08100036 CITY OF CUPERTINO
BUILDING DIVISION PERMITCOt�iCRACTORINkQRMATIO, R,
BUIL OINGADDRFSS: PERMIT NO.
21852 MONTE CT DIAZ ROOFING 08100036
OWNER'S NAME: PER TISSUE DATE
KUMAR GANAPATHY 4652 SHETLAND WAY 10/07/2008
NE: SANITARY NO, CONTROL NO.
(925) 565-0960
ARCHITECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
0 0 LICENSED CONTRACTOR'S DECLARATION
7th F I herby of Tres that I sun llmmml ander provisions of malmer 9(mmmeneing lob Description -
nuy with Section 70(0)ofDi�on3ofJreBosoms and prarea�nmCode,and mylicense u RE—RF R/0 SHK& INSTL 30LB GERARD STEEL LIT WEIGHT
.n son roma and effe
g'gz Licen:ecI., 4'3 Lk.g !t t9 q TILE, 39SQ CLS A, INSTL BATTN
�t- Dao: ComacWr
ARCHITECT-S DECLA TON
rj 1 uadcreand my plans shill W used as Public records
5du
g C Licensed Professional
aa3 OWNER-BUILDER DECLARATION
E 1 hereby Mr.that I am exempt from Ne Conua tore License Law for the
.CO following mason.(Section 7131 S,Business and Podcasiom Calc:Any city or county
e Elff which requires a prnmit W continuous.alley Wprom,demolish.or mpair any suunum
prior W as issuance.also requires site applicant for such permit to rile,signed wmmmt
S< IhuheislicensedpursuanttolhcpmNsionsofineConuacteriLics.raw(ChaPWr9 Sq.Ft. Floor Area Valuation
yl- (commencing with Section 7000)rd Division 3 of the Business and Professions Code)or $24150
e 5 g dist he u exempt IMrefmm and the basis for the alleged exemption.Any violation of
Session 7031.5 by any applicant far a permit subjects de,pPlicant in a civil penalty of Number - Occupancy Type
nm mom d,n rtm madm l dollars(SSW). 3 2 619 0 81 'V(�
1,uowrrso(dapropertymmyemploymwidwagnudeusokcompc don,
will do de work and desuunurt u mtkaaded or oRemA foraMe(Sec.TO 4,Business
and Profen ons Cade:The Comac n'.Licence law doe,..I apply W an owner of Required Inspections
property who Wilda or iso proves dceon.and who does such work himself w through his
nano employees,Provided that such improvements art notintended weaned musale If.
however.the Wilding or improvement is sold within one year ofsompktim.the owner-
milder writ have the burden of proving that W did rot Wild w improve fan purpose of
akJ.
0 1,u owner of the property,am exclusively contracting with licensed mmaaturs W t
cavmset the Project(Sen.yoga.Business and Profeasians Code:)TW Cmmcte'S U-
cave Law does not apply W an owner of property who Wilds or improver Normo.and.
who compact for such Foulness with amnuacmr(s)licensed Immuam in the Conuacors
License Law.
O lamexemptundc Sm .B&PCfwthism.son
Owner Dve
WORKERS COMPENSATION DECLARATION
1 bcmby affirm wader penalty of perjury one of the fallowing declarations:
1 hire and will maintain a CcAsicate of Conant to self-ivum for Workers Csmpen-
satian,an Provided for by Section 3700 of the labor Code.for the performance of the
wants for which this permit is issued.
m and will maintain Workers Compewtian Invumce,as required by Section
f de Labor Conn.per the per(or s.of dv work for which Nis Permit u ivied.
My orke,,.r....s...ctomp''e--nado Nsu carrier and Polity...her art:
Carrier. rti, Polity No.: -
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W completed trusts permit is farms hundroddaBars($LOB)
or 1.)
1 certify that In the performance of the work for which this permit u issued.I shall not
employ anypevan in any manmrm as W become subject in than Wohus'Campevadan
Laws of California.Dane
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become subject W da Workcri Compensation provision of the Labor Cade,you mase
0O foMwith comply with such pravuiov or this permit shell W deemed revoked.
'Z'--' CONSrRUCT10N LENDING AGENCY
[-r sNa Iherby of ism that Nem is a conauctirn kMingagenry for the performance of
C than work for which this permit is issued(Sm.3097,Ci,C.)
