The URL can be used to link to this page

11040055 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1381 POPPY WAY CONTRACTOR:WESTSHORE ROOFING PERMIT NO: 11040055 INC OWNER'S NAME: JENNIFER HUEZ 2245-A FORTUNE DR DATE ISSUED:04/08/2011 f ER'S PHONE: 4158284920 SAN JOSE,CA 95131 PHONE NO:(408)694-0060 LICENSED CONTRACTOR'S DECLARATIONF_ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# /�72, �!C �. MECH RESIDENTIAL COMMERCIAL Contractor J J/�) /C-EJOII NU Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:RE-ROOF TEAR OF EXISTING ROOF,INSTALL OSB (commencing with Section 7000)of Division 3 of the Business&Professions SUBSTRATE OVER EXISTING,INSTALL COMP Code and that my license is in full force and effect. SHINGLES(LIFETIME SHINGLES)CLASS A 27SQ I hereby affirm under penalty of perjury one of the following two declarations: 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. 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 Sq.Ft Floor Area: Valuation:$12413 permit is issued. APPLICANT CERTIFICATION APN Number:36618030.00 Occupancy Type: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHI DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DA ROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Q_ ) Issued by: � U �/ Date: Signature Date `/ `/ L OWNER-BUILDER DECLARATION 7 RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: OAW ` ,J Date:Q / 1,as owner of the property,am exclusively contracting with licensed contractors to L/ U /D� ZUII construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I / become subject to the Worker's Compensation provisions of the Labor Code,I must ne or authorized a ent• forthwith comply with such provisions or this permit shall be deemed revoked. < ''• Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save in,'---unify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address C nd expenses which may accrue against said City in consequence of the gra..,.ng of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO 3 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36618030. 00 DATE ISSUED. . . . . . . : 04/08/2011 RECEIPT #. . . . . . . . . : BS000013135 REFERENCE ID # . . . : 11040055 SITE ADDRESS . . . . . : 1381 POPPY WAY SUBDIVISION . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : JENNIFER HUEZ ADDRESS . . . . . . . . . . : 1381 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : WESTSHORE ROOFING CONTRACTOR . . . . . . . : PAUL FOWLER LIC # 21417 COMPANY . . . . . . . . . . : WESTSHORE ROOFING INC ADDRESS . . . . . . . . . . : 2245-A FORTUNE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95131 TELEPHONE . . . . . . . . : (408) 694-0060 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 12,413 . 00 1.00 0. 00 1.00 0. 00 1BSEISMICR VALUATION 12,413 .00 1.24 0. 00 1.24 0.00 1REROOFRES SQ FEET 27 .00 351. 00 0.00 351.00 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT 353 .24 0. 00 353 .24 0. 00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 309 EXTERIOR LATH 311 SCRATCH COAT 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 604 ROOF IN-PROGRESS 605 FINAL REROOF CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1381 poppy way DATE: 04/08/2011 REVIEWED BY: larry s APN: BP#: 'VALUATION: 1$12,413 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK tear off existing roof,install osb substrate over existing, install comp shingles lifetime shingles) SCOPE NOTE. Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS 0,, e Resolution 09-05I I. . 7/1%I0) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 E7K s.f. Re-roof Suppl.PC Fee: E) Reg. 0 OT 1 0.0 1 hrs $0.00 $351.00 IREROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp.Fee-.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: Q Yes G No $0.00 Work Without Permit? 0 Yes G No $0.00 Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 i Strong Motion Fee: IBSEISMICR $1.24 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS': $2.24 $351.00 TOTAL FEE: $353.24 Revised: 01/15/2011 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 1381 poppy way DATE: 04/08/2011 REVIEWED BY: larry s APN: BP#: 'VALUATION: Iso "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex PENTAMATION 1 SFDWLROOF USE: PERMIT TYPE: WORK tear off existing roof install osb substrate over existing, install comp shingles lifetime shingles) SCOPE Li Ll NOTE. Thesefees are based on the prelindnaty in ormation available and are only an estimate. Contact the De t or addn 7 info. FEE ITEMS (Cee Resolution 09-05/ /.: f.' ''l.'%O) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2,700 s.f. Re-roof Suppl.PC Fee: Reg. 0 OT 0.0 hrs $0.00 $351.00 1REROOFRES PME Plan Check: $0.00 Permit Fee: $0.00 Suppl.Insp.Fee-0 Reg. 0 OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes G No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non-Residential G Building or Structure Strona Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $351.00 TOTAL FEE: $351.00 Revised: 01/15/2011 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS:13 '/ POEPPERMIT# ' OWNER'S NAME: J �lhl (/ PHONE# I 2Z� GENERAL CONTRACTOR: p C P e C)FN6 BUSINESS LICENSE# ADDRESS: �2 �"�U1�1� J CITY/ZIPCODE: - S 0114 /3 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. 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 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date REROOF PERMIT APPLICATION 1 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 :UPERTINO (408)777-3228• FAX(408)777-3333• buildin-ga�cupertino.orq PROJECT ADDRESS3PoP PV (A� ? C0rtP_TtN;T7 OWNER NAME PHONE ' "20EE-MAIL STREET ADDRESS r�g f V0 Q P y Wy CITY, STATE,ZIP Cu�p �� q50111 11 FAX CONTACT NAME '^!�*% / � / 808 PHONE E-MAIL STREET ADDRESS CITY,STATE, ZIP FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEN`tL Ff `,'�� LICENSE NUMB . 2 7-1LICENSE TYPE 7 BUS.LIC.# 2 i ` COMPANY NAME T i "o-a R00FIN6 �` E-MAIL �C 00F IC CO- � FAX L/0(/7(-/_6z 33 STREET ADDRESS 4 CITY,STATE,ZIP CJ' I PHONE109--l/ / /�r�/SQ �� FORTUrJ� R S u1Tf . J AlCJ11V�S� CA `f�131 T 6-YVII�J ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC.# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE c OF XSFD or Duplex ❑ Multi-Family ROOF AREA: VALUATION: .,�RUCTURE: ❑ Commercial Z 7 Is EXISTING ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES .,/WOOD SHAKES `WOOD SHINGLES ❑OTHER(SPECIFY) REMOVE/REPLACE DYES IF NO, PLYWOOD Joh" ❑ PLLYWD OSB PITCH: ROOF ❑ NO 1 #LAYERS: Z THICKNESS: ❑ 5/8" TYPE: ❑ CDX A:12 CLASS: A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF V ASPHALT SHINGLES ❑WOOD SHAKES ❑WOOD SHINGLES ❑OTHER ICC-ES REPORT# DESCRIPTION OF WORK: r^- iAZ UF \ 0,� P106F91 NS7 AL L S B . ALL Co oIGL 5 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 toIdi c struction. I authorize representatives of Cupertino to enter the above-i entified property for inspection purposes. Signature of Applicant/Agent: I eJAJCV1d_*"' Date: V 68 1 2a 1 SUPPLEMENT#INFORMATION REQUIRED OFFICE USE ONLY _ If building is associated with a Home Owner's Association,provide letter PLAN CHECK TYPE ROUTING SLIP of approval from HOA. ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW Provide Planning approval to verify if there any restrictions. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Provide copy of Manufacturer's Installation Specifications. ❑ STANDARD ❑ FIRE DEPT _Provide signed copy of Cupertino's Tear-Off Policy. ❑ OTHER- ReroofApp 2011.doc revised 03/16/11