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99090041 PIP e-Y�y CA' 7qcnoo Ail PERMIT APPLICATION FOR CITY OF CUPERTINO NUMBS REROOF PERMIT INSPECTION DIVISION PERMIT EXPIRATION (406) T77-3228 PERMIT EXPIRES IF WORK IS NOT STARTED . WfTHIN 130 DAVS OF PERMIT ISSUANCE OR 130 DAYS FROM LAST CALLED INSPECTION. BUILDING ADDRESS oZ/�yti �Y RESIDENTIAL COMMERCIAL OTHER OWNER'S aHAZARDOUS FIRE .AREA YES ❑ IIes— o indtlalClassA NAME ernshyaaagwred. NO DI - - Imbal I.C.S.O.k ADDRESS (O(ppJ (]��T EXISTING ROOF COVERING PHONE Flo to �2 (OJ NUMBER OF EXISTING COVERINGS CONTRACTOR'S /./ TO BE REMOVED TO BE RETAINED ADDRESSPE OF ROOF COVERING CITY&ZIP a� 3 r�' 3 " .r , .q,r,,3G EXISTING PHONE /7/0 BUILT-UP�/? —�3 3 BUILT-UP ROOF El UCENSENUMBER (� �Z.92.,� ASPHALT SHINGLES UCEN$ED CONTRACTORS DECLARATION _ hereby that em licensed!nslicensed!under provisions of Chapter B(commencing with Section WOOD SHAKES - ]000)of Division 3 0l the Business and Professions Code,and my license Is In lull lone and effect. -�' / �S WOOD SHINGLES ElLicense Clew�!_C� Lla Number l�-7.2 9 •2 Date ' contractorV OTHER(SPECIFY) OWNER-BUILDER DECLAAA N I hereby affirm that I am exempt from the Contractors Urease Law for the following reason. PROPOSED (Sac.7031.5,Business aam Professions Code: Any cty or county whlch requires a permit to J construct,ensu,Improve,demolish,orn repair any structure,prior to Its issuance,also requires the ' BUILT-UP ROOF of dre o tracto'permit a file a signed statement that it licensed pursuant to the prwof ma of the ss an dors Uconse Law(Chapter h(commencingisexptwith Section]000)of for the 3 of the ex Business and Pre violation of f Cade)or met he is exempt therefrom end the bads ler the alleged ASPHALT SHINGLES exemption.Any f act onof Sedlcn hundred byany applicantfor a Permit subledstiro applicant to. e dull penalty of not more than fire huntlred dollars($,SOO)J: ' I ❑1,as owner of the Property,or my employeas with wages as their sole compensation,will do, - WOOD SHAKES ❑ the work,and the structure Is not intended or.ifarad for Bele(Sec.706,1,Business and Proles-, cions Code: The Contractors Ureter,Law roes not appy to an owner of property who builds or WOOD SHINGLES Improves thereon,and who does such work himself orthrough his own employees,pro+kfed that ❑ such Improvements are not intended or offered for sale.If,however,the building or Improvement Is sold within one yearrol completion,the owner-builder will have the burden of proving that he did OTHER (SPECIFY) ❑ not buffo or Improve for purpose of sale.). E]1,as owner of the pmparty,am exclusively contracting with licensed contractors to constmct the project(Sec.7044,Business and Professions Code:The Contractors Llmnse Law does not PROVIDE I.C.B.O.REPORT NO. appy to an owner of property who bullde or Improves thereon,card who contracts for such projects with a contwctorls)ilmnsed pursuant to the Contractor's License law. PROVIDE MFGR.INSTALLATION SPECS. ❑I em exempt Lamer Sec. ,e&P.C.for this reason owner Date APPLICATION DATE PALLIATION PERMIT FEE -- WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declaration: ��{{{ Building ❑ have antl will melnceln a Certificate of Consent to sell-insure for Workers Oompensatbn, f ' 6CC� y d3S as provided for by Section 37W of the"IXa Coda,for the performance,of the work for which this II'`fll OU the Lperma is issued. Seismic �2 ❑I have aam will maintain Worker's Compensation Insurance,as required by Section 3]00 of `((//�� the Labs Cee,for the performance of the work for which this permit Is Issued.My Worker Total � 0 Compansatbn Insyure carr r and Polley number are ��w.�f�j 0 Caviar S -te'^� Policy N.. w"�" fcf i/0 6 IZATION DATE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE N.C.0 c^' (This sermon need rot be completed If the permit Is for one hundred dollars($100)on less.) Z !1 I rarity that in the performance of the work for which tiro permit Is Issued,.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Iowa of Call- All roofs shall be inspected prior to any roofing material being forma. ��, installed. If a roof is installed without first obtaining an Data Applicant inspection,I agree to remove all new materials for inspection. NOTIdET APPLICANT: 11,after making thi mficat.of 6remptlon,you shou becomer� Applicant understands and will Comply with all non point subject to the Workers'Compensation provision of the Labor Coce,you must forthwith comply pp p y with such provlalons or this permit shell W deemed revoked. Source regulations. I certly first I have read this application and state that the above Informetfon Is carted.I agree to comply with all city and county ordinances and state laws raising to building construction,and All roof coverings to be class"C"or better. hereby authorize representatives of this city to enter upon the above-mentioned property for in- spection purposes. . y� (We)agree isand save,intlemniw and keep harmless the Cly of Cupertino against liequen a •e/r y judgments,costa end expenses which may In arty way accrue against said City in consequence S URE F AP 'I NT' /, DATE of file prancing o1 this permit. _ ' PRE-INSPECTION: PLYWOOD: IN-PROGRESS: INSP. DATE INSP. DATE INSP. - DATE TEAR OFF INSPECTION: BATTENS: FINAL: INSP. DATE. INSP DATE INSP.- DATE NOTE: OSHA APPROVED ACCESSTO ROOF SHALL BE PROVIDED FOR INSPECTION OFFICE COPY _ - • CITY OF CUPERTINO - BUILDING DEPARTMENT RE-ROOFING POLICY 1. Prior to permit issuance, you must agree to comply with U.B.C. standards and manufacturers specs on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspections 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 types of roofs shall be inspected prior to any roof being installed. 4. In order to receive a final, you must complete steps 1,2, and J. t. Pre-inspection or tear-off approval 2. In-progress inspection approval 3. Final inspection approval a. Operable smoke detector verification 5. If plywood is installed, a plywood nail inspection is required. • 6. If any roof is applied without first obtaining an inspection, you will be required to remove all new material down to the sheating and a building inspector will inspect all sheating at that time. IMPORTANT: 1. Flat roofs must have a 'h" per foot slope, or,demonstrate that there is no ponding. 2. I.C.B.O. reports are required to be on the job site at the time of inspection. If you do not have one, contact the building department. WE UNDERSTAND THE ABOVE POLICY ON RE-ROOFING AND WILL COMPLY WITH THE POLICY. HOMEOWNER'S NAME: ADDRESS: 2/, / RE-ROOFING CO�NAY NAME: ZZ �s L , APPLICANT'S SIGNATURE: v CITY OF CUPERTINO BUILDING DEPARTMENT Rc.moi7winword 4-N ,(� 0 INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO • BUILDING PERMIT INVOICE OPERATOR: chrietya Sec: Twp: Rng: Sub: Blk: Lot:35715D98.00 INVOICE DATE...... : 09/07/1999 REFERENCE ID k ... : 99090041 SITE ADDRESS ..... : 21841 ALMADEN AV SUBDIVISION ...... . CITY .. ........... : CUPERTINO IMPACT AREA ...... . OWNER . ........... : ENG, KEN WONDY ADDRESS ..........: CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014-2855 CONTRACTOR .......: WAGNER, SCOTT R LIC # 12594 COMPANY .......... : WAGNER ROOFING CONTRACTORS INC ADDRESS .......... : 12242 SARATOGA-SUNNYVAL RD CITY/STATE/ZIP . .. : SARATOGA, CA 95070 TELEPHONE ..... . . . : (408)777-8331 FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- _"_ --------- ------------ ----------- BPERMFEE P 147.00 0.00 147.00 BSEISMICRE P 0.90 0.00 0.90 147 90 0.00 147.90 V ID DESCRIPTION VOICE ID DESCRIPTION _. .. ........ ---------- FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS • CITY OF CUPERTINO I• 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: chrietye COPY # 1 Sec: Tvp: Rng: Sub: Blk: Lot:35715098.00 i DATE ISSUED.... . . . : 09/07/1999 RECEIPT #....... . . : 9980 REFERENCE ID # . .. : 99090041 SITE ADDRESS ..... : 21841 ALMADEN AV SUBDIVISION ...... . CITY ............. : CUPERTINO IMPACT AREA ...... . OWNER .......... .. : ENG, KEN WONDY ADDRESS........ . .. CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014-2855 RECEIVED FROM .... : DAVE CONTRACTOR ....... : WAGNER, SCOTT R LIC # 12594 COMPANY .......... : WAGNER ROOFING CONTRACTORS INC ADDRESS .......... : 12242 SARATOGA-SUNNYVAL RD CITY/STATE/ZIP ... : SARATOGA, CA 95070 TELEPHONE ....:... : (408)777-8331 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 91000.00 147.00 0.00 147.00 0.00 BSEISMICRE VALUATION 91000.00 0.90 0.00 0.90 0.00 is PERMIT : ----147 90 -0.00 147 90 ------0 00 METHOD OF PAYMENT AMOUNT NUMBER _ ----------------- ------------ ------------------ CHECK 147.90 2670 ------------ TOTAL RECEIPT 147.90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ ............................ ........ ............................ 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS •