08110068 CITY OF CUPERTWO "17 ''-fib rarmk '"
eg'SLDING.'VISION PERMIT '4CONTRACTQR INFORMATION'
BUILDING ADDRESS: - PERMIT NO.
7,645 WATERFORD DR SOUTH VALLEY ROOFING ogjlno6sOWNER'S NAME: PERMIT ISSUE DATE
lNE: AAFA 9 0 8 CONTROL NO.
op (408)269-1698
ARCHTIECVFNGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
M 0 p LICENSED CONTRACTOR'S DECLARATION
U I hereby affirm that I am licensed under provisions of Clupw 9(commencing lob Description
with Section 7")of Division 3 of We Business and Profusion Code.sad my license is
in full farce and enm C 3q RE-RF T/0 EXT ROOFS INSTL 7/16" RADIANT.
^ H
:lad LieeraseClas Le" CERTAINTEED PRES CLS A 32 SQ BARRIER OSB 30LB FLT
nFp Dax 1� 1G/A0 conuuaor,
7W —"7Zv'I TA cs5 HTEcrSDECIwR + 7 VENTS
< 1 omemand my Plan shall be usod as public records Pmfinq
lie _I
g G Liceammd Pnsfcstlanai
u H 3 Oat I am empt f m We CoATION
qy 1 heeby osLrm that 1 1. exempt from We Cssions rs License taw for he
`p0 followingmoon.permit
7031.5,Business and Professions Code:Any dry or county
whim rets sa a permit ac sin the, althc impmsu do Permit
t or repair any structumwmcnt '
-zr pAmWiss istnna.ilsu requiw de applicant for such permit mo filcasignmstammenm
< that heisliccmed pumuntmhc pmriaian of ahc Conuacmr's Bane law(Chapaer9 Sq.Ft.Floor Area Valuation
s. that he wing with Serafrom Ina)of Division S of hasped pd-Any violation
of
y�3 that he is eawP ahrefram sod tae buis fm do aimgm aunption.Any violation of $15000
section 70513 by any applicant fm a permit subjecta the applicant to a dvil penalty of APN Number Occupancy Type
amt mom dun Bw hundred dollars(5300). 36617085 . 00 -
❑L u owner work,tae doestrty,or is of mucadd ers with wages r her sole cmWPemeuon,
will do lne nCodec he Cont Is not i Licause offered far sale tApply 7044,Business
and Pmruslobu Cmc:The Cenuuma's L dwW Law don not apply W an.mono of Required Inspections
property,lona builds n impmwa heman,and who does such caret himsrlfor Wvugh his
owv nna,th building
uiproMded dor such impmwd wit art not intendsmplfewd far theaak,If,
however,the Wilding or improwmainis mrd within on hold ofcmnpletif r We owner-
eak.). wild have de WaNera of proving aWt k did not duW er imPow[m purpose of
❑L as owner of the Papeny.am acla dvcly contracting with licensed commences to
convect the Mica(Sec.7044.Business and Pmremtlon Cade:)Tlm Comraemfs Li.
cane Law docs not apply an an owner of property who builds or impmws hereon,and,
who contracts for such projeeu with a eonmacmds)licensed pursuant W We Contrutoes
Lwoum Law.
❑I cam amept under Sec .B&P C for this moron
Owner Dam
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under perWty of Perjury aro of the following declaretimae
41 1 bsw and win maintain a Certificate of Consent W self-imum for WorkersCompen-
cation,u provided for by Section 5700 of the Later Cade.for the PeAoman¢of We
work for which his permit is issued
❑1 have and will maintain Workers Compensation Insurance,at required by Section
5700.1'uta Latter Code,fa We parfmmanee of he,work for which this permit is luued '
My Workers C�omyP�.wl uQan Inrsunna c�agnv arW Polity number art: p�f
Cartier. �.11 Wll. Yt�nU Policy Na.: 10-69 - 1f�l'O
CERTIFICATE OF EXEMPTION FROM WORKERS' '
COMPENSATION INSURANCE '
(Oris scrum need notbecamplced if he Permit is froom hundred do0an(5100)
o Ins.)
1 Mmfv that in he Performance of the work for which this Permit is Wood.I shall an,
employ inypeame in any manner an at m became subject to he Worked Compensation '
Laws of California.Dam
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption:you should
became mlajaa to he Worker's Compensation provision of the Labor Code,you mum
O forthwith comply with such provision or his Permit shah be dams mated
Z N CONSTRUCTION LENDING AGENCY
(r l hereby aRam hal Wert is aronsuuction lending agency for the Performance of
a> We work for which this Permit is issued(Sec.5097,Civ.C.)
W� Q larder's Name
D z Lenders Ammts
V C T comfy,that 1 haw rod this application and sum that he about information It
ty!' carom I agra m amply wih all city,and county ominancea and roam laws relating W
.O SU" Wilding anvrunim.W hereby authorise mpresauuws of hu city W mace upon he
W aMw-monuomd progw y for impaction parpotes
(We)agree m taw,indemnify and kap hannlrss the City of Cupertino against
fa'j1 Iiabiliva.jmgmenu.cnu and exis:nw which may in any way mace agaimisad City
Dale yj
V z in con pabc=err the strung of his Pmit /
^+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
C// nt '' G.
sOURCE{i UI.ATIONS
sign / , apprcaamcenuaCWr —•1/
�'�� Re-roofs �—
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will t e applicant err rumors building occupantsmrn m handle hasandon material
as de0md by the Cupertino Municipal Code.Chapter 9.17.and the Health and Safety
Cate.Section 255324)7 All roofs shall be inspected prior to any roofing material being installed.
oyn No
Will he applicant to uturt building aropant tax equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It hovardon air contaminants dcfiad by he Bay Area Air Quality Management all new materials for inspection.
iter t7
Yn u
I haw mad tae haws mamriab regmmiremenuunder ChaPmr495 ofhe Calirm-
nu Hnlh&Safety Cade,S.-0.0505.25533 am 25514.1 undemand haifue Wilding
does an,currently haw•mnsnt u m mcpecribility W noufy the arcupant of the
rom It hichmurs et Ora to r Signature of Applicant Date
.cane natixtasat Dam All roof coverings to be Class'%?."or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36617085 . 00
DATE ISSUED. . . . . . . : 11/18/2008
RECEIPT #. . . . . . . . . : BS000006643
REFERENCE ID # . . . : 08110068
SITE ADDRESS . . . . . : 7645 WATERFORD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : FELICIA ALBRIGHT
ADDRESS . . . . . . . . . . : 7645 WATERFORD DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : CHRISTY J METHOT
CONTRACTOR . . . . . . . : JAMES METHOT LIC # 20837
COMPANY . . . . . . . . . . : SOUTH VALLEY ROOFING
ADDRESS . . . . . . . . . . : 4960 ALMADEN EXPWY
CITY/STATE/ZIP . . . : SAN JOSE, CA 95118
TELEPHONE . . . . . . . . : (408) 269-1698
• 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
1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 0 . 00
---------- ---------- --- --------
TOTAL PERMIT 417 . 50 0 . 00 417 . 50 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------------- --------------- ------------
CREDIT CARD 417 . 50 MC
---------------
TOTAL RECEIPT 417 . 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
eTelephone: (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 1/4 " 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: rBd I a t t !/' II//�.�
Job Site Address: 1 ll - W U,7•C��l rd( br
Roofing Company Name: 3OU4-h 11al V (� W/ (nq
Applicant's Signature: 1M1 & Date:
Greg Casteel
Building Official
Revised 07/30/08
OF11004 ?
CITY OF CUPERTINO
REROOF
CUPEkTINO PERMIT APPLICATION
APN # �. Date:
oo
Building Address: -W,+5 W0,+ �-f0r-d D Y V&
Owner's Name: 4 Ci Phone #:
408 x.5'1 g
Contractor: I Q jJ�J/� Phone #:49 j Ocll_aQ q57
a1u-1 Y l Val w koc l I 1 Fax#: � �o — IAQ I
Cupertino Business License #: c�-GR Z-7 Contractor License #: Z 5
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ shalt Shingles I^,) K Asphalt Shingles
• cf Wood Shakes QUI I I Cm rgvI t7 d ❑ Wood Shakes
Wood Shin le ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
tY To be Removed ❑ Provide Mfgr. Installation Specs
Job Description: +/D -easy ocj rv„ s i� �� l 7/to/ " k , t6.f1 ,�-
3Z 5A Mrri� D� i ?o f b.�/��I �', VeilfI 4 l
Residential [l / 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: 15,0 DO
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
&t j)UA2t
Signature
Revised 6/16/08