose of
sale.).
❑1,as caner of the propcny,me exclusively contacting with licensed comtacturs m
construct the project(Sec.7014.Business and Professions Code:)The Cuntncter's U.
erne Law don not apply to so owns of property tubo Wilds or improves ft..and
who contacts for such Projects with a contractor(s)licensed pursuant m the Contra mors
License Law.
❑I not meront under S. .B&P C for this mune
Owner Data
WORKER'S COMPENSATION DECLARATION
41 1 bereby affirm under Penalty of perjury one of Ne following decimations:
1 bare sed w01 milnofn•Cerufsmm aConsent eneelr-home faworkces cumprn
on,ar provided for by Section 3700 of the Labor Code,for the pe fam ance of the
work for which this permit is issued.
Is and will maintain Workefs Compensation IrtR ..as required by Seetimn
3700 of the Labor Cook.for de Performance of do wort far which the permit a issued
My Worrkksees Compensation Lur
aance artart
carrier and Policy number :
Cartier,0021,/✓a AIL/'K/A A�a511ay No.: �/S/r1
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
men;section need aombocmmpleed if the permit Is(mane hundred dollar(SIM)
mr ea)
1 mtify that in um performance of IW work for which this permit is issued.I shall not
employ any person in any manner so as to become subject to lha Workers'Compensation .
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,am,making the Certificate of Eumpuon,you should
become subject to the Woftes Conformation previsions of de Labor Cred,you most
.,O forthwith comply with such Provisions or the permit mail be mounted mevakcd.
'Z'0 CONMUC ION LENDING AGENCY
E-+4 I bereby ailuro that Nem e a construction lending agency for ink Performance of
C!> the work for which the Permit Is is mad(Sec.30;•1,Civ.C.)
Q Lender's Name ,
z Lender's Addreu
V O I certify Nat I have mad this application and soon Nu the above infonnauun is
emcee'agree Ins comply with ill city and county oNimncn orb rete 1.relating to .
.C) Wilding consruaion,and hereby authorise mpmsofitm s of the city to cnmrupnn the
r tT7 above-mentioned pomarty for inspection puryosos.
4 (We)agree to love.indemnify and keep harmlru the City of CupeNnm against
Fr y Iiabiliue.judgmenls.comaMexposses which mayinanywayacnueagaiatsaidCity
C.l z APP Cracquence of the graming of s Permit-
ANT UNDERSTANDS AIND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SO LE RE ATIO
Id-z" Re-roofs
tff sign t H ARDOUs ATERI DISCLOSURE DateTypeof Roof
Will uuappliantorfutue 'Idingoe pantsmmorlundlchaurdousmaterod
ar defined by IW Cu,anine Municip .Chapter 9.1;and the limits and Safety
erode, yes z255320)?DAll roofs shall be inspected prior to any roofing material being installed.
tins Nm
Will the applicant or future Wild .occupant use equipment or dcvicm which If a roof is installed without first obtaining an inspection,I agree to remove
h harudnw air conuminanu tried by IW Bay Area Air Quality Management all new materials for inspection.
uict7
❑Ya ❑Nu
1 have read the lommiu eueriaHmquircomemomdcr Chapter&95aftbcCalifm-
maHmlth&SafcmyCode,Sectimu 25505,25533 and 7553,1.1undcrsmndthatifthc Wilding
don not currently have a tenant the it u my mespmuil ilitY m notify the occupant of the V !!TT
reqs rents morns 'err af.Cerdnmeof Okt-P y,we ign ureo Applica Date
s to be Class ll ro coverin
Owne au sdagent i
Date� � g 'W'Or better
CITY OF CUPERTINO
O 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 31632006 . 00
DATE ISSUED. . . . . . . : 10/22/2008
RECEIPT # . . . . . . . . . : BS000006433
REFERENCE ID # . . . : 08100139
SITE ADDRESS . . . . . : 19735 AUBURN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SCHERER ALBERT R AND JOANNE C
ADDRESS . . . . . . . . . . : 19735 AUBURN DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2413
RECEIVED FROM . . . . : MICHAEL D LUNNEBORG
CONTRACTOR MICHAEL LUNNEBORG LIC # 25896
COMPANY . . . . . . . . . . : WESTERN ROOFING SYSTEMS
ADDRESS . . . . . . . . . . : 1328 WHITE OAKS RD
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (831) 278-1837
FEE ID UNIT . QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --- --------- - ---- --
1BSEISMICR VALUATION 16, 200 . 00 1 . 70 0 . 00 1 . 70 0 . 00
1REROOFRES SQ FEET 28 . 00 364 . 00 0 . 00 364 . 00 0 . 00
TOTAL PERMIT 365 . 70 0 . 00 365 . 70 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -------
CREDIT CARD 365 .70 VISA
---------------
TOTAL RECEIPT 365 .70
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 paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/a "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.
Ho meowner's Name:
Job Site Address:
Roofing Company Name: (n/e,72�N Qoin y Sy�/pn j
Applicant's Signature Date: 1J—Zz--06F-
• Greg Casteel
Building Official
Revised 07/30/08
0100/ � 9
CITY OF CUPERTINO
REROOF
OF
•CUPEkTINO PERMIT APPLICATION
APN # C� Date:
31 & 3 ;� ov(o . o Icy-zz.-0 y
Building Address:
Ig73S r
Owner's Name: Phone #:
lH.Q3,,✓JO- Scherer `poi/
Contractor: Phone #:
I Jey�PrN RoeG�"'l $ys 5 Fax #:. a fr 1-" /7 i J
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) Other (Specify) M�e4w
Number of existing coverings ❑ Provide I.C.B.O. Report #
r To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
Teqr y{F wuact fhs c( Fi(f s',4omf^) ar iveedzc2/ 1K) /Ss 4(.F/ �•it
Residential Commercial El
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:
1(s Zao
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
CITY OF CUPERTINO, rf
REROOF
CI O
CUPERTINO FEE SCHEDULE •
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
-1•BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR0OF
1BSEISMICRE Seismic Residential B
1REROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08