07110029 CTTY OF CUPERTINO ` `
BI;ILDiNG 1}FVISION PERMIT �������� ��������� '
:: ,,.. , ,,.,.: ,..,. . _ ,.:, .:
BUILDING ADDRESS: PERMIT NO.
10465 E ESTATES DR TBD T�) BE DETERMINED 07110029 .
iER'S NAME: � �� DA �
MINASIAN JOHNNY AND VIVIAN � 11/06/2007
PHOtiH:o T T SANiTARY NO. CONTROL NO.
ARCHTI'ECT/ENGINEER: BUILDING PERMIT INFO
BLD EO PL� �
Q�
� o p LICENSED CONTRACfOR'S DECLARATION JOI7 DeSCI7PLlOi1
�CC I hcrcby affirm that I am liccnacd undcr provisians af Chaptcr 9(commencing
� z wilh Scction 7000) of Division 3 of Ihc Business and Profcssians Code and my ��censc is RE — ROO F, I N S T L 7/ 16 " RDNT BARR I ER O S B� 3 0 L B
°� a in full Corce and e[fect � '
��z LicenscClasa �- ��•x FLT, VEN'PS, VALLEYS PRESIDENTIAL, 2F SQ.
==� � ARCHITEGTS naw SOUTH V,=�LLYE ROOFING PD BSL 11 / 5/ 07
� a< I und¢ruand my plans s6s11 be used as public rccords ��� /�y
� � U � �—�
4
L O y Lii:cnud Prufcssional
y � OWNER-BUILDER DECLARA'i'ION
� <� I hcrcby ulTirm ihat 1 am excmpt from ihc Con�ractors Liccnsc Law Cor thc
i p O following reuon. (SccGon 7031.5, Busincss and Profccsions Ca1c: Any city ar county
K m Pi which icquires a pc�mit W conswc� altct. impmvc. dcmolixh. or mpair any swctwc
'� Z � pnor ui i�s issuancc, alw rcquires UM applicant for such permit to filc a signcd su�cmcnt
_< that he is liccnscd putsuant to lhc provisions of ihc ConUactor's Liccnse Caw (Chaptcr 9 5q. Ft. Floor Area $ 9 8 5 0 Valuation
� I— $(commcncing wi�h Scction 7000) of Division 3 of �Ac Busincu and Profcssions Codc) or
y �., �hat he ia exempt therefrom and the basis for the alieged exemption. Any violaGon of
Section 7031.5 by a�ry applicant for a permit subjecu the applicmt to a civil penal[y of Number Oeeupaney Type
not more than five hundred dollars (5500�. 3 6 9 2 6 0 3 3.`�(�
� 1, u owner of tlie property, or my empioyces with wages az We'v solc compensadon,
will do U�c work and �he s[cucw�e is not imm�ded or o[Ceced for sale (Sa. 7044. BusiMSS Re uired Ins ections
and Professions Cade: The Conuactor's Lia,nse Law docs not appiy w an owner of Q P
property who builds or improves thercon, and who does such work himseif or throagh his
awn emQlayces. Provided that such improvemenLS are not inlended or offered [or sale. l[.
hawever, the building or improvement ia wld wiihin om year of completion, ihe ownen
buildu will have the burden o[ peoving ihat he did not build ar improvc far pu�pose of
sakJ.
❑ 1, as awner of the property, am enclusively conuacting wiih licenxd rnnuacwrs w
constmct the project (Sec. 7044. Business and Professions Code:) 7Le Conlrxmr's Li.
cense [aw docs aot apply W an owner of propeny who builds or improves the�eon, and ,
who contrac�s far such p�ojects wiih a contractor(s) ticensed pursuant to the Contruror's
License I.aw.
