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BLD-2021-2078BUILDING PERMIT CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: 7489 RAINBOW DR Cupertino APN: 362 30 012 PERMIT NO: BLD-2021-2078 OWNER'S NAME: OWNER'S PHONE: Not Provided CONTRACTOR: JIREH INC DBA LOS GATOS ROOFING, 888 FAULSTICH CT SAN JOSE CONTRACTOR PHONE: DATE ISSUED 10/20/2021 10:50:39 AM ISSUED BY:VALUATION: $13921 JOB DESCRIPTION Re Roof - tear off two layers of shake and install on layer of OSB and one layer of composition 24 squares LICENSED CONTRACTOR INFORMATION CONTRACTOR: JIREH INC DBA LOS GATOS ROOFING LICENSED CLASS: C39 ROOFING, B GENERAL BUILDING, C43 SHEET METAL LICENSED NO: 800707 EXP DATE: 10/31/2023 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penatly of perjury one of the following three declarations: 1 I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2 I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, l must forthwith comply with such provisions or this permit shall be deemed revoked. I understand and agree that I am electronically signing and filing this application and that checking the box below has the same legal effect as manual signature. I also understand that I have the option of filing a paper copy of this application with a manual signature but have chosen instead to file this application electronically. CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • permitcenter@cupertino.org PERMIT aB CUPERTINO I REV# OFF# ❑ NEW CONSTRUCTION ❑ ADDIHON ❑ ALTERATION ❑ T.I. ❑ MEP n RE -ROOF ❑ SWIMMING POOL/SPA PROJECT ADDRESS APN# 7489 Rainbow Dr 362-30-012 OwNERNAME PHONE E-MAIL Chandan Sharma 4087998404 STREET ADDRESS CITY, STATE, ZIP 7489 Rainbow Dr Cupertino CA 95014 I] CONTRACTOR NAME []OWNER -BUILDER COMPANYNAME LICENSENUMBER LICENSE TYPE Los Gatos Roofing 800707 C-39 STREETADDRESS CITY, STATE, ZIP 888 Faulstich Ct San Jose CA 95112 E-MAIL PHONE BUS. LIC # lisa@losgatosroofing.com 4082989399 400318 ❑ ARCHITECf ❑ OWNER ❑ OWNERAGENT [] CONTRACTOR AGENTI] ENGWEER ❑ DEVELOPER [ TENANT CONTACT NAME E-MAIL Lisa Destefano Lisa@losgatosroofing.com STREET ADDRESS CITY, STATE, ZIP PHONE 888 Faulstich Ct San Jose CA 95112 4082989399 DESCRIT TON Re Roof - tear off two lavers of shake and install osb and one layer of composition 24 sauares TOTALVALUATION: 13921 lfflSINGLE-FAMILYIDUPLEX ❑MULTI -FAMILY []INDUSTRIAL [:]COMMERCIAL USE TYPE OCC SQ.FT. VALUATION($) EXISTING USE EXISTING SP NEW FLOOR SF FORM SF I DECK SF I DEMO SF STORIES# TOTAL NET SF REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE LJ ATTACHED BATHROOM SF SF SF SF DETACHED EMSING ❑ YES FIRE SPRINKLERS NO EICHLER I] YES ❑ NO SECOND STORY ADDrnoN EI VE's []NO DWELLING SECOND DWELLING AYES []ATTACHED❑DETACHED OTHER UNITS# UNIT ADDTLON: ONO 5F POOLS ❑ FIBERGLASS 0 VINYL-IANED ❑ GUNITE i] PREFABRICATED POOL -SF SPA -SF I SPAATTACHED I]YES ❑ NO TOTAL -SF RECEIVED BY - Co, ... serd.1 o, &E,16-F.,,sh, Rsildiso with Public Swimnina Pools r,,iresDeuerdrrrw,taf&,iro...ental Henth.py.1 RE -ROOF EXISTING ROOF TYPE: OBUR:T-UPROOF ❑ ASPHALT SHINGLES% WOOD SHAKES WOOD SHINGLES ❑TILE OTHER(SPECIFY) REMOVE /REPLACE❑NO EYES I IF NO # OF LAYERS 2 PLYWOOD ❑C" 0X 3/8" PLYWOOD THICKNESS ❑ 5/8" OTHER TYPE; R OSB ❑ COX OTHER PITCH: 4 :12 ROOF CLASS A PROPOSED ROOF TYPE: t]BUILT-UP ROOF DASTUALT SHINGLES 11 WOOD SHAKES DWOOD SHINGLES ]]OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy sF 2400 #or squAREs 24 By my signature below I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspeqion purposes. I acknowledge and authorize all information contained on this application form to be made available for public record. Signature of Applicant/Agent: Date: 10/20/21 SUPPLEMENTAL INFORMATION REQUI *New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure. form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association B1dgApp_2017.doe revised 01101121