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07100038 CIT�' OF CUPERTINO > ' ` ' ' ` BU[LDINGDIV PERMIT ��TR�4��?R ��`'�`T�ON:� : <:.: ,:: ,. _: ,:; .,. . .. BUILDI RESS: PERMIT NO. �� STAFFORD DR WESTSHORE ROOFING INC 07100038 . PERMIT LSSUE DATE OWNER'S NAME: JEFF CAI 2814 AIELLO DR C 10/03/2007 SANITARY NO. CONTROL NO. NE: (408)694-0060 BUILDING PERMIT [NFO ARCHITECT/ENGiNEER: BLDG ELECT PLUMB MECH � 0 0 � i p Q LICENSED CONTItACTOR'S DECLARA'fION JOU DeSCi1pC10II ; V p:. 1 hcrcby affirm that I am liccnscd undcr provisions of Chap�cr 9(cammencing ;y� wiihScction700U)o(Division3ofihcBusincssandProfcssionsCodc �j�j 1 LAYER CAL SHAKE, INSTL TECH SHIELD �SB� �` a in full force and e ct i�z Licensc tass �� L Z INSTL PRESIDENTAL 33 SQ. + F � pg� Conlractoc � ARCHITECI'S DECLARATlO i a a i undcrstand my plans shall bc uscJ as pu6lic recorcis )yU ' u. F' Licenscd Pmfcssional � y � OWNER-BUILDER DECLARATION 1 hcrcby �iTrm tha� 1 am excmpt Crom thc Contractars Liccnsc Law for �hc � p o Collowing roason. (Scction 7(131.5, Busincss and Profcssions Ca1c: Any city or coun�y �,°, � which rcquires a pertnit to conswct, altcr, improve, dcmulish, nr repair any stmctucc � Z} prior to ils issuance, also rcquires �he applicant for such permit to tIe a signed staiemen� ��. Ft. Floor Area Valuation -< that hc is liccnscd pursuant to the provisions of ihc Conuacar's Liccnsc Law (Chapu:r 9 `' $15 0 0 0 Y t �(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code) or L�� that he is exempt thcrcfrom and the basis [ar �he allegcd exempdon. Any violation o[ Secuan 703I.5 by a�ry applicant (or a pertnit subjecu the applicant to a civil penalty of AR� Number Oceupaney Type not more �han five hundred dollazs (SS00). 3 6 2 0 6 01 6 � Vll ❑ I, as owncr oC ttie properry, a my cmployca with wages u the'v salc compensaGon, will do �he work, and �he swctuie is notintended or ofiered for sale (Sec.7044 B�siness Required Inspections and Pro[essions Cade: The Contractor's License Law does irot apply to an owner of property wha builds or improves ihereon, and who does such work himself or Uuoagh hu awn employces, providcd that such improvemenls are not inlended or otteced Cor sale. [t. however, the building or improvement is sold within one year of complction, the owner- buitder will have the burdu� o! proving �hat he did not build or improvc (or pucpcue af sa�.). ❑ I, as awner of the property, am exclusively conuacting wi�h licensed rnnvactors m conswct the projen (Sec. 7044. Business and Professions Cade:) The Conuactols Li• ccnx Law docs no� apply �o an owner of propeny wAo builds or impraves �de�eon, md . who conuacts for such pmjects with a contnctor(a) licensed pursuant to the Contnctor's License Law. ❑ 1 am uempt under Sec. . B& P C for this ieawa Ownu Date _ . __ WORKER'S COMPENSATION DECLARATION I hercby �cm under penalty of pery'ury one o[ the following dalarations: �] 1 have and will main�ain a Certificate of Conscnt to xlf-insurc [or Worlrc�s Compen- satian, ss providcd for by Section 3700 of the Labor Code, for U�e pedormance of the wart for which this pertnit is issucd. ❑ I have and will maintain Worker's Compensatian Insurana, u required by Section . 3700 oC the Labar Code, Cor the performance of the work tor w6ich this permit is issued My Worker's Compensation Insvrance cartiv and Policy numbcr a�e: Q Carrier. � Policy No.: �l�?'