06090027 CITY OF CUPERTINO a- ti�+* �• 'F"^ °'"
wvO'R4 IN,IU?BUILDING DIVtsiON PERMIT RMATION
BUILDING ADDRESS: CERTIFIED ROOFING CO. PERMIT No.06090027
OWNER'S NAME: PERMIT ISSUE DATE
ALISON
NE: SANITARY NO, CONTROL NO.
(408) 489-7982
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG EO PLUMB MEOCH
�Op LICENSED CONTRACTOR'S DECLARATION Job Description(Zj 1 hereby affirm that I am licensed under provisions of Chapter 9(comminuting
i< wiNSocuon70M)ofDivLit3afN Bu.m f'°fessions Oodo,a m licen¢ts
a Lifall Co.nimenClas.eefmt Q REROOF - TEAR OFF WOOD SHAKES . INSTALL 1/2" PLY
Lleenm ma � "' t WOOD AND ASPHALT COMP SHINGLES . CLASS A
i
Do
— ' tractor r
RCHrECTS DECLARATION
i 1 understand my plans shall N used as public records
IWU
'Q Licensed Prefcaional
s OWNER-BUILDERexempt
CommON
I hereby (firreSect then 11. aempt from Ne Cssions o License Law for Nc
o O
following meson.Permian 7(171.5,Business and pm.direct Cale:Any city or county
$ which acquires a Permit w eanswet alter,nt f r such
demoltsh,or e a sig any structure
j=inn
thin lac
iuissuance.
ensedpalsemquithe Utevision o far amhpermivacause,aw(Chaned mem
then ue Is licensed puwant w the provisions of the he Bummr'a license Taw(Chapter 9 Sq.Ft.Floor Area Valu}�ipy 5 0 0
$
(commencing wiNSecdon7a00)ndth asks for
the
Neclein=uMon.M vi Cause)or -
- Nm k ts ettmpt therefrom arta the harm for the allgcd ettmpUon.My viplatian of
Section 7031.5 by any applicant fa a permit sebjeeu the applicant in a civil porosity of APN Number Occupancy Type
not mom than live hundred dollars($500).
D1,as owner of the Property,m my employ=with wages as their sele computations,
will
will do Use work,and the auuaure is act intended of offered for ask(Sm.7066.Business Required ln$ eC -ons
and Professions Cade:The Conummr's License law dons,ort apply m an owner of q V,p
property wboboiMsmimprovesNmwn.arM wk imarai h work himselforNmugh his
own employ=,provided thmsmh improvements are ort intended osuffered[.,ask.11. ^
however,she building or Improvement I,said within can year afcompletion.Use owner. Y•
builder win ve a rathe burden of proving Wt he did orm t Mid improve fa purpose of /
tale.).
El 1.u owner of she property,,a.B sines and
anumein{with Seasonal ronnamoa i- �C Q
contract d project(Sec.70.4,Business and Proletarian;,who Cade:)The Conumm..L-
ceme law d=rat apply ban owner of prapeny tubo hulks m improves thereon,and
who mnweta fm such projects with aeonumwrtsj licensed pumwm w dm('anvaetoh
LicI am Lew.
CI
D lam exempt under see, ,B&PCfar this reasen
Oo Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of t following declarations:
I hurt and will maintain a Cenifcam in Consent self-Insure fm Workers Compen-
sation,as provided for by Section 3700 of the Labor Code.for the Performance of the
work for which Nu permit is issued
❑1 have and will maimain Worker's Compensation Insurance,a required by Section
3700 of ren:Labor Cade,for the performance of Nc work for which this permit u isi
My Worker's Compensation lnannce artier and Polity number rt:
Cartier: Polity Na.:
CERTIFICATE OF EXEMPnON FROM WORKERS'
COMPENSATION INSURANCE
fruit maim need notbc completed if flue Permit Is fmone hundred dollen(SI07f
or less.) '
1 century that in the performance of Uama dwoork for which this permit u issued I shall not
employ any person in any manner so aiompm�u�u_ytmLa tk Workera Ca mmustaim
Laws of Cal Deno lJ (L n
NOTICE TO-APP ANT:If,aMr making this Cenifiate of Eacmpsirn.you should
bar=e Subject an Nr Workers Compensation provisions of the labor Code,you min
.J O foMwith comply with such pmvisiOM of Nu Permit shall k deemed ravoked.
z y CONSTRUCTION LENDING AGENCY
(-r I hereby affirm that Nem is a convection lending agency for the peffurmm¢e of
C> the work fm which this permit is boundm.A(S3077.Civ.C.)
ap Lendor'aName
7 Z Lenderk Add.
U 0 1 candy Nat I have real this application and sate that the above information is
IL F correct I agree to comply with all city and county ordinances and state laws relating to
0 U building construction,and hereby authorim reprrsenurivcs of this city to enter upontic
rV Wabove-mentioned property for inspection purposes.
