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07100074 CITY OF CUPERTINO BUILDiNG BIVISION PERMIT ��Q� Z��I ' ,.. : . . ;. . _,. __ . PERMIT NO. HUIL q��1 R DE LA FARGE DR SILICON VALLEY ROOFING 07100074 � PERMTT ISSUE DATE OWNER'S NAME: . NARAYANAN PARTHA SARATHY 825 CAMI�EN AVE 10/09/20.D7 SANITARY NO. CON7'ROI. NO. �NE: (408) 86E�-1800 BUILDING PERMITINFO ARCHITECT/ENGINEER: B�DG ELEGT PLUMB MECH � 0 � L� � p � LICENSED CONTRAGTOR'S DECLARATION JOb DeSCi1pL10❑ ^ v� I hcrcby aCfirm �hat I am licenscd undcr provisians oC Chapicr 9(commcnci�g :z� w iihsccuon7ocx))otDivision3ofihcBusincssandProfcssionsCode.andmy�iccnseis REMOVE F: EMAINDER �F ROOF, INSTALL 1/2" �SB INSTL >>y infuliCorccand c(( �� # 7.• 3� 50 YR C()MP� 30 SQU� CLASS A j v� Z Licensc Claz - p Datc Conusctor : ~ � RCHITECI'S DECLA Tl N j a .a � 1 undcrstand my plans shall bc uscd as public recordt )aU ° u. y Liccnsed Profcssional . � a OWNER-BUILDER DECLARAT'ION � a� 1 hcrc6y at7rm Ihat 1 am cxcmp� Gum ihc Contractor's Liccnsc Law for thc p o [ollowing rouon. (Scction 7031.5, Business and Profcctions Ca1c: Any city or rnumy <,°, �i which rcquires a�it tu consuvct. altcr. improve. dcmnlish. or repair any structure �''^ prior ui i�s issuancc, alsa rcquires ihc applicant for such permit to filc a signed statemcnt �; Ft. Floor Area Valuation -? a tha� he is liccnsed pursuant to the provisions of Uie Conuactor's Liccnsc Law (Chapter 9 ` � 1 O O O O Y t �(commcnci�g wi�h Scction 7000) of Division 3 of �c Business and Profcssions Cadc) or y�� that he is exempt the�efrom and the basu for tAe allegcd ezemption. Aoy violauon a( Section 703I.5 by a�ry applicant tor a permit subjecu iho applicant to a civil penalty af 3 5 9 2 6 0 2 i)�� Number Oceupancy Type not more than five hundrcd dollars (SS00). ❑ I, u owncr o[ tlie property. ar my cmployces with wages as th�'v solc compensadon, wilt do the work and the stcuctu¢ is not intendcd or offeted forsak (Sec. 7044. Busieiess Required Inspections and Professions Code: The Canuactor's License Law docs not apply w an owna uf property who builds or improves thercon, and who doas such wark himselt ar �hmugd his own employces. providcd that such improvements are not intended or o[fereA Cor sale. I[, however, the building or improvement is sold within one yesr oC complcdon. �he owner- builder will have the burden of proving Wat he did not build or improvc [ar pmpox of sa1cJ. �[, as awner o[ the property, am eacclusively convacting with licensed contraunrs W conswct the projett (Sec. 7044. Business and Protcssions Code:) The Contractnr's Li- ccnse Law docs not apply w an owncr of property who builds or improves U+eceon, and , who convacts for suc6 pmjects with a contractor(s) lia.nsed pursuant to the Conuutors License Law. Q 1 am uempt under Sec , B 8c P C for ihis mzwn Owner Date _ . - WORKER'S COMPENSA"ITON DECLARAI'ION 1 hereby aCfimi under penalty of perjury one o( �he following declara�iont: ❑ I h:ve and will maintain a CertiGcate of Conscnt to self-insure for Workers Compen- sation, as provided for by Section 3700 of the Labor Code, [ar the performance of the work for which this permic is issucd. ❑ I havc and will maintain Workcr's Compensation Insurance, as rt:quired by Section , 3700 oC �he labar Codc, for �he performance of the work for which ihis permit is issueQ My Workers Compensation Insucance carticr and Poliry number � � Carrier. S�� f"v`v� Policy No.: tl d �� I CERTiFICATE OF EXEMPI'fON FROM WORKERS' COMPENSATION INSURANCE (This sccdon necd not bc complctcd i( the pc[mit is far onc hundrcA doDus (5100) , ar Icss.) I certify th�t in thc performancc of thc wark for which this permit is issucd. I sAal� not employ any person in any manncr so as to becomc subject to the Workcn' Compensation Laws of Califomia. Da�c Applicant NOTICE TO APPC.ICAM: If, aftcr making this Ccrti6ca�c of Excmptian, you shau�d become subjcct to the Workei s Compcnsation provisions of thc Labor Codc, yau muu � O forthwith comply with such provisions or this pecmit sha0 bc dccmcd mrokcd. z '—' CONSTRUCI70N LENDING AGENCY (.�-� `-�. 1 hemby aflirm ihat there is a conswctian Iending age�rcy far the performance u( (Y„ � ihc wurk Cur which this permit is issucd (Scc. 3097, Civ. C.) , LL� Q Lendcr's Namc � z Lender's Address I cenify thai 1 have rcad this applieation and su�c that �he a6ove informauun is �� cortcct. I agrce to �omply with all ci�y and county ortlina�es and state laws �elating io 0 U building conswction, and he�eby authori�e rcprcsenutives of ihis city to enter u�n �hc � W abovc-mcntiuncd proper�y (or inspccuon purposes. a (We) agrce to save, indcmnify and kecp harmlcss the City of Cupertino against �,F"„� � liabiliues, judgmcnts. cos�s and expenscs which may in any way accruc against said �ty V z in consequcncc of U�c gcanting of ihis permit. DSIe � ►�+ APPLICANT UNDERSTANDS AND WILL COMPLY W1TH ALL NON-POINT Issued by y" sp�ee�u�oes, !� � c� t�,�_ Re-roofs �� —� Signat afApplicandConuactor �� HAZARDOUS MA'fERIALS D[SCLOSURE Type of R.00f Will Ihc applicant or Cutwc building occupantstore or handlc harardous matcrial as dcfincd by the Cupertino Municipal Code. Chapicr 9.12. and �he Hcal�h and Sa(ay c«k Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. � ycs �j No . �` If a roof is installed without first obtaining an inspection, I agree to remove Will thc applicant or Cuturc building occupant usc cyuipmcnt or dc+�iar whicb cmii hazardaus air con�aminants as dcfincd by the Bay Arca Air Qualiry Managcment all new n.aterials for inspecrion. ��su��? ❑ Ycs �['] No /\ � �� 1 havc rcaJ the ha�ardous matcrials rcyuiremcn�s undcrChaptcr 6.95 of ttic Cal+fw- /� nia Hcalth & Safcry Codc, Scctians 255Q5, 25533 and 25534.1 undcrsund thaz if ihe buildin6 ��. v locs not curtently have a tenan4 Ihat it is my responsitrility w nouCy the occupant of �he ky cn�w� s�bcmetpriortuissuanaoCaCcrti� atc�f�c�p� Signature ofApplicant Date � �-�--- All roof coverings to be Class "B" or better Owncr or authorizcd agcn� Da�c - �� c� o �7 y CITY OF CUPERTINO { �*``` RElZOOF CUP�t�T1N0 PERMIT APPL,ICATION FORM APN # Date� � ��9 � �� - ° C� a Building Address: , � � � � — 2 � Owner's Name: Phone #: t� A�.A- .�-� �- , cl�-�- c�8 0? t�-a 1� a— Contractor: ��% License #: � C�-U �r1Cf� f ��'1/ '�J � 2 . Contact: Cupertino Bu iness License #: �- � � � o�-��-�-� 2 � 3 � Z 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.B.O. Report # ❑ To be Removed ❑ Provide Mfgr. Installation Specs. I Ha�e Read, Understand and Will Comply With Cu ertino's Tear Off Policy: ❑ Job Description: , !Xllk�D �" � v�n � rU 1D�� ``o c� s L L � �� S NSf S�� c Residential (�-- Commercial ❑ � � C 1..ass �A � Fire Zone: Yes ❑ No � Conf'umed with Planning Dept. if there are any restrictions: LJ Cost of Project: Type of Constru�tion: Occupancy group: D Do �-- 2. — '� ' Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BIJILDING BENERGY Energy BLTILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BIJILDING Community Development Department ' - � Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408)777-3333 Building I)epartment Subject: Re-roofing policy for the City of Cupertino 1. Prior to permit issuance, you must agre�� to comply with 1997 UBC Standards and manufacturers specifications on re- roofing. 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 bui lding 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 :nspection is required. 6. Any roofing which is applied without f:rst obtaining an inspection, will require the removal of all new mat��rial down to the sheathing, so a proper City inspection can be perfc�rmed. 7. NOTE: If you call for a plywood nail ir�spection and the job is not ready, you will be charged a re-inspection fee �f $176.18. The re-inspection fee must be �aid 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 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: �� ' ��'J `'�� `�� Job Site Address: � '� `� � 1 J-k- �--- �— r � ��— Roofing Company Name: � �' � � A licant's Si ature: J 'C- --- ' __ _ Date: � Q �!�� rr � Greg Casteel Building Official RevisEd 11/2/04 CITY OF �UPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blk: Lot: APN ......... 35926020.00 DATE ISSUED.......: 10/09/2007 RECEIPT #.........: BS000002941 REFERENCE ID # ...: 07100074 SITE ADDRESS .....: 7491 DE LA FARGE DR SUBDIVISION ....... CITY .............. CUFERTINO IMPACT AREA ....... OWNER ............: NARAYANAN PARTHA SAR.ATHY ADDRESS ..........: 7491 DE LA FARGE DR CITY/STATE/ZIP ...: CUFERTINO CA, 95014-4308 RECEIVED FROM ....: JAI�A HORSAGER CONTR.ACTOR .......: PAi:L HORSAGER LIC # 23342 COMPANY ..........: SILICON VALLEY ROOFING ADDRESS ........... 82� CANIDEN AVE CITY/STATE/ZIP ...: CANPBELL, CA 95008 TELEPHONE ...... (4C8)866 FEE ID UNIT QUANTITY FMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 10,000.00 169.56 0.00 169.56 0.00 BSEISMICRE VALUATION 10,000.00 1.00 0.00 1.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 170.56 0.00 170.56 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 170.56 . MC --------------- TOTAL RECEIPT : 170.56 Community Development � � 10300 Torre Avenue ;�' .� , ;�;• Cupertino CA 95014 �� ' Telephone (408) 777-3228 CI7Y OF Fax (408) 777-3333 ';UPEI�TINO Buildi:n De artment JOB ADDRESS: • � i � L 4 �� PERMIT � � �� OWNER'S NAME: � a. tv ►J n- S4 Ra. PHONE #�-� �- �-',�� GENERAL CONTRACTOR: �„� � FAX # ={�8• - 86 E� /�. 7� I am not using any subcontractors: `� -- � j �`�- Si;;nature Date Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIrtESS NAME SUSINESS LICENSE # Cabinets & Millwork Cement Fini.shing IIectrical 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 � � O � � — Owner/Contracto Signature ate