0 I am exempi undu Sec. , B dc P C for thia reason
� Date
WORKER'S COMPENSAT70N DECLARA170N
I hereby �rm under penalty o[ perjury one o[ the falbwing declarstions:
❑ I hsve and will mainlain a Cenifiam of Conaent to self-inswe f� Workcr's Compen-
sation, as provided far by Secdon 3700 of the Iabor Code. for ihe performance oC the
work for which �his permit is issued.
f5e I have and will maintain Worker's Compensation Insurana, u requircd 6y Scction
�b0 oC the Labor Codc. Car the pefformsnce of the work fw which this pecmit is issued.
My Warku's C�om Insunnce carticr and Policy number are:
Cartier. S�T(-� - �1 �]� Polity No.: �
CERI7FICA7'E OF EXEMP170N FROM WORKERS'
COMPENSATiON INSURANCE '
(7Lis section necd not be complcuJ if the permit is for onc hundred daltus (S I00)
or Icu) '
I ceni(y thnt in thc perfortnance of thc work for which this �crmit is issucd, 1 shall not
employ any person in any manncr so az to bccomc subjoct a the Workcrs' Compensation
Laws of Califomia Da�c
Appiicant
NOl7CE TO APPLICAM: If, afmr making ihis CcniGcatc of F�ccmpGan, you shoulJ
become subjixt to �hc Workcr's Compensation provisions of thc lalar Codc, you must
, O forthwi� comply with such provisions or this permil shall bc dccmcd ccvokcd.
� '"'' CONSTRUCf10N LENDING AGENCY
E-+ i-�+ 1 hereby alTirm ilut there is a consuuction knding agency Cor the perfortnance o(
a� ihe wmrk fur which �his pemii� is iuued (Scc. 3097, Civ. C.)
W Q Lendcr's Namc '
� z L.cnder's Address
() � 1 certiCY ihat 1 havc read this applicuion and stam �hu thc abovc informatiun is
w►' corrcn. I ageee �o comply with all rity �nd county oNinanas and state laws rclating w
0 U building conswction, and hcreby auNoritt representadvcs of ihis ciry w cn�cr upon thc
� W above-mcnuoned prtapeny for inspeciion purposes
a (Wc) agice to save. indemnify and kecp humless ihe City of Cupcnino against
�� liabiliuu, judgmcnLS, casu and wcpenscs which may in any way accruc against said City
V z in consr.quence of iAe granung of ihis permi� Date —� t� `'"
�"� APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOUR E ULATIONS.
�/,��.� fi ! ���0 �D7 Re-roofs ��
Signuure ApplianUConuactor �8� T of R�of
HAZARDOUS MATFRIALS D[SCLOSURE }��
wll ihe applicant or Cuwre building accupant storc or handlc ha•rardous matcrial
az dcftned by the Cupertino Municipal Codc. Chap�cr 9.12, and the Hcalth and Safcty
�. Scction 25532(a)? �! All roofs :�hall be inspected prior to any roofing material being installed.
❑Ycs �No
Will thc applicant or futurc building occupant usc equipmcnt or dcviccs which
If a roof i:; installed without first obtaining an inspection, I agree to remove
emi� harardaus air coniaminan�s at dcfincd by the Bay Area Air Quality Managcmcnt all new m 3terials for inspection.
Disirict?
❑ Ycs �No QQ
1 havc rcad che haiacdwu matcrials rcquiremcn�s umlcr Chapicr 6.95 of Ihc Calitor- J, � i� ✓�/ //(�� �� /" /� �
nia Hcalih & Safcry Codc. Scctions 25505.25533 aru125534.1 undcrsund Uim iCthe building % ��/ / /
dacs not curtcn�ly havc a tcnan4 �at it is my respontiAility w naiCy the occupant nf thc � � �
rcyuirc w ich must bc me� p'o issuar�cc of a Ccnifica�c of Occup �r. S ignatur of Appl icant Date
Owncr or a ori�ed agcnt �„� All roof coverings to be Class ��8�� or better
CITY OF CUPERTINO
2 ITEMS OF 2 PERMI`I RECEIPT OPER.ATOR: patg
COPY # : 1
Sec: Twp: Rng: Sub: Blk.: Lot:
APN ...:..... 36�26038.00
DATE ISSUED.......: 11/06/2007
RECEIPT #.. .......: BSC00003176
REFERENCE ID # ...: 07110029
SITE ADDRESS .....: 10�65 E ESTATES DR
SUBDIVISION .......
