06080237 CITY OF CUP [NO
IIUILDING dIVISION PERMIT CONTRAC"rORNF.ORMATIQ
BUILDING ADDRESS: ALL SEASONS ROOFING SERVI )!'RN0'06080237
10194 BARBARA LA
0 W NER'S NAME PERMIT ISSUE DATE
MIKKEL HAYS 1720 SMITH AVE 08/29/2006
ONE SANITARY NO. CONTROL NO.
(408) 971-4455
ARCHITERYENCINEER:
BUILDING PERMIT INFO
BIDCa EIFCT PLUMB MECH
0 0
o p LICENSED C'ONrRACTORS DECLARATION lob Description
1 bacby affirm Wall an Iken+d wo LM poa of Clapes 9(mmmeaing
wlW Seerion7")ar DNisim3a(Jr Bunts.and Profeul«u Code.a my Bcenwh
o rwlraaawua�2,$) ��clp(�5 ( REMOVE 2 LAYERS OF COMP ROOF. INSTALL 31 SQUARE
,qz liccrtaCLpItCmua� MI $tea.—�.e�..31 7/16" OSB WITH RADIANT BARRIER & 31 SQUARES LIF
i'-� Da` ARCIifIECrSDECLARATION TIME COMP ROOF. WEIGHT 3 . 6 - CLASS A
1 undemaW mY Pla^a shall h used a pobAe uuW
i U
'and L,icenrd Ptnf..eal
OWNER-Bl.P,rnot IhO RATION
I hertby oRm than I am exempt from We Cmaarea o,l:A n C Law for tK
too f ich ng tamm.(Section]0314,Bmnea LAM Pmfes,ioa Com:Any city at county
9 which«gwrts,o.aln ncanlste alta,hopmw. ifol h lire luny urunum
.Za pri«n ilsiatutt¢,aLw tNwwrte pmdvolatu f«uxnpvroll n rmalgnN(=Pm t
% fcOnacd Batimm'lIJ®aVwIC dc)or Sq.Ft. Floor Area Valuation
$ (eaobe is cag pLtboobo7fO0)wDiacO3ftaftw B®wasaalt Pro(aioru Code)« �$.;2 5
dun m u asap they ppi and Ne bath(«We -thi, esamaOt to Any it"Ito of .
Salon]mu w any amd"It f..pesml subjew d<,pplkml w a can pen,lty of TN Number TOcefipan pe
n«mom than nK bmama ddlm($sBot � ' Ma;�,
❑I.uovarj of ttie propmY,rcaO'aaploym with wags uthe4 m4comprmathm,
.U,O,be`�aE.aa'dWe,D'K"u,bm`i""'wed«°rr�ed(°"a°(se`'m°''B°°""' Required Ins ectio s • 6f ,
W Pro(ealoo,Code:The Caavetars Limit fzw does w apply n an awmr Or 9 P 1 20urJ
pmpwy wla bwlda«Improm tbermm and wbodmas«h work Yim..lf«Waugh Ai,
awn vopbywu.pavidN WTI such impmrmau art not hteadd aaQerea r«v4 If.
howeKr,me hidmne«frnpomoat bsolti vlthln me aper of mtoplrym.tbe owner-
wader wlB save dr Imran ar pm.We wl ata m hdlg a'vopave r«pa.pn><tar
vk.L
❑I.u ctm a the paopnY•as esti ny'dY cm t--d t wild Burd ansa `a On
cmnrat We projm lsa.]BK.Buainea sad Profullau code:)The eaavac]ors U.
rmr law d«u hoe apply on to owns N paopeny wbo h1iWs a,Impm.a Weaem,and.
who con.r«,saw pakm wub aconn-..yartU ucrosd pttaim W We cmaar.+or,
LI¢n¢law. ,BkPC(«thhaeuaa �lN t(r�^ A .
Ira aompt mtia Sec t1 S ep YYP
Ow« Dar
WORKERS COMPENSATION DECLAIiAT10N `
I I aeby aR under paWty of palmy nM of Ne folkwins trelvubnc � ' '. .!. r'"I• . I .
Iba.c and wm vtrinuioaCWOorofCmuuav3f-insmc r«Wartcr,Cmnpry
sadm,a provided far by Settion 3]110 of the Labor Code.for W,pa(oron.of on,
work for which tkk prmit lsiweQ
p?d ftLaoo Bmaintain W,pcforCompensWm Wunn¢,uhs pct by scrim
3]OU M'Wtt th lsbn Code,fQ W�r{{�.es��aPcysaraf,t«¢¢n1uacc oftin:wvt for 1a r this pump Y tau 4.
Carricrku, w � rL.IA!`�Policy Nom. nwWcrr—ey:��/a/
�7�7JSi'o�
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION BiSURANCE _
(Thh smim nred w he mmpic"irthe pawn h far ante bunmcd doom 1510%
«ku)
I xnafv than m the parfomn.of WC wart r«which W.parmil h r e..n I,hall not
employ anypomn in any manor m a rbaame wbjcct to de WOr 'COmItcmancott
Laws of California.Dar
Appllaett
NOTICE TO APPLICANT:If.ager making this COmfkan of Eaemptam.You shmW
baonr wbjm On th,Wartcts Compe4vtlm pmWvani or Wa Labor Cody,you mat,
.JO forthwith comply with such pmvislmu or tbh penuit•ball wdremM rcwtN.
Z ^ CONSTRUCTION LENDING AGENCY
IheacbY srlisro tits drx hamanSatim kadinSaFncy la the prfamuavz of
fY > We wort roc rInich this pamlt h W«d(sec lrA].Civ.C.)
W 0 l'ndcr's Name
a <nmr,Aea=
VC) 1 catafy that I have rad N.aMkWan a,d vac thv We awls inrarmauan h
D. F. eortecL I.S.In comply with all city and cottony ominana4 arW Slav lows malng n
O U wilding mns oro.ano bcmby auNanx acpraauti. of Wit tiny to cnnr upon dr
a aM1ovc mcnurmN proPrnY f«ir"pccti.pure
(Wc) S.n salt,io ramify and lxcp ham4a tw City of CupertirtO,eainv
F'(n liabilitittjW:mcou.coas and eapaics which may in any way arvwc agaialaacl City
UZ Ioeom q.of the gra,tmg of Wu pamiL
APPLICANr UNDE ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR 9-29-06
Re-roofs
HAZARDOUS MATCIUAIS DISCLOSURE Doc Type of Roof
WH dr giaB 0,fnurc wading oavpw st«c Or hvdk hao d.raav W
u aefirui by be Coyenlm Muaicpal Code.Cbapa 9.12 anti the 11alth a,,1 Salay
Cam.s„-tam 8032(.>] All roofs shall be inspected prior to any roofing material being installed.
❑rot
pae.;m If a roof is installed without first obtaining an inspection,I agree to remove
Will thc.ppliant«const bwmm5 aaapsa=eywm,m a whkh
emit hvaadou,air conumirunu a lofined by h,Bay Arta Air Quality Manaicmcot all new materials for inspection.
Disvin]
Or �QNt
I hat mad l,0 haaaadtas ma,,jkmoaO, nu wxlcrChaper 6.93 oftk OBfor.
w,Holt,h Safu1Codc,Salons 25303.23533 a«I15534.1 uoicnamd tnaifthc holding U C_ Vsp
lou cot cunanly hate a t Ina h h my roapoatbnity to notary the occtpatn of W
rtquirtnr / rrct prmrniatwxorac,//m,rc.r afOccupaaY. a r 'A litcant Date
All roof coverings to be Class"B" or better
thviyW ' tat Dan. .
CITY OF CUPERTINO
•em 2 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . 1 : 35912022 . 00
DATE ISSUED. . . . . . . : 08/29/2006
RECEIPT # . . . . . . . . . : 35812
REFERENCE ID # . . . : 06080237
SITE ADDRESS . . . . . : 10194 BARBARA LA
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER MIKKEL HAYS
ADDRESS . . . . . . . . . . .
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : ALL SEASONS ROOFING
CONTRACTOR . . . . . . . : GORSHTEIN, VLADISLAV LIC # 21035
COMPANY . . . . . . . . . . : ALL SEASONS ROOFING SERVICES
ADDRESS . . . . . . . . . . : 1720 SMITH AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE (408) 971-4455
'*FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ----- - - ------ ---------- ---------- -------- - - ---- - ----- ---- ------
BPERMFEE VALUATION 13 , 000 . 00 201 . 96 0 . 00 201 . 96 0 . 00
BSEISMICRE VALUATION 13 , 000 . 00 1 . 30 0 . 00 1 . 30 0 . 00
TOTAL PERMIT 203 . 26 0 . 00 203 . 26 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- --- - - - ------ ------------- - ----
CHECK 395 . 62 20012
TOTAL RECEIPT 395 . 62
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408) 777-3333
CUPEkTINO
Building De artment
JOB ADDRESS EbrWm W• PERMIT #
OWNER'S NAME: Mivvel h2tis PHONE #
GENERAL CONTRACTOR FAX # Grj
Q
I am not using any subcontractors: 4e,"G� 9
'
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
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408) 777-3333
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 there-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:
Job Site Address: O
Roofing Company
Applicant's Signatu .rn/.f !1,(�, Date:-) �s k)
Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
REROOF
cnyor
e CUPEkTINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
10\ L-�
Owner's Name: Phone#:
V`n,\Y—\(--\ L E-lo2S Ff iS
Contractor: License#:
\\ o�
Contact: Cupertino Business License #:
\ 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)
Number of existing coverings ❑ 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:
• Job Description: fzR qV%u 2 Qix�s a. VA,`\eA-S I
Residential Commercial
Fire Zone: Yes>0 No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: S lel as Type of Construction: Occupancy group:
1 Y GA-00IG
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
e