04010027 CITY OF CUPERTINO
BUILDING DIVISION PERMIT 4X0NT.R&0T,OR'INF..�,OIBMATI®N'
fir, w F-.:;
BUILDING ADDRESS: FIVE -STAR ROOFING PERMIT NO 04010027
10167 MYER PT,
OWNER'S NAME: PERMIT ISSUE DATE
Alk SAMUEL ZUCCARO 387- 4
ONE: SANITARY NO. CONTROL NO.
(408) 972-7855
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
uOo LICENSED CONTRACTOR'S DECLARATION lob Descrl h
F I hereby affirm that l am licensed under provisions of Chapin 9(commencing P
wid,Sectti 7g�.MI,.)uf{�Division 3�ofthc Businc`a'a°`,''ru��fcssians COJe.entl mylicensc is
L Q o n'J�a'prr¢O—.fLl Cowan (77/r REROOF
J
qq� �� �s ARCHITECT90 ION A
?W `TalatMatanJ my plans shall M credits Pu lie records 2004 4
;a� Licensed Profcasional �® 7
` 3 OWNER-BUILDER DECLARATION ® q
a f 1 hereby affirm that It exempt fru.the Contractor's License Law fur the - �Y
p 0 following mason.(Section 7031.5,Business and Professions Code:Any city at county W
m 0� which requires a permit In ennatrua,alter,improve,demolish,or repair any structure
is poor its issuesee,also requiresthe applicant(orsuch pemlitm fileasigned statement
el
that he is licensed pursuanuothe pmvisinnrofthe Commclm'sLicense Law(Chapter 9 Sq.Ft. Floor Area Valuation
s Q (commencing with Section 7")of Division 3 of the Business and Professions Colk)or
y Nat he is exempt therefom entl on,bazis for the alleged nerch,ton.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty of 3 1422,11Faci-0 0 Occupancy Type
not more than Five hundred dollar($500). P Y YP
0 I,as owner of the property,or my employees with wages as their sole compensation,
will do Ne work,and iteswctule is not intended or offered Tarsale(Sec.7W.Business
and Pmficamor Code:The Cnnuacmra Liceme Law docs not apply to an owner of Required Inspections
progeny who buildsor Improver Ncrson,and who does such workhimxlf or though his
own employees,provided that such improvements are not intended oroRered for sale.If,
however,Ne building or improvement is sold within one year of completion,the owncr-
builder will have the burden of proving that he did not Wild or improve for PUT=of `
sale.).
0 I,ea owrrer of Out property,am exclusively contracting with licensed contractors to
construct the project(Sec.7W,Business and Professions Cade:)The Contractors LL
cellae law docs not apply to an owner of progeny,who builds or improves Neuron,and,
who contracts for such projects with a contractor(s)licensed purauant to the Convector's
License Law.
C l sur exempt under Sec. ,B&P C for We mason
Owner Data ,
WORKER'S COMPENSATIONDFA RATION
I hereby affirm under penalty of perjury ane of the following declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compem
7370)
ion,as provided for by Season 3700 of Ne Label Code,for the peAom....f the
rk for which this permit is issued. -
1 have and will maintain Worker's Compensation Insurance,as requited by Section
at the labor Code,for Ne performance of Ne work for which this permit�is�,Ea�r,n[ed�.
Workers CCLomps�gtaation lnsurance�c/a}ner and Policy number me: 7
Policy No.:Q�1Q��_ t
CERTIFICATE OF EXEMPgQN fatOM WORKERS'
COMPENSATION ANCE
(This section need not becomPlemd if the permit is for one hundred dollars($IIX)
al leas.)
I certify that in the performance of the work for which this Permit is failed.I shall not -
employ any Person in any manner an as in become subject to the Workers Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making his CtUmEam of Exemption,you should
become subject to the Worker's Compensation provisions of the Lobar Code,you must -
.JO forthwith comply with such provisions or Nis Permit shall W deemed lowked.
'Z' ^' CONSTRUCTION LENDING AGENCY
I herch MO.Out Nese is a construction lending agency for rhe
(~ Y 6 6 q perfurmanre of
firs ti tW work fur which this permit Is issued(Su:.3097.Civ.C.)
W� Q Lenticr's Name
z Lender'sAddress .
V Q 1 certify that 1 have read this application and state that to a Wve information is
D4 H correct.l agree to comply wit all city and county oNinmces and stare taws relating to .
0O building construction,and hereby aothodm representatives of this city to enter upon the
tLl abovwmentioned property for me,cnton purposes.
