08100047 CITY IF CUPERTINO
BUILDING DIVISION PERMIT " CTI<TRACT(TItIATF'ORA'IATI1v
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BUILDING ADDRESS: PERMIT NO.
10511 BARNHART CT SIMON SAYS ROOFING 08100047
OW NEWS NAME: PERMIT ISSUE DATE
NEERAJ PAKALA 3012 BECKLEY DR 10/09/2008
INE:
SANITARY NO. CONTROL NO.
(408) 531-9700
ARCHIIECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
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00, LICENSED CONTRACTOR'S DECLARATION Job De$Cn 1100
iF 1 hereby affirm Nu 1 em licensed under proviaiou of Chapel 9(mmmeneing p
o< with Section 7tK10)WDividon3arde Budrev and Prafcasians Cmde,ub myliccrrset T/O EXT BUR, NEW 30LB FLT CMP SHNGL CLS A 5SQ
_< full Toren ane ett
inOyz Luenu
a;:p DMi O Contract
W7 ARCHITECTS DECLARATION
ou
U 1 Mainland my plans Mall W u
wand public records
y o Licensed Profe .a
OWNER-BUILDER DECLARATION
E 1 Wmby affirm that 1 am eacmpt from U.Contacbrs License Law far rW
00 following moon.(Section 71D I.S.Business and Professions Cade:MY city or county
S$ff which requites a permit an construct.alter,improve.dcmnliah,or repair any structure
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< prior b it issuance.also requires rW applicant far such Permit b file.signed salemcul
0Net he is licensedpmuamb
stheProvisionsOftheComeete'SLicenseTaw(Chaprer9 Sq.Ft. Floor Area $ Valuation
0 (eommeracing with Section 7000)of Division 7 of the Business and Pmfcsimes Code).1 3181
—
that he b exempt thanefrom and the buss for Ne YIcgcd inscription.Any violation or
Section 70316 by my applicant for a permit subject the apsam b a civil Penalty or
.1.wan five hundred dollars MOBIL 3 7 5 3 7 0 2 4 .Number Occupancy Type
❑Lo ftr rk.andaperty,amwlin yceswiWwagau Wc(S=. ,Bir nn,
wifi dothewart.ande: he Conassets Lieeds LAW
Business
and Professions Cage:The ea dano r. nd who
taw encu not himus lf rt owner is Required Inspections
propertywho yces,prolds idedtatsu himparveewW docam asinte t himselfarthrough hu
awvemPWycn-prig or
War such improvement ere set ear ofee oroRmnd for vie r,
hawevv.We Wilding ol impmvemrrt V mid within are year car campleerm,the ore of
W ilea NB Its,the Watlra of poring that K did rot With or improve for purpose of
sale.).
Q 1,u awrer of the property am aclusiwlY contracting with licensed mnumtan m
comtmct ere project(See.7044.Business and Pmfcsilons Code:)The Cmhusnrs Li-
e.Law does out apply banowoerofpropertywho Wilds car improv threes,and.
whotm uactforouch pmjetts with.canvaztm(s)licensed pnvm to the Canumgors
Litems law.
❑1 M acmpt undo See. ,B k PC for this moan
Owner Data
WORKERS COMPENSATION DECLARATION
1 hereby alBm under pevlty of perjury oro of die following declanuons:
1 haw and will maintain s Cenirrcam.f Cmtentlo self-iuum far. Worte/sGmpcn-
utim.u provided for by Section 3700 of the tater Code,for the Performance of ft
were
-
wmrt for which this permit is issued.
w and will maintain Workers ComPenaUen Imuran..as required by Section
fee L.Wr Cade,for the perfomas.of de wart for which this permit is issued '
My Walkers Compensation Iwnna artier and Policynumberare:
Cartier-sag TE �J�EX Policy �/�7Z
CERTIFICATE OF EXEMPTION FROM WOMERS'
COMPENSATION INSURANCE
(Dots section need notbccmnpleed iflh permit is forane hundred dol an(3100)
arks&)
1 ceufy that u the Performance of that wort for which this Permit is iauc4 l shall as,
employ any person in my muner an as W become subject to the WorYen'Compensation
taws of California.Dae
Applicant
NOTICE TO APPLICANT:If,after making this Cenifrate of Esemption,you Mould
Wcome subject b We Worker's Compensation provisions of the tabs,Code,you must
.J O
E! forbwidt comply with such provisions or is permit shall W decreed reveled.
