07100010 CITY OF CUPERTINO ` / � s ' `
BU[LDING DIVISION PERMIT ������^������������ '
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PERMIT NQ.
BUILD � r ��� ES LINDA VISTA DR AMERICA S ROOFING 07100010 .
OWNER'S NAME: PERMTT LSSUEDATE
SPENCER ALAN L AND ALICE C 535 N 7`.'H ST � 10/01/2007
�NE: SANITARY NO. CONTROL NO.
(408) 66:_-6501
ARCHITECT/ENGINEER: BU►LD[NG PERMIT iNFO
BLDG EI,ECT PLUMH MECH
� 0 0 0
i p p LICENSED CONTRACTOR'S DECLARATION JOb DCSCflpt10❑
� v F I hcreby afGrm �hat I am liccnscd unJcr provisions oC Clup�cr 9(commencins .
; Z, � wi�h Sccdon 7000) o( ivisio 3 of the Business and ss���s Code � l ry� l i f cnsc is REMOVE ._ ROOF , I NSTL 1/ 2 IN C DX W/ LANDMARK TL .�
'�°� in full Coree and ef t � O �� �, f
j� 2 Licensc ats �� X 2 3
: F� Da � RCHITECTS DECLARATION SQUARES
i a a I undcrswnd my pl ns shall bc uud as public rcconls
�yU
' u. y Licenscd Pcufcssional
� � � OWNER-BUILDER DECLARATION
>' I hcreby alTirm that 1 am exempt frum thc Conuactor's Liccnsc Law for thc
� p O Collowing reason. (Sccuan 7031.5, Business and Profc4sions Cak: Any city or rnun�y
�,°, � which rcquires a pertnit to rnnswct, altcr. improvc, dcmolish, or repair any svucturc
� Z y prior to ils issuancc, also rcquires thc applicant for such permit to filc a signcd siammcnt
�= a �� he is licenscd pursuanl to thc provisions o[ thc Contractor's Liccnsc Law (Chapicr 9 ; iq. Ft. Floor Area r Valuation
� t— �(commencing wiih Sccdon 7000) of Division 3 of thc Busincss and Profcssians Cadc) or ^l 7 � � �
,�, �� that he is ezempt thcrcfrom and Ihe batis Cor ihe alicgcd eumption. Any violauon of
Section 7031.5 by arry applicant (or a pertnic subjects �he appiicant to a civil penalty oC Q� Number Oecupancy Type
not more than fivc hundmd dollars (5500). 3 5 6 2 6 � 2 ��: V�
❑ I, u owner o[ tt�e property, or my employces with wages az the'v solc compensadon,
willdaihework,andWeswduccisnotintendcdorof(eredforsale(Sec.7044.Business Re uired Ins eetions
and Professions Code:'il�e Conuactor's License Law does mt appiY w an owner of 9 P
property who 6uilds or improves thereon, and who dces such work himulf ar Uuough his
own emplayces, provided Uia� such improvements aze not intended or otlered for salc. I[,
however, the building or improvement is sold within one year of compktion, the ownu-
builder will have the burden of pmving that he did not buld or improvc for purpose af
sa�J.
❑ 1, as owner of the property, am exclusively conuacting wiU� licensed convxtors to
consvuct the pmject (Sec. 7044. Business and Professions CadeJ 1Le Contncwr's Li-
ccnse [aw docs not appiy to an owne� of propeny who builds or improves �he¢on, and .
who eontcacts for such projects with a comractoKs) Iicen:ed pursuant w ihe Convactor's
License [aw.
❑ I am exempt undu Sec. . B k P C(or ihis reaton
Owner ��
WORKER'S COMPENSA'I'ION DECLARAT[ON
I hercby �rtn under penalty of perjury onc o( ihe (ollawing declaralions:
❑ I h:ve an � I maintain a CertiGcatc of Consent to sclf-insure for Workers Compen-
saaan, vided far by Sec[ion 3700 af the Labor Code, for ihe performance o[ �Irc
wodc r which Wis permit is issued.
I havc and wiU maintain Workcr's Compens ' n Insurana, az �cquired by Scction
3700 oC thc Labor Codc, for thc performancc of �rk for which this permit is iswed.
My Worker's Com n Insu nce c r Po cy n�n� � I � ' � `
Camu: �� 1 l �
f7 TE FEXEMP!'[O FROMWORKERS'
COMPENSATION lNSURANCE
(Chis scction necd not bc campleted if the pertnit is foranc hundred da�ars (5100)
or Icss) '
I ceniCy thxt in thc performancc at thc work (or which Wis permit is issucd. I s6a11 not
employ any person in any manner so u w become subject ta the Workers' Compensadon
Laws of Califomia. Dam
Applicant
NOTICE TO APPLICANT: !f, aftcr making ihis Certitica�c of Ezcmption, yau shoulJ
bccome subjcct co lhc Worker's Compcnsation provisions o[ thc Labor Codc, yau must
� O forthwith comply with such provisions or this pccmit shall bc dccmcd retmkcd.
Z '"'' CONSTRUCTION LENDING AGENCY
E+� 1 hefeby affirm that there is a constructinn Icnding agency for the performance of
�., � �hc x�rk fur which �his pertnit is issucd (Scc. 3097, Civ. C.)
W� Q L.endcr's Namc '
a z L.cnders Address
U � [ certify U�at I havc read this applieaiion and sutc ihat �hc above information is
�►'� correc� I agree to comply with all city and county orefinances and siate laws relating to
rJ U building conswction, and hcrcby authori�e rcpmscnutivcs of this city io cntcr u�n lhc
� W abovc-mcntioncd pmperty (or inspccuon purposes.
a (Wc) agree to save, indcmni(y and kecp harmless ihe City o( Cupcnino against
H � liabilitiu, judgmcn�s, costs and expenscs which may in any way accruc against said City
() ,'� in consequcnce of thc granting oC ihis permi6 Date 2 ���
�+ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: �'
SOURCE ULATIONS. �(� � / �
� Re-roofs �—
Signaturc of ApplicantlConuac�or �� T of R�of
HAZARDOUS MATERIALS D[SCLOSURE }r�
Will thc applicant or futurc building accupantsmrc or handlc Iwardous matcrial
az dcfincd by tNc Cupertino Municipal Codc. Chap�cr 9.I2, and the Hcalth and SafMy
c� Scction 25532<a)? / -' All roofs : hall be inspected prior to any roofing material being installed.
❑ Y� ../ O No �
Will ihc applicant or future ilding occupant usc equipmcat or deviccs which If a roof i: installed without first obtaining an inspection, I agree to remove
cmit harardous air contaminan�fincd by thc Bay Arca Air Quality Managcmcn� all new m iterials for inspecrion.
as����
� Ycs ❑ Nu
1 havc rcad the hvarGous ma�crials reyuircmcn�s undcrChap�cr6.95 of thc Califw-
nialicalth & Safcty Code, Scctions 25505.25533 and 25534. ( undcrs�and that if Wc huiWing
ckcs not curtcntly havc a tcnan4 �at i� is my responsiAility m notify thc occupant n( ihc
rcyuircmcn�i m t bc met prior u� issuancc of a Ccrtificaic O� Signature �f Applicant Date
Owncrorauthorizcdagent p„� All roof coverings to be Class ��8� or better
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CITY OF CUPERTINO -���;� £ �� �� ����,����� 7�
BUILD[NG dIVI510N PF�,RNIIT ,., j ����� r� r���'� '
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PQtMIT NO.
8 ������LIIVDA VISTA DR AMERIC��' S ROOFING 07100010
OWNER'S NAME: pQiMLT L.SifE DAIE
SPENCER ALAN L AND ALICE C 535 N'�TH ST 10/01/2007
SAMITARY Na. CONTRO[. N0.
PHONE:
utcHrrECr�rrc�x�x: PHaNE#: REMOVE 1 ROOF, INSTL 1/ 2 IN Bu �� G P ����
BLDG ELECf PLCfMB MEtH
DX I�ANDMARK TL 23
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mF �s:>k::> ��- :;;, ;.e.,.�:` ,..�„ .���: ,� � 'CO ARRANGE INSPECTION JOB DESCRIPTION
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� � �#. -" �`<,A�,�;::va>���;�":':���:,f�"�:+;�' s �� .: : f �='k. s ll - ' R.ESIDENTIAL'
{.. � .��,��u���. .«:�.� ,��:�„ ; , ; �� : ,,. w t,�< � < �� , ,��;`' Ca 777 32..8 between 730 a.m. and 330 p.m.,
tq S :.+,.,'" :".S£%'<:":.�'YC`..A�a}� .?:i.$�^i.'�R ` ...�.'�,.?k:�RC: t%k%`�-�'. � ..2 �
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t- y Z ,. . <,>,� �� . �>..: }'s M-�� � `�>� � ��� _ •° � ' Monday thruugh Friday, at leust 24 hours before
z re uired in,; ection. Job address and Pe�mit Number ��DR1oN ❑ PLUMBING RE-PIPE
: F m FOUNDATION/P�RS/fLD•S. 9 P
� � are needed ��hen requesting an inspection. ❑�-TI-UNtT ❑ STR[1CIVRnL
� UFER GROUND MOD�iCATION
3,`,, t PAD/SET BACK-CERT ����(p1 COMMERCIAL U['FIER ❑ INTERIdR ' . � CHIMNEY REPAIR
�o" IMPROVEMENC ' ❑ SWIMMIIJG POOLS
y y � GARAGE SLABS/PREGUNITE
�' �; NA7ARBOUS FIRE AREA ❑ BATH REMODFLIREPAIR ❑ DEMOLITION
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W h UNDERGROLTND/SLAB Q Yes If yes - I uadersiaod iha� a Class A roof asxm6ly is required
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<=c UNDERGROUND PLUMBING
❑ No m«�� t.C.a.o. a
d�� UNDERGROUND ELECTRICAL COMMERCIAL•
DEMOLITIa
AD�I'fION N
VERING GJ ❑
F CO HLD
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00 NEIV
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EXI�'IN
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UNDERFi.00R PLUMBING ❑ TENAN►' " ❑ �a� SERVICE
Number of ui: ting tovuings IMPROVEMENT
UNDERFi..00R MECHANICAL . ❑ pTHEtt
UNDERFLOOR ELECI'R1CAL To he removed To 6e recained
UNDERFLOOR FRAMING VENTS
UNDERFL.OQR IN5U[.ATION • Typg OE ROOF COVERIIVG
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EQSTIN( _
ROOF SF3EATH/DIAPHRAGM ❑ euiit-�!p Roof ❑ euilt-Up Roaf
PLUMBING .
❑ Aspha t Shineles ❑ AsQhalt Shineles
TUBS & SHOWER PAN
ME�FiAN1CAL ❑ wood shakes ❑ wood Shakes
ELECTRfCALPOOL BOND ❑ Wood Shineles _Q Woad_�hingles ,
FRAMING/STAIRS/E. EGRESS ❑ O�her (SpeciFy) ❑ Other (Specify)
INSULATIONNENTILATION NO FII W1i. INSPECTIONS Provide I.C.B.O. Report Na
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latiaa S
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ravide Mf
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,:.:. :..: .:..::...:_:.�::...: .. . ... . .... , . .... UNTIL AtL RE6�UIRED BU I
EXTERIOR SHEAR/HOLD DOWN
INTERIOR SiiFAR/HbLD DOWN INSPECIIdN SFECiAL INSP�CTION REQUiRED ❑ oa.rE zr+sa
SHEEIROCK/SHEFIROCK SHEAR � �
EXTERIOR LATH/W-SCREED
SHOWER LATH
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SCRATCH COAT ,
S EW ERlWATER
TEMPORARY APPROVALS
OCCUPANCY
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y O :j':.',��<�„Y.,.�,�,��,�.,.,_`�,_'.`�',�2i%k::?:'.kt'�:::ii�::;::.:::?.;r;k::.�.k'S�.::y;..:<.k::�.k:i'E:'��;::::::s„F:»:.:$Y,.'Y;.:........•/ ..:..:...::.::::..:.:........
x _ •r •���' � � �-��A�-�--�- �'� CllPERTINO SANITARY DISTRIC
Z� P���G �� ' Closed c rcuit video inspection of property line cleanout, poiM of connection
x j GAS TEST and :�treet lateral required prior to passing FINAL CITY PLUMBING
� p GRADE (P.w. 777-3354) IR1SF'ECTION. Call the District (408-253-7071) for an appointment.
� Z FIRE - CALL (408) 378-�WlO
J � HANDICAP
� v ELEC['RICAL IMPORTANT
.��, a PLUMBING , .
J z When :� permit has expired, a charge totaling one the fees to
MECHANICAL
Y" Ei�rERGY obtain a new permit must be paid to reactivate the permit.
vISUAL FiNAL ONLY
BUtLDtNG [f a pe� mit has been expired for more than one year, a charge totaling
.. -: :-:�� the full fees to obtain a uew permit must be paid to reactivate the
�3�1�� �lfi��If:�B�� ��� �� � �
� �� F ��, � �..� �, ,��.� ����.� ��<. �,��<:, , � , . permi4
�.����'���'����i� � - .. �� $ ,
' �`�' � b �` ���-��'��'�,���;����;�`'� �� `%� . ° �� � � CERTIFiCATE OF OCCUPANCY ❑ ' .
F�F�EE�E3l� fi yY� y F, i" �5$ �.Y�'X°���bk�^ �� .r':�'...�6�'���
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PRE-MSPECTION: PLY`1VOOD: QV-PROGRESS:
[NSP. DATE �_ INSP. DATE INSA. �ATE
TEAR OFF IN5P£CCION: gaT�'�s� FINAL:
INSP. DATE INSA. �— DATE Q`tSP. DATE
NOTE: OSHA APPROVED ACCESS T�J ROOF SHALL BE PROVIDED FOR lNSPECTION _
, _ . _ ,�--ljo�v ��
CITY OF ��UPERTINO
��` REl�00F
CUPE�T�NO PERMIT APPL�ICATION FORM
APN #�� � � � � C� C� Datei , / . O �
Building Address: � I / � v . � � �
(� �
Owner's Name: Phone #: , I � � �
C tr ctor: �, License #: ��,
� �
o Cupertino Busmess License #:
tl�
Type of R oof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ ilt-Up roof
❑ Asphalt Shingles Asphalt Shingles
� Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) O Other (Specify) ,
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Spe .
I Have Read, Understand and Will Comply With Cu-�ertino's Tear Off Policy: ❑
Description• ' � '� j � � � ,
. � s��
esiden ' ❑ Commercial ❑
Fire Zone: Yes ❑ No Conf'irmed with Planning D�t. if
there are any restrictions: LJ
Cost of Pr ' ctE� Type of Constru�;tion: Occupancy ro p:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE 131dg Permit Fees BUILDING
BENERGY Energy BL�ILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
\
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CITY OF CUPERTINO
2 ITEMS OF 2 PERMI�' RECEIPT OPERATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Bl}:: Lot:
APN ......... 35E�26020.00
DATE ISSUED.......: 10,'01/2007
RECEIPT #.........: BS(100002837
REFERENCE ID # ...: 07:_00010
SITE ADDRESS .....: 11:.67 LINDA VISTA DR
SUBDIVISION .......
CITY .............. CU]'ERTINO
IMPACT AREA .......
OWNER ............: SP}:NCER ALAN L AND ALICE C
ADDRESS ...........
CITY/STATE/ZIP ...: CUI�ERTINO CA, 95014-4754
RECEIVED FROM ....: CHI:IS CASTILLO
CONTRACTOR .......: CHI:IS CASTILLO LIC # 27100
COMPANY ..........: AM}�RICA'S ROOFING
ADDRESS ........... 53`i N 7TH ST
CITY/STATE/ZIP ...: SAT1 JOSE, CA 95112
TELEPHONE ........: (4()8)661
FEE ID UNIT QUANTITY ���IOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -•-----=--- ---------- ---------- ----------
BPERMFEE VALUATION 7,000.00 137.16 0.00 137.16 0.00
BSEISMICRE VALUATION 7,000.00 0.70 0.00 0.70 0.00
----------- ---------- ---------- ----------
TOTAL PERMIT : 137.86 0.00 137.86 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CASH 137.86
---------------
TOTAL RECEIPT : 137.86
- _ Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building l�epartment
Subject: Re-roofing policy for the (:ity of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be appliecl 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 apprcval.
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 irspection and the job is not ready,
you will be charged a re-inspection fee ��f $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 on the job site at the time on inspection.
I understand and will comp 'th the above stated policy on re-roofing.
� ���,�
Homeowner's Name: `
J � �� c�
Job Site Address:
�
Roofing Company Name: � �
Applicant's Signature: �i( � ` Date:
Greg Casteel
Building Official
Revisec l 11 /2/ 04