Gy (We)agree to seve,indemnify and keep hatmlcai the City of Cupertino against
N liabilities,judgments.costs and expenses which may in any way aceme against said City
V z in consequence of the granting of this permit. /
rpt APPLICANT UNDERSTANG§AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 1/
rREI% IO s � Re-roofsA anUContnctor HAZARDOUS MATERIALS DISCLOSURE Type of RoofNe applicant or future Wildin6 occupant store or handle heoua material
y the Cupertino Munici i Codc.Chapter 9.11.and lW HcaIN end Satery
n 23532(e)? All roofs shall be inspected prior to any roofing material being installed.
the applicant or rola��5��5aaaaaa butdung occupant tree equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
ous air conlaminery6ss I red by the Bay Area Air Quality Management all new materials for inspection.
//
J C Ycs o
Ihave&Sulc Nedi,Seenusmarcriatsoquiremcnts under Chhouted 95of Ne Calding
doHcolth&Safety Cede,Sccuumead it i25533and 2553a.1 understoodth ccUmm.1 the
Jacs not cumcmly hoax a tenant�Nmal it is my msponsihility la nouly the rccupant nI the /
Xquircmcnts "h be me 'ar c��aCcntEcampr'a5P7. Sq' nature of Applicant� Date
or authorized ageentnt Dam
All roof coverings to be Class"B"or better
Community Development Department
Building Division
ar7mlil`
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
4UPEkTINO
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.
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:: /I�_a k'?? /7 V C C Gtr C,
Job Site Address: fy 1 ( /
Roofing Company Name: r`v e
AA P'A plicanl Signature: Date:
• Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF 6 �a
CUPEI�TINO PERMIT APPLICATION FORM
APN# ��. Date:
f —� —� ly
Building Address:
/OtC7 M Ir PL
Owner's Name: Phone#:
�4 Ny 6 2 �0
Contractor: Phone#: License#:
P;Ire 5 ¢GOr P,00fl,
^ Cl (yUB ) 4f7SL— 7 S k 77 7
Contact: Phone#: Cu ertinou iness License#:
WWI( yo 911— AOC3 � l 1
Type of Roof Covering:
Existing: Proposed:
�,❑ Built-Up Roof ❑ Built-Up roof
U Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify) d r
Number of existing coverings ❑ Provide I.C.B.O.Report 4
ATo be Removed ❑ Provide Mfgr.Installation Specs.
® I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
tiell, - r 0 — �Cci S ar
Residential X Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with ning De t. if
there are an estric 'ons: /
Cost Qf Pro' tG G Te of Coogstruction Occupanc grbu
06T—
Qty. if
A Lica 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
I �
30
CITY OF CUPERTINO
BUILDING DIVISION PERMIT 4X0NT.R&0T,OR'INF..�,OIBMATI®N'
fir, w F-.:;
BUILDING ADDRESS: FIVE -STAR ROOFING PERMIT NO 04010027
10167 MYER PT,
OWNER'S NAME: PERMIT ISSUE DATE
Alk SAMUEL ZUCCARO 387- 4
ONE: SANITARY NO. CONTROL NO.
(408) 972-7855
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
uOo LICENSED CONTRACTOR'S DECLARATION lob Descrl h
F I hereby affirm that l am licensed under provisions of Chapin 9(commencing P
wid,Sectti 7g�.MI,.)uf{�Division 3�ofthc Businc`a'a°`,''ru��fcssians COJe.entl mylicensc is
L Q o n'J�a'prr¢O—.fLl Cowan (77/r REROOF
J
qq� �� �s ARCHITECT90 ION A
?W `TalatMatanJ my plans shall M credits Pu lie records 2004 4
;a� Licensed Profcasional �® 7
` 3 OWNER-BUILDER DECLARATION ® q
a f 1 hereby affirm that It exempt fru.the Contractor's License Law fur the - �Y
p 0 following mason.(Section 7031.5,Business and Professions Code:Any city at county W
m 0� which requires a permit In ennatrua,alter,improve,demolish,or repair any structure
is poor its issuesee,also requiresthe applicant(orsuch pemlitm fileasigned statement
el
that he is licensed pursuanuothe pmvisinnrofthe Commclm'sLicense Law(Chapter 9 Sq.Ft. Floor Area Valuation
s Q (commencing with Section 7")of Division 3 of the Business and Professions Colk)or
y Nat he is exempt therefom entl on,bazis for the alleged nerch,ton.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil Penalty of 3 1422,11Faci-0 0 Occupancy Type
not more than Five hundred dollar($500). P Y YP
0 I,as owner of the property,or my employees with wages as their sole compensation,
will do Ne work,and iteswctule is not intended or offered Tarsale(Sec.7W.Business
and Pmficamor Code:The Cnnuacmra Liceme Law docs not apply to an owner of Required Inspections
progeny who buildsor Improver Ncrson,and who does such workhimxlf or though his
own employees,provided that such improvements are not intended oroRered for sale.If,
however,Ne building or improvement is sold within one year of completion,the owncr-
builder will have the burden of proving that he did not Wild or improve for PUT=of `
sale.).