' CONSTRUCTION LENDING AGENCY
F I hereby affirm dor tem u a mmrmction lending agcmy fordo performanec of
G' ti We wurl for which this permit t trued(Sec.3097,Civ.C.) '
W Q Lenders Name
z tenders Address .
U O i cenify that I have read this application red sue two the shove information is
IL P coned 1 ago¢b comply with all city and county ordin.nceir and sae was relating m
Q U Wilding conmucumn,and Items,anWorice repremmutivu of this city in Cora upon th
r .how-memimecd preq ny for inspection pulpae&
gL (We)agree or ave,indemnify and trap hemleu Its,City of Cupertino against
Iiabilitca,judgment,cost and eapeuu which may lo any waym.agaWtvid City
U in consequence of th goofing of this permit N
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOU10E REGULATI NS.
„-»n e �i „Ince /O-9-D 8 Re-roofs
Signature,of AppliandCommemor Due
HAZARDOUS MATERIA DISCLOSURE Type of Roof
Will th,applicant or None building acmpantnmm or handl,hi Mous maaial
as defined by the Cupertino Municipal Code.Chapter 9.12 and dte Halrh aril Safety
inIfcmm.se,fionxss3a(.)± LLLL All roofs shall be inspected prior to any roofing material being installed.
❑Yeo
W01 de.pprcant or future Wading oampant wse equipment or daiaa which
a roof is installed without firs[obtaining an inspection,I agree to remove
.dr buardous air conumimm s as dcfixd by the Bay A.Air Quality Management all new materials for inspection.
District?
Yca
I have read the huardmus�rish rcquhmcwumOr Chaper6.95 of de Califor-
niaHCrlthkSafmyCods.Sccuose 0S 25533 and 25534.I understand watirNc Wilding L .r)r- C _
docsm}qrm it he r�•..,.L this It u my map Wliry b notify Ile(Mupmr of de _ (/
requ''rbve/W which mor bf met piasbitwan„ar.cenirrab oraapwey Signature of Applicant Date
kY�-�J1/A'vnj ' 119-4-0 R
Owner m antharbed agent V U butte All roof coverings to be Class'Jq."or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 37537024 . 00
DATE ISSUED. . . . . . . : 10/09/2008
RECEIPT #. . . . . . . . . : BS000006309
REFERENCE ID # . . . : 08100047
SITE ADDRESS . . : 10511 BARNHART CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . .. NEERAJ PAKALA
ADDRESS . . . . . . . . . . : 10511 BARNHART CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : EDWARD A GREGORY
CONTRACTOR . . . . . . . : DARRYL SIMON LIC # 23053
COMPANY . . ... . . . . . . : SIMON SAYS ROOFING
ADDRESS . . . . . . . . . . : 3012 BECKLEY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95135
TELEPHONE . . . . . . . . : (408) 531-9700
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---- ---------- ---------- ---------- - - ----------
IBSEISMICR VALUATION 3 , 181 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1REROOFRES SQ FEET 5 . 00 65 . 00 0 . 00 65 . 00 0 . 00
TOTAL PERMIT 65 . 50 0 . 00 65 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 65 . 50 VISA
---------------
TOTAL RECEIPT 65 . 50
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 /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.
Homeowner's Name: 7i/ 2 e /`4i4-
V
Job Site Address: SOS// �s�a Gts✓ 07—
Roofing
TRoofing Company Name: (CU 0 ( I t
Applicant's Signature: Date: /0"2,0 Li"
Greg Casteel
Building Official
Revised 07/30/08 ,
d/ 000 y7
CITY OF CUPERTINO
10
� N,S440F
REROOF
*CUPERTINO PERMIT APPLICATION
APN # Date: .
. 75-3 7 v ,2 V o va�-e
Build in Address:
D Sl/ e,a G/G14 0 -74
Owner'''s Name: Phone #:
Alee r
//eer 5 410 e— S17o-09
Contractor: Phone #:
r W�Uh ��y� /S O�7 � ✓� _
S Fax #:
Cupertino Business License #: � Contractor License #:
Type of Roof Covering:
Existing: Proposed:
Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �C Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
41 ❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Zmber of existing coverings ❑ Provide I.C.B.O. Report#
TO'
be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:,i
/ Q ex,s� ks 73 �R �r1/e 3 �/b /�/ 0d 4e_
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: 3/ /
Itlave Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
Signature
Revised 6/16/08
-� CITY OF CUPERTINO
REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
S 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
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