�� C�t FICATE OP EXEMPf[ON FROM WORKERS' COMPENSATION INSURANCE (This section need not be completcd if the pecmit is for onc hundred dollus (510� orlcssJ I cenify that in the per(ormaoce of the worlc (or which Wis pertnit is issued. 1 shall not employ any person in any manncc so az to bccomc subjcct to �he Workcrs' Compensatian Laws of Califomia. Datc Applicant NOTICE TO APPLICAM: If, alYcr making �his CcniCcam of Exemption, you should become subject to �he Worker's Compensacion provisions o[ Uic Labor Codc, you must � O (onhwith comply wi�h such provisions or this pccmi� shall bc dccmcd ccvokcd. z ""' CONSTRUCTION LENDING AGENCY [-�r � I hefeby af(irm U�at there is a conswction knding agenry for the perfurmancc u! . �Y., .� thc wurk fur which �his permi� is issucd (Scc. 3097, Civ. CJ W Q Lendcr's Namc � z Lcnder's Address () � 1 certitY Iha� I havc rcad this application and s�atc �at thc abovc informalion is w �+ cortccL I agrce to comply with all city and county orelinances and siate laws reladng w � U building conswction, and hereby authome rcpresentativcs of this ci�y to cntcr u{xm lhc � W ahove-mrntioned properry for inspecuon purposes. a (Wc) agrce to save, indemni(y and kecp harmless the City of Cupcnino against �� liabilities,judgmcn�s, costs and expcnscs which may in any way accruc againsl said City V z in wnuquence oC thc granung o( ihis permit. D1L8 � � APPLICANT UNDERSTANDS AND WILL PLY WITH ALL NON-POINT Issued by: - -1 SOURCE RE LATIONS. V Re-roofs s� �� ofAppli o a� " T e of Roof ��' HAZARDOUS MATERIALS D[SCLOSURE }�p Will Ihe applicant or futurc building acupant storc or handlc ha•racdous matcrial as dcfincd by thc Cupenino Municipal Cadc. Chap�cr 9.12, and chc Hcalth and Sa[cty Ca1c, Sccdon 25532(a)? All roofs ;hall be inspected prior to any roofing material being installed. ❑ Ycs N� . Will �hc applicant or fu�urc builJing occupant usc cyuipmcnt ar Jcvicrs which If a roof i;> installed without first obtaining an inspection, I agree to remove cmil harardous air contaminan�s u dcfincd by the Bay Area Air Quality Managcmen� all new m aterials for inspection. Distr;cQ ❑ Ycs I have rcad the ha�arCous maicrials rcquircmcnLt undcrChap�cr 6.95 ol�hc Califor- � �� nia Hcalih & Safcry Codc, Sections 25505, 25533 and 25534. [ undcrsund Uiaz it ihc 6uilding 2_ docs not curtcntly havc a tcnan4 �at it is my rcs '' ity w notil'y ihe occupant of Uu ��7�1 rcyuircmcnts which must bc met prior �o i a Ccraf f Occu ancy ignature of Applicant Date G All roof coverings to be Class "B" or better n or authon•r.cd agent �� D� r oc� o�� CITY OF ��UPERTINO , ��"`�` RE:t�00F CU��T��o PERMIT APPI,ICATION FORM APN # a� �o ��U � Z3 C� Date: I O / 3 0 � ' U � Building Address: �' 3 u S�� fl'0 � t� ,� . 1 T J �J Owner's Name: � � l � � t _ � K G � � Pho � e� � ,$ � � �� ` f YI� � Contractor: License #: � $ � � Z � W��y� �-aa �- i � t v�G . Contact: Cupertino Business License #: C��,b ri e,1 Q-ow�, v�. tS °� �! �' v o 6 a ► Type of P.00f Covering: Eacisting: Proposed: 0 Built-Up Roof ❑ Built-Up roof ❑ Asphalt Shingles � Asphalt Shingles ❑ Wood Shakes ❑ Wood Shakes ❑ Wood Shingles � ❑ Wood Shingles � Other (Specify) GGI, � 51rw1, F� e. ❑ 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 Cupertino's Tear Off Policy: -� ►�� e Job Description: �w.,ov�{� ��j-�V c�.1 Sh.