W Q Iandeh Name
z Lenders Address
U O 1 sonify dut 1 have read this application and aim do the aim inmrmadon it
ILseances.1 agme incomply with all city Mustcounty onlw
itcaand!asera muting ing m
O Wildiagcanspucian,and hereby submarine representatives of this city tu mkt upon the
W above-mcniioned property for inspection purposes
Ly (Wer)agree to ave,indemnify and keep harmless the City of Cupertino against
«F-t H IiabiliWs judgments.cots ade.povca which may In ay way amain against said City
V z in conso wase of the granting of this permit, y //, ��
ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-P INT Issued by: Date 2/—
SOU�C,E��G,ULATION�.I ^ /
k� t/ "Lar�t��) �L Re-roofs
Sig'a rtes AppliwRDam
HAZARDOUS
S MATE RIALS DISCLOSURE Type of Roof
WIII the applicant or Futuro Wilding arupant marc or handle h Heim and
u ne
de0d WY tut Cupenim Municipal Code.paper 9.12.and!ft HWd Safety
Code.Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
Dyes n.�'
Will tut applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
I
t.a air contaminants u dclined by than Bay Area Air Quality Management all new materials for inspection.
❑yon 0196-__ -
I have mad de hwsrduama er ais requirements undar Chap m6.95 of the Caliror.
riaHealth&Safety Cade,Scedots25505.25533"25531.1un m.ddaifdo Willing
doss mt eurmnti,ham•inane that it u my resporpibilil W noir,the me.pant OF
rcyaW n Wbosh must be W issuance car W of gra re of Applicant Date
er amhomcd,gem 1546'
All roof coverings to be Class';W'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 32619081. 00
DATE ISSUED. . . . . . . : 10/07/2008
RECEIPT # . . . . . .. . . . : BS000006291
REFERENCE ID # : . . : 08100036
SITE ADDRESS . . . . . : 21852 MONTE CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. KUMAR GANAPATHY
ADDRESS . . . . . . . . . . : 21852 MONTE CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : PREMIER DIAZ ROOFIN
CONTRACTOR . . . . . . . : RODOLFO DIAZ LIC # 26457
COMPANY . . . . . . . . . . : DIAZ ROOFING
ADDRESS . . . . . . . . . . : 4652 SHETLAND WAY
CITY/STATE/ZIP . . . : ANTIOCH, CA 94531
TELEPHONE . . . . . . . . : (925) 565-0960
• FEE ID UNIT I QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 24, 150 . 00 2 . 50 0 . 00 2 . 50 0 . 00
1REROOFRES SQ FEET 39 . 00 507 . 00 0 . 00 507 . 00 0 . 00
-
--------- ---------- ---- ----------
TOTAL PERMIT 509 . 50 0 . 00 509 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 509 . 50 VISA '
---------------
TOTAL RECEIPT 509 . 50
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------- --------------------- -------- ------------------- --
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
OWL
Community Development
10300 Torre Avenue
'"jam Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPERTINO
Building Department
JOB ADDRESS: /8- C� PERMIT # Oil
D U /
OWNER'S NAME: May, o ih PHONE #
GENERAL CONTRACTOR: n I 1Z Lrl FAX #
I am not using any subcontractors: Gy--i )
Signature Date
Please check applicable subcontracto d complete 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
WSheetk
Contractor Signature Date
Community Development Department
t Building Division
City of Cupertino
e 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 1/4 " 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: y A10 ✓y� C7a l 41eLI th 14
Job Site Address:
Roofing Company Name: �! q 7� i1 (z—
Applicant's Signature: Date: Id1
• Greg Casteel
Building Official
Revised 07/30/08
c��l000� (P
am
CITY OF CUPERTINO
REROOF
UPEIZTINO PERMIT APPLICATION
APN II Z,� 6 / q / 00
T5ate: /d
Building Address:
Owner's Name: Phone #: y0S/
Contractor: // Phone #:
/Z ` /in. Fax#:
Cupertino Business License Contractor License #:
8l/ 9
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ A ophalt Shingles a Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles /
❑ Other (Specify) ❑ Other (Specify) C7C>> ald 57 _al
Number of existing coverings ❑ Provide I.C.B.O. Report #
o To be Removed ❑ Provide Mfgr. Installation Specs.
Lha
Job Description: a 5h4lf(, )15`t(11 Prarei.
�n L n 3c? Zh fet-1 �]
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: v
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
#ntre
Revised 6/16/08
CITY OF CUPERTINO j
REROOF
CUPERTINO FEE SCHEDULE
Number of . Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
/ 1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
IBSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08