CITY .............. CUF'ERTINO
IMPACT AREA .......
OWNER ............: MIPfASIAN JOHNNY AND VIVIAN TRU
ADDRESS ...... 10�65 EAST ESTATES DR
CITY/STATE/ZIP ...: CUF'ERTINO CA, 95014-4565
RECEIVED FROM ....: SOL�TH VALLEY ROOF
CONTR.ACTOR .......: TBI> - TO BE DETERMINED LIC # 00096
COMPANY ..........: TBI) - TO BE DETERMINED
ADDRESS ...........
CITY/STATE/ZIP ...: ,
TELEPHONE .........
FEE ID UNIT QUANTITY ��MOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9,850.00 169.56 0.00 169.56 0.00
BSEISMICRE VALUATION 9,850.00 1.00 0.00 1.00 0.00
----------- ---------- ---------- ----------
TOTAL PERMIT : 170.56 0.00 170.56 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 170.56 #5626
---------------
TOTAL RECEIPT : 170.56
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408) 777-3228
Fax: (408) 777-3333
Building ]�epartment
Subject: Re-roofing policy for the C;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 applie�� 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 material down to the sheathing,
so a proper City inspection can be perf��rmed.
7. NOTE: If you call for a plywood nail v�spection 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 he job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: � � � �� � (�l_.i" 1
Job Site Address: 1 U"TCIJ � �a�� `— ����� �Jr •
Roofing Company Name: � l�t� �
A licant's Si ature: � Date: �� ��� /
PP �'
Greg Casteel �
Building Official
RevisE d 11 / 2/ 04
. . �'�"� f L a o .2-�
.��
CITY OF ��UPERTINO
��� ,
� ���<��
�����t��pt�� PERMIT APPI,ICATION FORM
APN # Date: �
,�� C�U3�r 11-�-n
Buildin '/ `l n �� � •
Y � V� l�t�� � a
Own r's me: Phone #: ��� � ��' �
10 � �st ��fG�-�--� �p,�
Contractor: , License #: ,����
50�:� h Ual I� ��O�i ''
Contact: • � Cupertino Business License #:
Ch I� � S I�.�- -�" I�l l� �" �"�S�l -�5�� 7 �
Type of P oof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof /.�
❑ Asphalt Shingles � Asphalt Shingles C�r�f n •
�. Wood Shakes ❑ Wood Shakes �,/'pG,l� ���I
❑ Wood Shingles ❑ Wood Shingles � r '`�
❑ Other (Specify) ❑ Otl�er (Specify)
Number of existing coverings 1 ❑ Provide I.C.B.O. Report #
� To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read, Understand and Will Com ly With Cu�ertino's Tear Off Policy:
Job Description: �(p SC�I�d�'.�5,
i�15�t�1.�/ �/�� y � � � r ��> �3G /b /��%d�/? /.
Residentia( � Commercial ❑
Fire Zone: Yes ❑ No �---- Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: ����� Dn Type of ��rG;�or�,; Occupanc grou :
C,� •f' ,-
Qty. if
A plicable Fee ID Fee Description _ Fee Grou
� BPERMFEE 131d Permit Fees BUILDING
BENERGY Ener BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
Community Development
� '� 10300 Torre Avenue
�• �{�;<,; Cupertino CA 95014
�: Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
CUPEI�TINO
B1111C�1]Cl De artment
jOB ADDRESS: PERMIT #
1 !� � 5f ��� � /l v �'z.-�' .
OWNER'S NAME: < < PHONE # G J�
GENERAL CONTRACTOR: � # '
I am not using any subcontractors:
�.� ���!��l�� �� (O �
• �,nature Date
Please check a licable subcontractors and com �lete the followin information:
SUBCONTRACTOR BUSIrfESS 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
'� ' � — � ��
' er/ Contractor Signature Date