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05080141 CITY OF CUPERTINO =777777777777777777= x,.�s;•x'u,✓z BUILDING DIVISION PERMITCONTRACTQRt NFORMATIONi BUILDING ADDRESS: PERMIT NOLO 5080141 10642 N PQRTAT, All OWNER'S NAME: PERMIT ISSUE DATE Alk NANCY TRESSEL 08/17/2005 ONE: SANITARY NO. CONTROL NO. ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG t� [� FO MECH t� .OZO LICENSED CONTRACTOR'S DECLARATION Job Description 48with hereby affirm Net 1 am licensed under provisions,of Chapter 9(mmmcncing p nt1 with Section 70W)O1 Division 3 of NC Basin.and Professims Coda end my license is n full fmceandeftec6 REROOF W/PLYWOOD & COMP. i02 Lkeose Cl cuc.ABy i If 3� Dam . can .terW.044 CONTRACTOR: ROCK' S ROOFING gg ARCHITECTS DECLARATION I understand my Plana Nell he used as public records b u 50 Licensed Pnsfcseional OWNER-BUILDER DECLARATION COE I hereby.(Sens that 11. exempt from an he Cssor. m :cense Law for ove OO followwhich requires ,ronin 7onstruBuinea and Professions Ca de:My city or county $�a which rto Issuance, a permit m construct,the elms improve.for such h Permit t ri repair any tamcmro 0 mionorsficcrance,elwntinfttMepionsofTarwchpcnnitmfismsele a Laed w(Cummcnn zFF< that k ftheuacuhlJ¢velaw(Chapur9 Sq.Ft.Floor Area Valui$16000 3� (Com a Is exehnit,mpt with Sereirom nd)of Division f r of the egd Business and Profon,Any CadO or 3 Nat he u exempt Ncmfrom and the bus,icer dm alleged esempHoa Any vloladon of Section 7031.5 by arty applicant fon a permit subjects the applicant in a civil penalty of APN Number Occupancy T not mom than five hundred dollars($500). 31632054 . 00 p y yPe ❑L u ownerk.Na proprny,on my cmploych with vngh a Nei(oke Business will do the work.and sine structure ra Mk Intended onoRe do forsakepply 7061.Owner of and property, once Cade:The Conuecmn.License Law doh work apply lf rt owner is Required Inspections prop ertywhobuiIda i ed thavuch improvements andwho dosauchooh Mmse1fedthrough his Own employees.the h,proNded pral suchimis mid wtsartmyou uled ofemplaerW faradic,H, hoaeer,Nebuildingor Improvementishathwithin ane Sear or mprow for the owner- builder will hove Ne burden of provinC Nek he did not Wild or improve(or purpose of [j 1,as owner of the properly,.Business e a d caffesdo g with liccnecd mn0aeorn i. conswm the not (Seta an crfend Pro(eai Wi Cade:)The COnv mon,Li- !( i melee IJw daG nm apply a an awrlar Of properly Who sed p arlmpmVef dCRoa,and whoa.Lou(ar such pmjecu wiNaeonuanortsl licensed pumuamuthe Conwracmta `` ♦ '�wm L' Iam Law. d! ' lam caempt under Sec. ,BBPCfOrNbreaoq Owner Data WORKERS COMPENSATION DECLARATION -'' -'""""_'"' a 9 �"•r. ... _. ....... .. ... yLf 19(4 r�Y7lT I hereby aimedalnder penalty 0I perjuryante of the following declarations: I have Ord will maintain a Certificate of Consent m selGlneum fm Worker's Camper. 6 setlon,se provided far by Section 3700 of the Labor Cade.fon the performance of the — v work for which Nu permit is issued. C]1 have and will maintain Worker's Compeuedon Insunnm.u required by Section 3100 of the labor Code.for the performance of the work for which this permit is Issued. My Worker's Campensedon Insurance carrier and Policy number am: Carrier: Policy No.: _ CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Thisseclum need not becompleud if tis,Permit is form hundred dollars($I00) or lux) I cer if-v that In the periu mmeo of the work for which this permit is Iuucd.l shall not employ any person in any mann, os,in banns, 'est to the Warton'Compensation - tawsofGlifomiv0su Applicant �. NOTICE TO APPLIANT.7fL a cr mat g s e Irimi of Eaemptim,you should became subject m the Wohefs Compemadon provisions of the Utter Cade,you mus, .,O forthwith comply with such provisions or this Permit hall W deemed revoked. 