08100169 CITY OF CUPERTINO J "a:: '•s=+c • . .;t a�' + �' `h"-r`* r
BUILDING DIVISION PERAUTCONTI glt-To l,NF,OURMATI�ON,, ,.
BUILDING ADDRESS: PERMIT NO.
8159 PRESIDIO DR DIAZ ROOFING '
OWNER'S NAME: PERMrr ISSUE DATE
E: A O. CONTROL NO.
(925) 565-0960
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECN
w o o LICENSED CONTRACTOR'S DECLARATION Job Description
1 hereby arlimt boat 1 w li¢nsW under provisions of Clupmr 9(commencing p
wsh Section 7ONy)ofOiviskm 3aft Business and Professions Code,and my licenx Is
+ H inpoll force,andwf 3Ol ung 8 RE-RF T/0 EXT RF& INSTL OSB W/30LB FLT&. INSTL
pqz Lt..nese
Ca=� Dam Commuter COMP
rE ARCHr1=DECLARATION
i=< Iunderwndmyplans shall Is,used as public mcoNs CLS A 30SQ
5yu
G in Licensed Profcasiovl
5OWNER,BUIMER DECLARATION
f 1 hereby a1Rnn
that 1 jun ucmp from the Cawrutars License Law for the
00 following wan.(Section IU31.5,Burd.and Profeesims Code:My city or county
$lar which reauum a permit to cmmrucL ober.Improve,demolish,or repair any structure
orb is issuance.aha requiremm
s am.ppliesnt fursech peit m 0le.signed samen
tat
to ha is licensed fameam to de pmvisionsa me eaawemra Licemn naw(Cltmer9 Sq.Ft.Floor Area Valuation
y�g (commencing with Section 70m aDivision Sof Ne Business arta Pm(essiov Code)or
`<- Nat he is commit ti erefm n and the basis far the megnd exampdam Any viohdon of 16500
Section 7031.5 by any applicant for a Permit subjects the applicant to a Civil Penalty of APN Number Occupancy aryl
em mom than five hundred dollars(SStIM). P y `'
I,a warof the ynmp oyw W pima 35611087 . 00
❑ pmpmy,am 1 w offs Asda (S..7om dans
send p e wort-and the he Com s aces 1-nded ar caw don,
Out.(Sec.7044,Owner o•
and enywhoma Cade:lie tut dan ors cad who law aura not ropy m an Owner Cir Required Inspections
man erry who Wildsorimprows chicon,and vets mea avhwark himewfw Nromic his
awnemployes,pmgaedthat such bmprovemwt erean,mmndeaaraRated formic.R.
however.tin Wildingarimpupro,inhhalowithinarcyearofcprovefrthewar-
baildm olid h.ve the When of proving Out bo did trot build Or improve Tor purpose of
aldJ.
❑1,as owner of the property,arm exclusively conaaming with licensed conmamrs m
construct the pmjea(Sec.7044.Bmbmss sod PmfestiOns Cade:)The COYmaemra Li-
cause Law does mat appy m an wasr of poPerrY who Wilds or impose daemon.and,
who contracts for such pmlec s with a comracub(s)licensed pursuant to the Conmactor's
Lmmaa law.
❑lam esempt under See ,B&PCforthisreaon
Owner Das
WORKER'S COMPENSATION DECLARATION
I hereby affirm under pemaity of perjury arc of the following declmtiom
have and will maintain a Cenific re of Consent m self-insum for Workcra Compen.
on,as provided for by Section 3700 a the labor Code.far the performance of the
work fur which the permit is issued.
❑1 have and will maintain Woakers Compensation I..as required by Section
37W athe labor Code,far dac Pertomance ache wok far which this permit is lune
My Work!? Co/m_p d lnsyLea'�,ta�carla and Policy number am:
carrier. �ITLi�"e Tlvlf 6l' Policy No.:
CERTIFlCATI30F E%EMPrION FROM WORKERS'
COMPENSATION INSURANCE
mals scNw need an,he completed if the permit is(arone hundred dollars($100)
or tars.)'
1 certify that in dm performance a the work far which this Permit is bssuN.l Nil not -
employ any person in my manacr an as in become subject to Ne Workers'Comp mMoa
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If.afar making this Ccaificam of Eacmpmn.you should
become subject to the Workers Compensation Provisional of the faEOr Cods,you mm
Oforthwith comply with men provisions or this permit shall be demand invoked.
z2 CONSTRUCTION LENDING AGENCY
(-�— IAerebl.M.shat Nem h aconswNnn lendbng.pen:y,for Ne peillmor 4
C > Newark far which NLs pmmis s issued(Sm.3097,Civ.C.) .
