08120005 CITY OF CUPERTINO
BUIt'm4,L_YO DIV151ON PERNIITCON,_'„Y�'12AC T4RINF0RMAT-ICON
BUILDING ADDRESS: - PERMITNO.
21685 NOONAN CT WESTERN
OWNER'S NAME: PERMIT ISSUE DATE
ONE: tgRA CONTROL NO.
831) 278-1837
ARCHTTECTENGINEEIR: BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0 0 0 0
u00 LICENSED CONTRACTOR'S DECLARATION Job Description
uC1 baeby efnrm dust 1 am li¢raN under Por iumd of CMPmr 9(mmearming
ZU
whin
Bmu0.7")of Division 3 of use Business and Profusions Code,and my license is
.„ a infullforeearst L Z�— RE—RF T/0 WDSHK FILL SHTNG ASNEED 40 LBS FLT
�i License Clan � g4 IY.N
Dam /a INSTL
ee r” ARCNRE, D I
t�y{t Iundancradmyph ahailbouudu pubBcmcoMa METL TILE PER ICC 5626 34SQ CLSS A .
06
yG� Licensed Pmfeaianal
3 OWNER-BUILDER DECLARATION
ny I hereby.Bene that 1 am comp[from the Contactors lueuo Law rat tbo
z
00 following mason.(Secuan 7W 1.5,Business and Professions Code:My city.r county
g� which mquims a pconit to constmck alcor improve.demalish,ar repair any stuaure
Zj• prior an its issuance.also roqubast the applicanl rot such permit is file a signed statement
EE G that he is Bertrand pursuant w the provisions of the ConrmtmS Lux.law(Chapmr 9 Sq.Ft.Floor Area Valuation
Y�s (commencing with Section 7000)of Division 3 of the Bull.and Paressimu CoAc)or
.. tut he is exempt therefrom and the baso for the alleged assumption.Any violation of 518500
Section 7031.5 by any applicant far a pandit subjects use applicant at a civil pauslty,of APN Number Occupancy Type
not a.than live hundred dollars ISM 35719074 . 00
I,a owner of lM Propmy.m my emplaycea with wagesa tm'u wle compeswdon,
will do the watt and lheatmcture t nut intended orortered for,go(See.7044.Business Required Inspections
and Prear w.0 Cade:ran onne
Connectors Liccnsa n Law dom,apply w an owner.1' e q P
property,who build or improves therms,and what does ouch wing himself.,though his
own employees.provided that such improvements are not intended or offered far sale If,
however,that Wilding or a n.ca,is sold within arm year of mmPkdon,Ne owna-
WiMer will have the Waren of proving tut Ins did net build or improve for puryose of
I,u owner of the property sum exclusively contacting with licensed canrmwn as
construct the project(Sec 7044.Business atW P,efessioru Code:)The Comacmes U-
«nse law dots m[apply as an ossa of property"a boilds ar hoped.IMreun.and,
who convects for such projects with acentracwt(s)licensed pursuant w the Contractor's
Lteense Law.
0r'am ace,danderser. ,B&PCfmudareamn
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penally of perjury arc of to following dmlenu.rsm .
ko1 have and will maintain a Cerdliiam of Conant w self-iuum fun WorgeYsComprn-
n.u provided for by serum 37M of ten labor Cade,fm dse performance of de
for which Nis permit W owed.
1:1-1 have and will maintain Worker's Compensation Insurance,as;required by Section
3700 of ten rata,Code,far the puformance of the wart fur which this permit u issued
My Worlar^r's��Co�r—epe��so_me"Inauranm[/}��1aa_rrtnna and Policy mother ate:
Cartier./+Yah !ZA't•/RkMWOalhey No.: t7f
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need wtmcwplcwd ifthe permit is foram hundred dollars($100)
or tesa)
1 certify that lo the parfarro.of the work for which Ad.Permit Ia issmd.I sisal net
employ any person in any mammy a u to became subject to to Worke,i Csmpeustlon
Law,of California Dam
Applicants,
NOTICE TO APPLICANT:If,after making this Cer inease of Exemption.you should
hmome subject to the Worka'a Compensation provisions of lbo Lather Code,you muss
.J z forthwith comply with such provisions or this permit shall he dcemed revoked.
Z O CONSTRUCTION LENDING AGENCY .
I bembyafnrm Net there iaa coaorucunn lending agency,for the parrmmance.1'
!�> the work for which sits pemtit tissued(Sen.3097,Civ,C.)
M E renN
der, ame
= z Landers a
Addm
U0 I ester that I haw mad this application and sum tut the above infmmadun W
jy 6co commI a&=to comply with all city and county mdiun¢s and stag laws Ruling as
.O Wilding construction,and hereby someone,repmsenuuws of this city m enter upon IM
W above-mentioned property for impaction purposes
(We)agree to am,indemnify and keep harmless the City of Cupertino against
,a'jy Iiabillums,judgmmts,comandeapmm which May its anyway atmm g9teRsaid City
U z in canscquence of um granting of this pmmil.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
S07 REGU TION
Re-roofs
natu ppli Dam
US MATFAIALS DISCLOSURE Type of Roof
Will the,, mfu, building meapanl store or Media haallou material
u dcBaed by th Cu nuns Mu ipal Code.Chapter 9.11 and the Health and Safety
Code.Section 25s32(a. All roofs shall be inspected prior to any roofing material being installed.
Oyer
1,11 the applicant or future'Wilding mea,ant use equipment m device which If a roof is installed without first obtaining an inspection,l agree to remove
it lmsadou it canuminanu as,termed by the Bay Area Air Quality Managemcnl all new materials for inspection.
met, —/
0y. R
I have road the haaAau/ nusteriaW requirements under Chapter 6.95.f lbo call[".
.is Hulth&Safety Cade.satiw15505.15533 real 25534.1 undrrstaM that if ft Wdiumg L
does not currently haw a tenant dust It' my re,orn' ili,Y b mdrY the eecupant of the
m 'mmcmuwhichmuu atpri Wameof.cof Occupancy, SL IatureofApplic Date
J
0 rcdagm, Dam' roof coverings to be Class'R"or better
CITY OF CUPERTINO
• 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35719074 . 00
DATE ISSUED. . . . . . . : 12/01/2008
RECEIPT # . . . . . . . . . : BS000006713
REFERENCE ID # . . . : 08120005
SITE ADDRESS . . . . . : 21685 NOONAN CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : POUNDS LOYE A AND ALICE V
ADDRESS . . . . . . . . . . : 21685 NOONAN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5912
RECEIVED FROM . . . . : MICHAEL D LUNNEBORG
CONTRACTOR . . . . . . . : MICHAEL LUNNEBORG LIC # 25896
COMPANY . . . . . . . . . . : WESTERN ROOFING SYSTEMS
ADDRESS . . . . . . . . . . : 1328 WHITE OAKS RD
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (831) 278-1837
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------- ------ ---- ------- ------- ------
1BSEISMICR VALUATION 18, 500 . 00 1 . 90 0 . 00 1 . 90 0 . 00
1REROOFRES SQ FEET 34 . 00 442 . 00 0 . 00 442 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 443 . 90 0 . 00 443 . 90 0 . 00
METHOD OF PAYMENT . AMOUNT REFERENCE NUMBER
----------------- --- - ------------
CREDIT CARD 443 . 90 VISA
---------------
TOTAL RECEIPT 443 . 90
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- ------- ------ -----------
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
604 ROOF IN-PROGRESS 605 FINAL REROOF
•
�J 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 2007 IBC Standards
and manufacturers specifications on re-roofing.All roofs are Class "A"per Cupertino
municipal code 16.04.080.
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: Lyy,e (Oo„,J �5
Job Site Address: Z f G;r1' N OJ a AN C1—
Roofing
1—Roofing Company Name: (,J4-T�e0Q 4j'P(;�5 .S,, $4-415
Applicant's Signature Date: 12'fl°�
• Greg Casteel //
Building Official
Revised 07/30/08
P. CITY OF CUPERTINO okl'2, OU
'craw ` REROOF
OF
UPERTINO PERMIT APPLICATION
APN # 7 � �0 0 6 Date: Z—
c_5-!5 �
Building Address: 1 —
Q 'J emN
Owner's Name: Phone #:
Contractor: Phone #: yUY 3(v cl -4r v 1-
�J.ep� ,j y
Fax #: 'YjY S-n
Cupertino Business License #: Contractor License #:
U � y7-z�r
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) -p— Other (Specify) rv�.c_�-
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description: /
-TeCr a LJJJ S�alaL f• U rAee4i,G) !4r nFe.dce I �(/ �5S
i ✓ rJr �/ e4v, f- �-c. /I P/ Zcc c,`4 Z-to
Residential Commercial ❑
Green Building: Please complete relevant portion of the Confirmed with Planning Dept. if
Green Building Checklist & attach it to the application or if there are any restrictions: ❑
applicable, include in plan set & the sheet index.
Valuation:
/r d�
I Have Read, Understand and Will Comply with Cupertino's Tear-Off Policy:
•
ignature
Revised 6/16/08
CITY OF CUPERTINOot
REROOF
CUPEI,TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares . Group
1RER00FCOM Re-roof Commercial B 1COMMLROOF
IBSEISMICO Seismic Commercial B
1RER00FRES ' Re-roof Residential B ISFDWLROOF
i
1BSEISMICRE Seismic Residential B
1RER00FMRES Re-roof Multi-Family B IMFDWLROOF
IBSEISMICRE Seismic Residential B •
1BUSLIC Business License B
Revised 6/16/08
•