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07110035 CITY OF CUPERTINO ` °' ` BU1LD'tNG DIVIStON pERMIT �`��]��+�1� �� ' <: , :. ..: .:. . :. _ . ;: ... .... BUILDING ADDRESS: PERMIT NO. 7746 OROGF�NDE PL ALL SEASONS ROOFING SERVICE 07110035 . �VER'S NAME: PERMTf ISSUEDATE LUM DARREL 1720 SMITH AVE 11/07 2007 PHONE: SANITARY NO. COMROL NO. ARCHITECT/ENGiNEER: BUiLDING PERMTTINFO TEAR OFF EXSTNG ROOF & INST B� EO p�O � � O p LICENSED CONTRACTOR'S DECLARATION � I hcrcby afGcm that I am liccnscd undcr pmvisions of Chaptcr 9(commencing Job Description � V � wiih SccGon 7000) of Division 3 of thc Business �nd f'ons ��nd my licensc is .T ~^ ^^^~^ '� y in full force and eff , / � Z Licenac Clats L�. � ,'^, � O Da�c Coniracwr ARCHITECI'S DECLARA7'10 ,� � U I undcrstand my plans shall be wcd u puAiic rccords a 4 O y Licensel Pn�fcssional n y � OWNFR-BUILDER DECLARA'CION � <� I hercby alTirm �hat I am cxcmpt Crom �hc Coniractors Liccnsc Law Cor thc L p O foliowing rcason. (Scction 7031.5. Business and Profcssions Calc: Any city or county K m Pi which requiccs a permit to consuuc4 a�tcr, improvc, dcmolish, or �epuir any swaurc �� prior w iis istuancc, alsu rcquires ihc applicant for such permit to filc a signcd smtement � x � that he is ticenxd pursuant to �hc pmvisions o[ thc Contractor's Li��cnse Caw (Chapicr 9 Sq. Ft. Floor Area Valuation y F- $ (commencing wi�h Sccdon 7000) of Division 3 0[ ihc Busincss and Professions Codc) or y �.. that he ia exemp� therofrom and ihe basis for the aileged exemptian. Any violation o[ Sectian 7031.5 by a�ry applicant (w a pem�it subjecu ihe applican� to a civil penalty of APN Number Oeeupaney Type not more Ihan fiw 6undred dollats (5500). 0 I, u owner of Uie properry, or my employces with wages as the'v sole compensadon, will do the work and ihe s�cuaure is not intended or olleced tor sale (Sec. 7044. Busineu and Pro(essions Code: The ConuacWr's License Law does not apply W an owur af Required Inspections propeny who builds or impmves �heccon, and who das such work himsel[ or Uuough his awn employccs, providcd that such improvemen�s are not iNended or olibred for salc. If. however. �he building or improvanent ia sold wiihin one yesr of compleGon, the owner- builda will htw We burden of proving Wat he did no� build or improvc for purpose of sakJ. 0 I, as owner of the property, am exclusively conuacting wi�h licenxd conuactors a consuuct the pmjea (Sec. 7044. Business and ProCessions Code:) The Contractor's Li- cente Law docs no� apply W an ownu o( propeny wha builds or improves themon, and , who contracts (or such projects wiU� a conlractor(s) licensed pursusnt w �he Conlractor's r.icense I.aw. 1 am exempt undu Sec , B dc P C for this rcason „W� Date WORKER'S COMPENSAT[ON DECLARATION 1 hereby allirm under penalty at pery'ury one of the following declarations: ❑ I hsve and will mainuin a Cenificate of Consen� W ulf-insure far Workcrs Compen- sarion, as provided fw by Section 3700 of �he Labor Code, [ar the performance oC the work for which this pem�it is issued. ❑[ Aave and will maintain Wwker's Compensation Insurance, u �equired by Section 3700 of �hc Iabor Codc, for the pedorm ce o( �he work for which �his permi� is issued My Work �C rticr and Policy n�g azc: M �� Cartier:c� 1'T I'� �"� Poliry No.: t/ FJv CER'I7F7CA7E OF EXEMPI'ION FROM WORKERS' COMPENSATION iNSURANCE • (fhis sectian need not bc completed if the pecmit is for anc hundred dollaza (S I00) or Icss.) • 1 cenify th¢t in t6c performancc of �hc work for which �his pertnit is issucd, l shall not employ any persan in my manncr so u to bccomc subject to thc Workcrs' Compensatlon Laws of Califomia Date Applicam NOl7CE T'O APPLICAM: If, a(tcr making ihis CcrtiCcatc of ExcmpGon, you should become subjcct w �hc Workcr's Compcnsation provisions af thc [ahor Codc, you muu � O foMwith camply with such provisions or this permit shall be dcemcd �evoked. z ""' CONSTRUCCION I.ENDING AGENCY (- �- I heredy alTirm ihat there is a consuucUon Iending agency Cor ihe perCormance of a� ihc work fur which this pertnit is issued (Scc. 3097, Civ. C.) W� Q Lendcr's Namc , • � z Lender's Addmss V 0 1 certify Wat 1 haw rcad ihis application snd su�c �hat the above informaliun is w►�' cortcc� I agree w comply with alt ciry and county ortiinances and state laws celadng w 0 U buildin6 consuuction, and he�by authariae representatives of this ciry to en�cr upon �hc � w ahove-mcntioned property fm inspccdaa purpaus. (Wc) a�ce �o save, indcmnify and Iwm�less the City of Cupertino agaimt �� liabilitiu, judgmcnls, cosls and eacpenses w may in any way accruc against said City // V z in conseque�c oC thc grandng of this pc i� //�� "� APPLICANT UNDERSTANDS AN ILL COMPLY WITH ALL NON-POINT Issued by: Date � SOURCE REGULATTONS. Re-roof:; Signaturo of Appliant/Contracwr Da�c T of Roof HAZARDOUS MATERIALS DISCLOSURE }�� 11 the applicant or fmurc buildiag occupant storc or handtc ha•rardous matcrial kfincd by the Cupertino Municipal Codc. Chap�cr 9.12, and rAe Heal�h and Safety _.