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08100147 CITY OF CUPERTINO BUILDING DIVISION z�� . gx4XINFO' RMT PERMIT ON BUILDING ADDRESS: PERMITNO. 7596 ERIN WAY ROSSETTAS ROOFING OWNER'S NAME: PERFUT ISSUE DATE NE: O. CONTROL NO. (408) 294-4400 ARCHITECD'ENGINEER, BUILDING PERMITINFO BLDG ELECT PLUMB MECH 0 0 0 0 00c LICENSED CONTRACTORS DECLARATION Job Description U C 1 kreby aRrm Nat 1 am licensed under pmvuiwu of Chapter 9(commencing P n�1ns with Swtion7seatOM0of D!Ai on3ofdu Rusin dPmfe =Code.admyliccesson _may mmnfonecnecrc _ Do` RE—RF T/O SHKS INSTL 1/2CDX PLYWD INSTL NEW ELK DamC1 0 Contru+w wjeJUYR RF CLS A 30SQ et; ARCHI'IERSOECIARATION ? U 1 understand my plans shell W seed u,hlic records lea O t; Licensed Pmfesalowl qqq 3 OWNER-BUILDER DECLARATION y i F I ICreby afli.that I am exempt from the Contractors Uccom IJw far de, e O O fo ollowing mon.(Section 7D31.5.Business and Professions Code:Any city or county $ which requires a permit m no utuuct,alter.improve.demolish,or ropalr any structure prior teas issuance.arm requires the applicant for such permit to file a signed statement thus,Ito is licensed patwam to the pmualons of the ConnecmrsU.n.Law(Char=9 Sq.Ft.Floor Area Valuation t (commencing with Section 7000)of Division 3 of the Buuwas stud Pmfeuiou Cods).1 3 that he is exempt tMrtlrom and me basis for flee alleged eumption.Any violation of 15 0 0 0 session 7031.5 by any applicant fee a Permit subjects the applicant m a civil Penalty of APN Number Occupancy e not mom men live hundred dollars WAM 35921022 . 00 P YTYP I,u tun of the property,or my employcs with wages as their sole cempees duhm, will do the waft and the structure is not intended or Offered for sale(Sec.7M4,BneineV Required Inspections and Pneresslons ends The Commrwmrs Licensees Law donot apply in an maw 9 P pmpeny who builds or i m proves thereon,and who dos such work himul f w thmugh hu own emplayess,pmvided thatsuch improvementsart not intended oroffemd for ale.if. however.the building w impmverearst u sold within ane yw of completion.the owns. builder will ban the sunder of proving mat he did nat build or improve for pumoso of sale.). ❑1.u moss of the property w exclusively contracting with liwrued contraclwa to wmtmct the Project(sec.70x4.Business sod Professions code:)The contractor.U- to=Law does not apply b an manor of proper wine build,or impmm demon,and. who contracts for such omjcets wish a mntrac ot(s)licensed paramount in the Conuacwrs Licesse law. ❑letnaemptundersee .B&PCforthumuon Owner Date WORKERS COMPENSATION DECLARATION I beteby,arum under penalty of pcdwy nor of the following declarations: 411 have and will maintain a CeniRose of Co..[m uhf-insuro for WorkersCmulam- on,a,provided for by Seedon 37M of the tabor code.for the performance of dee workforr which this permit is issued. p I nave W will mumam Workers Compewtion I...as unspotted by Bettina 37W of the Labor Code.qJk me performance of the were for which this permit is issued My Workers C amw W Polity num art: _ Cartler. C Paliry No.: Z i- 117y CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Thesscodue wed her W computed irthe permit 1,fororro hundred dollars(5100) or leu) I cenify that in the purformawe of the wart for which Nis Permit is issued,I shall not employ any person in any mannerm as no became subject m the Workers'Compeunion Lav,of California.Dam Applicsm NOTICE TO APPLICANT.IL after making this Certificate of Exemption,you should become subject in me Wafters Compcuasion previsions of the labor Code.you most .