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10020074 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7975 SUNDERLAND DR (ONTRACTOR:DADDARIO ROOFING PERMIT NO: 10020074 OWNER'S NAME: CHARLES POE 1734 WILLA WAY DATE ISSUED:02/12/2010 i ER'S PHONE: 4088721828 SANTA CRUZ,CA 95062 PHONE NO:(831)476-9109 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT I— PLUMB License Class �7 Lic. a � � MECH r RESIDENTIAL r COMMERCIAL r Contractor Date d`L !2r 0 I hereby affirm hat I am cense u der the provisions of Chapter 9 OB DESCRIPTION:RE-ROOF T/O SHAKE INSTALL PLYWOOD&50 YEAR (commencing with Section 7000)of Division 3 of the Business&Professions COMP ('LASS A 33SQ;DADDARIO ROOFING RNWD BSL 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 Sq.Ft Floor Area: Valuation:$13600 permit is issued. APPLICANT CERTIFICATION kPN Number:36211015.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. i _�2-f!� (sued by: _ Date: Signature Date CZ-/2r Y.©(C) f CJ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of 411 roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: nstalled without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, -- Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVER S TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. 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 Owner or authorized g t: forthwith comply with such provisions or this permit shall be deemed revoked. Date: X)-2__A0 �o w CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save in,' ify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address C( ad expenses which may accrue against said City in consequence of the granung of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Gam_/'Z- 250/a Licensed Professional CITY OF CUPERTINO 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 362L1015 . 00 DATE ISSUED. . . . . . . : 02/ L2/2010 RECEIPT #. . . . . . . . . BSO)0009745 REFERENCE ID # . . . : 10020074 SITE ADDRESS 7975 SUNDERLAND DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER CHARLES POE ADDRESS 7975 SUNDERLAND DR CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-4913 RECEIVED FROM DADDARIO ROOFING CO CONTRACTOR EDGAR MONTOYA LIC # 26245 COMPANY . . . . . . . . . . : DALDARIO ROOFING ADDRESS 1734 WILLA WAY CITY/STATE/ZIP . . . : SANTA CRUZ, CA 95062 TELEPHONE (831) 476-9109 FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---- 1BCBSC VALUATION 13, 600 .00 1. 00 0 . 00 1. 00 0 . 00 1BSEISMICR VALUATION 13, 600 . 00 1 .40 0 .00 1 .40 0 . 00 1BUSLIC FLAT RATE 1.00 114 . 00 0 . 00 114 . 00 0 . 00 1REROOFRES SQ FEET 33 . 00 429 . 00 0 .00 429 . 00 0 . 00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 545 .40 0 . 00 545 .40 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 545 .40 #1025 --------------- TOTAL RECEIPT 545 .40 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ------ 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF -,, CITY OF CUPERTINO k REROOF CUPEkT1NO PERMIT AIPPLICATION APN # Date: S Building Address: C� rl e5 ?— 0/2 Owner's Name: rPhone #: i HOA: Yes ❑ No �Ifes provide letter from HOA Contractor: Phone #: Ra�d j -10 jr" Fax #- _" 4476`-�/O�/ Cupertino Business License W: - Contractor License #: r Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ halt Shingles sphalt Shingles Wood Shakes ❑ Wood Shakes ❑ Wood Shingles ❑ Wood Shingles ❑ Other (Specify) ❑ Other (Specify) Number of existing coverings ❑ Provide I.C.C.E.S. Report# ❑ To be Removed ❑ Provide Mfgr. Installation Specs. CeA Job Description: 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- 13 I Have Read, Understand and Will Comply wits Cupertino's Tear-Off Policy: ignatur Revised 02/05/09 CITY OF CITY OF CIUPERTINO REROOF CUPERTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BCBSC Ca1'Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 3 1RER00FRES Re-roof Res.dential B 1SFDWLR00F ' 1BCBSC Cal Bldg Sti.ndards B ALL PERMIT TYPES Commission. Fee 1BSEISMICRE Seismic Residential B 1REROOFMRES Re-roof Mu-ti-Family B 1MFDWLROOF 1BCBSC Cal Bldg St�mdards B ALL PERMIT TYPES Commission Fee 1BSEISMICRE Seismic Residential B 1BUSLIC Business Li,;ense 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 re-roofing.All roofs are Class "A"per Cupertino municipal code 16.04.080. 2. New roof coverings shall not be apphad 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 Ciiy,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 withoui 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 ori 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 e-ss 2 Job Site Address: Jq16' S.,t t4 J .c1 Roofing Company Name: i O le"V?Ck Applicant's Signature: Date: ell Greg Casteel Building Official Revised 07/30/08 Community Development E 10300 Torre Avenue ' '`_ Cupertino CA 95014 Telephone(408)777-3228 CIV OF Fax(408)777-3333 ,UPEkTINO Building Department JOB ADDRESS: PERMIT # � ����,,� 5 e-,— C/ OWNER'S NAME: &\uLr( S PHONE # / 6_910 GENERAL CONTRACTOR 1 o FAX # I am not using any subcontractors: l2_ 20/t Sig, tur 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 P stering lumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date