08110020 CITY OF CUPERTINOa
BUILDING DIVISION PERMIT " COIVTRAC'I'.O,R NFORMAT�ION.
BUILDING ADDRESS: PERMIT NO.
1333 PRIMROSE INSULLIVAN_RQDF_1NG__ 08110020
OWNER'S NAME: PERMIT ISSUE DATE
p A CONTROL NO.
408) 842-1057
ARCHITECTMNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION Job Description
rd=C I bunchy from that 1 w lixnad under Pre isimn or Chapterenc
9(comming
<tJ with Section 70M)of Division 3 of the BumocasoMd Profeuiom Codec, myliccnmu
force and I RE-RF RMV SHKS INSTL 7/16" OSB 30LB FLT 30 YR
-'r o m�—c tumor COMP
ARCHTIECTS DECLARATION
I understand my plans Nall W umd as public records SHNGLS CLS A 23SQ
O
le G In Licensed professional
OWNER-BUILDER DECLARATION
X 1 breby a/lim Nat 1 em exempt from Um Commetoes I3cense Lew for the
COO following moon.(Section 7031.5,Business and predictions Cale::My city or county
$ which mpubus a permit to cmxm ml amen.improve,demolim.or repair any amarum
i prior w its issvme.also mquims the applicant for such permit to rake&signed atmmem
E o than hekransedpuned.nl1.tmprovisioNofthacanbacmrsu«nseLaw(Chap-9 'Sq.FL Floor Area Valuation
.4s moremencng with Suction 7000)dDivision 3 ofine Busimessand Pcofeaions Code)of
y that he is exempt tort from and the basis for the alleged exemption My Notation of 0 0
Section 7031.5 by any applicam fee a permit subjccu the apse icxt to a civil penalty of APN Number Occupancy Type
trot moa WTI fw,hundred dollars($500).
1,uowna ottia: 36617044 . 00
❑ thermucturmyotime.wwithw&gvame,(sole 044.Buatm,
will tlomewodc andthe caecumm me,Lt. oraw dofar sale(Sec.]Oen.Owner
and Pmfrtians coda:The nstherem,Liana law amus Out apply lf an owner is Required Inspections
man
property who .providds mprowamimprowdwho aahemmwork bed oroelred maximrough hu
awn[ ,taw,proHtledmatsuuhntis mid within
net inundndmPkOeefatale,r-
Wild. the building orimpmvemmlisholdedid oa year or completion,theownery
Wtdv will love the burden of pouring that k alai rot Wild a improv(a purpose of
ale.).
❑1,a ower of Ih property,am exclusively contracting with Banana centricmn on
mastrecl the pmjcn(See 7014.Business and promotions Cade:)The CootracmYs V-
ave Law dos not apply to an ownv Of property who Wilds or improves themmm,and
who rnntncu for such projects with a contracom(s)licensed parental to the Camsanv's
Liana law.
❑l un exempt under gee .B A PC for this reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affmm under penalty or perjury aro of the following declaration[
1 haw and will maintain a Certificate of Consent o mlf-Wum for Worker's Compact.
n.so provided for by Suction 37M of the labor Code.for tb perfarmana of the
one for which this permit is issued.
1 Noe and will maintain Worker's Comiseva0an Insurum e.a acquired by Section
3 of the labor Code.for tW Krim...Of mere work tar which this permit Is laid '
My Workers Comipua unarm¢artier and Policy num
Carrie. Polity No.: tcw
CERTIFlG7E OF LI MON MOM WORKERS
COMPENSATION INSURANCE
renis scNon aced rot W canpleud irthe permit is foram hundred dollars(SIM)
m less)
I eeniry that in the perfomane..I ton work for which this permit is lattice.I"I ml
..play any person in any mannerw as he become subject to the Worters Compensation
Laws of Cadir.mis.Dam
Applicant
NOTICE TO APPLICANT:If.after making iris Certificate of Exemption,you should
becmne,subject an the Workers Compensidon provisim of the labor Code,YOU muss
oral O forthwith comply with such provisions or this permit Nall b domed revoked.