�z forthwith comply with such provisions or this permit shall be domed revoked. z O CONSTRUCTION LENDING AGENCY [--I I bereby affirm der mem is.coutrwsinn lending agency for the pmr....of rr> tiro wish for which this permit is issued(Sec.3097,Civ,C.) 0 Lenders Name ' ] z tenders Address U Q 1 wmify met 1 ban rad We application and some thu the above information is gL t" COMCL L agree in camnply with all city and COWIy Ordinances and mon law,relating to .0U Wilding construction,and hereby authorise repecsomdm or this city in enter north use W above-mentioned property for inspection puriuus (We)agree to ave,indemnify and keep homeless the City of Cupertim,against fajl liabilities,judgments,costs and expenses which may in tiny way accrue against said City (� C)z A APPLICANT of thegods[of this permit. y '—' APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued b Date SOURCE GU TIONS. Ip23 4 Re-roofs SignarrtofApplia1Dam HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applianl or future Wilding wcupantsmre w handle haxamous material u&Rwd by ft Cuw m Muni l Con.Chapmr 9.12.ad dm Halm ad Salety Code.section 25532(.)? All roofs shall be inspected prior to any roofing material being installed. [j Y. p46 Will the appli sm or future Wilding ompant use equipment or dcvicus which If a roof is installed without first obtaining an inspection,I agree to remove ,it haurdnus air chr uminanu u defined by me Bay Area Air Quality Management all new materials for inspection. WlclT ❑Yes No I have mad the hvardmu materials requirements under Chapter 6.95 of the Califon. me Hahm&Safety Code.Seen.25505.25533 stud 25534.1 undersand that if the Wilding Jaa not currently neve a meant Wt it u my responsibility m notify dmce ouosot of dro regnremen whithm -put mho issuanceofaccrufeamofocaprl S Signature of Applicant Date v Ownerwiwhurnsdagnni Dow roof coverings to be Class'Rx'or better CITY OF CUPERTINO • 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 35921022 . 00 DATE ISSUED. . . . . . . : 10/23/2008 RECEIPT #. . . . . . . . . : BS000006443 REFERENCE ID # . . . : 08100147 SITE ADDRESS . . . . . : 7596 ERIN WAY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . .. ROLAND KENNER ADDRESS . . . . . . . . . . : 7596 ERIN WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014 RECEIVED FROM . . . . : ROSSETTA' S ENTERPRI CONTRACTOR . . . . . . . : ROSETTA, DAN LIC # 20781 COMPANY . . . . . . . . . . : ROSSETTAS ROOFING ADDRESS . . . . . . . . . . : 401 LINCOLN AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95126 TELEPHONE . . . . . . . . : (408) 294-4400 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC . NEW BAL --------- ------- ---------- ---------- ---------- - - 1BSEISMICR VALUATION 15, 000 . 00 1 . 50 0 . 00 1 . 50 0 . 00 1BUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00 1REROOFRES SQ FEET 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00 ---------- ---------- ------ ---------- TOTAL PERMIT 501 . 50 0 . 00 501 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 501 . 50 #14724 --------------- TOTAL RECEIPT 501 . 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 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: t � ,y Y wtu Job Site Address: 02 Roofing Company Name: t 24S+�p� C', S `.A- . Applicant's Signature: Agm)L Date: Z3 �g • Greg Casteel Building Official Revised 07/30/08 it CITY OF CUPERTINO Saw REROOF •CUPERTINO PERMIT APPLICATION APN # _ Date: � u23lAo Building Address: _ Owner's Name: Phone #: T-zC- G'1tog Contractor: nW fs „b c Phone #: k,)8 - 29 t!- kYob 1l '�c� Fax #: aQ 29Y-7-�YY Cupertino Business License #: 0`2n Contractor License #: Type of Roof Covering: Existing: Proposed: a Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles e' Asphalt Shingles ar'Wobd Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other(Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.B.O. Report # (;-jnN . ❑ To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: 1 1 1 i• Sze 9— Ys/} 0 -r'0 S1�lkcf� Pit ICU QK P�� 1�+.,�- ' to-! {^t-W (��C 3�yr rf 'f' 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: S I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: Signature Revised 6/16/08 � CITY OF CUPERTINO (i, REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1RER00FC0M Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 3 1RER00FRES Re-roof Residential B 1SFDWLR00F IBSEISMICRE Seismic Residential B IREROOFMRES Re-roofMulti-FamilyB 1MFDWLROOF 1BSEISMICRE Seismic Residential B IBUSLIC Business License B Revised 6/16/08