�. �G �..►- ►tiStk l 1 't'e�-l"! S ao p (7`a ..i �v��.11 �'+c�aL , d,evt -f Residential Commercial ❑ Fire Zone: Yes ❑ No Q' Confirmed with Planning D�t. if there are any restrictions: Cost of Project: Type of Construction: Occupancy group: � 5 (� 0 U �� 120'Z� � 1 ) r � Qty. if Applicable Fee ID Fee Description Fee Group BPERMFEE Bldg Permit Fees BLJILDING BENERGY Energy BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BIJILDING 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 l�epartment Subject: Re-roofing policy for the (�ity of Cupertino 1. Prior to permit issuance, you must agrE e to comply with 1997 UBC Standards and manufacturers specifications on re- roofing. 2. New roof coverings shall not be applieci without first obtaining all inspection and written approval from the buildin€; inspector. A final inspection and approval shall be obtained from the bu .lding 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 apprc�val. 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 f irst obtaining an inspection, will require the removal of all new mat�rial down to the sheathing, so a proper City inspection can be perfc�rmed. 7. NOTE: If you call for a plywood nail vispection 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 ihe job site at the time on inspection. I understand and will comply with the above stated policy on re-roofing. Homeowner's Name: � � � ��' �' � � 1 G �l � Job Site Address: �(�� `J'�Z d ��[' • l 51 �"� u . Roofing Company Name: w�'r�� Y�. �� d T� � �� L� 7 � Applicant's Signature: Date: !U 3 �` Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO 2 ITEMS OF 2 PERMI`[' RECEIPT OPER.ATOR: patg COPY # : 1 Sec: Twp: Rng: Sub: Blic: Lot: APN ......... 36:?06016.00 DATE ISSUED.......: 10�03/2007 RECEIPT #.........: BS�)00002881 REFERENCE ID # ...: 07:L00038 SITE ADDRESS .....: 11:39 STAFFORD DR SUBDIVISION ....... CITY .............. CU:?ERTINO IMPACT AREA ....... OVJNER ............. JE:?F CAI ADDRESS ..........: 11:39 STAFFORD DR CITY/STATE/ZIP ...: CU.?ERTINO, CA 95014 RECEIVED FROM ....: SH:CRINE FOWLER CONTRACTOR .......: PA1JL FOWLER LIC # 21417 COMPANY ..........: WE;3TSHORE ROOFING INC ADDRESS ..........: 28:L4 AIELLO DR C CITY/STATE/ZIP ...: SA7J JOSE, CA 95111 TELEPHONE ........: (4 )8)694 - 0060 FEE ID UNIT QUANTITY .�MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- BPERMFEE VALUATION 15,000.00 223.56 0.00 223.56 0.00 BSEISMICRE VALUATION 15,000.00 1.50 0.00 1.50 0.00 ---------- ---------- ---------- ---------- TOTAL PERMIT : 225.06 0.00 225.06 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 225.06 MC --------------- TOTAL RECEIPT : 225.06 Community Development � `' 10300 Torre Avenue • `"�; , ��' , ' �� Cupertino CA 95014 Telephone (408) 777-3228 CITY OF Fax (408) 777-3333 �UPE(�TINO Buildin De artment JOB ADDRESS: PERMIT # \ 1 5�tu. o r�t pt�' . �°h� O� `�3 OWNER'S NAME: �,�, L�� PHONE # od 6 R K�v o b o GENERAL CONTRACTOR: �ts�-=,1�,.�-�C, �Zvc�� FAX # �j� �o -vr� 5 I am not using any subcontractor • 7 _ _ �� J� � V Si,;nature Da e Please check a licable subcontractors and com �lete the followin information: SUBCONTRACTOR BUSIrTESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing IIectrical 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 D � Owner/Contractor Signature D e