'Z CONSTRUCTION LENDING AGENCY F I hereby aam that dem H 4 lending agency for one performance of CY.> shewish for which this permit Is issued(Sec.3091,Civ.Q) 0.Q Le Lender's Name Q z landefs Address U Q I cenlfy that 1 have mad this application and stake Net the shove Information is correct.1 a&me no comply with all city and county Ordinances and also laws relating to Q SV' Wilding construction,and hereby authoria repruemaont of Nis city m enter upon the W shove-mentioned property far inspection purposes. LL (hoc)as=to an.indemnify and keep hamtlw she City of Cupertino against h liabilities.judgmenu,costs and eepensh which may in any way smut maim,said City L)`1 in consequence of the granting of this permit. F7 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: do Date SOURCE REG TIONS. Re-roofs Signature of AnhnUConoacmr HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building oceupanutore rehandle heradous material se dented by the Cupertino Municipal Coda Chapter 9.13,and the Health and Safety Code,Section 35533(01 ...���nnn��� All roofs shall be inspected prior to any roofing material being installed. [Dyes ylrva Will the applicant or future Wilding Occupant use equipment at devices which If a roof is installed without first obtaining an inspection,I agree to remove II huardaus 0r mnuminmu as dclincd by Ne Bay Area Air Quality Management all new materials for inspection. isuict? Oyu �Nu I he.read the hva msmuerids requirements under Chapur6.95 ofthc Califor. ties Socumps533 ummrsunde occur Wilding doh not currently bar a unant.Net it u my rnsponslhllitY b nmify tike aceupant of the G requirements wiiuxmmpri i uatuear ar,, afOccupaney. Signature of Applicant Date Owner anuNon d a cm Data All roof coverings to be Class"B"Or better Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 I oc Fax(408)777-3333 UPEkTINO Building Department JOB ADDRESS: PERMIT# O &L OWNERS NAME: N PHONE # GENERAL CONTRACTOR FAX# I am not using any subcontractors: /04 &.d= 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 Ornamental Sheet Metal Painting/ Wallpaper . Paving Plastering Plumbing Roofing 6-J SEryice$ Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Community Development Department Building Division City Cupertino 10300 Torre Avenue CITY OF Telephone: (408)777-3228 Fax: (408) 777-3333 C U PE INTI NO 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 fora 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 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: �Jqviryeoe 11 Job Site Address: �7(�y� por r�t AUL. n Roofing Company Name: /,,C,0,( /`061"/'b 6 A Applicant's Signature: J ' ��, Date: Greg Casteel Building Official Revised 11/2/04 CITY OF CUPERTINO f SCae,Ayo REROOF URTINO PERMIT APPLICATION FORM APN# Date: 3 3 � Building Address: J06L_ N or �c+I f� � . Owner's Name. Phon e#: ®vi e L Ilog—e,S3- a'Z93 Contractor: - - - ,--- Phone#: License#: yo&R- - 7170 ---71 essLicense#: Contact: Phone#: Cupertino Business L srRock Q oQ- g -1797 Type of Roof Covering: Existing: Proposed: ❑ Built-Up Roof ❑—/ Built-Up roof K/Asphalt Shingles Asphalt Shingles jd/ Wood Shakes ❑ Wood Shakes Cl Wood Shingles ❑ Wood Shingles r /gypp ❑ Other(Specify) ❑ Other(Specify) Inocft 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: old M� Job Descn'ption: dCOW © G H aTr s�rh1 . n 5 �a l/ Wao Residential JJ Commercial ❑ Fire Zone: Yes ❑ No ® Confirmed with Planning Dept. if there are any restrictions: LJ Cost of Project:,/'/b/ 000.6'0 Type of Construction: Re_Ado Occupancy group: Qty. if Fee Grou A licable Fee ID Fee Description BPERMFEE BldgPermit Fees BUILDING BENERGY Ener BUILDING BSEISMICRE Seismic Fee Res BUILDING BSEISMICOM Seismic Commercial BUILDING BPLANCHK Plan Check Fee BUILDING BUSLIC Business License BUILDING � u7 � C� 337 ��