(We)agree to ve,indemnify and keep harmess nue lCity of Cupertino against
rF"y amfg Iiabiliden.judgments,costsand expenses which may in any way acerae against aid City
U z in consequence of the granting of this permit.
'••' APPLICANT UNDER DS AND WILL COMPLY WITH ALL NON-POINr Issued by: Date 15E,
--��G
SOUR
Re-roofs
nature)
ppllearu ontrxwr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant m future building mem amarum m handle statements material
as defined by the Columnar Municipal Code.Chapter 9.12,and the Health and Safety
code,Section 25532(+)7 - All roofs shall be inspected prior to any roofing material being installed.
Dyer,
Will Nc APPluant or future building rainproof use equipment of&vi=Mich If a roof is installed without first obtaining an inspection,I agree to remove
emit hoardoua air conmminints a defined by the Bay Area Air Quality Management all new materials for inspection.
Disuict7
DYo N
Ihavcmad thehmamasmaarlatsmquimmenuumlcrChapmr6.95of Um Califor- ��� ��
niaHgith&SafnyCa&,S..a.25S05.25533m 25534.1undcn,W Uwifthe building
docs not cu m yhave a onan4 Wf ii u my resp mihillty to notify Uerau�t=ugpmt of the
ue
reyul nu met priormissumKc of enifea Oc Ufe pplicant Date
rcarsethomrd agent D,te All roof coverings to be Class"B"or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY Of Fax(408)777-3333
W.UPERTINO
Building De artment
JOB ADDRESS: 'J PERMIT#
Z Z 2 6 6
OWNER'S NAME: -V4 fj PHONE # D —
GENERAL CONTRACTOR �r t-,� a n FAX #
I am not using any subcontractors: S��6
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
CITY OF CUPERTINO
Om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . 1 . : 32613087 . 00
DATE ISSUED.. . . . . . : 09/05/2006
RECEIPT # . . . . . . . . . : 35915
REFERENCE ID # . . . : 06090027
SITE ADDRESS . . . . . : 22266 HARTMAN DR
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : ALISON RICKERT
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . CERTIFIED ROOFING
CONTRACTOR . . . . . . . : DAVID CAMERON LIC # 25538
COMPANY . . . . . . . . . . : CERTIFIED ROOFING CO.
ADDRESS . . . . . . . . . . : CONTINENTAL DR.
CITY/STATE/ZIP . . . : SAN JOSE, CA 95111
TELEPHONE . . . . . . . . : (408) 489-7982
'FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
- --------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 20, 000 . 00 277 . 56 0 . 00 277 . 56 0 . 00
BSEISMICRE VALUATION 20, 000 . 00 2 . 00 0 . 00 2 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 279 . 56 0 . 00 279 . 56 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
---------------- - ------------ ------------------
CASH 279 . 56
TOTAL RECEIPT 279 . 56
•
CITY OF CUPERTINO
�t ' REROOF
• CUPEkTINO PERMIT APPLICATION FORM
APN# iy�(n� ( ,� Date:
Bu
i2n�d� er.41 pr
QN�
Owe or' Name: Phone#:
ItG Cel -73,5 J
C actor: Lic e#
n act: Cupertino Business License #:
Q
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
_❑ �sphalt 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: n
Job Desc .ption: ( eq " - � �f7vv u BS•
a y� : h
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Det. if
there are any restrictions: IJ
Cost of Project:l Type of Construction: Occupancy group:
St0
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
•
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 Siandards
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:
Job Site Address:
Roofing Company Name:
Applicant's Signature: Date:
Greg Casteel •
Building Official
Revised 11/2/04-
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
• Telephone: (408) 777-3228
Fax: (408) 777-3333
Building Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
3:30 p.m. to request a next-day inspection:
' 2. When the roof is torn off, the nails have been removed or driven in,
and all of the dry-rotted wood has been replaced, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this service: from 7:30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from
7.30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear-off 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.
• Greg Casteel
Building Official
Revised 8/13/04