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08120119Boa �uF 3pz n t- gLLt ray=ny� 1 HC EF[ Y�5 i 0�2 z: a= VC OF �r 0 U i CITY OF CUPERTINO r >pp.*♦�♦�*^A.,} 'wp"�qpp��*€`,��-ryry�i`z"�" BUILDING DIVISION PERbIIT �� 1�2'GUMI�I," PMATI.V' BUILDING ADDRESS: PERMIT NO. 7580 ORANGE BLOSSOM DR C & C ROOFING 08120119' OWNER'S NAME: PERMIT ISSUE DATE PHONE: A A 0. CONTROL NO. (408)298-1868 ARCNTIECT7ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECN 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description beret, affirm It 1 am licensed under Provisions of Chapter 9 (commesminy with Section 7000) of Division 3 of the Rusinev and Profcssfons Code.+^d my Become is in full forte andeIfecL �+ - Z RE -RF T/0 SHKS, ADD 1/2 CDX PLYWD RE -RF W/40 YR License la a Li^ a --� Date - conuacwr COMP CLS A 27$Q ARCHITECT'S DECLARATION I andenumd my plans thall be used a public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm Nn 1 am cmmpt from the Contractors License Law for the following mason. (Section 7101.5, Business and Pmfa slum Code: Any city or county which acquires a Permit to construct. alter, improw, demolish. or repair any structure poor in its issuance. don mquima tic applicant rorsuch pormitto rile a signed suwmcm Conuacwri Licove Law (Chaptm9 Sq. FC Floor Area Valuation that he, licensed inrwam to the previsions of the (cammentlng with Section 7000) of Division 3 of the Business and Professions Code) or $10500 ep, theacfrom soul due bas, for the alleged eumptlon. Any violation of Nat k uxem APN Number - Occupancy Type Section 703M by any applicant fm a parted, subjects dte applicant to a civil penalty of era, mom Nen fiw hundrtd dollars (SSW). 36611060 .00 0 1, m owner of the pmpeny, or my employees with wages to their rale compensation, Required Inspections will da me work and the stracwm is oat intended or offered for sale (Sec. 7014, Businms and Rafessiov Cade: The Contrseme, License law does Ml apply to an owner of preparly, who builds mimpomms merrnn,and who doessach work himself or through b, own employees. paoHded that such improwo mis ...I Intention maRered foraala If. hwewr, the building or improwment is sold within ore year of completion. the owner - builder wilt haw the burden of proving that he did not build or improv for purpose of sale.). 1, or owner of the properly. am eaclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cade:) The Contractors LL ceou Taw does not apply an an owner of property who Wilds or improv thereon, and who contracts for such projects with a eantractou(s) licensed persons, w use Contractors Licence Taw. ❑ I am exempt under Be- . B B P C for this reason Owner Dam WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of Perjury erne of the following decimations: Q 1 hew and will maintain aCntificam of Cavan w self --insert fro Workers Campcm setion, az provided for by Section 3700 of do Labor Code. for she performance of do work for which this Permit is issueaL 1 haw armd will maintain Watters Compensation Inimanee, as m quired by Section IV of tic labor Code, for Ne performance of tic work for which this permit is issued. ' WarkerY Compensation Ns ce caricr and Policy number sac: Carrier. Policy NO &� Z6 CERTIFlCAOE OF • PITON FRDM WORKERS' COMPENSATION INSURANCE S mm, actin need not beeompmmd it the Permit, rmonc hundred dollars ($100) or less) 1 certify that in Inc famfonnanec of use work for which this Permit, issued. I shall not employ myperaom many manner.. to keomc subjecuo the Workers' Compeva0on Laws of California. Dam Applicant NOTICE TO APPLICANT. If, after making this Certificate or Exemption, you should become subject in me Warkcrs Compensation provisions of dm Labor Cod[, you run ' forthwith comply with such provision or this pmmit shall to deemed mwkcd. CONSTRUCTION LENDING AGENCY 1 hereby alarm that martne I,is . a aonswcu lending agyencfor Ne perfurmanw of ' tireLo work for which tit, permit, Wood (Sec. 3x0 9'1, Civ, C.) Lenders Name , Lenders Adieu I codify that I low, read this application and sum that the aWw information u ' cored. l agree in comply with all city and county ordinances and sum laws relating to building consuuction. and hereby action. repteunuti. of this city w anter upon the a ow -mentioned property for inspection purposes. (We) agree to u e, indemnify and keep harmless the City of Cupcutimo against j liabilities.Judgments. casts and cxpoeas which may, in any way... against said City ' in ennstant. of the granting of but permit. ' APPLICANT, UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date - SOUR EGULAMON Re -roofs Type of Roof Signature of Applicant/Contractor Data HAZARDOUS MATERIALS DISCLOSURE Will Ne applicant or future Wilding occupant store or handle becommus material as defined by the, Cupertino Municipal Code. Chapter 9. 