06080008 CITY OF CUPERTINO
su1LDInC DrvisloN PERMIT CO h � ttao �T pNy
BUILDING ADDRESS: JE IERNEY PERMR NO.O6OH OOOB
10313 DEGAS CT
OWNER'S NAME: PERMIT ISSUE DATE
JEFF TIERNEY 08/01/2006
E: SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG O PLUMB MO
0o LICENSED CONTRACTORS DECLARATION lob Description
iii I Wmby afllrm Wt l w l'umned UMcr provirion a fChpt.9(mmmeneing pp��ppp p
with Section 70801 of Divabn Softhe Baainevand PmfUld—Code,and MY leenset, y p �
in IalIrereeandcB REROOF FROM SHAKE TO [Biiira(��7►•7 7/16 OSB
, z DowweeTa"_ _ ue'R iy�HEETING CLASS A
i Dam ARCHITECTS DWLARATION
i 1 understand my plana shall be used As public record& '1 � • rj�� `/ 2�UQ
tit Licensed Professional ( YY
1 OWNER-BUILDER DECLARATION
I Wrehy affirm Not I am exempt from the Co araclah Ldenw Law for she
0 o following mason.(Section 703 1.5,Business and Professions Cade:Any city or county
9I which iequUea a permit d consuun,alms Improve,demoiah,.repair any swctum
-Z12 prior m its issuance.Alan Parlance led appldmt forsuch permit d rile&signed mwnem
: < shathislicensed pursuant dgo,provisions ofthe Contractor's llmveLaw(Chapter 9 Sq.Ft.Floor Area Valuation
5 B (commencing wish Section 7000)of Division 3ofthe Business adProfcsmon,Code)or $17500
the he a exempt gemfron and the but,fm she aimged exemption.Any violation of
Sagan 7071.5 by my applicant(aa permit mbjcas she applies.[d a CM]penalty of APN Number Occupancy Type
not come sham new hundred dollua($100).
❑L As mvner of the property.a my employer with wages As shed sok eampeaagan, 3 423902
will do den work and Wmuclure ho not annealed oroRered(a sets(Sec.7014,Business Required Inspections
and Profession Cade:Th Commoners License Lew dao cot apply d m owner or 9 p
property who builds aimprovest ercon,and who does such work himwlfor though his
awn employees,provided that web lmprommmse are not intended"offered for ale if. -
hawcwr•the building or imprownsent is mid within am year of completion.the owner.
Wilder will hew she bushes of am,ing that has did rot build or improve fa purpose of
.In.).
❑1,As awner of the property,am exclusively annealing with licensed conmecron As
common the Project(See.7014.Business and Profendn Cade:)The Commode,Ll-
anew Law docs nm apply d an owners of property who Wilda or Improves thereon.and.
who concocts for such projects nim a cmuwdm s)licensed pursuant d she Conumaerl
Li ame law.
❑I Am exempt under Sa ,B R P C for thi,now.
Owner Dec
WORKERS COMPENSATION DECLARATION
I hereby&farm under peaty of perjury an of the foldwing dalamownn
I haw and will maim ain aCerti lcata of Cement an wlfdnsum for Workers Comport-
Minn.a provided for by Section 3700 of the Labor Code,fa ma performance of she
work for which this permit is ivwd.
D 1 have and will maintain Warker's Compensation Insurance,as required by Section
3700 of the labor Code,fa the performance of the weak for which this permit is lwad.
My Workers Compeapon Tomorrow:wrier and Polley number AM:
Carder. STAef_ ,6/e]IJn Policy No. Gbh
CERTIFI TER&PP ION FROM WORKERS
COMPENSATION INSURANCE
(This section reed rot Ise cwnplemd truer permit is farm hundred do0am(2100)
nr leu)
I wrtify me In the performance of me work for which this permit Is Wood,I shell not
employ any person in my mmterso As ae became subject d tie Workers'COMPAMmon
Laws of California.Data
Applicant
NOTICE TO APPLICANT:If.AMr making this Cemiacam of Exemption,you should
traome subject in tie Workers Compensation provisions of mo Labor Cade.you mum
.J 0
[ti forthwith comply wish such provision or ibis permit&bell W domed ked.
