15040240 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10162 ALPINE DR CONTRACTOR:KEITH ROOFING CO INC PERMIT NO: 15040240
OWNER'S NAME:
SAN JOSE,CA 95126 PHONE NO:(408)295-8616
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑
REMOVE ONE LAYER OF EXISTING ROOFING AND
Itiicense_Qa _— _ Lic.# _ REPLACE
WITH TAR AND COOL CAP SHEET(700 SQ FT).
Contrao or E t T ;
I hereby affirm t at I am license nder the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
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
fiehItion
formance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$7850
ve and will maintain Worker's Compensation Insurance,as provided for by
3700 of the Labor Code,for the performance of the work for which this APN Number:32615023 00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
;r ertify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned 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
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with Cupertino Municipal Code,Section
918.
RE-ROOFS:
- —
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
1121 ADDRESS: 10162 Alpine Dr Apt A DATE: 04/30/2016 REVIEWED BY: SEan
APN: BP#: *VALUATION: 1$7,850
xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair
PRIMARY SFD or Du lex1 . PENTAMATION 1 SFDWLROOF
USE: p PERMIT TYPE:
WORK Remove one layer of existing roofing and replace with tar and cool cap sheet 700 sq ft).
SCOPE
'.
,,,ech. P11,n Check I' t}stI>.1':`car,£:hoe I;lec,.Plan C h er;1
F1ery..1'eimii Fee: I'iawlb.P erm'ir Fee" Istec..I'ea rrtii I ce:
03 he,'A'fech. Insp. ET-1- Othe7 .Y`hw,b Mq,, E1_L_ ()dreg 1'le'c•.Irsu.
Xlec}t.jrlq'.Fee:': 13hwtb.Insr>,Fee ISlec. rtFee:
NOTE.This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 700 s.f. Re-roof
Suppl.PC Fee: Reg. 0 OT 0.0 hrs $0.00 $119.00 IREROOFRES
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee: Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
.yC3Pi1/r"rlCtlflT} 7'av:
Arlrn rrisir al ve Few: 0
Work Without Permit? 0 Yes No $0.00 G)
Advanced Planning Fec: $0.00 Select a Non-Residential E)
Building or Structure 0
7i'aml Documentation Fees: A
Strong Motion Fee: 1BSEISMICR $1.02 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTQTALS.:' $2.02 $119.00 q TOTAti FEEL $121.02
Revised: 04/01/2015