12, and the Health and Safety CWc. Section 35533(07 All roofs shall be inspected prior to any roofing material being installed. ❑Yea 4No If a roof is installed without first obtaining an inspection, I agree to remove Will to applicant or rmurt Wildingoccvpant .1 &,1. which emit havardous air cocurromamu u derined by fee Bay Area Air Quality Management all new materials for inspection. Dnoiet? I ❑Yes ON. I haw real Ne hmuEmuv materia, mquimmenu under Chapter 6.95 of be, Califm- Heslth&Sofcty Cade,Savmn25505.25S31 am135534.IuMcrwnb Nmifdc buil ding m, cutsc^tly hew a meson, mat i„ my respomssibilitY w notify Ne acoupant of dte [�//A L� f G / /j acgai wnmhmuatWmctpriorwissnan¢araCrniBcatearacuparuy. Signature of Applicant Date % 1� All roof coverings to be Class dT or better - ownerpr.tWnocdagcni Dow 2 ITEMS OF 2 CITY OF CUPERTINO PERMIT RECEIPT • Sec: Twp: Rng: Sub: Blk: Lot: APN .....1.... 36611060.00 DATE ISSUED.......: 12/19/2008 RECEIPT #.........: BS000006858 REFERENCE ID # ...: 08120119 SITE ADDRESS .....: 7580 ORANGE BLOSSOM DR SUBDIVISION ....... CITY .............: CUPERTINO IMPACT AREA ......: OPERATOR: patg COPY # : 1 OWNER ............: MIRANJHAN ADDRESS ..........: 7580 ORANGE BLOSSOM DR CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4953 RECEIVED FROM ....: C AND C ROOFING CONTRACTOR .......: OSVALDO CAMARA LIC # 22982 COMPANY ..........: C & C ROOFING ADDRESS ..........: 89 S 21 ST CITY/STATE/ZIP ...: SAN JOSE, CA 95116 TELEPHONE ........: (408)298-1868 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL -------------- lBSEISMICR VALUATION ---------- 10,500'.00 ------ 1.10 0.00 1.10 --------- 0.00 lREROOFRES SQ FEET 27.00 351.00 0.00 351.00 0.00 TOTAL PERMIT ---------- 352.10 ---------- 0.00 ---------- 352.10 ---------- 0.00 METHOD OF PAYMENT ----------------- CREDIT CARD TOTAL RECEIPT : AMOUNT --------------- 352.10 --------------- 352.10 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS 0 REFERENCE NUMBER -------------------- VISA VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 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: /vt 19 4+y 11, AP✓ Job Site Address: Roofing Company Name: i' L /(O O n/ 6 - Applicant's Signature: �� in� aF Date: 12 -49-,9V Greg Casteel Building Official 9 Revised 07/30/08 40 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax(408)777-3333 Building Department JOB ADDRESS: 4 09 NG -E GLOSS ^,- D ✓L PERMIT # DOD/,;? 0//,? OWNER'S NAME: Yl• r nJ PHONE GENERAL CONTRACTOR: a X) 3 7,5 G I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: 16 Owner/ Contractor Signature Date 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 16 Owner/ Contractor Signature Date C ogI�oI�9 CITY OF CUPERTINO REROOF C11Y OF CUPERTINO PERMIT APPLICATION APN # �3(P !o // D (v D • 0 v Date: Building Address: SO o A A rJ & E a LO 6,n/ Gi /L Owner's Name: Phone #: M/;izta�/ 4aW 25-2 Contractor: Phone #: ydf -2 9k- 44 9- e < e (zoo F)TvU Fax —29f-3360 Cupertino Business License #: Contractor License #: y99z9 z Type of Roof Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles X Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings 4„yE ❑ Provide I.C.B.O. Report # To be Removed ❑ Provide Mfgr. Installation Specs. Job Description: Te7,4 tz a/f S ti r+ /e c s A /VL e D X P L_/ 6, 7 [_! Residential Commercial El 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: .Signature Revised 6/16/08 CI IF CUPERTINO CITY OF CUPERTINO REROOF FEE SCHEDULE Number of Squares Fee ID Fee Description Fee Group Permit Type 1RER00FC0M Re -roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES " Re -roof Residential B 1SFDWLR00F i 1BSEISMICRE Seismic Residential B 1RER00FMRES Re -roof Multi -Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 •