� SccGon 25532(a)? All roof � shall be inspected prior to any roofing material being installed. ❑Ycs �No Will the applicant or future building accupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove emi� harardous air con�aminan�s u dcfincd by �he Bay Arca Air Quslity Managcmcnt all new : naterials for inspection. a$�;�� aYa �. 1 havc rcad ihe haiardwu matcrials requircm ndcr Chapicr 695 of Ihc Califor- nia Hcalih & Safcry Code. Scctiort� 25505, 25533 534.1 umlcrstand ihaz if Uu building does not curten�y have a tenan4 that it is my nsiAiliry w noufy the occupant af �he requiremcnLS which must be mel prior W' a Ccnificam of Occupancy. S IgI13ti1L � of Applieant Date Owncr or autharized agcni p„� All roof coverings to be Class ��8�� ar better CITY O? CUPERTINO 2 ITEMS OF 8 PERMLT RECEIPT OPERATOR: patg COPY # : 1 Sec: Twp Rng: Sub: BLk Lot: APN ......... 3�218023.00 DATE ISSUED.......: 1L/07/2007 RECEIPT #.......... B3000003183 REFERENCE ID # ...: 01110035 SITE ADDRESS .....: 7746 OROGR.ANDE PL SUBDIVISION ....... CITY .............. CJPERTINO IMPACT AREA ....... OWNER ............. L7M DARREL ADDRESS ..........: 7746 OROGR.ANDE PL CITY/STATE/ZIP ...: C7PERTINO, CA 95014 RECEIVED FROM ....: A�L SEASONS ROOFING CONTRACTOR .......: G�RSHTEIN, VLADISLAV LIC # 21035 COMPANY ..........: A�L SEASONS ROOFING SERVICES ADDRESS ..........: 1720 SMITH AVE CITY/STATE/ZIP ...: S.�N JOSE, CA 95112 TELEPHONE ........: (�08)971 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 5,600.00 126.36 0.00 126.36 0.00 BSEISMICRE VALUATION 5,600.00 0.60 0.00 0.60 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 126.96 0.00 126.96 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 736.74 #22666 --------------- TOTAL RECEI�'�' ':, 736.74 Community Development Department . Building Division City of Cupertino 10300 Torre Avenue Telephone: (408) 777-3228 Fax: (408) 777-3333 Building ��epartment Subj ect: Re-roof ing policy f or the C�.ty 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 applied without first obtaining all inspection and written approval from the building inspector. A final inspection and approval shall be obtained from the buil ding 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 sheathi.ng, so a proper City inspection can be perfc�rmed. �. NOTE: If you call for a plyWe�o fee $17618 n The re- fee must you will be charged a re-insp 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 comply with the abovf� stated policy on re-roofing. Homeowner's Name: � � � �E' -e -� � �.� � Job Site A��re SS: D� o�'-� ti c✓e ,��. ��P.�; �c.o GA � 9.So/ �j ofin Com an Name: �� " " " � � � �� Ro g p Y Applicant's Signature: Date: ��'�� Greg Casteel Building Official Revi ;ed 11 / 2/ 04 __- �`7i 1 ��.�� CITY OF' CUPERTINO � Rl1T�tJt�F ��P��T��C� PERMIT APPLICATION FORM APN # � � r� �('� b� t Q� Date: �� '�4 Building Address: . ti� � �e � e � N��e P�e Cu �e,e c� �o! Owner's Name: Phone #: �a �. � � � l urn �08 -�L��'-4�4 9 Contractor: License #: A�e eQ�o,v� �oo iti ��evi�Q� �5909�/ Contact: Cupertino Business License #: A��x � yo8-�,10-�2.3 � � � 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) 4 �� p U � Number of existing coverings Q'e �'S � Provide I.C.B.O. Report # � � To be Removed ❑ Provide Mfgr. Installation Specs. ��L14 � I Have Read, Understand and Will Com 1 With Cii ertino's Tear Off Polic : � Job Description: 7'� c � � p �` x[ �� .�^tig`��-e �om� P �emg�a� � �? S �cs. Residential � Commercial ❑ Fire Zone: Yes ❑ No � Confirmed with Planning Dept. if there are an restrictions: L� Cost of Project: Type of Constru �tio�;_ Occupancy group: �, 6 od, csJ Re �2 00 �, �� _ -- Qh'. if A licable Fee ID Fee Descri tion Fee Grou BPERMFEE 131d Permit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING