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08040005 CITY OF CUPppERTINO `
BUILDINOdIVISION" PERMIT 'e ON�RA.CT�,OR IN .�QORMATIONN, �+r��
Bu1It9'§'d'2DWBINDELL WAY ALL PHASE ROOFING "M'40005
OWNER'S NAME: PERMIT ISSUE DATE
CORRAL BARBARA M 315 CLARKE LN 04/03/2008
HONE: SANITARY NO, CONTROL NO,
RCHITELT/PNGINEER: BUILDING PERMIT INFO
RE-RF,T/0 1CMP RF, RPLC W/CLS BLDG elEcr PLUMB MECH
0 0 0 0
�Ocs LICENSED CONTRACTOR'S DECLARATION Job Description
hereby afnrm Jut i w Ilmneed ns under Provisioof Chapter 9(commencing
with Section 70M)ofDivlswo3ofJreB�yp( and PmrsomuCode.and mylicense is
<< to full forte anile�.�,�''] �
C w Z License am Lle.M S fryry , -
S Dere mos=ARCHITECTS DECLARATION
1 send m plans syall Ec used u public records
5G Lj�offd Pm mi...1
OWNER BUILDER DECLARATION
<� 1 hereby anirm that 1 em exempt from to Conlrenare License law for the
E O o following moan.(Swoon 7031.5,Business and Profession Cote:Any city or county
$ which requires a Permit on conoul,alter.improve,demnlixh,or repsr my structure
_ZSm prim in its issuance.alw requires to applicant rorsuch permit in Ills a signed staremem
E G than he is licensed pummm to the provisions or the conuecter's iJceese Law(charter 9 Sq.Ft. Floor Area Valuation
3 (commencing with Section 7000)of Division 3 of the Business and Pwfwou Code)or
e5— that he a exempt drerefom and the basis for the alleged co mptian.Any Holadon of
Section 7031.5 by airy appiment for a permit subjecu the applicant in a evil penalty of APN Number Occupancy e
owl mare Nut Eve hundred dollars ISMp y •T'y p
I,u owner of tW prvpmty,or my employm with mgu u then sole eompewaJan,
will do the work,and thestrocium is notirmnded or offered forest.(Sm.70 a4.B.Anwni
and Profeaiaw Cade:The Quoracsers License Law dwu of apply w an awn,of Required Inspections
prop.ny who Wilde orimproves thetron,and whodoweuch work him elforthrough his
own employers,provided that such improvemenu art not intended oroffiano for ala If.
however,Ne building or improvement Is old within one year of completion.the owner.
builder will ban this,Workers of proving that he did not Wild or improve for purpose of
ask.).
❑1,u own,of de property am exclusively comms ing with licensed conuusen in
censwet the prole,(Seo 7014,Bwinws ant Professou Code)The Cuuowra Li.
mem taw does not apply in an owner of property who Wilde or imprem Jwmen,and
who...fo,osis projects with.conua,or(O imcowed purawnt se sea Camusesera -
Limman,law.
❑I sm..crept under See .B k P C for that moan
Owner Data
WORKER'S COMPENSATION DECLARATION _
I hereby of nn under peulty of perjury one of the following declinations:
I have and will maintain•Certificates of Consent in self-inure for WorkersComper-
Wrku Provided for by Section 3700 of the labor Code,for the performance of the
for which this permit is issuel
❑I have and will maintain Workers Compensation Iwuanm,as wished by Section
3700 of Jre Iabor the perfumanm of the work for which this permit u issued. '
My Workers nnwo artier od Policy number am:
C. r Polley No.:
ir1�RTi`CA7E0 NMON INSURAN WORKERS
41"1
asT SATION INSURANCE
(This amour wed not W compared If the permit taformn hundlNdollus(SIM)
or lees.)
1 cenify that in the performance d the work for which this permit Is issued,l still rat
employ any person in my memento u at become object to the WorkerCompensti
Laws of California.Data
Applicant
NOTICE TO APPLICANT.If,afar making this Dominate of Exemption.you swuld
bwome subian to the Workers CompenatIon provisions of the laher Code you most
Oforthwith comply with such provisoes or thio permit Nall W deemed mated.
LZy^ CONSTRUCTION LENDING AGENCY
I hereby affirm that Nem is a awuunion lending agency for thelerfermanm of
G' > de work for which Nis permit a issued(Sec.309'1.Co.C.) '
W Lenders Name
Z lander.AM.
U O I certify that 1 haw and this application,and me thin the show informNun Is
I& F correct.I atm:to amply with all city and county ordinances and sum lam misting to
OU building comstaction,and berebyodarice mpresenmim of do.city in enter upon use
UQ above-mentioned property for Inspection pugweL
LL (We)agree to save,indemnify and amp harmless the City of Cupertino agaWt
ww fn Ilabilitimjudgments.tutu and exp•^.-nt which may in my my ac,nc against said City -
(„)'Z to coucguenc.of the gaoling of this permh.
^' APPLICANT RSTANDS AND ILL COMPLY WITH AL 0 OINr Issued by:9 Date
SOURCE LA ONS. . s/ D
signature of pplianUConu.c r r'r � Re-roofs
HAZAROOUSM AIS OISCLO E Type of Roof
Will the.pplirsnt 0,
future Wilding wapanlamm or Mle heuAow material
as dented by the Cupertino Municipal Cade.Chapter 9.I2,sed the Health and Safety
caJc,Sc y. No
z5s3zp)7
❑Yrs �p All roofs shall be inspected prior to any roofing material being installed.
Will the.pplicam or future Wilding oc ipam to Wuipho nt a devices which If a roof is installed without first obtaining an inspection,I agree to remove
It hrurdws air conumimnts u denied by the Bay Arta Air Quality Management all new materials for inspection.
W07 �J
❑Yrs 'a' No
I ban mad ftheurdus\marerlalemquhemcnu underohmour6.95 aline Califnr- 14�
eta Health k S.fctyCade S.6=25505.25533anti 75334.1 understood thanlfthe 'Idin9dors rat torn a Imam,than It's my respon ibility u nmiry tie scat t of
requirements Welchm Wmet Loisam ue.I.Cerofca¢af Ce Signature of Applica
cororauthQ6Mdagm, are All roof coverings to be Class'p"or better
CITY OF CUPERTINO
• 2 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36223002 .00
DATE ISSUED. . . . . . . : 04/03/2008
RECEIPT # . . . . . . . . . : , BS000004334
REFERENCE ID # . . . : 08040005
SITE ADDRESS . . . . . : 7802 ROBINDELL WAY
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CORRAL BARBARA M
ADDRESS . . . . . . . . . . : 7802 ROBINDELL WY
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5015
RECEIVED FROM . . . . : ALL PHASE RAINGUTTE
CONTRACTOR . . . . . . . : LOUIS J. REBOZZI LIC # 27941
COMPANY . . . . . . . . . . : ALL PHASE ROOFING
ADDRESS . . . . . . . . . . : 315 CLARKE LN
CITY/STATE/ZIP . . . : MORGAN HILL, CA 95037
TELEPHONE . . . . . . . . : (408)779-3740
• FEE ID UNIT QUANTITY AMOUNT �PD-TO-DT THIS REC NEW BAL
---------- -
------------ ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 7, 900 . 00 0. 80 0. 00 0.80 0. 00
1REROOFRES SQ FEET 26 . 00 338. 00 0. 00 338 . 00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 338 . 80 0. 00 338 . 80 0. 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
oh nc�oS
CITY OF CUPERTINO
REROOF
CUPERTINO PERMIT APPLICATION
A APN# 3 (,0 AA � C)va • Date: Y u3—
Building Address:
e
Owner's Name: Phone #:
caaa
Contractor: Phone #:
`7-7ci- 3-2510
Fc' Fax#: -7 7GI-3
Cupertino 13usiness License #: Contractor License #:
S& cc
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof o Built-Up roof
X Asphalt Shingles Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other (Specify) ❑ Other (Specify)
Number of existing coverings o Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
'QAC o-P -P o t✓ Q Cem� (Z o©
ee foo
Residential Commerci
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation:
od •'�
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
gnature
p` CITY OF CUPERTINO
REROOF
CUPEkT NO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1RER00FC0M Re-roof Commercial B 1COMMLROOF
1BSEISMICO Seismic Commercial B
1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
1BUSLIC Business License B
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 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: i6a b o-r A-- CCS r rcA L
Job Site Address: `7 D q X V.,,ti 'lt'L L
Roofing Company Name: &CD Fh
Applicant's Signature: Date: 3 G jf
• Greg Casteel
Building Official
Revised 11/2/04
R Community Development
10300 Torte Avenue
Ira
. Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
CUPEkTINO
•
Building De artment
JOB ADDRESS: PERMIT #
OWNER'S NAME: ,o eo Y✓ jC PHO # Y
GENERAL CONTRACTOR: S tD FAX # ^7
I am not using any subcontractors: 3 d
SignaturP 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
I
Owner/Contract gnature Date