09030224 CITY OF CUPERTINO �T � r;,
BUILDING DIVISION - PERMIT
PERMIT NO.
BUILDING ADDRESS:
10491 DEODARA DR ALL PHASE ROOFING
pIItMrf LSSUE DATE
OWNER'S NAME:
KEN SCHNEIDER SA
AR CONTROL NO.
B:
F(408)7779-3740
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
a ed C LICENSED CONTRACTOR'S DECLARATION Job Description
U I hereby affirm that I am licensed under provisions of Chapter 9(commencing
_z, with Section 7000)of Division3oftheBusinessandProfessionsCode,andmylicenscis RE—RF T/O SHKS & INSTL OSB 40 YR CERTINTEED
12'<y in full force and e�ACHrrMECTS
i§z License ClassLi conl#rador r SHNGLS
2- °areCLS A 30SQ
` DECLARA 1
0 ( nd my plans shall be used as public records
W U H—c
d
4 Q y Li d P fcssional
OWNER-BUILDER DECLARATION
I
he alTrrm 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
m which requires a permit a conswct alter,improve,demolish,nr repair any structure
n'- prior to its issuance,also requires the applicant for such permit to file a signed statement 3 .Ft.Floor Area Valuation
Z< that he is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 q $10380
Y F$ (commencing with Scction 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 Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number p Y Yp
not more than fire hundred dollars(S500)• 31630048 . 00
❑I,as owner of the property.or my employees with wages as their sole compensation, Required Inspections
will do the work and the structure is not intended or offered for sale(Sec.7044,Business
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.).
❑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 Caw 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. B&P C for this reason
❑I am exempt under Sec
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 Cock,for the performance of the
for which this permit is issued.
I ave and will maintain Workces Compensation Insurance,as required by Scction
of the Labor Code,for the pcdormance o the work for which this permit is issued.
My Worker's Compensation nsuLIT pri nd W.Ocy number arc:
Carrier. Policy No.:
E EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars(S 100)
or less.)
I certify 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 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
Z forthwith comply with such provisions or this permit shall be deemed revoked.
Z CONSTRUCTION LENDING AGENCY
F►rA— I hereby affirm that there is a construction lending agency for the performance of
a+> the work for which this permit is issued(Sec.3097,Civ.C.)
W Q L.endces Name
Z L.endees Address
V C) tat
I certify that I have read this application and se that the above information is
(Sr 04
correct.I agree a comply with all city and county ordinances and state laws relating a
0 U building concoction,and hereby authorize representatives of this city to enter upon the
stave-mentioned property for inspection purposes.
OtW. (We)agree to save,indemnify and keep harmless the City of Cupertino against
CA liabilities,judgments,costs and expenses which may in any way accrue against said City Date r
V z in consequence of the granting of this permit.
►+ APPLICA RSTAND AND WILL COMPLY WITH ALL NON-POINT Issued b
SOUR ATIQ
r Re-roof., -
ignaturc of Applicant/Contrac T of Roof
HAZARDOUS ATERIALS DISCLOSURE YPe
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 roof i shall be inspected prior to any roofing material being installed.
❑Yno
Will the applicant or f�re building occupant use equipment or devices which
If a roof is installed without first obtaining an inspection, agree to remove
hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection.
strict?
❑Yes o
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Cotte,Sections 25505,25533 and 25534.1 undcrsmnd that if the building
docs not cure ve a tenant.th • is my responsibility a notify the occupant of the Date
requiremc which be m • r a issuance of a Certificate of Occup t:y Signatul•e of Applicant
d All roof coverings to be Class'n"or better
nor or authorizcd agent are
CITY OF CUPERTINO
REROOF
CUPIE TING PERMIT APPLICATION
APN # Date: �A
2 L V3co • C� j
Building Address: I q
Owner's Name: �- , Phone
,�e/� � cv� enc-7 7 � �f )
HOA: Yes ❑ No If es rovide letter from HOA : 7 - l
Contractor: Phone #: _��U�
Fax #: 7
Cupertino Business License Contractor License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings '( ❑ Provide I.C.C.E.S. Report#
❑ Provide Mfgr. Installation Specs.
❑ To be Removed
Job Description: r
�0 V�-11 -e I + Nie
�4,,� L) oz e-
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: 00 1 d
;Have Read erst nd ill Comply witli Cupertino's Tear-Off Policy:
ature
Revised 02/05/09
CITY OF CTPERTINO
a REROOF
CITY OF FEE SCIH_EDULE
CUPEi�T1NO
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICO Seismic Corunercial B
1RER00FRES Re-roof Residential B 1SFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE Seismic Re,,idential B
1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commissio z Fee
1BSEISMICRE Seismic Residential B
1BUSLIC Business L.cense B
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:-e-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be appLed 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 a:ly 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 nai:' 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 li. "per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be o:1 the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: 1/� ,(,) sC Ltd ae d-7
Job Site Address: 10 (I he o 1)A
Roofing Company Name:
Applicant's Signa /� Date: D�
Greg Casteel
Building Official
Reviled 07/30/08
Community Development
10300 Tone Avenue
tq; Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
%K TINO
Buildin De artment
JOB ADDRESS: PERMIT # SOZZe-(
b 2 A yn
OWNER'S NAME: C PHONE # �z 7YD
GENERAL CONTRACTOR: FAX # 75;
I am not using any subcontractors:
S.gra 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