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09100029I CITY OF CUPERTINO BUILDING PERMIT I IBUILDING ADDRESS: 10441 BANDLEY DR I ROOFING CORP BIGHAM TAYLOR I PERMIT NO: 09100029 I OWNER'S NAME: APPLE MCANTOSH , NER'S PHONE: 4089743506 ❑ LICENSED CONTRACTOR'S) DECLARATION License License Class ' Lic # 1 V r7 Contractor ' Date I hereby affl'rm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, 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 provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. n Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, 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 provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter r the above mentioned property for inspection purposes. (We) agree to save nify and keep harmless the City of Cupertino against liabilities, judgments, cons, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature_ Date 22721 ALICE ST I DATE ISSUED: 10/05/2009 HAYWARD, CA 94541 1 PHONE NO: (510)886-0197 BUILDING PERMIT INFO: BLDG r— ELECT f— PLUMB f— MECH f— RESIDENTIAL F_ COMMERCIAL I— JOB DESCRIPTION: RE -ROOF TEAR OFF OLD BUR AND REPLACE WITH NEW CARLISLE TPO TITLE 24 COMPLIANT CLASS A 191 SQ Sq. Ft Floor Area: I Valuation: $38000 APN Number: 32633079.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 D YS FROM ST CALLED INSPECTION. Issued by: V � O Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for I—,inspection. I , 1 Signature of Applicant;!(a .� - �� Date: C �� ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owfi— or ar ho rze age t: t Date:' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Licensed Professional 4 ITEMS OF 4 CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 32633079.00 DATE ISSUED.......: 10/05/2009 RECEIPT #.........: BS000008833 REFERENCE ID # ...: 09100029 SITE ADDRESS .....: 10441 BANDLEY DR SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ....... OWNER APPLE MCANTOSH ADDRESS 10441 BANDLEY CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: BIGHAM TAYLOR ROOFI CONTRACTOR .......: STEVE BIGHAM LIC # 24901 COMPANY BIGHAM TAYLOR ROOFING CORP ADDRESS ..........: 22721 ALICE ST CITY/STATE/ZIP ...: HAYWARD, CA 94541 TELEPHONE ........: (510)886-0197 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- 1BCBSC ------------- VALUATION ---------- 38,000.00 ---------- 2.00 ---------- 0.00 ---------- 2.00 ---------- 0.00 1BSEISMICO VALUATION 38,000.00 7.98 0.00 7.98 0.00 1BUSLIC FLAT RATE 1.00 114.00 0.00 114.00 0.00 1REROOFCOM SQUARES 191.00 1296.00 0.00 1296.00 0.00 ---------- TOTAL PERMIT ---------- 1419.98 ---------- 0.00 ---------- 1419.98 0.00 METHOD OF PAYMENT ----------------- CHECK TOTAL RECEIPT AMOUNT --------------- 1,419.98 --------------- 1,419.98 VOICE ID DESCRIPTION -------- ---------------------------- 601 ROOF TEAR OFF REFERENCE NUMBER -------------------- #34055 VOICE ID DESCRIPTION -------- ---------------------------- 602 ROOF PLYWOOD NAIL 604 ROOF IN -PROGRESS 605 FINAL REROOF CIN OF CUPEkTINO CITY OF CUPERTINO REROOF PERMIT APPLICATION APN &:3 3 C) Date: Building Address: D I ,� Owner's Name: ` ( Phone #: n�OSC-1, HOA: Yes ElNo ❑ If yes, provide letter from HOA N� l< 9-1q-3�>o(,a Contractor: Phone p Q Cupertino ghsiness License #: Existi Built -Up Roof ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shingles ❑ Other (Specify) Number of existing coverings ❑ To be Removed Fax #: !S�- 10 Contractor License #: Type of Roof Covering: Proposed: ❑ Built -Up roof ❑ Asphalt Shingles ❑ Wood Shakes ❑ Wood Shingles ❑ Other (Specify) s ��► f ❑ Provide I.C.C.E.S. Report # ❑ Provide Mfgr. Installation Specs. r e ! /5 c+ Job Description: 6 rCf°s l�e TP C) 2 d06l eq Residential n Commercial 1 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�e I Have Read, Understand and Will Signature y with Cupertino's Tear -Off Policy: Revised 02/05/09 FA 5 t) M 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/ " 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: L Roofing Company Name: Applicant's Signature: Greg Casteel Building Official C, Revised 07/30/08 Date: 0 `