05110072 CITY OF CUPERTINO -i' -
BUILDING DIVISION PERMIT �OIFRACTOR INF�OR�MARI1
BUILDING ADDRESS: CASTO ROOFING PEBmrrn0.05110072
891 ALDERBROOK Ld
OWNERS NAME: PERhQf Ire DATE
WILLIAM LOVVORN 1938 OLD MIDDLEFIELD Way 11 /1 c;/2nnc;
SA ARY NO. CONTROL NO.
(650) 961-8922
ARCHfTECT/ENOIN E" BVRDINO PERMRINFO
BIRO EL= PLUMB NECII
186 LICENSED CONIRACronS DECLARATION lob Description
EC M I botchy afrmm tku l tart Iicc under Pmt•of CW per 9(ammercln{ .
UU �L Section 70MdDMsI.Ot of Nc Buv�.ots PrefruWm Code,utl ml fc�u
ml rWl7 Off 7��3 REROOF-T/O SHINGLES, INSTALL COMP.
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Date It'r 4-. r7 Caenanot
3 W ARCHnF.CIS DECORATION
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OWNER-BUILDER DECLA I MN
v�T I botchy.17irm that I M=W1 fmm the carr t s I,xna Law for Wo
D fdmwne rcuoa(Salm 7W IS,Bufimu.ftd Pmfesaiou Colc:Arty city«muuy
$� whim mwitu a permit to auu«t aha,hnpwe-damu$«orepair any nnmre $8250
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WORKHiS COMPENSATION DECLARATION
I baeby.Birm order prmLL/af pnjay arc of We WllowinP AM �••••^
1haw.nd wnl maintain•Ccrifieta of C«uent to sclfi f«WorkelCompcn-
codoe,as puNticd for by Semon 3700 of the Labor Code.for We prform.na of de
work f«wbich Wla prmit is iaN.
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7700 of We labor Code,(«aio pJormume of work f«whir Wier Permit u Iwrd.
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CER'IIFlCATE OF IXEMPr10N P0.0M WORKERS
COMPIN ATION INSURANCE
0-bb,seflm Dad m bc�Pkad Jrha:parch V f«one hurtAsd doBm(5100)
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LapmyanyioatoL any mamcraoubhaome wb)tttm We Wortai Campvnuim .
Laws of CalifodL Due
Applicant
NOTICE TO APPLICANT:If.Cor
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bcome sob) WW CmNosadn M Lo «codO.Ym
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Z` CONSIAUCf10N LENDING AGENCY
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LY.> the work for which this pernfit la W d sm 3097.Cir.C)
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V,'� APPLICANT
of Lk statortial RSTANof this WIL Date
^ APPLICANT UNDE0.STANDS AND WILL COMPLY WRH 911.NON-POINT Issued by:
SOURCE REGULA
`� �'/n 11-r S DS Re-roofs
SlSrutu.edAppllcwUCaHAURD�(HIS MATERIALS DISCLOSURE Type Type of Roof
WIB We appllau or fuuc bulldlar oaoP•ot note a baulk hamdaa`oaoc ai
as lerrted by the Cupenlro Mood*Cade.Duper 9.1;ad We HUBS and Safctl
ale.5ectlon]7573G)7All roofs shall be inspected prior to any roofing material being installed.
El Yu
wm me appllo««rauvc b9i1din5 occupant a=waiP�0,dnim w* If a roof is installed without first obtaining an inspection,I agree to remove
mit huarMlo a1r vonumimnu u scfi t by the Bay Arta Au Qw1hy MmaFuex all new materials for inspection.
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Ma Healmoorcr*Coda.tcc tha,1,i2177 Ospoo t000ffy arra Jmc Moa tot �r f
dafrutcmrtxly nus.anmip It6myrcfp&RC=tymoofr Weo -Y. of dr
tegbmmrx.which ti<mel pd«mivuaLe or.ratirtnte or o'ogmray. -_ Signature of Applicant Date
7.1 rczz All roof coverings to be Class"B"or better
Owocr«.thxn iscru
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
40 F Fax(408)777-3333
�UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
891 I e✓br os-// 00r7'L
OWNER'S NAME: ; I i"Ckrh ✓o✓ rl PHONE # SD•9U I-R9
GENERAL CONTRACTOR C o-sJ-D 200F\ FAX # So .9 678/
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing.
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing eves s vol R ma
Septic Tank
Sheet Metal
Sheet Rock
Tile
yam_ CaAhL
Owner/Contractor Signature Date
Community Development Department
CL Building Division
City of Cupertino
10300 Torre Avenue
CITY OF Telephone: (408)777-3228
OUPEkTINO
Fax: (408) 777333
Building Department
Subject: Re-roofing policy for the City 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 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 1/4 " 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: 1)) M n /C_OV yo- ,rn
Job Site Address: o� / t I CUA V"` 0
Roofing Company Name:
Applicant's Signature: /1 W 1M�Cl4lflD Date: 0 ��
Greg Casteel
Building Official
Revised 71/2/04
Pnnted m Recycled Paper
1Q CITY OF CUPERTINO
REROOF
OF
CUPERTINO PERMIT APPLICATION FORM
APN # Date:
Building Address: o q
Owner's Name: LLQ/ [ Phone#:
Wj Il (+M L6VVOrAl wok c)is?-- -7S67
Contractor Phone #•, License#:
C�iv 20o- &17) qv 00--P
Contact, Phone#: I 1 Cupertino Business License #:
ids a13a
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
9, Asphalt Shingles X Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles O Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing covering ❑ Provide I.C.B.O.Report#
To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy: 54
Job Description: Pk vvt OL-e_ •_F.c( 1 A avkz.8 . � (1. n-1)eq (
2e-� w 40 6U, , o
Residential Commercial ❑ _.
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy,gro :
lb� 2 r K
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING