06100091 CITY OF CUPERTINO
BUILDING DIVISION PERMIT C 1 'JC'RAG OR�NPID TI�N�
BUILDING ADDRESS: MANADA ROOFING INC PERMIT No. 0 610 0 0 91
7791 ORION PL
PERMIT ISSUE DATE
OWNER'S NAME:
NITIN J SHAH 1593 INDUSTRIAL PKWY W.- if-cl 10/12/2006
SANITARY NO. CONTROL NO.
NE:
(510) 780-9517
BUILDING PERMIT INFO
ARCHITECT/ENGINEER:
BLDG7 ELECT PLUMB M�,C7H
c p LICENSED CONTRACTOR'S DECLARATION Job Description
V(= I hereby affirm that I am licensed under provisions of Chapter 9(commencing
Z with Section 7000)of Division 3 of the Business and Professions Code,and my license is
cy in full force andc(fect, REROOF- TEAR OFF EXISTING. INSTALL 1 LAYER OF 3
Lice..Class Lw•# 36" FELT AND 34 SQUARES OF CERTAINTEED GRAND
p Date Contractor
ti ARCHITECISDECLA A MANOR COMP SHINGLES . CLASS A OR B
o:< I understand my plans shall be used as public records
UJ r)
U.H Licensed Professional
H
.< OWNER-BUILDER DECLARATION
} I hereby affirm that 1 am exempt from the Contractor's License Law for the
:00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
which requires a permit to construct,alter,improve,demolish,or repair any structure
Z r prior to its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation
that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 Sal
(commencing with Section 7000)of Division 3 of the Business and Professions Code)or $16530
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).
❑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 for sale(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 are 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.).
0 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 Contractor's
License Law.
❑I 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:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I 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 Worker's Co pen tion Insurance carrier and Policy number am:
Carrier. Policy No.:
CE TIFICATE F EXEMPTION FROM ORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars($100)
or less.)
I certify,that in the performance of the work for which this permit is issued,I shall not
employ any person in any manner so as to become subject to the Workers'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
,J O forthwith comply with such provisions or this permit shall be deemed revoked.
"" CONSTRUCTION LENDING AGENCY
[~� I hereby affirm that there is a construction lending agency for the performance of
(Y> the work for which this permit is issued(Sec.3097,Civ.C.)
L>a A Lender s Name
az Lender's Address
U 0 1 certify that 1 have read this application and state that the above information is
Li+►•+ 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
above-mentioned property for inspection purposes.
nWi (We)agree to save,indemnify and keep harmless the City of Cupertino against
c/) liabilities,judgments•costs and expenses which may in any way accrue against said City
U z in consequen a granting of this permit. Date
APPLIC U ER ANDS AND WILL COM WITH ALL NON- INT Issued by:
SOUR RE LA S.r
Re-roofsC,
Si to o ppl Contractor Date
HAZARDOUS MATERIALS DI OSURE Type of Roof
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Munic' al Codc.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 u
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants defined by the Bay Arca Air Quality Management all new materials for inspection.
District?
Yes No
I have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&,WLV Code,Sections 25505,25533 and 25534.1 understand that if the building
docs not n have pant that it u;my rosponsi 'lity to notify the occupant of the
require is hien t br/rtet priorw issuance ficale of Occup . XhatureZSi pplieant Date
All roof coverings to be Class B or better
r authorized agent ADate
CITY OF CUPERTINO
�m 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN 36218048 . 00
DATE ISSUED. . . . . . . : 10/12/2006
RECEIPT # . . . . . . . . . 36418
REFERENCE ID # 06100091
SITE ADDRESS 7791 ORION PL
SUBDIVISION
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER NITIN J SHAH
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP ,
RECEIVED FROM . . . . : RUBEN PEREZ
CONTRACTOR . . . . . . . : RICARDO PERES LIC # 24826
COMPANY . . . . . . . . . . : MANADA ROOFING INC
ADDRESS * * . . . . . . . : 1593 INDUSTRIAL PKWY W, #5
CITY/STATEZIP . . . : HAYWARD, CA 94544
TELEPHONE . . . . . . . . : (510) 780-9517
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- -- - ---- - - -- ---- ------ - ---------- ---------- ---------- --------
BPERMFEE VALUATION 17 , 000 . 00 245 . 16 0 . 00 245 . 16 0 . 00
BSEISMICRE VALUATION 17 , 000 . 00 1 . 70 0 . 00 1 . 70 0 . 00
---------- ------- --- ---------- ----------
TOTAL PERMIT 246 . 86 0 . 00 246 . 86 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - ---- - - ---- ---- - ------ ------ ------------------
OTHER 246 . 86 VISA
TOTAL RECEIPT 246 . 86
Community Development Department
Building Division
y City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
CUPEkTINO
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.
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:
Job Site Address: �24.1. kt( `e--
Roofing Company Name: l� G°�c'tL <_� ?'
A plicant's Signature. ��--'E-_ s� '` Date:
�o
Greg Q eel
Building Official
Revised 1/30/03
Printed on Recycled Paper
vim;, Community Development
10300 Torre Avenue
;K Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
*UPEkTINO
Building Department
JOB ADDRESS: � � � G PERMIT #O�`
OWNER'S NAME: A A Jt PHONE # p 71no, -iF5127
GENERAL CONTRACTOR: t FAX #
I am not using any subcontractors: 14-IV-. 4�
Signature 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
CITY OF CUPERTINO o(_01000q1
REROOF
aw.
CITY OF
CUPEkTINO PERMIT APPLICATION FORM
APN # S&2_ Date:
Building Address: I's
Owner's Name: Phone'#:
Contractor: Phone#: License#:
V
U
Contact Phone#: Cupertino Business License#:
\V-K, ee9 2— 2k4V1_(__
Type of Roof Covering:
Existing: Proposed:
Ll Built-Up Roof El Built-Up roof
Ll Asphalt Shingles Com-Asphalt Shingles
Er'l-Wood Shakes Ei Wood Shakes
• Wood Shingles U Wood Shingles
• Other(Specify) Q Other(Specify)
Number of existing coverings L3 Provide I.C.B.O.Report#
8""'To be Removed UK—Provide Mfgr.Installation Specs._D�n. 0
I Have Read,Understand and Will Comply With Cupertino's Tear Off Policy:
Job Descript' 4
Residential 2-- Commercial Fj
Fire Zone: Yes El No a, Confirmed with Planning Dept. if
there are any restrictions: Er
Cost of Project: T e of Consp-uc,tion: Occupancy group:
rL-3
Qty. if Fee Description Fee Gro
Applicable Fee ID
BPERMFEE Bldg Permit Fees BUILDING
BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING