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10080220CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10356 PLUM TREE LN I CONTRACTOR: R J BEAN ROOFING PERMIT NO: 10080220 OWNER'S NAME: THOMAS GALLUP 16355 COTTLE RD ' DATE ISSUED: 08/30/2010 I 'NER'S PHONE: 4082551448 ❑ LICENSED CONTRACTOR'S DECLARATION License Class l,`— Lic. # 73o �> 0 Contractor 1 V Date — G 0 I hereby affirm 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. I 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. uN 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. Signature kaaDatei!� 0 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) I, 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 upon the above mentioned property for inspection purposes. (We) agree to save i-4 minify and keep harmless the City of Cupertino against liabilities, judgments, , and expenses which may accrue against said City in consequence of the b_ _.acing 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 SAI1 JOSE, CA 95123 1 PHONE NO: (408)3584028 BUILDING PERMIT INFO: BLDG r ELECT r- PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: RE -ROOF TEAR OF 28SQ SHAKES, FIX ANY DRY ROTT THEN APPLY CAPSHEET 30LB FELT, (1/2" PLYWOOD ON GARAGE ON .Y 7SQ THE REST OF HOUSE OVER SKIP SHEETING) Sq. Ft Floor Area: ' Valuation: $19000 APN Number: 31633018.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by�v " Dater 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 ins lection. _ Sil nature of Applicant: ��' /1 ��i�tn� Date: - !?, 4 ;(Z 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 Cs lifornia Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain co npliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Anditionally, should I use equipment or devices which emit hazardous air co itaminants as defined by the Bay Area Air Quality Management District I will mAntain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or co ' edomrit. AAnZ Date CONSTRUCTION LENDING AGENCY I I ereby affirm that there is a construction lending agency for the performance of work's fo which this permit is issued (Sec. 3097, Civ C.) Lc nder's Name L4 rider's ARCHITECT'S DECLARATION I c nderstand my plans shall be used as public records. Licensed Professional 3 ITEMS OF 4 CITY OF CUP ERTINO PERMIT RE �EIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31633018.00 DATE ISSUED.......: 08/30/2010 RECEIPT #..••..•••: BSOOOC11331 REFERENCE ID # ...: 10080220 SITE ADDRESS .....: 10356 PLUM TREE LN SUBDIVISION ....... CITY CUPER"INO IMPACT AREA ....... OWNER ............: THOMAS GALLUP ADDRESS . 10356 PLUM TREE LN CITY/STATE/ZIP CUPER`CINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM BEAN, ROBERTTFING JAMES LIC # 20511 CONTRACTOR ....... COMPANY R J BEAN ROOFING ADDRESS . 6355 :!OTTLE RD CITY/STATE/ZIP ...: SAN JDSE, CA 95123 TELEPHONE ........: (408)358-4028 FEE ID UNIT QUANTITY AMCUNT - PD -TO -DT ---------- THIS -REC- -- ----- NEW -BAL- ----------------------- 1BCBSC VALUATION 1BSEISMICR VALUATION 1REROOFRES SQ FEET ---------- 19,000.00 19,000.00 28.00 --------- 1.00 1.90 364.00 0.00 0.00 0.00 1.00 1.90 364.00 0• 00 0.00 ------ ---- TOTAL PERMIT 366.90 0.00 366.90 0.00 VOICE ID DESCRIPTION -------- ----------------- ---------- 601 ROOF TEAR OFF 604 ROOF IN -PROGRESS VOICE ID DESCRIPTION -------- - -------------------------- 602 ROOF PLYWOOD NAIL 605 FINAL REROOF CITY OF CUPERTINO CITY OF C-UPERTINO REROOF PERMIT APPLICATION I1�� 02z. APN # ., Date: Building Address: Owner's Name: --I'o Phone #: HOA: Yes ❑ No Q If yes, provide letter from HOA " z Contractor: j/'� �. � Phone #: � _ � 10 1 Fax #: Cupertino Business License #: Contractor License #: Type of Roo -"Covering: Existing: Proposed: ❑ Built -Up Roof ❑ Built -Up roof ❑ Asphalt Shingles ❑ Asphalt Shingles 911- Wood Shakes 'g— Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report # .W To be Removed ❑ Provide Mfgr. Installation Specs. _7L Job Description: �� 2 ( t G•fkriy 0A) l �4()v4t 0 U-2(' I-, . Q, �►� C fos A- Residential Commercial ❑ Green Building: Please complete relevant portion of the Confirmed Awith 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: I Signature Revised 02/05/09 REROOF TEAR -OFF POLICY COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 •FAX (408) 777-3333 • built ina(cugertino.orq PROJECT ADDRESS .1/I � '4PN# -0I OWNER NAME C) Y V ` 161 E -MAIL STREET ADDRESS �^ _ „ CITY, STATE, AP FAX CONTRACTOR NAME �� ,• J ( KJ LICENSE NUMB - LICEN� TYPLj CF !� BUS. LIC H COMPANY NAME " 4 �\T�AW E-MAIL FAX STREET ADDRESS -�C� CITY, STATE, i IP-_ /^ PHONE I UNDERSTAND AND AGREE TO THE FOLLOWING: 1. The re -roof project shall comply with all applicable provisions of the 2007 California Building Code. 2. You must schedule all needed inspections a minimun of one day before the requested inspection date. Please schedule inspections online or call (408)777-3228 between 7:30-3:30 (Mon -Fri). 3. Tear -off roof inspection is required. Please call for tear -off inspection after the roof is torn off and all the nails/fasteners have been removed. Any and 01 dry -rotted wood shall be replaced prior to this inspection. A building inspector will be available w ithin one hour. There are special hours for this service: 7:30 — 10:30am and 1:00 — 3:30pm (Mon — Thurs); 7:30 — 10:30am and 1:00 — 2:30pm (Friday). 4. If plywood is installed, a plywood nailing inspection is required. 5. In -Progress roof inspection is required. Call for an in -progress roof inspection to verify building is weather tight after installation of approximately 250/'o of the roofing material. 6. New roof coverings shall not be applied without firs t obtaining all inspections and written approvals from the building inspector. Any roofing which is � pplied without first obtaining an approved inspection will require the removal of all new material down to: the sheathing so a proper inspection can be performed. 7. A final inspection and approval shall be obtained from the building inspector when the re -roofing is complete. To receive a final sign -off, the following items will be verified: a. Flat roofs shall have a minimum of per foot of slope and must demonstrate there is no ponding. b. Listings from approved testing agencies for all pre -manufactured products used shall be available on-site to review at the time of the inspection. c. Proper spark arrestor installation. 8. NOTE: If you call for a tear -off or plywood nailing; inspection and the work is not complete, you will be charged a re -inspection fee of $126.00. The re -inspection fee shall be paid before another inspection can be scheduled. By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the property owner's be lf. I understand and agree to comply with the re -roof policy stated above. Signature of Applicant/Agent: 1&Iao✓ Date: U So—( I C7 RerooJPolicy_2010.doc revised 05/17/10 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST 2 PERMIT # U Z JOB ADDRESS: j PHONE # 63 OWNER'S NAME: GENERAL CONTRACTOR: BUSINESS LICENSE # 730 Q CITY/ZIPCODE: ADDRESS:rtino business *Our municipal code requires all businesses working in the city to have a City of C E eSCHEDULEDhUNTIL THE NO BUILDING FINAL OR FINAL OCCUPANCY INSI ECTION(S) WILL B GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITTY OF CUPERTINO BUSINESS LICENSE. (� I am not using any subcontractors: Signat�re Please check applicable subcontractors and complete tlP following information: �SUBCONTRACTOR BUSINESS 1` Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Date Date Owner / Contractor Signature