08100119 CITY OF,CUPERTINO
BUILDING DIVISION PERMIT CONTI2A.C' OR`INFURMAION..
BUILQIfjC(�IpDjtF5NPERMIT NO.
OONAN CT LOS GATOS ROOFING 08100119
OWNER'S NAME: PERMIT L'SE DATE
LOW BRIAN P AND GIT P P 0 BOX 1726 10/20/2008
NE: SANITARY NO. CONTROL NO.
ARCHITECr/ENGINEER: BUILDING PERMIT INFO
RE—RF RMV EXT SHK RFNG INST BLDG ELECT PLUMB MF-cx
0 0 0 0
upQ LICENSED CONTRACTOR'S DECLARATION Ib Description
F 1 berth,affirm WO05Ci1I7
t I am licensed under provisions of Chapter 9(eomm=ing
xauj iN Section 70(18)of Division 3 offt Business and Profeuions Code.and my license is
n<a thfullfarceand. ct 7l/7
License Class Lto.g
Contractor
7W RCHPIECI'S DECLARATION
1 audessmnd my plans shall be need as public records
U
kw� Licensed Professional
OWNER.BUILDER DECLARATION
m 1 hereby affirm that I am exempt from the ConuacmYs Uccnw Law for the
O O following reason.(Section 7031.5.Business and Pmfessns ioCmk:Any city or county
e m_ which requires a permit to termed alter,improve,dinumi m,or repair any shucmre
nti prior to its issuance.also mquima the applicant reattach permit m Em a signed statement
F C Nat he is licensed pursumttothe Provisions Ofthe ConuaztolsLic.r.Law(Chapter9 Sq.Ft.Floor Area Valuation
y.S (commencing with Section 70D0)of Division 3 of the Business and Professions Cade)or
y Nat he u exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subject the applicant to a civil penalty of APN Number Occupancy Type
not mare ther Ess hundred dollars(5500).
I,as owner of Bic property,or my employees with wages a then sole compensation,
will do the work,and Nestremm Isnot intended or offmdl formic(Sec.7064,Business Required Inspections
and Professions Cade:The Commutes License Law dao e not apply b an owner of q P
pre,rty who buiIdamimpor.thereon,and wMduessuchworkhimselforduough his
own.Mployens,pmvide t that such improvements are notinended oronemA for We.B,
however,the building or impmvemmn is mid within one year of completion,Ise own.r-
builder will have the burden of proving deet he did not wild or improve fa Purpose of .
samJ.
❑1,as owner of the prop rty,ars exclusively contracting with licensed mmmaters us
construct the project(Sec.7014,Business and Professions Cade)The ConeacmYs Li-
cause law does not apply an an owner of property who builds or improvns themes,and
who contract for such project wish a contactor(s)licensed pursuant an dve Conomises
License Law.
❑I are exempt under See ,B d PC fathis mason
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury oro of the following declamations:
i have and will Madrid..Certificate of Consent o selNomon fa WaYm's Cmnp.m
nt(m,as provided far by Section 3700 of the Labor Code,far the perfmmaas of the
work for which this Permit is issued.
$T have and will maintain Workees Compensation lose.,ss inquired by Section
3700 of the Latta Code.for the Performance of the woh fawhich this permit is issued.
My WmImes�agryp�eread.Yuen.artier and Policy number am:
Camer:�A•Q!V FIN✓W Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu saBon need not M completed if Re permit is for ane hundred dollar(5100)
or less)
I certify that in the perfumuae of ths work for which this Permit is bound,I shall not
employ any'person in any reamverse v to become mbjeel to the Workers'Comperuauan
Laws of Cathlee iu Dam
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Exemption,you should
become subject an the WorkeYs Compensation provisions of the labor Conn.you menu '
.,O forthwith comply with such provisions or this permit shall be deemed reeled.
Z ti CONSTRUCTION LENDING AGENCY
'r+ I bemhy.firm that them u s coustrvctlm lending speay,for Ica perfanmance of
!Yi ti the work for which this permit u issued(Sec.3097,Civ.C.)
(g1 Q Lender§Name .
] Z U.&es Address
V O I certify that 1 have mud this application and sum the the above iNmmalim in
IL,^r corrin 1 agree to comply with all city and comfy ordinances and some laws malting m
O V building construction,and hereby mthorinemponeefeafimofthis city to cover upon the
r [37 above-mentioned property for impccdon purposes.
(We)agree to ave.indemnify and keep homeless the City of Cupcnina ag mat
y liabilities,judgments.cast and expenses which may th my way acerae against said City
V 2 APPL CANT UNDERSTANDS of the grourninj Of AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Signatom ofA,,Iicm[PCmIractor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building aaupantatere or handle ba>ardous material
se deEncd by the Calamine Municipal Code.Chapter 9.11.and the Health and Safety
Cade.Semon 15531(.)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yca ❑No
n Will the applicant or fume building occupant use equipmml Of devices which If a roof is installed without first obtaining an inspection,I agree to remove
m hamrOM.air cmuminanu ss definer by Ne Bay Area Ah,Quality Management all new materials for inspection. _
Disrict7
0 Yes ON.
I have real doe hvardsmsmaverialsmquimmmt undcrChapmr6.95 of the Califor-
tiaHcalthlkSafetyC.&-Secdoscs 5M5.15533 md25534.1undeusmnt Ntifunc building
does not currently hero a tenant that it u my respnsibility m notify the occupant of that
requirement which more he fent prior to issuance aft Ccrificeve of Occopeneq. Signature of Applicant Date
Owner or authomcd agent Dam' '
All roof coverings to be Class"'or better
CITY OF CUPERTINO
• 2 ITEMS OF 10 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35719068 . 00
DATE ISSUED. . . . . . . : 10/20/2008
RECEIPT #. . . . . . . . . : BS000006404
REFERENCE ID # . . . : 08100119
SITE ADDRESS . . . . . : 21736 NOONAN CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOW BRIAN P AND GIT P
ADDRESS . . . . . . . . . . : 21736 NOONAN CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5912
RECEIVED FROM . . . . : LOS GATOS ROOFING
CONTRACTOR . . . . . . . : RANDY BROWN LIC # 23481
COMPANY LOS GATOS ROOFING
ADDRESS . . . . . . . . . . : P 0 BOX 1726
CITY/STATE/ZIP . . . : LOS GATOS, CA 95031
TELEPHONE . . . . . . . . : (408) 298-9399
• FEE ID UNIT QUANTITY AMOUNT. PD-TO-DT THIS REC NEW BAL
---- ----- ---------- ---- ---------- ---------- ----------
1BSEISMICR VALUATION 6, 480 . 00 0 . 70 0 . 00 0 . 70 0 . 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 338 . 70 0 . 00 338 . 70 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- - --------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
Commun ty 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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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: _ Bhq n Lau_j
Job Site Address: c2 'L 3 ,� zVooI2C"
Roofing Company Name: os /TCt �rJ c �� /i) q ,
y n
Applicant's Signature: 16)M J Date:
L / a
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
e 'T Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
GtUPSCI INO
Builth¢ Department
JOB ADDRESS: n D��!/
v� /PERMIT q
oL 6 U U
OWNER'S NAME: f L PHONE _ f eP CJ G>
GENERAL CONTRACTOR: J G:� DS FAX
I am not using any subcontractors:
Signature D to
Please check a 1icable subcontractors and com Tete the followin information:
SUBC0NT-ACTOR BUSINESS DAME 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
Own /Contr or Signature Date
CITY OF CUPERTINO
�` ' REROOF
Cin OF
CUPEkj1N0 PERMIT APPLICATION
APN# CD
Date:
Building Address:
l 23 oar
Owner's Name: Phone #:
z
J_
Contractor: 1 V S c_`L L' E` C�C7 y 1 r �� Phone#: .LI616' -2 e)s 9�y
tv J Fax Jgt - 9L3
Cupertino Business License#: Contractor License #:
� 0q �- .3co1? 07
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) -J716, QSB
Number of existing coverings I ❑ Provide I.C.B.O. eport#
To be Removed Provide Mfgr. Installation Specs.
Jo Descpption: � .e' , 7
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Plamring Dept. if
there are any restrictions: ❑
Valuation:
,7
I Have Read, Understand and-Will Comply with Cupertino's Tear-Off Policy:
O
Sig�ure