04090051 -(,:TTY OF CUPERTINO raw' "ei'"�k"�a"
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION. -
•rk 'm•.,s• '.+ ' .Tawa:;?w. ..
BUILDING ADDRESS: KEVIN SULLIVAN ROOFING PE ""'04O90O51
IPER's NAME: PERMIT ISSUE DATE
ALGERI SALVATORE
PHONE: SANITARY 5C. CONTROL NO.
0
BUILDING PERMIT INFO
ARCHITECT/ENGINEER: BLDG ELECT PLUMB MECH
u°CZLICENSED CONTRACTOR'S DECLARATION ����® O
Job Descriptio
G I hereby affirm shat I am licensed under pmvisimu of Chi 9(mmmeming P
U wiNS on70W)af Division 3af dmB sinew and Nofcuium Code.and my]icer.is
in muNt aderrhe 3 ( 15 T/O EXISTING/INSTALL 50 YR
Del i License
,Le,—o Dam mracm PRES COMP ROOF
OCT� 01 2004
I my 1 U li
1 tro
Dku
°� me BUILDING
OWNER-BUILD4 DECLARATION
1 hereby alarm that 1 em exempt ftern the Contractors License Law for the
E 00 fallowing recon.(Scetiun 7031.5.Business end PmRssmort Coke:Any city or county
$lei which requires•permit m cnnsuucL alley,intercom.demolish,nr repail any I.Ctu.
prior to its issuance,also requires the applicant forsuch Fermis to file a signed summent
that he is licensed pursuant to the prOVl5lens of the Camomile's License Law(Chapmr 9 Sq. Ft. Floor Area Valuatd(ID600
�F$ (commencing with Section 7")of Division 3 of the Business and Psalm...COde)urthe,he M exempt 4�
basis for the
_
Section 7031.5 by any applicant for•Permit suhjecu the applicant1..civilipc alty of
net mem Nan fie hundred deltas,Lased). Number Occupancy Type
1.M owner of the pmpeny,or my employees wIN wage u their sale compensnlan, 3 6 66 1 1 0 0 9 3 ' (]
and Pr Newmk.ands, swmureisnminLice Law
elsee.so a,Business Required Inspections
,ruland Pny who
Cade:The ass uammfi License raw does at gums lf an owner of q P
Own employ �.Providlum ed the such imph mmenot daesomhended omaVm Wough his
own employ=. Nat such ift is smmenu ere net ear ofc mpletoW to Own r-
Wilde,qiU buildingorimprovementis sold within one year ofimpletion,phowner-
builder wiV here Ne Burda of pmvin61Nr he did not build m improve for Purpose of
ale J.
O I.as owner of the Property,em exclusively contracting with licensed an ecus to
consumes the Project(Sec.7016,Busincas and professions Code:)The Contractor's Li.
cense law does not apply m Lin owner of progeny who builds or improves Ncreon.and
who wouri for such pmjceu with a emuamor(s)lioenad punanl In the Consomme,
License law.
O 1 am exempt under Sec. .B&P C fm this recon
Data
WORKERS COMPENSATION DECLARATION
1 hetaby aRm under penally of perjury one of the following declarations:
❑1 ban and will maintain.Cenifiauof Censenl On self-insure for WorkefsCempcn-
mean,a provided for by Section 3700 of the labor Code,for the performance of dm
weak for which this permit is issued.
1 1 have and will maintain Worker's Compensation Insurance,as required by Sccdon
37M of the labor Cam.for The performance of the work for which this Permit is issued.
My Workees Compenadon bourne^carim and Policy number are:
C r. S_f7T ICUAI _Policy NC�sZG.-d0n22-
CERTIFICATE OF EXEM MON FROM WORKERS'
COMPENSATION INSURANCE
(Trissxtim reed not becompleted 14permit is feaene hundnddellan(SIM)
er less)
1 certify Out in Ne perronnanee of Ne work for which this Permit is issued,1 shall not
employ any Fera.in any manerso u to become subject to the Workcri Compensation
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,after making this Certificate of Exemption,you should
become subject In Bre WOrkeh Compensation previsions of The labor Code,you must
forthwith cannot,with such pmvisimu Or Nis permit shall W dcemcd revoked.
Z O CONSTRUCTION LENDING AGENCY
(.. 1 hereby affirm Nat there is a construction lending agency for the Performance of
a > the work for which this permit u issued(Sec.3097,Co,C.)
(BI Lender's Name
D Lender's Address
U p T minify that I have rad this applicamn and sum that Ore above information is
Ii.t" coma 1.1.to comply with all city ad county oNimnas and sum laws relating to
> ( building cansuuniao adhedemnireby y ad epreourmiss the thisCityof
mcnmUpon
ago Ne
r W ahovc-mentioned properly for inspection purpmes
Fw G (we)agrce m ave,indemnify ad keep hay In LO dre City of Cupenino ed City
st
N liabilitia,judgmcnu,costa adexpenv which may in any way accrue against sod City 1//
U z in camsequcn Bracing of Nis ltmmiL Date
^ ke�
APPLIC DERST 'Y'WITH ALL Ni
?N-POI Issued by:
50 AE NS.
— – �a Re-roofs
signore o AvpRcauconuena' ate
/ HAZARDOUS MATERIALS DISCLOSURE Type of Roof
will the appliam or!more building accupem smredr handle hmallous mamriai
defined by the Cupertino Municipal Code.Chapter 9.11,and dm.Health and Safety
CoM.Seation15331(a)? All roofs shall be inspected prior to any roofing material being installed.
You
If a roof is installed without first obtaining an inspection,I agree to remove
rore building occupant use equipment or devices which
will the applicant oA
coot harallous air conmminan List defmcd by the Bay Area Air Quality Management ;allnew ma rials for inspection.District? /L,�(\/1❑have real ehuno u6 smaRrials reyI eon oerChamr6.95oftWCaliMr
niceHealth BS odc.Scedons l551553_ d.l dcrundNm if the Wildindoesoat c rat h Il i dLI NOU the ore ofvi mnmmatbe a er e a nrGeeygae! [ureofApplieant Dat
x r D All roof coverings to be Class "B" nr better
m r atom irad egcm
CITY OF CUPERTINO
I 1 of 1 PERMIT RECEIPT OPERATOR: suem
COPY # 3
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36610093 .00
DATE ISSUED. . . . . . . : 09/10/2004
RECEIPT #. . . . . . . . . : 26997
REFERENCE ID # . . . : 04090051
SITE ADDRESS . . . . . : 1535 JAMES TOWN DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ALGERI SALVATORE AND RUTH
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, CA 95014-5312
RECEIVED FROM . . . . : ROOFSERV ROOFING
CONTRACTOR . . . . . . . : KEVIN E. SULLIVAN LIC #. 23810
COMPANY . . . . . . . . . . : KEVIN SULLIVAN ROOFING
ADDRESS . . . . . . . . . . : 1696 VALLEY OAKS DR.
CITY/STATE/ZIP . . . : GILROY, CA 95020
TELEPHONE . . . . . . . . : (408) 842-1057
•
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
__________ _____________ __________ __________ __________ ----------, __--------
BPERMFEE VALUATION 10, 000.00 169.56 0.00 169.56 0.00
BSEISMICRE VALUATION 10, 000.00 1.00 0.00 1.00 0.00
__________ __________ __________ ----------
TOTAL PERMIT 170.56 0.00 170.56 0.00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ :--______--_-_-___
CHECK 170.56 2839
TOTAL RECEIPT 170.56
•
CITY OF CUPERTINO
REROOF �CD9DOS/
• CUPERTINO PERMIT APPLICATION FORM
APN # Date: /J 0
Building Address: /S -3 -5- Am JeS.TG,W,J 2•
Owner's Name: Phone#:
cS4�VATote GeRI �/d�-aS3-8o3z
Contractor: �/�1 �}//��1' J,v e• Phone#: _ 42_ S} License#:
! `O"���✓ �SJLLIJRAJ ,e0o�i%JG.SCRV/CC.S, O`3
Contact: J.tr+F.& S14s6'4" Phone#:�8_�99-3j99 Cupertino Business License#:
GD. C. M+'J4-r'e2 Zig 10
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles t( Asphalt Shingles
X Vfee hakes — C,44 SLIAI�g ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings / ❑ Provide I.C.B.O.Report#
XTo be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Comply With Cu ertino's Tear Off Polic
T Job Description: o 4-L 0.s a, 31d #Fe[Td
.50 2 Res Co O o �
Residential Commercial ❑
FireZone: Yes ❑ No Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project: X91 Goo_ ^ Type of Construction: Occupancy group: sr�
fd eAoo F
Qty. if
A li le 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
•
Community Development Department
1 Building Division
✓' City of Cupertino
10300 Torre Avenue
• CITY OF Telephone: (408)777-3228
Fax: (408)777-3333
C U P E IST I N O
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.
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: C3.4[-L/,*
Job Site Address: /S3 5 14hP_s Tdu1A1
Roofing Company Name: 012-06&16 CSeo'2 V c
eJ
A plicant's Signator . Date: 9 �`¢
• Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
Community Development
� 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
PE f�TINO Fax(408) 777-3333
IDU
Building D#parWwmt
JOB ADDRESS: _Az. PERMIT #
153��,g,,yesTvw.�
OWNER'S NAME: Stl L1 -To2t LG e2i PHONE # .zS3-8032-
GENERAL CONTRACTOR: AodL5exv FAX #
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 p
Roofing /�0 0 �S_ek V ef o.3 S
Septic Tank
Sheet Metal
Sheet Rock
• Tile
r1607'J'eXj1 9 to
Owner/Contractor Signature Date
11 J Community Development
,' -• 10300 Torte Avenue
a
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF /Fax(408)-77y7-3333
UPEI,TINO
Buildin De_ )ar ,went
JOB ADDRESS: / �\ PERMIT #
" /s3ST�yesroc�..�
OWNER'S NAME: PHONE # ,zs3-So 3 2
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signature 1 Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS'MkME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical v
Excavation r' ,.. f;,�••
Fencing s
Flooring: Carpeting,/
)C Linoleum/ Wood
• Glass / Glazing
Heating _ F
Insulation
Landscaping
Lathing ✓
Masonry
Ornamental Sheet Metal
Painting./ Wallpaper
Paving—)
-Plasterri
Plumb
Roofing ��� e1211 o iLs
Septic Tank
Sheet Metal �?
Sheet Rock
r�
Tile n
?40
/� Owner/Contractor Signature Date