08120106 CITY OF CUPERTINO
BulLolnc DIVISION PERMIT COI TRAGTOR'IN'FU' r TION
BUILDING ADDRESS: PERMIT NO.
10870 E ESTATES DR NUSHAKE ROOFINU- jNQ 08120106
OWNER'S NAME: PERMIT ISSUE DATE
ONE: A CONTROL NO.
(209) 239-8616
ARCH=fENGINEER, BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
000 LICENSED CONTRACTORS DECLARATION Ib Description
1 busby affirm that I am Imved OeSCiI under provisions of Chapter 9(commencing p
with Section 7")of Division 3 of the Bvinm and Professimis Cade,and my 1¢eme is
°may in full force ameffea rs RE—RF T/0 RF SOLID SHEET 7/16 OSB W/30YR COMP CLS
jnzq License Class Lis.
o&E Dam /�//.—'Xq Contractor Cc
i "k- T, A FIRE RATING 26SQ
9W ARCHrrECTSDECLARATION
w U I understand my plans shall W used as public records
6
5 o N Licensed Professional
5OWNER-BUILDER DECLARATION
a� f 1 bercby affirm Nat 1 est cxcmpl(rote tW Contractors License Law for tic
00 following mama.(Section 7W 0,Business and Professions Codc:Any city or county
$ which requires a Permit to construct,alma improve,demolish,or repair any structure
z y prig m its caned c,aim¢quires the applicant for such permit tu rtes a,Law
summcnt
xx< Nommen Consumes Sq.F[. Floor Area Valuation
iF$ that be s(commencing Section,and of basis n 3 them oriel euand Profusions Cade)or
—
that ha u exempt therefrom and the bait for the alleged,..mption.Any violation of 57800
Section 7031.5 by any applicant for a Puma subjects the applicants to a civil posse ty of APN Number Occupancy Type
oat mart Nan five hundred dollars ). 36922002 . 00 p y YP
D 1,u owner of the pmperey,army emplaych with wage v Nolo mic eompevadnn,
wnl dothesim..Code: he Csirtunots License
awWTarsale(Sec.in an Business
and Rofndobu Code:The Contractors and
Law doh Out apply lf rt own. is Required Inspections
property who b.pmA&d dral each
thereon,and who mesal amend k himselforthrough his
ownver.theWiprovidedthatsuchimProvnmmts>Rns intendedmoRered the oforsinee-
however.the Wilding m improwmral u mid within ane year of mproleefor the owe of
Wilder w10 have Bre bwdm of proving cut W did not Wild m improve for purpose of
vlcJ.
D 1,as awbor of the property ten exclusively canuatling with licensed mntrsemrs m
mnsuun the proem(Sec.7044.Business and Profnuiov Code:)7W Come¢urs Li.
cove law does not apply to an owner of property who Wilds or improves therton.and
who mnbacts for such projects with a conuauor(s)licensed r u mart in tha Contractor's
License law.
D l an exempt under See ,B&P C for this mann
Owner Dam
WORKER'S COMPENSATION DECLARATION
I herobY air=under penalty of perjury ane of the following declwions:
I have and will maintain a Certificate of Content to selNoons.for Wortcra Campcn.
ton,in Provided for by Section 3700 of the labor Code.for the performance of the
work for which this Permit is wood.
D 1 have and will maim am Wasters Compensation Imuran..u required by Section
37W of the lobar Cads,for the performance of the work for which Nu permit is issued. '
My Workers Compensation Ms... I.and Policy number art:
Caber. 1lvwvr:rot 44Policy No.: S31 R&13
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(ITU section bond not tacomplezu if We Permit is forooc hundrtd dollars(SIM)
or Ina)
1 mrtifv that in the perfarmaart of the work for which this Permit is issued.I shall not
employ any permit in any mammrm as to become subject to the Workers'Compensation
laws of Cafrunda.Dam
Applicant
NOTICE TO APPLICANT:IL after making this Certificate of Biennial.,you should
become subject to thc Workers Compensation provisions of the labor Code,you most
.J z faMwith comply with such provisions ser this permit shall W doomed revoked.
z O CONSTRUCrION LENDING AGENCY
[.► Ibortby affirm Na then u.conswctinn lending agency for the performance of
Lx > the work for whim this Permit Is Wood(Sec.3097,Civ.C.)