5 5; CONSTRUCTION LENDING AGENCY
Ihwhich mat gen is a construcdnn lending agency for the performance of
Lu she wart ra Lenders Nene lgen sea permit t,Issued(see 3097,Ca.C.)
0.p
7 Z LamdehAdamss _
U O 1 astify dam I haw hath this applicWw and shod mm the above informed.is
U, coma.I agree in comply with all city and county Moamar and sae taw,relating to
OU building construction,and hereby authorize mpresenmivrs clods city an enter upno the
0. Avve-mentioned property for inspection purposes
(We)agree to sew,indemnify and kap hornless tie City of Cupertino Against
liabilities.judgments.costs and expense,which may in my wry erne against said City
(„)7 In canwquence of meg ma permit.
Gl APPLICANT UND AND COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGU
o Re-roofs
Sigmau l U r ed
WA2ARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building occupant mom or handle hamdous reasons]
As dean l by the Cupertino Municipal Code.Chapwr 9.13.and tie Healsh and Sonny
Cade.Sedan 255324)? / All roofs shall be inspected prior to any roofing material being installed.
❑Yea mw
Will tie applicant or future Wilding occupant use equipment adevices which If a roof is installed without first obtaining an inspection,I agree to remove
mh h4mootA air conumimenas dallned by the Bay AMA Air QuWRY Metagemcnt all new materials for inspection.
District?
❑Yea
I haw mW he hnodotte am,a 3 requirements under Chapter 6.93 of the Califor.
nia Health&Safety Cade, 505.1 21534.1undcmdndmetl(me building .s+
does not currently he a my nee rihl' ly tie"acupant Ne
nequlwmena w' price a cut. of Osco Signature of Applicant Date
0wncro cath e e am I 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
#UPEkTINO
Building De artment
JOB ADDRESS: PERMIT#
OWNER'S NAME: PHONE # / .Z
GENERAL CONTRACTOR: #
I am not using any subcontractors:
Mature 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
r/Contractor Signature Date
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 Standards
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 Y4"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:--. — —O
• Greg Casteel
Building Official
Revised 11/2/04
CITY OF CUPERTINO
om 1 of 1 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :,
APN . . . . . . . . : 34230026 . 00
DATE ISSUED. . . . . . . : 08/01/2006
RECEIPT # . . . . . . . . . : 35473
REFERENCE ID # . . . : 06080008
SITE ADDRESS . . . . . : 10313 DEGAS CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JEFF TIERNEY
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : ANTOUN BOGHOS
CONTRACTOR . . . . . . . : LIC # *OWNER*
COMPANY . . . . . . . . . . : JEFF TIERNEY
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . :
SEE .ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 18 , 000 . 00 255 . 96 0 . 00 255 . 96 0 . 00
BSEISMICRE VALUATION 18, 000 . 00 1 . 80 0 . 00 1 . 80 0 . 00
BUSLIC FLAT RATE 1 . 00 105 . 00 0 . 00 105 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 362 . 76 0 . 00 362 . 76 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
----------------- ------------ ------------------
OTHER 362 . 76 VISA
TOTAL RECEIPT 362 . 76
CITY OF CUPERTINO
OQD&V
REROOF
• CUPERTINO PERMIT APPLICATION FORM
APN# Date:
Building Address:
?e Name: Phone#-
e mQ4y cl —
Contractor: I License#:
N ' r `;cWN
Contact*- D Cupertino Business License #:
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles CYICsphalt Shingles
(r 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:
Job Description:
ro o AOMr o e�11
Residential Commercial ❑ ars
Fire Zone: Yes ❑ No I' Confirmed with Planning De t. if
there are any restrictions:
Cost Project: CD Type C struction: Occupancy group: —
cJ
i
Qty. if
Applicable Fee ID Fee Description Fee Group
fj 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
•