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08100080 CITY OF CUPERTINO ,�"4c5� BUILDIN�UIVISION' PERMIT CONTRAG QRjI QRMAT-I0W ' BUILDING ADDRESS: FERMI NO. 10605 FARALLONE DR KEITH ROOFING CO INC 08100080 OWNER'S NAME: PERMIT ISSUE DAIS SCOTT & SABRINA ELLIS 920 LINCOLN AVE 10/15/2008 NE: (908) 295-8616 SANITARY NO. CONTROL NO. ARCHTIECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION O O O O 4 F 1 hvcby effuse Nu 1 am licensed under provisions of Chapter 9(commencing Job Description wzUE wiNSeem.7").fDivumm3ofNeBusioeuandPrUnwiovCode,admylicense is RE—RF RMV SHK& INSTL 7/160SB 30LB FLT 40YR 7 N In fell feRG arid Cf tel i�? Warm Clue Lied p/ CMPSHNGLS CLS A 30SQ cmuse n:� Dam mr ee ARCHITECTS DECLARATION I understand my plans"I be used u public records ? U y c� Licensed Professional OWNER-BUILDERDECLARATION ef I hereby a1Rres Nu 1 am uempt from the Comlraerori License Law for Oe OO following wan.(section 71013,Business and Professimm Cale:Any city or county S$V which"at.a permit in cnrwum,alter,improve.demolish,or repair any suunuro _Z< prior to its issuance.also requites the applicant for such permit to file a signed suemenl ss that he is licensed pursuant to Ne provisions of the canuaemrsLossumLaw(Chapter 9 Sq.Ft.Floor Area Valuation Ih (commencingwiNSection7000)OfDivision3oftheBusinessandProfessinuCode)at $13000 y w§ this he is exempt therefrom and she buts for the Algmd uemption Any violation of Scenario 70313 by any applicant for a Permit subjects NC appllcNl in a civil penalty Of p Number Occupancy not mart Wan five hundred dollva($5(0). 36939037y:U� pane y Type I,ummrof the l ❑ prvpaty,a my employees with wages u thew vele compevaon, will do Newark and the structure Is notimended or offered formic(Sec.7044,Business and Prefesslou Caen:The Conoumrs License law does nut apply m an Owner of Required Inspections property who Wilds or impovea Merton,and who doessuch work himself m through his own anployees,provided that such improvements art not ma nded or Mered forsak.B. however.Ne building or improvement is sold within one yur of canple ion.the owner- Insider will new the burden of proving that he did Out Wild or improve for purpose of ale.), ❑L u oww of the property am uclusinly commesing with Banned tmnaulan to cmnlNet the Project(Sec.7W4.BaeloGV mad Professions Cole)The CanVKlOrs LI- cove Law does not apply as an owner of property who Wilds or Improves thereon,and, who contracts for such prejceu wits a comraa o(s)licensed pursuant m nate Conoaemes - LkemeLaw. ❑IamuempturserSee .B&PCfcr Nsmvrin Owner Gaut— WORKERS amWORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following dalarsnaom: 1 haw and will maintain a Ceniftamaf Camera maelf-ivum far Wor4rs Compeer- suion,as provided for by Section 3700 mf the Iabsr Code,for the performance of the work for which this Permit is issued. ❑1 have and will maintain Workers Compensation Insurance,as required by Section 3700 of One labor Code,for the pciformuce of the work for which this permit is issued My Workers Cope on 1 tons no.and Polity number are: Cartier. ! /;W ; " PoIh No.: C71-37/1' CERTIFICATE OF EXEM PITON FROM WORKERS COMPENSATION INSURANCE Inds secdon nerd um W completed if the permit is formic hundred dollars(5100) or ser) 1 certify that in Ne pufor moa N the.,it fa which this Permit is issued.I"I not employ any person in any manerso as in become subject in the Wakma'Compemauon Laws of California-Dam Applicant NOTICE TO APPLICANT:If.after making this Cenifieme of Exemption,you should became subject an the Wolters Com,mmbdom provisions of me Labor Cocke you most ❑zforthwith comply with such provisions or this shall ll W demand muted. z 0 CONSTRUCTION LENDING AGENCY t..4 I hereby 1101m that Nem is a comouctinn lending agency for the performance of Tt > the work for which this