QLenders Name
D z Lenders Addw
U Q 1 mrtify that I have mad this application and sum that the above infamutiun is
ly correct,I agree to comply wish all city and county aNbuves and stale laws msdng to
.� Wilding conamction,and hereby author repmanwiws of this city to cher upon ft
LT) ahuve-mcntionea"Kay for inspection purfases.
(We)agree in ave.indemnify and keep harmless the City of Carper i..gaivt
(ZI Uabilithmjadgmcns,ensu and expenhaa which may in any way acme against said City
U in consequence of the granting or this permit.
► APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE GULATIONS.
in/27/M Re-roofs
A�l —
SidmarAppioMComrxmr Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Ne applicant w future Wilding owmpentamre or handle hmsNov material
as defined by the CuPenino Municipal Code,Chaptar 9.13,and Ns Health and Safely
code, ham 25532(.)?s3z(a)+
0Yes py yyyNa All roofs shall be inspected prior to any roofing material being installed.
Will the.pplicant Or future Wilding Occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
hsrWad,air contaminana a defatcd by the Bay Area Air Quaity Management all new materials for inspection.
.rola?
❑Yes 94-NO
I have mad the haaatdav mumnals mquircmens under ChmW6.95of the Califor-
nuHesW&Safety Cade,Stoats 25505.25533 and25.534.1 undcmand andifthe Wilding
dos rot Currently baw a mens n.than it is my responsibility m may the=upset of the
requirewnowhicnmmx oe or ofa Cenlfemear Occup Signature of Applicant Date
v All roof coverings to be Class'%?"or better
Ow r amcd tgcm Dam'
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN 35611087 . 00
DATE ISSUED. . . . . . . : 10/27/2008
RECEIPT # . . . . . . . . . : BS000006469
REFERENCE ID # . . . : 08100169
SITE ADDRESS . . . . . : 8159 PRESIDIO DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : U P SWONOY
ADDRESS . . . . . . . . . . : 8159 PRESIDIO
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4027
RECEIVED FROM . . . . : RODOLFO N DIAZ
CONTRACTOR . . . . . . . : RODOLFO DIAZ LIC # 26457
COMPANY . . . . . . . . . . : DIAZ ROOFING
ADDRESS . . . . . . . . . . : 4652 SHETLAND WAY
CITY/STATE/ZIP . . . : ANTIOCH, CA 94531
TELEPHONE . . . . . . . . : (925) 565-0960
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- - --------
1BSEISMICR VALUATION 16, 500 . 00 1 . 70 0 . 00 1.70 0 . 00
. 1REROOFRES SQ FEET 30 . 00 390 . 00 0 . 00 390 . 00 0 . 00
TOTAL PERMIT 391 . 70 0 . 00 391 . 70 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- ---------- -
CHECK 391.70 #5624
---------------
TOTAL RECEIPT 391. 70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- -------- -------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
t
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/ " 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: �Jv, /�� Gq
Job Site Address: g1�2IC�(O
Roofing Company Name: A-4
Applicant's Signature: Date: 10 I V(09
• Greg Casteel
Building Official
Revised 07/30/08
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
PEI�TINO Fax(408)777-3333
OU
Building Department
JOB ADDRESS: PERMIT #
151 �restd�o D 6 6?
OWNER'S NAME: o 2 PHONE #
GENERAL CONTRACTOR: - TPCL n FAX #
I am not using any subcontractors: �r^"C l O(27 10'�,
Signature Date
Please check applicable subcontractors and complete the following information
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
Owner/Contractor Signature Date
CITY OF CUPERTINO
l�R REROOF
*CUPERTINO PERMIT APPLICATION
APN # �5�/ / U d Date:
Building Address:
5
Owner's Name: Phone #: c.(p:S -253-4-7(4y
Contractor: Phone #: 9SoU
2 - �CoS-09(
ra
1pa V coo PIN(1 Fax#:
Cupertino Business License #: Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles )�. Asphalt Shingles
)L Wood 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:
Thr CK (N rz Vk von vcoF osr1 krfs , , 053 W kMn \b
ar6 tnsbu
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:
•
Sign re
Revised 6/16/08
CITY OF CUPERTINO
REROOF
C1 OF
CUPERTINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
� 41 1RER00FRES Re-roof Residential . B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08