QLimiters Name
z Lenders Addrev
t,P Q I rarefy that I have mad this application and sum that the above information Is _
it, F corrin.1 agree to comply with all city and county ordin.m+s and sum laws mining to
.O U Wilding construction,and hereby mthonre mprnmutives or this city to cmerupon tW
{g1 show-mentioned property for inspection purposes
(~ py (We)ague to ave,indemnify and keep harmless the City of Cuperlino!gaivt
ti Iiabilitin.judgmcnu,cosu end capacious which may in any way accrue against said City
V z in eorucquu ce of the gutting of this ermit. //
^ APPLICANT UNDERSTANDS ) WILL COMPLY WITH ALL NON-POINT Issued by: Date <G-
SOURCERE LATIO
Re-roofs /
SiSignatureof phi an r Date
HAZARDOUS MATERIALS DISCLOSUREType of Roof
Will the applicant or future Wilding arvpant smse or handle hau muss material
as defined by the Cupertino Municipal Code.Chapter 9.13,and the Health and Safety
Cods,Scotian 355334)?
❑Yu )4N. All roofs shall be inspected prior to any roofing material being installed.
Win the applicant or future Wading occurrent use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
It hazardous air contaminants in dcfmod by the Bay Am.All Quality Management all new materials for inspection.
:vic0
Dyes k;rNo
I have mad the hazardous materials requimmenu under Chapter S.95afthe Califor.
nu Health&SafetyCadaSm.25505.25533 mdZ534.1 undersand thuathe Wilding _O
deo not enmemly haw amtm
t6 thv m u u mapm n
muibiluY notify the ant the
m occupof
rtquimmrnswhustW moire mascara CerllfKam ofO. -;. Slgnat Of plI est Date
Owner or am e0 age Datum
�� ! t All roof coverings to be Class'W'or better
- '
CITY OF CUPERTINO
O 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . .. 36922002 . 00
DATE ISSUED. . . . . . . : 12/16/2008
RECEIPT #. . . . . . . . . : BS000006831
REFERENCE ID # . . . : 08120106
SITE ADDRESS . . . . . : 10870 E ESTATES DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LEWIS GLENNA J
ADDRESS . . . . . . . . . . : 10870 ESTATES DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4534
RECEIVED FROM . . . . : NUSHAKE INC
CONTRACTOR . . . . . . . : DOUG HEATH LIC # 28920
COMPANY . . . . . . . . . . : NUSHAKE ROOFING INC.
ADDRESS . . . . . . . . . . : 708 D INDUSTRIAL PARK DR
CITY/STATE/ZIP . . . : MANTECA, CA 95337
TELEPHONE . . . . . . . . : (209) 239-8616
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- --- -------- -----
1BSEISMICR VALUATION 7, 800 . 00 0 . 80 0 . 00 0 . 80 0 . 00
1REROOFRES SQ FEET 26 . 00 338 . 00 0 . 00 338 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 338 . 80 0 . 00 338 . 80 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-- --------------- -------
CHECK 338 . 80 #32069
---------------
TOTAL RECEIPT 338 . 80
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
--------------------- -------- ----- --------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: PERMrr #
OWNER'S NAME: Yh✓s LPw: s PHONE # 39- g-uc-
GENERAL CONTRACTOR: A/ s tiak Xh c FAX # a o 9- a39 gs1 S'
I am not using any subcontractors: h-�to-og
gna 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
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/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: In-iFS G P ui- 5
Job Site Address: 1,,0870 '�r,4r-S
Roofing Company Name: a t� C
Applicant's Signature: Date: Imo16-c&
eGreg Casteel
Building Official
Revised 07/30/08
09/
CITY OF CUPERTINO
lam - REROOF
CITY OF
�CUPERTINO PERMIT APPLICATION
APN # Date:
3 (P9aao0a. 0 1G-ass
Building Address:
/0670 �_s4o4e,& T>P
Owner's Name: Phone #:✓/o S_ate- 7189
Contractor: Phone
Fax#: 2 0 9 a-3 i-SS (r
Cupertino Business License #: Contractor License #:
Z/ao 17r-
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
%A Asphalt Shingles X Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
Ye Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings y ❑ Provide I.C.B.O. Report#
X To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: -71,6 ao58
/to✓ oFF ;Fo6F Scl Slhrrf f vciocx-K wi14 30c/
i
�ovh �osi� ovi l /,q vel ;r, /t aV; •�
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: o=
7. gov
I Have Read, Understan an ill Comply with Cupertino's Tear-Off Policy:
•
Signature
Revised 6/16/08
CITY OF CUPERTINO
REROOF
CUPE(,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
Z 1RER00FRES ' Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B lip
1BUSLIC Business License B
Revised 6/16/08