06100033 77
CITY OF CUPERTINO
BUILDING DIVISION PERMITS
BUILDING ADDRESS: S TONERIDGE ROOFING PERMIT NO-
06100033
10260 ANTHONY PL
OWNER'S NAME: PERMIT ISSUE DATE
MAHESH METHA 2440 POPLAR DR10/0612006
ONE: SANITARY NO. CONTROL NO.
(4 08) 729-5101
BUILDING PERMIT INFO
ARCHITECTIENGINEER: BLDG ELECT PLUMB MECH
o p LICENSED CONTRACTOR'S DECLARATION Job Description
I hereby affirm that I am licensed under provisions of Chapter 9(commencing
t 2 with Section 7000)of Division 3 of the Business and Professions Code,and my license is
>oy in full force andcfect REROOF-T/O OLD, INSTALL 1/211 OSB 30LB FELT
ij z Licenso Class - Lic•a 5 0 YR COMP
t wDate o-a Contractor 3+0
„t ARCHITECTS DECLARATION
m-,, I understand my plans shall be used as public records
,a
4 C y Licensed Professional
OWNER-BUILDER DECLARATION
a 1 hereby affirm that I am exempt from the Contractor's License Law for the
`O O following reason.(Section 703 1.5,Business and Professions Code:Any city or county
a
^Pi which requires a permit w construct.alter,improve,demolish,or repair any structure-Z y prior to its issuance,also requires the applicant for such permit to rile a signed statement Valuatl yR3
z
that he is licensed pursuant to the provisions of the Contractor's License law(Chapter 9 Sq.Ft. Floor Area 9 0 0
FE
r t- (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
y that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type
not more than five hundred dollars($500). 34212069 . 00
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work and the structure is not intended or offered forsale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law does not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements arc not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li-
cense Law does not apply to an owner of property who builds or improves thereon,and
who contracts for such projects with a contractor(s)licensed pursuant to the Contractors
License law.
❑1 am exempt under Sec. B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
J 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compcn-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Polity number are:
Carrier.Il�/��G� F,/y7 j Policy No.: G 1
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for anc hundred dollars($100)
or less.)
I certif-v that in the performance of the work for which this permit is issued,1 shall not
employ any person in any manner so as to become subject to the Workcrs'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
Oforthwith comply with such provisions or this permit shall be deemed revoked.
Z. CONSTRUCTION LENDING AGENCY
(~-t CA I hereby affirm that there is a construction lending agency for the performance of
> the work for which this permit is issued(Sec.3097,Civ.C.)
W ALender's Name
aZ Lender's Address
U O 1 certify that I have read this application and state that the above information is
0' correct.I agree to comply with all city and county ordinances and state laws relating to
0 U building construction,and hereby authorize representatives of this city to enter upon the
W above-menliuncd property for inspection purposes.
CL (We)agree to save,indemnify and keep harmless the City of Cupertino against
to liabilities,judgmens,costs and expenses which may in any way accrue against said City
V Z in consequence of the granting of this permit. Date
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOURCE REGULATIONS.
L,4�- ,¢2m& tJ .10-06-W Re-roofs
Signatu^redrApplicaddContractor Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes [ 0
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yes ON.
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Hcalth&Safcty Codc,Sections 25505.25533 and 25534.I understand that if the building
does not currently have a tenant,that it is my responsibility to notify the occupant of the
requirements which must be met prior to issuance of a Certificate of occupancy. Signature of Applicant Date
a 0i ", e L to-"e-04- All roof coverings to be Class"B"or better
Owner authorized agent �' Date
CITY OF CUPERTINO
1 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN 34212069.00
DATE ISSUED. . . . . . . : 10/06/2006
RECEIPT #. . . . . . . . . 36327
REFERENCE ID # • • • 06100033
SITE ADDRESS 10260 ANTHONY PL
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER MAHESH METHA
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5646
RECEIVED FROM STONERIDGE ROOFING
CONTRACTOR SERGIO GONZALEZ LIC # 25625
COMPANY STONERIDGE ROOFING
ADDRESS 2440 POPLAR DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE (408) 729-5101
_EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 10, 000.00 169.56 0.00 169.56 0.00
BSEISMICRE VALUATION 10,000.00 1.00 0.00 1.00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT 170.56 0.00 170.56 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
CHECK 170.56 802
TOTAL RECEIPT 170.56
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 1997 UBC Standards
and manufacturers specifications on re-roofing.
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$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: ,/ _SRC A
Job Site Address: 1,096-4 ,L 4 ah 2�
Roofing Company Name: � f on e r i e d C)
Applicant's Signature: �� (1n2�%��Z Date: ,o-o 6-o j�-
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO j-, �;IMP -3,3
� -� REROOF (�
CUPEkTINO PERMIT APPLICATION FORM
APN# 2 t / ;? 06 �) Date: - Q - O
Building Address/:
D
Owner's Name:
Pone : (yQ$� 72�'-S)o)
Contractor: License#: 7 6 6 y l f
Contact:
Cupertino Business License #:
. 2
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles p"'Asphalt Shingles
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.
I Have Read,Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
Gl U �f Ww !v 1) , a0 o eC
Residential (� Commercial F-1
Fire Zone: Yes ❑ No ❑ Confirmed with Planning Det. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING