06060054 CITY OF CUPERTINO4:.
hUILDING DIVISION PERMIT kCONTRACTCIINFO,,.ItMATI,O,DE
BUILDING ADDRESS: WINTER ROOFING INC P°`M"06060054
10295 N BLANEY AV
OWNERS NAME: PERMRLSUEOATE
MR. VENKAT 151 WYANDOTTE DR 06/07/2006
ONE SANITARY NO. CONTROL NO.
4083638052
ARCNrfECf/FNGINEFR: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
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U6 LICENSED CONTRACTORS DECLARATION Job Description
FF I hucby affirm Ow I w lice d WIRr pmrivaru or CD-PW 9(mmracm'hl{
with Sccll°n7001)orDivima B ofde Buanas and P[ofoueN Coo.and MY lconno is
<a 0runI uhe a _ O TEAR OFF WOOD SHAKES 1/2 OSB AND 40 YEAR COMP
;L1�;: L�' L SHINGLES
L1� Dam 1L Contmar �rq, ppp
ARCHITECTS N /� �J D
is I undcwlW my pWuylWl k Ned u record[
FINALED
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OBNLDER DECLARATION
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JULY aRw No,u I am exempt ffromftConuanefs Lion¢l�for the 11 1
e°O rollawing naa m rection]OI U Bava,s and w PrnfcCodAn
e: y city W muay ZOOY(.
$ which n rd.a Pcn^it on carWn.alas.Ibor .dana11bk or ropar any suumum
.zr PAW nus itooa also nylmN the 1wicarn for Mach pmnil on file a slyloi awcmeat
< P„Ihe(aB[<N=apron,.mmlxl.a.i:bNard.ecanaa[la'ar �.(a.p�r9 Sq.Ft. Floor Valuati$16000
ASF•° (baomclrmngwlN rano ,aoti of Division O or Nc Buaitla+aMPmfeaioNCodc)or
� Nat k U eumpt Nvrtnn and Ne bash for LLe alleged eaemploa MY violater of
Scaima]misnyanrappBolx r«.Peml,anFcu lhe,pm.Im,aHl peo.nyaf pp��NN T .. CuPanCyTYpe
nam°r<ImnSwbomn%I&1 ($50n 31U0900 .
❑I,u owry of lk prvpm),a my wpb]a�.Nh wp a lhc'c,°Ie[mt�^,Ira.
and do IM.coN abunlue actors T_ aa.doca auk P*In an,B®rcu Required Inspections
and PrNadmu Cade The Clauacmrs Liana I�r dm m apply n m arrner of � eq I�
pmauaY.ha buBdaa.opors Nana,and wlodan,att roh himrtf a Ibrough hu
awn anpbyo-y ptorWed t!>v such hnP[oKraenu ue m Nlalded aartrd fa YIG a.
howeKr,ate bWidiy a imp°raoem V aoW wlWin are)er a(mnpkau,me awc�
budder orifi haK Ik blvden a ptoNng ma k did m pviW a impmK fa plupoae W
❑1.u owner W Ik pmpeur.as vtlu anni conarang Coa )Taxed mamma n
=W lma Ilse ptofem(see]Oan.BNinea a�PNfnailbo Code:)h C thenta n.and,a won doa eat apply ,an avoc of it apcny wTa Indda a it.t to Icoor sad.
.bo conpaca fa avch Prolena`ilhamovanm(s)Banscd paswntm we Cmwaeofs '
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❑lam aorta lndc See .B•PC fa WL wm
Ora Dam
WORKERS COMPENSATION DECL ArION
thereby aNm order peealty of PalWr arc a We fallo,mig •-..___
Ib,KWrid menum aCs+tifiam ofCa mmself-iuve faworct,C°mpen. .
Motor,u Provided for by Smion 7f W of Ilr Labor Code.for Jn pufatmanc,of We
wart far.hcb Na tomb la i>nd.
181 Me too,wU wi
main Wartcfs CompeNWs�
on Inwmce.as daN by Semon .
I3 WaNe Ichor Cale.for Nep nfomunct,aft a for which Iia para.a laud
My Wakes Cmtp/ecmtioe W Wan¢aria sed Pilin'miter arc:
Porky No_: o cr
c. j TEOFF ECEMPTIQN FROM WORK `
COMPENSATION INSURANCE
Mon aeedon lard rat keaepkud J We P,.a U faun.hmAsd daaaa Wam
alas.)
1 amh Nm in as prrrtnoaane N We wn=t fa.hcY a.s perolt V iaoed.l a1W I m
empty airy Person in any maser m u In baron sa t to than Wortas'CompenutrM .
l of Ctlifamt Due
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NOTICE TO APn ft Wow:If.sRa mrtfng Nis CeNlbx of Labor o Yau a1MoW
brcome abjrn m Nc Warta pn Comp=o tibia
a pmvitlona of Ne LAha Calc._ mm
.UZ farNwi0 mrnplY.+lach pmviaioma Ila pvmllalud Ee tlamN leKtcl
z° CONSIRUCIION L ENDOaG AGENCY
I knotty alltrm Na Nctc I,acmlvucnm mnding agony fa de or
D: Ne wort(a which Ihis pump V laced(See AYO],Civ.C.)
GA Lsadrfs Nm '
a,Z Icweda Addw .
U0 I casJy trot 1 haK reW Iia applcuim and aux dor the chose lafaw.ln 4
OUmild,n, emmmaod miNwatraad[amtyotati tees aM aura mxru,nlym
budding c°naauclian.std kmbY au ionm lcpra¢nwiKs al Nu city co rner upnn Ns
� [tJ lhoKm[ntivad pmpcny for iNpcc.on purpaas
(wC)K'(a la aK.lnd=mNfy WI tr2p Iwlale.9lk Clly Cf CUp[alln l(alNl
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U Z Aliabcan q..jadLlnenaclvuangdoefal�eewhi.
PTI-1 TDRU.maY la aaY wyaaTe yawa[vid City /'
COMPLY WITH ALL NON-POINT Issued by: 6i Date
SOU REG
— fRe-roofs
N HAZARDOUS MATERIALS DISCLOSURE LVx Type of Roof
Wed Noapplima a for.building occopantnae or hamic ha .maorial
u&fued by Oe C.PW Mortir Cale.Cbapc 9.11 and Ne HeYN uq Wur
Cnde.sada.1553$ayf All roofs shall be inspected prior to any roofing material being installed.
❑yN o No
maim If a roof is installed without firs[obtaining an inspection,I agree to remove
V,iB Na applu,nt or rase budding amap,nt=cgmploat or which
:mit hsaroyroa air cmumiNnu a dcfited by Nc Bay A.Air Qually Ma crrcnt all new materials for ins ion.
v t]
❑YN Na
IhaKnad Ne hamdma � IT5331"uu .I Clupxr R95afde Ctlifa
ItIa HplJcu Safety Code, ALS. try re a11SNIRY latraury N¢.P bmtiy L' O
d¢a aamaly It Nat II.myrcya.ccrynmiry .NcaaWal of Nc
raemsw h ptiWn¢wveear.Crnilian°r°m'pa'[y' rat reo App cant Date
—0All roof coverings to be Class"B"or better
M,
Ihar�cd a Das.
f Community Development
10300 Torre Avenue
a �' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
I : CUPERTINO
Building Department
JOB ADDRESS: PERMIT #
i o o D 0o6aos—y
O 'S NAME: PHONE # �
GENERAL CONTRACTOR (_<,,� FAX # -3
I am not using any subcontractors-. �L
tgnature Date
Please check applicable subcon a rs 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
1 Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
*CUCITY
E f�TFI N O 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 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: !/e41A1/
Job Site Address: 10,29q— 1/4x!A gV lly 4ZIL
Roofing Company Name:
Applicant's Signature: Dater
• Greg Casteel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
t�' REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# 31 ���— 009 Date: w I I D W
Building Address: IG I W Qnd ,y_
Owner's Name - •: ✓J V10y t Ph on #:
Contractor: W inte - rax5inc. License
Contact:
Contact: #:
Cupertin2-;s nes License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Z Asphalt Shingles
0 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 Mfg. Installation Specs.
• I Have Read, Understand and Will Comply With Cu ertino's Tear Off
/Policy:
Job Description �Taar o�-P W Shakes 1/ZWg an y�
Residential [ Commercial
Fire Zone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions:
Cost of Project: Type of Construction: Occupancy grou
C7 -
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