08100061 CITY OF CUPERTINO ^r arz.;*
BUIL69NCDIVIryON PERMIT CpOpN^TRACORNF�UItMATrN,�, ._
BUILI1211yS DDRESS: PERMIT NO.
75�% NOVEMBER DR WESTERN ROOFING SYSTEMS 08100061
OWNER'S NAME: PERMIT ISSUE DATE
MARIE LEE 1328 WHITE OAKS RD 10/10/2008
ONE: SANITARY N0, CONTROL NO.
AlLcarrECTyENGINEER: RE—RF T/O WDSHK FLSHTNG AS BLDG BUILDING a�MB MEcx
X00 LICENSED CONTRACTOR'S DECLARATION O O O
e V 1 Eveby affirm Iw I w IkcasN under pmrisiau of CTapmr 9(rommeKing ••^_ ... _ .. .... .._ .._ Job Description
e withllto n]IXXI)of Division larNC Bueincs,orb Pmfcssium Code,and my licmue i,
'oH imm�rartearbeReSt3� Ix.g li }yam
nn? License dssa
nFp Dow---
Ab.. ConlD
e 7W ARCHITECT'S D R
e�U 1 underaanJ my plans,hall W used as public rxoba
a
g o Licensed Professional
OWNER exananERDECLARATION
COOhereby o(Bm 11. x.mpt from the Caanctor,s:My c taw for Ne
COO O following mason. r t 701.5.Bud•...and Oe.thmans Code:My city m county
I_
which sego n•Permit to cnnswcL Man.Wprow,dcmnl m,ar.,.I,any a mmum
_Zy prior in its issuance.aim mquiru the applicant for such permit in file a signed snamanl
<
that Ie is licensed purmanl to the provisions of the Cmeaselm',Lismrm Lma Cem=9 Sq.FL Floor Area Valuation
%H$ (commencing with Seedon]000)of Divuton3 ofth.Busincesand Promotions Cum)or
— dot be-exempt merriment and the basis for the alleged exomptian.My violation of
Section 7631.5 by any applicant for a permit submcu the applicant to a civil penalty of APN Number Occupancy
nm mom mann five bawm l dollars(ssod). Parc Y Type
[]I,u owner of da property.m mY wploym with wage u(heir sole eempenssUon,
win W tfe work orb.:Th.Commencer
Lt tied ora w do for Sam(Sec.so aa,cums,o•
aro Professions
Cadc:The centrazmr,ndwho Law don at apply lf x11 awns or Required Inspections
own ceywW build,orlmmat s ch improvements
andwW medratnouchw tied!or ffered hmugh his
how ver,m eWipwdor i duo such impmsemmu in m year
fe mpleti ed for ale R,
Wilde, Ne Wildingmimprowmmtm mid within arcyear or wmplefar thesom of
Wilder MB lose th WNan of proving dot W did w dada m improv(a purpose of
sale.).
0 1,sa owns of the property,am exclusively contracting with licensed mnlractan m
cm,strum the project(Sec.]Odd.Business am Profusions code:)The Cornesemr,Li.
a.law don out apply in m owner of property who Wilds or improves menton.and,
who contracts for such pmkcm with a ca tussaw(s)licensed puncant In IW Canormmr,
License taw.
❑I anexempt under See .B&PC for this reamn
Oweer Dam
WORKER'S COMPEaSA11ON DECLARATION
1 hereby affirm under penalty of perjury ane of the fallowing declwdons:
have and will maintain a Cer iBote of Consent an mlyinsure for WortcrsCommon-
on,ss provided for by Section 3700 of the Labour Code.for tW performance of me
wort for which this permit is issued.
have and will maintain Wotker,Compensation I..,as natImeed by Section
]00 of the Mbar Code,for the perfarmma or die work for which this;permit u issued.
My Workk�c1e�s Compensation Iase as.�l a�ria numb
and Policy er w:
GrtierlAssOur/�ti�MIATI.�Iicy Na.: �3I Jrl f—
CERTIFlGTE OF EX PfTbN MOM WORKERS'
COMPENSATION INSURANCE
rLTbscctian reed set W cwplcmd lithe permit Is foraw hundreddo0an(5100)
or mu)
I mtifY that in tW performaac of iW work fm which this Permit is issued.I shall set
employ any morson In my ma nor an as in became mbjeet in time Wmkets'Compensation
Laws of California-Doth
Applicant
NOTICE TO APPLICANT:If.Allo making this CeniOcam of Exemption,you shout
become subject to 1W Wmiscra Compensation provisions of the Labor Code you const
OfoMwilh comply with such provisions or mix pewit shall be deemed tevokcd.
zw"' CONSTRUCTION LENDING AGENCY
r
f" I herby M.manft.I is.co (So,.30 sending agency for da pMowame of
C> the work for which this permit H issued(See.3119'1,civ.C.)
QL<Mers Nan.
.7 z Irndeh Address
U O 1 minify Nat 1 Tuve mad oris appikslim,aid sum ded the abovs information is
[p.F comeL 1 agree m comply will,all city and county aNinmm and sum laws mlating m
OU Wilding conmucdon,and heaby.uthorim repmsmutives ofthucioy,in cnmsupro the
H yaWw-mentioned pmpeny for inspection purposes
WO)agree to save,indemnify and keep hawlw dm City of Cupertino!g"
to liabilities,judgmcmu,coast and expense,which may in my way amue against said City
U Z in camorpse ee of the granting or this poral.
'-" APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
?RCE R LATON .
Re-roofs
igna A iUAUconnacl Dam
IiAzARDo TERTAI S DISCLOSURE Type of Roof
Will thoappliont orfu WI ng rccupant storm or handle harammus mamrid
n de0ncd by thea Cupertino 1 Code.Chapter 9.13,and dm Health and Safety
Code.
Sccdon 353324)7
Arcs All roofs shall be inspected prior to any roofing material being installed.
o
Will th.applicant o Tutu.Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
l haaNnns air contwinams a defitad by IW Bay Arca Air Quality Managcanal all new materials for inspection.
Irict]
C3res
I have mad themamrida require.undo Chapar6.95ofthe Califor.
nu Health&Sdcty Code,Soc n=M505,25533md2553/.lunworn dthaifNe Wilding to
arcs rat cumntiy haw•wand tiw It u mY mpansibiliry m ntify the occupant of the ll
mpinum saw ml prior uamc of.Cctdfa.m of Occupamy. Si nature of Applicant Date
q�per or Data
All roof co e ' gs to be Class'W'or better
seam. agent '
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36213041 . 00
DATE ISSUED. . . . . . . : 10/10/2008
RECEIPT # . . . . . . . . . : BS000006322
REFERENCE ID # . . . : 08100061
SITE ADDRESS . . . . . : 937 NOVEMBER DR
SUBDIVISION . . . . . . :
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : MARIE LEE
ADDRESS . . . . . . . . . . : 937 NOVEMBER DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4120
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
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBSEISMICR VALUATION 15, 500 . 00 1 . 60 0 . 00 1 . 60 0 . 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0 . 00
TOTAL PERMIT 339 . 60 0 . 00 339 . 60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------- --------------- --------------------
CREDIT CARD 679 . 20 VISA
---------------
TOTAL RECEIPT 679 . 20
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 1/4 "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: p/r e l e -
Job Site Address: C13/� , yd✓? �/
Roofing Company Name: W p✓ �^J 1`0.'r/V r �y f*�4�
Applicant's Signature: A Date: 1`Nd-04V
Greg Casteel
Building Official
Revised 07/30/08
Community Development
�4 10300 Torre Avenue
F�J Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
4UPERTINO
Building De artment
JOB ADDRESS: PERMIT #
3 7 r✓e-A�4- �e- CJ,J'l c) U C) �v/
OWNER'SNAME: pr,y Let PHONE # 344' 4/ ;Ll—
GENERAL CONTRACTOR: i„i „. Sr{.i. FAX# 5Tr f 9.75
I am not using any subcontractors:
Signa Date
Please check applicable subcontractors and complete ollowin 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
i
Owner/Contractor Signature Date
CITY OF CUPERTINO
(41 REROOF
Cry OF
OCUPERTINO PERMIT APPLICATION
APN # 0 Date:
.W vc6/.
Building Address:
q3?- /Nd�e,•�6v� ��
Owner's Name: Phone #:
Lem SZ';<rteY
Contractor: /) Phone #:
1,✓fbY(�i�/ �J�/.� Sz t ^ 5 Fax#: TT /73j
Cupertino Business License #: Contractor License #:
f32f
Type of Roof Covering:
Existing: Proposed:
a Built-Up Roof ❑ Built-Up roof
a Asphalt Shingles a Asphalt Shingles
,a-Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) Other (Specify) ,ne,4.1 •lc.
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:rL
—rec r aTl/ w 0--)a / !✓fie�l•d/ /At {�
jrC'fr� l /' -/al 7'•Ic. Z (y � / GSA!! n-
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:
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
•
Signature
Revised 6/16/08
CITY OF CUPERTINO
� a
REROOF
CUPERTINO FEE SCHEDULE •
Number of Fee ID' Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO, Seismic Commercial B
2� 1REROOFRES Re-roof Residential B 1SFDWLROOF
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08
•