permit s issad(Sec.NM,Civ.C.) Tenders Name D z Tonder!Address U C) I anify that 1 have rhe this applimdrin and sum dist Ne above information is I7, cornea 1 agree in comply with all city and county ordinances and mum laws misting in Q Wilding construction,and hereby mmoda mpocomadva ofthis city to curer upon the V move-mentioned property for inspection purposes FG (Wer)agree Ise eve,indemnify and kap harmless the City of Cupertino agaivl N IiaWlitin,jndgmenu.cvuand upenr4 which may inanywayama',drutsmi Ciry U in consequnta of the granung of this permit '-' APPLICANT U ERSTANDS AND WILL COMPLY WITH ALL NO -POINT Issued by: Date / — SOURCE R TIONS. i �/J7,' Re-roofs Si of AppliantlCanuateor Dam �Z HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will de applicant Or forum Wilding aeuPanlnoro or handlc herallou material u de0ned by Ne Cupenino Municipal Code.Chapter 9.13,and the Health and Safety Code, 0y.25532(,)+ - All roofs shall be inspected prior to any roofing material being installed. ❑Yes � PWill um Miami or fuu'ture Wilding occupant um equim^ent Or mica which If a roof is installed without first obtaining an inspection,I agree to remove ''t huardry air conuminar0 u mOncd by the Bay Arta Air Quality Management all new materials for inspection. Disuicl7 [3 Yes Fri. I have toad the haardatsmam6asmquiemewunmrChaper&95 of Ne Califor- ns Hulm&Safety •Scliom7SSD5.25533w n534.Iundersu ifthebilding does net cur, a errant.Nu it u my respontlbility in notify the oaupaot of Oe rcgaiemen hi m ustherrmtpriormiaaanarif-CcnlOateofOcapancy. ature pplicant Date Ow mtharb<d agent Dam' All roof coverings to be Class'%4"or better 2e CITY OF CUPERTINO •2 ITEMS OF 2 PERMIT RECEIPT- OPERATOR: patg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . . 36939037 . 00 DATE ISSUED. . . . . . . : 10/15/2008 RECEIPT # . . . . . . . . . : BS000006351 REFERENCE ID # . . . : 08100080 SITE ADDRESS . . . . . : 10605 FARALLONE DR SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SCOTT & SABRINA ELLIS ADDRESS . . . . . . . . . . : 10605 FARALLONE DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : ROGER BRIGHT CONTRACTOR . . . . . . . : BRIGHT, ROGER LIC # 21477 COMPANY . . . . . . . . . . : KEITH ROOFING CO INC ADDRESS . . . . . . . . . . : 920 LINCOLN AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95126 TELEPHONE . . . . . . . . : (408) 295-8616 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- -- 1BSEISMICR VALUATION 13 , 000 . 00 1 .30 0 . 00 1 .30 0 . 00 1REROOFRES SQ FEET 30 . 00 . 39,0 . 00 0 . 00 390 . 00 0 . 00 TOTAL PERMIT 391 . 30 0 . 00 391 .30 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER --- -------------- CREDIT CARD 391.30 VISA --------------- TOTAL RECEIPT, : 391 .30 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 Tone 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: I//lam ��I6- Job Site Address: �b��l r��11614, Roofing Company Name: Applicant's Signature Date: • Greg Casteel Building Official Revised 07/30/08 CITY OF CUPERTINO sout REROOF COF WUPERTINO PERMIT APPLICATION APN # �1/p %e7�`?037, C) (-) Date: �d JC < 6g Building Address: Owner's Name: / Phone #: Contractor: Phone Fax #: Cupertino Business License #: Contractor License #: Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles -jC-Asphalt Shingles ?Wobd Shakes ❑ Wood Shakes ❑ 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: sl a <�ea ' H yc} 1� (G 65a . 36�Gc l� �{(�✓�o sG. _ Clash ,A- 30 I Residentia 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: / SI Have Read n rstand and Will Comply with Cupertino's Tear-Off Policy: Si to Revised 6/16/08 CITY OF CUPERTINO REROOF CUPEkTiNO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMIC0 Seismic Commercial B 1REROOFRES Re-roof Residential B 1SFDWLROOF f 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 •