„'zy 5; CONSrBucnON LENDING AGFNCY
'r-a.N-r Iburebyelrum mhuthcm isacomulnuctm hudingagenry,forthe pvfomenaaf
C. the work for which this permit Is issued(Sec.3097,Civ,C.)
WM Q lsndcrs Nixon ,
z sanders Mnm..
V 0 1 curtly that 1 bare mad this application and sum than the show information Is
lar ^ corm I agar to comply with 41 city and county moinamost and sum Ion mining to
.C) Wilding construction.and hereby authorian repmaentauves of this city to enter upon me
fJd atmve-mendoned property for inspection purposes
G (We)agree to asw,indcmNfy and kvp beamlvs than City of Cupertino against
rp liabiliao.Judgmcnti ensu ora whim May in any v&y aacum against&ale City
V z Aeon1CormUNDE NDSykN of the, ag of this an OMPLY WITH ALL N N-POINT Issued by: Date
SO
�t
A —&—
SiRe-roofs
gtwu a Appli o r Dek
H US MATERIALS DISCLOSURE Type of Roof
Wil apC" am for=Muni Wal Coazmpatstomorand haallood Safety a dcMN by Cu 'm Municipal Code.Chapter 9.12,and the Health end Safety
Code.Section 2551 e)T
Cl Yu All roofs shall be inspected prior to any roofing material being installed.
Will theapi,i am or utum Wilding Occupant use,cqulpment cur devices which If a roof is insithout first obtaining an inspection,I agree to remove
t haearenue air comamlvnu a defined by me Bay Area Air Quality Management all new mate ' Is for peetion.
rinT
❑Yo r�Nm_j
I hew mad can bac; amambla mquimmew under Cluper6.95 ofthe Califor. 1 1
Nis HnlN&Sakry u5aa 25505.25533 and 25SIC 1uMvsunE thmd the building \`
dons ml cumnll) w a lasnt. mapauahiliay m maty me l of dm
w abnne orroiss ar,cnanamof Signat reofAplica Date
Owner aedmad< agent ,m All roof coverings to be Class'V'or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg,
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN 36617044 . 00
DATE ISSUED. . . . . . . : 11/05/2008
RECEIPT # . . . . . . . . . : BS000006551
REFERENCE ID # . . . : 08110020
SITE ADDRESS . . . . . : 1333 PRIMROSE WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : AUDREY CHEN
ADDRESS . . . . . . . . . . : 1333 PRIMROSE WAY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5229
RECEIVED FROM . . . . : KEVIN E SULLIVAN
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC # 23810
COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING
ADDRESS . . . . . . . . . . : 1696 VALLEY OAKS DR
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-1057
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- --
1BSEISMICR VALUATION 8, 500 . 00 0 . 90 0 . 00 0 . 90 0 . 00
1REROOFRES SQ FEET 23 . 00 299 . 00 0 . 00 299 . 00 0 . 00
TOTAL PERMIT 299 . 90 0 . 00 299 . 90 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 299 . 90 MC
---------------
TOTAL RECEIPT 299 . 90
VOICE ID - DESCRIPTION VOICE ID DESCRIPTION
-------- --------------------- ------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF V
•
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 Raid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/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:
Job Site Address: /333 P/�clhiQpSc�/ U—J7V'
Roofing Company Name: I6p�
Applicant's Signa. :-
• Greg Casteel
Building Official
Revised 07/30/08
CITY OF CUPERTINO �/�
'�d REROOF
CUPERTINO PERMIT APPLICATION
APN # 2)b (7 rO L/ O Date:
Building 3Addres : I
Owner's Name: Phone #:
Contractor: Phone #:
Fax#: 9¢`j-
Cupertino Business License #: C,gntractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles &Asphalt Shingles
u,,'/Wood Shakes ❑ Wood Shakes
40 ❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report#
❑ To be Removed ❑ Provide Mfg. Installation Specs.
Job Description: /2.0ii,".g S66azc,,6T1 r� C_7!6 ufg -{-30 b. i zT f 3-
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:
*nature
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
1BSEISMICO Seismic Commercial B
2, 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
Revised 6/16/08