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09090024 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10291 BONNY DR CONTRACTOR:LOS GATOS PERMIT NO:09090024 ROOFING "— P O BOX 1726 DATE ISSUED:09/04/2009 `NER'S NAME: ZWAANSTRA JOHN O"ANER'S PHONE: 4084460946 LOS GATOS,CA 95031 PHONE NO:(408)298-9399 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class ,T J� Lie.# MECH I- RESIDENTIZ COMMERCIAL r ContractorDate_ —1L1 __ ---TTT 106 DESCRIPTION: REMOVE 2 LAYERS SHAKE AND CEDAR 1 hereby affirm that 1 am licensed under Tie provisions o Chapter 9 SHINGLES INSTALL (commencing with Section 7000)of Division 3 of the Business&Professions 7/16" ROOFERS SELECT FELT AND PRESIDENTIAL Code and that my license is in full force and effect. SHINGLES CLASS A 32 SQUARES 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 Valuation:$10071 performance of the work for which this permit is issued. Sq.Ft Floor Area: I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the t.ahor Code,for the performance of the work for which this APN Number:35913004.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to compiy with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioiied property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs and expenses which may accrue against said City in consequence of the Issued by Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point s rce regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: vre \ �—_—Date_j 3 All roofs shall be inspected prior to any roofing material being installed.If a roof is -- ---— installed without first obtaining 'ns ection,I agree to remove all new materials for inspection. OWNER-BUILDER DECLARATION Date: Signature of Applicant: - 1 hereby affirm that i am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) HAZARDOUS MATERIALS DISCLOSURE 1,as owner of the property,am exclusively contracting with licensed contractors to corsuuct the project(See.7044,Business&Professions Code). I have read the hazardous materials requireme:�ts under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will i hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should i store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3 700 of the Labor Code,for the 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 performance of the wort;for which this permit is issued. the Health&Safety Code,Section 5 ,25533,and 25534. 1 have and will maintain Worker's Compensation insurance,as provided for by u SPctron 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,1 become subject to the��,orker's Compensation provisions of the Labor Code,i must 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.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read rhis application and state that the above information is correct.i agree to comply with all city and county ordinances and state laws relating "uilding construction,and hereby authorize representatives of this city to enter )the above mentioned property for inspe.;tion purposes.(We)agree to save ARCHITECT'S DECLARATION_ udemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit..Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 1_icensed Professional 9.18. Signature Date_ __ 1 --� CITY OF CUPERTINO REROOF CUPEkTINO PERMIT APPLICATION CC1 6q ao2� APN # Date: Building Address: 1OZ9 V Atpe .r Sc�/ Owner's Name: Phone #: 3AB -� 08 6) Contractor` Phone #: ,;fig 2 y L Fax#: Cupertino Business License #: Contractor License #: l gao ` t� : Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑ Built-Up roof ❑ Asphalt ShinglesAsphalt Shingles Wood Shakes l�Wood Shakes XWood Shingles ❑ Wood Shingles ❑ Other(Specify) Other(SpeciS Number of existing coverings ❑ Provide I.C.B.O. eport# To be Removed ❑ Provide Mfgr. Installation Specs. 3 � 5 's ., rG`� < Job Des ription:1 ' 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: lb d -- I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy: SigOt re Revised 6/16/08 CITY OF CUPERTINO REROOF CUPEkTINO FEE SCHEDULE Number of Fee ID Fee Description Fee Permit Type Squares Group 1REROOFCOM Re-roof Commercial B 1COMMLROOF 1BSEISMICO Seismic Commercial B 1RER00FRES ' Re-roof Residential B 1SFDWLROOF Z 1BSEISMICRE Seismic Residential B 15 C98c, 1REROOFMRES Re-roof Multi-Family B 1MFDWLROOF 1BSEISMICRE Seismic Residential B 1BUSLIC Business License B Revised 6/16/08 CITY OF CUPERTINO 3 ITEMS OF 12 PERMIT RECEIPT OPERATOR: SY1viaM COPY # : 1 Sec : Twp: Rng: Sub: Blk: Lot : APN 35913004 . 00 DATE ISSUED. . . . . . . : 09/04/2009 RECEIPT #. . . . . . . . . BS000008610 REFERENCE ID # 09090024 SITE ADDRESS 10291 BONNY DR SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . . OWNER ZWAANSTRA JOHN ADDRESS . 10291 BONNY DR CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-2905 RECEIVED FROM LOS GATOS ROOFING CONTRACTOR RANDY BROWN LIC # 23481 COMPANY LOS GATOS ROOFING ADDRESS . P 0 BOX 1726 CITY/STATE/ZIP LOS GATOS, CA 95031 TELEPHONE (408) 298-9399 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC --NEW-BAL - ---------- ------------- ---------- ---------- --- 1BCBSC VALUATION 10, 071 . 00 1 . 00 0 .00 1 . 00 0 . 0 1BSEISMICR VALUATION 10, 071 . 00 1 . 10 0 .00 1. 10 0 . 00 1REROOFRES SQ FEET 32 . 00 416 . 00 0 . 00 416 . 00 ------0_00 ---------- ---------- ---------- TOTAL PERMIT 418 . 10 0 . 00 418 . 10 0 . 00 VOICE ID DESCRIPTION VOICE ID ----DESCRIPTION -------- _ _ - ------ ---- ----------- - -- ---------- _ 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF 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: YJ Job Site Address: 1 O Roofing Company Name: , Applicant's Signature: Date: 2 Greg Casteel Building Official Revised 07/30/08 Community Development 10300 Torre Avenue Cupertino CA 95014 408 Telephone 777-3228 P ( ) Fax(408) 777-3333 CUPElCI (NO Building Depaetment JOB ADDRES . ./ i PERMIT � 9 _ OWNER'S NAME: _ PHONE GENERAL CONT CTOR: - I am not using any subcontractors: Sim�ature b D ze Please check a2plicable subcontractors and complete the following-information: 8`r SUBCO T-13AClO� BUSINESS NAME I BUSINESS LICENSE. Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting L;n.oleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank I Sheet Metal (-.Sheet Rock Tile v /C tractor Signature Dae