0 I,ea owrrer of Out property,am exclusively contracting with licensed contractors to
construct the project(Sec.7W,Business and Professions Cade:)The Contractors LL
cellae law docs not apply to an owner of progeny,who builds or improves Neuron,and,
who contracts for such projects with a contractor(s)licensed purauant to the Convector's
License Law.
C l sur exempt under Sec. ,B&P C for We mason
Owner Data ,
WORKER'S COMPENSATIONDFA RATION
I hereby affirm under penalty of perjury ane of the following declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compem
7370)
ion,as provided for by Season 3700 of Ne Label Code,for the peAom....f the
rk for which this permit is issued. -
1 have and will maintain Worker's Compensation Insurance,as requited by Section
at the labor Code,for Ne performance of Ne work for which this permit�is�,Ea�r,n[ed�.
Workers CCLomps�gtaation lnsurance�c/a}ner and Policy number me: 7
Policy No.:Q�1Q��_ t
CERTIFICATE OF EXEMPgQN fatOM WORKERS'
COMPENSATION ANCE
(This section need not becomPlemd if the permit is for one hundred dollars($IIX)
al leas.)
I certify that in the performance of the work for which this Permit is failed.I shall not -
employ any Person in any manner an as in become subject to the Workers Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:IL after making his CtUmEam of Exemption,you should
become subject to the Worker's Compensation provisions of the Lobar Code,you must -
.JO forthwith comply with such provisions or Nis Permit shall W deemed lowked.
'Z' ^' CONSTRUCTION LENDING AGENCY
I herch MO.Out Nese is a construction lending agency for rhe
(~ Y 6 6 q perfurmanre of
firs ti tW work fur which this permit Is issued(Su:.3097.Civ.C.)
W� Q Lenticr's Name
z Lender'sAddress .
V Q 1 certify that 1 have read this application and state that to a Wve information is
D4 H correct.l agree to comply wit all city and county oNinmces and stare taws relating to .
0O building construction,and hereby aothodm representatives of this city to enter upon the
tLl abovwmentioned property for me,cnton purposes.
Gy (We)agree to seve,indemnify and keep hatmlcai the City of Cupertino against
N liabilities,judgments.costs and expenses which may in any way aceme against said City
V z in consequence of the granting of this permit. /
rpt APPLICANT UNDERSTANG§AND WILL COMPLY WITH ALL NON-POINT Issued by: Date 1/
rREI% IO s � Re-roofsA anUContnctor HAZARDOUS MATERIALS DISCLOSURE Type of RoofNe applicant or future Wildin6 occupant store or handle heoua material
y the Cupertino Munici i Codc.Chapter 9.11.and lW HcaIN end Satery
n 23532(e)? All roofs shall be inspected prior to any roofing material being installed.
the applicant or rola��5��5aaaaaa butdung occupant tree equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
ous air conlaminery6ss I red by the Bay Area Air Quality Management all new materials for inspection.
//
J C Ycs o
Ihave&Sulc Nedi,Seenusmarcriatsoquiremcnts under Chhouted 95of Ne Calding
doHcolth&Safety Cede,Sccuumead it i25533and 2553a.1 understoodth ccUmm.1 the
Jacs not cumcmly hoax a tenant�Nmal it is my msponsihility la nouly the rccupant nI the /
Xquircmcnts "h be me 'ar c��aCcntEcampr'a5P7. Sq' nature of Applicant� Date
or authorized ageentnt Dam
All roof coverings to be Class"B"or better
Community Development Department
Building Division
ar7mlil`
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
CITY OF Fax: (408)777-3333
4UPEkTINO
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.
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:: /I�_a k'?? /7 V C C Gtr C,
Job Site Address: fy 1 ( /
Roofing Company Name: r`v e
AA P'A plicanl Signature: Date:
• Greg teel
Building Official
Revised 1/30/03
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF 6 �a
CUPEI�TINO PERMIT APPLICATION FORM
APN# ��. Date:
f —� —� ly
Building Address:
/OtC7 M Ir PL
Owner's Name: Phone#:
�4 Ny 6 2 �0
Contractor: Phone#: License#:
P;Ire 5 ¢GOr P,00fl,
^ Cl (yUB ) 4f7SL— 7 S k 77 7
Contact: Phone#: Cu ertinou iness License#:
WWI( yo 911— AOC3 � l 1
Type of Roof Covering:
Existing: Proposed:
�,❑ Built-Up Roof ❑ Built-Up roof
U Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify) d r
Number of existing coverings ❑ Provide I.C.B.O.Report 4
ATo be Removed ❑ Provide Mfgr.Installation Specs.
® I Have Read, Understand and Will Comply With Cu ertino's Tear Off Policy:
Job Description:
tiell, - r 0 — �Cci S ar
Residential X Commercial ❑
Fire Zone: Yes ❑ No ❑ Confirmed with ning De t. if
there are an estric 'ons: /
Cost Qf Pro' tG G Te of Coogstruction Occupanc grbu
06T—
Qty. if
A Lica 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
I �
30